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6,506 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 57-year - old patient with a diagnosis of chronic itp for 1 year was referred to our emergency department with complaints of left flank pain and diffuse petechial bleeding all over his body .
a complete blood count revealed thrombocytopenia ( 4,000/mm ) , which led to his admission into the clinics of internal medicine . on the third day of chronic itp therapy ,
the patient developed macroscopic hematuria , and we consulted with the patient after the urinary system ultrasound revealed bilateral perirenal hematoma .
we learned from his medical history that he had not previously had any complaints of gross hematuria .
he had previously undergone extracorporeal shock wave lithotripsy ( eswl ) because of a left ureteral distal stone .
the physical examination revealed a relaxed abdominal region with left costovertebral angle tenderness in addition to diffuse petechiae all over his body . in his biochemical analysis , blood urea nitrogen
( 53 mg / dl ) , creatinine ( 3.2 mg / dl ) , and fasting blood sugar ( 167 mg / dl ) levels were also measured .
escherichia coli was detected in the urine culture , and the urinalysis revealed microscopic hematuria and pyuria .
the results of the complete blood count analysis were as follows : white blood cells 27,000/mm , hemoglobin 12.2 g / dl , hematocrit 37.3% , platelet count 4,000/mm , prothrombin time 16.6 seconds ( 9 to 14 ) , and international normalized ratio 1.36 ( 0.8 to 1.19 ) .
owing to suddenly evolving macroscopic hematuria , the patient received prednisolone ( 80 mg / d ) and intravenous immune globulin ( 0.5 g / kg / d ) ( kiovig 10 g/100 ml - eczacba - baxter ) , and an ultrasound examination of the urinary system demonstrated right and left perirenal hematoma and irregular renal contours . a non - contrast computed tomography ( ct )
the ct scan revealed a right perirenal hematoma with dimensions of 212042 mm , a 15-mm stone in the right distal ureter without any marked ectasia , a left perirenal hematoma with dimensions of 15012090 mm ( fig .
1 ) , left... | idiopathic thrombocytopenic purpura ( itp ) is an immune thrombocytopenia with a usually benign clinical course .
bleedings are mostly of the mucocutaneous type with mild symptoms
. massive bleedings requiring transfusion are rarely seen , unless the number of platelets decreases to extremely low levels . in this case ,
bilateral perirenal hematoma and bilateral distal ureteral stones were detected on a non - contrast computed tomography scan of a 57-year - old male patient who developed macroscopic hematuria during his treatment in the clinics of internal medicine because of left flank pain and diffuse petechial rashes all over his body .
the patient , who had been receiving chronic itp treatment for 1 year , had a very low platelet count ( 4,000/mm3 ) .
the patient was prescribed bed rest , and his platelet count increased to a safe level for surgical intervention of above 50,000/mm3 with administration of prednisolone , intravenous immune globulin , and platelet suspension .
a stone - free state was achieved after bilateral ureterorenoscopy and pneumatic lithotripsy .
a conservative approach was followed for the perirenal hematoma . upon regression of the perirenal hematoma ,
the patient was discharged at 9 weeks postoperatively . |
6,507 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it provides structural support in bone , cartilage , and the basement membrane ; specific association of cells with the ecm also provides contextual information that controls cellular phenotype , including differentiation , proliferation , or apoptosis .
ecm also regulates availability and activity of many signaling molecules , including tgf- , through controlled sequestration , presentation , and release .
the primary cell surface receptors for the ecm are the integrins , a family of 24 heterodimeric proteins composed of one of 18 -subunits and 8 -subunits .
integrins bind to motifs present in the ecm though an interaction domain located between the - and -subunit ; while many integrin - binding motifs have been identified , the best studied is the arginine - glycine - aspartate ( rgd ) sequence that is present in fibronectin and many other extracellular molecules .
integrins become activated in a process that is regulated both by availability of ecm substrate ( outside - in activation ) and signals from within the cell ( inside - out activation ) .
activated integrins can bind to the actin cytoskeleton and recruit a variety of cytosolic components into adhesion complexes . through those interactions integrins
can transduce biochemical signaling dependent on ecm composition , as well as directly link physical forces acting on the ecm to the cellular cytoskeleton ( fig .
stimulation of cellular signaling pathways can lead to increased affinity for binding sites in the ecm .
integrin ligation to the ecm triggers assembly of cytoplasmic molecules that can lead to focal adhesion complex formation and connection to the actin cytoskeleton
integrin activation .
stimulation of cellular signaling pathways can lead to increased affinity for binding sites in the ecm .
integrin ligation to the ecm triggers assembly of cytoplasmic molecules that can lead to focal adhesion complex formation and connection to the actin cytoskeleton
three tgf- isoforms are present in mammals , tgf-1 , -2 , and -3 , each encoded by a... | extracellular matrix ( ecm ) provides both structural support and contextual information to cells within tissues and organs .
the combination of biochemical and biomechanical signals from the ecm modulates responses to extracellular signals toward differentiation , proliferation , or apoptosis ; alterations in the ecm are necessary for development and remodeling processes , but aberrations in the composition and organization of ecm are associated with disease pathology and can predispose to development of cancer .
the primary cell surface sensors of the ecm are the integrins , which provide the physical connection between the ecm and the cytoskeleton and also convey biochemical information about the composition of the ecm .
transforming growth factor- ( tgf- ) is an extracellular signaling molecule that is a powerful controller of a variety of cellular functions , and that has been found to induce very different outcomes according to cell type and cellular context .
it is becoming clear that ecm - mediated signaling through integrins is reciprocally influenced by tgf- : integrin expression , activation , and responses are affected by cellular exposure to tgf- , and tgf- activation and cellular responses are in turn controlled by signaling from the ecm through integrins .
epithelial - mesenchymal transition ( emt ) , a physiological process that is activated by tgf- in normal development and in cancer , is also affected by the composition and structure of the ecm . here
, we will outline how signaling from the ecm controls the contextual response to tgf- , and how this response is selectively modulated during disease , with an emphasis on recent findings , current challenges , and future opportunities . |
6,508 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: we recently applied a urea in - solution digestion ( uisd ) method to prepare protein from ffpe tissue for liquid chromatography tandem mass spectrometry ( lc - esi - ms / ms ) , providing a more efficient workflow relative to qproteome ffpe tissue kit .
uisd poses several advantages to other preparation techniques : preparation is carried out in a single tube minimizing sample handling , urea is lc - esi - ms / ms compatible requiring no additional washing beyond desalting , and both of these factors enhance sample throughput .
however , artificial carbamylation is introduced when using urea at elevated temperatures , reducing trypsin digestion efficiency . in solution , urea is in equilibrium with isocyanate and ammonium . between ph 7 and 9 , isocyanate reacts with -amines on n - termini and -amines on lysine side chains of peptides to form carbamyl groups .
trypsin digestion efficiency was reduced by carbamylation , and uisd had more missed cleavages and a lower lysine to arginine ( k : r ) peptide terminal amino acid ratio relative to the commercially available qproteome ffpe tissue kit ( qkit ) .
ammonium bicarbonate , included in the uisd extraction buffer , inhibits carbamylation when using urea as a protein denaturant , but its efficacy is greatly reduced above 37c [ 4 , 5 ] . despite having this drawback , uisd preparation detected similar numbers of peptides and proteins obtained using qkit and some not detected by qkit with a bias toward arginine terminal peptides .
it has been demonstrated previously that ffpe tissue shows high equivalence with fresh tissue , but ffpe preservation introduces peptide modifications , particularly lysine methylation . as ffpe tissue appears to be an unreliable substrate for investigating lysine modifications , the introduction of lysine carbamylation primarily affects proteomic study by reducing cleavage efficiency . in addition
, the introduction of artificial carbamylation with isotopically labeled urea can provide an alternative quantitative tool to... | urea based protein extraction of formalin - fixed paraffin - embedded ( ffpe ) tissue provides the most efficient workflow for proteomics due to its compatibility with liquid chromatography electrospray ionization tandem mass spectrometry ( lc - esi - ms / ms ) .
this study optimizes the use of urea for proteomic analysis of clinical ffpe tissue .
a series of protein extraction conditions manipulating temperature and buffer composition were compared to reduce carbamylation introduced by urea and increase protein detection .
each extraction was performed on a randomized pair of serial sections of homogenous ffpe tissue and analyzed with lc - esi - ms / ms .
results were compared in terms of yield , missed cleavages , and peptide carbamylation .
lowering extraction temperature to 60c decreased carbamylation at the cost of decreased protein detection and yield .
protein extraction for at least 20 minutes at 95c followed by 60c for 2 hours maximized total protein yield while maintaining protein detection and reducing carbamylation by 7.9% .
when accounting for carbamylation during analysis , this modified extraction temperature provides equivalent peptide and protein detection relative to the commercially available qproteome ffpe tissue kit .
no changes to buffer composition containing 7 m urea , 2 m thiourea , and 1 m ammonium bicarbonate resulted in improvements to control conditions .
optimized urea in - solution digestion provides an efficient workflow with maximized yields for proteomic analysis of clinically relevant ffpe tissue . |
6,509 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
according to the world health organization ( who ) , obesity can be defined as the accumulation of body fat in an abnormal and/or excessive manner showing serious health problems . in this scenario ,
overweight and obesity are considered a serious public health problem , and it is therefore a subject of considerable impact and worldwide interest .
this particular condition characterized by increased adipose tissue from the positive energy calculation in the relation intake versus calorie expenditure has a multifactorial etiology ; among these we can highlight genetic susceptibility , metabolic disorders , sex , age , occupation , diet , and others [ 2 , 3 ] .
the concern with this health condition is becoming increasingly clear since the exponential increase in its prevalence and incidence , due to declining levels of physical activity and increased inadequate food intake [ 46 ] .
it is estimated that the worldwide prevalence of obesity in the period between 1980 and 2008 has doubled ; today it is estimated that worldwide approximately 2.8 million annual deaths are related to the harmful effects of excess weight [ 1 , 79 ] , raising global public spending as a result of this condition [ 10 , 11 ] . until recently , obesity was considered a problem only in developed countries ; however , it is currently on the rise in developing countries [ 1 , 79 ] . in brazil ,
the overweight and obesity are on the rise among children and adolescents , mainly after the age of five , in all economic classes and in all regions . between 2008 and 2009
the excess weight reached 33.5% of children from five to nine years old and within this group 16.6% of boys were obese , while 11.8% of girls were obese .
overweight in childhood predisposes the short- and long - term comorbidities such as diabetes mellitus , hypertension , and dyslipidemia .
since children are still in their infancy , early control is necessary at this stage of life , in order to avoid an unfavorable long - term prognosis , as in adulthood .
future... | introduction .
infant juvenile obesity is currently a worldwide public health problem and it is increasing at alarming rate in the brazilian population , showing its relevance in terms of public health . objectives .
determine the prevalence of overweight and obesity in children and adolescents between 2 and 19 years old in different regions of brazil .
methods .
the following electronic databases were searched ( from september through november 2013 ) : medline ( pubmed ) , lilacs , and scielo , using the descriptors and boolean operators ( obesity ) and ( overweight ) and ( child ) and ( prevalence ) and ( brazil ) .
prospective and/or cross - sectional designs studies were found regarding the prevalence of overweight and obese children and adolescents in the five regions of brazil .
results .
a total of 191 scientific articles were found of which 17 met all inclusion criteria .
a higher prevalence of overweight was found in the south ( 25.7% ) and north ( 28.8% ) of the country , and obesity in the southeast ( 15.4% ) and south ( 10.4% ) .
conclusions .
the scope of the studies was mostly based on municipal coverage , which resulted in limitations for conclusive analysis , showing the need for further studies of prevalence at the national level , with emphasis on public health in obese children and adolescents throughout the brazilian territory . |
6,510 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: for patients with newly diagnosed breast carcinoma , evaluation of the extent of the disease in the breast is of paramount importance in planning appropriate surgical therapy . magnetic resonance imaging ( mri )
plays an ever increasing role in the evaluation of additional areas in the affected breast deemed suspicious but indeterminate by other radiologic modalities .
technical developments such as mri with high spatial resolution , special breast coils , dynamic kinetic imaging techniques , and intravenous contrast agents contribute to enhanced diagnosis of breast abnormalities . while excitement about
the role of this modality in improving the planning of surgical treatment of breast cancer patients is increasing [ 16 ] , many areas of uncertainty remain , especially related to the clinical importance of additional lesions that are detected by the use of mri [ 79 ] . in this study
we evaluated the pathologic findings in mri - guided needle core biopsies of the breast obtained from other suspicious areas in the affected breast of patients with a new diagnosis of breast carcinoma .
our study population consisted of 44 mri - guided needle core breast biopsies performed on 40 patients with newly diagnosed breast carcinoma at rush university medical center , chicago , il , usa between may 2007 and july 2008 .
overall , 9/44 ( 20.4% ) of our mri - guided breast biopsies were malignant , 29/44 ( 66% ) were benign , and 6/44 ( 13.6% ) showed atypia ( table 1 ) . of the 9 malignant cases , 4 were infiltrating ductal carcinomas with tubular features , 2 infiltrating lobular carcinomas , and 3 ductal carcinoma in situ lesions ( table 2 ) .
of the 6 atypical cases , 2 were atypical ductal hyperplasia ( adh ) , 2 were atypical lobular hyperplasia ( alh ) , and 2 showed areas of columnar cell hyperplasia with atypia ( table 3 ) . of interest ,
more than one third of our benign cases ( 11/29 , 38% ) consisted of a specific complex multicystic lesion lined by apocrine metaplastic epithelium , a lesion we called
during... | the role of mri in the management of breast carcinoma is rapidly evolving from its initial use for specific indications only to a more widespread use on all women with newly diagnosed early stage breast cancer .
however , there are many concerns that such widespread use is premature since detailed correlation of mri findings with the underlying histopathology of the breast lesions is still evolving and clear evidence for improvements in management and overall prognosis of breast cancer patients evaluated by breast mri after their initial cancer diagnosis is lacking . in this paper
, we would like to bring attention to a benign lesion that is frequently present on mri - guided breast biopsies performed on suspicious mri findings in the affected breast of patients with a new diagnosis of breast carcinoma . |
6,511 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: electrophysiological studies in animal models have shown that propafenone reduces the maximum rate of rise and the amplitude of the action potential ( 1 ) , and increases the duration of the action potential ( 2 , 3 ) .
furthermore , the drug has been shown to depress the transient outward current ( ito ) in atrial myocytes of the rabbit and ventricular myocytes of the rat ( 4 ) , the hyperpolarization - activated inward current ( if ) in isolated human atrial myocytes ( 5 ) and the delayed rectifier current ( ikr ) in sinoatrial node cells and atrial myocytes of rabbits and ventricular myocytes of guinea pigs ( 3 , 4 , 6 ) .
voltage - operated potassium currents play important roles in shaping and terminating cardic action potentials .
although several potassium current components have been isolated , two types of currents can be distinguished : fast activating and inactivating currents , referred to as ito , and delayed , more slowly inactivating currents , referred to as ikr ( 7 ) . for ito , in particular , kv1.4 potasium channel has been identified or discussed , since the kv1.4 channel carries the ito current which is a major contributor to the repolarizing currents terminating the cardic action potential .
several experiments have showed that the expression of kv1.4 channels in heart is altered under pathologic conditions associated with arrhythmias .
thus , 1 ) hyperthyroidism drastically decreased the protein level of kv1.4 in cultured newborn rat ventricular myocytes ( 8) ; 2 ) rats with infarcted myocardium showed reduced mrna and protein levels of kv1.4 in different regions of left ventricular myocardium ( 9 ) ; 3 ) cardic hypertrophy in rats ( induced by phorbol esters ) increased the density of kv1.4 ( 10 ) ; 4 ) diabetic heart ( induced by streptozotocin ) yielded a increase of kv1.4 mrna density and protein level in rat ventricle ( 11 ) .
therefore , understanding the molecular basis of the kinetic behavior of kv1.4 channels in response to changes in ph and [ k]0 may be of considerable... | the effects of the antiarrhythmic drug propafenone at c - type kv1.4 channels in xenopus laevis oocytes were studied with the two - electrode voltage - clamp techinique .
defolliculated oocytes ( stage v - vi ) were injected with transcribed crnas of ferret kv1.4n channels . during recording
, oocytes were continuously perfused with control solution or propafenone .
propafenone decreased the currents during voltage steps .
the block was voltage- , use- , and concentration- dependent manners .
the block was increased with positive going potentials .
the voltage dependence of block could be fitted with the sum of monoexponential and a linear function .
propafenone accelerated the inactivate of current during the voltage step .
the concentration of half - maximal block ( ic50 ) was 121 m / l . with high , normal , and low extracellular potassium concentrations , the changes of ic50 value had no significant statistical differences .
the block of propafenone was ph- dependent in high- , normal- and low- extracellular potassium concentrations .
acidification of the extracellular solution to ph 6.0 increased the ic50 values to 463 m / l , alkalization to ph 8.0 reduced it to 58 m / l .
the results suggest that propafenone blocks the kv1.4n channel in the open state and give some hints for an intracellular site of action . |
6,512 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: leiomyoma is a benign smooth muscle neoplasm of mesenchymal origin which commonly occurs in the genitourinary system and the gastrointestinal tract of the body but which rarely occurs in the liver [ 1 , 2 ] .
the first case report of primary leiomyoma of the liver was first described in a 42-year - old woman by demel in 1926 .
this paper seeks to review primary leiomyoma of the liver in the literature because of its rarity , unclear pathogenesis , and the diagnostic challenges it poses in clinical practice .
case reports and case series of primary leiomyoma of the liver were retrieved by extensive literature search of pubmed , ovid sp , cochrane database of systematic reviews , embase , and clinical evidence online .
further search of the literature was carried out by manually searching the relevant references of the studies retrieved .
the inclusive criteria include relevant publications of primary leiomyoma of the liver and hence studies with coexisting leiomyoma in other parts of the body were excluded .
epidemiologic , pathologic , clinical , imaging , and prognostic data were retrieved and assessed for all studies .
the search keywords include primary hepatic leiomyoma , primary leiomyoma of the liver , primary benign lesions of the liver , and primary tumours of the liver .
the clinical and pathologic characteristics of the 35 cases reviewed with the treatment and the clinical outcome are outlined in table 1 .
eighty - seven years after the first case of primary leiomyoma of the liver was reported , to the best knowledge of the author , 36 cases of primary leiomyoma of the liver have so far been reported in the literature .
hawkins et al . in 1980 proposed criteria that must be met for the diagnosis of primary liver leiomyoma .
secondly , the presence of leiomyoma in other sites of the body like uterus and the gastrointestinal tract must be excluded .
if the uterus is surgically absent , the diagnosis of primary leiomyoma of the liver must not be made without the review of the report and sections from... | context . primary leiomyoma of the liver is a rare tumour with uncertain pathogenesis with similar presentation with other tumours of the liver .
little is known about its clinical course .
objectives . to review the literature for case reports of primary leiomyoma of the liver . methods .
extensive literature search was carried out for case reports of primary leiomyoma of the liver .
results . a total of 36 cases of primary leiomyoma of the liver were reviewed .
the mean age of presentation is 43 years with slight female sex affectation ; females accounted for 55.6% of the cases reported in the literature .
the average size of the tumour is 8.7 cm .
34.4% of the cases reviewed were incidental finding with the mean follow - up time of 33 months with most cases reporting no evidence of disease .
conclusions .
primary leiomyoma of the liver is very rare tumour with complex pathogenesis which remains largely unknown .
imaging of the tumour does not allow for a tissue specific diagnosis ; hence histological review of the tissue specimen and immunohistochemical stains are imperative for diagnosis .
surgical resection is both diagnostic and curative .
the diagnosis of primary leiomyoma of the liver should be considered as a differential in the management of liver tumours . |
6,513 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the following mice strains were used : c57bl / j ins2 , which display elevated glucose at 46 weeks of age ; b6 ( c57bl/6 ) ( a gift from dr . s. smith , georgia health sciences university ) and db / db ( bks cg - dock7 m ) , which display elevated glucose at 48 weeks of age ; and blks ( c57blks / j ) ( diabetes and obesity discovery institute , georgia health sciences university ) . blood glucose was measured after a tail clip using accu - chek aviva ( roche , worldwide ) .
fibroblasts were obtained through trypsin digestion of mouse ears for 1 h and cultured in dulbecco s modified eagle s medium ( dmem ) ( invitrogen , carlsbad , ca ) from rage - deficient ( rage , n = 3 ) ( 17 ) , c57bl / j ins2 ( n = 4 ) , and b6 ( n = 4 ) mice . all protocols for animal use and euthanasia were reviewed and approved by the animal use committee at georgia health sciences university and were in accordance with national institutes of health guidelines .
solei were dissected from mice , secured to 35-mm culture dishes by a drop of new - skin ( medtech , irvington , ny ) liquid bandage , and kept ( < 1 h ) in ice - cold tyrode solution : 128 mmol / l nacl , 4.7 mmol / l kcl , 1.36 mmol / l cacl2 , 20 mmol / l nahco3 , 0.36 mmol / l nah2po4 , 1 mmol / l mgcl2 , and 10 mmol / l glucose , ph 7.4 ( 18 ) . laser analysis was carried out in 37c tyrode solution containing 1.36 mmol / l cacl2 , or tyrode without added cacl2 .
fm 143 dye ( invitrogen ) , a membrane impermeant dye , was added ( 2.5 mol / l ) before laser injury ( 19 ) .
intact plasma membranes of healthy myocytes , highlighted by staining of fm dye , were targeted for laser injury using a two - photon laser scanning confocal microscope ( lsm 510 ; zeiss , thornwood , ny ) coupled with a 10-w argon / ti - sapphire laser ( spectra - physics lasers ) operated at 100% power , 100 iterations , with a 5 35 pixels bleach area .
fluorescence , associated with the injured domain of the myocyte , was measured in a 120-m diameter circular window centered on the myocyte injury... | objectiveskeletal muscle myopathy is a common diabetes complication .
one possible cause of myopathy is myocyte failure to repair contraction - generated plasma membrane injuries . here
, we test the hypothesis that diabetes induces a repair defect in skeletal muscle myocytes.research design and methodsmyocytes in intact muscle from type 1 ( ins2akita+/ ) and type 2 ( db / db ) diabetic mice were injured with a laser and dye uptake imaged confocally to test repair efficiency .
membrane repair defects were also assessed in diabetic mice after downhill running , which induces myocyte plasma membrane disruption injuries in vivo .
a cell culture model was used to investigate the role of advanced glycation end products ( ages ) and the receptor for age ( rage ) in development of this repair defect.resultsdiabetic myocytes displayed significantly more dye influx after laser injury than controls , indicating a repair deficiency .
downhill running also resulted in a higher level of repair failure in diabetic mice .
this repair defect was mimicked in cultured cells by prolonged exposure to high glucose .
inhibition of the formation of age eliminated this glucose - induced repair defect .
however , a repair defect could be induced , in the absence of high glucose , by enhancing age binding to rage , or simply by increasing cell exposure to age.conclusionsbecause one consequence of repair failure is rapid cell death ( via necrosis ) , our demonstration that repair fails in diabetes suggests a new mechanism by which myopathy develops in diabetes . |
6,514 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: parathyroid carcinoma is a very rare cause of primary hyperparathyroidism in children . in adults ,
the incidence is 1 to 5% , but in children , the incidence is not exactly known .
several articles have reported sporadic cases of parathyroid carcinoma occurring in pediatric patients [ 2 - 7 ] .
this patient is the eighth reported case of parathyroid carcinoma occurring in a child under the age of 16 years .
a previously healthy 13-year - old girl was admitted to our thyroid department for an asymptomatic palpable thyroid mass .
a 4 cm hard mass was palpable in the right lobe of the thyroid gland .
her total serum calcium was 12.0 mg / dl ( normal , 7.8 to 10 mg / dl ) , ionized calcium 1.52 mm / l ( normal , 0.96 to 1.4 mm / l ) , phosphorus 2.6 mg / dl ( normal , 2.9 to 4.3 mg / dl ) , alkaline phosphatase 2,700 iu / l ( normal , 25 to 100 iu / l ) , intact parathyroid hormone ( ipth ) level was 8,368 pg / ml ( normal , 15 to 65 pg / ml ) .
ultrasonography of the neck showed a 4 cm multifocal cystic mass in the right thyroid gland ( fig .
a 35 30 20 mm firm oval tumor was found behind and adherent to the right lobe of the thyroid gland .
an en bloc resection of the tumor , along the right lobe of the thyroid gland was performed and the central lymph node was removed .
the tumor weighed 22 g. on section it appeared grayish - yellow while histologically there were capsular , vascular and perineural invasion ( fig .
the patient underwent a chest computed tomography ( ct ) scan to evaluate for metastasis . on chest
ct scan , multiple scattered subpleural nodules in both lower lung lobes were found and we considered them to be benign nodules such as an inflammatory granuloma rather than metastases .
the total serum calcium and ipth levels decreased to 8.4 mg / dl and 49.48 pg / ml on the first postoperative day , and was 9.9 mg / dl , 70.99 pg / ml two weeks , respectively .
six months postoperatively , her calcium and parathyroid hormone levels increased to 9.7 mg / dl and 297.8 pg / ml , respectively . on... | parathyroid carcinoma is a rare disease in pediatric patients . we present a case of a 13-year - old girl who presented to the thyroid department for an asymptomatic palpable neck mass for 1 year .
the high levels of calcium , ionized calcium , and parathyroid hormone level along with parathyroid scintigraphy studies suggested primary hyperparathyroidism .
parathyroid carcinoma was confirmed by biopsy and pathologic examination after resection .
six months postoperatively , persistent hypercalcemia and multiple lung metastases were found on computed tomography .
bilateral lung wedge resection was performed . en
bloc resection for primary parathyroid carcinoma and aggressive resection of metastatic disease is the most effective treatment to control hypercalcemia . |
6,515 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 48-year - old man underwent right partial glossectomy with neck dissection for tongue cancer under general anesthesia .
past medical history showed that he had been diagnosed with diabetes mellitus ( dm ) for five years and that he is a 30 pack - year smoker . during the five hours of operation , his vital signs were kept stable and blood sugar levels were well controlled between 82 - 84 mg / dl .
pulse oxygen saturation ( spo2 ) , pulse rate , and non - invasive blood pressure ( nibp ) were stable during immediate postoperative period in the recovery room .
he began complaining of troubled breathing and showed agitation 30 minutes after arrival in the recovery room .
we informed his otolaryngologist of the situation and relieved the dressing bandage around his neck . as his oxygen saturation gradually decreased to 0% , we started bag - mask ventilation .
although severe hypoxemia occurred , it did not lead to cardiac arrest , which was known from palpable pulse of radial artery throughout the course .
his heart rate remained above 40 beats / min . at the same time , his otolaryngologist arrived and immediately opened the incision site for decompression .
all vital signs were unremarkable ( spo2 98 - 99% , heart rate 80 - 120 beats / min , and temperature 36.0 - 36.2 ) , except blood pressure . it was checked below 90/60 mmhg twice during the 2 hours of operation , and ephedrine 10 mg was injected . on average , the mean arterial pressure was kept between 60 - 80 mmhg . at the end of the operation ,
bispectral index ( bis ) was increased to 90 and his eyes were opened spontaneously ; he was extubated .
however , soon after extubation , he showed generalized tonic - clonic seizure and it was only discontinued by inhalation of sevoflurane and administration of thiopental .
he was reintubated and phenytoin , lorazepam , and midazolam were administered to control the seizures .
he was admitted to the intensive care unit ( icu ) in a sedated state .
six hours later , when a tactile stimulus was applied , he... | myoclonic status epilepticus ( mse ) within the first 24 hours after cardiopulmonary resuscitation ( cpr ) predicts poor prognosis , enough to discontinue the treatment .
in contrast , chronic mse appearing a few days after cpr is called lance - adams syndrome ( las ) , which is characterized by preserved intellect and a favorable prognosis .
we herein report a case of las , which developed after a transient hypoxic event without an overt cardiac arrest due to hematoma formation in the neck after partial glossectomy .
differential diagnosis was also challenging as las was developed 8 hours after the hypoxic event . |
6,516 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: neurosyphilis has a special place in the history of neuropsychiatric diseases and the unraveling of the etiology , pathogenesis and control remains one of the instructive lessons in the principles and practice of medicine .
its propensity to affect all social classes is intricately linked to it being a sexually transmitted disease .
the ravages left in its wake as it spread across europe and the subsequent fascinating story of the discovery of penicillin leading to a treatment for syphilis gave impetus for its eradication in the second half of the nineteenth century . despite some measure of success in the control and eradication ,
neurological presentations still occur and can pose a diagnostic dilemma to physicians . as this illness has become rare , opportunities for modern day neuroimaging are few .
we report a case presenting as right sided limb weakness , facial numbness and slurred speech five months prior , diagnosed as a computed tomography ( ct ) scan negative vascular event in which there was subsequent deterioration leading to admission to hospital with features diagnostic of normal pressure hydrocephalus . additionally , clinical findings consistent with dementia paralytica were present and this combination together with ct and magnetic resonance imaging ( mri ) of the modern era are uncommon in the medical literature .
furthermore , to the best of our knowledge , there have been only seven reported cases of neurosyphilis presenting as normal pressure hydrocephalus .
a 46-year - old male presented the emergency department with a history of a decline in his mental status and reduced level of cognition for four months .
he sought medical care five months prior to his presentation for weakness of the right side involving right upper and lower limbs associated with facial numbness and slurred speech .
the ct brain at that time showed diffuse atrophic and small vessel changes with mild hydrocephalus ( figure 1a ) .
he was suspected to have an atherosclerotic cerebrovascular accident and was treated... | we report a case of a 46-year - old man presenting with a progressive cognitive decline , ataxic gait , urinary incontinence for 4 months and neuroimaging consistent with normal pressure hydrocephalus .
the atypical presentation of a progressively worsening dysphasia and a right hemiparesis dismissed as a vascular event 1 month earlier associated with normal pressure hydrocephalus prompted further investigations confirming neurosyphilis also manifesting as dementia paralytica .
treatment using consensus guidelines led to resumption of activities of daily living .
neurosyphilis , considered rare in the neuroimaging era , must still be considered a reversible cause of dementia and other neurological manifestations in contemporary neurological practice . |
6,517 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: microfibrillated cellulose ( mfc ) , which was first developed in the early 1980s , is cellulose produced by high - shear mechanical homogenization ( often of enzymatically hydrolyzed cellulose pulp ) in water,(3 ) as opposed to microcrystalline cellulose ( mcc ) produced by hydrolysis with strong mineral acids to a level - off degree of polymerization ( dp ) .
due to the mild character of the enzymatic hydrolysis , the cellulose fibers in mfc are substantially longer than mcc whiskers,(4 ) and the fibers are therefore capable of producing very thick hydrogels at very low solid content ( > 99 wt % water content ) upon high - shear mechanical homogenization in the absence of protective hydrocolloids , such as carboxymethylcellulose.(5 ) by controlling the number of passes during high - shear homogenization , microfibrils with diameters in the range 10100 nm and lengths on the order of several micrometers can be obtained .
mfc(6 ) together with bacterial cellulose and green algae cellulose are examples of native nanocelluloses .
thanks to its special rheological properties , mfc hydrogels were originally envisaged for use as thickening agents in food and cosmetics products .
more recent applications include dried mfc - based materials such as paper of exceptionally high tensile strength,(12 ) optically transparent paper,(13 ) and flexible organic light - emitting diode ( oled ) displays.(14 ) highly porous nanocellulose materials are generally of high interest in the manufacturing of filtration media as well as for biomedical applications , e.g. , in dialysis membranes . upon removal of water , mfc , which is produced in the form of hydrogels with very high water contents ,
collapses into a dense opalescent cellulose material of high mechanical strength.(12 ) the collapse of the structure after removal of water is initially in the drying process due to the capillary forces which water exerts on the hydrophilic cellulose microfibrils and later in the drying process due to the strong cooperative hydrogen bonding... | it is demonstrated that it is possible to coat the individual fibers of wood - based nanocellulose with polypyrrole using in situ chemical polymerization to obtain an electrically conducting continuous high - surface - area composite .
the experimental results indicate that the high surface area of the water dispersed material , to a large extent , is maintained upon normal drying without the use of any solvent exchange .
thus , the employed chemical polymerization of polypyrrole on the microfibrillated cellulose ( mfc ) nanofibers in the hydrogel gives rise to a composite , the structure of which unlike that of uncoated mfc paper does not collapse upon drying .
the dry composite has a surface area of 90 m2/g and a conductivity of 1.5 s / cm , is electrochemically active , and exhibits an ion - exchange capacity for chloride ions of 289 c / g corresponding to a specific capacity of 80 mah / g .
the straightforwardness of the fabrication of the present nanocellulose composites should significantly facilitate industrial manufacturing of highly porous , electroactive conductive paper materials for applications including ion - exchange and paper - based energy storage devices . |
6,518 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: giant cell tumor ( gct ) of bone usually occurs in the epiphyses of long bones like the distal femur , proximal tibia , distal radius and proximal humerus1 .
craniofacial bone involvement is rare but has been reported to occur in the mandible , temporal bone , maxilla , occipital and sphenoid23 .
the incidence of gct varies between regions and is highest amongst the asian population , especially the chinese and japanese where they account for nearly 15% of all primary bone tumors4 .
although generally thought to be benign tumors , gcts are known to be locally aggressive at times , with local recurrence occurring in about 25%-35% of patients3 .
this is a case of a 22-year - old female who was previously well till she experienced swelling and pain over her right temporal region for 18 months .
she had episodes of jaw locking and could hear clicking sounds when chewing or talking .
she sought medical help but was treated as temporomandibular disorder ( tmd ) and was given analgesics , physiotherapy and an occlusal splint . the pain reduced after the prescribed treatment and
the swelling was inconspicuous initially but increased in size and hence further investigations were carried out .
examination revealed a 22 cm swelling over the right temporal region which was firm and tender on palpation . upon opening her mouth ,
computed tomography ( ct ) scan showed an aggressive erosive tumor of the squamous temporal bone extending to the right temporomandibular joint ( tmj).(fig .
a magnetic resonance imaging ( mri ) of the brain and tmj was performed which showed an extra - axial mass at the right middle cranial fossa involving the right tmj , measuring 4.21.62.6 cm .
