WorldWideScience

Sample records for restores corticosteroid function

  1. Long acting β2-agonist and corticosteroid restore airway glandular cell function altered by bacterial supernatant

    Nawrocki-Raby Béatrice

    2010-01-01

    Full Text Available Abstract Background Staphylococcus aureus releases virulence factors (VF that may impair the innate protective functions of airway cells. The aim of this study was to determine whether a long-acting β2 adrenergic receptor agonist (salmeterol hydroxynaphthoate, Sal combined with a corticosteroid (fluticasone propionate, FP was able to regulate ion content and cytokine expression by airway glandular cells after exposure to S. aureus supernatant. Methods A human airway glandular cell line was incubated with S. aureus supernatant for 1 h and then treated with the combination Sal/FP for 4 h. The expression of actin and CFTR proteins was analyzed by immunofluorescence. Videomicroscopy was used to evaluate chloride secretion and X-ray microanalysis to measure the intracellular ion and water content. The pro-inflammatory cytokine expression was assessed by RT-PCR and ELISA. Results When the cells were incubated with S. aureus supernatant and then with Sal/FP, the cellular localisation of CFTR was apical compared to the cytoplasmic localisation in cells incubated with S. aureus supernatant alone. The incubation of airway epithelial cells with S. aureus supernatant reduced by 66% the chloride efflux that was fully restored by Sal/FP treatment. We also observed that Sal/FP treatment induced the restoration of ion (Cl and S and water content within the intracellular secretory granules of airway glandular cells and reduced the bacterial supernatant-dependent increase of pro-inflammatory cytokines IL8 and TNFα. Conclusions Our results demonstrate that treatment with the combination of a corticosteroid and a long-acting β2 adrenergic receptor agonist after bacterial infection restores the airway glandular cell function. Abnormal mucus induced by defective ion transport during pulmonary infection could benefit from treatment with a combination of β2 adrenergic receptor agonist and glucocorticoid.

  2. Corticosteroids

    ... control and prevention of asthma. They can reduce asthma symptoms, and your child may not need to take as many other ... restart the medicine and continue using it. Your Child's Growth Recent studies have shown that inhaled corticosteroids for asthma may slow down growth in some children during ...

  3. Restoration of Corticosteroid Sensitivity in Chronic Obstructive Pulmonary Disease by Inhibition of Mammalian Target of Rapamycin.

    Mitani, Akihisa; Ito, Kazuhiro; Vuppusetty, Chaitanya; Barnes, Peter J; Mercado, Nicolas

    2016-01-15

    Corticosteroid resistance is a major barrier to the effective treatment of chronic obstructive pulmonary disease (COPD). Several molecular mechanisms have been proposed, such as activations of the phosphoinositide-3-kinase/Akt pathway and p38 mitogen-activated protein kinase. However, the mechanism for corticosteroid resistance is still not fully elucidated. To investigate the role of mammalian target of rapamycin (mTOR) in corticosteroid sensitivity in COPD. The corticosteroid sensitivity of peripheral blood mononuclear cells collected from patients with COPD, smokers, and nonsmoking control subjects, or of human monocytic U937 cells exposed to cigarette smoke extract (CSE), was quantified as the dexamethasone concentration required to achieve 30% inhibition of tumor necrosis factor-α-induced CXCL8 production in the presence or absence of the mTOR inhibitor rapamycin. mTOR activity was determined as the phosphorylation of p70 S6 kinase, using Western blotting. mTOR activity was increased in peripheral blood mononuclear cells from patients with COPD, and treatment with rapamycin inhibited this as well as restoring corticosteroid sensitivity. In U937 cells, CSE stimulated mTOR activity and c-Jun expression, but pretreatment with rapamycin inhibited both and also reversed CSE-induced corticosteroid insensitivity. mTOR inhibition by rapamycin restores corticosteroid sensitivity via inhibition of c-Jun expression, and thus mTOR is a potential novel therapeutic target for COPD.

  4. Corticosteroid therapy for duchenne muscular dystrophy: improvement of psychomotor function.

    Sato, Yuko; Yamauchi, Akemi; Urano, Mari; Kondo, Eri; Saito, Kayoko

    2014-01-01

    Of the numerous clinical trials for Duchenne muscular dystrophy, only the corticosteroid prednisolone has shown potential for temporal improvement in motor ability. In this study, the effects of prednisolone on intellectual ability are examined in 29 cases of Duchenne muscular dystrophy because little information has been reported. And also, motor functions and cardiac functions were evaluated. The treated group was administered prednisolone (0.75 mg/kg) orally on alternate days and the compared with the untreated control group. Gene mutations were investigated. The patients were examined for intelligence quotient adequate for age, brain natriuretic peptide, creatine kinase, and manual muscle testing before treatment and after the period 6 months to 2 years. Intelligence quotient scores of the treated increased to 6.5 ± 11.9 (mean ± standard deviation) were compared with the controls 2.1 ± 4.9 (P = 0.009). Intelligence quotient scores of the patients with nonsense point mutations improved significantly (21.0 ± 7.9) more than those with deletion or duplication (1.9 ± 9.0; P = 0.015). Motor function, such as time to stand up, of those treated improved significantly and brain natriuretic peptide level was reduced to a normal level after treatment in 15 patients (73%). Our results demonstrate the effectiveness of prednisolone in improving intellectual impairment as well as in preserving motor function and brain natriuretic peptide levels. We presume that prednisolone has a read-through effect on the stop codons in the central nervous systems of Duchenne muscular dystrophy because intelligence quotient of point mutation case was improved significantly. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Role of corticosteroids in Functional Endoscopic Sinus Surgery--a systematic review and meta-analysis

    Pundir, Vishal; Pundir, Jyotsna; Lancaster, Gillian; Baer, Simon; Kirkland, Paul; Cornet, Marjolein; Lourijsen, E. S.; Georgalas, Christos; Fokkens, W. J.

    2016-01-01

    The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS). Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was

  6. Forest restoration, biodiversity and ecosystem functioning

    2011-01-01

    Globally, forests cover nearly one third of the land area and they contain over 80% of terrestrial biodiversity. Both the extent and quality of forest habitat continue to decrease and the associated loss of biodiversity jeopardizes forest ecosystem functioning and the ability of forests to provide ecosystem services. In the light of the increasing population pressure, it is of major importance not only to conserve, but also to restore forest ecosystems. Ecological restoration has recently started to adopt insights from the biodiversity-ecosystem functioning (BEF) perspective. Central is the focus on restoring the relation between biodiversity and ecosystem functioning. Here we provide an overview of important considerations related to forest restoration that can be inferred from this BEF-perspective. Restoring multiple forest functions requires multiple species. It is highly unlikely that species-poor plantations, which may be optimal for above-ground biomass production, will outperform species diverse assemblages for a combination of functions, including overall carbon storage and control over water and nutrient flows. Restoring stable forest functions also requires multiple species. In particular in the light of global climatic change scenarios, which predict more frequent extreme disturbances and climatic events, it is important to incorporate insights from the relation between biodiversity and stability of ecosystem functioning into forest restoration projects. Rather than focussing on species per se, focussing on functional diversity of tree species assemblages seems appropriate when selecting tree species for restoration. Finally, also plant genetic diversity and above - below-ground linkages should be considered during the restoration process, as these likely have prominent but until now poorly understood effects at the level of the ecosystem. The BEF-approach provides a useful framework to evaluate forest restoration in an ecosystem functioning context, but

  7. Effects of metabolic syndrome on the functional outcomes of corticosteroid injection for De Quervain tenosynovitis.

    Roh, Y H; Noh, J H; Gong, H S; Baek, G H

    2017-06-01

    Metabolic syndrome is a constellation of medical conditions that arise from insulin resistance and abnormal adipose deposition and function. In patients with metabolic syndrome and De Quervain tenosynovitis this might affect the outcome of treatment by local corticosteroid injection. A total of 64 consecutive patients with De Quervain tenosynovitis and metabolic syndrome treated with corticosteroid injection were age- and sex-matched with 64 control patients without metabolic syndrome. The response to treatment, including visual analogue scale score for pain, objective findings consistent with De Quervain tenosynovitis (tenderness at first dorsal compartment, Finkelstein test result), and Disability of the Arm, Shoulder, and Hand score were assessed at 6, 12, and 24 weeks follow-up. Treatment failure was defined as persistence of symptoms or surgical intervention. Prior to treatment, patients with metabolic syndrome had mean initial pain visual analogue scale and Disability of the Arm, Shoulder, and Hand scores similar to those in the control group. The proportion of treatment failure in the metabolic syndrome group (43%) was significantly higher than that in the control group (20%) at 6 months follow-up. The pain visual analogue scale scores in the metabolic syndrome group were higher than the scores in the control group at the 12- and 24-week follow-ups. The Disability of the Arm, Shoulder, and Hand scores of the metabolic syndrome group were higher (more severe symptoms) than those of the control group at the 12- and 24-week follow-ups. Although considerable improvements in symptom severity and hand function will likely occur in patients with metabolic syndrome, corticosteroid injection for De Quervain tenosynovitis is not as effective in these patients compared with age- and sex-matched controls in terms of functional outcomes and treatment failure. III.

  8. Restoration of biogeochemical function in mangrove forests

    McKee, K.L.; Faulkner, P.L.

    2000-01-01

    Forest structure of mangrove restoration sites (6 and 14 years old) at two locations (Henderson Creek [HC] and Windstar [WS]) in southwest Florida differed from that of mixed-basin forests (>50 years old) with which they were once contiguous. However, the younger site (HC) was typical of natural, developing forests, whereas the older site (WS) was less well developed with low structural complexity. More stressful physicochemical conditions resulting from incomplete tidal flushing (elevated salinity) and variable topography (waterlogging) apparently affected plant survival and growth at the WS restoration site. Lower leaf fall and root production rates at the WS restoration site, compared with that at HC were partly attributable to differences in hydroedaphic conditions and structural development. However, leaf and root inputs at each restoration site were not significantly different from that in reference forests within the same physiographic setting. Macrofaunal consumption of tethered leaves also did not differ with site history, but was dramatically higher at HC compared with WS, reflecting local variation in leaf litter processing rates, primarily by snails (Melampus coffeus). Degradation of leaves and roots in mesh bags was slow overall at restoration sites, however, particularly at WS where aerobic decomposition may have been more limited. These findings indicate that local or regional factors such as salinity regime act together with site history to control primary production and turnover rates of organic matter in restoration sites. Species differences in senescent leaf nitrogen content and degradation rates further suggest that restoration sites dominated by Laguncularia racemosa and Rhizophora mangle should exhibit slower recycling of nutrients compared with natural basin forests where Avicennia germinans is more abundant. Structural development and biogeochemical functioning of restored mangrove forests thus depend on a number of factors, but site

  9. Glucocorticoid Receptor Hetero-Complex Gene STIP1 Is Associated with Improved Lung Function in Asthmatics Treated with Inhaled Corticosteroids

    Hawkins, Gregory A.; Lazarus, Ross; Smith, Richard S.; Tantisira, Kelan G.; Meyers, Deborah A.; Peters, Stephen P.; Weiss, Scott T.; Bleecker, Eugene R.

    2015-01-01

    Background Corticosteroids exert their anti-inflammatory action by binding and activating the intracellular the glucocorticoid receptor (GR) hetero-complex. Objective Evaluate the genes HSPCB, HSPCA, STIP1, HSPA8, DNAJB1, PTGES3, FKBP5, and FKBP4 on corticosteroid response. Methods Caucasian asthmatics (382) randomized to once daily flunisolide or conventional inhaled corticosteroid therapy were genotyped. Outcome measures were baseline FEV1, % predicted FEV1, and % change in FEV1 after corticosteroid treatment. Multivariable analyses adjusted for age, gender, and height, were performed fitting the most appropriate genetic model based on quantitative mean derived from ANOVA models to determine if there was an independent effect of polymorphisms on change in FEV1 independent of baseline level. Results Positive recessive model correlations for STIP1 SNPs were observed for baseline FEV1 [rs4980524, p=0.009; rs6591838, p=0.0045; rs2236647, p=0.002; and rs2236648; p=0.013], baseline % predicted FEV1 [rs4980524, p=0.002; rs6591838, p=0.017; rs2236647, p=0.003; and rs2236648; p=0.008] ; % change in FEV1 at 4 weeks [rs4980524, p=0.044; rs6591838, p=0.016; rs2236647; p=0.01] and 8 weeks therapy [rs4980524, p=0.044; rs6591838, p=0.016; rs2236647; p=0.01]. Haplotypic associations were observed for baseline FEV1 and % change in FEV1 at 4 weeks therapy [p=0.05 and p=0.01, respectively]. Significant trends towards association were observed for baseline % predicted FEV1 and % change in FEV1 at 8 weeks therapy. Positive correlations between haplotypes and % change in FEV1 were also observed. Conclusions STIP1 genetic variations may play a role in regulating corticosteroid response in asthmatics with reduced lung function. Replication in a second asthma population is required to confirm these observations. Clinical Implications Identifying genes that regulate corticosteroid responses could allow a priori determination of individual responses to corticosteroid therapy, leading to

  10. Bone loss in rheumatoid arthritis. Influence of disease activity, duration of the disease, functional capacity, and corticosteroid treatment

    Hansen, M; Florescu, A; Stoltenberg, M

    1996-01-01

    Axial and appendicular bone mass were studied in 95 patients with rheumatoid arthritis. The aims were to quantify bone mineral density (BMD) and to evaluate the importance of disease activity, duration of disease, functional capacity, and corticosteroid treatment for bone loss in patients...... after the start of the disease. The overall functional capacity in terms of physical activity increased BMD in the axial skeleton. The local functional capacity in terms of grip strength was positively related to BMD in the appendicular skeleton. Patients with severe functional impairment had the lowest...

  11. Anterior provisional restorations used to determine form, function, and esthetics for complex restorative situations, using all-ceramic restorative systems.

    Reshad, Mamaly; Cascione, Domenico; Kim, Tae

    2010-02-01

    A technique is proposed for the restoration of a large and visible maxillary anterior defect. The importance of proper diagnosis, treatment planning, and communication is emphasized. Irreversible treatment should only be rendered once patient approval has been obtained through objective evaluation with provisional restorations. The techniques presented in this article use a combination of ceramic systems currently available to satisfy functional demands while achieving acceptable esthetics. A controlled series of steps, where the provisional restorative components are being replaced by the definitive ones is planned. The only difference between the provisional and definitive restorative components is the material used. The definitive restorations consisted of an implant-supported zirconium oxide framework. Individual pressed porcelain restorations were luted to the framework and a natural tooth. CLINICAL SIGNIFICANCE Provisional restorations allow an objective form of communication. Vertical and horizontal transitional lines can be effectively masked with appropriate treatment planning and a skilled ceramist. Many traditional dental laboratory steps may be eliminated or simplified without compromising the definitive restorations.

  12. Effect of Metabolic Syndrome on the Functional Outcome of Corticosteroid Injection for Lateral Epicondylitis: Retrospective Matched Case-Control Study.

    Roh, Young Hak; Oh, Minjoon; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

    2017-09-07

    Both obesity and diabetes mellitus are well-known risk factors for tendinopathies. We retrospectively compared the efficacy of single corticosteroid injections in treating lateral epicondylitis in patients with and without metabolic syndrome (MetS). Fifty-one patients with lateral epicondylitis and MetS were age- and sex-matched with 51 controls without MetS. Pain severity, Disability of the Arm, Shoulder, and Hand score, and grip strength were assessed at base line and at 6, 12 and 24 weeks post-injection. The pain scores in the MetS group were greater than those in the control group at 6 and 12 weeks. The disability scores and grip strength in the MetS group were significantly worse than those of the control group at 6 weeks. However, there were no significant differences at 24 weeks between the groups in terms of pain, disability scores and grip strengths. After 24 weeks, three patients (6%) in the control group and five patients (10%) in the MetS group had surgical decompression (p = 0.46). Patients with MetS are at risk for poor functional outcome after corticosteroid injection for lateral epicondylitis in the short term, but in the long term there was no difference in outcomes of steroid injection in patients with and without MetS.

  13. A Function-Based Framework for Stream Assessment & Restoration Projects

    This report lays out a framework for approaching stream assessment and restoration projects that focuses on understanding the suite of stream functions at a site in the context of what is happening in the watershed.

  14. Structural and functional loss in restored wetland ecosystems.

    David Moreno-Mateos

    2012-01-01

    Full Text Available Wetlands are among the most productive and economically valuable ecosystems in the world. However, because of human activities, over half of the wetland ecosystems existing in North America, Europe, Australia, and China in the early 20th century have been lost. Ecological restoration to recover critical ecosystem services has been widely attempted, but the degree of actual recovery of ecosystem functioning and structure from these efforts remains uncertain. Our results from a meta-analysis of 621 wetland sites from throughout the world show that even a century after restoration efforts, biological structure (driven mostly by plant assemblages, and biogeochemical functioning (driven primarily by the storage of carbon in wetland soils, remained on average 26% and 23% lower, respectively, than in reference sites. Either recovery has been very slow, or postdisturbance systems have moved towards alternative states that differ from reference conditions. We also found significant effects of environmental settings on the rate and degree of recovery. Large wetland areas (>100 ha and wetlands restored in warm (temperate and tropical climates recovered more rapidly than smaller wetlands and wetlands restored in cold climates. Also, wetlands experiencing more (riverine and tidal hydrologic exchange recovered more rapidly than depressional wetlands. Restoration performance is limited: current restoration practice fails to recover original levels of wetland ecosystem functions, even after many decades. If restoration as currently practiced is used to justify further degradation, global loss of wetland ecosystem function and structure will spread.

  15. Function of mechanically lengthened jejunum after restoration into continuity.

    Sullins, Veronica F; Wagner, Justin P; Walthers, Christopher M; Chiang, Elvin K; Lee, Steven L; Wu, Benjamin M; Dunn, James C Y

    2014-06-01

    Distraction enterogenesis is a potential treatment for patients with short bowel syndrome. We previously demonstrated successful lengthening of jejunum using a degradable spring device in rats. Absorptive function of the lengthened jejunum after restoration into intestinal continuity needs to be determined. Encapsulated polycaprolactone springs were placed into isolated jejunal segments in rats for four weeks. Lengthened segments of jejunum were subsequently restored into intestinal continuity. Absorption studies were performed by placing a mixture of a non-absorbable substrate and glucose into the lumen of the restored jejunum. Restored jejunal segments demonstrated visible peristalsis at specimen retrieval. Compared to normal jejunal controls, restored segments demonstrated equal water absorption and greater glucose absorption. Restored segments had thicker smooth muscle, increased villus height, increased crypt depth, and decreased sucrase activity compared to normal jejunum. The density of enteric ganglia increased after restoration to near normal levels in the submucosa and to normal levels in the myenteric plexus. Jejunum lengthened with a degradable device demonstrates peristaltic and enzymatic activity as well as glucose and water absorption after restoration into intestinal continuity. Our findings further demonstrate the therapeutic potential of a degradable device. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Can Quantitative Muscle Strength and Functional Motor Ability Differentiate the Influence of Age and Corticosteroids in Ambulatory Boys with Duchenne Muscular Dystrophy?

    Buckon, Cathleen; Sienko, Susan; Bagley, Anita; Sison-Williamson, Mitell; Fowler, Eileen; Staudt, Loretta; Heberer, Kent; McDonald, Craig M; Sussman, Michael

    2016-07-08

    In the absence of a curative treatment for Duchenne Muscular Dystrophy (DMD), corticosteroid therapy (prednisone, deflazacort) has been adopted as the standard of care, as it slows the progression of muscle weakness and enables longer retention of functional mobility. The ongoing development of novel pharmacological agents that target the genetic defect underlying DMD offer hope for a significant alteration in disease progression; however, substantiation of therapeutic efficacy has proved challenging. Identifying functional outcomes sensitive to the early, subtle changes in muscle function has confounded clinical trials. Additionally, the alterations in disease progression secondary to corticosteroid therapy are not well described making it difficult to ascertain the benefits of novel agents, often taken concurrently with corticosteroids. The purpose of this study was to examine outcome responsiveness to corticosteroid therapy and age at the onset of a natural history study of ambulatory boys with DMD. Eighty-five ambulatory boys with DMD (mean age 93 mo, range 49 to 180 mo) were recruited into this study. Fifty participants were on corticosteroid therapy, while 33 were corticosteroid naïve at the baseline assessment. Within each treatment group boys were divided in two age groups, 4 to 7 years and 8 and greater years of age. The Biodex System 3 Pro isokinetic dynamometer was used to assess muscle strength. Motor skills were assessed using the upper two dimensions (standing/walking, running & jumping) of the Gross Motor Function Measure (GMFM 88) and Timed Motor Tests (TMTs) (10-meter run, sit to stand, supine to stand, climb 4-stairs). Two way analysis of variance and Pearson correlations were used for analysis. A main effect for age was seen in select lower extremity muscle groups (hip flexors, knee extensors and ankle dorsiflexors), standing dimension skills, and all TMTs with significantly greater weakness and loss of motor skill ability seen in the older age

  17. Functional proteomic analysis of corticosteroid pharmacodynamics in rat liver: Relationship to hepatic stress, signaling, energy regulation, and drug metabolism.

    Ayyar, Vivaswath S; Almon, Richard R; DuBois, Debra C; Sukumaran, Siddharth; Qu, Jun; Jusko, William J

    2017-05-08

    Corticosteroids (CS) are anti-inflammatory agents that cause extensive pharmacogenomic and proteomic changes in multiple tissues. An understanding of the proteome-wide effects of CS in liver and its relationships to altered hepatic and systemic physiology remains incomplete. Here, we report the application of a functional pharmacoproteomic approach to gain integrated insight into the complex nature of CS responses in liver in vivo. An in-depth functional analysis was performed using rich pharmacodynamic (temporal-based) proteomic data measured over 66h in rat liver following a single dose of methylprednisolone (MPL). Data mining identified 451 differentially regulated proteins. These proteins were analyzed on the basis of temporal regulation, cellular localization, and literature-mined functional information. Of the 451 proteins, 378 were clustered into six functional groups based on major clinically-relevant effects of CS in liver. MPL-responsive proteins were highly localized in the mitochondria (20%) and cytosol (24%). Interestingly, several proteins were related to hepatic stress and signaling processes, which appear to be involved in secondary signaling cascades and in protecting the liver from CS-induced oxidative damage. Consistent with known adverse metabolic effects of CS, several rate-controlling enzymes involved in amino acid metabolism, gluconeogenesis, and fatty-acid metabolism were altered by MPL. In addition, proteins involved in the metabolism of endogenous compounds, xenobiotics, and therapeutic drugs including cytochrome P450 and Phase-II enzymes were differentially regulated. Proteins related to the inflammatory acute-phase response were up-regulated in response to MPL. Functionally-similar proteins showed large diversity in their temporal profiles, indicating complex mechanisms of regulation by CS. Clinical use of corticosteroid (CS) therapy is frequent and chronic. However, current knowledge on the proteome-level effects of CS in liver and

  18. Shedding light on restoring respiratory function after spinal cord injury

    Warren J Alilain

    2009-10-01

    Full Text Available Loss of respiratory function is one of the leading causes of death following spinal cord injury. Because of this, much work has been done in studying ways to restore respiratory function following SCI - including pharmacological and regeneration strategies. With the emergence of new and powerful tools from molecular neuroscience, new therapeutically relevant alternatives to these approaches have become available, including expression of light sensitive proteins called channelrhodopsins. In this article we briefly review the history of various attempts to restore breathing after C2 hemisection, and focus on our recent work using the activation of light sensitive channels to restore respiratory function after experimental spinal cord injury. We also discuss how such light induced activity can help shed light on the inner workings of the central nervous system respiratory circuitry that controls diaphragmatic function.