2 ) during surgery , we used a modified frontotemporal flap for access to the temporal bone and tmj . an intraoral right sulcular incision along the ascending ramus of the mandible was used for access to the coronoid process .
intraoperatively , the tumor was seen to invade the temporal bone , mandibular condyle , tmj and overlying temporalis muscle but... | giant cell tumor ( gct ) of the craniofacial bones has been reported but they are not common .
this tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life .
gcts are generally benign but can be locally aggressive as well .
we report a case of gct involving the temporomandibular joint ( tmj ) , which was initially thought to be temporomandibular disorder ( tmd ) . a 22-year - old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds . on examination ,
her jaw deviated to the right during opening and there was a 22 cm swelling over the right temporal region . despite routine treatment for tmd , the swelling increased in size .
computed tomography and magnetic resonance imaging of the brain and tmj revealed an erosive tumor of the temporal bone involving the tmj which was displacing the temporal lobe .
surgical excision was done and the tumor removed completely .
histopathological examination was consistent with a gct .
no clinical or radiological recurrence was detected 10 months post - surgery . |
6,519 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the clinical evaluation of left ventricular ( lv ) diastolic function has been a difficult challenge .
lv filling and pulmonary venous doppler patterns have been utilized to estimate lv diastolic function , comprising variables as such stiffness , relaxation and even lv filling pressures .
doppler echocardiography has been utilized not only as a diagnostic tool but also as a monitoring tool , permitting follow - up of the effects of therapeutic interventions . in the previous issue of critical care , vignon and
colleagues demonstrated the value of tissue doppler imaging ( tdi ) to estimate lv diastolic function in a setting where acute alterations of preloading conditions may interfere .
they also clearly show some weak points with respect to the correct use of these function variables .
a typical transmitral doppler pattern consists of a larger early filling velocity wave ( e wave ) followed by an atrial contraction flow velocity wave .
reduced lv relaxation ( present in patients with advanced age , ischaemic heart disease or arterial hypertension ) will induce a reduction of the e wave in comparison with the atrial contraction flow velocity wave . increasing filling
pressures will increase the e wave velocity and will shorten the deceleration time of the e wave , with a transition from pseudonormalization to a restrictive pattern .
the phase of diastolic dysfunction for an individual patient remains difficult because of the interplay between relaxation and preload , which makes the routine pulsed wave doppler indices useless particularly in a setting where preloading conditions may change constantly and abruptly , as in many critically ill patients .
this doppler mode facilitates the assessment of the movement of the myocardial tissue , which typically reflects low velocity with very high amplitude doppler signals .
tdi can therefore be utilized to estimate myocardial velocities at the mitral annulus to obtain an impression of both systolic and diastolic myocardial motion .
the spectral doppler pattern is... | assessment of left ventricular diastolic function in the critically ill patient remains a difficult issue in clinical practice . combined use of routine transmitral and pulmonary venous doppler patterns in conjunction with tissue doppler imaging
have been claimed to allow bedside diagnosis of diastolic dysfunction .
although in the previous issue of critical care it was clearly demonstrated there might be a difference in load dependency of the early myocardial tissue doppler velocity between lateral and septal placed sample volume , there remain still several unanswered questions , particularly with respect to the preload dependency of these indices . |
6,520 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recognition of abnormal glycosylation in almost any cancer type has raised great interest in the exploration of the tumor glycome for biomarker discovery [ 13 ] . in this study , we explored potential glycan markers that are overexpressed on the surfaces of breast cancers . a key immunological probe of this investigation is an antitumor monoclonal antibody ( mab ) , hae3 .
this mab was raised against epiglycanin , the major sialomucin glycoprotein ( ~500 kda ) of murine mammary adenocarcinoma ta3 cells .
it was initially called ae3 but was later renamed hae3 to avoid confusion with a commonly used anti - cytokeratin antibody in cancer research [ 6 , 7 ] .
interestingly , hae3 was found to strongly cross - react with a number of human epithelial tumors in tissues , including lung , prostate , bladder , esophagus , and ovarian cancers [ 5 , 810 ] .
this cross - species tumor binding profile suggests the possibility that hae3 may recognize a conserved tumor glycan marker that is coexpressed by both mouse- and human - derived epithelial cancers .
hae3 was initially suggested to resemble lectin peanut agglutinin ( pna ) , which recognizes the t disaccharide ( gal1,3galnac1- ) linked to ser / thr .
however , the antibody differed from pna in that the concentration of the blood group t disaccharide required for inhibition of binding to epiglycanin was 10 times greater than for pna .
moreover , a t - specific mab hh8 was found to be negative with epiglycanin in elisa microtiter plates .
reported recently that the neoglycolipid conjugates that display a single t disaccharide epitope were negative with hae3 .
given that hae3 has been analyzed using a large collection of synthetic neoglycoconjugates ( n = 492 ) , this study focused on identification of the potential natural ligands of hae3 .
in essence , we produced a comprehensive carbohydrate microarray using a large collection of purified natural carbohydrate antigens for screening .
these include a , b , o , lewis , i and i , and the blood group precursors of... | using carbohydrate microarrays , we explored potential natural ligands of antitumor monoclonal antibody hae3 .
this antibody was raised against a murine mammary tumor antigen but was found to cross - react with a number of human epithelial tumors in tissues .
our carbohydrate microarray analysis reveals that hae3 is specific for an o - glycan cryptic epitope that is normally hidden in the cores of blood group substances . using hae3 to screen tumor cell surface markers by flow cytometry
, we found that the hae3 glycoepitope , gphae3 , was highly expressed by a number of human breast cancer cell lines , including some triple - negative cancers that lack the estrogen , progesterone , and her2/neu receptors .
taken together , we demonstrate that hae3 recognizes a conserved cryptic glycoepitope of blood group precursors , which is nevertheless selectively expressed and surface - exposed in certain breast tumor cells . the potential of this class of o - glycan cryptic antigens in breast cancer subtyping and targeted immunotherapy warrants further investigation . |
6,521 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | exposure of low - passage endothelial cells in culture to nonlethal amounts of asbestos , but not refractory ceramic fiber-1 , increases cell motility and gene expression .
these changes may be initiated by the fibers mimicking matrix proteins as ligands for receptors on the cell surface . in the present study , 1- to 3-hr exposures of endothelial cells to 5
mg / cm2 of chrysotile asbestos caused marked cell elongation and motility .
however , little morphological change was seen when chrysotile was added to cells pretreated with either mannosamine to prevent assembly of glycophosphatidylinositol ( gpi)-anchored receptors or with herbimycin a to inhibit tyrosine kinase activity .
affinity purification of gpi - anchored urokinase - type plasminogen activator receptor ( upar ) from chrysotile - exposed cells demonstrated that asbestos altered the profile of proteins and phosphoproteins complexed with this receptor .
tyrosine kinase activities in the complexes were also increased by asbestos .
immunoprecipitations with selective monoclonal antibodies demonstrated that both chrysotile and crocidolite asbestos increase kinase activities associated with p60 src or p120 focal adhesion kinase ( fak ) .
further , chrysotile also changed the profile of proteins and phosphoproteins associated with fak in intact cells .
these data suggest that asbestos initiates endothelial cell phenotypic change through interactions with upar - containing complexes and that this change is mediated through tyrosine kinase cascades.imagesfigure 1 .
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6,522 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: osteoarthritis ( oa ) is the most prevalent disease associated with significant morbidity ,
and it is one of the most common causes of functional limitation and dependency .
knee oa is
particularly disabling because of symptoms such as pain , stiffness , and muscle weakness1 , 2 .
it
causes difficulty in climbing stairs , rising from a seated position , and walking , eventually
leading to physical disability and decreased quality of life3 , 4 . in many previous studies ,
associations between the mechanical axis alignment of the lower
limb and oa severity were found5,6,7,8,9 .
malalignments of the knee
joint make individuals more susceptible to developments of knee oa7 , and valgus or varus alignment increase the risk of knee oa
occurrence6 , 10 .
varus alignment , in particular , resulted in the largest stresses
at the medial compartment of the knee5 .
the adduction moment at the knee during gait is the primary determinant of the
medial - to - lateral distribution11 .
measurement of the knee joint moments provides an indication of the actual knee joint loads
related with the progression of oa12 .
the
knee adduction moment is mainly determined by the ground reaction force and its lever arm .
the line of action of the ground reaction force is directed to the medial side and the
center of the knee during gait , and its lever arm is the perpendicular distance from this
force vector to the knee joint center .
the knee adduction moment tends to adduct the knee
into a varus position , which is significantly correlated with disease severity11 .
an altered kinematic pattern of the ankle joint can also influence lower extremity
function13,14,15,16,17,18 , and the foot progression angle is related to the knee adduction
moment during gait19,20,21,22 . during the late stance phase in the gait cycle , the ground
reaction force passes through the forefoot , and medial to lateral disturbances caused by
foot rotation influence knee kinetics23 .
thus , patients with knee oa tend to... | [ purpose ] the aim of this study was to determine the relationships among the foot
progression angle , foot rotation angle , lower limb alignment , and knee adduction moments
in patients with degenerative knee osteoarthritis ( oa ) . [ subjects ] forty - eight patients
diagnosed with degenerative knee oa ( kellgren - lawrence grades 2 and 3 ) were included .
[ methods ] to assess the lower extremity alignment and weight - bearing ratio , static
radiographic measurement was used .
foot progression angle , foot rotation angle , and knee
adduction moments were measured by using a three - dimensional motion analysis system .
[ results ] the results of this study were as follows : the foot progression angle in the
early and late stance phase was significantly correlated with the first and second peak
knee adduction moments ; the weight - bearing ratio was significantly correlated with the
first and second peak knee adduction moments ; and the tibiofemoral angle was significantly
correlated with the first and second peak knee adduction moments .
[ conclusion ] the results
of the present study indicated that as the foot progression angle and the foot lateral
rotation angle increased , the knee adduction moment decreased .
the weight - bearing ratio
and tibiofemoral angle assessment with mechanical axis alignment were correlated with the
knee adduction moments .
these parameters may be helpful for selecting therapeutic options
for patients with degenerative knee oa . |
6,523 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: during the past 2 decades , two noninvasive imaging methods , optical coherence tomography ( oct ) and fundus autofluorescence ( faf ) photography , have become available in routine clinical practice .
these methods provide qualitative and quantitative information about retinal changes that are not only important for the management of patients with many retinal diseases but also for patients with intraocular tumors.13 oct and faf imaging , when used together and combined with fundus photography , fluorescein angiography / indocyanine green angiography ( fa / icg ) , and ultrasonography , have been shown to be useful for early tumor diagnosis , monitoring of tumor growth , and follow - up of the results of therapies.111 today , spectral domain ( sd)-oct can provide cross- sectional images of the individual retinal layers and sd - oct scans have been used for the detection and quantification of secondary retinal , retinal pigment epithelium ( rpe ) , and choroidal changes overlying ocular tumors , for example , subretinal fluid ( srf ) , which may have predictive value for ocular tumor growth and could be a clinical indicator for malignancy in eyes with indeterminate choroidal melanocytic lesions ( imls).1,6,1012 oct was found to be more sensitive than clinical examination or ultrasonography for the identification of srf.13 sd - oct findings have recently been reported to be helpful in the diagnosis , follow - up , and treatment of different choroidal tumors , such as nevi , melanomas , metastases , hemangiomas , and lymphomas.6,1418 secondary retinal and rpe changes associated with various intraocular tumors can also be documented by faf .
faf imaging is a noninvasive method that provides a topographical map of lipofuscin , which is the main fundus fluorophore.19 lipofuscin ( a mixture of proteins , lipids , and small chromophores ) is the end product of phagocytosed photoreceptor outer segments , mostly accumulating within the rpe cells .
it has been shown that excessive accumulation of lipofuscin may impair... | purposeto describe clinical , optical coherence tomography ( oct ) and fundus autofluorescence ( faf ) findings in patients with intraocular tumors and determine if oct and faf could be helpful in the differential diagnosis and management of different choroidal tumors.methodsforty-nine patients with untreated , macular , midperipheral , and extrapapillary intraocular tumors were included .
all patients underwent ophthalmic examination : best - corrected visual acuity , slit - lamp biomicroscopy , funduscopy , and standardized b mode , and if possible a mode , ultrasonography , and oct and faf imaging of the surface of the intraocular tumors.resultsof the 49 patients studied , 19 had choroidal nevi , ten had indeterminate choroidal melanocytic lesions ( imls ) , ten had malignant melanomas , and ten had other choroidal tumors .
the choroidal nevi revealed subretinal fluid ( srf ) on oct in only 11% .
faf detected isoauto - fluorescence in 42% , hypoautofluorescence in 37% , patchy faf pattern in 16% , and a diffuse faf pattern in 5% .
seventy percent of patients with iml showed srf on oct and 20% showed tumor growth on follow - up , detected only by oct and faf imaging .
faf revealed a patchy pattern in 50% and a diffuse pattern in 40% of cases with iml .
ninety percent of the patients with choroidal melanoma had srf on oct and faf revealed a patchy pattern in 60% and a diffuse pattern in 40% .
patients with other choroidal tumors had srf on oct in 30% of cases and no characteristic pattern on faf.conclusionboth oct and faf were helpful in the differential diagnosis of choroidal nevi versus imls , choroidal melanomas , and other choroidal tumors .
also , detailed and periodical clinical evaluation of patients with intraocular tumors using oct and faf imaging for the detection of both srf and faf patterns overlying the tumor can be useful for detection of tumor growth . |
6,524 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cystic lesions of the pancreas occasionally present problems in diagnosis and management , especially when found incidentally .
cystic lesions can be broadly classified as follows : congenital true cyst ; primary cystic neoplasms ; acquired cysts , including parasitic cysts and postinflammatory cysts ( pseudocyst , retention cyst ) ; extra - pancreatic cystic disorders masquerading as pancreatic cyst ; and other miscellaneaus cystic lesion .
endometriosis is defined as the presence of endometrial glands and stroma occurring outside of the uterine cavity .
it has been encountered in multiple sites such as the ovaries , fallopian tubes , uterus , peritonium , uterine ligaments , rectovaginal septum , cervix , vagina , vulva , skin , umbilicus , incisional scars , hernia scars , bladder wall , kidney , pelvic lymph nodes , extremities , lung , pleura , large intestine , rectum , appendix , gallbladder , stomach , and spleen .
we report a patient with a cyst in the body of the pancreas that on pathologic examination proved to be lined by the ectopic endometrial tissue .
a 21-yr - old korean woman was admitted to the hospital with a recurrent epigastric pain and 8 kg weight loss over a one year period .
she denied a history of hepato - biliary disease , alcoholism , previous surgery , traumatic abdominal injury or cyclic abdominal pain .
her menstrual history was normal . on admission , her blood pressure was 120/80 mmhg , pulse 80/min , temperature 36.5c and respirations 20/min . on examination , there was no abnormally palpable mass in her abdomen .
laboratory data on admission was as follows : hemoglobin 12.4 g / dl , hematocrit 37.3% , white blood cell count 5,500/mm , platelet 300,000/mm , total protein 6.4 g / dl , albumin 4.2 g / dl , total bilirubin 0.7 mg / dl , ast 10
iu / l , alt 9 iu / l , alklaine phosphatase 135 iu / l , ggt 12 iu / l , amylase 60 u , cea 1.24 ng / dl , ca-125 8.71 u / ml , ca 19 - 9 54.34 u / ml , afp 0.4 ng / ml , ca 15 - 3 9.09 u / ml .
computed tomography of the abdomen showed a... | pancreatic endometrial cyst is an extremely rare instance of ectopic endometriosis that was first described by marchevsky in 19841 ) .
a 21-yr - old woman with a history of epigastric pain and weight loss was found to have a cystic lesion in the pancreas on ct - scan . under the tentative diagnosis of a pancreatic cystic neoplasm
, partial pancreatectomy was performed .
histopathological examination of the specimen revealed cystic endometriosis .
the clinicopathological features of the lesion are discussed and literature concerning this extremely rare lesion is reviewed . |
6,525 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: disease modeling in neuropsychiatric disorders implicates the role of abnormal cellular structure and function , resulting in consequential disturbances in synaptic signaling and discrete neural circuits .
a concatenation of research evidence underscores the role of genetic , epigenetic , as well as environmental pathogenic influences .
however , the specific pathoetiological mechanisms underlying the phenomenology of most neurological and psychiatric disorders have yet to be elucidated .
notwithstanding , convergent evidence indicates that alterations in neuronal integrity and function are mediated by abnormal central insulin signaling .
the critical role of insulin in normal and abnormal cns functioning provides the framework for characterizing its role in the pathoetiology , progression , and treatment of several neuropsychiatric disorders .
moreover , refining disease models for neuropsychiatric disorders , by evaluating the phenotypic and neurobiological overlap between neuropsychiatric disorders with metabolic disturbances , is an essential step in the development of personalized , preventative , and/or pre - emptive treatments .
this review broadly aims to underscore insulin 's salience to pathoetiological and therapeutic research in neuropsychiatric disorders . towards these aims ,
we review , herein , descriptive studies in human and animal models documenting the phenotypic overlap of psychiatric and neurological disorders with metabolic disturbances ; we also report on a pathophysiological nexus shared by neuropsychiatric disorders and metabolic disturbances with a particular emphasis on the interplay between insulin and central reward networks , stress , and neuroinflammation .
we also attempt to identify research vistas capable of empirically establishing a therapeutic role for targeting insulin and/or insulin - related pathways to generate novel correction strategies for select neuropsychiatric disorders .
the original association between disruptions in peripheral glucose metabolism and... | evidence supporting the concurrence of metabolic disturbances ( e.g. insulin resistance , diabetes and obesity ) and neuropsychiatric disorders has been demonstrated in both human and animal studies , suggesting the possibility that they have shared pathophysiological mechanisms . during the past decade , our understanding for the role of insulin in both normal and abnormal central nervous system ( cns ) processes has become increasingly refined .
evidence indicates that insulin is a pleiotropic peptide , critical to neurotrophism , neuroplasticity , and neuromodulation .
moreover , the role of insulin underscores its importance in the development of several neuropsychiatric disorders , including , but not limited to , mechanisms involved in the pathogenesis and progression towards diabetes , obesity , and neurodegenerative disorders , such as alzheimer 's disease .
this review focuses on the insulin - mediated effects on normal and abnormal brain function and discusses why targeting insulin - related pathways in the brain may emerge as a new approach for refining treatment of neurological and psychiatric disorders . |
6,526 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the introduction of dihydroxyphenylalanine ( levodopa ) to the treatment of pd was a major scientific and clinical breakthrough in the treatment of this devastating disease .
second , comes the realization that an understanding of biochemical deficits can provide a clue as to how replacement , therapy could be successfully employed in neurodegenerative diseases , providing significant symptomatic benefit , if not a cure .
dopa had an enormous impact on attempts to treat other neurodegenerative disorders , particularly ad .
unfortunately , in spite of miraculous effects on patients with early and advanced pd and the motor benefits afforded to them , it soon became clear that dopa does not slow the neurodegenerative process and its effects are purely symptomatic .
consequently , the dopa dose required to control the motor manifestations must , be gradually increased as the disease progresses .
it quickly became clear also that , of the two dopa isomers , only the levorotatory stereoisomer , levodopa , produced therapeutic benefits , and chemical means to separate the two isomers were developed . in practice , only levodopa is now used in the treatment of pd , resulting in an improved safety profile . soon after came the recognition that some of the adverse effects associated with the drug were the result of peripheral - rather than central - conversion of levodopa into da , which , unlike levodopa , has significant autonomic activity .
since da does not cross the blood - brain barrier ( bbb ) , any da produced in the peripheral nervous system docs not contribute to the clinical benefits afforded by levodopa , and actually causes significant , adverse events , particularly gastrointestinal and other autonomic disturbances . the enzyme involved in the transformation of levodopa to da , ie ,
l - amino acid decarboxylase ( l - aad , initially called dopa decarboxylase ) is widespread in the body , with high concentrations in the liver .
two agents were developed that could inhibit , it , and both are still in use :... | parkinson 's disease ( pd ) is a common neurodegenerative disease .
while its cause remains elusive , much progress has been made regarding its treatment .
available drugs have a good symptomatic effect , but none has yet been shown to slow the progression of the disease in humans .
the most efficacious drug is levodopa , but it remains unclear whether the symptomatic benefit is associated with neurotoxic effects and long - term deterioration . the long - term problem associated with levodopa is the appearance of dyskinesias , which is significantly delayed among patients treated with dopamine agonists as initial therapy .
less clear is the role of other drugs in pd , such as monoamine oxidase inhibitors ( maois ) , including selegiline and rasagiline , the putative n - meihyl - o - aspartaie ( nmda ) receptor antagonists amantadine and memantine , and the muscarinic receptor blockers .
all these may be used as initial therapy and delay the use of dopaminergic drugs , or can be added later to reduce specific symptoms ( tremor or dyskinesias ) .
advanced pd is frequently associated with cognitive decline . to some extent , this can be helped by treatment with cholinesterase inhibitors such as rivastigmine .
similarly , hallucinations and delusions affect pd patients in the advanced stages of their disease .
the use of classical neuroleptic drugs in these patients is contraindicated because of their extrapyramidal effects , but atypical drugs , and particularly clozapine , are very helpful .
the big void in the therapy of pd lies in the more advanced stages .
several motor symptoms , like postural instability , dysphagia , and dysphonia , as well as dyskinesias , are poorly controlled by existing drugs .
new therapies should also be developed against autonomic symptoms , particularly constipation . |
6,527 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: although stimulus evoked electromyography ( emg ) is commonly used to confirm the accuracy of pedicle screw placement .
there are no studies to differentiate between solid screws and hollow screws to the electrical resistance of pedicle screws .
we speculate that the electrical resistance of the solid and hollow pedicle screws may be different and then a potential source of error with stimulus - evoked emg may happen .
resistance measurements were obtained from 12 pedicle screw varieties ( 6 screws of each manufacturer ) across the screw shank based on known constant current and measured voltage .
resistance of all solid screws ranged from 0.084 to 0.151 ( mean = 0.118 0.024 ) and hollow screws ranged from 0.148 to 0.402 ( mean = 0.285 0.081 ) .
there was a significant difference of resistance between the solid screws and hollow screws ( p < 0.05 ) .
the screw with the largest diameter no matter solid screws or hollow screws had lower resistance than screws with other diameters .
no matter in solid screws group or hollow screws group , there were significant differences ( p < 0.05 ) between the 5.0 mm screws and 6.0 mm screws , 6.0 mm screws and 7.0 mm screws , 5.0 mm screws and 7.0 mm screws , 4.5 mm screws and 5.5 mm screws , 5.5 mm screws and 6.5 mm screws , 4.5 mm screws and 6.5 mm screws .
the resistance of hollow screws was much larger than the solid screws in the same diameter group ( p < 0.05 ) .
hollow pedicle screws have the potential for high electrical resistance compared to the solid pedicle screws and therefore may affect the emg response during stimulus - evoked emg testing in pedicle screw fixation especially in minimally invasive percutaneous pedical screw fixation surgery .
the reported incidence of malpositioned pedicle screws in both cadaveric studies and clinical series has ranged from about 5% to as much as 40% , with potential consequences of construct failure , visceral injury , or neurologic injury.12345678 in traditional open instrumentation procedures , pedicle screws are... | background : although stimulus evoked electromyography ( emg ) is commonly used to confirm the accuracy of pedicle screw placement .
there are no studies to differentiate between solid screws and hollow screws to the electrical resistance of pedicle screws .
we speculate that the electrical resistance of the solid and hollow pedicle screws may be different and then a potential source of error with stimulus - evoked emg may happen.materials and methods : resistance measurements were obtained from 12 pedicle screw varieties ( 6 screws of each manufacturer ) across the screw shank based on known constant current and measured voltage .
the voltage was measured 5 times at each site.results:resistance of all solid screws ranged from 0.084 to 0.151 ( mean = 0.118 0.024 ) and hollow screws ranged from 0.148 to 0.402 ( mean = 0.285 0.081 ) .
there was a significant difference of resistance between the solid screws and hollow screws ( p < 0.05 ) .
the screw with the largest diameter no matter solid screws or hollow screws had lower resistance than screws with other diameters .
no matter in solid screws group or hollow screws group , there were significant differences ( p < 0.05 ) between the 5.0 mm screws and 6.0 mm screws , 6.0 mm screws and 7.0 mm screws , 5.0 mm screws and 7.0 mm screws , 4.5 mm screws and 5.5 mm screws , 5.5 mm screws and 6.5 mm screws , 4.5 mm screws and 6.5 mm screws .
the resistance of hollow screws was much larger than the solid screws in the same diameter group ( p < 0.05).conclusions : hollow pedicle screws have the potential for high electrical resistance compared to the solid pedicle screws and therefore may affect the emg response during stimulus - evoked emg testing in pedicle screw fixation especially in minimally invasive percutaneous pedical screw fixation surgery . |
6,528 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: prepublication concerns , rumors , and the subsequent publication of two studies that reported the generation of mammalian - transmissible h5n1 virus in the laboratory have launched a passionate dialog among biomedical scientists about biosafety , biosecurity , and bioterrorism , not to mention the social responsibility of scientists . because of the language and intensity of the discussion , the influenza virology community agreed to a voluntary 60-day pause of any research that involved highly pathogenic avian influenza h5n1 viruses and led to the generation of viruses that are more transmissible in mammals . although originally planned for 60 days
, this self - imposed moratorium remains in place , and there is a great deal of pressure to continue the moratorium until the multiple issues that have been raised about this research and its implications are dispassionately discussed at the worldwide level .
the issues are not trivial . some argue that research of this kind pushes the limits of legitimate scientific inquiry .
others argue that the research is essential for world health , epidemic surveillance , and vaccine development .
the research is viewed in the broader context of genetic engineering and so - called dual - use research of concern ( durc ) . at a more fundamental level
, there is a need to explain both the benefits and the hazards of such research to the public .
i have been asked to take a historical perspective of these questions based on my active participation in the asilomar meeting of 1975 and my role as one of the original members of the recombinant dna committee charged with drafting the first recombinant dna research guidelines .
i think research on virus transmissibility is an essential focus of contemporary research not just for h5n1 but for all infectious agents .
how such experiments are performed needs to be discussed openly , with more attention paid to the science rather than to the rhetoric .
the university of wisconsin and erasmus university groups had their h5n1 mammalian... | abstractin mid-1974 , soon after the first recombinant dna molecules were replicated in escherichia coli , scientists called for , and observed , a voluntary moratorium on certain experiments . one goal of the moratorium was to hold a conference ( asilomar ) to evaluate the risks , if any , of this new technology .
the asilomar conference concluded that recombinant dna research should proceed but under strict guidelines .
the furor surrounding the recent genetic manipulation of the transmissibility of avian influenza virus h5n1 led to a short - term moratorium that has been extended indefinitely .
the question is how long should the moratorium remain in place , or should it be permanent ?
voltaire observed ,
history never repeats itself ; man always does .
i believe the parallels of asilomar can be applied to the problem facing biomedical science today .
we should move forward to establish standardized guidelines , using common sense and scientific creativity .
the onus of responsibility falls on the individual scientist and involves the education of a new generation of scientists into the social and ethical implications of genetic engineering in a new age of genomics and synthetic biology .
in addition , scientists who work with infectious agents must deal not only with biosafety but also , alas , with bioterrorism .
the h5n1 affair is not a question of freedom of inquiry or the dissemination of scientific research ; it is a question of the social responsibility of science and scientists to ensure that the public understands why this work is beneficial and worthwhile . |
6,529 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: dental caries is still a highly prevalent pathology in the worldwide population despite all the traditional and original prevention methods . in spite of dramatic improvement in the caries status of children , dental caries
although fluorides are highly effective in prevention of caries on smooth surfaces , they are not equally effective in protecting the occlusal surfaces .
permanent posterior teeth construct about 90 percent of carious lesions of the pits and fissures .
molars are the most vulnerable tooth type for this defect . the application of pit - and - fissure sealants is considered as the most appropriate treatment modality for prevention of occlusal caries .
therefore , the retention rate becomes a determinant of their effectiveness as a caries preventive measure .
sealants are rarely retained completely over the tooth s lifetime and must be reapplied . even under proper application conditions , 5 to 10 percent of sealants
are lost annually . in order to enhance the longevity of pit - and - fissure sealants , several materials and techniques
have been evolved , among which is the use of flowable composite resins as pit - and - fissure sealants [ 811 ] .
the higher filler content causing decrease in the surface wear is the main logic for using flowable composites as pit - and - fissure sealants .
however , there are few clinical studies comparing the retention of these materials with that of conventional resin based sealants .
the purpose of this study was to compare the retention of a conventional resin - based sealant and a flowable composite resin placed on occlusal pits and fissures over a 12-month period .
children in the age range of 6 to 9 years having caries free , fully erupted first permanent molars were included in this study . written informed consent was obtained from the parents or guardians of all children in the study , and the study design was approved by the ethics committee of the school of dentistry , university of isfahan .
prior to examination , the occlusal surfaces were first... | objective : long - term retention of pit and fissure sealants is crucial for their success .
this clinical study evaluated the retention rate of a flowable composite resin ( filtek supreme xt flowable restorative ) compared to a conventional resin - based sealant ( concise light cure white sealant ) over 12 months.materials and methods : forty subjects aged 6 to 9 years were included in the study . using a half - mouth design ,
a total of 80 first permanent molars were sealed with conventional fissure sealant on one side of the mouth and flowable composite on the contralateral side .
clinical evaluation was performed at 3 , 6 , and 12 months by a single blind examiner and the retention was classified as complete retention , partial loss , or total loss.results:for both materials , there was no total loss of sealants over 12 months .
partial loss of both materials was observed in one sealant after 3 months .
after 6 months , 36 teeth sealed with conventional fissure sealant were intact compared with 37 sealed with a flowable composite , and after 12 months , 33 teeth sealed with conventional fissure sealant were intact compared with 35 that were sealed with a flowable composite .
there were no statistically significant difference ( p>0.05 ) between the two materials regarding the retention rate at each follow - up period.conclusion:as flowable composite resulted in comparable sealant retention rates , this material could be a good choice for fissure sealant . |
6,530 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: decubital ischemic fasciitis is a rare entity occurring mostly in the elderly and in debilitated patients , in the deep subcutaneous tissue , at pressure points or bony prominences.[14 ] it can simulate a soft - tissue sarcoma clinically and histopathologically.[14 ] imaging helps to rule out malignancies and therefore to prevent unnecessary interventions .
a 72-year - old woman presented with a palpable mass over the right hip region .
physical examination revealed a 4- to 5-cm , hard , and fixated mass in the right proximal thigh , located posterolateral to the greater trochanter .
mri revealed diffuse hyperintense signals on the t2w images [ figures 1a and 1b ] consistent with edema and inflammation , in the muscles and subcutaneous tissues , with prominent , peripheral , and ill - defined enhancement [ figure 2 ] , over an area measuring approximately 4 - 7 cm , at the level of the greater trochanter .
a ct - guided needle biopsy showed coagulative necrosis , hemorrhage , and fibrosis involving the adipose tissue .
the capillary and muscular vessels within the lesion also showed fibrinoid necrosis in their walls , without evidence of primary vasculitis [ figure 3 ] .
these findings , along with the clinical features , were considered compatible with the diagnosis of ischemic fasciitis ( atypical decubital fibroplasia ) .
axial ( a ) and coronal ( b ) fat - suppressed t2w images show diffuse hyperintense signals ( arrows ) in the muscles and subcutaneous tissues , adjacent to the right greater trochanter axial contrast - enhanced t1w , fat - suppressed mri shows subtle , peripheral enhancement ( arrow ) in an area measuring approximately 47 cm , at the level of the greater trochanter histopathologic slide ( h and e stain ) shows coagulative necrosis and hemorrhage with capillary and muscular vessels showing fibrinoid necrosis in their walls ( arrows )
decubital ischemic fasciitis , also called atypical decubital fibroplasia , is a distinctive fibroplasia occurring predominantly in the elderly and... | the mri findings in a case of decubital ischemic fasciitis located posterolateral to the right greater trochanter , in a 72-year - old woman , are presented .
decubital ischemic fasciitis is an uncommon entity encountered mostly in debilitated , elderly patients , in the deep subcutaneous tissue , at pressure points or bony prominences .
it can simulate soft - tissue sarcomas .
recognition of this lesion radiologically is important to prevent unnecessary interventions . |
6,531 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: therapeutic lifestyle interventions tlss are recommended as an essential component of the initial and lifelong therapeutic regimen for the majority of individuals with or at risk for type 2 diabetes .
tls interventions consist of dietary and exercise recommendations that promote weight loss in overweight and obese individuals with the ultimate goal of reducing risk for cardiovascular disease cvd , the primary contributor to early morbidity and mortality in type 2 diabetes . despite the implied importance of the influence of tls on promoting glycemic and metabolic control and ultimately reducing risk for cvd events
, there were no long - term randomized controlled clinical trials investigating the impact of diet and exercise on cvd outcomes . until recent publication of the results of the look action for health in diabetes ahead trial
, the majority of intervention studies have focused on achieving strict levels of glycemic control using existing pharmacologic therapies as a way of addressing cvd risk . the failure to observe reductions in cvd outcomes with intensive pharmacologic strategies in several recent large clinical trials supported the need to investigate the contribution of tls recommendations on amelioration of risk for macrovascular complications .
the primary objective of look ahead study was to examine the long - term effects of an intensive lifestyle intervention program in overweight subjects with type 2 diabetes when compared with a control group receiving diabetes support and education .
the primary outcome was a composite of the first postrandomization occurrence of fatal and nonfatal myocardial infarction and stroke .
the study was powered to detect an 18% difference in cvd events between the two groups at 13.5 years of follow - up .
due to the observation of fewer events than anticipated , angina requiring hospitalization was added to this composite measure during the second study year .
look ahead randomized 5145 participants with type 2 diabetes between the ages of 45 and 74 years to an... | the look action for health in diabetes ahead study was designed as a long - term randomized controlled clinical trial and powered to detect differences in cardiovascular outcomes , the primary cause of early morbidity and mortality in type 2 diabetes , among subjects randomized to receive an intensive lifestyle intervention or a control group of diabetes support and education .
the study was terminated early due to the absence of any difference in the primary outcome , defined as a composite of the first postrandomization occurrence of fatal and nonfatal myocardial infarction and stroke , or angina requiring hospitalization . however , important secondary favorable outcomes were observed in those receiving the intensive lifestyle intervention .
this included more weight loss , greater fitness , less disability , less depression , reductions in sleep apnea and urinary incontinence , better glycemic control , and more subjects experiencing diabetes remission .
these results underscore the importance of lifestyle interventions as a component of diabetes therapy .
long - term follow - up of look ahead participants is planned , despite discontinuation of the intensive lifestyle program . |
6,532 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
an acquired dacryocystocele is a diffuse and centrifugal enlargement of the lacrimal sac that forms as a result of obstruction of lacrimal drainage system proximally at the level of the common canaliculus and distally at the level of nasolacrimal duct .
findings associated with dacryocystocele are irreversible fibrotic narrowing in the lacrimal system , osseous changes in the nasolacrimal duct and chronic and low - grade inflammation . adult dacryocystoceles are often observed after dacryocystitis ; however , they may also develop idiopathically or due to autoimmune fibrous diseases , sinusitis and paranasal sinus mucoceles , after trauma or osseous configuration in the dysplastic duct wall and tumors , or secondarily to dacryocystorhinostomy surgeries . in computerized tomography ( ct ) and magnetic resonance imaging ( mri ) ,
a dacryocystocele appears as a fluid collection that is separated from other solid structures by a thin rim .
differential diagnosis includes malformations of the lacrimal sac , diverticulum , dermoid and epidermoid cysts , encephalocele , primary epithelial tumors of the sac , and external tumors . in this study
, we aimed to determine the probable etiology as well as clinical , microbiological , histopathological , and radiological findings of dacryocystoceles in acquired dacryocystocele cases . to our knowledge , this is one of the largest case series published of acquired dacryocystoceles in adult patients .
in the study , the charts of patients who had undergone external dacryocystorhinostomy ( edcr ) surgery in our clinic between 2008 and 2013 were reviewed retrospectively , and 10 eyes of 8 patients who were diagnosed with dacryocystocele were included in the study .
the median follow - up time for those patients was 22 months ( range 13 to 38 months ) .
the study was conducted in accordance with the tenets of the declaration of helsinki by obtaining written consent from all patients , with the approval of the local ethical review board .
complete ophthalmologic examinations ,... | purpose .
the aim of this study is to investigate the etiology and the clinical , microbiological , histopathological , and radiological findings of acquired dacryocystoceles . methods . in this retrospective study
, we reviewed the clinical records of 10 eyes of 8 patients with dacryocystoceles who underwent external dacryocystorhinostomy ( dcr ) surgery .
etiology , presenting symptoms and radiological findings as well as microbiological and histopathological assessment results and outcome were analyzed . results .
the records of 8 patients with dacryocystoceles were included in this study . in the histopathological evaluations of the samples collected from the lacrimal sac wall ,
chronic inflammation was found in all biopsied samples and fibrosis was observed in two histopathological evaluations .
computerized tomography ( ct ) imaging showed fluid collection separated from adjacent tissues by a thin rim , corresponding to dacryocystoceles in the sac . in the microbiological culture examination of samples collected from the fluid within the cyst , no bacterial growth in 5 eyes , gram - negative bacillus growth in 3 eyes , and gram - positive cocci growth in 2 eyes
were found . conclusions .
acquired dacryocystoceles were observed extremely rarely and a definite pathogenic agent could not be identified in any of the cases , either microbiologically or histologically , whereas chronic inflammation was detected in all cases in our study . |
6,533 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this disorder may cause by frequent and prolonged contact of the skin with the urine , stool and moisture , and exacerbated by candidiasis infection and abrasion .
signs and symptoms of this disorder may include erythema , flaking , papules and lesions in the areas such as buttocks , thighs , scrotum , and mons pubis .
this disorder commonly occurs in the age of 9 - 12 months old , and its prevalence have reported to be around 7 - 35 and even 50% . the prevalence of diaper dermatitis among the infants is reported to be 75% in the united states ( us ) , 87% in japan , 15% in italy , and 34.9% in iran .
the onset of this disorder commonly occurs within the first 3 to 12 weeks of life , but its peak is in the first 7 to 12 weeks .
the routine treatment options for diaper dermatitis includes changing the diaper and washing the genital area frequently , applying vaseline or zinc oxide , and corticosteroids .
furthermore , a topical antifungal agent ( such as miconazole , clotrimazole , and nystatin ) may be used if fungal infections occurred .
calendula is a plant with the yellow color , which is used to cure skin disorders and pain .
bentonite is basically a kind of mineral , which is in the form of aluminum phyllosilicates with al2o34sio2 h2o formula .
this material can absorb several folds of water as its own volume , and makes a jellified , plastic , and viscose form .
medical powder of bentonite is so fine , odorless , with the color of white to grey , or yellow or pink .
studies have shown that bentonite was effective on the treatment of chronic dermatitis of the hands .
likely , it may be effective on the treatment of skin disorders and diaper dermatitis , but no published studies are found in this regard . on the other hand , in local observations , the researchers observed that parents traditionally apply this mineral to decrease redness , severity , and extent of affected area by diaper dermatitis .
as regard to the observed positive effects , no side - effects and cost - effectiveness of bentonite , and... | background : diaper dermatitis is one of the most common skin disorders of infancy and childhood . the present study aimed to compare the effects of bentonite and calendula on the improvement of diaper dermatitis in infants.materials and methods : a double - blind randomized controlled trial , which was conducted on 60 out - patient infants referred to health care centers or pediatric clinics in khomein city and diagnosed with diaper dermatitis .
data were collected by checklist and observation , and analyzed using t - test , chi - square , and fisher 's exact test.results:mean ( standard error ) age of the total sample was 6.55 0.69 months . totally ,
93.3% of lesions in the bentonite group started its recovery in the first 6 h , while this rate was 40% in calendula group ( p < 0.001 ) . furthermore , 90% of infants in the bentonite group and 36.7% in the calendula group were improved completely in the first 3 days ( p < 0.001).conclusion : bentonite was effective on the improvement of diaper dermatitis , and also had faster effects compared with calendula . |
6,534 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
immunometabolism is an emerging field of investigation including immunology and biochemical pathways that govern metabolism
. accelerating interest in this area is being fuelled by increased lifespan and the relatively recent knowledge that aging affects the immune system and promotes inflammation that is associated with metabolic dysfunctions .
ageing is associated with an increase in visceral obesity in men and women , which has been claimed as the prominent cause of systemic metabolic perturbations and chronic inflammation . in particular , with ageing , vat expands and becomes hypovascularized and resident adipocytes quickly release proinflammatory cytokines as response to such stressful condition [ 35 ] . among the produced proinflammatory molecules , tumour necrosis factor ( tnf ) and interleukin 6 ( il-6 ) have been most intensively studied for their involvement in inducing systemic metabolic perturbations .
polyphenols are the most promising natural compounds to combat metabolic syndromes including age - related inflammatory states .
many polyphenols are efficient antioxidants and anti - inflammatory molecules by virtue of their ability to directly scavenge inflammation - derived radicals , to increase antioxidants expression , and to block inflammatory cytokines production by modulating the activity of specific transcription factors . in adipose tissue
, the polyphenol resveratrol ( rsv ) suppresses both systemic and adipose tissue inflammation and has the potential to improve age - associated metabolic disorders and to increase insulin sensitivity [ 7 , 8 ] .
moreover , rsv inhibits triglycerides accumulation by suppressing adipocytes differentiation and by stimulating lipid catabolism via the induction of the adipose triglyceride lipase ( atgl ) .
it has been firstly identified in white adipose tissue and represents the rate - limiting enzyme of triglycerides lipolysis . moreover ,
fatty acids ( fas ) liberated by atgl have been implicated in lipid signalling mediated by the family of... | ageing is characterized by the expansion and the decreased vascularization of visceral adipose tissue ( vat ) , disruption of metabolic activities , and decline of the function of the immune system , leading to chronic inflammatory states .
we previously demonstrated that , in vat of mice at early state of ageing , adipocytes mount a stress resistance response consisting in the upregulation of atgl , which is functional in restraining the production of inflammatory cytokines . here , we found that , in the late phase of ageing , such an adaptive response is impaired .
in particular , 24-months - old mice and aged 3t3-l1 adipocytes display affected expression of atgl and its downstream ppar-mediated lipid signalling pathway , leading to upregulation of tnf and il-6 production . we show that the natural polyphenol compound resveratrol ( rsv ) efficiently suppresses the expression of tnf and il-6 in an atgl / ppar dependent manner .
actually , adipocytes downregulating atgl do not show a restored ppar expression and display elevated cytokines production .
overall the results obtained highlight a crucial function of atgl in inhibiting age - related inflammation and reinforce the idea that rsv could represent a valid natural compound to limit the onset and/or the exacerbation of the age - related inflammatory states . |
6,535 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: remodeling after tooth extraction results in substantial horizontal ( 3 - 4 mm ) and vertical ( 1 - 2 mm ) alveolar bone loss [ 13 ] .
this postextraction alveolar bone loss can compromise or prevent subsequent implant placement , while loss of crestal support compromises the position and appearance of the soft tissues in aesthetic areas . in an effort to minimize postextraction alveolar bone remodeling and thus prevent its undesirable sequelae , alveolar ridge preservation ( arp , a form of guided bone regeneration , gbr ) was developed as a therapeutic modality .
several studies have been conducted to evaluate the effectiveness of different arp surgical techniques ( e.g. , flapped versus flapless and primary intention healing versus no primary closure ) and materials ( e.g. , occlusive membranes and bone grafts ) , and several approaches have proven successful to varying degrees [ 116 ] .
systematic reviews indicate that the combination of bone grafts with resorbable membranes achieved the best results [ 13 ] . however , a high incidence of membrane exposure ( potentially leading to infection ) , early membrane degradation with inadequate barrier function , postoperative discomfort with coronal flap movement , and loss of width and thickness of keratinized tissue in the alveolar ridge are among the reported complications [ 2 , 6 , 8 , 17 ] .
soft tissue management is important for maintaining an appropriate soft tissue profile for future tooth- or implant - supported restorations [ 1821 ] .
for example , in patients with thin biotype , a connective tissue graft may be recommended during or after arp . in this context , a resorbable barrier that preserves soft tissue attributes could be a valuable addition to arp protocols .
recently , a new xenogeneic collagen matrix ( xcm ) ( mucograft , geistlich pharma ag , wolhusen , switzerland ) of porcine origin has been introduced into clinical practice that is made of non - cross - linked collagen types i and iii .
the new xcm is designed with a bilayer structure... | alveolar ridge preservation ( arp ) has been shown to prevent postextraction bone loss .
the aim of this report is to highlight the clinical , radiographic , and histological outcomes following use of a bilayer xenogeneic collagen matrix ( xcm ) in combination with freeze - dried bone allograft ( fdba ) for arp .
nine patients were treated after extraction of 18 teeth . following minimal flap elevation and atraumatic extraction ,
sockets were filled with fdba .
the xcm was adapted to cover the defect and 2 - 3 mm of adjacent bone and flaps were repositioned .
healing was uneventful in all cases , the xcm remained in place , and any matrix exposure was devoid of further complications . exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2 - 3 months .
radiographic and clinical assessment indicated adequate volume of bone for implant placement , with all planned implants placed in acceptable positions . when fixed partial dentures were placed , restorations fulfilled aesthetic demands without requiring further augmentation procedures .
histological and immunohistochemical analysis from 9 sites ( 4 patients ) indicated normal mucosa with complete incorporation of the matrix and absence of inflammatory response .
the xcm + fdba combination resulted in minimal complications and desirable soft and hard tissue therapeutic outcomes , suggesting the feasibility of this approach for arp . |
6,536 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: renal cell carcinoma ( rcc ) is representative kidney cancer and has increased annually in the recent 2 decades .
although surgery remains the standard curative treatment for rcc , approximately 30% of patients with rcc develop metastatic disease after surgery , and approximately one third of patients with rcc have metastasis at the time of diagnosis .
several prognostic parameters have been evaluated and grade , histologic subtype , and stage remain important prognostic parameters in localized rcc . in addition , some preoperative parameters , including platelet count , c - reactive protein ( crp ) , and erythrocyte sedimentation rate have been considered for their prognostic relevance .
thrombocytosis ( tc ) , particularly secondary type has been regarded as a poor prognostic factor in many malignant diseases including gastric , gynecologic , and lung cancer .
recent studies have demonstrated an association of lower survival after operation with reactive tc for variable type of cancer , platelet count could have relation with the systemic inflammatory response , even though the exact relation between inflammation , platelet , and cancer outcomes is still not known .
the purpose of this study is to examine the association of preoperative tc with the prognosis of nonmetastatic rcc patients .
this study was approved by the ethics committee of yeungnam university school of medicine and informed consents were waived because the operations were done between 1997 and 2009 . in this
study the medical records of 187 patients who underwent radical nephrectomy for nonmetastatic rcc between july 1997 and june 2009 were reviewed retrospectively .
all patients were examined by routine hematologic laboratories and radiologic imaging including chest x - ray and abdominal computed tomography .
the definition of tc was platelet count400,000 l , and patients were divided into 2 groups by presence of preoperative tc .
tumor stage was reassigned using the 2002 tnm classification of the american joint committee on cancer ( ajcc... | purposethe aim of this study was to examine the association of preoperative thrombocytosis with the prognosis of patients with nonmetastatic renal cell carcinoma ( rcc).materials and methodswe conducted a retrospective analysis of 187 patients who underwent a radical nephrectomy for nonmetastatic rcc between july 1997 and june 2009 .
thrombocytosis was defined as a platelet count400,000 l , and patients were divided into 2 groups according to presence of preoperative thrombocytosis , and the cancer - specific survival rates and overall survival rates of the 2 groups after radical nephrectomy were compared.resultsthe mean age of the patients was 56.011.7 years and the mean follow - up period was 59.342.1 months ; there were 20 patients with preoperative thrombocytosis .
thirty patients developed metastases and 9 patients died during the follow - up period . in kaplan - meier analysis using a univariate log - rank test ,
both cancer - specific survival rate ( p=0.013 ) and overall survival rate ( p=0.012 ) showed significant association with preoperative thrombocytosis .
controlling for pathological tnm stage , fuhrman grade and tumor diameter , the cox proportional hazards model for cancer - specific survival rates showed that preoperative thrombocytosis was an independent prognostic factor ( p=0.025).conclusionspreoperative thrombocytosis was associated with poorer prognosis in patients with nonmetastatic rcc .
thus , preoperative platelet count may be clinically useful for risk stratification of patients undergoing surgery for nonmetastatic rcc . |
6,537 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recent technical developments have improved the versatility , applicability and quantitative nature of em , leading to a revival of ultrastructural analysis .
advances include 3d em , large scale 2d em and improved methods and reagents for correlated light microscopy and electron microscopy ( clem ) to compare other modes of microscopic analysis directly to the em level .
large - scale 2d em is particularly suitable to quantify or identify ( novel ) disease features for human pathology , study animal models for disease and tissue culture models . due to the typically small field of view
it is difficult to correlate changes at high magnification to a tissue wide scale , as well as to unbiasedly and quantitatively analyze ultrastructural features . for pathological analysis of human tissue or the assessment of pathology in animal models , haematoxylin and eosin ( h&e ) colored sections of formaldehyde fixed paraffin
embedded ( ffpe ) tissue is the standard . besides simple h&e staining immunolabeling is also performed to identify pathological abnormalities .
if such tissues could be analyzed at the em level , specific cell types , and subcellular changes could be identified .
the unbiased nature of large scale em allows finding unexpected and novel features of disease . by large - scale em areas up to
we and others previously applied nanotomy to rat pancreatic islets , cell culture , rat brain , skin and mucosa and whole zebrafish larvae ( www.nanotomy.org ) .
zebrafish are highly suitable for in vivo imaging , in particularly to visualize cell types which are difficult to access in mammalian tissues including brain immune cells . here
the nanotomy procedure is described in detail , applied to coronal sections of zebrafish heads undergoing conditional neuronal ablation by conversion of metronidazole by neuronal expressed nitroreductase ( www.nanotomy.org ) .
all raw data is presented as zoomable html files , visualizing molecular to tissue scale changes .
the presentation of the raw data allows unbiased... | large - scale 2d electron microscopy ( em ) , or nanotomy , is the tissue - wide application of nanoscale resolution electron microscopy .
others and we previously applied large scale em to human skin pancreatic islets , tissue culture and whole zebrafish larvae1 - 7 . here
we describe a universally applicable method for tissue - scale scanning em for unbiased detection of sub - cellular and molecular features .
nanotomy was applied to investigate the healthy and a neurodegenerative zebrafish brain .
our method is based on standardized em sample preparation protocols : fixation with glutaraldehyde and osmium , followed by epoxy - resin embedding , ultrathin sectioning and mounting of ultrathin - sections on one - hole grids , followed by post staining with uranyl and lead .
large - scale 2d em mosaic images are acquired using a scanning em connected to an external large area scan generator using scanning transmission em ( stem ) .
large scale em images are typically ~ 5 - 50 g pixels in size , and best viewed using zoomable html files , which can be opened in any web browser , similar to online geographical html maps .
this method can be applied to ( human ) tissue , cross sections of whole animals as well as tissue culture1 - 5 . here
, zebrafish brains were analyzed in a non - invasive neuronal ablation model .
we visualize within a single dataset tissue , cellular and subcellular changes which can be quantified in various cell types including neurons and microglia , the brain 's macrophages .
in addition , nanotomy facilitates the correlation of em with light microscopy ( clem)8 on the same tissue , as large surface areas previously imaged using fluorescent microscopy , can subsequently be subjected to large area em , resulting in the nano - anatomy ( nanotomy ) of tissues . in all
, nanotomy allows unbiased detection of features at em level in a tissue - wide quantifiable manner . |
6,538 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: healthy male and female volunteers , 1870 years of age , were recruited from the greater baton rouge , louisiana area .
eligible participants were free of chronic disease with fasting serum glucose levels of 125 mg / dl and a bmi between 25 and 35 kg / m .
the study was approved by the institutional review board at pennington biomedical research center ; all subjects provided written informed consent .
all foods were prepared and provided by the pennington metabolic kitchen core . for each diet period , participants were fed a standard american diet ( 34% fat , 15% protein , 51% carbohydrate ) for 3 days in order to control for diet prior to test days .
clinicians often recommend that patients consume a diet rich in carbohydrates prior to oral glucose tolerance testing ( 6 ) .
the energy level of the diet was individualized based on each participant s estimated resting metabolic rate .
lunch was provided as takeout . on day 4 , participants consumed all their meals for their assigned diet in clinic .
participants were asked to consume their meals within 20 min with breakfast centered at 8:00 a.m. lunch was provided 4 h following completion of breakfast and dinner 4 h following completion of lunch .
one daily menu , including breakfast , lunch , and dinner , was constructed for four isocaloric diets differing in gl by manipulation of gi based on white bread values and percent energy from carbohydrate .
dietary fiber was also held constant among diets with the addition of cellulose when needed .
the meals consisted of mixed foods ( casseroles ) that matched the diets gi and percent energy from carbohydrate as closely as possible .
table 1 provides a summary of the test diets ( high gi , high carbohydrate [ hgi - hc ] ; high gi , low carbohydrate [ hgi - lc ] ; low gi , high carbohydrate [ lgi - hc ] ; and low gi , low carbohydrate [ lgi - lc ] ) .
gi , gl , energy , macronutrient , and fiber content of each diet at the 2,200-kcal energy level on day 4 , after a 10-h fast , blood samples were drawn via... | objectivewe evaluated the effects of mixed meals differing in glycemic index ( gi ) and carbohydrate content on postprandial serum glucose and insulin response , hunger , and satiety over the course of a 12-h day.research design and methodsin this randomized crossover trial , 26 overweight or obese adults received four diets in random order ( high gi , high carbohydrate [ hgi - hc ] ; high gi , low carbohydrate [ hgi - lc ] ; low gi , high carbohydrate [ lgi - hc ] ; and low gi , low carbohydrate [ lgi - lc ] ) .
all meals were prepared by a metabolic kitchen .
participants received breakfast , lunch , and dinner over the course of a 12-h day .
primary outcomes were postprandial serum glucose and insulin quantified as area under the curve .
hunger , fullness , and satiety were assessed by visual analog scale.resultsthe hgi - lc , lgi - hc , and lgi - lc diets significantly reduced glucose and insulin area under the curve compared with the hgi - hc diet ( p < 0.001 for all comparisons ) . there were no significant differences in ratings of hunger , fullness , or satiety between the different dietary treatments.conclusionsreducing the gi or carbohydrate content of mixed meals reduces postprandial glycemia and insulinemia , and these changes can be sustained over the course of an entire day .
however , there were no differences in subjective hunger and satiety ratings between the diets .
these results demonstrate that maintaining a low gi or glycemic load diet is an effective method of controlling serum glucose and insulin levels . |
6,539 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: symptomatic cerebral air embolism ( cae ) is a rare complication associated with cerebral angiography with a reported incidence of 0.08%.2 ) clinical manifestations of symptomatic cae may include decreased level of consciousness , hemiparesis , seizures , and neuromonitoring changes while under anesthesia.6 ) early recognition , diagnosis , and treatment of cae can minimize irreversible neurological deficits and avoid potential mortality .
we report on a rare case of cae , which highlights that symptomatic cae should be considered in differential diagnoses when abnormal neuromonitoring signals are observed during cerebral angiography and prompt treatment can minimize neurological deficits .
a 69-year - old female presented for elective stent - assisted coiling of a 7 mm , unruptured right middle cerebral artery ( mca ) bifurcation aneurysm .
she was started on aspirin 325 mg and clopidogrel 75 mg daily seven days prior to undergoing the elective procedure .
neuromonitoring with electroencephalography ( eeg ) and somatosensory evoked potential ( ssep ) were set up with good quality baseline signals prior to starting the procedure . a 6-french neuron guide catheter ( penumbra inc . ,
alameda , ca , usa ) was advanced over a 5-french berenstein catheter for selection of the patient 's right common carotid artery . using a roadmap technique and over - the - wire technique ,
the diagnostic catheter was used for selection of the patient 's right internal carotid artery .
a microcatheter ( excelsior sl-10 , stryker neurovascular , fremont , ca , usa ) and a wire ( synchro-14 , stryker neurovascular ) were then used for selective catheterization of the mca and coiling of the mca aneurysm was started . during coiling of the aneurysm however , the neurophysiologist reported severe attenuation of sseps in the bilateral upper and lower extremities along with near flatlining of the eeg .
there was no change in anesthetics , blood pressure , or body temperature prior to the ssep and eeg change .
an intraoperative dynact... | symptomatic cerebral air embolism during cerebral angiography is extremely rare .
we report on the case of a 69-year - old woman undergoing elective stent - assisted coiling of an unruptured right middle cerebral artery ( mca ) bifurcation aneurysm , who was found to have severe attenuation of somatosensory evoked potential ( ssep ) and electroencephalography ( eeg ) during the procedure .
intra - operative dynact showed hypodense cortical vessels consistent with cerebral air embolism .
diagnostic and management strategies for this rare complication are reviewed . |
6,540 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: phosphorus ( p ) is the 11th most abundant element of the earth s crust ; while simultaneously the most immobile nutrients in the soils resulting in in its poorly availability for plants .
the major available form of p for plants in the soils is inorganic p ( pi ) . to overcome pi deficiency ,
a massive pi supply is chosen as an immediate remedy , a practice that is neither ecologically sustainable nor economically viable .
interestingly , crops take up only 1530% of the applied pi fertilizer within the year of its application , whereas rest of the applied fertilizer is lost in form of leaching and polluting the water bodies . thus improving the ability of crops to use the available pi
is necessary to reduce a plant dependency on pi - fertilizers while maintaining an optimum yield .
such an objective requires a better understanding on mechanisms regulating both the pi transport system in plants and the root growth capacity in response to fluctuating pi concentrations in soil . during the last few decades ,
our knowledge on the transport of pi and its accumulation in plants has been considerably advanced , mainly using arabidopsis as a reference model plant [ 3 , 4 ] . for an extensive review of the pi transporter gene family
the physiological and molecular aspects of root growth and development in response to pi deficiency has been also investigated in arabidopsis ecotype columbia ( col ) .
low pi conditions have been shown to affect the course of root development in plants , for instance on low pi media , a reduction in primary root length as well as increase in lateral root length have been reported [ 8 - 11 ] .
these morphological changes have been opined to increase the root surface , thus enabling plants for the better exploration of the top layer of soil to improve the acquisition of the poorly mobile pi .
number of key genes involved in the primary root growth inhibition upon pi deficiency has been identified in arabidopsis through classical genetic ( reverse and forward ) studies . based on detailed... | phosphorus ( p ) is an essential macronutrient for plant growth and development .
inorganic phosphate ( pi ) is the major form of p taken up from the soil by plant roots .
it is well established that under pi deficiency condition , plant roots undergo striking morphological changes ; mainly a reduction in primary root length while increase in lateral root length as well as root hair length and density .
this typical phenotypic change reflects complex interactions with other nutrients such as iron , and involves the activity of a large spectrum of plant hormones .
although , several key proteins involved in the regulation of root growth under pi - deficiency have been identified in arabidopsis , how plants adapt roots system architecture in response to pi availability remains an open question . in the current post - genomic era , state of the art technologies like high - throughput phenotyping and sequencing platforms,omics methods , together with the widespread use of system biology and genome - wide association studies
will help to elucidate the genetic architectures of root growth on different pi regimes .
it is clear that the large - scale characterization of molecular systems will improve our understanding of nutrient stress phenotype and biology .
herein , we summarize the recent advances and future directions towards a better understanding of arabidopsis root developmental programs functional under pi deficiency . such a progress is necessary to devise strategies to improve the pi use efficiency in plants that is an important issue for agriculture . |
6,541 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nebulizer solutions are widely used in the treatment of asthma and chronic obstructive pulmonary disease .
a number of bronchial and nasal nebulizer preparations contain benzalkonium chloride ( bac ) ( 1 ) .
quaternary ammonium compounds are used as antiseptics , disinfectants , detergents , and preservatives , and of these bac is the most frequently used .
we report a 23-yr - old woman presenting with anaphylactic shock following an intradermal skin test with a nebulizer solution containing bac . as far as we could ascetain from available literatures ,
this is the first reported case of anaphylaxis caused by benzalkonium in a nebulizer solution .
a 23-yr - old woman who had complained of exacerbation of cough and dyspnea after inhalation therapy with a nebulizer solution was referred to our outpatient clinic .
she had been diagnosed with asthma 3 yr previously and treated with a metered dose of a short - acting b2-agonist inhaler as needed .
she had no history of anaphylaxis , urticaria , or drug allergy . on admission ,
her white cell count was 7,400/l with 5% eosinophils and the serum total ige was 256 iu / ml by the eia method .
on spirometry , her forced vital capacity and forced expiratory volume in 1 sec were 3,520 ml ( 90% of the predicted value ) and 2,700 ml ( 86% of the predicted value ) , respectively .
she underwent skin prick tests with a panel of 10 common inhalant allergens and histamine ( allergopharma co. , hamburg , germany ) and serial dilution of nebulizer solution containing bac ( ventolin , glaxosmithklein , u.k . ) .
the skin prick test was positive only for house dust mites species ( dermatophagoides farinae and d. pteronyssinus ) .
subsequently , an intradermal skin test with a serial dilution of her nebulizer solution was performed .
a positive reaction was observed with 1:10 solution ( wheal : 45 mm in diameter , flare : 1820 mm ) .
her blood pressure was 70/30 mmhg , and her pulse was 120 - 140 per minute .
she was resuscitated with a subcutaneous injection of epinephrine ( 0.5 mg... | benzalkonium chloride ( bac ) is commonly used as a bactericidal preservative in nebulizer solutions , and can cause paradoxical onchoconstriction following nebulizing therapy in some asthmatics .
we describe a case of anaphylactic shock in a 23-yr - old asthmatic woman following an intradermal skin test with a salbutamol solution containing bac .
since she complained of cough and dyspnea after inhalation therapy with a nebulizer solution , we conducted an intradermal skin test using the same solution , which contained bac .
about 10 min later , the patient reported dizziness , palpitations , and dyspnea . on examination , tachycardia ,
tachypnea , and hypotension were found .
she was resuscitated with a subcutaneous injection of epinephrine and an infusion of saline .
one month later , we conducted a bronchial provocation test with bac , and she showed a positive response . |
6,542 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: moyamoya disease ( mmd ) is a specific cerebrovascular disease affecting the termini of the internal carotid arteries , typically bilaterally9 ) .
thus , a natural approach is to investigate the vessel wall cells of mmd patients in search of significant findings that are relevant to mmd pathophysiology and treatment .
we propose that this research interest must be driven in two directions , endothelial - lineage cells and smooth muscle - type ( mural ) cells , as both cells are indispensable to completely healthy vasculature . in reality , it is not easy to obtain these cells directly from patients , except for tiny specimens that are obtained during direct bypass surgery and tissues from autopsy cases . therefore , vascular progenitor cells seem to be a valuable cell type for disease research because they can be derived from patient peripheral blood .