  19. Inhaled corticosteroids for abnormal pulmonary function in children with a history of Chronic Lung Disease of Infancy: study protocol [ISRCTN55153521

    Sauve Reginald

    2005-04-01

    Full Text Available Abstract Background There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD. Methods Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD. Discussion We propose that Beclomethasone Dipropionate (QVAR will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.

  20. Neuroprosthetics and Solutions for Restoring Sensorimotor Functions

    2009-12-01

    prosthetic feet. 15. SUBJECT TERMS neural interface, neural prosthesis , biocompatibility, virtual reality, amputee, sensory feedback 16. SECURITY...limbs. By providing a communication link between the prosthesis and the user’s nervous system, our goal is to integrate the prosthetic limb as a...neuroprosthetic control. This new class of prosthetic devices will literally look, feel , and function like natural limbs, but their internal

  1. Clinical responsiveness of self-report functional assessment measures for children with juvenile idiopathic arthritis undergoing intraarticular corticosteroid injections.

    Brown, G Ted; Wright, F Virginia; Lang, Bianca A; Birdi, Nina; Oen, Kim; Stephens, Derek; McComas, Joan; Feldman, Brian M

    2005-12-15

    The Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Functional Assessment Report (JAFAR), and Juvenile Arthritis Functional Status Index (JASI) are widely used functional measures for juvenile idiopathic arthritis (JIA) that differ in content, format, and completion time. We compared the responsiveness and child-parent agreement of the JAFAR, CHAQ, and JASI in a prospective, multicenter study. Children and adolescents from 5 rheumatology centers were enrolled. Subjects were about to undergo therapy (intraarticular corticosteroid injections [IAS] and methotrexate or hip surgery (MTX/hip]) expected to produce a functional improvement. All subjects were studied before the intervention and at 6 weeks and 6 months posttreatment. At each study visit, the 3 measures were administered in randomized, balanced order to both parents and children. A total of 92 subjects (mean age 12.8 years) were enrolled in the study, 74 of which were in the IAS group. The responsiveness of all 3 measures was moderate to strong. The standardized response mean at 6 weeks for the IAS group on the JAFAR, CHAQ, and JASI was 0.41 (95% confidence interval [95% CI] 0.18, 0.64), 0.70 (95% CI 0.47, 0.93), and 0.36 (95% CI 0.13, 0.59), respectively. The CHAQ was somewhat more responsive to change at 6 weeks (IAS group: relative efficiency 0.34 [JAFAR], 0.27 [JASI]), but less responsive at 6 months (MTX/hip group: relative efficiency 5.1 [JAFAR], 3.9 [JASI]). All 3 questionnaires showed acceptable parent-child agreement, and overall, there were few differences between the 3 questionnaires. The functional outcome measures currently used for JIA are all adequately responsive for use in trials or in the clinic setting. The choice of which measure to use should therefore be based on the time available for completion, the intended clinical/research use, and the depth of content required.

  2. Restoring a smooth function from its noisy integrals

    Goulko, Olga; Prokof'ev, Nikolay; Svistunov, Boris

    2018-05-01

    Numerical (and experimental) data analysis often requires the restoration of a smooth function from a set of sampled integrals over finite bins. We present the bin hierarchy method that efficiently computes the maximally smooth function from the sampled integrals using essentially all the information contained in the data. We perform extensive tests with different classes of functions and levels of data quality, including Monte Carlo data suffering from a severe sign problem and physical data for the Green's function of the Fröhlich polaron.

  3. Amelogenesis imperfecta: A challenge to restoring esthetics and function

    Ranganath V

    2010-01-01

    Full Text Available Rehabilitation of complicated cases poses difficulty in clinical practice, both with respect to restoring function and with esthetics. One such clinical condition where the dentist has to give importance to proper planning of the treatment and execution of the plan is amelogenesis imperfecta (AI, a condition where both function and esthetics are accommodated. This article discusses both the functional and esthetic rehabilitation of a patient with AI. Both the esthetics and function were hampered in this patient due to the condition. As a result, the treatment was properly planned and executed. A number of treatment options are available for us today to treat such a case. There is no one technique to be followed as such. However, the aim was to properly diagnose the case and provide good function and esthetics to the patient.

  4. Predicting restoration of kidney function during CRRT-free intervals

    Heise Daniel

    2012-01-01

    Full Text Available Abstract Background Renal failure is common in critically ill patients and frequently requires continuous renal replacement therapy (CRRT. CRRT is discontinued at regular intervals for routine changes of the disposable equipment or for replacing clogged filter membrane assemblies. The present study was conducted to determine if the necessity to continue CRRT could be predicted during the CRRT-free period. Materials and methods In the period from 2003 to 2006, 605 patients were treated with CRRT in our ICU. A total of 222 patients with 448 CRRT-free intervals had complete data sets and were used for analysis. Of the total CRRT-free periods, 225 served as an evaluation group. Twenty-nine parameters with an assumed influence on kidney function were analyzed with regard to their potential to predict the restoration of kidney function during the CRRT-free interval. Using univariate analysis and logistic regression, a prospective index was developed and validated in the remaining 223 CRRT-free periods to establish its prognostic strength. Results Only three parameters showed an independent influence on the restoration of kidney function during CRRT-free intervals: the number of previous CRRT cycles (medians in the two outcome groups: 1 vs. 2, the "Sequential Organ Failure Assessment"-score (means in the two outcome groups: 8.3 vs. 9.2 and urinary output after the cessation of CRRT (medians in two outcome groups: 66 ml/h vs. 10 ml/h. The prognostic index, which was calculated from these three variables, showed a satisfactory potential to predict the kidney function during the CRRT-free intervals; Receiver operating characteristic (ROC analysis revealed an area under the curve of 0.798. Conclusion Restoration of kidney function during CRRT-free periods can be predicted with an index calculated from three variables. Prospective trials in other hospitals must clarify whether our results are generally transferable to other patient populations.

  5. Time-dependent effects of corticosteroids on human amygdala processing

    Henckens, M.J.A.G.; van Wingen, G.A.; Joëls, M.; Fernández, G.

    2010-01-01

    Acute stress is associated with a sensitized amygdala. Corticosteroids, released in response to stress, are suggested to restore homeostasis by normalizing/desensitizing brain processing in the aftermath of stress. Here, we investigated the effects of corticosteroids on amygdala processing using

  6. Counteracting loneliness: on the restorative function of nostalgia.

    Zhou, Xinyue; Sedikides, Constantine; Wildschut, Tim; Gao, Ding-Guo

    2008-10-01

    Four studies tested whether nostalgia can counteract reductions in perceived social support caused by loneliness. Loneliness reduced perceptions of social support but increased nostalgia. Nostalgia, in turn, increased perceptions of social support. Thus, loneliness affected perceived social support in two distinct ways. Whereas the direct effect of loneliness was to reduce perceived social support, the indirect effect of loneliness was to increase perceived social support via nostalgia. This restorative function of nostalgia was particularly apparent among resilient persons. Nostalgia is a psychological resource that protects and fosters mental health.

  7. Neurotechnology for monitoring and restoring sensory, motor, and autonomic functions

    Wu, Pae C.; Knaack, Gretchen; Weber, Douglas J.

    2016-05-01

    The rapid and exponential advances in micro- and nanotechnologies over the last decade have enabled devices that communicate directly with the nervous system to measure and influence neural activity. Many of the earliest implementations focused on restoration of sensory and motor function, but as knowledge of physiology advances and technology continues to improve in accuracy, precision, and safety, new modes of engaging with the autonomic system herald an era of health restoration that may augment or replace many conventional pharmacotherapies. DARPA's Biological Technologies Office is continuing to advance neurotechnology by investing in neural interface technologies that are effective, reliable, and safe for long-term use in humans. DARPA's Hand Proprioception and Touch Interfaces (HAPTIX) program is creating a fully implantable system that interfaces with peripheral nerves in amputees to enable natural control and sensation for prosthetic limbs. Beyond standard electrode implementations, the Electrical Prescriptions (ElectRx) program is investing in innovative approaches to minimally or non-invasively interface with the peripheral nervous system using novel magnetic, optogenetic, and ultrasound-based technologies. These new mechanisms of interrogating and stimulating the peripheral nervous system are driving towards unparalleled spatiotemporal resolution, specificity and targeting, and noninvasiveness to enable chronic, human-use applications in closed-loop neuromodulation for the treatment of disease.

  8. Using plant functional traits to restore Hawaiian rainforest

    Rebecca Ostertag; Laura Warman; Susan Cordell; Peter M. Vitousek

    2015-01-01

    Ecosystem restoration efforts are carried out by a variety of individuals and organizations with an equally varied set of goals, priorities, resources and time-scales. Once restoration of a degraded landscape or community is recognized as necessary, choosing which species to include in a restoration programme can be a difficult and value-laden process (Fry, Power &...

  9. Restoring canonical partition functions from imaginary chemical potential

    Bornyakov, V. G.; Boyda, D.; Goy, V.; Molochkov, A.; Nakamura, A.; Nikolaev, A.; Zakharov, V. I.

    2018-03-01

    Using GPGPU techniques and multi-precision calculation we developed the code to study QCD phase transition line in the canonical approach. The canonical approach is a powerful tool to investigate sign problem in Lattice QCD. The central part of the canonical approach is the fugacity expansion of the grand canonical partition functions. Canonical partition functions Zn(T) are coefficients of this expansion. Using various methods we study properties of Zn(T). At the last step we perform cubic spline for temperature dependence of Zn(T) at fixed n and compute baryon number susceptibility χB/T2 as function of temperature. After that we compute numerically ∂χ/∂T and restore crossover line in QCD phase diagram. We use improved Wilson fermions and Iwasaki gauge action on the 163 × 4 lattice with mπ/mρ = 0.8 as a sandbox to check the canonical approach. In this framework we obtain coefficient in parametrization of crossover line Tc(µ2B) = Tc(C-ĸµ2B/T2c) with ĸ = -0.0453 ± 0.0099.

  10. Antenatal Corticosteroids and Postnatal Fluid Restriction Produce Differential Effects on AQP3 Expression, Water Handling, and Barrier Function in Perinatal Rat Epidermis

    Johan Agren

    2010-01-01

    Full Text Available Loss of water through the immature skin can lead to hypothermia and dehydration in preterm infants. The water and glycerol channel aquaglyceroporin-3 (AQP3 is abundant in fetal epidermis and might influence epidermal water handling and transepidermal water flux around birth. To investigate the role of AQP3 in immature skin, we measured in vivo transepidermal water transport and AQP3 expression in rat pups exposed to clinically relevant fluid homeostasis perturbations. Preterm (E18 rat pups were studied after antenatal corticosteroid exposure (ANS, and neonatal (P1 rat pups after an 18 h fast. Transepidermal water loss (TEWL and skin hydration were determined, AQP3 mRNA was quantified by RT-PCR, and in-situ hybridization and immunocytochemistry were applied to map AQP3 expression. ANS resulted in an improved skin barrier (lower TEWL and skin hydration, while AQP3 mRNA and protein increased. Fasting led to loss of barrier integrity along with an increase in skin hydration. These alterations were not paralleled by any changes in AQP3. To conclude, antenatal corticosteroids and early postnatal fluid restriction produce differential effects on skin barrier function and epidermal AQP3 expression in the rat. In perinatal rats, AQP3 does not directly determine net water transport through the skin.

  11. Corticosteroid signaling in frog metamorphosis.

    Kulkarni, Saurabh S; Buchholz, Daniel R

    2014-07-01

    Stress in fetal and larval life can impact later health and fitness in humans and wildlife. Long-term effects of early life stress are mediated by altered stress physiology induced during the process of relaying environmental effects on development. Amphibian metamorphosis has been an important model system to study the role of hormones in development in an environmental context. Thyroid hormone (TH) is necessary and sufficient to initiate the dramatic morphological and physiological changes of metamorphosis, but TH alone is insufficient to complete metamorphosis. Other hormones, importantly corticosteroid hormones (CSs), influence the timing and nature of post-embryonic development. Stressors or treatments with CSs delay or accelerate metamorphic change, depending on the developmental stage of treatment. Also, TH and CSs have synergistic, antagonistic, and independent effects on gene regulation. Importantly, the identity of the endogenous corticosteroid hormone or receptor underlying any gene induction or remodeling event has not been determined. Levels of both CSs, corticosterone and aldosterone, peak at metamorphic climax, and the corticosteroid receptors, glucocorticoid and mineralocorticoid receptors, have wide expression distribution among tadpole tissues. Conclusive experiments to identify the endogenous players have been elusive due to difficulties in experimental control of corticosteroid production and signaling. Current data are consistent with the hypothesis that the two CSs and their receptors serve largely overlapping functions in regulating metamorphosis and synergy with TH. Knowledge of the endogenous players is critical to understanding the basic mechanisms and significance of corticosteroid action in regulating post-embryonic development in environmental contexts. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The Ecosystem Functions Model: A Tool for Restoration Planning

    Hickey, John T; Dunn, Chris N

    2004-01-01

    .... Project teams can use the EFM to visualize existing ecologic conditions, highlight promising restoration sites, and assess and rank alternatives according to the relative enhancement (or decline...

  13. Neural substrate expansion for the restoration of brain function

    Han-Chiao Isaac Chen

    2016-01-01

    Full Text Available Restoring neurological and cognitive function in individuals who have suffered brain damage is one of the principal objectives of modern translational neuroscience. Electrical stimulation approaches, such as deep-brain stimulation, have achieved the most clinical success, but they ultimately may be limited by the computational capacity of the residual cerebral circuitry. An alternative strategy is brain substrate expansion, in which the computational capacity of the brain is augmented through the addition of new processing units and the reconstitution of network connectivity. This latter approach has been explored to some degree using both biological and electronic means but thus far has not demonstrated the ability to reestablish the function of large-scale neuronal networks. In this review, we contend that fulfilling the potential of brain substrate expansion will require a significant shift from current methods that emphasize direct manipulations of the brain (e.g., injections of cellular suspensions and the implantation of multi-electrode arrays to the generation of more sophisticated neural tissues and neural-electric hybrids in vitro that are subsequently transplanted into the brain. Drawing from neural tissue engineering, stem cell biology, and neural interface technologies, this strategy makes greater use of the manifold techniques available in the laboratory to create biocompatible constructs that recapitulate brain architecture and thus are more easily recognized and utilized by brain networks.

  14. Histone Deacetylase Inhibition Restores Retinal Pigment Epithelium Function in Hyperglycemia.

    Danielle Desjardins

    Full Text Available In diabetic individuals, macular edema is a major cause of vision loss. This condition is refractory to insulin therapy and has been attributed to metabolic memory. The retinal pigment epithelium (RPE is central to maintaining fluid balance in the retina, and this function is compromised by the activation of advanced glycation end-product receptors (RAGE. Here we provide evidence that acute administration of the RAGE agonist, glycated-albumin (gAlb or vascular endothelial growth factor (VEGF, increased histone deacetylase (HDAC activity in RPE cells. The administration of the class I/II HDAC inhibitor, trichostatin-A (TSA, suppressed gAlb-induced reductions in RPE transepithelial resistance (in vitro and fluid transport (in vivo. Systemic TSA also restored normal RPE fluid transport in rats with subchronic hyperglycemia. Both gAlb and VEGF increased HDAC activity and reduced acetyl-α-tubulin levels. Tubastatin-A, a relatively specific antagonist of HDAC6, inhibited gAlb-induced changes in RPE cell resistance. These data are consistent with the idea that RPE dysfunction following exposure to gAlb, VEGF, or hyperglycemia is associated with increased HDAC6 activity and decreased acetyl-α-tubulin. Therefore, we propose inhibiting HDAC6 in the RPE as a potential therapy for preserving normal fluid homeostasis in the hyperglycemic retina.

  15. Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis obliterans.

    Calabrese, Cecilia; Corcione, Nadia; Rea, Gaetano; Stefanelli, Francesco; Meoli, Ilernando; Vatrella, Alessandro

    2016-01-01

    Post-infectious bronchiolitis obliterans (PIBO) is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and followed for three years. After short- and long-term therapy with an inhaled corticosteroid/long-acting 2 agonist combination, together with an inhaled long-acting antimuscarinic, the patient showed relevant improvement of airway obstruction that had been irreversible at the time of the bronchodilator test. The lung function of the patient worsened when he interrupted the triple inhaled therapy. In addition, a 3-week pulmonary rehabilitation program markedly improved his physical performance. RESUMO A bronquiolite obliterante pós-infecciosa (BOPI) é uma doença das pequenas vias aéreas caracterizada por limitação fixa do fluxo aéreo. Portanto, os broncodilatadores e os corticosteroides inalatórios não são recomendados como opções de terapia de manutenção. Atualmente, o manejo da BOPI consiste apenas de um acompanhamento rigoroso dos pacientes afetados, visando à prevenção e ao tratamento precoce de infecções pulmonares. A incidência de BOPI tem aumentado na população pediátrica nos últimos anos. Os pacientes com BOPI caracterizam-se por um declínio progressivo da função pulmonar, associado a uma diminuição da capacidade funcional global. Relatamos aqui o caso de um homem relativamente jovem diagnosticado com BOPI, acompanhado por três anos. Ap

  16. Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

    Wichmann, Thomas; DeLong, Mahlon R

    2016-04-01

    Deep brain stimulation (DBS) is highly effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal ganglia-thalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

  17. Nature versus nurture: functional assessment of restoration effects on wetland services using Nuclear Magnetic Resonance Spectroscopy

    Sundareshwar, P.V.; Richardson, C.J.; Gleason, R.A.; Pellechia, P.J.; Honomichl, S.

    2009-01-01

    Land-use change has altered the ability of wetlands to provide vital services such as nutrient retention. While compensatory practices attempt to restore degraded wetlands and their functions, it is difficult to evaluate the recovery of soil biogeochemical functions that are critical for restoration of ecosystem services. Using solution 31P Nuclear Magnetic Resonance Spectroscopy, we examined the chemical forms of phosphorus (P) in soils from wetlands located across a land-use gradient. We report that soil P diversity, a functional attribute, was lowest in farmland, and greatest in native wetlands. Soil P diversity increased with age of restoration, indicating restoration of biogeochemical function. The trend in soil P diversity was similar to documented trends in soil bacterial taxonomic composition but opposite that of soil bacterial diversity at our study sites. These findings provide insights into links between ecosystem structure and function and provide a tool for evaluating the success of ecosystem restoration efforts. Copyright 2009 by the American Geophysical Union.

  18. Sildenafil restores endothelial function in the apolipoprotein E knockout mouse

    Balarini Camille M

    2013-01-01

    Full Text Available Abstract Background Atherosclerosis is an inflammatory process of the arterial walls and is initiated by endothelial dysfunction accompanied by an imbalance in the production of reactive oxygen species (ROS and nitric oxide (NO. Sildenafil, a selective phosphodiesterase-5 (PDE5 inhibitor used for erectile dysfunction, exerts its cardiovascular effects by enhancing the effects of NO. The aim of this study was to investigate the influence of sildenafil on endothelial function and atherosclerosis progression in apolipoprotein E knockout (apoE−/− mice. Methods ApoE−/− mice treated with sildenafil (Viagra®, 40 mg/kg/day, for 3 weeks, by oral gavage were compared to the untreated apoE−/− and the wild-type (WT mice. Aortic rings were used to evaluate the relaxation responses to acetylcholine (ACh in all of the groups. In a separate set of experiments, the roles of NO and ROS in the relaxation response to ACh were evaluated by incubating the aortic rings with L-NAME (NO synthase inhibitor or apocynin (NADPH oxidase inhibitor. In addition, the atherosclerotic lesions were quantified and superoxide production was assessed. Results Sildenafil restored the vasodilator response to acetylcholine (ACh in the aortic rings of the apoE−/− mice. Treatment with L-NAME abolished the vasodilator responses to ACh in all three groups of mice and revealed an augmented participation of NO in the endothelium-dependent vasodilation in the sildenafil-treated animals. The normalized endothelial function in sildenafil-treated apoE−/− mice was unaffected by apocynin highlighting the low levels of ROS production in these animals. Moreover, morphological analysis showed that sildenafil treatment caused approximately a 40% decrease in plaque deposition in the aorta. Conclusion This is the first study demonstrating the beneficial effects of chronic treatment with sildenafil on endothelial dysfunction and atherosclerosis in a model of spontaneous

  19. Corticosteroids for pneumonia.

    Stern, Anat; Skalsky, Keren; Avni, Tomer; Carrara, Elena; Leibovici, Leonard; Paul, Mical

    2017-12-13

    Pneumonia is a common and potentially serious illness. Corticosteroids have been suggested for the treatment of different types of infection, however their role in the treatment of pneumonia remains unclear. This is an update of a review published in 2011. To assess the efficacy and safety of corticosteroids in the treatment of pneumonia. We searched the Cochrane Acute Respiratory Infections Group's Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS on 3 March 2017, together with relevant conference proceedings and references of identified trials. We also searched three trials registers for ongoing and unpublished trials. We included randomised controlled trials (RCTs) that assessed systemic corticosteroid therapy, given as adjunct to antibiotic treatment, versus placebo or no corticosteroids for adults and children with pneumonia. We used standard methodological procedures expected by Cochrane. Two review authors independently assessed risk of bias and extracted data. We contacted study authors for additional information. We estimated risk ratios (RR) with 95% confidence intervals (CI) and pooled data using the Mantel-Haenszel fixed-effect model when possible. We included 17 RCTs comprising a total of 2264 participants; 13 RCTs included 1954 adult participants, and four RCTs included 310 children. This update included 12 new studies, excluded one previously included study, and excluded five new trials. One trial awaits classification.All trials limited inclusion to inpatients with community-acquired pneumonia (CAP), with or without healthcare-associated pneumonia (HCAP). We assessed the risk of selection bias and attrition bias as low or unclear overall. We assessed performance bias risk as low for nine trials, unclear for one trial, and high for seven trials. We assessed reporting bias risk as low for three trials and high for the remaining 14 trials.Corticosteroids significantly reduced mortality in adults with severe pneumonia (RR 0.58, 95% CI 0.40 to 0

  20. Corticosteroids for Bacterial Keratitis

    Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Lalitha, Prajna; Glidden, David V.; Ray, Kathryn J.; Hong, Kevin C.; Oldenburg, Catherine E.; Lee, Salena M.; Zegans, Michael E.; McLeod, Stephen D.; Lietman, Thomas M.; Acharya, Nisha R.