endothelial progenitor cells ( epcs ) have been an important topic in research evaluating several vascular diseases , including heart disease and ischemic cerebrovascular disease ; however , the concept of smooth muscle progenitor cells ( spcs ) has only recently been introduced . in this review
, we present the up - to - date accomplishments with regard to vascular progenitor cell studies in moyamoya disease .
circulating epcs originate from the bone marrow , and they seem to take part in both postnatal vasculogenesis and vascular homeostasis7 ) .
epcs are usually characterized by the surface protein expression of cd31 [ an endothelial cell marker , also known as pecam-1 ( platelet endothelial cell adhesion molecule-1 ) ] , cd34 ( a hematopoietic or progenitor marker ) , and vascular endothelial growth factor receptor-2 [ vegfr-2 , also known as kdr [ kinase insert domain receptor ) ] .
several investigators consider the stem cell marker cd133 to be a more precise epc marker .
cd133/cd34/vegfr-2 cells are considered to represent a more primitive epc type with high proliferative potential . in identifying epcs , the usefulness of other markers such as cd45 (... | various approaches have been attempted in translational moyamoya disease research . one promising material for modeling and treating this disease is vascular progenitor cells , which can be acquired and expanded from patient peripheral blood .
these cells may provide a novel experimental model and enable us to obtain insights regarding moyamoya disease pathogenesis .
we briefly present the recent accomplishments in regard to the studies of vascular progenitor cells in moyamoya disease . |
6,543 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | dna adducts derived from complex mixtures of polycyclic aromatic compounds emitted from tobacco smoke are compared to industrial pollution sources ( e.g. , coke ovens and aluminum smelters ) , smoky coal burning , and urban air pollution .
exposures to coke oven emissions and smoky coal , both potent rodent skin tumor initiators and lung carcinogens in humans , result in high levels of dna adducts compared to tobacco smoke in the in vitro calf thymus dna model system , in cultured lymphocytes , and in the mouse skin assay .
using tobacco smoke as a model in human studies , we have compared relative dna adduct levels detected in blood lymphocytes , placental tissue , bronchoalveolar lung lavage cells , sperm , and autopsy tissues of smokers and nonsmokers .
adduct levels in dna isolated from smokers were highest in human heart and lung tissue with smaller but detectable differences in placental tissue and lung lavage cells .
comparison of the dna adduct levels resulting from human exposure to different complex mixtures shows that emissions from coke ovens , aluminum smelters , and smoky coal result in higher dna adduct levels than tobacco smoke exposure .
these studies suggest that humans exposed to complex combustion mixtures will have higher dna adduct levels in target cells ( e.g. , lung ) as compared to nontarget cells ( e.g. , lymphocytes ) and that the adduct levels will be dependent on the genotoxic and dna adduct - forming potency of the mixture .
imagesfigure 1.figure 1.figure 2.figure 3.figure 3.figure 3.figure 3.figure 3.figure 3.figure 4 . |
6,544 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hepatitis c virus ( hcv ) is a major cause of post transfusion hepatitis and liver transplantation in many countries .
it is estimated that approximately 3% of the world 's population is infected with hcv and 60% to 85% of the patients develop chronic infection that leads to cirrhosis , and hepatocellular carcinoma , and need liver transplantation ( 1 , 2 ) .
three groups of hcv testing are available : 1 ) serological assays to detect anti - hcv .
hcv tests are used to diagnose hcv and to guide therapy and/or monitor the treatment of hcv infection ( 1 , 3 - 5 ) . the most common type of hcv antibody testing is the enzyme immunoassay by methods of enzyme linked immunosorbent assay ( elisa ) , and chemiluminescence immunoassay ( cia ) .
elisa testing is a semi - quantitative assay that its results are reported as positive or negative based on comparison of absorbance reading of each sample with a cut - off value defined for the lot used expressed as a signal to cutoff ratio ( s / co ) , and shows the quantity of antibody in blood ( 6 ) . although hcv antibody assays are highly sensitive and specific in patients with chronic hcv infection , there are frequent false positive in anti - hcv results .
quantitative viral load tests are used to measure the amount of hcv - rna in one milliliter of blood .
pcr - based hcv rna methods are used as the gold standard to confirm the hcv positivity in anti - hcv assays and monitor the treatment ( 1 , 4 , 7 - 9 ) .
the current study aimed to evaluate the relationship between quantitative anti - hcv ( s / co ratio ) and quantitative hcv - rna levels , also to determine a specific s / co ratio with a routine commercial hcv - ab kit used in the laboratories to identify viremic from non - viremic anti - hcv positive patients .
in the current cross sectional study , from may 2012 to october 2013 , 378 patients suspected with hcv who referred to iranian blood transfusion organization ( ibto ) research center were included .
patients had no history of hepatitis b virus ( hbv ) and... | background : hepatitis c virus ( hcv ) infection is diagnosed by antibody and rna based methods .
patients with anti - hcv sample rate / cutoff rate ( s / co ) ratios > 1 are reported as anti - hcv positive .
rna based methods are introduced to confirm positivity in seropositive samples.objectives:the current study aimed to assess relationship between s / co rates and hcv - rna levels in the laboratory to identify hcv viremia in patients with a positive anti-hcv.patients and methods : all serum samples were assayed for anti - hcv by elisa method .
a total of 265 anti - hcv positive patients were tested for hcv - rna testing by quantitative method using artus hcv rg real - time polymerase chain reaction ( rt- pcr ) kit .
statistical analysis was done by spss version 16.results:of the 265 patients with hcv infection , 204 ( 77% ) were male and the mean age was 43.53 13.17 years , ranging 1 - 81 years .
no correlation was found between s / co ratios and hcv - rna levels
. there was significant difference in s / co ratio between viremic and non - viremic subjects .
the sensitivity , specificity , negative predictive value , and positive predictive value were 100% , 81.4% , 100% , and 77.2% , respectively in the s / co ratio of 2.7.conclusions:the present study indicated that anti - hcv s / co ratio is useful to predict non - viremic patients .
a cut - off value of 2.7 can determine the usefulness of hcv - rna testing .
patients with s / co < 2.7 are not viremic ; therefore , hcv - rna testing is not recommended .
it is suggested that laboratories report s / co ratio along with anti - hcv results to manage hcv infection better , especially in countries that quantitative hcv testing is expensive or not available . |
6,545 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: laminectomy without reconstruction has been the standard surgical treatment method for intradural and posterior epidural spinal lesions7 ) .
although this surgical technique provides an adequate operative field , it may lead to hematoma in the spinal canal , invasion of scar tissue after surgery , or postoperative instability and scoliosis45 ) . as microscopic surgical techniques have evolved ,
new surgical methods such as laminoplasty with the use of a t - saw for reconstruction36 ) or laminoplasty with a 90 or 60 change in the lamina with en bloc removal14 ) have been introduced .
some authors have reported that certain spinal cord tumors can be removed through hemilaminectomy and a minimally invasive technique that involves the use of a tubular retractor system , which enables maximum preservation of the posterior elements210 ) . here ,
we report a spinous process - splitting hemilaminoplasty technique that maintains the shape and integrity of the posterior elements and retains a barrier that prevents hematoma in the spinal canal and scar tissue damage .
between 2011 and 2014 , spinous process - splitting hemilaminoplasty was performed in nine patients .
physical examinations , mri with gadolinium , ct , and routine radiography with dynamic imaging of the intradural and posterior epidural lesions were performed prior to surgery .
unilateral paravertebral muscle dissection reveals the lamina and a part of the medial facet joint .
a hole is created in the spinous process , lamina , and medial articular facet with a match head burr ( 1.7 mm ) drill to achieve laminoplasty to replace the bone that was removed en bloc into the exact pre - surgery position .
the splitting of the spinous process can be performed by 1 ) cutting to a depth determined on the basis of measurements on computed tomography ( ct ) scans with an oscillating saw in the midline where the epidural space is wide or 2 ) splitting with the t - saw by partially removing the surrounding ligament flavum to facilitate use of the t - saw , revealing... | objectiveto describe a novel spinous process - splitting hemilaminoplasty technique for the surgical treatment of intradural and posterior epidural lesions that promotes physiological restoration.methodsthe spinous process was split , the area of the facet lamina junction was drilled , and en bloc hemilaminectomy was then performed . after removing intradural and posterior epidural lesions , we fitted the previously en bloc - removed bone to the pre - surgery same shape , and held it in place with non - absorbable sutures .
surgery was performed on 16 laminas from a total of nine patients between 2011 and 2014 .
bony union of the reconstructed lamina was assessed using computed tomography ( ct ) at 6 months after surgery.resultsspinous process - slitting hemilaminoplasty was performed for intradural extramedullary tumors in eight patients and for ossification of the ligament flavum in one patient . because we were able to visualize the margin of the ipsilateral and contralateral dura
, we were able to secure space for removal of the lesion and closure of the dura .
none of the cases showed spinal deformity or other complications .
bone fusion and maintenance of the spinal canal were found to be perfect on ct scans.conclusionthe spinous process - splitting hemilaminoplasty technique presented here was successful in creating sufficient space to remove intradural and posterior epidural lesions and to close the dura .
furthermore , we were able to maintain the physiological barrier and integrity after surgery because the posterior musculature and bone structures were restored . |
6,546 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: erythropoietin ( epo ) is a 34 kda glycoprotein hormone that controls the proliferation , differentiation , and survival of erythroid progenitor cells through an antiapoptotic mechanism .
it has become apparent that epo protects many organs , including brain , heart , kidney and liver , against the injury caused by ischaemia / reperfusion , hemorrhagic shock and systemic inflammation . in this issue of critical care , kao and colleagues
they found that recombinant human epo ( 400 iu / kg ) exerts significant beneficial effects when it is given as late as 18 hours after caecal ligation and puncture ( clp ) .
although epo had no effect on the ( small ) decline in blood pressure , the decline in platelet and white blood cell counts , or the rise in lactate , it significantly increased tissue perfusion and reduced tissue hypoxia . within 18 hours after clp there was a decline in the number of perfused capillary beds ( reduced oxygen delivery ) ; this , in turn , resulted in an impairment in mitochondrial electron transport and hence respiration ( measured as increase in mitochondrial nadh fluorescence ) in skeletal musle ( extensor digitorum longus ) .
most notably , epo rapidly ( within 10 min ) reversed both of these effects of clp , and hence it increased the number of patent capillaries and increased mitochondrial function .
unfortunately , the authors did not measure any parameters of organ injury and dysfunction , and the model of clp used did not ( within 24 hours ) result in any deaths .
thus , it remains to be seen whether the improvement in oxygen delivery or mitochondrial function afforded by epo also results in a significant improvement in outcome .
the study by kao and coworkers is of particular importance because epo protects the brain , heart , kidney and liver against the tissue injury and dysfunction caused by ischaemia / reperfusion ( for review ) .
the pathophysiology of the shock associated with trauma / haemorrhage also comprises elements of ischaemia / reperfusion injury ( because of... | erythropoietin protects many organs against the tissue injury and dysfunction caused by ischaemia / reperfusion and excessive inflammation .
this editorial comment discusses the effects of erythropoietin in preclinical models of septic shock , endotoxemia , hemorrhagic shock , spinal cord trauma and zymosan - induced multiple organ failure . |
6,547 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a fundamental event
in the folding and oligomerization of membrane
proteins is the association of the transmembrane ( tm ) helices .
helix
association is required to achieve the final fold and oligomeric state
of the protein . a favorite system for investigating the rules that
govern tm helix association are the single - span membrane proteins , primarily because a variety of methods are available for measuring
their oligomerization ( including fret , sedimentation equilibrium analytical
ultracentrifugation , in vivo assays in biological
membranes , sds - page , and steric trapping ) .
conversely , assessing the folding energetics of multispan membrane
proteins still represents a tremendous challenge .
in addition to being a tractable system , the single - span membrane
proteins attract interest because of their biological importance .
these proteins comprise the most numerous class of membrane proteins ,
constituting about half of the total . rather than acting as
mere membrane anchors for soluble domains ,
as it was once assumed ,
the oligomerization of single tm domains actively plays roles in assembly ,
signal transduction , ion conduction and regulation in a wide variety
of biological processes . to investigate
the basis of oligomerization in tm helices , our
group and others have pursued a strategy based on the analysis of
frequently occurring association motifs .
one of the most important motifs is gasright ( figure 1 ) , which is
best known as the fold of a widely studied model system for tm association ,
the glycophorin a tm dimer .
gasright gets its name from its right - handed crossing angle ( figure 1b ) , and from the characteristic small amino acids
at its interface ( gas : gly , ala , ser ) , which are arranged to form gxxxg and gxxxg - like patterns ( gxxxa ,
axxxg , etc . ) . in many ways
gasright parallels the important coiled coil , a frequently occurring interaction
motif and model for folding and association for soluble proteins . like the... | interactions
between -helices within the hydrophobic environment
of lipid bilayers are integral to the folding and function of transmembrane
proteins ; however , the major forces that mediate these interactions
remain debated , and our ability to predict these interactions is still
largely untested .
we recently demonstrated that the frequent transmembrane
association motif gasright , the gxxxg - containing fold of
the glycophorin a dimer , is optimal for the formation of extended
networks of ch hydrogen bonds , supporting the hypothesis
that these bonds are major contributors to association .
we also found
that optimization of ch hydrogen bonding and interhelical
packing is sufficient to computationally predict the structure of
known gasright dimers at near atomic level . here ,
we demonstrate
that this computational method can be used to characterize the structure
of a protein not previously known to dimerize , by predicting and validating
the transmembrane dimer of adck3 , a mitochondrial kinase .
adck3 is
involved in the biosynthesis of the redox active lipid , ubiquinone ,
and human adck3 mutations cause a cerebellar ataxia associated with
ubiquinone deficiency , but the biochemical functions of adck3 remain
largely undefined .
our experimental analyses show that the transmembrane
helix of adck3 oligomerizes , with an interface based on an extended
gly - zipper motif , as predicted by our models .
the data provide strong
evidence for the hypothesis that optimization of ch
hydrogen bonding is an important factor in the association of transmembrane
helices .
this work also provides a structural foundation for investigating
the role of transmembrane association in regulating the biological
activity of adck3 . |
6,548 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | a general ,
asymmetric synthesis of amino acid derivatives is reported .
masked
acyl cyanide ( mac ) reagents are shown to be effective umpolung synthons
for enantioselective additions to n - boc - aldimines .
the reactions are catalyzed by a modified cinchona alkaloid , which
can function as a bifunctional , hydrogen bonding catalyst , and afford
adducts in excellent yields ( 9098% ) and high enantioselectivities
( up to 97.5:2.5 er ) . unmasking the addition products
gives acyl cyanide
intermediates that are intercepted by a variety of nucleophiles to
afford -amino acid derivatives .
notably , the methodology provides
an alternative method for peptide bond formation . |
6,549 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: testicular cancer is a rare disease ; it occurs most commonly in young men in their third to fifth decade of life and accounts for about 13% of all cancers in men in western countries and about 17% of cancers in men below 45 , .
germany is one of the countries with the highest incidence rates of testicular cancer , with an estimated age - standardized incidence rate ( europe standard ) of 11.1/10 in 2004 .
the risk factors associated with testicular cancer are not very well known apart from the association with cryptorchidism ( undescended testis ) documented in multiple studies , , , , , , familial association and exposure to high level of estrogen in utero .
some occupational exposures were suggested to be associated with a higher risk for testicular cancer .
rural residence during adulthood was associated with an increased risk of testicular cancer in italy ( odds ratio ( or ) = 3.31 ; 95% confidence interval ( ci ) 1.368.01 ) ; use of pesticides in gardening was similarly associated with an elevated or of 1.83 ( 95% ci 1.023.29 ) .
further relevant occupations seem to include fire fighters and carpenters . in professional fire fighters in florida
the standardized incidence ratio ( sir ) was 1.60 ( 95% ci 1.202.09 ) , and similar results were obtained in new zealand and in germany .
studies concerning carpenters also showed an increased risk for testicular cancer ; in new jersey the sir of testicular cancer for carpenters between 19792000 was 1.29 ( 95% ci 0.782.01 ) . the incidence rate was increased after a 15-years lag from initial work date ( sir=2.40 ; 95% ci 1.294.32 ) , with similar results documented in germany .
results for selected other occupations have shown inconsistency associated with an increased risk of testicular cancer . a study on
vietnam war veterans showed a twofold elevated risk for testicular cancer with an or of 2.5 ( 95% ci 1.15.7 ) .
no clear associations were seen for metal workers , but paper and pulp maintenance workers ( and not process workers ) in sweden had higher risk... | objectives : testicular cancer affects mainly men below the age of 50 .
an association with occupation and social status has been suggested but risk factors are not well understood .
a registry - based case - control study focusing on occupation was performed in germany.methods : all 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005 ; as well as 564 suitable controls ( from a pool of other cancers ) were drawn from the cancer registry of rhineland - palatinate .
unconditional logistic regression was used to compute odds ratios ( or ) and associated 95% confidence intervals ( ci).results : slightly elevated or were observed for technicians and related professionals ( or 1.62 , 95% ci 1.002.63 ) and for clerical support workers ( or 1.71 , 95% ci 1.142.56 ) .
this increase was highest in the age group 2050 for technicians ( or 2.02 , 95% ci 1.233.33 ) and clerks ( or 2.00 , 95% ci 1.303.09 ) , respectively .
an association with testicular cancer was observed for no other occupation.conclusion : an increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers .
this could be related to socioeconomic status or sedentary life style , two factors that were identified in previous studies .
while the feasibility of a purely registry - based study was shown , missing occupational data and the choice of cancer controls represent challenges to the validity of this approach . |
6,550 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: amyotrophic lateral sclerosis ( als ) is a progressive and fatal neurodegenerative disease affecting motor neurons in the anterior horn of the spinal cord , the brainstem and the motor cortex with a pattern of progression not shared by other fatal diseases ( mitchell and borasio , 2007 ) .
it is clinically characterized by progressive increasing weakness leading to death by respiratory insufficiency usually within three years ( haverkamp et al . , 1995 ) .
als typically manifests itself as a muscle wasting or weakness in a limb or bulbar regions ( talbot , 2002 ) .
it then progresses to pervasive muscle weakness with a combination of upper and lower motor neuron dysfunction .
patients become relentlessly immobile , develop an impaired speech , often leading to social isolation . in the late stages of the disease
, progressing paralysis can result in a locked - in state in which only residual muscular movement is possible ( borasio et al . , 2001 ) , but the intellect and the personality usually remain unimpaired . the incidence of als is reported to be between 1.5 and 2.7 per 100,000 population / year ( average 1.89 per 100,000/year ) in europe and north america , with a uniform incidence across these countries ( worms , 2001 ) .
the mean age of onset for als is between 55 to 65 years , with a 5% of cases that had an onset before the age of 30 years ( haverkamp et al .
although most cases of als are sporadic , about 5% of cases have a family history of als ( mulder et al . , 1986 ) .
so far it is not possible to stop the progression of the disease therefore the primary goal in caring for patients with als is often considered to be the enhancement of their quality of life ( simmons , 2005 ) .
quality of life is generally defined in its biopsychosocial issues , which means an integration of physical and biological aspects ( i.e. , symptoms of illness or wellness ) , psychological aspects ( i.e. , emotions and thoughts ) , and social aspects ( i.e. , family relationships , social support ) ( engel , 1977 )... | amyotrophic lateral sclerosis is a fatal and progressive disease , characterized by progressive muscles weakness , with consequent loss of physical capacities .
psychologists can play an important role in als care , by providing clinical activities in every step of the disease , including support and counseling activities directed to patients , their caregivers and to physicians . |
6,551 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: abdominal muscle strengthening exercises are frequently used for the promotion of health
and prevention of musculoskeletal disease , as well as for rehabilitation of lower back
pain1 , 2 .
strengthening the abdominal muscles helps to stabilize the trunk
and lessen the stress on the lumbar spine3 .
the curl - up exercise has been shown to produce reasonable levels of
activity in the rectus abdominis ( ra ) muscle while minimizing the resultant load on the
spine4 .
however , the curl - up exercise may activate the superficial cervical flexors , such as the
sternocleidomastoid ( scm ) , because the head and shoulders are raised off the floor during
the neck flexion .
superficial cervical flexors are the dominant muscle group during neck
flexion movement5 . a neck flexion position
that causes neck pain could be a contributing factor to increased back pain , because the
vertebral regions are connected to each other6 .
according to lee et al.7 the activity of the scm muscle increases as the neck flexion angle
increases .
muscle activity of the superficial neck flexor is significantly increased in
cervical pain during the neck stabilizing task ; increased activity of the scm could be
compensatory for poor segmental stability of the deep muscles .
therefore , an intervention to
decrease scm activity with neck flexion restriction during the curl - up exercise is
required .
research has focused primarily on increased abdominal activity during curl - up exercises
using an unstable surface8 and different
positions of the upper and lower limbs9 to
identify the most effective position to increase abdominal strength . the question of whether
neck flexion restriction can alter the muscle activity of the ra , external oblique ( eo ) , and
scm muscles during a curl - up has not been investigated .
thus , the purpose of this study was
to assess the effect of neck flexion restriction on scm and abdominal muscle activity during
the traditional curl - up exercise and the curl - up... | [ purpose ] the purpose of this study was to investigate the effect of neck flexion
restriction on sternocleidomastoid ( scm ) , rectus abdominis ( ra ) , and external oblique ( eo )
muscle activity during a traditional curl - up exercise and a curl - up with neck flexion
restriction .
[ subjects ] in total , 13 healthy male subjects volunteered for this study .
[ methods ] all subjects performed a traditional curl - up exercise and a curl - up exercise in
which neck flexion was restricted by the subject s hand
. surface electromyography ( emg )
signals were recorded from the scm , ra , and eo during the curl - up .
[ results ] there was
significantly lower emg activity of the scm during the curl - up exercise with neck flexion
restriction compared to the traditional curl - up exercise .
conversely , the activity of the
ra and eo muscles was significantly higher in the curl - up exercise with neck flexion
restriction than in the traditional curl - up exercise .
[ conclusion ] neck flexion
restriction is recommended to prevent excessive activation of superficial cervical flexors
during the curl - up exercise . |
6,552 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: lung cancer has been the leading cause of cancer - related deaths in korea , and its incidence continues to rise . despite therapeutic advances , the overall 5-year survival remains only 15% .
lung cancer is a multicellular and multistage process that involves a number of genetic changes in oncogenes and tumor suppressor genes .
nevertheless , the prognosis of lung cancer has remained poor despite innovations in diagnostic testing and surgical technique and the development of new chemotherapeutic agents .
recently introduced targeted agents show different responses according to histological subtype , and the efficiency of treatment modalities for lung cancer depends on the time of diagnosis .
therefore , there is a great need for rapid and efficient early detection methods . for developing improved molecular biomarkers for the early detection and prediction of response to chemotherapy
, it is important to identify genetic alterations specific to each subtype of lung cancer .
single - nucleotide polymorphisms ( snps ) represent an important class of genetic variations and affect an individual 's susceptibility to disease in certain circumstances [ 4 - 6 ] .
activation of the intracellular survival signal transduction protein akt , known as protein kinase b , has been proposed as a central signaling event in carcinogenesis and has been shown in experimental models to confer resistance to chemotherapy and radiation [ 7 , 8 ] .
akt is activated by phosphatidylinositol 3 phosphates , the products of phosphoinositide 3-kinase ( pi3k ) activity .
additionally , akt activity is commonly dysregulated in a variety of human tumors because of frequent inactivation of the pten tumor suppressor gene , which negatively regulates phosphatidylinositol 3 phosphate levels , and alterations of this gene have been identified in various cancers , including lung cancer [ 10 , 11 ] . to date , 3 human isoforms of akt have been identified , akt1 , akt2 , and akt3 , which are expressed in lung , breast , colon , and prostate tumor... | akt is a signal transduction protein that plays a central role in the tumorigenesis .
there are 3 mammalian isoforms of this serine / threonine protein kinase - akt1 , akt2 , and akt3-showing a broad tissue distribution .
we first discovered 2 novel polymorphisms ( akt2 -9826 c / g and akt3 -811 a / g ) , and we confirmed 6 known polymorphisms ( akt2 -9473 c / t , akt2 -9151 c / t , akt2 -9025 c / t , akt2 -8618g / a , akt3 -675 a/- , and akt3 -244 c / t ) of the akt2 and akt3 promoter region in 24 blood samples of korean lung cancer patients using direct sequencing . to evaluate the role of akt2 and akt3 polymorphisms in the risk of korean lung cancer , genotypes of the akt2 and akt3 polymorphisms ( akt2 -9826 c / g , akt2 -9473 c / t , akt2 -9151 c / t , akt2 -9025 c / t , akt2 -8618g / a , and akt3 -675 a/- ) were determined in 360 lung cancer patients and 360 normal controls .
statistical analyses revealed that the genotypes and haplotypes in the akt2 and akt3 promoter regions were not significantly associated with the risk of lung cancer in the korean population .
these results suggest that polymorphisms of the akt2 and akt3 promoter regions do not contribute to the genetic susceptibility to lung cancer in the korean population . |
6,553 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: electrocardiogram ( ecg ) is an important diagnostic tool for the prompt recognition of myocardial infarction ( mi ) .
identification of st elevation mi by ecg in the critically ill patient population is limited by the lack of specificity due to a variety of non - ischemic processes .
this is a case report of a 77-year - old male patient who presented with generalized weakness , confusion , somnolence , recurrent falls and tea - colored urine for 3 - 4 days .
his past medical history was significant for hypertension , chronic obstructive pulmonary disease and coronary artery disease with a remote history of mi .
his vitals showed blood pressure 97/42 , heart rate of 51 , respiratory rate of 12 and oxygen saturation of 93% on room air .
there were extensive ecchymoses in different stages of healing on all 4 extremities and on the torso .
baseline electrocardiogram during admission to the hospital the patient was rehydrated with intravenous normal saline and nephrotoxic medications were withheld .
his renal function improved and on the 2 day , his chest x - ray revealed patchy bilateral infiltrates . on the 3 day , he developed respiratory distress with an increase in oxygen requirements .
the chest computed tomography revealed bilateral ground glass opacities with consolidation consistent with acute lung injury / acute respiratory distress syndrome . after failing a trial of
non - invasive positive pressure ventilation , he was intubated and mechanically ventilated for hypoxic respiratory failure .
he developed intermittent supraventricular tachycardia , atrial flutter and atrial fibrillation were treated with intravenous esmolol and diltiazem after which he converted to sinus rhythm . on the 4 hospital day , he developed increasing oxygen requirements and asynchronous volume control ventilation ; his ventilator settings were switched to pressure control ventilation .
an echocardiogram revealed left ventricular ejection fraction of 45 - 50% with grade ii diastolic dysfunction and no wall motion abnormalities... | a 77-year - old male patient presented with rhabdomyolysis .
he developed progressive respiratory failure and acute respiratory distress syndrome during his hospital stay requiring mechanical ventilation .
an electrocardiogram during mechanical ventilation showed findings suggestive of st elevation myocardial infarction .
closer review showed dome and spike findings that have been likened to a spiked helmet .
this finding has been associated with significant mortality .
we discuss this under - recognized finding and the potential contributing mechanisms . |
6,554 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in about 45 bc , hippocrates used the words mania and melancholia to describe mental disorders .
mood disorders , especially depression , are among the most common mental disorders of adults , in which the individuals involvement during their lifetime is estimated to be 10 - 25% .
numerous factors including biological , psychological , and social elements influence the incidence of depression .
constant pain and suffering and hopelessness , not enjoying the most joyful events , and loss of interest in visiting family members and friends or to go to work or to have other leisure time activities are among the signs of depression .
its other signs include existence of negative thoughts including feeling of not being worthy , sinfulness , hopelessness , and even suicidal thoughts .
depression can be a disabling disorder , and most of the types of depression can be successfully treated by timely diagnosis and medication or psycho therapy , so that their recurrence onset can be prevented .
mentally retarded children , whose presence is a disturbing factor for family 's normal condition , act as a very important and effective stressor , which can threaten familial mental health .
studies show that existence of a mentally retarded child in a family can result in special problems and concerns for other family members .
in researches investigating and comparing the level of depression in mothers of mentally retarded children with that of mothers with healthy children , a notable percentage of depression was reported among mothers of the former group .
the families who take care of their mentally retarded children at home are surrounded by various problems to different extent .
detection of their problems and their related factors can be used by supportive organizations for providing support and guidance of these families . since the health of mothers is considered the main core of the family in all societies , and due to the importance of health of mothers with mentally retarded children in making use of existing... | background : nowadays , depression is one of the most prevalent mental diseases to which some individuals like mothers of mentally retarded children are more vulnerable due to their ( children s ) special condition .
therefore , the present study aimed to investigate the level of depression and its related factors in these mothers.materials and methods : this cross - sectional study was conducted on 120 qualified mothers with mentally retarded children who were from exceptional children girls schools in isfahan .
the subjects filled personal characteristics and beck depression inventory assessment , and their level of depression and its association with some baseline factors were analyzed through descriptive statistics in spss.results:results showed that 75% of the mothers experienced various levels of depression , of whom 25.8% suffered from minor depression , 24.2% from moderate depression , and 25% suffered from major depression .
the results obtained showed that there was a significant direct association between the intensity of depression and students age , mothers age , fathers age , the number of children , and the length of parents marriage and a reverse association between the intensity of depression and subjects , fathers , and mothers education ( p = 0.004 ) . no association was observed between mothers occupation and the intensity of depression .
meanwhile , there was a negative significant association between fathers occupation and mothers depression ( p = 0.02 ) .
about 33.3% of the mothers did not believe that their spouses and families psychological and mental support was adequate.conclusions:the present study showed that mothers of mentally retarded children are predisposed to depression . with regard to the important role of mothers in the family and , consequently , the risk of impaired health of the family members , especially these children 's health , prevention and diagnosis of depression and treatment of these mothers seem to be essential .
adequate support to these... |
6,555 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: tsetse flies are vectors of african trypanosomes , the causative agents of sleeping sickness in humans and nagana in animals . following a long period of increasing prevalence
however , this debilitating disease still affects a wide range of people in sub - saharan africa and is invariably fatal if untreated .
nagana is estimated to cost african agriculture us $ 4.5 billion per year . until now ,
therefore , the search for novel strategies must continue and among them are alternative vector - based strategies .
these strategies require a clear and full understanding of the various steps and mechanisms involved in the transmission of the parasite . to be transmitted , trypanosomes must undergo cycles of development of varying complexity within the tsetse fly , transforming from bloodstream forms to procyclic nonmammalian infective forms in the fly midgut ( establishment ) . to complete their life cycle , trypanosoma brucei brucei and
the causative agents of human african trypanosomiasis , trypanosoma brucei rhodesiense , and trypanosoma brucei gambiense must migrate from the midgut to the salivary glands where they transform into infective metacyclic forms .
the fly 's ability to acquire the parasite , favor its maturation , and transmit it to a mammalian host is known as vector competence , which depends on complex interactions between glossina , the parasite , and the environment .
the factors involved in establishment are largely unknown and those involved in maturation are unclear .
nevertheless , among factors involved in vector competence appear to be the sex of the fly [ 6 , 7 ] , the trypanosome genotype , the tsetse intestinal lectin [ 9 , 10 ] , and the tsetse immune responses .
more recently , antioxidants have been shown to greatly increase midgut trypanosome infection rates in tsetse , suggesting that oxidative stress plays a role in the refractoriness of tsetse to trypanosome infection . moreover
, a no signal has been suggested to be required to promote the trypanosome migration to the... | trypanosoma secretome was shown to be involved in parasite virulence and is suspected of interfering in parasite life - cycle steps such as establishment in the glossina midgut , metacyclogenesis .
therefore , we attempted to identify the proteins secreted by procyclic strains of t. brucei gambiense and t. brucei brucei , responsible for human and animal trypanosomiasis , respectively .
using mass spectrometry ,
427 and 483 nonredundant proteins were characterized in t. brucei brucei and t. brucei gambiense secretomes , respectively ; 35% and 42% of the corresponding secretome proteins were specifically secreted by t. brucei brucei and t. brucei gambiense , respectively , while 279 proteins were common to both subspecies .
the proteins were assigned to 12 functional classes .
special attention was paid to the most abundant proteases ( 14 families ) because of their potential implication in the infection process and nutrient supply .
the presence of proteins usually secreted via an exosome pathway suggests that this type of process is involved in trypanosome esp secretion .