    2013-01-01

    Objective To determine whether there is a benefit in clinical outcomes with the use of topical corticosteroids as adjunctive therapy in the treatment of bacterial corneal ulcers. Methods Randomized, placebo-controlled, double-masked, multicenter clinical trial comparing prednisolone sodium phosphate, 1.0%, to placebo as adjunctive therapy for the treatment of bacterial corneal ulcers. Eligible patients had a culture-positive bacterial corneal ulcer and received topical moxifloxacin for at least 48 hours before randomization. Main Outcome Measures The primary outcome was best spectacle-corrected visual acuity (BSCVA) at 3 months from enrollment. Secondary outcomes included infiltrate/scar size, reepithelialization, and corneal perforation. Results Between September 1, 2006, and February 22, 2010, 1769 patients were screened for the trial and 500 patients were enrolled. No significant difference was observed in the 3-month BSCVA (−0.009 logarithm of the minimum angle of resolution [logMAR]; 95% CI, −0.085 to 0.068; P = .82), infiltrate/scar size (P = .40), time to reepithelialization (P = .44), or corneal perforation (P > .99). A significant effect of corticosteroids was observed in subgroups of baseline BSCVA (P = .03) and ulcer location (P = .04). At 3 months, patients with vision of counting fingers or worse at baseline had 0.17 logMAR better visual acuity with corticosteroids (95% CI, −0.31 to −0.02; P = .03) compared with placebo, and patients with ulcers that were completely central at baseline had 0.20 logMAR better visual acuity with corticosteroids (−0.37 to −0.04; P = .02). Conclusions We found no overall difference in 3-month BSCVA and no safety concerns with adjunctive corticosteroid therapy for bacterial corneal ulcers. Application to Clinical Practice Adjunctive topical corticosteroid use does not improve 3-month vision in patients with bacterial corneal ulcers. PMID:21987582

  1. Recycling Energy to Restore Impaired Ankle Function during Human Walking

    Collins, S.H.; Kuo, A.D.

    2010-01-01

    Background: Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is

  2. Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

    Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

    2014-06-01

    Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation. © 2014 Eur J Oral Sci.

  3. Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia

    2017-09-01

    AWARD NUMBER: W81XWH-16-1-0395 TITLE: Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in...estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

  4. Development of Multi-Functional Voltage Restore System

    Suzuki, Satoshi; Ueda, Yoshinobu; Koganezawa, Takehisa; Ogihara, Yoshinori; Mori, Kenjiro; Fukazu, Naoaki

    Recently, with the dawn of the electric deregulation, the installation of distributed generation with power electronics device has grown. This current causes a greater concern of power quality, primarily voltage disturbance for power companies, and their interest in power quality is peaking. Utilities are also interested in keeping their customers satisfied, as well as keeping them on-line and creating more revenue for the utility. As a countermeasure against the above surroundings, a variety type of devices based on power electronics has been developed to protect customers' load from power line voltage disturbance. One of them is the series type voltage restore. The series device is an active device, designed to provide a pure sinusoidal load voltage at all times, correcting voltage disturbance. Series type device compensates for voltage anomalies by inserting the ‘missing’ voltage onto the line through insertion transformer and inverter. This paper shows the setting guideline of target level to compensate voltage disturbance, that is, voltage dip, voltage harmonics, voltage imbalance and voltage flicker, and the design approach of the prototype of series voltage restores to accomplish the required compensation level. The prototype system gives satisfactory compensation performance through evaluation tests, which confirm the validity and effectiveness of the system.

  5. Recycling energy to restore impaired ankle function during human walking.

    Steven H Collins

    Full Text Available BACKGROUND: Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is necessary for steady gait, in which mechanical energy is constant on average, external dissipation is negligible, and no net work is performed over a stride. However, dissipation and replacement by muscles might not be necessary if energy were instead captured and reused by an assistive device. METHODOLOGY/PRINCIPAL FINDINGS: We developed a microprocessor-controlled artificial foot that captures some of the energy that is normally dissipated by the leg and "recycles" it as positive ankle work. In tests on subjects walking with an artificially-impaired ankle, a conventional prosthesis reduced ankle push-off work and increased net metabolic energy expenditure by 23% compared to normal walking. Energy recycling restored ankle push-off to normal and reduced the net metabolic energy penalty to 14%. CONCLUSIONS/SIGNIFICANCE: These results suggest that reduced ankle push-off contributes to the increased metabolic energy expenditure accompanying ankle impairments, and demonstrate that energy recycling can be used to reduce such cost.

  6. Geomorphic Function and Restoration Potential of Spring Creeks in Southeastern Idaho: Analysis and Communication

    Hanrahan, T. P.; Hill, Z.; Levell, A.; Maguire, T.; Risso, D.

    2014-12-01

    A large wetland and floodplain complex adjacent to the Snake River in southeastern Idaho, USA, encompasses numerous spring-fed creeks that originate on the floodplain and discharge at their confluence with the Snake River and American Falls Reservoir. Resource managers are implementing a program to restore these spring creeks for the recovery of Yellowstone cutthroat trout and ecosystem health. Our objectives were to evaluate the physical characteristics of these spring creeks, develop a conceptual model of their geomorphic function, compare the restoration potential of individual reaches, and communicate our findings to a broad audience of resource managers and regional stakeholders in order to foster restoration planning. A geomorphic assessment along 38 km of three spring creeks was completed by collecting data at several transects within distinct geomorphic reaches, and by collecting data continuously throughout all reaches. These data were summarized in a GIS database and used to quantify the overall geomorphic functioning of each reach. The geomorphic functional scores were scaled from 0% (non-functional) to 100% (fully functional). Among all three spring creeks, geomorphic function ranged from 29% to 63%, with bank conditions and riparian vegetation being the primary causes of overall channel degradation. Results from the geomorphic assessment fostered the development of a conceptual model for spring creek function, whereby degraded bank conditions represent the primary controlling factor of decreased geomorphic function and fish habitat quality. The reach-based geomorphic functional scoring provides an indicator of relative restoration potential for each reach, and is one of the factors used in determining site-specific priorities for protecting, enhancing, and restoring spring creeks on the Fort Hall Bottoms. The study results, conceptual model and restoration strategy were communicated to resource managers and regional stakeholders through a graphically

  7. Blurred image restoration using knife-edge function and optimal window Wiener filtering

    Zhou, Shudao; Yan, Wei

    2018-01-01

    Motion blur in images is usually modeled as the convolution of a point spread function (PSF) and the original image represented as pixel intensities. The knife-edge function can be used to model various types of motion-blurs, and hence it allows for the construction of a PSF and accurate estimation of the degradation function without knowledge of the specific degradation model. This paper addresses the problem of image restoration using a knife-edge function and optimal window Wiener filtering. In the proposed method, we first calculate the motion-blur parameters and construct the optimal window. Then, we use the detected knife-edge function to obtain the system degradation function. Finally, we perform Wiener filtering to obtain the restored image. Experiments show that the restored image has improved resolution and contrast parameters with clear details and no discernible ringing effects. PMID:29377950

  8. Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

    Jousset, Nathalie; Fanello, Serge; Bontoux, Luc; Dubus, Valérie; Billabert, Colette; Vielle, Bruno; Roquelaure, Yves; Penneau-Fontbonne, Dominique; Richard, Isabelle

    2004-03-01

    Randomized parallel-group comparative trial with a 6-month follow-up period. To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

  9. Optimization of hybrid imaging systems based on maximization of kurtosis of the restored point spread function

    Demenikov, Mads

    2011-01-01

    to optimization results based on full-reference image measures of restored images. In comparison with full-reference measures, the kurtosis measure is fast to compute and requires no images, noise distributions, or alignment of restored images, but only the signal-to-noise-ratio. © 2011 Optical Society of America.......I propose a novel, but yet simple, no-reference, objective image quality measure based on the kurtosis of the restored point spread function. Using this measure, I optimize several phase masks for extended-depth-of-field in hybrid imaging systems and obtain results that are identical...

  10. Restoring function in major depressive disorder: A systematic review.

    Sheehan, David V; Nakagome, Kazuyuki; Asami, Yuko; Pappadopulos, Elizabeth A; Boucher, Matthieu

    2017-06-01

    Functional impairment contributes to significant disability and economic burden in major depressive disorder (MDD). Treatment response is measured by improvement in depressive symptoms, but functional improvement often lags behind symptomatic improvement. Residual deficits are associated with relapse of depressive symptoms. A literature search was conducted using the following terms: "major depressive disorder," "functional impairment," "functional outcomes," "recovery of function," "treatment outcome," "outcome assessment," "social functioning," "presenteeism," "absenteeism," "psychiatric status rating scales," and "quality of life." Search limits included publication date (January 1, 1995 to August 31, 2016), English language, and human clinical trials. Controlled, acute-phase, nonrecurrent MDD treatment studies in adults were included if a functional outcome was measured at baseline and endpoint. The qualitative analysis included 35 controlled studies. The Sheehan Disability Scale was the most commonly used functional assessment. Antidepressant treatments significantly improved functional outcomes. Early treatment response predicted functional improvement, while baseline disease severity did not. Clinical studies utilized various methodologies and assessments for functional impairment, and were not standardized or adequately powered. The lack of synchronicity between symptomatic and functional improvement highlights an unmet need for MDD. Treatment guided by routine monitoring of symptoms and functionality may minimize residual functional impairments. Copyright © 2017. Published by Elsevier B.V.

  11. Corticosteroid injection for de Quervain's tenosynovitis

    Peters-Veluthamaningal, Cyriac; van der Windt, Danielle A. W. M.; Winters, Jan C.; Jong, Betty Meyboom-de

    2009-01-01

    Back ground De Quervain's tenosynovitis is a disorder characterised by pain on the radial (thumb) side of the wrist and functional disability of the hand. It can be treated by corticosteroid injection, splinting and surgery. Objectives To summarise evidence on the efficacy and safety of

  12. The importance of hydrology in restoration of bottomland hardwood wetland functions

    Hunter, R.G.; Faulkner, S.P.; Gibson, K.A.

    2008-01-01

    Bottomland hardwood (BLH) forests have important biogeochemical functions and it is well known that certain structural components, including pulsed hydrology, hydric soils, and hydrophytic vegetation, enhance these functions. It is unclear, however, how functions of restored BLH wetlands compare to mature, undisturbed wetlands. We measured a suite of structural and functional attributes in replicated natural BLH wetlands (NAT), restored BLH wetlands with hydrology re-established (RWH), and restored BLH wetlands without hydrology re-established (RWOH) in this study. Trees were replanted in all restored wetlands at least four years prior to the study and those wetlands with hydrology re-established had flashboard risers placed in drainage ditches to allow seasonal surface flooding. Vegetation, soils, and selected biogeochemical functions were characterized at each site. There was a marked difference in woody vegetation among the wetlands that was due primarily to site age. There was also a difference in herbaceous vegetation among the restored sites that may have been related to differences in age or hydrology. Water table fluctuations of the RWH wetlands were comparable to those of the NAT wetlands. Thus, placing flashboard risers in existing drainage ditches, along with proper management, can produce a hydroperiod that is similar to that of a relatively undisturbed BLH. Average length of saturation within the upper 15 cm of soils was 37, 104, and 97 days for RWOH, RWH, and NAT, respectively. Soil moisture, denitrification potential, and soluble organic carbon concentrations differed among wetland sites, but soil carbon and nitrogen concentrations, heterotrophic microbial activity, and readily mineralizable carbon concentrations did not. Significant linear relationships were also found between soil moisture and heterotrophic microbial activity, readily mineralizable carbon, and soluble organic carbon. In addition, sedimentation rates were higher in NAT and RWH

  13. Restoration and functional analysis of nuclear medicine images

    Wendt, R.E. III.

    1982-01-01

    The nuclear medicine physician uses visual interpretation of a movie-like display of the beating human heart to detect wall motion abnormalities which might be related to impaired cardiac function. The present work is directed toward extracting more information from the heart motion study, and presenting it in a useful manner. A spatially adaptive smoothing routine using a quadtree image representation gives an improvement in mean squared error compared to the S9 smoother commonly used for nuclear medicine studies. Functional images show the two-dimensional distribution of parameters of the heart motion. The most popular, the first harmonic phase functional image, formed from the first Fourier harmonic fit to each pixel time-activity curve, is subject to significant artifacts which make a simple interpretation of it difficult. A multi-harmonic approximation is more accurate and offers a wealth of unique parameters with which to construct more directly meaningful functional images

  14. Functional Outcomes for Clinical Evaluation of Implant Restorations

    Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad W.; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

    2013-01-01

    The functional outcomes related to treating patients afflicted with tooth loss are an important hallmark in substantiating prosthodontic intervention. The Oral Rehabilitation Outcomes Network (ORONet) conducted two international workshops to develop a core set of outcome measures, including a

  15. Corticosteroids for Bell's palsy (idiopathic facial paralysis).

    Madhok, Vishnu B; Gagyor, Ildiko; Daly, Fergus; Somasundara, Dhruvashree; Sullivan, Michael; Gammie, Fiona; Sullivan, Frank

    2016-07-18

    Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy. Corticosteroids have a potent anti-inflammatory action that should minimise nerve damage. This is an update of a review first published in 2002 and last updated in 2010. To determine the effectiveness and safety of corticosteroid therapy in people with Bell's palsy. On 4 March 2016, we searched the Cochrane Neuromuscular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS. We reviewed the bibliographies of the randomised trials and contacted known experts in the field to identify additional published or unpublished trials. We also searched clinical trials registries for ongoing trials. Randomised trials and quasi-randomised trials comparing different routes of administration and dosage schemes of corticosteroid or adrenocorticotrophic hormone therapy versus a control group receiving no therapy considered effective for this condition, unless the same therapy was given in a similar way to the experimental group. We used standard Cochrane methodology. The main outcome of interest was incomplete recovery of facial motor function (i.e. residual facial weakness). Secondary outcomes were cosmetically disabling persistent sequelae, development of motor synkinesis or autonomic dysfunction (i.e. hemifacial spasm, crocodile tears) and adverse effects of corticosteroid therapy manifested during follow-up. We identified seven trials, with 895 evaluable participants for this review. All provided data suitable for the primary outcome meta-analysis. One of the trials was new since the last version of this Cochrane systematic review. Risk of bias in the older, smaller studies included some unclear- or high-risk assessments, whereas we deemed the larger studies at low risk of bias. Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation

  16. Restoring Bladder Function by Spinal Cord Neuromodulation in SCI

    2016-10-01

    Pharmaceutical Company Cooperative Group (e.g., Children’s Oncology Group, AIDS Clinical Trial Group) Other If other, specify. 4.0 Review For and...proximal to the injury level [39] and the expression of neurotrophic factors in the spinal cord [40, 41]. In human subjects, functional MRI evidence

  17. Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study.

    Feng, Shaoyan; Liang, Zibin; Zhang, Rongkai; Liao, Wei; Chen, Yuan; Fan, Yunping; Li, Huabin

    2017-03-01

    The objective of the study is to investigate the impact of receiving daily WeChat services on one's cell phone on adherence to corticosteroid nasal spray treatment in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS). This study was a two-arm, randomized, follow-up investigation. Patients with chronic rhinosinusitis with/without nasal polyps following bilateral FESS were randomised to receive, or to not receive, daily WeChat service on their cell phone to take corticosteroid nasal spray treatment. A prescription of budesonide aqueous nasal spray 128 µg bid was given to all the subjects. Then they returned to the clinic after 30, 60, 90 days. The primary study outcome was adherence to nasal spray treatment, whereas secondary outcomes were change in endoscopic findings and SinoNasal Outcome Test-20 (SNOT-20). On the whole, there was a significant inter-group difference in the change of adherence rate (F = 90.88, p = 0.000). The WeChat group had much higher adherence rate than the control group during the follow-up. In terms of postoperative endoscopic scores and SNOT-20, except granulation score, no significant differences were observed between the two randomization groups. WeChat services are already after a short period of observation associated with improved adherence to corticosteroid nasal spray treatment in CRS patients after FESS.

  18. Massage Therapy Restores Peripheral Vascular Function following Exertion

    Franklin, Nina C.; Ali, Mohamed M.; Robinson, Austin T.; Norkeviciute, Edita; Phillips, Shane A.

    2014-01-01

    Objective To determine if lower extremity exercise-induced muscle injury (EMI) reduces vascular endothelial function of the upper extremity and if massage therapy (MT) improves peripheral vascular function after EMI. Design Randomized, blinded trial with evaluations at 90 minutes, 24 hours, 48 hours, and 72 hours. Setting Clinical research center at an academic medical center and laboratory Participants Thirty-six sedentary young adults were randomly assigned to one of three groups: 1) EMI + MT (n=15; mean age ± standard error (SE): 26.6±0.3), 2) EMI only (n=10; mean age ± SE: 23.6±0.4), and 3) MT only (n=11; mean age ± SE: 25.5 ± 0.4). Intervention Participants were assigned to either EMI only (a single bout of bilateral, eccentric leg-press exercise), MT only (30-minute lower extremity massage using Swedish technique), or EMI + MT. Main outcome measures Brachial artery flow-mediated dilation (FMD) was determined by ultrasound at each time point. Nitroglycerin-induced dilation was also assessed (NTG; 0.4 mg). Results Brachial FMD increased from baseline in the EMI + MT group and the MT only group (7.38±0.18 to 9.02±0.28%, p<0.05 and 7.77±0.25 to 10.20±0.22%, p < 0.05, respectively) at 90 minutes remaining elevated until 72 hrs. In the EMI only group FMD was reduced from baseline at 24 and 48 hrs (7.78±0.14 to 6.75±0.11%, p<0.05 and 6.53±0.11, p<0.05, respectively) returning to baseline after 72 hrs. Dilations to NTG were similar over time. Conclusions Our results suggest that MT attenuates impairment of upper extremity endothelial function resulting from lower extremity EMI in sedentary young adults. PMID:24583315

  19. Recruiting specialized macrophages across the borders to restore brain functions.

    Corraliza, Inés

    2014-01-01

    Although is well accepted that the central nervous system has an immune privilege protected by the blood-brain barrier (BBB) and maintained by the glia, it is also known that in homeostatic conditions, peripheral immune cells are able to penetrate to the deepest regions of brain without altering the structural integrity of the BBB. Nearly all neurological diseases, including degenerative, autoimmune or infectious ones, compromising brain functions, develop with a common pattern of inflammation in which macrophages and microglia activation have been regarded often as the "bad guys." However, recognizing the huge heterogeneity of macrophage populations and also the different expression properties of microglia, there is increasing evidence of alternative conditions in which these cells, if primed and addressed in the correct direction, could be essential for reparative and regenerative functions. The main proposal of this review is to integrate studies about macrophage's biology at the brain borders where the ultimate challenge is to penetrate through the BBB and contribute to change or even stop the course of disease. Thanks to the efforts made in the last century, this special wall is currently recognized as a highly regulated cooperative structure, in which their components form neurovascular units. This new scenario prompted us to review the precise cross-talk between the mind and body modes of immune response.

  20. Changes in biodiversity and ecosystem function during the restoration of a tropical forest in south China

    REN Hai; LI ZhiAn; SHEN WeiJun; YU ZuoYue; PENG ShaoLin; LIAO ChongHui; DING MingMao; WU JianGuo

    2007-01-01

    Tropical forests continue to vanish rapidly, but few long-term studies have ever examined if and how the lost forests can be restored. Based on a 45-year restoration study in south China, we found that a tropical rain forest, once completely destroyed, could not recover naturally without deliberate restoration efforts. We identified two kinds of thresholds that must be overcome with human ameliorative measures before the ecosystem was able to recover. The first threshold was imposed primarily by extreme physical conditions such as exceedingly high surface temperature and impoverished soil, while the second was characterized by a critical level of biodiversity and a landscape context that accommodates dispersal and colonization processes. Our three treatment catchments (un-restored barren land, single-species plantation, and mixed-forest stand) exhibited dramatically different changes in biodiversity and ecosystem functioning over 4 decades. The mixed forest, having the highest level of biodiversity and ecosystem functioning, possesses several major properties of tropical rain forest.These findings may have important implications for the restoration of many severely degraded or lost tropical forest ecosystems.

  1. Chitosan tubes can restore the function of resected phrenic nerves.

    Tanaka, Nobuyoshi; Matsumoto, Isao; Suzuki, Mitsutaka; Kaneko, Mami; Nitta, Kanae; Seguchi, Ryuta; Ooi, Akishi; Takemura, Hirofumi

    2015-07-01

    We previously reported that the phrenic nerve could be morphologically repaired by implantation of a chitosan nanofibre tube (C-tube). In the current study, we investigated whether implantation of C-tubes could improve the function of an injured phrenic nerve using a beagle dog model. Seven beagle dogs underwent right thoracotomy under general anaesthesia. An approximately 5 mm length of the right phrenic nerve was resected. Five dogs had a C-tube implantation (C-tube group) and other two dogs did not have the C-tube implantation (control group). Diaphragm movements were longitudinally measured by X-ray fluoroscopy before surgery, immediately after the surgery, and 3, 6 and 12 months after the surgery. The diaphragm movement was determined by diaphragm levels at inspiration and expiration phases, and the excursion difference between them was calculated. At 12 months after the surgery, rethoracotomy was performed to examine electrical phrenic nerve conduction. The C-tube and phrenic nerve were then excised for histological assessment of nerve regeneration. Three of the five animals of the C-tube group showed improvement of diaphragm movement with time. In these three animals, slow phrenic nerve conduction was observed. Histological assessment showed that the injured nerve was connected by newly regenerating nerve fibres surrounded by granulation tissue within the C-tube. On the other hand, the animals in the control group and two animals of the C-tube group showed neither improved diaphragm movement, nor electrical conduction to the diaphragm. No nerve fibre regeneration was found by histology. Our results suggest that, in addition to morphological improvement, C-tube implantation can functionally improve the injured phrenic nerve by promoting phrenic nerve regeneration. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. High immunosuppressive burden in advanced hepatocellular carcinoma patients: Can effector functions be restored?

    Lugade, Amit A; Kalathil, Suresh; Miller, Austin; Iyer, Renuka; Thanavala, Yasmin

    2013-07-01

    The accumulation of immunosuppressive cells and exhausted effector T cells highlight an important immune dysfunction in advanced stage hepatocellular carcinoma (HCC) patients. These cells significantly hamper the efficacy immunotherapies and facilitate HCC progression. We have recently demonstrated that the multipronged depletion of immunosuppressive cells potentially restores effector T-cell function in HCC.

  3. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors

    Jansen, P. L.; Chamuleau, R. A.; van Leeuwen, D. J.; Schipper, H. G.; Busemann-Sokole, E.; van der Heyde, M. N.

    1990-01-01

    Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single-photon computed tomography (SPECT), using 99mTc-colloid as tracer. The method was

  4. Using plant functional traits to guide restoration: A case study in California coastal grassland

    Sandel, Brody Steven; Corbin, Jeffrey; Krupa, Monica

    2011-01-01

    Restoration ecology can benefit greatly from developments in trait-based ecology that enable improved predictions of how the composition of plant communities will respond to changes in environmental conditions. Plant functional traits can be used to guide the restoration of degraded habitats...... generally from the treatments. Carbon addition led to large intraspecific trait shifts, with individuals in C addition plots having smaller, denser leaves and shorter stature. Species' trait plasticity, however, was not related to the community composition response to C addition.   Our study indicates...

  5. The Interplay of Orthodontics, Periodontics, and Restorative Dentistry to Achieve Aesthetic and Functional Success.

    Trushkowsky, Richard D; Alsadah, Zainab; Brea, Luis M; Oquendo, Anabella

    2015-07-01

    Previously dentists focused on repair and maintenance of function. However, the emphasis of many patients and dentists is now on esthetics. Often there is a need for the disciplines of orthodontics, periodontics, restorative dentistry, and maxillofacial surgery to work together in order to achieve optimum results. Currently the sequencing planning process begins with esthetics and then function, structure, and ultimately biology. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. 11-Deoxycortisol is a corticosteroid hormone in the lamprey

    Close, D.A.; Yun, S.-S.; McCormick, S.D.; Wildbill, A.J.; Li, W.

    2010-01-01

    Corticosteroid hormones are critical for controlling metabolism, hydromineral balance, and the stress response in vertebrates. Although corticosteroid hormones have been well characterized in most vertebrate groups, the identity of the earliest vertebrate corticosteroid hormone has remained elusive. Here we provide evidence that 11-deoxycortisol is the corticosteroid hormone in the lamprey, a member of the agnathans that evolved more than 500 million years ago. We used RIA, HPLC, and mass spectrometry analysis to determine that 11-deoxycortisol is the active corticosteroid present in lamprey plasma. We also characterized an 11-deoxycortisol receptor extracted from sea lamprey gill cytosol. The receptor was highly specific for 11-deoxycortisol and exhibited corticosteroid binding characteristics, including DNA binding. Furthermore, we observed that 11-deoxycortisol was regulated by the hypothalamus-pituitary axis and responded to acute stress. 11-Deoxycortisol implants reduced sex steroid concentrations and upregulated gill Na+, K+-ATPase, an enzyme critical for ion balance. We show here that 11-deoxycortisol functioned as both a glucocorticoid and a mineralocorticoid in the lamprey. Our findings indicate that a complex and highly specific corticosteroid signaling pathway evolved at least 500 million years ago with the arrival of the earliest vertebrate.

  7. Restoring nervous system structure and function using tissue engineered living scaffolds

    Laura A Struzyna; James P Harris; Kritika S Katiyar; H Isaac Chen; D KacyCullen

    2015-01-01

    Neural tissue engineering is premised on the integration of engineered living tissue with the host nervous system to directly restore lost function or to augment regenerative capacity following ner-vous system injury or neurodegenerative disease. Disconnection of axon pathways – the long-distance ifbers connecting specialized regions of the central nervous system or relaying peripheral signals – is a common feature of many neurological disorders and injury. However, functional axonal regenera-tion rarely occurs due to extreme distances to targets, absence of directed guidance, and the presence of inhibitory factors in the central nervous system, resulting in devastating effects on cognitive and sensorimotor function. To address this need, we are pursuing multiple strategies using tissue engi-neered “living scaffolds”, which are preformed three-dimensional constructs consisting of living neural cells in a deifned, often anisotropic architecture. Living scaffolds are designed to restore function by serving as a living labeled pathway for targeted axonal regeneration – mimicking key developmental mechanisms– or by restoring lost neural circuitry via direct replacement of neurons and axonal tracts. We are currently utilizing preformed living scaffolds consisting of neuronal clusters spanned by long axonal tracts as regenerative bridges to facilitate long-distance axonal regeneration and for targeted neurosurgical reconstruction of local circuits in the brain. Although there are formidable challenges in preclinical and clinical advancement, these living tissue engineered constructs represent a promising strategy to facilitate nervous system repair and functional recovery.

  8. Restoring nervous system structure and function using tissue engineered living scaffolds

    Laura A Struzyna

    2015-01-01

    Full Text Available Neural tissue engineering is premised on the integration of engineered living tissue with the host nervous system to directly restore lost function or to augment regenerative capacity following nervous system injury or neurodegenerative disease. Disconnection of axon pathways - the long-distance fibers connecting specialized regions of the central nervous system or relaying peripheral signals - is a common feature of many neurological disorders and injury. However, functional axonal regeneration rarely occurs due to extreme distances to targets, absence of directed guidance, and the presence of inhibitory factors in the central nervous system, resulting in devastating effects on cognitive and sensorimotor function. To address this need, we are pursuing multiple strategies using tissue engineered "living scaffolds", which are preformed three-dimensional constructs consisting of living neural cells in a defined, often anisotropic architecture. Living scaffolds are designed to restore function by serving as a living labeled pathway for targeted axonal regeneration - mimicking key developmental mechanisms- or by restoring lost neural circuitry via direct replacement of neurons and axonal tracts. We are currently utilizing preformed living scaffolds consisting of neuronal clusters spanned by long axonal tracts as regenerative bridges to facilitate long-distance axonal regeneration and for targeted neurosurgical reconstruction of local circuits in the brain. Although there are formidable challenges in preclinical and clinical advancement, these living tissue engineered constructs represent a promising strategy to facilitate nervous system repair and functional recovery.

  9. Predicting the establishment success of introduced target species in grassland restoration by functional traits.

    Engst, Karina; Baasch, Annett; Bruelheide, Helge

    2017-09-01

    potential of functional trait analysis to predict success in restoration projects.

  10. The use of soil quality indicators to assess soil functionality in restored semi-arid ecosystems

    Muñoz-Rojas, Miriam; Erickson, Todd E.; Dixon, Kingsley W.; Merritt, David J.

    2016-04-01

    Keywords: Pilbara, 1-day CO2 test, microbial activity, mine restoration, soil health, ecosystem services. Introduction Semi-arid and arid environments are highly vulnerable to land degradation and their restoration has commonly showed low rates of success (James et al., 2013). A systematic knowledge of soil functionality is critical to successful restoration of degraded ecosystems since approximately 80% of ecosystem services can be connected to soil functions. The assessment of soil functionality generally involves the evaluation of soil properties and processes as they relate to the ability of soil to function effectively as a component of a healthy ecosystem (Costantini et al., 2015) Using soil quality indicators may be a valuable approach to assess functionality of topsoil and novel substrates used in restoration (Muñoz-Rojas et al., 2014; 2015). A key soil chemical indicator is soil organic C, that has been widely used as an attribute of soil quality because of the many functions that it provides and supports (Willaarts et al., 2015). However, microbial indicators can be more sensitive to disturbances and could be a valuable addition in soil assessment studies in restoration programs. Here, we propose a set of soil quality indicators to assess the soil status in restored soils (topsoil and waste material) of semi-arid environments. The study was conducted during March 2015 in the Pilbara biogeographical region (northwestern Australia) at an iron ore mine site rehabilitated in 2011. Methods Soil samples were collected from two sub-areas with different soil materials used as growth media: topsoil retrieved from nearby stockpiles and a lateritic waste material utilised for its erosive stability and physical competence. An undisturbed natural shrub-grassland ecosystem dominated by Triodia spp. and Acacia spp. representative of the restored area was selected as the analogue reference site. Soil physicochemical analysis were undertaken according to standard methods

  11. Efficacy of IPL device combined with intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with regards to the recovery of skin barrier function: A pilot study.

    Kim, Dong Young; Park, Hyun Sun; Yoon, Hyun-Sun; Cho, Soyun

    2015-10-01

    Keloids and hypertrophic scars are prevalent and psychologically distressful dermatologic conditions. Various treatment modalities have been tried but without complete success by any one method. We evaluated the efficacy of a combination of intense pulsed light (IPL) device and intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to the recovery of skin barrier function. Totally 52 Korean patients were treated by the combined treatment at 4-8-week intervals. Using digital photographs, changes in scar appearance were assessed with modified Vancouver Scar Scale (MVSS), physicians' global assessment (PGA) and patient's satisfaction score. In 12 patients, the stratum corneum (SC) barrier function was assessed by measuring transepidermal water loss (TEWL) and SC capacitance. Most scars demonstrated significant clinical improvement in MVSS, PGA and patient's satisfaction score after the combined therapy. A significant decrease of TEWL and elevation of SC capacitance were also documented after the treatment. The combination therapy (IPL + corticosteroid injection) not only improves the appearance of keloids and hypertrophic scars but also increases the recovery level of skin hydration status in terms of the skin barrier function.

  12. Functions and requirements for tank farm restoration and safe operations, Project W-314. Revision 3

    Garrison, R.C.

    1995-01-01

    This Functions and Requirements document (FRD) establishes the basic performance criteria for Project W-314, in accordance with the guidance outlined in the letter from R.W. Brown, RL, to President, WHC, ''Tank Waste Remediation System (TWRS) Project Documentation Methodology,'' 94-PRJ-018, dated 3/18/94. The FRD replaces the Functional Design Criteria (FDC) as the project technical baseline documentation. Project W-314 will improve the reliability of safety related systems, minimize onsite health and safety hazards, and support waste retrieval and disposal activities by restoring and/or upgrading existing Tank Farm facilities and systems. The scope of Project W-314 encompasses the necessary restoration upgrades of the Tank Farms' instrumentation, ventilation, electrical distribution, and waste transfer systems

  13. Point spread function modeling and image restoration for cone-beam CT

    Zhang Hua; Shi Yikai; Huang Kuidong; Xu Zhe

    2015-01-01

    X-ray cone-beam computed tomography (CT) has such notable features as high efficiency and precision, and is widely used in the fields of medical imaging and industrial non-destructive testing, but the inherent imaging degradation reduces the quality of CT images. Aimed at the problems of projection image degradation and restoration in cone-beam CT, a point spread function (PSF) modeling method is proposed first. The general PSF model of cone-beam CT is established, and based on it, the PSF under arbitrary scanning conditions can be calculated directly for projection image restoration without the additional measurement, which greatly improved the application convenience of cone-beam CT. Secondly, a projection image restoration algorithm based on pre-filtering and pre-segmentation is proposed, which can make the edge contours in projection images and slice images clearer after restoration, and control the noise in the equivalent level to the original images. Finally, the experiments verified the feasibility and effectiveness of the proposed methods. (authors)

  14. Rapidly restoring biological soil crusts and ecosystem functions in a severely disturbed desert ecosystem.

    Chiquoine, Lindsay P; Abella, Scott R; Bowker, Matthew A

    2016-06-01

    Restoring biological soil crusts (biocrusts) in degraded drylands can contribute to recovery of ecosystem functions that have global implications, including erosion resistance and nutrient cycling. To examine techniques for restoring biocrusts, we conducted a replicated, factorial experiment on recently abandoned road surfaces by applying biocrust inoculation (salvaged and stored dry for two years), salvaged topsoil, an abiotic soil amendment (wood shavings), and planting of a dominant perennial shrub (Ambrosia dumosa). Eighteen months after treatments, we measured biocrust abundance and species composition, soil chlorophyll a content and fertility, and soil resistance to erosion. Biocrust addition significantly accelerated biocrust recovery on disturbed soils, including increasing lichen and moss cover and cyanobacteria colonization. Compared to undisturbed controls, inoculated plots had similar lichen and moss composition, recovered 43% of total cyanobacteria density, had similar soil chlorophyll content, and exhibited recovery of soil fertility and soil stability. Inoculation was the only treatment that generated lichen and moss cover. Topsoil application resulted in partial recovery of the cyanobacteria community and soil properties. Compared to untreated disturbed plots, topsoil application without inoculum increased cyanobacteria density by 186% and moderately improved soil chlorophyll and ammonium content and soil stability. Topsoil application produced 22% and 51% of the cyanobacteria density g⁻¹ soil compared to undisturbed and inoculated plots, respectively. Plots not treated with either topsoil or inoculum had significantly lower cyanobacteria density, soil chlorophyll and ammonium concentrations, and significantly higher soil nitrate concentration. Wood shavings and Ambrosia had no influence on biocrust lichen and moss species recovery but did affect cyanobacteria composition and soil fertility. Inoculation of severely disturbed soil with native

  15. The Use of Nerve Transfers to Restore Upper Extremity Function in Cervical Spinal Cord Injury.

    Fox, Ida K; Novak, Christine B; Krauss, Emily M; Hoben, Gwendolyn M; Zaidman, Craig; Ruvinskaya, Rimma; Juknis, Neringa; Winter, Anke C; Mackinnon, Susan E

    2018-03-15

    Nerve transfer surgery to restore upper extremity function in cervical spinal cord injury (SCI) is novel and may transform treatment. Determining candidacy even years post-SCI is ill defined and deserves investigation. To develop a diagnostic algorithm, focusing on electrodiagnostic (EDX) studies, to determine eligibility for nerve transfer surgery. Retrospective descriptive case series. Tertiary university-based institution. Individuals with cervical SCI (n = 45). The electronic medical records of people referred to the Plastic Surgery Multidisciplinary Upper Extremity Surgery unit in the SCI clinic from 2010-2015 were reviewed. People were considered for nerve transfers to restore elbow extension or finger flexion and/or extension. Data including demographic, clinical evaluation, EDX results, surgery, and outcomes were collected and analyzed. EDX data, including nerve conduction studies and electromyography, for bilateral upper extremities of each patient examined was used to assess for the presence of lower motor neuron injury, which would preclude late nerve transfer. Based on our criteria and the results of EDX testing, a substantial number of patients presenting even years post-SCI were candidates for nerve transfers. Clinical outcome results are heterogeneous but promising and suggest that further refinement of eligibility, long-term follow-up, and standardized assessment will improve our understanding of the role of nerve transfer surgery to restore function in people with midcervical SCI. Many patients living with SCI are candidates for nerve transfer surgery to restore upper extremity function. Although the ultimate efficacy of these surgeries is not yet determined, this study attempts to report the criteria we are using and may ultimately determine the timing for intervention and which transfers are most useful for this heterogeneous population. IV. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All

  16. Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study.

    Wu, Yiqun; Wang, Xu Dong; Wang, Feng; Huang, Wei; Zhang, Zhiyong; Zhang, Zhiyuan; Kaigler, Darnell; Zou, Duohong

    2015-10-01

    Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED). The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients. Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded. Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem. This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients. © 2015

  17. Corticosteroid receptors adopt distinct cyclical transcriptional signatures.

    Le Billan, Florian; Amazit, Larbi; Bleakley, Kevin; Xue, Qiong-Yao; Pussard, Eric; Lhadj, Christophe; Kolkhof, Peter; Viengchareun, Say; Fagart, Jérôme; Lombès, Marc

    2018-05-07

    Mineralocorticoid receptors (MRs) and glucocorticoid receptors (GRs) are two closely related hormone-activated transcription factors that regulate major pathophysiologic functions. High homology between these receptors accounts for the crossbinding of their corresponding ligands, MR being activated by both aldosterone and cortisol and GR essentially activated by cortisol. Their coexpression and ability to bind similar DNA motifs highlight the need to investigate their respective contributions to overall corticosteroid signaling. Here, we decipher the transcriptional regulatory mechanisms that underlie selective effects of MRs and GRs on shared genomic targets in a human renal cellular model. Kinetic, serial, and sequential chromatin immunoprecipitation approaches were performed on the period circadian protein 1 ( PER1) target gene, providing evidence that both receptors dynamically and cyclically interact at the same target promoter in a specific and distinct transcriptional signature. During this process, both receptors regulate PER1 gene by binding as homo- or heterodimers to the same promoter region. Our results suggest a novel level of MR-GR target gene regulation, which should be considered for a better and integrated understanding of corticosteroid-related pathophysiology.-Le Billan, F., Amazit, L., Bleakley, K., Xue, Q.-Y., Pussard, E., Lhadj, C., Kolkhof, P., Viengchareun, S., Fagart, J., Lombès, M. Corticosteroid receptors adopt distinct cyclical transcriptional signatures.

  18. EEG-Triggered Functional Electrical Stimulation Therapy for Restoring Upper Limb Function in Chronic Stroke with Severe Hemiplegia

    Cesar Marquez-Chin

    2016-01-01

    Full Text Available We report the therapeutic effects of integrating brain-computer interfacing technology and functional electrical stimulation therapy to restore upper limb reaching movements in a 64-year-old man with severe left hemiplegia following a hemorrhagic stroke he sustained six years prior to this study. He completed 40 90-minute sessions of functional electrical stimulation therapy using a custom-made neuroprosthesis that facilitated 5 different reaching movements. During each session, the participant attempted to reach with his paralyzed arm repeatedly. Stimulation for each of the movement phases (e.g., extending and retrieving the arm was triggered when the power in the 18 Hz–28 Hz range (beta frequency range of the participant’s EEG activity, recorded with a single electrode, decreased below a predefined threshold. The function of the participant’s arm showed a clinically significant improvement in the Fugl-Meyer Assessment Upper Extremity (FMA-UE subscore (6 points as well as moderate improvement in Functional Independence Measure Self-Care subscore (7 points. The changes in arm’s function suggest that the combination of BCI technology and functional electrical stimulation therapy may restore voluntary motor function in individuals with chronic hemiplegia which results in severe upper limb deficit (FMA-UE ≤ 15, a population that does not benefit from current best-practice rehabilitation interventions.

  19. Cholinergic Potentiation of Restoration of Visual Function after Optic Nerve Damage in Rats

    Mira Chamoun

    2017-01-01

    Full Text Available Enhancing cortical plasticity and brain connectivity may improve residual vision following a visual impairment. Since acetylcholine plays an important role in attention and neuronal plasticity, we explored whether potentiation of the cholinergic transmission has an effect on the visual function restoration. To this end, we evaluated for 4 weeks the effect of the acetylcholinesterase inhibitor donepezil on brightness discrimination, visually evoked potentials, and visual cortex reactivity after a bilateral and partial optic nerve crush in adult rats. Donepezil administration enhanced brightness discrimination capacity after optic nerve crush compared to nontreated animals. The visually evoked activation of the primary visual cortex was not restored, as measured by evoked potentials, but the cortical neuronal activity measured by thallium autometallography was not significantly affected four weeks after the optic nerve crush. Altogether, the results suggest a role of the cholinergic system in postlesion cortical plasticity. This finding agrees with the view that restoration of visual function may involve mechanisms beyond the area of primary damage and opens a new perspective for improving visual rehabilitation in humans.

  20. Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery

    Haotian Lin

    2018-04-01

    Full Text Available Background: Visual function and brain function decline concurrently with aging. Notably, cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear. Optical structures of the anterior segment of the eyes, such as the lens and cornea, can be readily reconstructed to improve refraction and vision quality. However, the effects of visual restoration on human brain function and structure remain largely unexplored. Methods: A prospective, controlled clinical trial was conducted. Twenty-six patients with bilateral age-related cataracts (ARCs who underwent phacoemulsification and intraocular lens implantation and 26 healthy controls without ARC, matched for age, sex, and education, were recruited. Visual functions (including visual acuity, visual evoke potential, and contrast sensitivity, the Mini-Mental State Examination and functional magnetic resonance imaging (including the fractional amplitude of low-frequency fluctuations and grey matter volume variation were assessed for all the participants and reexamined for ARC patients after cataract surgery. This trial was registered with ClinicalTrials.gov (NCT02644720. Findings: Compared with the healthy controls, the ARC patients presented decreased brain functionality as well as structural alterations in visual and cognitive-related brain areas preoperatively. Three months postoperatively, significant functional improvements were observed in the visual and cognitive-related brain areas of the patients. Six months postoperatively, the patients' grey matter volumes in these areas were significantly increased. Notably, both the function and structure in the visual and cognitive-related brain areas of the patients improved significantly and became comparable to those of the healthy controls 6 months postoperatively. Interpretation: We demonstrated that ocular reconstruction can functionally and structurally reverse cataract

  1. Glycerol restores the p53 function in human lingual cancer cells bearing mutant p53

    Ota, Ichiro; Yane, Katsunari; Yuki, Kazue; Kanata, Hirokazu; Hosoi, Hiroshi; Miyahara, Hiroshi

    2001-01-01

    Mutations in p53, tumor suppressor gene, have recently been shown to have an impact on the clinical course of several human tumors, including head and neck cancers. The genetic status of the p53 gene has been focused on as the most important candidate among various cancer-related genes for prognosis-predictive assays of cancer therapy. We examined the restoration of radiation- or cisplatin (CDDP)-induced p53-dependent apoptosis in human lingual cancer cells. The results suggest that glycerol is effective in inducing a conformational change of p53 and restoring normal function of mutant p53, leading to enhanced radiosensitivity or chemosensitivity through the induction of apoptosis. We have also represented the same results in vivo as in vitro. Thus, this novel tool for enhancement of radiosensitivity or chemosensitivity in cancer cells bearing m p53 may be applicable for p53-targeted cancer therapy. (author)

  2. Intra-articular corticosteroid for knee osteoarthritis.

    Jüni, Peter; Hari, Roman; Rutjes, Anne W S; Fischer, Roland; Silletta, Maria G; Reichenbach, Stephan; da Costa, Bruno R

    2015-10-22

    Knee osteoarthritis is a leading cause of chronic pain, disability, and decreased quality of life. Despite the long-standing use of intra-articular corticosteroids, there is an ongoing debate about their benefits and safety. This is an update of a Cochrane review first published in 2005. To determine the benefits and harms of intra-articular corticosteroids compared with sham or no intervention in people with knee osteoarthritis in terms of pain, physical function, quality of life, and safety. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE (from inception to 3 February 2015), checked trial registers, conference proceedings, reference lists, and contacted authors. We included randomised or quasi-randomised controlled trials that compared intra-articular corticosteroids with sham injection or no treatment in people with knee osteoarthritis. We applied no language restrictions. We calculated standardised mean differences (SMDs) and 95% confidence intervals (CI) for pain, function, quality of life, joint space narrowing, and risk ratios (RRs) for safety outcomes. We combined trials using an inverse-variance random-effects meta-analysis. We identified 27 trials (13 new studies) with 1767 participants in this update. We graded the quality of the evidence as 'low' for all outcomes because treatment effect estimates were inconsistent with great variation across trials, pooled estimates were imprecise and did not rule out relevant or irrelevant clinical effects, and because most trials had a high or unclear risk of bias. Intra-articular corticosteroids appeared to be more beneficial in pain reduction than control interventions (SMD -0.40, 95% CI -0.58 to -0.22), which corresponds to a difference in pain scores of 1.0 cm on a 10-cm visual analogue scale between corticosteroids and sham injection and translates into a number needed to treat for an additional beneficial outcome (NNTB) of 8 (95% CI 6 to 13). An I(2) statistic of 68

  3. Improved functional capacity evaluation performance predicts successful return to work one year after completing a functional restoration rehabilitation program.