the overall results provide leads for further research to develop novel tools for blocking trypanosome transmission . |
6,556 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in the previous issue of critical care , van herpe and colleagues describe a new method of blood glucose reporting for hospitalized patients , the glycemic penalty index ( gpi ) . a stepped scale weights the clinical significance of differences of blood glucose ( bg ) from target .
the gpi scale is appropriately accordioned on the hypoglycemic range and expanded on the hyperglycemic range .
the authors recommend that use of the index should be combined with counting of episodes of severe hypoglycemia .
the index , capturing both overall hyperglycemia and hypoglycemia , could permit analysis of the ability of an algorithm to control between - patient glycemic variability . in the evaluation of glycemic control , the measures that are simplest to ascertain are the average and standard deviation , using the bg as the unit of observation .
in the leuven , belgium surgical intensive care unit , the standard deviations in intensively and conventionally treated groups was 19 and 33 mg / dl , respectively .
it could have been asked whether the greater bg variability in the conventionally treated group reflected the contribution of a hyperglycemic subgroup . until a second report was issued referring to control at the patient level , within the conventionally treated group even the relationship between hyperglycemia and mortality rate was unclear . in order to evaluate patient outcomes , there is no substitute for reporting on the patient as the unit of observation .
a key question is whether patient outcomes relate to overall hyperglycemia during a critical timeframe or to specific episodes of severe hyperglycemia .
the answer , predicated upon the mechanism of harm , could depend upon what outcome is being studied .
single episodes of severe hyperglycemia , such as the in - hospital development of diabetic ketoacidosis or hyperglycemia - associated dehydration , may result in specific consequences , such as dialysis fistula thrombosis , readmission to a critical care unit , or treatment - related pulmonary edema... | the article by van herpe and colleagues in the previous issue of critical care describes the glycemic penalty index ( gpi ) , which weights both hyperglycemic and hypoglycemic blood glucose measurements commensurate to their clinically significant difference from target .
although certain adverse consequences result from isolated severe hyperglycemic episodes , several specific outcomes depend upon overall hyperglycemia .
in contrast , although mortality has been related epidemiologically to overall low blood glucose , specific negative outcomes may depend upon isolated episodes . capturing both hypoglycemia and hyperglycemia in a single index
will be shown to be useful if the gpi enables us to better define insulin strategies , outcomes , and targets . |
6,557 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: metformin ( n , n-dimethylbiguanide ) is a widely used drug for the treatment of type 2 diabetes mellitus , condition associated with insulin sensitivity and obesity .
additionally , it has been shown that metformin may inhibit growth of tumor cells and thus potentially may find application in therapy of various types of cancer [ 16 ] .
metformin was also classified for conceptual group of drugs , known as calorie restriction mimetics ( crm ) .
have shown that calorie restriction model involving metformin supplementation is a very effective way of increasing the lifespan by reducing morbidity and mortality both of healthy mice and of mice with tumor .
the progressive aging of the human population together with increasing obesity are the main reasons of metabolic diseases .
the world health organization ( who ) reported that over 500 million people suffer from overweight and/or obesity ( data from 2013 ) . this serious medical condition becomes a great challenge for modern pharmacotherapy .
metformin is considered a part of the solution to this problem due to its multidirectional action on adipose tissue metabolism [ 9 , 10 ] .
metformin has an ability to decrease adiposity and obesity related conditions what was proved either in human or animal model [ 1114 ] .
additionally , according to a randomized study performed by srinivasan et al . and yanovski et al .
children and adolescents may be much more responsive to metformin - induced weight reduction as compared to adults .
these results might suggest that the metformin has an effect not only on morphology and distribution of fat tissue but also on proliferation potential of adipocytes precursors .
progenitor cells in the uncultured stroma - vascular fraction ( svf ) derived from adipose tissue usually amount to up to 3% of the whole cells .
this unique population is defined as adipose - derived multipotent stromal cells , ascs [ 15 , 16 ] .
although ascs are of mesoderm origin , these stem cells possess a unique ability to differentiate into ectoderm and... | metformin is applied not only as antidiabetic drug , but also in the treatment of obesity or as antiaging drug .
the first part of the research discussed the effect of metformin at concentrations of 1 mm , 5 mm , and 10 mm on the morphology , ultrastructure , and proliferation potential of mice adipose - derived multipotent mesenchymal stromal cells ( ascs ) in vitro . additionally , we determined the influence of metformin on mice adipose tissue metabolism .
this study has shown for the first time that metformin inhibits the proliferative potential of ascs in vitro in a dose- and time - dependent manner .
in addition , we have found a significant correlation between the activity of ascs and osteopontin at the mrna and protein level .
furthermore , we have demonstrated that 5 mm and 10 mm metformin have cytotoxic effect on ascs , causing severe morphological , ultrastructural , and apoptotic changes .
the reduced level of opn in the adipose tissue of metformin - treated animals strongly correlated with the lower expression of ki67 and cd105 and increased caspase-3 .
the metformin influenced also circulating levels of opn , which is what was found with systemic and local action of metformin .
the results are a valuable source of information regarding the in vitro effect of metformin on adipose - derived stem cells . |
6,558 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: tbe ( 2,2,2- tribomoethanol 97% , c2h3br3o , mw 282.8 ) , tert - amyl alcohol ( 99% ) and methyl orange were purchased from sigma aldrich , ( st .
hp--cd ( kleptose hpb , mw 1440 ) was obtained from a gift from roquette lestrem , france .
combititrant 5 and methanol ( 99.8% ) were purchased from merck ( auckland , new zealand ) .
atropine was obtained as phoenix atropine injection from provet nz ltd ( christchurch , new zealand ) .
hematoxylin and eosin dyes for histological examination were obtained from surgipath medical ( illinois , usa ) .
tbe is reported to have a solubility of 1 in 40 parts water at 40c , soluble in alcohol , ether , bezene and chloroform and very soluble in tert - amyl alcohol and is supplied as a white crystalline powder .
a 1.25% w / v tbe anesthetic solution was produced following the method recommended by the animal welfare office , university of otago , by dissolving 0.5 g tbe in 0.25 g tert - amyl alcohol then diluting to 40 ml with 0.9% nacl .
dilution of the tert - amyl alcohol solution produced a precipitate , which redissolved with stirring for 30 - 60 min on a magnetic stirrer .
the final solution was filtered ( 0.2 m ) into an amber glass bottle , protected from light by covering the vial with foil and stored at 4c .
the water content of hp--cd samples ( 0.05 g , n = 5 ) was determined by karl fischer titration ( 736 gp titrino , metrohm , usa ) .
the mixture was calibrated with 10 l of distilled water until a consistent value was obtained .
the water content of the hp--cd solid was calculated to be 8.4% w / w .
tbe has no appreciable ultra violet absorbance and so direct measurement of the binding constant for tbe and hp--cd could not be performed .
an approximate phase solubility diagram was constructed by addition of small aliquots ( 5 - 30 mg ) of tbe to hp--cd solutions ( 0 - 0.035 m ) until no further tbe would dissolve .
solutions were protected from light to reduce the risk of chemical degradation during the observation period and stored at 20c .
temperature was... | objective : efficacy and safety concerns have been raised in the literature with the use of tribromoethanol ( tbe ) ( avertin ) for anesthesia in rats and mice when administered by intraperitoneal ( ip ) injection . despite the controversy , it remains in common usage as an anesthetic agent in laboratory rodents for short - term surgical procedures .
cyclodextrins have been shown to improve drug solubility and were investigated here as an improved anesthetic formulation for mice.materials and methods : the phase solubility of tbe with hydroxypropyl--cyclodextrin ( hp--cd ) was estimated .
the efficacy of two anesthetic regimens was compared in this study ; the conventional tbe formulation solubilized in tert - amyl alcohol and a hp--cd formulation containing tbe .
mice ( n = 6 ) were administered the formulations by ip injection and the pharmacodynamic parameters of time to induction of anesthesia , duration of anesthesia and recovery time were measured using a combined reflex score ( crs).results and discussion : phase solubility studies showed a linear increase in the solubility of tbe with increasing hp--cd concentration and suggested > 1:1 binding of the drug in the cyclodextrin complex . at a dose of 260 mg
/ kg the standard tbe formulation appeared to produce deeper anesthesia than the cyclodextrin formulation , with a minimum average crs of 1.8 compared with 5.2 .
no post - mortem pathology was observed in mice that received either the conventional or cyclodextrin formulation.conclusion:the cyclodextrin tbe formulation did not conclusively provide an improved anesthetic response at a dose of 260 mg / kg compared with the conventional formulation .
the improved solubility of tbe with hp--cd and the reduced variability in anesthetic response warrants the further investigation of this formulation .
this study has also identified the value of using the anticholinergic atropine in association with tbe for anesthesia . |
6,559 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the percentage of elderly people has increased from 11.4% in 1984 to over 18% in 2011 and is estimated to reach 35% in 2050.1 today , 3.5% of those over 65-years old are aged over 80 ; since 1984 the number has increased from 1.2 million to 2.4 million and in 2050 this will reach 5 million;1 of these , 50% will be suffering from concurrent diseases and will be chronically disabled .
frail elderly patients whose health is worsening usually seek care from a general practitioner and then , in the case of complex clinical care , to the service network ( specialist s and home visits , nursing home , hospital , and so on ) .
a significant percentage of elderly subjects ( 50%80% ) with chronic ischemic cerebrovascular disease with or without moderate - to - severe cognitive decline , and with or without behavioral and psychological disorders , show complex symptoms related to the progressive deterioration of their general state of health and/or to situations causing an increase in stress ( eg , institutionalization ) .
symptoms are characterized by confusion and/or stupor , which are difficult to manage clinically and require a great deal of care .
the percentage of elderly people has increased from 11.4% in 1984 to over 18% in 2011 and is estimated to reach 35% in 2050.1 today , 3.5% of those over 65-years old are aged over 80 ; since 1984 the number has increased from 1.2 million to 2.4 million and in 2050 this will reach 5 million;1 of these , 50% will be suffering from concurrent diseases and will be chronically disabled .
frail elderly patients whose health is worsening usually seek care from a general practitioner and then , in the case of complex clinical care , to the service network ( specialist s and home visits , nursing home , hospital , and so on ) .
a significant percentage of elderly subjects ( 50%80% ) with chronic ischemic cerebrovascular disease with or without moderate - to - severe cognitive decline , and with or without behavioral and psychological disorders , show complex symptoms related to... | a significant percentage of elderly subjects ( 50%80% ) suffering from sub - acute ischemic cerebrovascular disease , with or without moderate or severe cognitive memory decline and with or without associated behavioral and psychological symptoms , shows a complex syndrome .
this syndrome is related to the progressive impairment of health conditions and/or stressing events ( ie , hospitalization ) , characterized by confusion and/or stupor , which are consequently difficult to manage and require a great deal of care .
geriatric patients often suffer from multiple chronic illnesses , may take numerous medications daily , exhibit clinical instability , and may experience worsening of medical conditions following cerebral ischemic events and thus have an increased risk of disability and mortality .
there are several studies in literature which demonstrate the efficacy of citicoline , thanks to its neuroprotective function , for the recovery and in postischemic cerebral rehabilitation .
it has been shown that , even soon after an ischemic stroke , administration of oral citicoline ( 5004000 mg / day ) improves the general conditions evaluated with the rankin scale and the national institute of health stroke scale 12 . in particular , it has been shown that the cdp - choline improves the cognitive and mental performance in alzheimer s dementia and vascular dementia .
we have evaluated the administration of citicoline in geriatric patients following a protocol of intravenous study on improvement of individual performances . |
6,560 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: urethral diverticular adenocarcinoma is a rare cancer found in female patients , presenting only 5% of female urothelial cancers .
we report a case of a urethral diverticular adenocarcinoma after the fenestration of the anterior vaginal wall for pelvic floor abscess .
a 61-year - old woman presented to the gynecology department with complaints of atypical genital bleeding .
magnetic resonance imaging ( mri ) revealed a localized urethral tumor extended to vagina ( fig . 1 ) .
computed tomography did not reveal any evidence of metastasis . under the diagnosis of urethral tumor , the patient was referred to our department . because the fenestration of the anterior vaginal wall was performed under the diagnosis of the abscess in the pelvic floor for the patient 15 years ago and the histological test demonstrates the adenocarcinoma , we suspected a urethral diverticular adenocarcinoma .
figure 1:sagittal t2-weighted mri of the pelvis revealed a localized urethral tumor extended to vagina .
sagittal t2-weighted mri of the pelvis revealed a localized urethral tumor extended to vagina . on admission , we performed standard open total cystectomy with lymph node excision and ileal conduit .
the resected specimen showed the mass on the anterior vaginal wall ( fig . 2 ) .
histopathological examination of the specimen showed adenocarcinoma tumor that continues to anterior vaginal wall , but urethral diverticular wall could not be identified ( fig .
we could not establish a diagnosis of urethral diverticulum ; however , we clinically diagnosed as urethral diverticular adenocarcinoma .
the proximal margin was negative , and all lymph nodes were negative . because the post - surgical course was uneventful , the patient was discharged from our hospital on day 27 post - surgery .
figure 3:histopathological examination of the specimen showed adenocarcinoma tumor which continues to anterior vaginal wall , but urethral diverticular wall could not be identified .
histopathological examination of the specimen showed... | a 61-year - old woman presented to the gynecology department with complaints of atypical genital bleeding . magnetic resonance imaging revealed a localized urethral tumor extended to vagina .
histological test of the biopsy tissue of the mass suggested the adenocarcinoma .
the patient was performed the fenestration of the anterior vaginal wall 15 years ago . under the diagnosis of urethral diverticular adenocarcinoma , we performed standard open total cystectomy with lymph node excision and ileal conduit .
we could not establish a diagnosis of urethral diverticulum from the histological test ; however , we clinically diagnosed as urethral diverticular adenocarcinoma . because carcinoma arising from urethral diverticula is reported , a close long - term follow - up for the recurrence or generation of malignant tumors by genitourinary examinations or images is necessary , for the patient with urethral diverticula . |
6,561 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: joint contracture occurs when joint movements are reduced , such as by immobilization of a
joint with a plaster cast , orthosis , or after prolonged bed rest .
several conditions limit
the range of motion ( rom ) of joints , including cerebrovascular diseases , neuromuscular
diseases , bone and joint diseases , and various other diseases .
contracture may be classified into three groups : arthrogenic , myogenic , and soft
tissue1 .
arthrogenic contracture is
caused by immobility caused by damage and inflammation of cartilage , synovial tissue , and
joint capsule .
soft
tissue contracture occurs because of pathological shortening of connective tissue , including
the skin , subcutaneous tissue , tendons , and ligaments .
examples of intrinsic causes include
trauma , inflammation , degenerative changes , and ischemia .
examples of extrinsic causes
include spasticity , flaccid paralysis , malpositioning , and immobilization .
many investigators have studied the pathogenesis of contracture in dogs , monkeys , rats , and
other experimental animals .
these studies provided evidence of a relationship between the
period of immobilization and rom limitation factors , and changes in joint components and
soft tissue , including muscle and skin . in addition , decreases in mobility and plasticity of
the nervous system are considered to cause rom limitation2 .
nervous system mobilization is used as a physical therapeutic
approach to improve such conditions .
it uses palpation or joint movements to initiate
physical or physiological changes in blood flow or the axonal flow of nerves , aiming to
improve the plasticity of the nerve3 . in
addition
, nervous system mobilization has been reported to be effective at improving rom
limitation and pain , and induces the largest longitudinal excursion of the nerve relative to
its surrounding structures without being associated with a potentially detrimental increase
in nerve strain4,5,6 . on the other hand ,
there is
no evidence that... | [ purpose ] this study was performed to investigate the histological changes that occur in
the periphery of the sciatic nerve in rats undergoing knee immobilization .
[ subjects and
methods ] 29 male 9-week - old wistar rats were divided randomly into a control group ( c
group , n = 7 ) and an immobilized group ( i group , n = 22 ) .
the animals in the i group had
the left knee joint immobilized in maximal flexion with plaster casts for two weeks .
after
the experimental period , we obtained cross - sections of tissues from the center of the left
thigh , and the periphery of the sciatic nerve was observed under an optical microscope
after hematoxylin - eosin staining .
[ results ] in contrast to the rats of c group , the rats
in i group showed adherence between the bundle of nerve fibers and perineurium , as well as
thickening of the perineurium .
these histological changes were statistically significant .
[ conclusions ] immobilization of the knee joints of rats resulted in characteristic
histological changes in the connective tissue around the sciatic nerve . |
6,562 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: subjects for this study were identified from an institutional review board approved clinical registry of all ischemic strokes at the new york - presbyterian hospital / weill cornell medical center , a tertiary - care hospital and certified primary stroke center .
all patients admitted to our hospital s stroke service with ischemic stroke during 2013 were prospectively included in a database that is part of the aha s get with the guidelines stroke national registry.9 the get with the guidelines data collection was performed using a standardized template to collect clinical data on consecutively admitted stroke patients.9 ischemic stroke was determined by inpatient vascular neurologists using the aha s definition10 of an episode of neurologic dysfunction caused by focal brain ischemia , based on either imaging evidence of infarction in a defined vascular distribution or clinical symptoms persisting > 24 hours .
trained hospital personnel collected information about the national institutes of health stroke scale upon presentation , prior stroke history , inpatient hospital diagnostic studies performed , and demographic characteristics .
in addition , the presence of the following vascular risk factors was also recorded : active tobacco use , diabetes ( defined as a hemoglobin a1c of > 6.5% or on diabetes medication ) , insulin use , hypertension ( blood pressure > 140/90 mm hg or on antihypertensive medication ) , atrial fibrillation , dyslipidemia ( low - density lipoprotein > 100 mg / dl or on statin therapy ) , coronary heart disease , and cardiac valvular disease . for subjects included in this prospective registry , 2 vascular neurologists , using all available medical data , independently assigned stroke etiology using the toast classification scheme.11 disagreements in subjects stroke subtype classification were adjudicated by a third vascular neurologist .
once this cohort of ischemic stroke patients was identified , the following additional inclusion criteria were applied : ( 1 ) ischemic stroke of... | backgroundmagnetic resonance imaging of carotid plaque can aid in stroke risk stratification in patients with carotid stenosis .
however , the prevalence of complicated carotid plaque in patients with cryptogenic stroke is uncertain , especially as assessed by plaque imaging techniques routinely included in acute stroke magnetic resonance imaging protocols .
we assessed whether the magnetic resonance angiography
defined presence of intraplaque high - intensity signal ( ihis ) , a marker of intraplaque hemorrhage , is associated with ipsilateral cryptogenic stroke.methods and resultscryptogenic stroke patients with magnetic resonance imaging evidence of unilateral anterior circulation infarction and without hemodynamically significant ( 50% ) stenosis of the cervical carotid artery were identified from a prospective stroke registry at a tertiary - care hospital .
high - risk plaque was assessed by evaluating for ihis on routine magnetic resonance angiography source images using a validated technique . to compare the presence of ihis on the ipsilateral versus contralateral side within individual patients
, we used mcnemar s test for correlated proportions .
a total of 54 carotid arteries in 27 unique patients were included .
a total of 6 patients ( 22.2% ) had ihis - positive nonstenosing carotid plaque ipsilateral to the side of ischemic stroke compared to 0 patients who had ihis - positive carotid plaques contralateral to the side of stroke ( p=0.01 ) .
stroke severity measures , diagnostic evaluations , and prevalence of vascular risk factors were not different between the ihis - positive and ihis - negative groups.conclusionsour findings suggest that a proportion of strokes classified as cryptogenic may be mechanistically related to complicated , nonhemodynamically significant cervical carotid artery plaque that can easily be detected by routine magnetic resonance imaging / magnetic resonance angiography acute stroke protocols . |
6,563 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: schizophrenia ( sz ) is a debilitating illness characterized by delusions , hallucinations and disorganized thought .
impairments of cognitive functions , such as working memory , are also considered core features of the disorder ( green , 2006 ; kahn and keefe , 2013 ; park and gooding , 2014 ) and have been linked to genetic liability ( agnew - blais and seidman , 2013 ; reichenberg and harvey , 2007 ) .
however , little is known about how cognitive dysfunction is related to underlying brain anatomy and brain function , and improving our understanding of these associations may help uncover the neuronal substrates of the disease ( kahn and keefe , 2013 ; schultz et al . , 2012a ) .
neuroimaging studies have identified brain regions and networks involved in cognitive processing ( alnaes et al .
, 2015 ; cabeza and nyberg , 2000 ; cole et al . , 2014 ) , and both hypo- and hyperactivation ( brandt et al . , 2014 ; glahn et al . , 2005 ; kraguljac et al . , 2013 ;
ragland et al . , 2007 ) , as well as brain network dysconnectivity ( brandt et al .
, 2015 ; fornito et al . , 2012b ; kaufmann et al . , 2015 ; pettersson - yeo et al . ,
, fmri studies have demonstrated abnormal neuronal recruitment during working memory processing ( anticevic et al . , 2013 ;
callicott et al . , 2003 ; glahn et al . , 2005 ; henseler et al .
, 2009 ; karlsgodt et al . , 2007 ; kim et al . , 2010 ; potkin et al .
2011 ) reflecting dysfunction of a fronto - parietal network including the lateral prefrontal cortex and posterior parietal cortex , as well as anterior cingulate and other regions related to execution of challenging cognitive tasks ( owen et al . , 2005 ) .
this network shows increased activation during cognitive processing and is thought to reflect focus on task - relevant information , like updating information in working memory .
similar networks have been referred to as central executive ( bressler and menon , 2010 ; sridharan et al . , 2008 ) , executive control ( seeley et al . , 2007 ) , and task - positive ( fox... | schizophrenia ( sz ) is a psychotic disorder with significant cognitive dysfunction .
abnormal brain activation during cognitive processing has been reported , both in task - positive and task - negative networks .
further , structural cortical and subcortical brain abnormalities have been documented , but little is known about how task - related brain activation is associated with brain anatomy in sz compared to healthy controls ( hc ) . utilizing linked independent component analysis ( lica ) , a data - driven multimodal analysis approach , we investigated structure function associations in a large sample of sz ( n = 96 ) and hc ( n = 142 ) .
we tested for associations between task - positive ( fronto - parietal ) and task - negative ( default - mode ) brain networks derived from fmri activation during an n - back working memory task , and brain structural measures of surface area , cortical thickness , and gray matter volume , and to what extent these associations differed in sz compared to hc . a significant association ( p < .05 , corrected for multiple comparisons ) was found between a component reflecting the task - positive fronto - parietal network and another component reflecting cortical thickness in fronto - temporal brain regions in sz , indicating increased activation with increased thickness .
other structure function associations across , between and within groups were generally moderate and significant at a nominal p - level only , with more numerous and stronger associations in sz compared to hc .
these results indicate a complex pattern of moderate associations between brain activation during cognitive processing and brain morphometry , and extend previous findings of fronto - temporal brain abnormalities in sz by suggesting a coupling between cortical thickness of these brain regions and working memory - related brain activation . |
6,564 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: renal cell carcinoma ( rcc ) represents the most common cancer of kidney and accounts for approximately 3% of all adult malignancies in western countries ( 1 ) .
rcc remains primarily a surgical disease requiring early diagnosis to optimize the opportunity for cure .
the treatment for patients with rcc who have no clinical signs of distant metastases is radical nephrectomy .
however , metastases occur in approximately 30% of these patients , usually within 1 yr .
moreover 30% of patients already have metastases at the time of presentation ( 2 ) , and in this situation neither chemotherapy nor radiation therapy is effective . despite the lack of an effective systemic therapy ,
a small but significant improvement in overall 5-yr survival has been noted due to early detection and advances in surgical management of the disease ( 3 ) .
a number of investigations have recently undertaken to search for a protein marker for rcc , which can be used for early diagnosis , staging , detection of occult metastatic disease , and to monitor the response to treatment .
however , they have been shown to be either nonspecific or insensitive ( 4 ) .
proteins are key materials to understand cellular functions and disease process , such as tumorigenesis , tumor growth and metastases .
thus , it is expected that protein expression would differ between normal kidney tissue and homologous rcc tissue .
many investigators are currently working on the characterization of rcc using proteome - based techniques .
this technique has been shown to be a useful tool to identify novel proteins for diagnosis and prognosis of malignant disease including colorectal carcinoma ( 5 ) , lung ( 6 ) , and breast cancer ( 7 ) . in rcc , sarto et al .
( 8) reported a number of polypeptides differentially expressed in rcc by comparing 2-dimensional electrophoresis patterns of whole normal kidney epithelium and rcc tissue . in this study , we prepared proteins from the rcc tissue and the homologous normal kidney tissue , and analyzed a number of proteins... | renal cell carcinoma ( rcc ) is one of the most malignant tumors in urology , and due to its insidious onset patients frequently have advanced disease at the time of clinical presentation .
thus , early detection is crucial in management of rcc . to identify tumor specific proteins of rcc
, we employed proteomic analysis .
we prepared proteins from conventional rcc and the corresponding normal kidney tissues from seven patients with conventional rcc .
the expression of proteins was determined by silver stain after two - dimensional polyacrylamide gel electrophoresis ( 2d - page ) .
the overall protein expression patterns in the rcc and the normal kidney tissues were quite similar except some areas . of 66 differentially expressed protein spots ( p<0.05 by student t - test ) , 8 different proteins from 11 spots were identified by maldi - tof - ms .
the expression of the following proteins was repressed ( p<0.05 ) ; aminoacylase-1 , enoyl - coa hydratase , aldehyde reductase , tropomyosin -4 chain , agmatinase and ketohexokinase . two proteins , vimentin and -1 antitrypsin precursor , were dominantly expressed in rcc ( p<0.05 ) . |
6,565 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: osteonecrosis of the jaw ( onj ) emerged as a well - known devastating side effect of parenteral bisphosphonate therapy since the widespread use of biphosphonates to reduce skeletal related events ( sre ) .
biphosphonates are commonly used every three to four weeks with around 1448% reduction of sre occurrence and onj occurrence in 1.23.8% despite preventive measures , , , .
although the positive results of 4 different trials , the use of biyearly biphosphonates regimens to reduce aibl is not approved , , , . this spaced interval of six months achieved an increase in median bone mineral density of 2.74.3% in the lumbar spine and 1.61.7% in the hip when used in post - menopausal women receiving adjuvant hormonal aromatase inhibitor , . however , the risk of developing onj with the bi - annually regimen of zoledronic acid is not well recognized .
a review of literature in women having breast cancer receiving zoledronate biannually to prevent aibl was conducted . reported cases of onj are collected from the selected studies and an estimation of the onj risk in this category of patients is reported .
electronic searches of the literature published until september 2014 were conducted using pubmed and the cochrane collaboration database to identify articles evaluating the onj as a side effect in women receiving zoledronic acid every six months for the prevention of aromatase inhibitor associated bone loss ( aibl ) in patients with early stage breast cancer . only randomized and non - randomized controlled clinical trials were included .
zoledronic acid , early breast cancer and aromatase inhibitors. this search was augmented by a hand search of the reference lists of relevant articles included in the literature review .
two different investigators performed the search and the abstracts were independently reviewed for possible inclusion .
types of participants : included studies were limited to post - menopausal women receiving zoledronic acid every six months with aromatase inhibitors to prevent aibl .
selection... | osteonecrosis of the jaw ( onj ) is one of the most relevant and specific complication of biphosphonates .
onj in patients receiving zoledronic acid every 3 to 4 weeks is frequently described , but the onj biyearly regimen used to reduce aromatase inhibitor associated bone loss ( aibl ) , is rarely reported . a literature review , focusing on the important trials using zoledronic acid to reduce aibl , found that the mean risk of developing onj when zoledronic acid is used biyearly varies between 0.12% and 0.7% . |
6,566 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it was established by the 1980 's that drug treatment of elevated blood pressure ( bp ) reduces the risks of cardiovascular complications of hypertension .
the prevailing assumption among clinicians and regulators was , and probably continues to be , that the benefits of antihypertensive treatment were a direct consequence of the reduction in systolic and/or diastolic bp .
based on this premise , we have seen a flood of new antihypertensive agents from multiple classes of drugs introduced into the marketplace .
the scientific documentation has often consisted of small , short - term trials . as long as the new agents are superior to placebo in reducing bp , and as long as they are reasonably free of side effects , the drugs receive regulatory approval .
clinicians now have more than 100 antihypertensive drugs from which to choose . because the blood - pressure - lowering potential of these drugs is fairly similar , use of individual pharmaceutical agents is determined more by marketing forces than by science .
a health services concern is that there is a greater than 20-fold difference in drug cost .
the key question today is , " does it matter how elevated bp is lowered ? "
this question is best answered by randomized clinical trials that compare antihypertensive agents . however , a number of issues and concerns have been raised about the design of these trials .
regulatory agencies prefer placebo - controlled trials , since they want to know whether a drug is effective for its intended use and whether it is reasonably safe .
comparative or active - controlled trials have other objectives and provide answers along the superiority inferiority axis .
although extremely relevant clinically , the regulatory agencies have limited interest and use for information regarding which drug is superior .
comparative trials are a cause for concern to the pharmaceutical industry , since such trials may produce losers ( inferior drugs ) , whereas the outcome of placebo - controlled trials of new antihypertensive agents is... | the key question in hypertension research today is , " does it matter how elevated blood pressure is lowered ? "
the antihypertensive and lipid - lowering treatment to prevent heart attack trial ( allhat ) initiated in 1994 serves as a model for comparative trials .
its strengths include its independent sponsorship , scope and design .
the alpha - blocker arm was stopped early ; doxazosin was shown to be clearly inferior to low - dose chlorthalidone not only in preventing heart failure , but also stroke , in spite of similar blood pressure reduction .
the findings have major public health implications as pointed out by krakoff in this journal .
other commentaries by gavras and gavras and hooper discuss possible mechanisms behind the excess of cardiovascular events in doxazosin - treated patients . |
6,567 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: bullous pemphigoid ( bp ) , the most common autoimmune blistering disease , is mediated by autoantibodies .
bp primarily affects the elderly and is characterized by the development of urticarial plaques surmounted by subepidermal blisters , and the deposition of immunoglobulins and complement at the basement membrane zone ( bmz ) of the skin .
bp is immunologically characterized by the development of autoantibodies targeting two structural proteins of the hemidesmosomes , bp180 ( collagen xvii ) and bp230 ( bpag1 ) .
a 63 -year - old caucasian female patient was evaluated for a 4 day history of several itching , erythematous blisters on her extremities .
biopsies for hematoxylin and eosin ( h&e ) examination , as well as periodic acid - schiff ( pas ) , immunohistochemistry ( ihc ) and direct immunofluorescence ( dif ) analysis were performed .
h&e demonstrated a subepidermal blister , with partial re - epithelialization of the blister floor . within the blister lumen ,
numerous neutrophils were present , with occasional eosinophils and lymphocytes also noted . within the dermis ,
a mild , superficial , perivascular and periadnexal infiltrate of lymphocytes , histiocytes and occasional eosinophils was identified , with mild perivascular leukocytoclastic debris .
the pas stain was positive at the bmz , and around selected blood vessels , nerves and sweat glands .
dif revealed linear deposits of igg and complement / c3 and fibrinogen at the bmz , and around selected dermal nerves , blood vessels and sweat glands .
strong granular deposits of ige were also observed , colocalizing with monoclonal antibodies to collagen iv ( civ ) . by ihc ,
positive cd45 staining of lymphocytes was seen surrounding selected dermal blood vessels , eccrine sweat glands , and nerves .
the patient displayed igg , ige , and fibrinogen autoantibodies against the bmz , as well as around some dermal nerves and sweat glands ; their binding in the skin could trigger complement activation .
bullous pemphigoid ( bp ) is an autoimmune... | context : bullous pemphigoid ( bp ) , the most common autoimmune blistering disease , is mediated by autoantibodies .
bp primarily affects the elderly and is characterized by the development of urticarial plaques surmounted by subepidermal blisters , and the deposition of immunoglobulins and complement at the basement membrane zone ( bmz ) of the skin .
bp is immunologically characterized by the development of autoantibodies targeting two structural proteins of the hemidesmosomes , bp180 ( collagen xvii ) and bp230 ( bpag1).case report : a 63 -year - old caucasian female patient was evaluated for a 4 day history of several itching , erythematous blisters on her extremities .