    Fore, Lisa; Perez, Yoheli; Neblett, Randy; Asih, Sali; Mayer, Tom G; Gatchel, Robert J

    2015-04-01

    To evaluate whether functional capacity evaluation (FCE) scores are responsive to functional restoration treatment, and to assess the ability of FCEs at program discharge to predict work outcomes. An interdisciplinary cohort study of prospectively collected data. A functional restoration center. A consecutive sample of 354 patients with chronic disabling occupational musculoskeletal disorders (CDOMDs) completed a functional restoration program consisting of quantitatively directed exercise progression and multi-modal disability management with interdisciplinary medical supervision. Each patient participated in an FCE at admission and discharge from treatment. The results of each FCE yielded the physical demand level (PDL) at which patients were functioning. Patients were initially divided into 5 PDL groups, based on job-of-injury lifting, carrying, and pushing/pulling requirements, for the pre- to posttreatment responsiveness analyses. Patients were subsequently divided into 5 PDL groups, based on their performance on the FCE upon program completion. Outcome measures included admission-to-discharge changes in PDLs and 2 specific FCE lifting tasks: isokinetic lifting; and the Progressive Isoinertial Lifting Evaluation (PILE). Socioeconomic outcomes were also evaluated, including post-discharge work return and work retention 1-year after treatment completion. Overall, 96% of the patients demonstrated improvement in their PDLs from admission to discharge. A majority of patients (56%) were able to achieve a discharge PDL that was comparable to their estimated job-of-injury lifting requirement or higher (P work return (P work retention (P work return after treatment completion and work retention 1 year later. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  4. Separable roles of UFO during floral development revealed by conditional restoration of gene function.

    Laufs, Patrick; Coen, Enrico; Kronenberger, Jocelyne; Traas, Jan; Doonan, John

    2003-02-01

    The UNUSUAL FLORAL ORGANS (UFO) gene is required for several aspects of floral development in Arabidopsis including specification of organ identity in the second and third whorls and the proper pattern of primordium initiation in the inner three whorls. UFO is expressed in a dynamic pattern during the early phases of flower development. Here we dissect the role of UFO by ubiquitously expressing it in ufo loss-of-function flowers at different developmental stages and for various durations using an ethanol-inducible expression system. The previously known functions of UFO could be separated and related to its expression at specific stages of development. We show that a 24- to 48-hour period of UFO expression from floral stage 2, before any floral organs are visible, is sufficient to restore normal petal and stamen development. The earliest requirement for UFO is during stage 2, when the endogenous UFO gene is transiently expressed in the centre of the wild-type flower and is required to specify the initiation patterns of petal, stamen and carpel primordia. Petal and stamen identity is determined during stages 2 or 3, when UFO is normally expressed in the presumptive second and third whorl. Although endogenous UFO expression is absent from the stamen whorl from stage 4 onwards, stamen identity can be restored by UFO activation up to stage 6. We also observed floral phenotypes not observed in loss-of-function or constitutive gain-of-function backgrounds, revealing additional roles of UFO in outgrowth of petal primordia.

  5. Evaluation of Restoration and Flow Interactions on River Structure and Function: Channel Widening of the Thur River, Switzerland

    Eduardo J. Martín

    2018-04-01

    Full Text Available Removal of lateral constraints to restore rivers has become increasingly common in river resource management, but little is known how the interaction of de-channelization with flow influences ecosystem structure and function. We evaluated the ecosystem effects of river widening to improve sediment relations in the Thur River, Switzerland, 12 years after implementation. We tested if restored and non-restored reaches differed in water physico-chemistry, hyporheic function, primary production, and macroinvertebrate density and composition in relation to the flow regime. Our results showed that (i spatio-temporal variation in sediment respiration and macroinvertebrate taxonomic richness were driven by interactions between restoration and flow; (ii riverbed conditions including substrate size, organic matter content, and groundwater–surface water exchange changed due to restoration, but (iii physico-chemistry, hydraulic conditions, and primary production were not altered by restoration. Importantly, our study revealed that abiotic conditions, except channel morphology, changed only marginally, whereas other ecosystem attributes responded markedly to changes in flow-restoration interactions. These results highlight integrating a more holistic ecosystem perspective in the design and monitoring of restoration projects such as river widening in resource management, preferably in relation to flow-sediment regimes and interactions with the biotic components of the ecosystem.

  6. Inhaled corticosteroid treatment for 6?months was not sufficient to normalize phagocytosis in asthmatic children

    da Silva-Martins, Carmen L?via Faria; Couto, Shirley Claudino; Muniz-Junqueira, Maria Imaculada

    2013-01-01

    Background Corticosteroids are the first-line therapy for asthma; however, the effect of corticosteroids on the innate immune system remains unclear. This study?s objective was to evaluate the effect of inhaled corticosteroid therapy (ICT) on phagocytic functions. Methods To evaluate the impact of ICT, the phagocytosis of Saccharomyces cerevisiae by blood monocytes and neutrophils and the production of superoxide anions were assessed before and after three and six months of ICT treatment in 5...

  7. Restoring Ovarian Endocrine Function with Encapsulated Ovarian Allograft in Immune Competent Mice.

    David, Anu; Day, James Ronald; Cichon, Alexa Leigh; Lefferts, Adam; Cascalho, Marilia; Shikanov, Ariella

    2017-07-01

    Premature ovarian insufficiency (POI) is a major complication of cytotoxic treatments due to extreme ovarian sensitivity to chemotherapy and radiation. In pediatric cancer patients modern therapy has improved the long-term survival to over 80% in the United States. However, these cancer survivors face long-term health problems related to treatment toxicity. In female cancer survivors POI leads to sterility, along with the consequences of estrogen deficiency such as premature osteopenia, muscle wasting, accelerated cardiovascular diseases and a vast array of other health and developmental problems. These long-lasting effects are particularly significant for young girls reaching puberty. As such, restoring ovarian endocrine function is paramount in this population. In the present study, we evaluated the feasibility of restoring ovarian endocrine function in ovariectomized mice by transplanting syngeneic and allogeneic ovarian tissue encapsulated in alginate capsules or TheraCyte ® . Histological analysis of the implants retrieved after 7 and 30 days' post implantation showed follicular development up to the secondary and antral stages in both syngeneic and allogeneic implants. Implantation of syngeneic and allogeneic ovarian grafts encapsulated in TheraCyte devices restored ovarian endocrine function, which was confirmed by decreased serum FSH levels from 60 to 70 ng/mL in ovariectomized mice to 30-40 ng/mL 30 days after implantation. Absence of allo-MHC-specific IgG and IgM antibodies in the sera of implanted mice with allogeneic ovarian tissue encapsulated in TheraCyte indicate that the implants did not evoke an allo-immune response, while the allogeneic controls were rejected 21 days after implantation. Our results show that TheraCyte effectively isolates the graft from immune recognition but also supports follicular growth.

  8. Importance of orthodontic movement in interdisciplinary treatment for restoring esthetics and functional occlusion

    Carlos Henrique Guimarães

    2015-01-01

    Full Text Available This article describes interdisciplinary treatment conducted in adult patients, 49-year-old, with periodontal problems, losses and dental inclination, occlusal trauma, localized bone loss, and necessity of rehabilitation with dental implants. Alignment and leveling of the teeth, the molars uprighting with cantilever, and space closure were performed the treatment was facilitated by periodic periodontal control. The resultant occlusion was stable throughout a 5-year retention period. In conclusion, interdisciplinary treatment combined with periodontics, orthodontics, implantodontist, and restorative dentistry was useful for improving the patient′s oral health, function, and esthetics.

  9. Osseous metastases from renal cell carcinoma: embolization and surgery for restoration of function. Work in progress

    Rowe, D.M.; Becker, G.J.; Rabe, F.E.; Holden, R.W.; Richmond, B.D.; Wass, J.L.; Sequeira, F.W.

    1984-01-01

    Five patients underwent preoperative embolization of osseous metastases from renal cell carcinoma. The group consisted of four men and one woman who ranged in age from 46 to 79 years. The lesions were located in the pubic ramus and acetabulum, proximal femur, femoral midshaft, proximal humerus, and proximal tibia. All embolizations were performed within 24 hours of surgery. The internal fixation and tumor curettage was accomplished with estimated perioperative blood loss ranging from 10 ml to 1,250 ml. All patients had significant restoration of function following surgery. The authors suggest that preoperative embolization is an important and efficacious adjunct in the management of hypervascular renal cell osseous metastases

  10. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors

    Jansen, P.L.M.; Chamuleau, R.A.F.; Leeuwen, D.J. van; Schippor, H.G.; Busemann-Sokole, E.; Heyde, M.N. van der

    1990-01-01

    Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single photon computed tomography (SPECT), using 99m Tc-colloid as tracer. The method was assessed in 11 patients by comparing the pre- and post-operative volume measurement with the volume of the resected liver mass. Liver function was determined by measuring the galactose elimination capacity and the caffeine clearance. After a postoperative follow-up period of 50 days, the liver had regenerated maximally to a volume of 75 ± 2% of the preoperative liver mass. Maximal restoration of liver function was achieved 120 days after operation and amounted to 75 ± 10% for the caffeine clearance and to 100 ± 25% for the galactose elimination capacity. This study shows that SPECT is a useful method for assessing liver regeneration in patients after partial hepatectomy. The study furthermore shows that caffeine clearance correlates well with total liver volume, whereas the galactose elimination capacity overestimates total liver volume after partial hepatectomy. 22 refs

  11. Laminin-111-derived peptide conjugated fibrin hydrogel restores salivary gland function.

    Kihoon Nam

    Full Text Available Hyposalivation reduces the patient quality of life, as saliva is important for maintaining oral health. Current treatments for hyposalivation are limited to medications such as the muscarinic receptor agonists, pilocarpine and cevimeline. However, these therapies only provide temporary relief. Therefore, alternative therapies are essential to restore salivary gland function. An option is to use bioengineered scaffolds to promote functional salivary gland regeneration. Previous studies demonstrated that the laminin-111 protein is critical for intact salivary gland cell cluster formation and organization. However, laminin-111 protein as a whole is not suitable for clinical applications as some protein domains may contribute to unwanted side effects such as degradation, tumorigenesis and immune responses. Conversely, the use of synthetic laminin-111 peptides makes it possible to minimize the immune reactivity or pathogen transfer. In addition, it is relatively simple and inexpensive as compared to animal-derived proteins. Therefore, the goal of this study was to demonstrate whether a 20 day treatment with laminin-111-derived peptide conjugated fibrin hydrogel promotes tissue regeneration in submandibular glands of a wound healing mouse model. In this study, laminin-111-derived peptide conjugated fibrin hydrogel significantly accelerated formation of salivary gland tissue. The regenerated gland tissues displayed not only structural but also functional restoration.

  12. Closed-loop control of spinal cord stimulation to restore hand function after paralysis

    Jonas B Zimmermann

    2014-05-01

    Full Text Available As yet, no cure exists for upper-limb paralysis resulting from the damage to motor pathways after spinal cord injury or stroke. Recently, neural activity from the motor cortex of paralyzed individuals has been used to control the movements of a robot arm but restoring function to patients’ actual limbs remains a considerable challenge. Previously we have shown that electrical stimulation of the cervical spinal cord in anesthetized monkeys can elicit functional upper-limb movements like reaching and grasping. Here we show that stimulation can be controlled using cortical activity in awake animals to bypass disruption of the corticospinal system, restoring their ability to perform a simple upper-limb task. Monkeys were trained to grasp and pull a spring-loaded handle. After temporary paralysis of the hand was induced by reversible inactivation of primary motor cortex using muscimol, grasp-related single-unit activity from the ventral premotor cortex was converted into stimulation patterns delivered in real-time to the cervical spinal grey matter. During periods of closed-loop stimulation, task-modulated electromyogram, movement amplitude and task success rate were improved relative to interleaved control periods without stimulation. In some sessions, single motor unit activity from weakly active muscles was also used successfully to control stimulation. These results are the first use of a neural prosthesis to improve the hand function of primates after motor cortex disruption, and demonstrate the potential for closed-loop cortical control of spinal cord stimulation to reanimate paralyzed limbs.

  13. Biomolecules in the treatment of lichen planus refractory to corticosteroid therapy: Clinical and histopathological assessment.

    Piñas, Laura; Alkhraisat, Mohammad Hamdan; Suárez-Fernández, Ricardo; Anitua, Eduardo

    2018-03-01

    Local deficit of several biomolecules have been described in oral lichen planus (OLP). Such a deficit impairs cellular functions and cell-matrix communication. Assess the efficacy of the local application of autologous biomolecules in the treatment of erosive OLP. In this study, the use of plasma rich in growth factors (PRGF) as a source of blood-derived and autologous growth factors and proteins were tested in erosive oral lichen planus refractory to corticosteroids. Histopathological features of the disease were also analysed at the time of diagnosis. Clinical data were the number of recurrences and achievement of pain reduction and complete healing of the lesions. A total of 10 patients with erosive OLP refractory to treatment by corticosteroids were included in the study. All patients were females with a mean age of 48±12years. A complete remission of the disease was achieved after one infiltration of PRGF in 8 patients. Only 2 patients required a total of 2 infiltrations to heal. Hydropic degeneration of the epithelium basal layer, band-like subepithelial lymphocytic infiltration and fibrin deposits in the epithelium were observed in all patients. Interestingly plasma cells were present in 2 patients. All patients presenting plasma cells healed after only one PRGF infiltration. However, 2 patients out of 6 (no plasma cells) required 2 infiltrations. The local administration of autologous local factors could overcome the deficit of biomolecular clues and thus improve cell functions and restore cell-matrix communication. Copyright © 2017 Elsevier GmbH. All rights reserved.

  14. Systemic corticosteroid therapy for acute sinusitis

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest

  15. Systemic corticosteroid therapy for acute sinusitis

    Venekamp, R.P.; Thompson, M.J.; Rovers, M.M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibiotics may be associated with modest

  16. Systemic corticosteroids for acute gout.

    Janssens, H.; Lucassen, P.L.B.J.; Laar, F.A. van de; Janssen, M.; Lisdonk, E.H. van de

    2008-01-01

    BACKGROUND: Gout is one of the most frequently occurring rheumatic diseases, worldwide. Given the well-known drawbacks of the regular treatments for acute gout (non-steroidal anti-inflammatory drugs (NSAIDs), colchicine), systemic corticosteroids might be safe alternatives. OBJECTIVES: To assess the

  17. Rate and Time of Ovarian Function Restoration in Menopausal Breast Cancer Patients Who Received Letrozole Following Chemotherapy

    Shapour Omidvari

    2015-01-01

    Full Text Available Background: The present study aimed to investigate the rate and time of ovarian function restoration in breast cancer patients between 40 and 60 years of age who were in menopause (biochemically documented and received letrozole after chemotherapy. We intended to further clarify the management strategy for breast cancer patients with different menopausal status. Methods: We prospectively measured the effects of replacing tamoxifen with letrozole on ovarian function recovery in 90 women from two age groups (40-50 and 51-60 years. All had breast cancer and were treated by chemotherapy. Patients had laboratory documentation of menopause (FSH >40 mIU/ml and estradiol <20 pg/mL. Patients did not have menstruation for at least one year. Study patients received letrozole. At three month intervals, we checked their FSH and estradiol levels. Results:At three months after beginning letrozole, 12 patients in the younger age group had laboratory ovarian function restoration, among which three had vaginal bleeding. In the older group, 8 patients had increased estradiol levels; however, there was no evidence of vaginal bleeding in this group. At 6, 9 and 12 months, no ovarian function restoration was seen in the older group. However in younger patients, 4 had laboratory evidence of ovarian function restoration at 6 months, 2 at 9 months and 1 patient showed laboratory ovarian function restoration at 12 months of follow-up. Totally, there was a significant difference in the occurrence of ovarian function restoration between the two groups (P=0.03. Conclusion: A remarkable portion of women with chemotherapy-induced amenorrhea may develop ovarian function restoration. Therefore, endocrine therapy using aromatase inhibitors in patients with chemotherapy-induced amenorrhea should be followed by a regular hormonal study.

  18. Functional approach for pairing in finite systems: How to define restoration of broken symmetries in Energy Density Functional theory?

    Hupin, G; Lacroix, D; Bender, M

    2011-01-01

    The Multi-Reference Energy Density Functional (MR-EDF) approach (also called configuration mixing or Generator Coordinate Method), that is commonly used to treat pairing in finite nuclei and project onto particle number, is re-analyzed. It is shown that, under certain conditions, the MR-EDF energy can be interpreted as a functional of the one-body density matrix of the projected state with good particle number. Based on this observation, we propose a new approach, called Symmetry-Conserving EDF (SC-EDF), where the breaking and restoration of symmetry are accounted for simultaneously. We show, that such an approach is free from pathologies recently observed in MR-EDF and can be used with a large flexibility on the density dependence of the functional.

  19. Schwann cell seeded guidance tubes restore erectile function after ablation of cavernous nerves in rats.

    May, F; Weidner, N; Matiasek, K; Caspers, C; Mrva, T; Vroemen, M; Henke, J; Lehmer, A; Schwaibold, H; Erhardt, W; Gänsbacher, B; Hartung, R

    2004-07-01

    Dissection of the cavernous nerves eliminates spontaneous erections. We evaluated the ability of Schwann cell seeded nerve guidance tubes to restore erections after bilateral cavernous nerve resection in rats. Sections (5 mm) of the cavernous nerve were excised bilaterally, followed by immediate bilateral microsurgical reconstruction. In 10 animals per group (20 study nerves) reconstruction was performed by genitofemoral nerve interposition, interposition of silicone tubes or interposition of silicone tubes seeded with homologous Schwann cells. As the control 10 animals (20 study nerves) underwent sham operation (positive control) and bilateral nerve ablation (without reconstruction) was performed in a further 10 (negative control). Erectile function was evaluated 3 months postoperatively by relaparotomy, electrical nerve stimulation and intracavernous pressure recording. After 3 months neurostimulation resulted in an intact erectile response in 90% (18 of 20) of Schwann cell grafts, while treatment with autologous nerves (30% or 6 of 20) or tubes only (50% or 10 of 20) was less successful (p Schwann cell grafts compared to results in the other treatment groups (p Schwann cell grafts. Schwann cell seeded guidance tubes restore erectile function after the ablation of cavernous nerves in rats and they are superior to autologous nerve grafts.

  20. Mesenchymal Stem Cell-Derived Factors Restore Function to Human Frataxin-Deficient Cells.

    Kemp, Kevin; Dey, Rimi; Cook, Amelia; Scolding, Neil; Wilkins, Alastair

    2017-08-01

    Friedreich's ataxia is an inherited neurological disorder characterised by mitochondrial dysfunction and increased susceptibility to oxidative stress. At present, no therapy has been shown to reduce disease progression. Strategies being trialled to treat Friedreich's ataxia include drugs that improve mitochondrial function and reduce oxidative injury. In addition, stem cells have been investigated as a potential therapeutic approach. We have used siRNA-induced knockdown of frataxin in SH-SY5Y cells as an in vitro cellular model for Friedreich's ataxia. Knockdown of frataxin protein expression to levels detected in patients with the disorder was achieved, leading to decreased cellular viability, increased susceptibility to hydrogen peroxide-induced oxidative stress, dysregulation of key anti-oxidant molecules and deficiencies in both cell proliferation and differentiation. Bone marrow stem cells are being investigated extensively as potential treatments for a wide range of neurological disorders, including Friedreich's ataxia. The potential neuroprotective effects of bone marrow-derived mesenchymal stem cells were therefore studied using our frataxin-deficient cell model. Soluble factors secreted by mesenchymal stem cells protected against cellular changes induced by frataxin deficiency, leading to restoration in frataxin levels and anti-oxidant defences, improved survival against oxidative stress and stimulated both cell proliferation and differentiation down the Schwann cell lineage. The demonstration that mesenchymal stem cell-derived factors can restore cellular homeostasis and function to frataxin-deficient cells further suggests that they may have potential therapeutic benefits for patients with Friedreich's ataxia.

  1. Functional restoration of diaphragmatic paralysis: an evaluation of phrenic nerve reconstruction.

    Kaufman, Matthew R; Elkwood, Andrew I; Colicchio, Alan R; CeCe, John; Jarrahy, Reza; Willekes, Lourens J; Rose, Michael I; Brown, David

    2014-01-01

    Unilateral diaphragmatic paralysis causes respiratory deficits and can occur after iatrogenic or traumatic phrenic nerve injury in the neck or chest. Patients are evaluated using spirometry and imaging studies; however, phrenic nerve conduction studies and electromyography are not widely available or considered; thus, the degree of dysfunction is often unknown. Treatment has been limited to diaphragmatic plication. Phrenic nerve operations to restore diaphragmatic function may broaden therapeutic options. An interventional study of 92 patients with symptomatic diaphragmatic paralysis assigned 68 (based on their clinical condition) to phrenic nerve surgical intervention (PS), 24 to nonsurgical (NS) care, and evaluated a third group of 68 patients (derived from literature review) treated with diaphragmatic plication (DP). Variables for assessment included spirometry, the Short-Form 36-Item survey, electrodiagnostics, and complications. In the PS group, there was an average 13% improvement in forced expiratory volume in 1 second (p Phrenic nerve operations for functional restoration of the paralyzed diaphragm should be part of the standard treatment algorithm in the management of symptomatic patients with this condition. Assessment of neuromuscular dysfunction can aid in determining the most effective therapy. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Interdisciplinary management for restoration of function and esthetics in a patient with hereditary amelogenesis imperfecta

    Sushma Dhiman

    2015-01-01

    Full Text Available Amelogenesis imperfecta (AI is a type of the hereditary disorder which is expressed as a group of conditions causing developmental alterations in the structure of enamel. It is associated with a reduction of oral health-related quality-of-life, has an impact on psychological well-being, and leads to various physiological problems. Children or adults with AI express varying degree of malocclusions either in the form of crowding, impacted teeth, spacing, retained teeth, reduced vertical height due to abnormal tooth structure or undue tooth loss. Orthodontic treatment should precede esthetic rehabilitation. Proper diagnosis of the case is quintessential to provide durable functional and esthetic result to these patients, improving the quality of their lives. We present a case of interdisciplinary management for restoring function and esthetics in a patient with hereditary AI of the hypoplastic type accompanied with tooth impaction and some other dental anomalies.

  3. Posterior composite restoration update: focus on factors influencing form and function

    Bohaty, Brenda S; Ye, Qiang; Misra, Anil; Sene, Fabio; Spencer, Paulette

    2013-01-01

    Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration–tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth. PMID:23750102

  4. Early Response of Soil Properties and Function to Riparian Rainforest Restoration

    Gageler, Rose; Bonner, Mark; Kirchhof, Gunnar; Amos, Mark; Robinson, Nicole; Schmidt, Susanne; Shoo, Luke P.

    2014-01-01

    Reforestation of riparian zones is increasingly practiced in many regions for purposes of biodiversity conservation, bank stabilisation, and improvement in water quality. This is in spite of the actual benefits of reforestation for recovering underlying soil properties and function remaining poorly understood. Here we compare remnant riparian rainforest, pasture and reforestation plantings aged 2–20 years in an Australian subtropical catchment on ferrosols to determine the extent to which reforestation restores key soil properties. Of the nine soil attributes measured (total nitrogen, nitrate and ammonium concentrations, net nitrification and ammonification rates, organic carbon, bulk density, fine root biomass and water infiltration rates), only infiltration rates were significantly lower in pasture than remnant riparian rainforest. Within reforestation plantings, bulk density decreased up to 1.4-fold and infiltration rates increased up to 60-fold with time post-reforestation. Our results suggest that the main outcome of belowground processes of early reforestation is the recovery of the soils' physical structure, with potential beneficial ecosystem services including reduced runoff, erosion and associated sediment and nutrient loads in waterways. We also demonstrate differential impacts of two commonly planted tree species on a subset of soil properties suggesting that preferential planting of select species could accelerate progress on specific restoration objectives. PMID:25117589

  5. Functional restoration of the esophagus after peroral endoscopic myotomy for achalasia

    Huh, Cheal Wung; Youn, Young Hoon; Chung, Hyunsoo; Lee, Yong Chan; Park, Hyojin

    2017-01-01

    Purpose Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define “esophageal remodeling” as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate “esophageal remodeling” after POEM for achalasia. Materials and methods We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE). We recruited 23 patients (13 male; mean age: 53.9 years) whose preoperative and postoperative HRM and BE results were available, from among 30 patients with achalasia who underwent POEM at two institutions between July 2013 and December 2015. Results All patients achieved clinical treatment success (Eckardt score≤3). Partial recovery of esophageal body peristalsis was noted in 1/5 patients with type I (20%), 6/11 with type II (54.5%), and 7/7 with type III (100%) achalasia after POEM. Pan-esophageal pressurization disappeared after POEM in 10/11 type II achalasia patients. The average diameter of the esophageal body after POEM was significantly decreased in all types of achalasia. Conclusion POEM provided excellent clinical symptomatic relief and esophageal remodeling in terms of restoration of peristalsis and reduction in diameter of the esophageal body, especially in patients with type III achalasia. PMID:28542509

  6. Functional restoration of the esophagus after peroral endoscopic myotomy for achalasia.

    Huh, Cheal Wung; Youn, Young Hoon; Chung, Hyunsoo; Lee, Yong Chan; Park, Hyojin

    2017-01-01

    Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define "esophageal remodeling" as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate "esophageal remodeling" after POEM for achalasia. We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE). We recruited 23 patients (13 male; mean age: 53.9 years) whose preoperative and postoperative HRM and BE results were available, from among 30 patients with achalasia who underwent POEM at two institutions between July 2013 and December 2015. All patients achieved clinical treatment success (Eckardt score≤3). Partial recovery of esophageal body peristalsis was noted in 1/5 patients with type I (20%), 6/11 with type II (54.5%), and 7/7 with type III (100%) achalasia after POEM. Pan-esophageal pressurization disappeared after POEM in 10/11 type II achalasia patients. The average diameter of the esophageal body after POEM was significantly decreased in all types of achalasia. POEM provided excellent clinical symptomatic relief and esophageal remodeling in terms of restoration of peristalsis and reduction in diameter of the esophageal body, especially in patients with type III achalasia.

  7. Early response of soil properties and function to riparian rainforest restoration.

    Rose Gageler

    Full Text Available Reforestation of riparian zones is increasingly practiced in many regions for purposes of biodiversity conservation, bank stabilisation, and improvement in water quality. This is in spite of the actual benefits of reforestation for recovering underlying soil properties and function remaining poorly understood. Here we compare remnant riparian rainforest, pasture and reforestation plantings aged 2-20 years in an Australian subtropical catchment on ferrosols to determine the extent to which reforestation restores key soil properties. Of the nine soil attributes measured (total nitrogen, nitrate and ammonium concentrations, net nitrification and ammonification rates, organic carbon, bulk density, fine root biomass and water infiltration rates, only infiltration rates were significantly lower in pasture than remnant riparian rainforest. Within reforestation plantings, bulk density decreased up to 1.4-fold and infiltration rates increased up to 60-fold with time post-reforestation. Our results suggest that the main outcome of belowground processes of early reforestation is the recovery of the soils' physical structure, with potential beneficial ecosystem services including reduced runoff, erosion and associated sediment and nutrient loads in waterways. We also demonstrate differential impacts of two commonly planted tree species on a subset of soil properties suggesting that preferential planting of select species could accelerate progress on specific restoration objectives.

  8. Introduction to proceedings of a workshop on science considerations in functional restoration

    Carlos Rodriguez-Franco

    2014-01-01

    There has been a great deal of discussion in the scientific literature and in traditional forest management literature about forest restoration, ecological restoration, adaptive and active management for restoring forest ecosystems, and a variety of linked topics. The USDA Forest Service manages 193 million acres of forest and grasslands for a variety of uses, and...

  9. Severe Adverse Effects Associated With Corticosteroid Treatment in Patients With IgA Nephropathy

    Qingqing Cai

    2017-07-01

    Discussion: Corticosteroid use is associated with a high risk of SAEs in IgAN patients, especially those who are older, have hypertension, or impaired renal function. Current guidelines on corticosteroid regimens in IgAN should be reviewed with regard to safety.

  10. Irreversible neurological worsening following high-dose corticosteroids in advanced progressive multiple sclerosis

    Koch, M; De Keyser, J

    2006-01-01

    Background: A course of high-dose corticosteroids has been shown to hasten recovery from a relapse of multiple sclerosis (MS). Some patients with progressive MS ask for a course with corticosteroids outside a relapse, hoping to gain some functional improvement. Objective: To describe 4 patients with

  11. Gene Therapy Restores Balance and Auditory Functions in a Mouse Model of Usher Syndrome.

    Isgrig, Kevin; Shteamer, Jack W; Belyantseva, Inna A; Drummond, Meghan C; Fitzgerald, Tracy S; Vijayakumar, Sarath; Jones, Sherri M; Griffith, Andrew J; Friedman, Thomas B; Cunningham, Lisa L; Chien, Wade W

    2017-03-01

    Dizziness and hearing loss are among the most common disabilities. Many forms of hereditary balance and hearing disorders are caused by abnormal development of stereocilia, mechanosensory organelles on the apical surface of hair cells in the inner ear. The deaf whirler mouse, a model of human Usher syndrome (manifested by hearing loss, dizziness, and blindness), has a recessive mutation in the whirlin gene, which renders hair cell stereocilia short and dysfunctional. In this study, wild-type whirlin cDNA was delivered to the inner ears of neonatal whirler mice using adeno-associated virus serotype 2/8 (AAV8-whirlin) by injection into the posterior semicircular canal. Unilateral whirlin gene therapy injection was able to restore balance function as well as improve hearing in whirler mice for at least 4 months. Our data indicate that gene therapy is likely to become a treatment option for hereditary disorders of balance and hearing. Copyright © 2017. Published by Elsevier Inc.

  12. Restoration of the immune functions in aged mice by supplementation with a new herbal composition, HemoHIM.

    Park, Hae-Ran; Jo, Sung-Kee; Jung, Uhee; Yee, Sung-Tae

    2008-01-01

    The effect of a new herbal composition, HemoHIM, on immune functions was examined in aged mice, in which various immune responses had been impaired. The composition HemoHIM was prepared by adding the ethanol-insoluble fraction to the total water extract of a mixture of three edible herbs, Angelica Radix, Cnidium Rhizoma and Paeonia Radix. Supplementation to the aged mice with HemoHIM restored the proliferative response and cytokine production of splenocytes with a response to ConA. Also, HemoHIM recovered the NK cell activity which had been impaired in the aged mice. Meanwhile aging is known to reduce the Th1-like function, but not the Th2-like function, resulting in a Th1/Th2 imbalance. HemoHIM restored the Th1/Th2 balance in the aged mice through enhanced IFN-gamma and IgG2a production, and conversely a reduced IL-4 and IgG1 production. It was found that one factor for the Th1/Th2 imbalance in the aged mice was a lower production of IL-12p70. However, HemoHIM restored the IL-12p70 production in the aged mice. These results suggested that HemoHIM was effective for the restoration of impaired immune functions of the aged mice and therefore could be a good recommendation for immune restoration in elderly humans. Copyright (c) 2007 John Wiley & Sons, Ltd.

  13. "In Situ Vascular Nerve Graft" for Restoration of Intrinsic Hand Function: An Anatomical Study.

    Mozaffarian, Kamran; Zemoodeh, Hamid Reza; Zarenezhad, Mohammad; Owji, Mohammad

    2018-06-01

    In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an "in situ vascular nerve graft" to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles. Twenty fresh male cadavers were dissected in order to evaluate the feasibility of this modification of technique. The size of nerve branches, the number of axons and the tension at repair site were evaluated. This nerve transfer was technically feasible in all specimens. There was no significant size mismatch between the donor and recipient nerves Conclusions: The possible advantages of this modification include innervation of both median and ulnar nerve innervated intrinsic muscles, preservation of vascularity of the nerve graft which might accelerate the nerve regeneration, avoidance of leg incision and therefore the possibility of performing surgery under regional instead of general anesthesia. Briefly, this novel technique is a viable option which can be used instead of conventional nerve graft in some brachial plexus or combined high median and ulnar nerve injuries when restoration of intrinsic hand function by transfer of posterior interosseous nerve branches is attempted.

  14. Evapotranspiration from drained wetlands: drivers, modeling, storage functions, and restoration implications

    Shukla, S.; Wu, C. L.; Shrestha, N.

    2017-12-01

    Abstract Evapotranspiration (ET) is a major component of wetland and watershed water budgets. The effect of wetland drainage on ET is not well understood. We tested whether the current understanding of insignificant effect of drainage on ET in the temperate region wetlands applies to those in the sub-tropics. Eddy covariance (EC) based ET measurements were made for two years at two previously drained and geographically close wetlands in the Everglades region of Florida. One wetland was significantly drained with 97% of its storage capacity lost. The other was a more functional wetland with 42% of storage capacity lost. Annual average ET at the significantly drained wetland was 836 mm, 34% less than the function wetland (1271 mm) and the difference was statistically significant (p = 0.001). Such differences in wetland ET in the same climatic region have not been observed. The difference in ET was mainly due to drainage driven differences in inundation and associated effects on net radiation (Rn) and local relative humidity. Two daily ET models, a regression (r2 = 0.80) and a Relevance Vector Machine (RVM) model (r2 = 0.84), were developed with the latter being more robust. These models, when used in conjunction with hydrologic models, improved ET predictions for drained wetlands. Predictions from an integrated model showed that more intensely drained wetlands at higher elevation should be targeted for restoration of downstream flows (flooding) because they have the ability to loose higher water volume through ET which increases available water storage capacity of wetlands. Daily ET models can predict changes in ET for improved evaluation of basin-scale effects of restoration programs and climate change scenarios.

  15. Restoring cortical control of functional movement in a human with quadriplegia.

    Bouton, Chad E; Shaikhouni, Ammar; Annetta, Nicholas V; Bockbrader, Marcia A; Friedenberg, David A; Nielson, Dylan M; Sharma, Gaurav; Sederberg, Per B; Glenn, Bradley C; Mysiw, W Jerry; Morgan, Austin G; Deogaonkar, Milind; Rezai, Ali R

    2016-05-12

    Millions of people worldwide suffer from diseases that lead to paralysis through disruption of signal pathways between the brain and the muscles. Neuroprosthetic devices are designed to restore lost function and could be used to form an electronic 'neural bypass' to circumvent disconnected pathways in the nervous system. It has previously been shown that intracortically recorded signals can be decoded to extract information related to motion, allowing non-human primates and paralysed humans to control computers and robotic arms through imagined movements. In non-human primates, these types of signal have also been used to drive activation of chemically paralysed arm muscles. Here we show that intracortically recorded signals can be linked in real-time to muscle activation to restore movement in a paralysed human. We used a chronically implanted intracortical microelectrode array to record multiunit activity from the motor cortex in a study participant with quadriplegia from cervical spinal cord injury. We applied machine-learning algorithms to decode the neuronal activity and control activation of the participant's forearm muscles through a custom-built high-resolution neuromuscular electrical stimulation system. The system provided isolated finger movements and the participant achieved continuous cortical control of six different wrist and hand motions. Furthermore, he was able to use the system to complete functional tasks relevant to daily living. Clinical assessment showed that, when using the system, his motor impairment improved from the fifth to the sixth cervical (C5-C6) to the seventh cervical to first thoracic (C7-T1) level unilaterally, conferring on him the critical abilities to grasp, manipulate, and release objects. This is the first demonstration to our knowledge of successful control of muscle activation using intracortically recorded signals in a paralysed human. These results have significant implications in advancing neuroprosthetic technology

  16. Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study.

    Popovic, Milos R; Zivanovic, Vera; Valiante, Taufik A

    2016-01-01

    Non-traumatic spinal cord pathology is responsible for 25-52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16-21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials, showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function, in people with stroke and traumatic SCI. Motivated by this success, we decided to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61-year-old male who had C3-C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntarily open and close the hand and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study ~22 months following initial surgical intervention. Participant was assessed using Toronto Rehabilitation Institute's Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT), Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre-post differences in scores on all measures clearly demonstrated improvement in voluntary hand function following 15 1-h FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.

  17. Comparison between Fenugreek and Lovastatin in restoration of endothelial function in an experimental old rat model

    "Pipelzadeh MH

    2003-06-01

    Full Text Available The aim of this study was to compare the effectiveness of Fenugreek (Trigonella foenum-graecum with that of lovastatin in restoration of endothelia function in the aorta taken form aged N-Mair rats. For this purpose, 4 groups of old N-Mari rats were used (n=6, normal saline treated control group, lovastatin (10 mg/kg, orally and fengreek seed powder in normal saline suspension (100 or 500 mg/kg were administered orally daily for 8 weeks. The rate of relaxation of ephedrine- precontracted aorta to acetycholine, the lipid profiles, and histological examinations of the aorta were compared between these two groups and with a control non-treated normal saline treated group. The results showed that treatment with lovastatin and fenugreek produced significant reduction in IDL, VLDL triglyceride and total cholesterol, while HDL was increased as compared to control non-treated group. Lovastatin induced an increase in contraction/mg tissue weight. However, improvement in endothelial function was significantly increased in all treatment groups. The histological findings showed significant reduction in thickness and lipid deposits in the aorta in all treatment groups. The improvement in the epithelial function was correlated with LDL-cholesterol lowering and partly with the reduction in the thickness of the aortic intimal layer. This study demonstrated that fenugreek is as effective as lovastatin in reducing the features associated with atherosclerosis.

  18. Nitrate removal in a restored riparian groundwater system: functioning and importance of individual riparian zones

    S. Peter

    2012-11-01

    Full Text Available For the design and the assessment of river restoration projects, it is important to know to what extent the elimination of reactive nitrogen (N can be improved in the riparian groundwater. We investigated the effectiveness of different riparian zones, characterized by a riparian vegetation succession, for nitrate (NO3 removal from infiltrating river water in a restored and a still channelized section of the river Thur, Switzerland. Functional genes of denitrification (nirS and nosZ were relatively abundant in groundwater from willow bush and mixed forest dominated zones, where oxygen concentrations remained low compared to the main channel and other riparian zones. After flood events, a substantial decline in NO3 concentration (> 50% was observed in the willow bush zone but not in the other riparian zones closer to the river. In addition, the characteristic enrichment of 15N and 18O in the residual NO3 pool (by up to 22‰ for δ15N and up to 12‰ for δ18O provides qualitative evidence that the willow bush and forest zones were sites of active denitrification and, to a lesser extent, NO3 removal by plant uptake. Particularly in the willow bush zone during a period of water table elevation after a flooding event, substantial input of organic carbon into the groundwater occurred, thereby fostering post-flood denitrification activity that reduced NO3 concentration with a rate of ~21 μmol N l−1 d−1. Nitrogen removal in the forest zone was not sensitive to flood pulses, and overall NO3 removal rates were lower (~6 μmol l−1 d−1. Hence, discharge-modulated vegetation–soil–groundwater coupling was found to be a key driver for riparian NO3 removal. We estimated that

  19. The study on the immunity restoring function of cWPROL in treating experimental radiation esophagitis

    Shen Li; Shan Baoen; Zhang Li; Lu Fuhe; Guo Xiujuan

    2007-01-01

    Objective: To study the restorative function of compound white peony root oral liquids (cWPROL) in treating rats' experimental acute radiation-induced esophagitis from the aspect of immunodeficiency. Methods: 128 Wistar rats were divided into eight groups. The radiation esophagitis was induced by 43 Gy 60 Co. Then the rats were treated with medicine in different ways. On every experimental point the absolute number and percentage of T lymphocyte subsets were analyzed by flow cytometry. The changes of the leukocyte in number and differential count were detected by haemocyte counting instrument. IgG and C3 in rats' serum were analyzed by immunological turbidimetry. Results: Radiation brought on decrease of experimental rats 'leukocyte count, the lymphocyte differential count, absolute count and absolute T lymphocyte subsets in the blood and the content of IgG and C3 with radiation esophagitis. cWPROL could increase the lymphocyte percentage compared that in with the radiated group 2. The preventive (high dose) could increase lymphocyte count while Western medicine decreased rats' leukocyte count, lymphocyte percentage and absolute count (P<0.05). The absolute T lymphocyte subsets in rats' peripheral blood increased in the group infused with cWPROL (high dose) (P<0.001). Compared with the radiated group 2 the absolute T lymphocyte subsets decreased significantly(P<0.001), and the content of complement C3 increased in the group infused with cWPROL (high dose) (P<0.05) but decreased in the group infused with Western medicine (P<0.01). Conclusion: cWPROL plays the role of restoring the cytoimmunity and immunity damaged by radiation in rats with radiation esophagitis. (authors)

  20. Soil functional diversity analysis of a bauxite-mined restoration chronosequence.

    Lewis, Dawn E; White, John R; Wafula, Denis; Athar, Rana; Dickerson, Tamar; Williams, Henry N; Chauhan, Ashvini

    2010-05-01

    Soil microorganisms are sensitive to environmental perturbations such that changes in microbial community structure and function can provide early signs of anthropogenic disturbances and even predict restoration success. We evaluated the bacterial functional diversity of un-mined and three chronosequence sites at various stages of rehabilitation (0, 10, and 20 years old) located in the Mocho Mountains of Jamaica. Samples were collected during the dry and wet seasons and analyzed for metal concentrations, microbial biomass carbon, bacterial numbers, and functional responses of soil microbiota using community-level physiological profile (CLPP) assays. Regardless of the season, un-mined soils consisted of higher microbial biomass and numbers than any of the rehabilitated sites. Additionally, the number and rate of substrates utilized and substrate evenness (the distribution of color development between the substrates) were significantly greater in the un-mined soils with carbohydrates being preferentially utilized than amino acids, polymers, carboxylic acids, and esters. To some extent, functional responses varied with the seasons but the least physiological activity was shown by the site rehabilitated in 1987 indicating long-term perturbation to this ecosystem. Small subunit ribosomal DNA (SSUrDNA)-denaturing gradient-gel electrophoresis analyses on the microbiota collected from the most preferred CLPP substrates followed by taxonomic analyses showed Proteobacteria, specifically the gamma-proteobacteria, as the most functionally active phyla, indicating a propensity of this phyla to out-compete other groups under the prevailing conditions. Additionally, multivariate statistical analyses, Shannon's diversity, and evenness indices, principal component analysis, biplot and un-weighted-pair-group method with arithmetic averages dendrograms further confirmed that un-mined sites were distinctly different from the rehabilitated soils.

  1. Corticosteroids

    ... side effects of steroids outweigh their anti-inflammatory benefits. Some of the most common ones include the ... Want to Talk? Talk to a Specialist by phone at (888) MY-GUT-PAIN by email at info@crohnscolitisfoundation.org , or ... Visit our mobile site Full Site CCF Facebook Follow The CCF ...

  2. Spot light on skeletal muscles: optogenetic stimulation to understand and restore skeletal muscle function.

    van Bremen, Tobias; Send, Thorsten; Sasse, Philipp; Bruegmann, Tobias

    2017-08-01

    Damage of peripheral nerves results in paralysis of skeletal muscle. Currently, the only treatment option to restore proper function is electrical stimulation of the innervating nerve or of the skeletal muscles directly. However this approach has low spatial and temporal precision leading to co-activation of antagonistic muscles and lacks cell-type selectivity resulting in pain or discomfort by stimulation of sensible nerves. In contrast to electrical stimulation, optogenetic methods enable spatially confined and cell-type selective stimulation of cells expressing the light sensitive channel Channelrhodopsin-2 with precise temporal control over the membrane potential. Herein we summarize the current knowledge about the use of this technology to control skeletal muscle function with the focus on the direct, non-neuronal stimulation of muscle fibers. The high temporal flexibility of using light pulses allows new stimulation patterns to investigate skeletal muscle physiology. Furthermore, the high spatial precision of focused illumination was shown to be beneficial for selective stimulation of distinct nearby muscle groups. Finally, the cell-type specific expression of the light-sensitive effector proteins in muscle fibers will allow pain-free stimulation and open new options for clinical treatments. Therefore, we believe that direct optogenetic stimulation of skeletal muscles is a very potent method for basic scientists that also harbors several distinct advantages over electrical stimulation to be considered for clinical use in the future.