biopsies for hematoxylin and eosin ( h&e ) examination , as well as periodic acid - schiff ( pas ) , immunohistochemistry ( ihc ) and direct immunofluorescence ( dif ) analysis were performed.results:h&e demonstrated a subepidermal blister , with partial re - epithelialization of the blister floor . within the blister lumen ,
numerous neutrophils were present , with occasional eosinophils and lymphocytes also noted . within the dermis ,
a mild , superficial , perivascular and periadnexal infiltrate of lymphocytes , histiocytes and occasional eosinophils was identified , with mild perivascular leukocytoclastic debris .
the pas stain was positive at the bmz , and around selected blood vessels , nerves and sweat glands .
dif revealed linear deposits of igg and complement / c3 and fibrinogen at the bmz , and around selected dermal nerves , blood vessels and sweat glands .
strong granular deposits of ige were also observed , colocalizing with monoclonal antibodies to collagen iv ( civ ) . by ihc ,
positive cd45 staining of lymphocytes was seen surrounding selected dermal blood vessels , eccrine sweat glands , and nerves.conclusion:the patient displayed igg , ige , and fibrinogen autoantibodies against the bmz , as well as around some dermal nerves and sweat glands ; their binding in the skin could trigger complement... |
6,568 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: one part of the aging process involves a decline in cellular housekeeping functions disturbing the maintenance of organism homeostasis [ 1 , 2 ] .
the accumulation of damaged and defective components increases cellular stress , for example , oxidative stress , which activates cellular defence mechanisms including nf-b signaling pathway and innate immunity system , such as inflammasomes [ 35 ] ( section 3.1 ) .
aging is associated with a low - grade proinflammatory phenotype which further interferes with housekeeping and cellular homeostasis .
recent studies have indicated that autophagy is a crucial cleansing system preventing inflammation but its capacity clearly declines with aging [ 68 ] .
the nf-b signaling system and the autophagic degradation pathway have been closely conserved during evolution and emerging studies indicate that these systems have many context - dependent interactions with each other .
we will review the recent literature on the control mechanisms of autophagy by nf-b signaling and particularly we will focus on its context - dependent regulation during the aging process . by definition , autophagy or autophagocytosis
is a cellular self - digestion process involving the uptake of cellular components and organelles for degradation by lysosomal system .
the hallmark of autophagy is the appearance of autophagosomes which subsequently fuse with primary lysosomes to form autolysosomes where the ingested material is digested by lysosomal enzymes .
there also exist microautophagy and chaperone - mediated autophagy which deliver cytoplasmic material directly into the lysosomes without the formation of autophagosome .
several reviews have detailed the mechanisms involved in autophagosome formation , for example , over thirty autophagy - related ( atg ) proteins are known to participate in this process [ 911 ] .
beclin 1 and its interactome , that is , proteins interacting with beclin 1 , have a crucial role in the vesicle nucleation during autophagosome formation [ 12 , 13 ] .
beclin 1 and... | the nf-b signaling system and the autophagic degradation pathway are crucial cellular survival mechanisms , both being well conserved during evolution .
emerging studies have indicated that the ikk / nf-b signaling axis regulates autophagy in a context - dependent manner .
ikk complex and nf-b can enhance the expression of beclin 1 and other autophagy - related proteins and stimulate autophagy whereas as a feedback response , autophagy can degrade ikk components .
moreover , nf-b signaling activates the expression of autophagy inhibitors ( e.g. , a20 and bcl-2/xl ) and represses the activators of autophagy ( bnip3 , jnk1 , and ros ) .
several studies have indicated that nf-b signaling is enhanced both during aging and cellular senescence , inducing a proinflammatory phenotype .
the aging process is also associated with a decline in autophagic degradation .
it seems that the activity of beclin 1 initiation complex could be impaired with aging , since the expression of beclin 1 decreases as does the activity of type iii pi3k . on the other hand ,
the expression of inhibitory bcl-2/xl proteins increases with aging .
we will review the recent literature on the control mechanisms of autophagy through ikk / nf-b signaling and emphasize that nf-b signaling could be a potent repressor of autophagy with ageing . |
6,569 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: polypropylene ( pp ) is a well - known hydrophobic polymer which has good mechanical properties and easy processing with low cost and excellent recyclability [ 1 , 2 ] . because of its good film and fiber properties
however , in order to obtain a better in vivo biocompatibility , hydrophilic groups can be introduced into this polymer to overcome its hydrophobic character via postpolymerization reactions .these
newly formed polymers are named as amphiphilic block copolymers . grafting reactions of the hydrophilic segments with a hydrophobic chain
can be performed in three routes [ 46 ] : grafting from , grafting through , and grafting onto leading to comb- or brush - type graft copolymers [ 711 ] .
brush - type graft copolymers consist of a linear backbone with a high grafting density of side chains ( usually one side chain per repeat unit of the backbone ) .
comb - type graft polymers consist of a main polymer chain , the backbone with one or more side chains attached to it through covalent bonds , and the branches .
the total molar mass and the properties of comb - type graft are determined by the backbone length , grafting density , and side chain length . grafting onto method of polymerization
block copolymers having a poly(ethylene glycol ) ( peg ) comprise a special and interesting category since peg is a crystalline , neutral , biocompatible material with hydrophilic properties [ 1315 ] .
they have a unique molecular structure containing parts with both hydrophobic and hydrophilic character [ 1618 ] .
since peg overcomes the hydrophobic effect of the pp , the diversity of in vivo application of pp - peg will be expanded . to our knowledge ,
experimental studies concerning the in vivo properties of low and pp - peg block copolymers with high molecular weight have not been studied previously .
another attractive research field in biomaterials is polymer - stabilized nanoparticles , especially metal nanoparticles such as gold and silver [ 1927 ] . in our previous study , we have already pointed... | the aim of this study is to evaluate the soft tissue response of the pure and au - embedded ppg - peg .
pp - g - peg2000 , pp - g - peg4000 , au - pp - g - peg2000 , and aupp - g - peg4000 were obtained via chlorination of polypropylene and polyethylene glycol in the presence of a base with a grafting onto technique .
solvent cast films of these four copolymers with pp as a control group were embedded into five different rats .
after 30 days of implantation , microscopic evaluation of inflammation and sem analysis were done .
pp had the most intense inflammatory reaction among the other polymers .
pp - peg block copolymers with high molecular weight and gold - nanoparticles - embedded ones revealed mild inflammatory reaction independently .
sem assessment revealed punched hole - like defects on the surface of all polymer samples except for pp .
graft copolymers with peg , especially au - attached ones , have favorable soft tissue response , and inflammatory reaction becomes milder as the number of peg side chains increases . |
6,570 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic myeloid leukemia ( cml ) is a myeloproliferative disease that represents 15%25% of all leukemias .
the disease was the result of a reciprocal translocation between chromosome 22 and chromosome 9 , the so - called philadelphia translocation .
this rearrangement joins the c - abl gene on chromosome 9 and bcr on chromosome 22 creating a bcr - abl fusion gene , which codes for a 190230 kda , bcr - abl fusion protein with elevated tyrosine kinase activity .
the upregulated bcr - abl fusion protein includes the tyrosine kinase domain , which likely contributes to dysregulation of the mechanism of cellular signals transduction , normally involved in controlling apoptosis , proliferations , and cell - cell adhesions , and thus promoting leukemogenesis .
the abrogation of bcr - abl function has become a model for development of targeted therapies .
the enzymatic inhibition of bcr - abl using imatinib mesylate ( gleevectm , sti571 ; novartis pharmaceutical corp .
, east hanover , nj ) has been shown to possess potent in vitro and in vivo activities in preclinical studies [ 3 , 4 ] .
the activity of this inhibitor in patients with previously treated cml was further confirmed in early clinical trials [ 57 ] .
recently , the landmark international randomized study of interferon versus sti571 ( iris ) study has shown cytogenetic responses in 87% of their patients after 5 years of imatinib as a primary treatment . over the past few decades , allogeneic bone marrow transplantation ( allo - bmt ) has been used to treat cml and other malignant and nonmalignant diseases .
however , this success is frequently not maintained since leukemic relapse substantially occurs in 30% to 60% of patients who undergo transplantation during the advanced stages of disease ( accelerated phase and blast crisis ) and 5% to 20% of those who undergo transplantation during the chronic phase .
moreover , the impact of this potential treatment is limited because it depends considerably on the patient 's age and availability of... | we describe the
response of imatinib as lifesaving treatment of
chronic myeloid leukemia ( cml ) relapse in seven
patients who underwent allogeneic bone marrow
transplantation ( allobmt ) at our institution
over a period of 4 years .
retrospective analysis
of their medical records revealed that a mean age at
transplant was 45.2 years .
the median time to
diagnosis was 7.4 years after transplant . at
relapse ,
four , two , and one patients were
classified as having hematologic , major
molecular , and cytogenetic relapse , respectively .
at imatinib initiation ,
five had cml in a
chronic phase , while one patient was
diagnosed as having accelerated phase and blast
crisis .
all these patients could be evaluated
for the therapeutic efficacy . at a mean of
follow - up of 1.9 years of therapy , all
evaluable
patients achieved major molecular response
without compromising safety .
consistent with
available data , our results indicate that
imatinib is safe and effective treatment option
for patients with relapse after
bmt . |
6,571 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: participants included 613 youth ( 52% female ) enrolled in grades 6 ( 35% ) , 7 ( 29% ) and 8 ( 36% ) at study outset .
the ethnic composition of the sample included 86% white / caucasian , 4% asian - american , 2% latino / a - american , 1% african - american , and 6% mixed ethnicity students .
participants were enrolled in a single public middle school within a city of fairly homogeneous middle - class socioeconomic status . according to school records ,
11% of children were eligible for free / reduced - price lunch . at time 1 , all sixth through eighth grade students and their families received mailed and hand - distributed consent forms for study recruitment with strong encouragement and incentives ( e.g. , raffles ) for consent form return .
consent forms were returned by 92% of families ( n = 784 ) ; of these , 80% of parents gave consent for their child s participation ( n = 627 ; 74% of the total population ) .
students who were absent on one of the days of testing ( n = 10 ) or refused to participate ( n = 4 ) , were excluded from analyses , yielding a final sample of 613 participants at time 1 . a total of 567 ( 92% ) of these participants were available for testing eleven months later ( i.e. , time 2 ) , when students were in grades seven through nine .
attrition was due to participants moving away from the area ( n = 36 ) , absenteeism ( n = 7 ) , and three participants who refused to continue participation . no significant differences were revealed for any of the constructs measured in this study between adolescents who participated at both time points and those who only participated at one time point . because listwise deletion would unnecessarily omit valuable data , all analyses were conducted with all available data ( see data analyses below ) .
analyses using only available data revealed an identical pattern of results . at time 1 , measures of pubertal timing , depressive symptoms , and reputation - based peer status ( i.e. , popularity ) were administered .
( i.e. , time 2 )... | the transition to adolescence marks a time of sharply increased vulnerability to the development of depression , particularly among girls .
past research has examined isolated risk factors from individual theoretical models ( e.g. , biological , interpersonal , and cognitive ) of depression , but few have examined integrative models .
this study investigated the conjoint effects of early pubertal timing and popularity in the longitudinal prediction of depressive symptoms .
a total of 319 girls and 294 boys ( ages 1114 ) provided information on their pubertal status , depressive symptoms , and the social status ( i.e. , popularity ) of their peers .
adolescents completed a second measure of depressive symptoms 11 months after the initial time point .
findings supported an integrated biological - interpersonal model in explaining the development of depressive symptoms during adolescence .
early pubertal development was associated with increase in depressive symptoms only when accompanied by low levels of popularity .
high levels of popularity buffered the association between early pubertal development and later depressive symptoms .
unexpectedly , these results were significant both for girls and boys .
results are discussed in terms of dynamic systems theories . |
6,572 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: atypical fibroxanthoma ( afx ) is a malignancy developed typically in the dermis of the head and neck of senior caucasians , however it is a very rare tumor in asians [ 1 - 5 ] .
in addition , the incidence of afx in koreans is very low and only 6 cases developed in the sun - exposed face and hand area have been reported in dermatology [ 6 - 10 ] . although the metastatic potential is known to be low , it grows rapidly and has a highly local recurrent ability . it must be differentiated from many diseases since it shows the sarcoma pattern consisting of atypical spindle cells within the dermis histology .
it can also be considered a benign lesion because there is no pain or local invasion clinically . although rare , metastases have been reported , and they could not be differentiated from malignant fibrous histiocytoma ( mfh ) histopathologically . as a treatment ,
however , local recurrence can occur frequently because the margin is not distinct when performing an excision .
therefore , a wide excision has been known to be the most effective . in this study , we examine a case diagnosed as atypical fibroxanthoma in the head and neck area , and report this case with a review of the literature .
our patient was a 70-year - old male who 3 months ago underwent an incision biopsy at another hospital for a 1.01.0 cm sized palpable and protruding reddish nodule in the left infra - auricular area . by result of a histological test ,
a malignant tumor was suspected and he was transferred to our hospital . in the physical examination , there was a round scar remaining from the previously performed biopsy and the size of the resected tissue was approximately 0.70.7 cm .
the specimen acquired at the other hospital was examined again at our hospital . in our histopathologic
finding , we detected a numerously mitotic figure with atypical , bizarre , large and hyperchromatic nuclei ( fig .
, we had cd34 , cd45 , cytokeratin and desmin showing negative reaction with a positive reaction for vimentin as well as cd68 .
in... | atypical fibroxanthoma is a pleomorphic spindle cell tumor of the dermis and it 's been known to be a benign lesion clinically in spite of malignant histologic features .
but recurrence is estimated at between 2%-20% and metastasis has been reported .
we are about to describe a 70-year - old man with the lesion developed on the left infra - auricular area .
the lesion was located superficially and is composed of compact pleomorphic spindle cells and several bizarre multinucleated giant cells .
the patient was treated with wide excision .
we would like to discuss about this case with a review of literatures . |
6,573 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: to investigate the prevalence of different plasmodium spp . in wild great apes living in their natural habitat ( tropical rainforests ) , we analyzed tissue samples from 16 wild west african chimpanzees that died primarily of anthrax or respiratory disease in ta national park , cte divoire .
a generic real - time pcr that detects all known plasmodium spp . was used to test all samples for the parasite .
sequence analysis of the cytb gene and small subunit rrna genes was conducted for real - time pcr positive samples to determine the strain present ; 1,140 bp of the cytb gene and 765 bp of the 18s gene of the plasmodium genome were amplified by classic pcr .
resulting products were sequenced either directly or after cloning for rrna gene and when initial sequence information showed the possible presence of 2 different species ( table ) . *
all chimpanzees were pan troglodytes verus from tai except p. t. schweinfuthii chimpanzees , which were from budongo forest .
parentheses indicate the number of samples for which sequences were obtained and used for phylogenetic tree analyses .
phylogenetic analyses of sequences obtained confirmed the presence of 5 species : p. reichenowi and p. gaboni , which had been found previously ( 2,3 ) ; but also p. vivax , p. ovale , and p. malariae like strains ( figure 1 , figure 2 ) .
the most prevalent species was p. reichenowi ( 6/16 ) , which had representatives in subclusters p. gaboni and p. reichenowi .
the other species were rare , seen only 1 ( p. ovale and p. vivax ) or 2 ( p. malariae ) times .
( figure 1 , figure 2 ) , 1 infected with p. reichenowi and a p. malariae like strain and the other with p. reichenowi and p. gaboni .
maximum - likelihood trees of plasmodium spp . obtained from the analysis of a 1,087-bp cytb alignment .
blue indicates sequences determined from chimpanzee hosts ; green , bonobos ; gray , gorillas ; and red , humans .
blue indicates sequences determined from chimpanzee hosts ; green , bonobos ; gray , gorillas ; and red , humans .
typical for... | data are missing on the diversity of plasmodium spp . infecting apes that live in their natural habitat , with limited possibility of human - mosquito - ape exchange .
we surveyed plasmodium spp .
diversity in wild chimpanzees living in an undisturbed tropical rainforest habitat and found 5 species : p. malariae , p. vivax ,
p. ovale , p. reichenowi , and p. gaboni . |
6,574 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: eccrine poroma is a benign neoplasm of the sweat glands originating from the intraepidermal eccrine duct.1 ) this unusual tumor is known to arise in bare skin areas , such as the sole of the foot .
recently it was revealed that it could occur in more various skin region.2 ) but only few cases have been reported in the head and neck area .
a 54-year - old female presented with a gradually increasing mass on the auricle for one year . on physical examination , there was a soft , protruding , and purple - colored , solitary mass , 1.01.0 cm in size on the retroauricular surface of the left auricle ( fig .
the patient reported serous discharge but there was no pain nor tenderness . with an impression of an atypical nevus or a melanoma
histopathological findings revealed that broad anasto - mosing bands extended from the epidermis to dermis with multifocal fibrovascular cores and irregular duct - like structures ( fig .
there were also tightly packed small uniform cells with central round to oval nuclei , prominent nucleoli , and occasional clear cytoplasm ( fig .
we did not find any necrosis , nuclear atypia , or mitosis in the specimen .
after complete excision , the patient has been followed up without any recurrence for more than 6 months .
eccrine poroma was first described by goldman , et al.2 ) in 1956 as a neoplasm composed of cells that are analogous to cells in the walls of eccrine sweat pores .
it is composed of poroid cells and cuticular cells that have much eosinophilic cytoplasm , similar to eccrine ductal cuticles.1 ) vacuolizations in the intracytoplasmic and intercellular areas are characteristic histological features , resembling the formation of eccrine ducts.1 ) this tumor is occurred in bare areas of skin such as the sole of the foot .
goldman , et al.2 ) reported that the most common sites were soles of feet ( 65% ) followed by the hands ( 10% ) .
only one case of the ear ( external auditory canal ) has been previously reported , and only three cases reported in the postauricular scalp skin ,... | eccrine poroma is described as a benign neoplasm originating from the intraepidermal eccrine duct of sweat glands .
this tumor is known to arise in bare skin areas , but more rarely appeared in head and neck region . a 54-year - old female presented with a mass on the retroauricular aspect of the left auricle .
there was a soft , protruding , and purple - colored , solitary mass of about 1.01.0 cm in size .
after authors performed an excisional biopsy , eccrine poroma was confirmed histopathologically .
thus , we report a rare case of eccrine poroma of the ear with the review of literature . |
6,575 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: uncomplicated and complicated crown fracture is the most common traumatic dental injury to permanent teeth .
most dental injuries involve just one tooth , and the majority of the affected teeth are maxillary central incisors.[24 ] this may be attributable to their anterior position and protrusion caused by the eruptive pattern . during the last century
, clinicians used a variety of procedures ( e.g. , pin - retained resin , orthodontic bands , modified three - quarter crowns , full - coverage gold with bonded porcelain , porcelain jacket crowns , porcelain - bonded crowns , porcelain inlays ) for the restoration of the fractured crown .
several factors influence the management of coronal tooth fractures , including extent of fracture ( biological width violation , endodontic involvement , alveolar bone fracture ) , pattern of fracture and restorability of fractured tooth ( associated root fracture ) , secondary trauma injuries ( soft tissue status ) , presence / absence of fractured tooth fragment and its condition for use ( fit between fragment and the remaining tooth structure ) , occlusion , aesthetics , finances and prognosis.[79 ] if the fracture is uncomplicated ( i.e. , not involving the pulp ) and the pulpal health is uncompromised , it may be restored with composite resin or a jacket crown . if the pulp is involved , the tooth is treated endodontically and then restored with the help of a jacket crown with or without post and core . if the fracture is sub - gingival , the tooth may require surgical crown lengthening or forced eruption ( orthodontic extrusion ) followed by prosthetic rehabilitation . in situations where a ferrule effect can not be established , the only treatment left is the extraction of the tooth followed by prosthetic rehabilitation .
one of the options for managing coronal tooth fractures , especially when there is no or minimal violation of the biological width , is the reattachment of the dental fragment when it is available .
tooth fragment bonding offers the advantage of... | reattachment of the fractured anterior tooth is a highly conservative and aesthetic treatment that has gained popularity in the recent past .
presented here is one such case in which a combination of external enamel bevel and internal dentinal groove has been used to enhance the bonding between the fractured fragment and the remaining tooth .
the treatment was found to be successful both functionally and aesthetically at the 18-month follow - up . |
6,576 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: neuropeptide y ( npy ) is one of the most common peptides in the brain and an abundant neurotransmitter in the peripheral sympathetic nervous system ( sns ) .
it plays a well - established role in the hypothalamic control of body energy balance by promoting feeding and lipid storage in white adipose tissue ( wat ) .
however , in pair - fed rats , central npy administration still leads to increased fat accumulation , which suggests that npy has an important role in promoting adiposity independent of food intake .
npy outside the hypothalamus in the regulation of energy homeostasis has not been widely studied , although npy and its receptors are located in key peripheral tissues , such as wat , liver , and pancreas .
npy inhibits lipolysis in adipocytes via y1 receptors , and could modulate adipose tissue expansion by regulating angiogenesis .
npy also inhibits insulin release via pancreatic y1 receptors . on the other hand , npy in the brainstem
could modulate sympathetic tone , which is known to have multiple effects on energy homeostasis .
to address the role of npy colocalized with noradrenaline in sns and brain noradrenergic neurons , we created a transgenic mouse model ( oe - npy mouse ) , where npy is overexpressed under the dopamine - betahydroxylase ( dbh ) promoter .
this resulted in moderately increased levels of npy protein ( 1.31.8-fold ) peripherally in adrenal glands and centrally in noradrenergic neurons of the brainstem , but not in the hypothalamus .
the oe - npy mice displayed increased adiposity and liver triglyceride accumulation without changes in body weight , food consumption , or physical activity on a normal chow diet .
the increased adiposity was observed in both genders at all ages studied , but the major metabolic complications such as impaired glucose tolerance , hyperinsulinemia , and hepatosteatosis were only present in male oe - npy mice .
furthermore , the oe - npy mice showed elevated sympathetic tone and increased responses to stress , and increased susceptibility to arterial... | neuropeptide y ( npy ) is a neurotransmitter associated with feeding and obesity .
we have constructed an npy transgenic mouse model ( oe - npydbh mouse ) , where targeted overexpression leads to increased levels of npy in noradrenergic and adrenergic neurons .
we previously showed that these mice become obese on a normal chow .
now we aimed to study the effect of a western - type diet in oe - npydbh and wildtype ( wt ) mice , and to compare the genotype differences in the development of obesity , insulin resistance , and diabetes .
weight gain , glucose , and insulin tolerance tests , fasted plasma insulin , and cholesterol levels were assayed .
we found that female oe - npydbh mice gained significantly more weight without hyperphagia or decreased activity , and showed larger white and brown fat depots with no difference in ucp-1 levels .
they also displayed impaired glucose tolerance and decreased insulin sensitivity .
oe - npydbh and wt males gained weight robustly , but no difference in the degree of adiposity was observed . however , 40% of oe - npydbh but none of the wt males developed hyperglycaemia while on the diet .
the present study shows that female oe - npydbh mice were not protected from the obesogenic effect of the diet suggesting that increased npy release may predispose females to a greater risk of weight gain under high caloric conditions . |
6,577 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: prions are infectious proteins , able to propagate and transmit the infection from one individual to another without an essential nucleic acid .
in addition to this horizontal transmission , typical of the mammalian transmissible spongiform encephalopathies ( tses ) , prions of fungi also transmit the infection vertically ( to their offspring ) , and so they are proteins acting as genes , just as nucleic acids can act as enzymes ( table 1 ) .
prions of mammals , yeast and the filamentous fungus podospora anserina most prions are amyloids filamentous polymers high in -sheet structure , usually protease resistant and with characteristic staining properties .
prion transmission occurs when donor amyloid enters the recipient cell and the equivalent recipient protein joins to the ends of the amyloid filaments , which act as a structural template , so that the recipient protein adopts ( usually ) the same conformation as the donor amyloid .
the known prion - forming proteins of yeast and mammals are listed in table 1 .
a single prion protein sequence can form any of several biologically distinct prion ' strains ' or ' variants ' , differentiated in mammals by incubation time , disease signs and lesion distribution , or in yeast by prion stability , phenotype intensity or sensitivity to elevated or depressed levels of particular chaperones ( reviewed in ) .
different prion variants have different amyloid structures , although the exact structures are as yet unknown .
prions that are fully infectious between individuals of the same mammalian or yeast species may transmit poorly or not at all between species , a phenomenon called the species barrier . in spite of centuries of exposure ,
sheep scrapie is not known to have been transmitted to humans , but bovine spongiform encephalopathy ( bse ) has ( fortunately only rarely ) done so .
the primary determinants of the species barrier are the sequences of the potential prion proteins of the two species . however , the prion variant is also an important factor .
for... | prion variants faithfully propagate across species barriers , but if the barrier is too high , new variants ( mutants ) are selected , as shown in a recent bmc biology report
. protein sequence alteration can prevent accurate structural templating at filament ends producing prion variants . |
6,578 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: burkholderia
pseudomallei ( bp ) is the causative agent
for the bacterial septic disease melioidosis .
melioidosis is endemic throughout the tropical southeast pacific region
and is considered a growing global health threat.bp , an environmental saphrophyte
by nature , is intrinsically resistant to multiple antibiotics due
to factors including drug inactivation ( e.g. , -lactamase activity ) ,
a multidrug efflux pump system , and an adaptive physiology that can
alter drug target sites throughout disease progression . as a result
, mortality rates from melioidosis
can approach 50% even with antibiotic treatment . despite increased scrutiny in recent years
, the
mechanisms by which bp can establish and propagate
an infection have remained unclear .
bioinformatics analyses of bp and its genetic relatives burkholderia mallei ( bm ) and burkholderia thailandensis ( bt ) indicate that substantial parts of their genomes
are dedicated to polyketide ( pk)- and non - ribosomal peptide ( nrp)-based
secondary metabolism , which we have hypothesized could be a key component
of burkholderia virulence .
while many of the gene clusters
common to all three species have been studied , clusters that are solely
found within the bp genome have remained uncharacterized ,
and to date , the specific roles that secondary metabolism has in establishing
melioidosis have not been evaluated . herein , we begin the characterization
of the unique secondary metabolome encoded by bp and
show that it is a key factor in melioid virulence .
the importance
of these molecules to bp pathogenicity suggests that
inhibition of their biosynthesis could present a viable avenue for
future therapeutic intervention .
cryptic and/or silent small - molecule
biosynthetic gene clusters
are routinely found within sequenced bacterial genomes .
while biosynthetic gene clusters encoding molecules
required for bacterial pathogenesis must be produced in vivo during an infectious event , many may remain silent in... | increasing evidence has shown that
small - molecule chemistry in
microbes ( i.e. , secondary metabolism ) can modulate the microbe
host
response in infection and pathogenicity .
the bacterial disease melioidosis
is conferred by the highly virulent , antibiotic - resistant pathogen burkholderia pseudomallei ( bp ) . whereas
some macromolecular structures have been shown to influence bp virulence ( e.g. , secretion systems , cellular capsule ,
pili ) , the role of the large cryptic secondary metabolome encoded
within its genome has been largely unexplored for its importance to
virulence .
herein we demonstrate that bp - encoded
small - molecule biosynthesis is indispensible for in vivo bp pathogenicity .
promoter exchange experiments were used to induce
high - level molecule production from two gene clusters ( mpn and syr )
found to be essential for in vivo virulence .
nmr
structural characterization of these metabolites identified a new
class of lipopeptide biosurfactants / biofilm modulators ( the
malleipeptins ) and syrbactin - type proteasome inhibitors , both
of which represent overlooked small - molecule virulence factors for bp .
disruption of burkholderia virulence by inhibiting the
biosynthesis of these small - molecule biosynthetic pathways may prove
to be an effective strategy for developing novel melioidosis - specific
therapeutics . |
6,579 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | we investigated mammary gland differentiation and cell proliferation in rats after acute exposure to xenoestrogens .
pubertal female sprague - dawley rats ( six / group ) were treated for 1 week with diethylstilbestrol ( des ) , genistein , o , p'-ddt , aroclor 1221 , aroclor 1254 , 2,3,7,8-tetrachlorodibenzo - p - dioxin ( tcdd ) , or the vehicle , sesame oil . animals were killed 18 hr after the last treatment .
analysis of mammary whole - mounts revealed that exposure to des , genistein , and o , p'-ddt resulted in enhanced gland differentiation and increased epithelial cell proliferation as measured by proliferating cell nuclear antigen immunohistochemistry , tcdd treatment inhibited cell proliferation and gland development .
aroclor 1221 and aroclor 1254 treatments had slight but not statistically significant effects on cell proliferation and mammary gland development .
we conclude that des , genistein , and o , p'-ddt given to pubertal rats act as morphogens ; i.e. , they increase cell proliferation , which promotes maturation of the undifferentiated terminal end buds to more differentiated lobular terminal ductal structures.imagesfigure 1 .
afigure 1 .
bfigure 2.figure 3 .
afigure 3 .
bfigure 3 .
cfigure 3 .
dfigure 4.figure 5.figure 6 . |
6,580 | 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 characterized by anemia , skin pigmentation , tremors , physical , and mental regression without a defined etiopathogenesis and low incidence .
we have studied 9 patients over 1 year for the changing clinical and laboratory variables of patients with its .
neuroregression and anemia were presented in all followed by tremors in 5 and hypotonia in 2 .
infantile tremor syndrome ( its ) is a syndrome characterized by anemia , skin pigmentation , tremors , physical , and mental regression .
it has been reported in children between 5 months and 3 years of age with a male predominance .
the purpose of this case series was to determine factors responsible for its continuing prevalence despite better knowledge and weaning practices .
we have studied 9 patients presenting to us with typical features of its and pre - its in a tertiary care hospital of hilly terrain [ table 1 ] . a detailed history and examination
investigations included complete hemogram , peripheral smear to type the anemia and malaria parasite , serum electrolytes , renal and liver function tests along with sepsis screen , and urine routine examination .
blood and urine cultures , serum b12 levels , chest x - ray , and tuberculosis screen were done when indicated . written informed consent was taken from all .
total 9 patients , 3 males and 6 females presented over the period of 1 year .
the mean age of presentation was 13.5 months , ranging from 7 months to 18 months .
all ( 100% ) patients admitted with the complaint of lethargy and weakness with a mean duration of 21 days .
neuroregression was present in all ( 100% ) with a mean delay of 7 months ranging from 4 to 11 months in all spheres of development .
tremors were present in 5 ( 55% ) and hypotonia in 2 ( 22% ) reflecting neurological changes .
seven ( 78% ) were exclusively breastfed and 2 ( 22% ) improperly weaned with diluted milk .
protein energy malnutrition was present in 5 ( 55% ) out of which 2 ( 40% ) had grade i and 3 had grade ii ( 60% ) protein... | background : infantile tremor syndrome ( its ) is characterized by anemia , skin pigmentation , tremors , physical , and mental regression without a defined etiopathogenesis and low incidence.materials and methods : we have studied 9 patients over 1 year for the changing clinical and laboratory variables of patients with its .
neuroregression and anemia were presented in all followed by tremors in 5 and hypotonia in 2.result:sepsis screen was positive in 6 and urine cultures in 2 .
antibiotics were required in 6 .
its with changing parameters still significantly contributes to healthcare burden.conclusion:it is important to screen for urinary infection and septicemia to avoid antibiotic abuse . |
6,581 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the clinical history and video - eeg features of a young boy , who presented with episodic chest pain , is described to illustrate this atypical presentation .
a 14-year - old boy preparing for his final exams was brought by his mother for evaluation of episodic left - sided chest pain of 2 weeks duration . the pain which lasted a few seconds to half a minute
was described as sharp , excruciating and localized to the lower chest on the left side and involved an area of only two finger breadths . the frequency varied from 1 to 8 episodes per day with variable severity but consistent location .
there were no accompanying clinical features like breathlessness , diaphoresis , palpitation , fear , abnormal behavior or movements .
there was no antecedent illness or trauma ; no history of febrile seizures , encephalitis or perinatal insult .
he was evaluated by a pulmonologist and cardiologist who performed relevant investigations including a chest ct scan , electrocardiogram , and echocardiogram which returned normal findings .
he was referred to a psychiatrist but the family preferred to get an opinion at our neurology center .
an interictal eeg was initially performed which showed spike - and - wave discharges in the awake state distributed frontocentrally over the left hemisphere ( fig .