  3. Ovarian transfer following irradiation as an alternative to restore reproductive functions

    Salgado, Andreia Ruis; Passos, Luiz Augusto Correa; Ginemes, Ana Paula; Dias, Viviane Liotti [Universidade Estadual de Campinas, SP (Brazil). Centro Multidisciplinar para a Investigacao Biologica (CEMIB/UNICAMP)], e-mail: viviliotti@cemib.unicamp.br; Spencer, Patrick Jack; Nascimento, Nanci do [Instituto de Pesquisas Energeticas e Nucleares (IPEN-CNEN/SP), Sao Paulo, SP (Brazil)

    2009-07-01

    Assisted reproduction technologies are essential for restoring reproductive functions, especially in ovary cancer cases, which besides impairing fertility; present the highest lethality amongst gynecological diseases. Classical treatment involves surgery, radiotherapy and chemotherapy, and in young women, the recommended treatment is the removal of the affected ovary, leading to physical, psychological and emotional problems. An alternative would be the ovarian transfer after the treatment. However, there are no data in the literature about experiments specifically designed to investigate the interference of this procedure on reproductive functions. In the present work, we used the C57BL/6Unib and B6CF1 hybrid mice strains to evaluate the viability of ovarian transfer before and after irradiation, as well as possible differences in radiosensitivity between the strains. To do so, female mice from both strains were irradiated with 4 Gy and submitted to either partial or total ovarian transfer form healthy donors. After the surgery, the animals were mated and the results obtained so far for mating 7 days after the procedure indicate that irradiation promoted a significant decrease in fertility (p=0.0127). Also, our data show that the recovery of fertility is proportional to the amount of grafted ovarian tissue. Furthermore, there seems to be differences in radiosensitivity, from genetic origin, between the two mice strain, since, after irradiation, the hybrid mice had bigger litters than the donor strain. (author)

  4. Ovarian transfer following irradiation as an alternative to restore reproductive functions

    Salgado, Andreia Ruis; Passos, Luiz Augusto Correa; Ginemes, Ana Paula; Dias, Viviane Liotti; Spencer, Patrick Jack; Nascimento, Nanci do

    2009-01-01

    Assisted reproduction technologies are essential for restoring reproductive functions, especially in ovary cancer cases, which besides impairing fertility; present the highest lethality amongst gynecological diseases. Classical treatment involves surgery, radiotherapy and chemotherapy, and in young women, the recommended treatment is the removal of the affected ovary, leading to physical, psychological and emotional problems. An alternative would be the ovarian transfer after the treatment. However, there are no data in the literature about experiments specifically designed to investigate the interference of this procedure on reproductive functions. In the present work, we used the C57BL/6Unib and B6CF1 hybrid mice strains to evaluate the viability of ovarian transfer before and after irradiation, as well as possible differences in radiosensitivity between the strains. To do so, female mice from both strains were irradiated with 4 Gy and submitted to either partial or total ovarian transfer form healthy donors. After the surgery, the animals were mated and the results obtained so far for mating 7 days after the procedure indicate that irradiation promoted a significant decrease in fertility (p=0.0127). Also, our data show that the recovery of fertility is proportional to the amount of grafted ovarian tissue. Furthermore, there seems to be differences in radiosensitivity, from genetic origin, between the two mice strain, since, after irradiation, the hybrid mice had bigger litters than the donor strain. (author)

  5. Restoration of heart functions using human embryonic stem cells derived heart muscle cells.

    Gepstein, Lior; Kehat, Izhak

    2005-02-01

    Extract: Recent advances in molecular and cellular biology and specifically in the areas of stem cell biology and tissue engineering have paved the way for the development of a new field in biomedicine, regenerative medicine. This exciting approach seeks to develop new biological solutions, using the mobilization of endogenous stem cells or delivery of exogenous cells to replace or modify the function of diseased, absent, or malfunctioning tissue. The adult heart represents an attractive candidate for these emerging technologies, since adult cardiomyocytes have limited regenerative capacity. Thus, any significant heart cell loss or dysfunction, such as occurs during heart attack, is mostly irreversible and may lead to the development of progressive heart failure, one of the leading causes of world-wide morbidity and mortality. Similarly, dysfunction of the specialized electrical conduction system within the heart may result in inefficient rhythm initiation or impulse conduction, leading to significant slowing of the heart rate, usually requiring the implantation of a permanent electronic pacemaker. Replacement of the dysfunctional myocardium (heart muscle) by implantation of external heart muscle cells is emerging as a novel paradigm for restoration of the myocardial electromechanical properties, but has been significantly hampered by the paucity of cell sources for human heart cells and by the relatively limited evidence for functional integration between grafted and host cells. The recently described human embryonic stem cell (hESC) lines may provide a possible solution for the aforementioned cell sourcing problem.

  6. Posterior composite restoration update: focus on factors influencing form and function

    Bohaty BS

    2013-05-01

    Full Text Available Brenda S Bohaty,1,2 Qiang Ye,3 Anil Misra,3,4 Fabio Sene,6 Paulette Spencer3,51Department of Pediatric Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA; 2Department of Pediatric Dentistry, Children's Mercy Hospital, Kansas City, MO, USA; 3Bioengineering Research Center, 4Department of Civil, Environmental, and Architectural Engineering, 5Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA; 6Department of Restorative Dentistry, State University of Londrina, School of Dentistry, Londrina, BrazilAbstract: Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient's caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of

  7. Corticosteroids in Myositis and Scleroderma.

    Postolova, Anna; Chen, Jennifer K; Chung, Lorinda

    2016-02-01

    Idiopathic inflammatory myopathies (IIMs) involve inflammation of the muscles and are classified by the patterns of presentation and immunohistopathologic features on skin and muscle biopsy into 4 categories: dermatomyositis, polymyositis, inclusion body myositis, and immune-mediated necrotizing myopathy. Systemic corticosteroid (CS) treatment is the standard of care for IIM with muscle and organ involvement. The extracutaneous features of systemic sclerosis are frequently treated with CS; however, high doses have been associated with scleroderma renal crisis in high-risk patients. Although CS can be effective first-line agents, their significant side effect profile encourages concomitant treatment with other immunosuppressive medications to enable timely tapering. Published by Elsevier Inc.

  8. Interim restorations.

    Gratton, David G; Aquilino, Steven A

    2004-04-01

    Interim restorations are a critical component of fixed prosthodontic treatment, biologically and biomechanically. Interim restoration serves an important diagnostic role as a functional and esthetic try-in and as a blueprint for the design of the definitive prosthesis. When selecting materials for any interim restoration, clinicians must consider physical properties, handling properties, patient acceptance, and material cost. Although no single material meets all the requirements and material classification alone of a given product is not a predictor of clinical performance, bis-acryl materials are typically best suited to single-unit restorations, and poly(methylmethacrylate) interim materials are generally ideal for multi-unit, complex, long-term, interim fixed prostheses. As with most dental procedures, the technique used for fabrication has a greater effect on the final result than the specific material chosen.

  9. Functional outcome of nerve transfer for restoration of shoulder and elbow function in upper brachial plexus injury

    Faruquee Sajedur

    2008-05-01

    Full Text Available Abstract Background Purpose of this study was to evaluate the functional outcome of spinal accessory to suprascapular nerve transfer (XI-SSN done for restoration of shoulder function and partial transfer of ulnar nerve to the motor branch to the biceps muscle for the recovery of elbow flexion (Oberlin transfer. Methods This is a prospective study involving 15 consecutive cases of upper plexus injury seen between January 2004 and December 2005. The average age of patients was 35.6 yrs (15–52 yrs. The injury-surgery interval was between 2–6 months. All underwent XI-SSN and Oberlin nerve transfer. The coaptation was done close to the biceps muscle to ensure early recovery. The average follow up was 15 months (range 12–36 months. The functional outcome was assessed by measuring range of movements and also on the grading scale proposed by Narakas for shoulder function and Waikakul for elbow function. Results Good/Excellent results were seen in 13/15 patients with respect to elbow function and 8/15 for shoulder function. The time required for the first sign of clinical reinnervation of biceps was 3 months 9 days (range 1 month 25 days to 4 months and for the recovery of antigravity elbow flexion was 5 months (range 3 1/2 months to 8 months. 13 had M4 and two M3 power. On evaluating shoulder function 8/15 regained active abduction, five had M3 and three M4 shoulder abduction. The average range of abduction in these eight patients was 66 degrees (range 45–90. Eight had recovered active external rotation, average 44 degrees (range 15–95. The motor recovery of external rotation was M3 in 5 and M4 in 3. 7/15 had no active abduction/external rotation, but they felt that their shoulder was more stable. Comparable results were observed in both below and above 40 age groups and those with injury to surgery interval less than 3 or 3–6 months. Conclusion Transfer of ulnar nerve fascicle to the motor branch of biceps close to the muscle consistently

  10. Carbon nanotubes functionalized with sodium hyaluronate restore bone repair in diabetic rat sockets.

    Sá, M A; Andrade, V B; Mendes, R M; Caliari, M V; Ladeira, L O; Silva, E E; Silva, G A B; Corrêa-Júnior, J D; Ferreira, A J

    2013-07-01

    We evaluated the effects of sodium hyaluronate (HY) and carbon nanotubes functionalized with HY (HY-CNT) on bone repair in the tooth sockets of diabetic rats. Diabetes was induced by streptozotocin (50 mg kg(-1) i.v.), and the sockets were divided into normal control, diabetic control, diabetic treated with HY (1%), and diabetic treated with HY-CNT (100 μg ml(-1)) groups. The sockets were analyzed according to the percentage of bone formation and the number of cell nuclei. The percentage of bone trabeculae was lower in diabetic control animals (11.16 ± 5.10% vs 41.92 ± 6.34% in normal animals) after 14 days. Treating diabetic animals with HY or HY-CNT significantly increased the percentage of neoformed trabeculae (HY: 29.43 ± 3.29%; HY-CNT: 36.90 ± 3.07%). Moreover, the sockets of diabetic animals had an increased number of cell nuclei and HY or HY-CNT reduced this parameter. Our results indicate that HY and HY-CNT restore bone repair in the tooth sockets of diabetic rats, suggesting that these biomaterials are potential adjuvant therapies for the management of diabetes. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Molecular Dynamic Simulation Insights into the Normal State and Restoration of p53 Function

    Jianzhong Chen

    2012-08-01

    Full Text Available As a tumor suppressor protein, p53 plays a crucial role in the cell cycle and in cancer prevention. Almost 50 percent of all human malignant tumors are closely related to a deletion or mutation in p53. The activity of p53 is inhibited by over-active celluar antagonists, especially by the over-expression of the negative regulators MDM2 and MDMX. Protein-protein interactions, or post-translational modifications of the C-terminal negative regulatory domain of p53, also regulate its tumor suppressor activity. Restoration of p53 function through peptide and small molecular inhibitors has become a promising strategy for novel anti-cancer drug design and development. Molecular dynamics simulations have been extensively applied to investigate the conformation changes of p53 induced by protein-protein interactions and protein-ligand interactions, including peptide and small molecular inhibitors. This review focuses on the latest MD simulation research, to provide an overview of the current understanding of interactions between p53 and its partners at an atomic level.

  12. Restoration of bladder function in spastic neuropathic bladder using sacral deafferentation and different techniques of neurostimulation.

    Schumacher, S; Bross, S; Scheepe, J R; Alken, P; Jünemann, K P

    1999-01-01

    Conventional sacral anterior root stimulation (SARS) results in simultaneous activation of both the detrusor muscle and the external urethral sphincter. We evaluated the possibilities of different neurostimulation techniques to overcome stimulation induced detrusor-sphincter-dyssynergia and to achieve a physiological voiding. The literature was reviewed on different techniques of sacral anterior root stimulation of the bladder and the significance of posterior rhizotomy in patients with supraconal spinal cord injury suffering from the loss of voluntary bladder control, detrusor hyperreflexia and sphincter spasm. The achievement of selective detrusor activation would improve current sacral neurostimulation of the bladder, including the principle of "poststimulus voiding". This is possible with the application of selective neurostimulation in techniques of anodal block, high frequency block, depolarizing prepulses and cold block. Nowadays, sacral deafferentation is a standard therapy in combination with neurostimulation of the bladder because in conclusion advantages of complete rhizotomy predominate. The combination of sacral anterior root stimulation and sacral deafferentation is a successful procedure for restoration of bladder function in patients with supraconal spinal cord injury. Anodal block technique and cryotechnique are excellent methods for selective bladder activation to avoid detrusor-sphincter-dyssynergia and thus improve stimulation induced voiding.

  13. Restoring the secretory function of irradiation-damaged salivary gland by administrating deferoxamine in mice.

    Junye Zhang

    Full Text Available One of the major side effects of radiotherapy for treatments of the head and neck cancer is the radiation-induced dysfunction of salivary glands. The aim of the present study is to investigate the efficacy of deferoxamine (DFO to restore the secretory function of radiation-damaged salivary glands in mice.DFO (50 mg/kg/d was administered intraperitoneally in C57BL/6 mice for 3 days before and/or after point-fixed irradiation (18 Gy of submandibular glands. The total 55 mice were randomly divided into: (1 Normal group: mice received no treatment (n = 5; (2 Irradiation group (IR: mice only received irradiation (n = 5; (3 Pre-DFO group (D+IR (n = 10; (4 Pre+Post DFO group (D+IR+D (n = 10; (5 Post-DFO group (IR+D (n = 10; (6 For each DFO-treated group, the mice were intraperitoneally injected with 0.1 ml sterilized water alone (by which DFO was dissolved for 3 days before and/or after irradiation, and served as control. Sham1: Pre-sterilized water group (n = 5; sham2: Pre+Post sterilized water group (n = 5; sham3: Post-sterilized water group (n = 5. The salivary flow rate (SFR was assessed at 30th, 60th and 90th day after irradiation, respectively. After 90 days, all mice were sacrificed and their submandibular glands were removed for further examinations.The salivary glands showed remarkable dysfunction and tissue damage after irradiation. DFO restored SFR in the irradiated glands to a level comparable to that in normal glands and angiogenesis in damaged tissue was greatly increased. DFO also increased the expression levels of HIF-1α and VEGF while reduced apoptotic cells. Furthermore, Sca-1+cells were preserved in the salivary glands treated with DFO before IR.Our results indicate DFO could prevent the radiation-induced dysfunction of salivary glands in mice. The mechanism of this protective effect may involve increased angiogenesis, reduced apoptosis of acinar cells and more preserved stem cells.

  14. Low basal serum cortisol in patients with severe atopic dermatitis : potent topical corticosteroids wrongfully accused

    Haeck, I.M.; Timmer-de Mik, L.; Lentjes, E.G.; Buskens, E.; Hijnen, D.J.; Guikers, C.; Bruijnzeel-Koomen, C.A.; de Bruin-Weller, M.S.

    2007-01-01

    BACKGROUND: Topical corticosteroids are used extensively to treat inflammatory skin disorders including atopic dermatitis (AD). Several studies have described temporary reversible suppression of hypothalamic-pituitary-adrenal function. However, sound evidence of permanent disturbance of adrenal

  15. Use of systemic corticosteroids for atopic dermatitis

    Drucker, A M; Eyerich, K; de Bruin-Weller, M S

    2018-01-01

    BACKGROUND: Guidelines discourage the use of systemic corticosteroids for atopic dermatitis (AD), but their use remains widespread. OBJECTIVES: To reach consensus among an international group of AD experts on the use of systemic corticosteroids for AD. METHODS: A survey consisting of statements...

  16. Heme oxygenase-1 (HO-1) inhibits postmyocardial infarct remodeling and restores ventricular function.

    Liu, Xiaoli; Pachori, Alok S; Ward, Christopher A; Davis, J Paul; Gnecchi, Massimiliano; Kong, Deling; Zhang, Lunan; Murduck, Jared; Yet, Shaw-Fang; Perrella, Mark A; Pratt, Richard E; Dzau, Victor J; Melo, Luis G

    2006-02-01

    We reported previously that predelivery of the anti-oxidant gene heme oxygenase-1 (HO-1) to the heart by adeno associated virus (AAV) markedly reduces injury after acute myocardial infarction (MI). However, the effect of HO-1 gene delivery on postinfarction recovery has not been investigated. In the current study, we assessed the effect of HO-1 gene delivery on post-MI left ventricle (LV) remodeling and function using echocardiographic imaging and histomorphometric approaches. Two groups of Sprague-Dawley rats were injected with 4 x 10(11) particles of AAV-LacZ (control) or AAV-hHO-1 in the LV wall. Eight wk after gene transfer, the animals were subjected to 30 min of ischemia by ligation of left anterior descending artery (LAD) followed by reperfusion. Echocardiographic measurements were obtained in a blinded fashion prior and at 1.5 and 3 months after I/R. Ejection fraction (EF) was reduced by 13% and 40% in the HO-1 and LacZ groups, respectively at 1.5 months after MI. Three months after MI, EF recovered fully in the HO-1, but only partially in the LacZ-treated animals. Post-MI LV dimensions were markedly increased and the anterior wall was markedly thinned in the LacZ-treated animals compared with the HO-1-treated animals. Significant myocardial scarring and fibrosis were observed in the LacZ-group in association with elevated levels of interstitial collagen I and III and MMP-2 activity. Post-MI myofibroblast accumulation was reduced in the HO-1-treated animals, and retroviral overexpression of HO-1 reduced proliferation of isolated cardiac fibroblasts. Our data indicate that rAAV-HO-1 gene transfer markedly reduces fibrosis and ventricular remodeling and restores LV function and chamber dimensions after myocardial infarction.

  17. Corticosteroids in relation to fear, anxiety and psychopathology

    Korte, S.M.

    2001-01-01

    Corticosteroids play extremely important roles in fear and anxiety. The mechanisms by which corticosteroids exert their effects on behavior are often indirect, because, although corticosteroids do not regulate behavior, they induce chemical changes in particular sets of neurons making certain

  18. The impact of joint line restoration on functional results after hinged knee prosthesis

    Serdar Yilmaz

    2016-01-01

    Conclusion: RHKA is an effective salvage procedure for serious instability and large bone defects. Restoration of the joint line improves the patellar score although it had no effect on the clinical outcome.

  19. Corticosteroids in Myositis and Scleroderma

    Postolova, Anna; Chen, Jennifer K; Chung, Lorinda

    2017-01-01

    Synopsis Idiopathic inflammatory myopathies (IIM) involve inflammation of the muscles and are classified based on the patterns of presentation and immunohistopathologic features on skin and muscle biopsy into four categories: dermatomyositis, polymyositis, inclusion body myositis, and immune mediated necrotizing myopathy. The term “scleroderma” refers to fibrosis of the skin. Localized scleroderma (morphea) is skin-limited, while systemic sclerosis (SSc) is associated with vascular and internal organ involvement. Although there is a paucity of randomized clinical trials, treatment with systemic corticosteroids (CS) is the standard of care for IIM with muscle and organ involvement. The extra-cutaneous features of systemic sclerosis are frequently treated with CS, however high doses have been associated with scleroderma renal crisis in high-risk patients. CS monotherapy is neither recommended for the cutaneous manifestations of dermatomyositis nor scleroderma. While CS can be effective first line agents, their significant side effect profile encourages concomitant treatment with other immunosuppressive medications to enable timely tapering. PMID:26611554

  20. Corticosteroids vs corticosteroids plus antiviral agents in the treatment of Bell palsy: a systematic review and meta-analysis.

    Goudakos, John K; Markou, Konstantinos D

    2009-06-01

    To review systematically and meta-analyze the results of all randomized controlled trials (RCTs) for the treatment of patients with Bell palsy with corticosteroids vs corticosteroids plus antiviral agents. A MEDLINE, EMBASE, Cochrane Library, and CENTRAL database search, followed by extensive hand-searching for the identification of relevant studies. No time and language limitations were applied. Prospective RCTs on the treatment of patients with Bell palsy. Odds ratios (ORs), 95% confidence intervals (CIs), and tests for heterogeneity were reported. Five studies were eventually identified and systematically reviewed. Meta-analysis was performed for 4 studies. Regarding the complete recovery rate of facial nerve paralysis 3 months after initiation of therapy, the current systematic review and meta-analysis suggests that the addition of an antiviral agent does not provide any benefit (OR, 1.03 [95% CI, 0.74-1.42]; P = .88). The same conclusion emerged at posterior (fourth, sixth, and ninth) months of assessment. Subgroup analysis, conducted on the basis of time point of therapy initiation, type of antiviral agent, and blindness of assessments did not change the results obtained. The occurrence rate of adverse effects attributable to therapy choice was not significantly different between patients receiving corticosteroids and those following combined treatment. The present systematic review and meta-analysis, based on the currently available evidence, suggests that the addition of an antiviral agent to corticosteroids for the treatment of Bell palsy is not associated with an increase in the complete recovery rate of the facial motor function.

  1. Effects of lamotrigine on hippocampal activation in corticosteroid-treated patients.

    Brown, E Sherwood; Zaidel, Liam; Allen, Greg; McColl, Roderick; Vazquez, Miguel; Ringe, Wendy K

    2010-11-01

    An extensive animal literature suggests that stress or excessive corticosteroid exposure is associated with changes in hippocampal function and memory. These findings are pertinent to psychiatric disorders with elevated cortisol, Cushing's disease and the millions of patients receiving prescription corticosteroids. In animals, agents that decrease glutamate release attenuate the effects of corticosteroids on the hippocampus. Minimal data are available on preventing or reversing the effects of corticosteroids on the human hippocampus. We previously reported improvement in memory in corticosteroid-treated patients given lamotrigine. In this report, we examined the impact of lamotrigine on task-related hippocampal activation in patients taking prescription corticosteroids. A total of 28 outpatients taking long-term oral prednisone for medical conditions, such as renal transplant rejection, were randomized to lamotrigine or placebo for 24 weeks. Hippocampal activation in response to a visual memory task was assessed with blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI). Consistent with a reduction in glutamate release, the right posterior hippocampus showed a significant decrease in task-related activation in the lamotrigine group as compared to the placebo group. The modest sample size and an assessment period of only 24 weeks are study limitations. Between-group differences in hippocampal activation were observed. The results suggest that an agent that modulates glutamate may modify the effects of long-term corticosteroid exposure on the human hippocampus. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. ramic restorations

    Ashish R Jain

    2013-01-01

    Full Text Available Rehabilitation of a patient with severely worn dentition after restoring the vertical dimension is a complex procedure and assessment of the vertical dimension is an important aspect in these cases. This clinical report describes the full mouth rehabilitation of a patient who was clinically monitored to evaluate the adaptation to a removable occlusal splint to restore vertical dimension for a period 1 month and provisional restorations to determine esthetic and functional outcome for a period of 3 months. It is necessary to recognizing that form follows function and that anterior teeth play a vital role in the maintenance of oral health. Confirmation of tolerance to changes in the vertical dimension of occlusion (VDO is of paramount importance. Articulated study casts and a diagnostic wax-up can provide important information for the evaluation of treatment options. Alteration of the VDO should be conservative and should not be changed without careful consideration.

  3. [Functional restoration--it depends on an adequate mixture of treatment].