1 ) . this prompted us to obtain a long term video - eeg recording . during the 24 h of study
, five events were recorded of which only one was associated with a clear - cut ictal pattern .
the clinical semiology was dominated by severe localized chest pain in the right lower chest ( as opposed to the typical left - sided location for chest pain ) .
however some paucity of movements were observed on the right side especially the right upper limb .
the initial part of the ictal recording was obscured by artifact while a nicely evolving 4.04.5 hz rhythm was noted in the parasagittal region a few seconds after clinical onset . a 910 hz faster rhythm was also observed in the left mid and posterior temporal regions which did not... | purposeto investigate the probable ictal origin of unexplained episodic chest pain and if possible to lateralize and localize the epileptic focus.methodsa 14 year old boy presented with episodic short lasting localized chest pain .
his cardiac and other systemic work - up were normal .
mri brain did not reveal any structural pathology .
video telemetry was done for characterization of the paroxysms.resultsinterictal record showed left fronto - central epileptiform discharges .
a left hemispheric , predominantly centroparietal ictal rhythm was identified .
the possible localizations of this unusual semiology are somatosensory areas i and ii , supplementary sensorimotor area , posterior insula and cingulate cortex .
patient responded remarkably to antiseizure drugs.conclusionpain is a rare manifestation of epilepsy observed in less than 1% of patients .
when present , it is usually accompanied by other focal features .
this rare occurrence of epileptic seizures masquerading as angina is a novel observation . |
6,582 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: marginal gingival recession is not an uncommon feature in almost all populations regardless of oral hygiene . covering exposed root surfaces
are indicated mainly in subjects with esthetic demands , root sensitivity , and cervical caries .
all free - graft procedures require a donor site and result in an additional wound site and discomfort for the patient while pedicle flaps without tissue grafts do not require harvesting the graft from a donor site and have been used for root coverage successfully .
one of the predictable techniques for recession coverage is the coronally positioned flap ( cpf ) .
it is a relatively easy procedure for the clinician and patient , with satisfactory esthetic results without the need for a second surgical site . despite the positive results reported by all root coverage procedures , surgical techniques using particular subepithelialized connective tissue graft and matrix graft should be considered as the first and second choice procedures , respectively , when complete root coverage is the desired outcome .
the reported range of root coverage with cpf is 70 - 99% with a mean of 83% .
the additional use of demineralized agents of varying ph as an adjunct to root coverage procedures has been recommended in order to remove the smear layer and bacterial toxins , to expose collagen fibers on the dentin surface , facilitate cell migration and retard epithelial downgrowth .
several controlled clinical trials comparing the effects of different surgical techniques with and without use of citric acid did not show any beneficial clinical effect from the use of citric acid .
some studies comparing the effects of etching agents operating at neutral ph ( ph = 7 ) such as ethylene diamine tetraacetic acid ( edta ) and agents operating at low ph such as citric acid ( ph = 1 ) demonstrated improved healing following etching with edta in comparison to controls with no etching or citric acid etching .
edta root treatment may facilitate the formation and adherence of the blood clot to the root... | background : localized gingival recession can be treated successfully via coronally positioned flap ( cpf ) and additional use of root surface demineralization agents .
the purpose of this study was to evaluate the effects of additional use of ethylene diamine tetraacetic acid ( edta ) and citric acid as a root conditioner in association with cpf to cover localized buccal gingival recessions.materials and methods : twenty - seven patients with 66 miller class i buccal gingival recession 2 mm on single - rooted teeth were studied .
patients were randomly assigned : cpf with edta gel ( test 1 ) and cpf with saturated citric acid ( test 2 ) or cpf alone ( control ) .
clinical parameters were measured at baseline and 1 , 2 , 3 and 6 months after surgery ; assessment included recession depth ( rd ) , clinical attachment level ( cal ) , probing depth ( pd ) and height of keratinized gingiva ( hkg ) .
spss version-20 was used to perform all statistical analyses .
data was reported as mean sd .
age , rd , cal , pd , and hkg before treatment and after 6 months among study groups were compared by one - way anova followed by the tukey test .
the level of significance was considered to be less than 0.05.results:at 6 months , all treatment modalities showed significant root coverage and gain in cal .
rd was reduced from 2.86 0.76 mm to 0.550.53 mm in the edta group and from 2.370.57 mm to 1.030.43 mm in the acid group and from 2.370.54 mm to 0.850.49 mm in the control group . the average percentage of root coverage for the edta , acid , and control groups were 80.73% , 52.16% , and 64.50% , respectively . at 6 months
, there was a significant difference ( p
< 0.05 ) in all parameters for the edta group ( except hkg that did not vary among the groups).conclusion : root preparation with edta was an effective procedure to cover localized gingival recessions and significantly improved the amount of root coverage obtained . |
6,583 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: genetics and environmental factors combine to produce different asthma phenotypes and various responses to controller medications .
the global initiative for asthma ( gina ) updated in 20161 is an ongoing international effort to provide a unified approach to the diagnosis and treatment of asthma .
table 1 summarizes the gina general treatment approach to asthma that uses a stepwise function based on the severity of asthma symptoms .
the table shows that inhaled corticosteroids ( icss ) play a major role as maintenance or preventative treatments in this stepwise approach to asthma .
table 2 summarizes the currently available and approved handheld inhalers by the us food and drug administration ( fda ) and several others not available in the usa .
fluticasone furoate ( ff ) is a potent corticosteroid that is dosed once daily due to its long half - life when inhaled .
it was approved by the fda as a once - daily ics for the maintenance treatment of asthma as a dry powder inhaler ( dpi ) in august 2014 with the brand name arnuity ellipta ( gsk , usa).2 controversy exists as to the role of long - acting beta2 agonists ( labas ) in the maintenance treatment of moderate to severe asthmatics .
early clinical trials of the laba salmeterol ( sal ) noted a nonstatistically significant increase in all - cause mortality in asthmatic patients treated over 16 weeks when compared to those using the short - acting beta2 agonist ( saba ) , albuterol.3 a large 2006 clinical trial of 26,355 asthmatics named the salmeterol multicenter asthma research trial ( smart ) evaluated sal by metered dose inhaler ( mdi ) compared to placebo mdi over 28 weeks.4 the use of ics and leukotriene modifiers was equal in both groups ( 47% and 11% , respectively ) .
the primary outcome included respiratory - related deaths or life - threatening events , and both were infrequent for the sal group ( 50 patients ) and placebo group ( 36 patients ) .
this difference did not reach statistical significance ( relative risk [ rr ] = 1.40 , 95% confidence... | the use of inhaled corticosteroids ( icss ) plays a key role in the treatment of asthmatic patients , and international guidelines have designated icss as an early maintenance therapy in controlling asthma symptoms .
when asthmatic patients remain symptomatic on icss , one common option is to add a long - acting beta2 agonist ( laba ) to the maintenance treatment .
fixed combination inhalers that contain both an ics and a laba have been popular for both chronic obstructive pulmonary disease ( copd ) and asthma .
historically , these inhalers have been dosed twice daily .
however , currently , there is a once - daily combination therapy with the ics fluticasone furoate ( ff ) and the laba vilanterol trifenatate ( vi ) with indications for use in both copd and asthma .
this dry powder inhaler ( dpi ) comes in two doses of ff ( 100 or 200 g ) both combined with vi ( 25 g ) .
this article reviews the clinical trial data for ff , vi and ff / vi combination inhalers and documents the efficacy and safety of once - daily inhaled maintenance therapy by dpi in asthmatic patients . |
6,584 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: immunoglobulin e ( ige ) predominantly mediates immunity and immune responses against parasitic infections , but it is also an essential component of type i hypersensitivity reaction , which can cause anaphylaxis , asthma , atopic dermatitis , and allergic rhinitis [ 2 , 3 ] .
inhalant and food allergies are induced and regulated by ige and can be present in children and adults with frequent or chronic upper respiratory inflammatory episodes that are often misdiagnosed as viral infections .
allergy is increasingly common worldwide : 20%25% of adults reportedly have an allergy - based respiratory disease , and up to 40% of children in western countries may be affected [ 68 ] .
children who are genetically prone to atopy commonly present with eczema up to the age of 3 years , after which asthma and rhinitis develop as the next stage of the atopic march .
the most effective treatment is prompt diagnosis followed by the identification of specific causative allergen(s ) .
the gold standard for the detection of specific allergens is the immunocap immunoassay , but this method can be costly and requires specialist equipment and skill .
many immunologists therefore initially assess the total ige levels in patients with suspected allergies , despite the reported low negative predictive value of this assay [ 1013 ] .
currently , the measurement of total ige is recommended only as a supplemental diagnostic measure for the diagnosis of allergic asthma .
however , this investigation is widely used by clinicians in the middle east , including those in saudi arabia , even though the efficacy and cost - effectiveness of assessing total ige remain unclear .
this study aimed to assess the predictive value of total ige in a group of patients with suspected allergies in saudi arabia , in order to determine whether this test is useful as a diagnostic tool in this population .
moreover , the predictive value of total ige was determined separately for inhalant , food , and multiple allergies , in order to verify which type of... | objective . to assess the diagnostic significance of total ige in foods , inhalant , and multiple allergies . methods .
retrospective review of the laboratory records of patients who presented with clinical suspicion of food or inhalant allergy between january 2013 and december 2014 .
total ige level was defined as positive for a value > 195
ku / l ; and diagnosis was confirmed by the detection of specific ige ( golden standard ) for at least one food or inhalant allergen and at least two allergens in multiple allergies .
results .
a total of 1893 ( male ratio = 0.68 , mean age = 39.0 19.2 years ) patients were included .
total ige had comparable sensitivity ( 55.8% versus 59.6% ) and specificity ( 83.9% versus 84.4% ) in food versus inhalant allergy , respectively , but a superior ppv in inhalant allergy ( 79.1% versus 54.4% ) .
roc curve analysis showed a better diagnostic value in inhalant allergies ( auc = 0.817 ( 95% ci = 0.7960.837 ) versus 0.770 ( 95% ci = 0.7070.833 ) ) . in multiple allergies ,
total ige had a relatively good sensitivity ( 78.6% ) , while negative ige testing ( < 195
ku / l ) predicted the absence of multiple allergies with 91.5% certitude .
conclusion .
total ige assay is not efficient as a diagnostic test for foods , inhalant , or multiple allergies .
the best strategy should refer to specific ige testing guided by a comprehensive atopic history . |
6,585 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | occupational and toxicological studies have demonstrated adverse health effects from exposure to toxic air contaminants .
data on outdoor levels of toxic air contaminants have not been available for most communities in the united states , making it difficult to assess the potential for adverse human health effects from general population exposures .
emissions data from stationary and mobile sources are used in an atmospheric dispersion model to estimate outdoor concentrations of 148 toxic air contaminants for each of the 60,803 census tracts in the contiguous united states for 1990 .
outdoor concentrations of air toxics were compared to previously defined benchmark concentrations for cancer and noncancer health effects .
benchmark concentrations are based on standard toxicological references and represent air toxic levels above which health risks may occur . the number of benchmark concentrations exceeded by modeled concentrations ranged from 8 to 32 per census tract , with a mean of 14 . estimated concentrations of benzene , formaldehyde , and 1,3-butadiene were greater than cancer benchmark concentrations in over 90% of the census tracts .
approximately 10% of all census tracts had estimated concentrations of one or more carcinogenic haps greater than a 1-in-10,000 risk level .
twenty - two pollutants with chronic toxicity benchmark concentrations had modeled concentrations in excess of these benchmarks , and approximately 200 census tracts had a modeled concentration 100 times the benchmark for at least one of these pollutants .
this comprehensive assessment of air toxics concentrations across the united states indicates hazardous air pollutants may pose a potential public health problem.imagesfigure 1figure 2figure 3figure 4 |
6,586 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: ameloblastic fibroodontomas ( afos ) are slow - growing , benign tumors developing from the odontogenic epithelium and ectomesenchyme .
they are usually found to be asymptomatic and are most often discovered on routine radiography .
the clinical features are painless swelling of the jaw , an asymmetrical face , missing permanent teeth , and displaced or impacted tooth .
radiographically , such a tumor appears as a well - circumscribed , expansile radiolucency that generally contains solitary or multiple small radiopaque foci .
the presence of radiopaque material ranging from small spots to extensive compact masses in the center of the tumor image is common .
we present a case of an 18-year - old female with giant complex odontoma present in the body of the mandible leading to an impacted mandibular third molar .
an 18-year - old female presented to our unit with the complaint of a painless swelling on the left side of the lower jaw for the last 3 years that seemed to show a progressive increase in size . on examination , a firm , diffuse , nontender swelling of size 9 5 cm involving the left body of the mandible was observed [ figure 1 ] .
on intraoral examination , a small hard tissue projecting over the posterior alveolus was present with normal surrounding mucosa . to our surprise ,
the orthopantomogram ( opg ) showed a well - defined radiopaque mass of size 3 6 cm present over the left body of the mandible .
an impacted third molar was present below the mass just above the inferior border [ figure 3 ] .
preoperative photograph showing diffuse swelling over the left side of the lower face intraoral photograph showing missing permanent left mandibular molars and a calcified , toothlike structure protruding from the alveolar mucosa over the retromolar region orthopantomogram revealsa large , well - defined radiopaque lesion with focal radiolucent areas occupying the whole left body of the mandible . an impacted tooth is also visible .
this appearance suggests that the lesion is a complex odontoma we... | an ameloblastic fibroodontoma ( afo ) is a rare odontogenic tumor of mixed dental tissue origin .
it exhibits histological features of ameloblastic fibroma and complex odontoma .
afos are usually found to be asymptomatic and are most often discovered on routine radiography .
sometimes their presence is suspected due to missing permanent dentition .
we report a case of an 18-year - old female patient with missing mandibular molars on the left side associated with a giant complex odontoma .
treatment included surgical excision of the tumor followed by reconstruction with iliac crest graft .
histopathological study revealed it as an afo , to our surprise . |
6,587 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: weech - maldonado , shea , and mor ( 2006 ) examined the cost / outcome relationship for nursing homes and found that the pattern of the relationship depended on the choice of outcome measures .
different studies examining the relationship between inefficiency and health outcomes have also yielded contradictory results .
morey et al . ( 1992 ) and deily and mckay ( 2006 ) found that a hospital 's inefficiency score was positively associated with the observed in - hospital mortality rate , whereas mckay and deily ( 2008 ) did not find any consistent association .
some studies have used cost functions with costs as the dependent variable , where outcome measures were explanatory variables in a given cost function ( fleming 1991 ; carey and burgess 1999 ; weech - maldonado , shea , and mor 2006 ) .
this cost function usually has a hybrid functional form following grannemann , brown , and pauly ( 1986 ) .
however , mukamel , zwanziger , and tomaszewski ( 2001 ) , deily and mckay ( 2006 ) , and mckay and deily ( 2008 ) used outcomes as the dependent variables , where hospital cost was one explanatory variable .
a common feature of these studies is their use of aggregate measures for costs and health outcomes .
most studies use mortality ( i.e. , usually in - hospital mortality ) as the only outcome measure ( morey et al .
1992 ; mukamel , zwanziger , and tomaszewski 2001 ; deily and mckay 2006 ; ) . using both readmissions and mortality , fleming ( 1991 ) found that the association with costs was positive at low outcome levels , negative at intermediate outcome levels , and positive again at high outcome levels for both outcomes measures .
however , mckay and deily ( 2008 ) also used readmissions in addition to mortality and found no systematic pattern .
carey and burgess ( 1999 ) used posthospitalization outcomes for mortality and readmission , as well as outpatient follow - up rates .
they found that all three outcome measures were positively associated with hospital costs ( i.e. , high levels of mortality were... | objectiveto investigate and to quantify the relationship between hospital costs and health outcomes for patients with acute myocardial infarction ( ami ) in veterans health administration ( vha ) hospitals using individual - level data for costs and outcomes.data sourcesvha administrative files for the fiscal years 20002006.study designcosts were defined as costs incurred during the index hospitalization for treatment of ami .
mortality and readmission , assessed 1 year after the index hospitalization , were used as measures of clinical outcome .
we examined health outcomes as a function of costs and other patient - level and hospital - level characteristics using a two - stage cox proportional hazard model that accounted for competing risks within a multilevel framework . to control for patient comorbidities , we compiled a comprehensive list of comorbidities that have been found in other studies to affect mortality and readmissions.principal findingswe found that costs were negatively associated with mortality and readmissions .
every u.s.$100 less spent is associated with a 0.63 percent increase in the hazard of dying and a 1.24 percent increase in the hazard to be readmitted conditional on not dying .
this main finding remained unchanged after a number of sensitivity checks.conclusionsour results suggest that there is a trade - off between costs and outcomes .
the negative association between costs and mortality suggests that outcomes should be monitored closely when introducing cost - containment programs .
additional studies are needed to examine the cost
outcome relationship for conditions other than ami to see whether our results are consistent . |
6,588 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: radical prostatectomy is regarded as the gold standard surgical treatment for organ confined prostate cancer . even though the surgical technique has been improved steadily stress urinary
incontinence is a well - known side effect of this procedure with reported incidence rates of up to 20% [ 1 , 2 ] .
another rare reason for postsurgery incontinence is the transurethral resection ( tur ) of the prostate .
the artificial urinary sphincter is still considered to be the standard surgical treatment for stress incontinence after prostate surgery with good long - term results in terms of continence and quality of life [ 4 , 5 ] . however , besides patients ' requirement of mental capacity and fine - motor control to operate the implanted pump , the significant reoperation rate 35% due to well - known complications such as cuff erosion , infection , or mechanical problems lead to an establishment of minimal invasive sling systems for treatment of urinary incontinence in the last years .
the retrourethral transobturator sling suspension ( rts ) , ( advance male sling , american medical systems , minnetonka , mn , usa ) , introduced in 2006 , offers a functional approach by relocating the descent proximal urethra into the original anatomic position and thus allowing adequate function of the sphincter [ 7 , 8 ] .
therefore sufficient sphincter contraction with or without complete closure is essential for the success of this approach .
promising results in recent studies show success rates from 5480% regarding improved continence with few serious complications .
however , failure rates of up to 36.5% and even worsening in 9% have been reported . taking these objections into account
, this study was performed to prospectively evaluate the functional outcome of the rts at our institution .
from september 2010 to september 2011 , 32 patients with mild to severe stress urinary incontinence after prostate surgery were treated with rts in the department of urology , university hospital ulm .
twenty - eight patients ( 87.5% )... | objective . to evaluate functional outcome of the retrourethral transobturator sling suspension ( rts ) in the treatment of stress urinary incontinence ( sui ) caused by prior prostate surgery
. methods .
the rts ( advance male sling ) was implanted in 32 patients who suffered from mild to severe postsurgical - treatment incontinence at the university hospital ulm from september 2010 to september 2011 including 10 patients with prior radiation therapy .
functional data ( uroflowmetry , daily pad use , and postvoid residual urine ) as well as quality of life with impact of urinary problems ( iciq - ui sf ) were prospectively assessed at baseline and during followup .
results . after a median followup of 9 months ( range , 314 )
the incontinence cure rate ( no pad usage ) was 56.2% and the improvement rate ( 1 - 2 pads / day or 50% reduction ) was 21.9% .
no improvement was observed in 21.9% .
daily pad use and iciq - ui sf score improved significantly .
no major perioperative complications occurred .
postoperatively , 15.6% of the patients exhibited transient acute urinary retention which resolved without further treatment after a maximum of 3 weeks .
one patient underwent sling explantation due to dislocation and persistent perineal pain .
conclusions .
the implantation of the rts is a safe and effective procedure in selected patients with sui resulting from prostate surgery . |
6,589 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: spontaneous intramedullary hemorrhage is a rare disease entity , and most cases have specific etiologies , such as vascular malformations and tumorous lesions61112 ) .
there are also reports indicating that anticoagulation therapy and hemophilia cause spontaneous intramedullary hemorrhage1313 ) .
it is extremely rare for this to occur without an apparent underlying etiology , and only a few such cases have been reported468910 ) .
recurrent hemorrhage is thought to be the cause of progressive and stepwise neurological deterioration in vascular malformations of the spinal cord2 ) , and a high risk of rebleeding from a vascular malformation is the reason why total excision of the pathology is important .
although there have been some reports suggesting the occurrence of recurrent bleeding in chronic forms of intramedullary hemorrhage without apparent etiology710 ) , it is extremely rare for recurrent intramedullary hemorrhage to occur acutely without a specific cause . here ,
while we describe this rare event , we discuss its etiology , and the diagnostic , therapeutic and prognostic implications of this disease including a review of the relevant literature .
a 48-year - old woman visited our emergency department complaining of voiding difficulty , weakness and sensory disturbances in both lower extremities , which had started 7 days ago prior to her visit .
an initial neurological examination revealed grade iii motor power for the right and grade iv motor power for left lower extremity , and she was unable to walk .
she had been taking an antihypertensive medication for 4 years . otherwise she had no known diseases such as blood dyscrasias , bleeding disorders , cardiovascular disorders , and various other central nervous system disorders .
thoraco - lumbar spine magnetic resonance imaging ( mri ) revealed an intramedullary mass lesion at the t9 - 10 level , which showed as a high signal in a t1 weighted image ( fig .
following gadolinium injection , subtle enhancement at the periphery of the mass was observed... | a 48-year - old woman presented with acute voiding difficulty , numbness and weakness of both lower extremities . magnetic resonance imaging ( mri ) showed an intramedullary hemorrhagic mass that extended from t9 to t10 .
t8-t10 laminotomy and surgical removal of the hemorrhagic mass was performed .
the pathological diagnosis was hematoma .
her neurological status remained the same after the operation . at 5 days post - operation ,
the patient suddenly became paraplegic , and mri that was immediately performed revealed a recurrent intramedullary hemorrhage .
emergent surgical evacuation was performed .
again , histological examination showed only hematoma , without any evidence of abnormal vessels or a tumor .
a postoperative mri revealed no abnormal lesions other than those resulting from postoperative changes . at a 9-month follow up ,
the patient could walk a short distance with the aid of a walker . because spontaneous intramedullary hemorrhage with unknown etiology is very rare
, it is essential to perform a meticulous inspection of the hemorrhagic site to find the underlying cause .
repeated hemorrhage can occur ; therefore , close observation of patients after surgery is important in cases without an apparent etiology .
urgent surgical evacuation is important to improve outcomes in these cases . |
6,590 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: treatment for acute mesenteric ischemia ( ami ) traditionally involves exploratory laparotomy to assess bowel viability and revascularization of visceral arteries , usually the superior mesenteric artery ( sma ) .
revascularization can be achieved through a bypass from the aorta or iliac arteries , embolectomy , open exposure of sma and retrograde recanalization and stent , or percutaneous antegrade stenting via a femoral or brachial approach . in patients without clinical evidence of acute bowel ischemia
flush occlusion of the sma , however , can make antegrade recanalization very challenging and is usually unsuccessful .
transcollateral recanalization of occluded vessels has been previously described for lower extremity disease with good outcomes .
urasawa et al have described retrograde recanalization of superficial femoral artery using profunda femoris collaterals , whereas successful transcollateral recanalization of chronically occluded tibial arteries has also been demonstrated .
there have been a few reports of totally endovascular transcollateral recanalization of sma in cases of chronic mesenteric ischemia and also open laparotomy with retrograde sma stenting ; however , totally endovascular retrograde transcollateral recanalization of sma via the celiac artery ( ca ) has not been described in ami .
we report a case of ami with flush occlusion of the sma and hostile abdomen , who underwent totally endovascular retrograde recanalization of the sma via the ca through the gastroduodenal artery ( gda ) and pancreaticoduodenal arcade .
a 69-year lady with a past medical history of hypertension , hyperlipidemia had 4 months prior presented with acute onset of diffuse abdominal pain with peritonitis , and an elevated lactate and white blood cell ( wbc ) count .
we performed an exploratory laparotomy , sma exploration with direct repair of dissection flap and thrombectomy , bovine pericardium patch angioplasty , and extensive small bowel resection .
her bowel was ultimately put in continuity with 160 cm... | abstractrevascularization for acute mesenteric ischemia ( ami ) can be achieved through a bypass from the aorta or iliac arteries , embolectomy , open exposure of sma and retrograde recanalization and stent , or percutaneous antegrade stenting .
flush occlusion of the sma can make antegrade recanalization very challenging and is usually unsuccessful.we present a novel approach for recanalization of superior mesenteric artery ( sma ) via the celiac artery for acute mesenteric ischemia . a 69-year - old lady with previous endarterectomy of sma and extensive small bowel resection presented with severe abdominal pain , emesis , leukocytosis , and imaging finding of new sma flush occlusion .
she refused to consent for a laparotomy .
percutaneous retrograde transcollateral recanalization of sma was performed via the celiac artery through the pancreaticoduodenal arcade , and the sma then stented .
this resulted in subsequent resolution of patient 's symptoms and discharge.sma revascularization with retrograde transcollateral wiring technique is an important tool in the armamentarium of the vascular care specialist when antegrade percutaneous approach and open exposure via laparotomy are not an option . |
6,591 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: age - related macular degeneration ( amd ) is the most common cause of blindness in industrialized countries affecting individuals over the age of 55 .
neovascular amd affects only 1015% of amd patients but approximately 90% of blindness due to this condition . the main cause of vision loss in neovascular amd is the development of choroidal neovascularization , which is ultimately the result of a break in a structural layer beneath the retina known as bruch 's membrane , which separates the nourishing vascular layer called the choroid from the retina .
these vessels can leak fluid or blood , initially distorting or blurring vision , and may eventually lead to scar in the macula and severe loss of central vision .
erectile dysfunction ( ed ) is defined as the inability to attain or maintain the penile erection required for sufficient sexual performance .
ed is a multifactorial disease ; the vascular , neurogenic , hormonal , psychogenic , cavernosal , iatrogenic , and anatomic causes lie in its pathophysiology .
the impact of ed can be devastating because evidence has shown that sexual function is one of the very important indices of quality of life .
cross - sectional studies have reported that ed is strongly associated with diabetes mellitus , hypertension , cardiovascular disease , hyperlipidemia , metabolic syndrome , depression , and lower urinary track symptoms [ 915 ] .
medication and recreational drugs are also associated with male sexual disorders , especially the use of antipsychotic drugs .
new epidemiological studies show an increase in the prevalence rates for ed in men who smoke as a standalone risk .
also , obesity , low testosterone levels , poor quality of life , apnoea - hypopnoea , and obstructive sleep apnoea syndrome were significantly associated with a higher risk of ed . to the best our knowledge , the association between neovascular amd and ed has not been evaluated before . in this cross - sectional study , we aim to investigate the relationship between ed and neovascular amd .
... | purpose . to evaluate association between erectile dysfunction ( ed ) and
neovascular age - related macular degeneration ( amd ) . methods .
195 men enrolled in this cross - sectional study .
90 of them had neovascular amd and 105 of them were healthy volunteers .
the international index of erectile function ( iief ) questionnaire 's erectile function ( ef ) domain was used to assess ed .
the patients in the study and control groups were statistically compared according to visual acuity , ef score , and body mass index .
results .
the mean ages were 62 ( 54.573 ) and 60 ( 5468 ) , in the neovascular amd and control groups , respectively .
the total ef scores were 9 ( 616 ) in neovascular amd and 18 ( 9.527 ) in control group .
the results of iief questionnaire on neovascular amd patients revealed that 85 men ( 94.4% ) had some degree of ed , whereas 68 men ( 64.8% ) had some degree of ed on control group .
patients with neovascular amd had a significantly higher incidence of ed than control patients ( p < 0.01 ) .
there was a significant association between ed and neovascular amd ( p < 0.01 ) .
conclusions .
our results suggested that neovascular amd has a high association with ed . |
6,592 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: these difficulties include cold welding between the screw head and locking screw hole , stripping of the recess of the screw head for the screwdriver , and cross - threading between threads in the screw head and screw hole . however , there are cases in which removal is difficult .
we describe a new technique for removing a round headed , jammed locking screws from a locking plate .
55 years old male patient received a locking distal tibial plate along with distal fibular plate 3years back from uae .
now patient came with complaint of non - healing ulcer over medial aspect of lower 1/3rd of right leg from past 1 year .
the patient consented to implant removal , with the express understanding that implant removal might be impossible because already one failed attempt had been performed at some other hospital six months back .
we used stainless steel metal cutting blades that are used to cut door locks or pad locks to cut the remaining stripped headed screws .
this technique is very quick , easy to perform and inexpensive because the metal cutting blades which are used to cut the screws are very cheap .
yet it is very effective technique to remove the stripped headed or jammed locking screws .
it is also very less destructive because of very less heat production during the procedure there is no problem of thermal necrosis to the bone or the surrounding soft tissue .
these difficulties include cold welding between the screw head and locking screw hole , stripping of the recess of the screw head for the screwdriver , and cross - threading between threads in the screw head and screw hole .
these include using a conical extraction screw , cutting the plate , and using high - speed carbide drill bits and burrs to remove the screw heads , and removing the shanks with conical extraction screws .
the available screw removal kits make implant removal successful more often than not . however , there are cases in which removal is difficult .
we describe a new technique for removing a round headed , jammed locking screws... | introduction : the advent of locking plates has brought new problems in implant removal .
difficulty in removing screws from a locking plate is well - known .
these difficulties include cold welding between the screw head and locking screw hole , stripping of the recess of the screw head for the screwdriver , and cross - threading between threads in the screw head and screw hole . however , there are cases in which removal is difficult .
we describe a new technique for removing a round headed , jammed locking screws from a locking plate.case report:55 years old male patient received a locking distal tibial plate along with distal fibular plate 3years back from uae .
now patient came with complaint of non - healing ulcer over medial aspect of lower 1/3rd of right leg from past 1 year .
non operative management did not improve the symptoms .
the patient consented to implant removal , with the express understanding that implant removal might be impossible because already one failed attempt had been performed at some other hospital six months back .
we then decided to proceed with the new technique .
the rest of the proximal screws were removed using a technique not previously described .
we used stainless steel metal cutting blades that are used to cut door locks or pad locks to cut the remaining stripped headed screws.conclusion:this technique is very quick , easy to perform and inexpensive because the metal cutting blades which are used to cut the screws are very cheap .
yet it is very effective technique to remove the stripped headed or jammed locking screws .
it is also very less destructive because of very less heat production during the procedure there is no problem of thermal necrosis to the bone or the surrounding soft tissue . |
6,593 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: sclerosing mucoepidermoid carcinoma with eosinophilia ( smece ) of the thyroid is a recently recognized primary malignant neoplasm of the thyroid gland associated with hashimoto 's thyroiditis / lymphocytic thyroiditis .
till now , cases have been reported in the literature that are diagnosed histologically . and
fine needle aspiration ( fna ) from smece often show nonspecific features and most often the diagnosis of a poorly differentiated or undifferentiated carcinoma is rendered in most of the cases ; but careful examination of cytological features and the background may sometimes be helpful in diagnosis . here , we describe the cytological features of this rare case along with its differential diagnosis .
a 35-year - old female presented with thyroid swelling for 3 years and ipsilateral lymph - node swelling of 6-month duration .
her physical examination revealed right - sided thyroid swelling of 4 cm 4 cm size and lymph - node of size 1.5 cm 1.5 cm .
her thyroid profile revealed mild hypothyroidism , while routine blood examination and serum calcitonin levels were within normal limits .
fna was performed with a 22-gauge needle from both thyroid as well from lymph node and on aspiration from both sites blood mixed material was obtained .
the richly cellular smears showed predominantly round to oval cells lying singly as well as in loosely cohesive clusters .
these cells had rounded hyperchromatic nuclei with an occasional prominent nucleus and a moderate amount of eosinophilic cytoplasm .
a few cell clusters showed squamoid differentiation in the form of pyknotic to densely compact nucleus and deeply orangophilic cytoplasm [ figure 1a ] . at a few paces , the cells formed ill - defined epithelial pearl - like structures and only very occasionally the cells showed intranuclear cytoplasmic inclusion ( inci ) [ figure 1b ] .
background population comprised predominantly of lymphocytes and a significant number of eosinophils ( 1 - 2 cells / hpf ) [ figure 1c ] .
the important negative findings were the lack... | sclerosing mucoepidermoid carcinoma with eosinophilia ( smece ) of the thyroid is a rare primary thyroid tumor arising in a background of hashimoto's / lymphocytic thyroiditis and has been recently introduced in the world health organization ( who ) classification of thyroid tumors .
it is characterized by extensive sclerosis , squamous and glandular differentiation , and inflammatory infiltrate rich in eosinophil . here
, we are discussing the cytological features of this rare case in a 35-year - old female presented with thyroid swelling and lymph - node enlargement . |
6,594 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | molecular markers such as mutational spectra or mrna expression patterns may give some indication of the mechanisms of carcinogenesis induced by fibers and other carcinogens . in our study , tumors were induced by application of crocidolite asbestos or benzo[a]pyrene ( b[a]p ) to rat peritoneum .
dna and rna of these tumors were subjected to analysis of point mutations and to investigation of mrna expression patterns . with both assays we found typical features depending on the type of carcinogen applied .
the analysis of point mutations in the tumor suppressor gene p53 revealed mutations in the b[a]p - induced tumors .
however , in the tumors induced by crocidolite asbestos that were of the same tumor type as those induced by b[a]p , mutations in p53 were not detectable . every mutation detected on the dna level causes an amino acid substitution within one of the functional domains of the tumor suppressor protein .
therefore , these mutations seem to be of biological relevance for tumor progression and indicate a difference in the carcinogenesis regarding the type of the carcinogenic substance . an additional specificity of crocidolite - induced tumors was detectable by analyzing the mrna expression of the tumor suppressor gene wt1 , which is known to be expressed in human mesothelial and mesothelioma cells .
a relatively high amount of wt1 mrna was measured by quantitative competitive reverse transcription - polymerase using rna extracted from crocidolite - induced tumors .
however , wt1 seems to be expressed on a rather low level in tumors induced by b[a]p.imagesfigure 1.figure 2.figure 2.figure 2.figure 2 . |
6,595 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: an essential development in the evolution of multicellular organisms with a variety of tissues serving different functions has obviously been the formation of specific semi - stable and dynamic cell - cell junctions , i.e. , architectonically positioned structures of limited size that connect cells of the same or different types into higher order organs .
laterally , i.e. , in the same plasma membrane , such assemblies can be homophilic or heterophilic and are generally oriented head - to - head , usually with distinct substructures .
in present textbooks of cell biology , four major categories of cell - cell junctions are distinguished ( table 1 ; for a historic review , see franke 2009 ) :
gap junctions ( nexus ) appear as densely packed hemichannels composed of tetraspan membrane proteins , which belong to the connexin family and which are symmetrically oriented into channels that allow cell - cell exchange of small molecules.tight junctions ( tj ; zonulae or fascial adhaerentes ) are arrays of tetraspan transmembrane proteins forming tight - sealing bands of various lengths , often branched or ornamentally woven .
these proteins are arranged head - to - head into membrane barrier structures containing cell - type - specific combinations of the claudin and the occludin families of proteins , mostly in association with specific immunoglobulin - like proteins of the junction adhesion molecule ( jam ) group spanning the membrane once.adherens junctions ( aj ) are a group of variously sized and shaped cell - type - specific assemblies of glycoproteins of the cadherin family spanning the membrane once and capable of forming a continuous cell - surrounding belt ( zonula adhaerens ) or streak - like fascia adhaerens , or local near - isodiametric puncta adhaerentia.generally the thickest and most robust junction type is represented by the desmosomes ( maculae adhaerentes ) formed by special subsets of cadherins ( desmogleins , desmocollins).table 1molecular components of the major categories ( i iv ) and... | immunocytochemical , electron- , and immunoelectron - microscopical studies have revealed that , in addition to the four major textbook categories of cell - cell junctions ( gap junctions , tight junctions , adherens junctions , and desmosomes ) , a broad range of other junctions exists , such as the tiny puncta adhaerentia minima , the taproot junctions ( manubria adhaerentia ) , the plakophilin-2-containing adherens junctions of mesenchymal or mesenchymally derived cell types including malignantly transformed cells , the composite junctions ( areae compositae ) of the mature mammalian myocardium , the cortex adhaerens of the eye lens , the interdesmosomal sandwich or stud junctions in the subapical layers of stratified epithelia and the tumors derived therefrom , and the complexus adhaerentes of the endothelial and virgultar cells of the lymph node sinus . on the basis of their sizes and shapes , other morphological criteria , and their specific molecular ensembles , these junctions and the genes that encode them
can not be subsumed under one of the major categories mentioned above but represent special structures in their own right , appear to serve special functions , and can give rise to specific pathological disorders . |
6,596 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in recent years , advances in technology and healthcare have improved people s lives ; even so , fighting , conflicts , violence , and other traumatic phenomena , such as vehicle accidents , occupational accidents , and injuries sustained in the martial arts , have substantially intensified the physical damage that people can incur , such as oral and maxillofacial injuries ( 1 ) . at the present time ,
they cause morbidity and mortality , increase healthcare costs , and cause physical and functional deficits , such as interference with mastication , swallowing , speech , breathing , and interacting with others ; they also cause cosmetic problems , which , in turn , can cause psychological problems ( 2 , 3 ) .
there are different causes and mechanisms of traumas , and their effects can depend on the location on the body and the victim s age and gender ( 47 ) . in adults ,
the most common causes of such traumas worldwide are traffic accidents , violence , falls , and sports injuries ( 5 ) .
facial injuries as the result of trauma are divided to three main categories , i.e. , injuries to the facial bones , injuries to soft tissues , and dentoalveolar injuries ( 8) . the most important soft tissue injuries include lacerations , hematomas , contusions , and abrasions , with lacerations being the most common injuries to soft tissues caused by trauma ( 38% ) .
the most common age range of people who suffer soft tissue injuries is 030 ( 61.5% ) , and the most common causes of such injuries are daily activities ( 49.4 % ) and exercise ( 43.8 % ) ( 8 , 9 ) .
facial bone injuries include fractures of the lefort i , ii , iii , orbital , nasal , zygomatic , mandibular , and maxillary bones , and 58% of patients with fractured facial bones were 2040 years old .
common daily activities and occupational activities account for 28.7% of such fractures , and accidents account for 21.5% ( 8) .
these injuries can be either an isolated trauma ( involving only the face ) or a multiple trauma ( damage to multiple parts of the body )... | background : many trauma patients in the emergency department are unconscious , and this causes many other problems to go undiagnosed , resulting in the loss of valuable time in initiating the appropriate treatments .
the purpose of this study was to determine the prevalence and types of injuries to the ears , nose , and throat that are ignored in patients with multiple traumas in an emergency department.methods:this study was conducted by assessing patients with multiple traumas who were admitted to the emergency department at shahid rahnamun hospital in yazd , iran , in 2012 and 2013 , and who were advised to acquire diagnostic workups and treatment in the ear , nose , and throat department .
the patients data were gathered by studying their records and by careful examinations , and the data were analyzed using the chi - squared test by spss version 18.results:among the 230 patients who were counseled , 170 patients had multiple traumas that were caused by accidents , falls , conflicts between individuals , and natural disasters .
fifty - four patients with low glassco coma scale ( gcs ) values who were admitted to the icu were counseled after they regained consciousness . among the 54 cases , 12 cases ( 22% ) had nasal fractures and four cases had septal hematomas that resulted in infections and severe deformities .
twenty - four cases ( 44% ) had lacerations of posterior auricular components , one case required extended debridement , and two cases had extensive necrosis that required a local flap .
two cases ( 3% ) had paralyzed facial nerves , 8 cases ( 14% ) had fractured mandibles , and 10 cases ( 18% ) had laceration of the oral mucosa ( lingual - buccal ) that require extended debridement in the operating room.conclusions:it is recommended that complete physical examinations be done in patients with multiple trauma after they are stabilized ; such examinations would require careful training of the medical staff and also careful and timely counseling . |
6,597 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: coexistence of hyperthyroidism and primary immune thrombocytopenia ( itp ) is a rather rare condition .
underlying untreated graves disease leads to worsening of the itp and rendering it refractory to standard therapy .
a 71-year - old female patient presented with a complaint of excessive sweating for nearly a month to a hematology unit where she had been followed - up with after a diagnosis of itp .
her laboratory tests revealed manifest hyperthyroidism in addition to thrombocytopenia , and hence she was referred to our endocrinology unit . on her physical examination , her pulse rate was 112 bpm , and her skin was warm and damp .
increased levels of anti - thyroid peroxidase , anti - thyroglobulin , and thyroid - stimulating antibody and enhanced uptake of radioactive iodine were observed , and the diagnosis of graves disease was confirmed .
methimazole therapy at daily doses of 30 mg was initiated . without any additional immunosuppressive treatment , at week 12 of methimazole therapy
, thyroid stimulating hormone ( tsh ) levels returned to normal , and platelet counts rose to tolerable levels .
when her hospital records were analyzed , they revealed that a year ago , when she had been diagnosed with itp , her tsh values had been suppressed . at that time
she had been given intravenous immune globulin ( 0.5 g / kg / day for 4 days ) and oral steroid ( 1 mg / kg / day ) for the treatment of itp .
the patient , whose platelet counts returned to being within normal limits , was followed - up with for 6 months . during this period ,
her platelet values were maintained at normal levels , and during her control visits , her tsh levels were measured twice and were within normal limits .
the patient 's laboratory test results are shown in chronological order [ table 1 ] .
afterwards , concomitancy of autoimmune thyroid diseases such as hashimoto thyroiditis and graves disease with itp has been reported many times . in graves disease ,
the lifespan of platelets is shortened significantly , and moderate degrees of... | a 71-year - old female patient followed primary immune thrombocytopenia ( itp ) was admitted to endocrinology unit with excessive sweating .
we started methimazole for graves disease . without any additional immunosuppressive treatment , at week 12 of methimazole therapy
, thyroid stimulating hormone ( tsh ) levels returned to normal , and platelet counts rose to tolerable levels .
when her hospital records were analyzed , they revealed that a year ago , when she had been diagnosed with itp , her tsh values had been suppressed .
after immunosuppressive therapy , her platelet values were maintained at normal levels , and during her control visits , her tsh levels were measured twice and were within normal limits .
we think that immunosuppressive therapy for itp without considering thyroid function tests may result in a transient euthyroid state , which potentially masks graves disease accompanying immunosuppressive therapy and associated recurrent itp attacks . |
6,598 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: fast neuronal network oscillations in the gamma frequency band ( 30100 hz ) that occur in the electroencephalogram or in local field potential recordings have been observed in virtually any mammalian cortical structure , including the neocortex and the hippocampus ( gray and singer , 1989 ; traub et al . , 1996 ; buzski and draguhn , 2004 ; bartos et al .
gamma oscillations reflect synchronous membrane potential oscillations of a large number of neurons in a given neuronal network , and they have been suggested to underlie higher cognitive functions such as sensual perception , attention , and memory formation ( lisman , 1999 ; axmacher et al . , 2006 ; mann and paulsen , 2007 ; uhlhaas and singer , 2010 ) .
gamma oscillations are generated in local neuronal networks by the complex interplay of excitatory neurons and specific inhibitory interneurons , both of which communicating via chemical and , perhaps , electrical synapses ( tams et al .
, 2000 ; whittington and traub , 2003 ; bartos et al . , 2007 ) . functionally , gamma oscillations bind neurons into a common temporal matrix , enabling precise temporal coding , spike timing - dependent plasticity , and formation of neuronal assemblies ( paulsen and moser , 1998 ; engel and singer , 2001 ; buzski and draguhn , 2004 ; axmacher et al . , 2006 ) .
a characteristic feature is the long - range synchronization of gamma oscillations in remote cortical areas ( knig et al . , 1995 ; bazhenov et al . ,
this phenomenon has been suggested to underlie binding of distributed neuronal representations and , therefore , forms a crucial neuronal prerequisite for the unity of sensual perception , attention , and , perhaps , consciousness ( engel and singer , 2001 ; fries et al .
importantly , gamma oscillations can be reliably induced in brain slice preparations in vitro ( see below ) .
the human brain consumes about 20% of the oxygen inspired at rest while accounting for only 2% of the body weight ( erecinska and silver , 2001 ) .
this suggests that neuronal information... | fast neuronal network oscillations in the gamma range ( 30100 hz ) in the cerebral cortex have been implicated in higher cognitive functions such as sensual perception , working memory , and , perhaps , consciousness . however
, little is known about the energy demand of gamma oscillations .
this is mainly caused by technical limitations that are associated with simultaneous recordings of neuronal activity and energy metabolism in small neuronal networks and at the level of mitochondria in vivo .
thus recent studies have focused on brain slice preparations to address the energy demand of gamma oscillations in vitro . here , reports will be summarized and discussed that combined electrophysiological recordings , oxygen sensor microelectrodes , and live - cell fluorescence imaging in acutely prepared slices and organotypic slice cultures of the hippocampus from both , mouse and rat .
these reports consistently show that gamma oscillations can be reliably induced in hippocampal slice preparations by different pharmacological tools .
they suggest that gamma oscillations are associated with high energy demand , requiring both rapid adaptation of oxidative energy metabolism and sufficient supply with oxygen and nutrients . these findings might help to explain the exceptional vulnerability of higher cognitive functions during pathological processes of the brain , such as circulatory disturbances , genetic mitochondrial diseases , and neurodegeneration . |
6,599 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 57-year - old woman presented with a three - day history of photophobia and diplopia in the left eye .
she was diagnosed with histologically confirmed nasal nktl of the right nasal cavity one month prior .
the snellen visual acuity of the affected eye with correction was 1.0 / 0.63 , and the intraocular pressure in the right and left eyes was 17 and 18 mmhg , respectively .
the patient had mild left eye conjunctival injection , ptosis , and swelling of the eyelid .
opthalmoplegia , vitreous opacity , and an iris mass developed in the left eye ( fig .
thirty - five percent of the cells obtained from the aspiration were morphologically atypical lymphocytes .
skin biopsy confirmed neoplastic infiltration of small- to medium - sized pleomorphic lymphocytes with irregular nuclei , inconspicuous nucleoli , and scant cytoplasm ( fig .
immunohistochemical staining was positive for cd56 ( fig . 2c ) and cd3 ( fig .
the patient was diagnosed with nasal nktl with ocular involvement . after receiving radiotherapy at 900 cgy ,
her visual acuity improved and her anterior uveitis , vitreous opacity , and iris mass resolved ( fig .
3a and 3b ) . however , the patient 's condition continued to deteriorate despite radiotherapy and chemotherapy , and her ptosis and ophthalmoplegia gradually progressed .
extranodal nktl , including nasal nktl , previously known as lethal midline granuloma , is a definitive diagnostic entity according to the world health organization lymphoma classification .
however , histopathologically identical tumors may be identified at other extranodal sites , including the skin , muscle , gastrointestinal tract , liver , kidney , and retroperitoneal space .
did report a case of histologically confirmed nasal nktl with intraocular involvement , however , in most cases intraocular involvement has not been confirmed histologically .
the presence of intraocular involvement raises the possibility of leptomeningeal or central nervous system dissemination , and prompts consideration for external - beam... | herein , we report a case of nasal natural killer t - cell lymphoma ( nktl ) with intraocular involvement . a 57-year - old woman was referred due to a three - day history of photophobia and diplopia in the left eye .
one - month previously , she was diagnosed with nasal nktl of the right nasal cavity .
ophthalmic examination revealed conjunctival injection and ptosis .
the left pupil was fully dilated and non - reactive to light .
ocular motion was restricted on left - upper gaze .
five days later , anterior uveitis developed and persisted despite topical steroid treatment .
an orbital magnetic resonance imaging was without specific findings , however , ophthalmoplegia , vitreous opacity , and an iris mass were observed .
a diagnostic anterior chamber aspiration was performed .
aqueous humor aspiration revealed 35% morphologically atypical lymphocytes .
after an intravitreal triamcinolone injection , radiotherapy and chemotherapy were administered ; this resolved the uveitis and iris mass .
when refractory uveitis or orbital pseudotumor occurs in patients with nasal nktl , ocular and orbital involvement of the nktl should be considered . |
6,600 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: malnutrition is present in 1855% of hospitalized patients ( sorensen et al . , 2008 ; imoberdorf et al . ,
studies show that nutritional support to undernourished patients and those at nutritional risk is advantageous ( stratton and elia , 2007 ) .
european guidelines state that provision of tailored food should be an integral part of patient care ( council of europe , 2002 ; kondrup et al .
, 2003a , 2003b ; norwegian directorate of health , 2009 ) . however , nutrition is often not given priority in clinical practice ( mowe et al .
insufficient knowledge and low commitment among nurses and physicians result in an insufficient focus on nutritional aspects of care ( kondrup et al . , 2002 ; bavelaar et al . , 2008 ;
dietary parameters are seldom monitored during hospital stays ; neither are they described in patients ' medical records or discharge summaries ( bavelaar et al . , 2008 ; meijers et al . , 2009
it is a great challenge to implement nutritional guidelines in hospitals ( llido , 2006 ; mowe et al . , 2006 , 2008 ; bavelaar et al . , 2008 ;
the goals were to increase professional awareness of the importance of nutritional care and to provide proper nutritional care to patients with such needs . to achieve these goals ,
it was considered necessary to develop guidelines , tools and skills , and to educate nurses and physicians in basic clinical nutrition .
responsibilities were defined and a professional framework was established ( figure 1 ) to implement these aspects of nutritional care .
an important factor was to increase the flexibility of the food services , leading to the provision of more tempting and nourishing food according to patient needs .
the aim of the present study was , by using repeated point prevalence surveys , to evaluate whether the implementation of a new strategy had positive effects on nutritional care in the hospital .
we performed a prospective quality improvement program implementing nutritional guidelines through the dedicated nutritional network ( figure 1 ) . repeated... | background / objectives : malnutrition is present in 2050% of hospitalized patients , and nutritional care is a challenge . the aim was to evaluate whether the implementation of a nutritional strategy would influence nutritional care performance in a university hospital.subjects/methods:this was a prospective quality improvement program implementing guidelines for nutritional care , with the aim of improving nutritional practice . the nutrition risk screening ( nrs ) 2002 was used .
point prevalence surveys over 2 years to determine whether nutritional practice had improved.results:in total , 3604 ( 70% ) of 5183 eligible patients were screened and 1230 ( 34% ) were at nutritional risk .
only 53% of the at - risk patients got nutritional treatment and 5% were seen by a dietician .
the proportion of patients screened increased from the first to the eighth point prevalence survey ( p=0.012 ) , but not the proportion of patients treated ( p=0.66 ) .
the four initial screening questions in nrs 2002 identified 92% of the patients not at nutritional risk.conclusions:implementation of nutritional guidelines improved the screening performance , but did not increase the proportion of patients who received nutritional treatment .
point prevalence surveys were useful to evaluate nutritional practice in this university hospital . in order to improve practice , we suggest using only the four initial screening questions in nrs 2002 to identify patients not at risk , better education in nutritional care for physicians and nurses , and more dieticians employed .
audit of implementation of guidelines , performed by health authorities , and specific reimbursement for managing nutrition may also improve practice . |
6,601 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: eosinophilic enteritis is an uncommon disease of unknown etiology , which can affect any area of the gastrointestinal tract , from the esophagus to the rectum , although the stomach and small bowel are most commonly involved1 ) .
it usually presents as colicky abdominal pain , and rarely as an acute intestinal obstruction2 , 3 ) or perforation4 - 6 ) , making the initial diagnosis very difficult .
eosinophilic enteritis should be considered in the differential diagnosis of unexplained gastrointestinal symptoms , since most patients with eosinophilic enteritis can be treated successfully with corticosteroid therapy , if the correct diagnosis is made7 ) .
development of a new capsule video endoscope , which is small enough to be swallowed and has no external wires , fiber - optic bundles , or cables , has made it possible to acquire images of the whole of the small bowel .
it has been proven to be very useful in the diagnosis of small bowel disease in the case of negative gastroscopy and colonoscopy8 ) , suggesting it can contribute to the localization of lesions for laparoscopic biopsy , and thus lead to conclusive diagnoses of eosinophilic enteritis .
we present the case of a patient who underwent an emergency laparotomy for acute intestinal obstruction due to ileal eosinophilic enteritis , followed by hematochezia due to mid - to - distal jejunal bleeding , which was visualized by capsule endoscopy .
the hematochezia was rapidly controlled by high - dosage steroid injection therapy , which suggests that it was a manifestation of eosinophilic enteritis .
a 62-year - old man visited the emergency room complaining of epigastric and periumbilical pain , which had developed 3 hours prior to his admission .
the nature of his complaint was colicky pain , but he had experienced neither nausea nor vomiting .
the patient 's leukocyte count was 10,420/mm ( 2.9% eosinophils , normal range [ nr ] , 0~5% ) .
abdominal computed tomography ( ct ) examination showed segmental wall thickening of the small bowel and proximal... | eosinophilic enteritis is a rare disease characterized by tissue eosinophilia , which can affect different layers of bowel wall .
normally , the disease presents as colicky abdominal pain , and rarely as an acute intestinal obstruction or perforation . in this paper
, we report a case of eosinophilic enteritis , hitherto unreported , presenting as an ileal obstruction , and followed by jejunal bleeding , which was visualized by capsule endoscopy .
a 62-year - old man received a 15 cm single segmental ileal resection at a point 50 cm from the ic valve due to symptoms of obstruction , which were diagnosed as eosinophilic enteritis .
seventeen days after operation , intermittent abdominal pain occurred again , and subsided upon 30 mg per day treatment with prednisolone .
fourteen days after this pain attack , the patient exhibited hematochezia , in spite of continuous prednisolone treatment .
capsule endoscopy showed fresh blood spurting from the mid - to - distal jejunum , in the absence of any mass or ulcer .
this hematochezia rapidly disappeared following a high - dose steroid injection , suggesting it was a manifestation of jejunal eosinophilic enteritis . |
6,602 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a total of 850 specimens collected from 306 patients who had encephalitis included 306 csf specimens , 304 blood samples , 120 throat swabs , and 120 rectal swabs .
all samples were stored at 20c before being transported for analysis and thereafter were stored at 70c at the national institute of virology in pune , india .
laboratory tests conducted by state government health services of uttar pradesh were negative for bacteria and malaria . according to standard protocol ( 2 ) ,
virus isolation was attempted in human rhabdosarcoma ( rd ) and in baby hamster kidney ( bhk ) cell lines .
separate aliquots were processed in 2 laboratories to maintain quality control and monitor possible contamination during pcr processing .
viral nucleic acids were extracted by using viral rna mini kits ( qiaamp , qiagen , hilden , germany ) .
rt - pcr was performed for ev by using 5 noncoding region ( ncr)specific primers , as has been described ( 5,6 ) .
genotyping was conducted by using rt - pcr of virion protein ( vp ) 1/2a and vp1 regions and sequencing ( 7,8 ) .
table 1 describes the locations and sequences of the primers used in the assays . *
ncr , noncoding region of viral genome ; vp , virion protein ; na , not applicable .
pcr products were purified by using a gel extraction kit ( qiaquick , qiagen ) .
both strands were sequenced by using bigdye terminator cycle sequencing ready reaction kit ( applied biosystems , carlsbad , ca , usa ) in abi prism 3130 xl genetic analyser ( applied biosystems ) .
mega 3.1 software generated the phylogenetic tree by using the neighbor - joining algorithm and kimura 2parameter distance model and applying a bootstrap test that used 1,000 bootstrap replications ( 9 ) .
clinical histories available for 253 of the 306 patients showed fever and altered sensorium in 100.0% , hepatomegaly in 70 ( 27.8% ) , splenomegaly in 49 ( 19.4% ) , and meningeal signs in 35 ( 13.9% ) of the 253 patients .
specimens that were adequate for isolation included 85 of 306 csf specimens , 18 of 304 serum samples... | an outbreak of viral encephalitis occurred in northern india in 2006 . attempts to identify an etiologic agent in cerebrospinal fluid by using reverse transcription
pcr showed positivity to enterovirus ( ev ) in 66 ( 21.6% ) of 306 patients .
sequencing and phylogenetic analyses of pcr products from 59 ( 89.3% ) of 66 specimens showed similarity with ev-89 and ev-76 sequences . |
6,603 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: obstructive sleep apnea syndrome ( osas ) is a condition of sleep - disordered breathing , which is characterized by the repetitive complete or partial collapses of the pharyngeal airway during sleep .
it has been known to frequently involve middle - aged people and to be found in 2% of women and 4% of men ( 1 ) .
patients with osas usually present excessive daytime sleepiness , unrefreshing sleep , fatigue , and even depression , and these symptoms may lead them to serious work or car accidents ( 2 , 3 ) . it has been reported that osas has numerous comorbidities , such as obesity , diabetes mellitus , coronary heart disease , stroke , congestive heart failure , cardiac arrhythmia , and gastroesophageal reflux ( 4 - 7 ) .
in addition , it is also an independent risk factor for hypertension ( 6 , 8) and has a close relationship with atherosclerotic cardiovascular disease ( 7 ) .
although the exact pathophysiological mechanisms are not yet fully understood , repetitive reduction of blood oxygen saturation , increased efforts to breathe , increased sympathetic tone and subsequent rennin - angiotension - aldosterone system are considered to be involved in the development of cardiovascular diseases ( 7 ) .
therefore , the assessment of cardiac functions in osas patients is an essential step in clinical settings .
heart rate variability ( hrv ) analysis has been widely used to non - invasively evaluate cardiac autonomic functions .
investigators have demonstrated that abnormal hrv is associated with increased mortality or adverse cardiac events and that the analysis of hrv can be a way of predicting sudden arrhythmic death , myocardial infarction , angina pectoris , stroke mortality , and even rapid progression of atherosclerosis in animals ( 9 - 12 ) .
changes of hrv parameters were also reported in osas patients ( 13 - 15 ) , and hrv analysis has been proposed as a screening tool for osas ( 16 ) .
however , there are numerous indices or variables in time or frequency domain analysis of hrv , and researchers have... | the risk of cardiovascular disease is known to be increased in obstructive sleep apnea syndrome ( osas ) .
its mechanism can be explained by the observation that the sympathetic tone increases due to repetitive apneas accompanied by hypoxias and arousals during sleep .
heart rate variability ( hrv ) representing cardiac autonomic function is mediated by respiratory sinus arrhythmia , baroreflex - related fluctuation , and thermoregulation - related fluctuation .
we evaluated the heart rate variability of osas patients during night to assess their relationship with the severity of the symptoms .
we studied overnight polysomnographies of 59 male untreated osas patients with moderate to severe symptoms ( mean age 45.4 11.7 yr , apnea - hypopnea index [ ahi]=43.223.4 events per hour , and ahi > 15 ) .
moderate ( mean age 47.19.4 yr , ahi=15 - 30 , n=22 ) and severe ( mean age 44.512.9 yr , ahi > 30 , n=37 ) osas patients were compared for the indices derived from time and frequency domain analysis of hrv , ahi , oxygen desaturation event index ( odi ) , arousal index ( ari ) , and sleep parameters . as a result , the severe osas group showed higher mean powers of total frequency ( tf ) ( p=0.012 ) , very low frequency ( vlf ) ( p= 0.038 ) , and low frequency ( lf ) ( p=0.002 ) than the moderate osas group .
the lf / hf ratio ( p=0.005 ) was higher in the severe group compared to that of the moderate group . on the time domain analysis ,
the hrv triangular index ( p=0.026 ) of severe osas group was significantly higher .
ahi was correlated best with the lf / hf ratio ( rp=0.610 , p<0.001 ) of all the hrv indices . according to the results
, the frequency domain indices tended to reveal the difference between the groups better than time domain indices .
especially the lf / hf ratio was thought to be the most useful parameter to estimate the degree of ahi in osas patients . |
6,604 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: relying on previous spatial analysis of bu incidence in akonolinga district , we analyzed a series of cases that occurred in the highest bu - risk area of the district , located along the nyong river upstream of akonolinga ( 3 ) .
we analyzed 562 new cases of bu that originated in this area from january 2002 through may 2012 , after aggregation by month of diagnosis .
biological confirmation was obtained from the national reference centre for mycobacteria for 354 ( 63% ) cases .
the bu incidence rate remained stable over the 10-year period at 2.2 cases/1,000 person - years .
median bu incidence peaked in march , and a second peak occurred in september ( technical appendix figure 2 ) , but monthly medians did not differ significantly ( kruskal - wallis test , p = 0.149 ) .
given the specificities ( nonstationarity ) of the bu case series , wavelet analysis was the appropriate method for analysis ( technical appendix ) .
a 1-year periodic signal was identified in the bu - case time series from 2005 to 2011 , and this periodicity was statistically significant from mid-2005 to the beginning of 2009 ( figure 1 ) .
wavelet analysis of buruli ulcer ( bu ) case series and nyong river flow , january 2002december 2010 .
a , b ) the color gradient indicates how well the wavelet of a given period adjusted with the series ( power ) .
the detection of periodic signals was performed within a confidence cone , which excluded the beginning and the end of the series where edge effects would be too likely ( black solid line ) .
statistically significant zones are circled with dashed lines , indicating detection of significant periodic signals during the corresponding years .
a ) wavelet power spectrum for the time series of bu cases : a seasonal signal with a 1-year period was detected from 2005 to 2011 ( green to black ) , and this period was statistically significant from mid-2005 to the beginning of 2009 ( dashed contour lines ) .
b ) wavelet power spectrum for the nyong river flow : the nyong river flow series exhibits a... | to determine when risk for buruli ulcer is highest , we examined seasonal patterns in a highly disease - endemic area of cameroon during 20022012 .
cases peaked in march , suggesting that risk is highest during the high rainy season . during and after this season
, populations should increase protective behaviors , and case detection efforts should be intensified . |
6,605 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the molybdenum cofactor ( moco ) is essential for the activity of these enzymes and is associated with amidoxime reductase in mitochondria .
moco deficiency ( mocd ) causes a severe progressive metabolic encephalopathy with neonatal convulsions , spasticity , opisthotonus , brain atrophy , altered facial morphology and severe developmental disability , spherophakia and dislocated lenses in survivors , associated with deficiency of both xanthine oxidase and sulfite oxidase .
histopathology of the brain shows severe loss of neocortical neurons , gliosis and areas of cystic necrosis in white matter , also seen in sulfite oxidase deficiency , suggesting that deficiency of sulfite oxidase causes much of the cerebral pathology .
the mocs1a and mocs1b genes encode an enzyme complex that forms cyclic pyranopterin monophosphate ( cpmp ) from gtp .
the mocs2a and mocs2b gene product , in association with a protein encoded by mocs3 , convert cpmp to molybdopterin ( mpt ) .
cpmp is deficient or absent when there are mutations in the mocs1 gene , while its oxidation product , compound z , is detectable in urine when there are mocs2 mutations ( fig . 1 ) .
the gephyrin gene product adenylates mpt and adds molybdenum to form moco . when urine amino acids are screened on suspicion of a metabolic disease , an elevated s - sulfo - l - cysteine level suggests either sulfite oxidase deficiency or mocd .
an elevation of urine xanthine and low blood uric acid indicate an additional deficiency of xanthine oxidase due to mocd .
patients with mocs1a or mocs1b deficiency have been treated with a stable injectable form of cpmp ( hitzert et al . , 2012 , veldman et al . , 2010 ) , but with mocs2 mutations supplementation with cpmp is ineffective .
pyridoxal-5-phosphate is sequestered by elevated levels of the cyclic form of alpha - amino adipic semialdehyde ( piperideine-6-carboxylate ) in mocd , so seizures in mocd might respond to pyridoxine supplementation ( struys et al . , 2012 ) .
a 3.2 kg full term newborn girl with apgar... | backgroundmolybdenum cofactor deficiency ( mocd ) is a severe autosomal recessive neonatal metabolic disease that causes seizures and death or severe brain damage .
symptoms , signs and cerebral images can resemble those attributed to intrapartum hypoxia . in humans ,
molybdenum cofactor ( moco ) has been found to participate in four metabolic reactions : aldehyde dehydrogenase ( or oxidase ) , xanthine oxidoreductase ( or oxidase ) and sulfite oxidase , and some of the components of molybdenum cofactor synthesis participate in amidoxime reductase . a newborn girl developed refractory seizures , opisthotonus , exaggerated startle reflexes and vomiting on the second day of life .
treatment included intravenous fluid , glucose supplementation , empiric antibiotic therapy and anticonvulsant medication .
her encephalopathy progressed , and she was given palliative care and died aged 1 week .
there were no dysmorphic features , including ectopia lentis but ultrasonography revealed a thin corpus callosum.objectivesthe aim of this study is to provide etiology , prognosis and genetic counseling.methodsbiochemical analysis of urine , blood , sanger sequencing of leukocyte dna , and analysis of the effect of the mutation on protein expression.resultsuric acid level was low in blood , and s - sulfo - l - cysteine and xanthine were elevated in urine .
compound z was detected in urine .
two mocs2 gene mutations were identified : c.501 + 2delt , which disrupts a conserved splice site sequence , and c.419c > t ( ps140f ) .
protein expression studies confirmed that the p.s140f substitution was pathogenic .
the parents were shown to be heterozygous carriers.conclusionsmutation analysis confirmed that the mocd in this family could not be treated with cpmp infusion , and enabled prenatal diagnosis and termination of a subsequent affected pregnancy . |
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