    Pfingsten, M

    2001-12-01

    In the last 50 years conventional treatments have not been able to slow down the expanding chronic low back pain problem. However, nowadays health care has changed according to a broad biopsychosocial model of health, the positive effect of activity on health and healing, emphasis on function rather than pain or impairment, and reliance upon clinical evidence. In search for new solutions "functional restoration" (FR) programs have been developed. They include multidisciplinary treatment of patients in groups, consisting of 6-8 h of treatment a day, lasting 3 to 6 weeks and usually integrating intense physical and ergonomic training, psychological (behavioral) therapy, patient education, and instruction in social- and work-related issues. FR programs have yet to demonstrate their effectiveness in several countries. Controlled studies in the USA were very positive regarding the return-to-work rate, whereas studies in Scandinavian countries did not demonstrate similar results. Possible reasons for the different results concerning back-to-work ratios might be that study design, patient population, content of the program, and other external factors are different and studies as well as effects are therefore not directly comparable. According to several well-controlled studies, the most probable reason for this different effect may be that social and security (health care) systems and cultures differ among countries and that patients with chronic low back pain respond differently to this combination. Sick absenteeism and inability to work may be influenced by many factors besides pain that cannot be addressed by intervention or prevention programs, e.g., job satisfaction, education level, and the compensation systems. It may be that the lower economic benefit during sick leave in the United States leads to favorable results from functional restoration programs. Concerning the prediction of success, several studies have shown that medical background, diagnosis and physical

  4. Platelet transfusions reduce fibrinolysis but do not restore platelet function during trauma hemorrhage.

    Vulliamy, Paul; Gillespie, Scarlett; Gall, Lewis S; Green, Laura; Brohi, Karim; Davenport, Ross A

    2017-09-01

    Platelets play a critical role in hemostasis with aberrant function implicated in trauma-induced coagulopathy. However, the impact of massive transfusion protocols on platelet function during trauma hemorrhage is unknown. The aim of this study was to characterize the effects of platelet transfusion on platelet aggregation and fibrinolytic markers during hemostatic resuscitation. Trauma patients enrolled into the prospective Activation of Coagulation and Inflammation in Trauma study between January 2008 and November 2015 who received at least four units of packed red blood cells (PRBCs) were included. Blood was drawn in the emergency department within 2 hours of injury and at intervals after every four units of PRBCs transfused. Platelet aggregation was assessed in whole blood with multiple electrode aggregometry. Plasma proteins were quantified by enzyme-linked immunosorbent assay. Of 161 patients who received four or more PRBCs as part of their initial resuscitation, 44 received 8 to 11 units and 28 received 12 units or more. At each timepoint during bleeding, platelet aggregation was similar in patients who had received a platelet transfusion compared with those who had only received other blood products (p > 0.05 for all timepoints). Platelet transfusion during the four PRBC intervals was associated with a decrease in maximum lysis on rotational thromboelastometry (start of interval, 6% [2-12] vs. end of interval, 2% [0-5]; p = 0.001), an increase in plasminogen activator inhibitor-1 (start of interval, 35.9 ± 14.9 vs. end of interval, 66.7 ± 22.0; p = 0.007) and a decrease in tissue plasminogen activator (start of interval, 26.2 ± 10.5 vs. end of interval, 19.0 +/- 5.1; p = 0.04). No statistically significant changes in these parameters occurred in intervals which did not contain platelets. Current hemostatic resuscitation strategies do not appear to restore platelet aggregation during active hemorrhage. However, stored platelets may attenuate fibrinolysis

  5. Resistance Exercise Restores Endothelial Function and Reduces Blood Pressure in Type 1 Diabetic Rats

    Marcelo Mendonça Mota

    2014-07-01

    Full Text Available Background: Resistance exercise effects on cardiovascular parameters are not consistent. Objectives: The effects of resistance exercise on changes in blood glucose, blood pressure and vascular reactivity were evaluated in diabetic rats. Methods: Wistar rats were divided into three groups: control group (n = 8; sedentary diabetic (n = 8; and trained diabetic (n = 8. Resistance exercise was carried out in a squat device for rats and consisted of three sets of ten repetitions with an intensity of 50%, three times per week, for eight weeks. Changes in vascular reactivity were evaluated in superior mesenteric artery rings. Results: A significant reduction in the maximum response of acetylcholine-induced relaxation was observed in the sedentary diabetic group (78.1 ± 2% and an increase in the trained diabetic group (95 ± 3% without changing potency. In the presence of NG-nitro-L-arginine methyl ester, the acetylcholine-induced relaxation was significantly reduced in the control and trained diabetic groups, but not in the sedentary diabetic group. Furthermore, a significant increase (p < 0.05 in mean arterial blood pressure was observed in the sedentary diabetic group (104.9 ± 5 to 126.7 ± 5 mmHg as compared to that in the control group. However, the trained diabetic group showed a significant decrease (p < 0.05 in the mean arterial blood pressure levels (126.7 ± 5 to 105.1 ± 4 mmHg as compared to the sedentary diabetic group. Conclusions: Resistance exercise could restore endothelial function and prevent an increase in arterial blood pressure in type 1 diabetic rats.

  6. Resistance Exercise Restores Endothelial Function and Reduces Blood Pressure in Type 1 Diabetic Rats

    Mota, Marcelo Mendonça; Silva, Tharciano Luiz Teixeira Braga da; Fontes, Milene Tavares; Barreto, André Sales; Araújo, João Eliakim dos Santos [Departamento de Fisiologia - Universidade Federal de Sergipe (UFS), São Cristóvão, SE (Brazil); Oliveira, Antônio Cesar Cabral de; Wichi, Rogério Brandão [Departamento de Educação Física - UFS, São Cristóvão, SE (Brazil); Santos, Márcio Roberto Viana, E-mail: marciorvsantos@bol.com.br [Departamento de Fisiologia - Universidade Federal de Sergipe (UFS), São Cristóvão, SE (Brazil)

    2014-07-15

    Resistance exercise effects on cardiovascular parameters are not consistent. The effects of resistance exercise on changes in blood glucose, blood pressure and vascular reactivity were evaluated in diabetic rats. Wistar rats were divided into three groups: control group (n = 8); sedentary diabetic (n = 8); and trained diabetic (n = 8). Resistance exercise was carried out in a squat device for rats and consisted of three sets of ten repetitions with an intensity of 50%, three times per week, for eight weeks. Changes in vascular reactivity were evaluated in superior mesenteric artery rings. A significant reduction in the maximum response of acetylcholine-induced relaxation was observed in the sedentary diabetic group (78.1 ± 2%) and an increase in the trained diabetic group (95 ± 3%) without changing potency. In the presence of NG-nitro-L-arginine methyl ester, the acetylcholine-induced relaxation was significantly reduced in the control and trained diabetic groups, but not in the sedentary diabetic group. Furthermore, a significant increase (p < 0.05) in mean arterial blood pressure was observed in the sedentary diabetic group (104.9 ± 5 to 126.7 ± 5 mmHg) as compared to that in the control group. However, the trained diabetic group showed a significant decrease (p < 0.05) in the mean arterial blood pressure levels (126.7 ± 5 to 105.1 ± 4 mmHg) as compared to the sedentary diabetic group. Resistance exercise could restore endothelial function and prevent an increase in arterial blood pressure in type 1 diabetic rats.

  7. Resistance Exercise Restores Endothelial Function and Reduces Blood Pressure in Type 1 Diabetic Rats

    Mota, Marcelo Mendonça; Silva, Tharciano Luiz Teixeira Braga da; Fontes, Milene Tavares; Barreto, André Sales; Araújo, João Eliakim dos Santos; Oliveira, Antônio Cesar Cabral de; Wichi, Rogério Brandão; Santos, Márcio Roberto Viana

    2014-01-01

    Resistance exercise effects on cardiovascular parameters are not consistent. The effects of resistance exercise on changes in blood glucose, blood pressure and vascular reactivity were evaluated in diabetic rats. Wistar rats were divided into three groups: control group (n = 8); sedentary diabetic (n = 8); and trained diabetic (n = 8). Resistance exercise was carried out in a squat device for rats and consisted of three sets of ten repetitions with an intensity of 50%, three times per week, for eight weeks. Changes in vascular reactivity were evaluated in superior mesenteric artery rings. A significant reduction in the maximum response of acetylcholine-induced relaxation was observed in the sedentary diabetic group (78.1 ± 2%) and an increase in the trained diabetic group (95 ± 3%) without changing potency. In the presence of NG-nitro-L-arginine methyl ester, the acetylcholine-induced relaxation was significantly reduced in the control and trained diabetic groups, but not in the sedentary diabetic group. Furthermore, a significant increase (p < 0.05) in mean arterial blood pressure was observed in the sedentary diabetic group (104.9 ± 5 to 126.7 ± 5 mmHg) as compared to that in the control group. However, the trained diabetic group showed a significant decrease (p < 0.05) in the mean arterial blood pressure levels (126.7 ± 5 to 105.1 ± 4 mmHg) as compared to the sedentary diabetic group. Resistance exercise could restore endothelial function and prevent an increase in arterial blood pressure in type 1 diabetic rats

  8. The performance of DC restoration function for MODIS thermal emissive bands

    Wang, Zhipeng; Xiong, Xiaoxiong Jack; Shrestha, Ashish

    2017-09-01

    The DC restore (DCR) process of MODIS instrument maintains the output of a detector at focal plane assembly (FPA) within the dynamic range of subsequent analog-to-digital converter, by adding a specific offset voltage to the output. The DCR offset value is adjusted per scan, based on the comparison of the detector response in digital number (DN) collected from the blackbody (BB) view with target DN saved as an on-board look-up table. In this work, the MODIS DCR mechanism is revisited, with the trends of DCR offset being provided for thermal emissive bands (TEB). Noticeable changes have been occasionally found which coincide with significant detector gain change due to various instrumental events such as safe-mode anomaly or FPA temperature fluctuation. In general, MODIS DCR functionality has been effective and the change of DCR offset has no impact to the quality of MODIS data. One exception is the Earth view (EV) data saturation of Aqua MODIS LWIR bands 33, 35 ad 36 during BB warm-up cool-down (WUCD) cycle which has been observed since 2008. The BB view of their detectors saturate when the BB temperature is above certain threshold so the DCR cannot work as designed. Therefore, the dark signal DN fluctuates with the cold FPA (CFPA) temperature and saturate for a few hours per WUCD cycle, which also saturate the EV data sector within the scan. The CFPA temperature fluctuation peaked in 2012 and has been reduced in recent years and the saturation phenomenon has been easing accordingly. This study demonstrates the importance of DCR to data generation.

  9. Does the economy affect functional restoration outcomes for patients with chronic disabling occupational musculoskeletal disorders?

    Hartzell, Meredith M; Mayer, Tom G; Neblett, Randy; Marquardt, Dennis J; Gatchel, Robert J

    2015-06-01

    To determine how the economy affects psychosocial and socioeconomic treatment outcomes in a cohort of chronic disabling occupational musculoskeletal disorder (CDOMD) patients who completed a functional restoration program (FRP). A cohort of 969 CDOMD patients with active workers' compensation claims completed an FRP (a medically-supervised, quantitatively-directed exercise progression program, with multi-modal disability management). A good economy (GE) group (n = 532) was released to work during a low unemployment period (2005-2007), and a poor economy (PE) group (n = 437) was released during a higher unemployment period (2008-2010). Patients were evaluated upon admission for demographic and psychosocial variables, and were reassessed at discharge. Socioeconomic outcomes, including work return and work retention 1 year post-discharge, were collected. Some significant differences in psychosocial self-report data were found, but most of the effect sizes were small, so caution should be made when interpreting the data. Compared to the PE group, the GE group reported more depressive symptoms and disability at admission, but demonstrated a larger decrease in depressive symptoms and disability and increase in self-reported quality of life at discharge. The PE group had lower rates of work return and retention 1-year after discharge, even after controlling for other factors such as length of disability and admission work status. CDOMD patients who completed an FRP in a PE year were less likely to return to, or retain, work 1-year after discharge, demonstrating that a PE can be an additional barrier to post-discharge work outcomes. A difference in State unemployment rates of <3% (7 vs. 5%) had a disproportionate effect on patients' failure to return to (19 vs. 6%) or retain (28 vs. 15%) work.

  10. Repressive mutations restore function-loss caused by the disruption of trimerization in Escherichia coli multidrug transporter AcrB

    Zhaoshuai eWang

    2015-01-01

    Full Text Available AcrAB-TolC and their homologs are major multidrug efflux systems in Gram-negative bacteria. The inner membrane component AcrB functions as a trimer. Replacement of Pro223 by Gly in AcrB decreases the trimer stability and drastically reduces the drug efflux activity. The goal of this study is to identify suppressor mutations that restore function to mutant AcrBP223G and explore the mechanism of function recovery. Two methods were used to introduce random mutations into the plasmid of AcrBP223G. Mutants with elevated drug efflux activity were identified, purified, and characterized to examine their expression level, trimer stability, interaction with AcrA, and substrate binding. Nine single-site repressor mutations were identified, including T199M, D256N, A209V, G257V, M662I, Q737L, D788K, P800S, and E810K. Except for M662I, all other mutations located in the docking region of the periplasmic domain. While three mutations, T199M, A209V, and D256N, significantly increased the trimer stability, none of them restored the trimer affinity to the wild type level. M662, the only site of mutation that located in the porter domain, was involved in substrate binding. Our results suggest that the function loss resulted from compromised AcrB trimerization could be restored through various mechanisms involving the compensation of trimer stability and substrate binding.

  11. Restoration of Gooseberry Creek

    Jonathan W. Long

    2000-01-01

    Grazing exclusion and channel modifications were used to restore wet meadows along a stream on the Fort Apache Indian Reservation. The efforts are reestablishing functional processes to promote long-term restoration of wetland health and species conservation.

  12. Restorative neuroscience

    Andres, Robert H; Meyer, Morten; Ducray, Angélique D

    2008-01-01

    There is increasing interest in the search for therapeutic options for diseases and injuries of the central nervous system (CNS), for which currently no effective treatment strategies are available. Replacement of damaged cells and restoration of function can be accomplished by transplantation of...

  13. Drug screens based on the newly found role of dystroglycan proteolysis and restoration of dystroglycan function thereof

    Bissell, Mina J.; Muschler, John L.

    2010-02-23

    The present invention provides methods and compositions for the diagnosis and treatment of cells lacking normal growth arresting characteristic. The present invention demonstrates that many tumor cells lack normal cell surface .alpha.-dystroglycan and thereby lack dystroglycan function. Dystroglycan can be lost from the cell surface by proteolytic shedding of a fragment of .alpha.-dystroglycan into the surrounding medium. Upon restoration of dystroglycan function and over-expression of the dystroglycan gene, the once tumorigenic cells revert to non-tumorigenic cells which polarize and arrest cell growth in the presence of basement membrane proteins, demonstrating that dystroglycan functions as a tumor marker and suppressor.

  14. Perceived relaxation as a function of restorative yoga combined with Reiki for cancer survivors.

    DiScipio, William J

    2016-08-01

    Twenty-six cancer survivor volunteers participated in a study of the efficacy of perceived relaxation after performing restorative yoga combined with Reiki. Subjects scoring high ratings of Meaning and Peace in life demonstrated greater perception of depth of relaxation. A comparison of subjects receiving concurrent Reiki (19) and restorative yoga with those who only received restorative yoga (7) showed that Reiki subjects experienced greater perceived depth of relaxation than subjects who were not afforded the Reiki intervention. Non-Reiki participants also showed more difficulty overcoming intrusive fearful thoughts than the Reiki group. Clinical implications suggest that patients should be screened and treated for trauma-like symptoms including intrusive thoughts linked to anxiety and depression before referral to complementary programs that offer meditative or relaxation interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Pharmacological activation of the EDA/EDAR signaling pathway restores salivary gland function following radiation-induced damage.

    Grace Hill

    Full Text Available Radiotherapy of head and neck cancers often results in collateral damage to adjacent salivary glands associated with clinically significant hyposalivation and xerostomia. Due to the reduced capacity of salivary glands to regenerate, hyposalivation is treated by substitution with artificial saliva, rather than through functional restoration of the glands. During embryogenesis, the ectodysplasin/ectodysplasin receptor (EDA/EDAR signaling pathway is a critical element in the development and growth of salivary glands. We have assessed the effects of pharmacological activation of this pathway in a mouse model of radiation-induced salivary gland dysfunction. We report that post-irradiation administration of an EDAR-agonist monoclonal antibody (mAbEDAR1 normalizes function of radiation damaged adult salivary glands as determined by stimulated salivary flow rates. In addition, salivary gland structure and homeostasis is restored to pre-irradiation levels. These results suggest that transient activation of pathways involved in salivary gland development could facilitate regeneration and restoration of function following damage.

  16. Intra-articular injection of hyaluronic acid for treatment of osteoarthritis knee: comparative study to intra-articular corticosteroids

    Soad A Elsawy

    2017-01-01

    Conclusion Both HA and corticosteroid groups showed improvement in pain and knee function, but the intra-articular HA was superior to corticosteroid on long-term follow-up. This supports the potential rate of intra-articular HA as an effective long-term therapeutic option for patients with OA of the knee.

  17. Scientific Coordination and Adaptive Management and Experimental Restoration of Longleaf Pine Community Structure, Function, and Composition

    1998-03-01

    Institutes of Health . Pfincipal Inlstigator’s Signature Date FY7621-94-90245-D Post-Treatment Analysis of Restoration Effects on Soils, Plants...MALVACEAE Hibiscus aculeatus Pineland Rose Mallow MELASTOMACEAE Rhexia alifanus Rose Meadow Beauty R. mrilana Pale Meadow Beauty MYRICACEAE Myrica

  18. Autonomic nervous system function in chronic exogenous subclinical thyrotoxicosis and the effect of restoring euthyroidism

    Eustatia-Rutten, Carmen F. A.; Corssmit, Eleonora P. M.; Heemstra, Karen A.; Smit, Johannes W. A.; Schoemaker, Rik C.; Romijn, Johannes A.; Burggraaf, Jacobus

    2008-01-01

    Knowledge on the relationship between the autonomic nervous system and subclinical hyperthyroidism is mainly based upon cross-sectional studies in heterogeneous patient populations, and the effect of restoration to euthyroidism in subclinical hyperthyroidism has not been studied. We investigated the

  19. Corticosteroid treatment in Sydenham's chorea.

    Fusco, C; Spagnoli, C

    2018-03-01

    Sydenham's chorea (SC) is an immune-mediated hyperkinetic movement disorder, developing after group A Beta-hemolytic streptococcal (GABHS) infection. Aside from conventional symptomatic treatment (carbamazepine, valproate, neuroleptics), the use of steroids has also been advocated, mainly in severe, drug-resistant cases or if clinically disabling side effects develop with first line therapies. Based on the description of 5 cases followed in the Child Neurology Unit of Santa Maria Nuova Hospital in Reggio Emilia and on the available medical literature on this topic, we propose considering the use of corticosteroids therapy in children with SC, with the administration of IV methyl-prednisolone followed by oral deflazacort in severe cases and of oral deflazacort alone in mild and moderate degrees of involvement. In our experience this therapy is effective both in the short and long-term period, in different clinical presentations (chorea paralytica, distal chorea, hemichorea, "classic" chorea, association with mood disorder or dyspraxia) and very well tolerated (no significant side effects were recorded). Copyright © 2017. Published by Elsevier Ltd.

  20. Adjunctive Corticosteroids in Adults with Bacterial Meningitis

    van de Beek, Diederik; de Gans, Jan

    2005-01-01

    Bacterial meningitis is a complex disorder in which neurologic injury is caused, in part, by the causative organism and, in part, by the host's own inflammatory response. In studies of experimental bacterial meningitis, adjuvant treatment with corticosteroids, specifically dexamethasone, has

  1. Atopic dermatitis: tacrolimus vs. topical corticosteroid use

    Atopic dermatitis (AD) is an inflammatory skin disease that is characterised .... effective in the treatment of AD.5. Although ..... original steroid preparations,20 the cost-effectiveness of ... Topical corticosteroids [homepage on the Internet]. c2010.

  2. Phospho-BAD BH3 Mimicry Protects β Cells and Restores Functional β Cell Mass in Diabetes

    Sanda Ljubicic

    2015-02-01

    Full Text Available Strategies that simultaneously enhance the survival and glucose responsiveness of insulin-producing β cells will greatly augment β cell replacement therapies in type 1 diabetes (T1D. We show that genetic and pharmacologic mimetics of the phosphorylated BCL-2 homology 3 (BH3 domain of BAD impart β-cell-autonomous protective effects in the face of stress stimuli relevant to β cell demise in T1D. Importantly, these benefits translate into improved engraftment of donor islets in transplanted diabetic mice, increased β cell viability in islet grafts, restoration of insulin release, and diabetes reversal. Survival of β cells in this setting is not merely due to the inability of phospho-BAD to suppress prosurvival BCL-2 proteins but requires its activation of the glucose-metabolizing enzyme glucokinase. Thus, BAD phospho-BH3 mimetics may prove useful in the restoration of functional β cell mass in diabetes.

  3. Mucosal immunity in HIV infection: what can be done to restore gastrointestinal-associated lymphoid tissue function?

    George, Michael D; Asmuth, David M

    2014-06-01

    This review describes the impact of HIV infection on gut-associated lymphoid tissue, the mechanisms for persistent gut-associated lymphoid tissue dysfunction despite effective antiretroviral therapy, and potential strategies to restore gut-associated lymphoid tissue function and promote immune reconstitution. Recent studies indicate that unresolved microbial translocation and intestinal dysbiosis may continue to promote enteropathy as well as HIV-associated and non-HIV-associated conditions in many HIV patients who otherwise maintain therapeutic control of systemic viral replication. Several novel therapeutic approaches to reduce intestinal inflammation and mitigate microbial translocation may hold promise for restoring gastrointestinal health and thereby increasing the efficacy of immune reconstitution in HIV-infected patients undergoing antiretroviral therapy.

  4. Targeting cFMS signaling to restore immune function and eradicate HIV reservoirs

    Gerngross, Lindsey

    While combination anti-retroviral therapy (cART) has improved the length and quality of life of individuals living with HIV-1 infection, the prevalence of HIV-associated neurocognitive disorders (HAND) has increased and remains a significant clinical concern. The neuropathogenesis of HAND is not completely understood, however, latent HIV infection in the central nervous system (CNS) and chronic neuroinflammation are believed to play a prominent role. CNS-associated macrophages and resident microglia are significant contributors to CNS inflammation and constitute the chief reservoir of HIV-1 infection in the CNS. Previous studies from our lab suggest monocyte/macrophage invasion of the CNS in HIV may be driven by altered monocyte/macrophage homeostasis. We have reported expansion of a monocyte subset (CD14+CD16 +CD163+) in peripheral blood of HIV+ patients that is phenotypically similar to macrophages/microglia that accumulate in the CNS as seen in post-mortem tissue. The factors driving the expansion of this monocyte subset are unknown, however, signaling through cFMS, a type III receptor tyrosine kinase (RTK), may play a role. Macrophage-colony stimulating factor (M-CSF), a ligand of cFMS, has been shown to be elevated in the cerebral spinal fluid (CSF) of individuals with the most severe form of HAND, HIV-associated dementia (HAD). M-CSF promotes a Macrophage-2-like phenotype and increases CD16 and CD163 expression in cultured monocytes. M-CSF has also been shown to increase the susceptibility of macrophages to HIV infection and enhance virus production. These findings, in addition to the known function of M-CSF in promoting macrophage survival, supports a role for M-CSF in the development and maintenance of macrophage viral reservoirs in tissues where these cells accumulate, including the CNS. Interestingly, a second ligand for cFMS, IL-34, was recently identified and reported to share some functions with M-CSF, suggesting that both ligands may contribute to HIV

  5. Global Ecosystem Restoration Index

    Fernandez, Miguel; Garcia, Monica; Fernandez, Nestor

    2015-01-01

    The Global ecosystem restoration index (GERI) is a composite index that integrates structural and functional aspects of the ecosystem restoration process. These elements are evaluated through a window that looks into a baseline for degraded ecosystems with the objective to assess restoration...

  6. Si-Jun-Zi Decoction Treatment Promotes the Restoration of Intestinal Function after Obstruction by Regulating Intestinal Homeostasis

    Xiangyang Yu

    2014-01-01

    Full Text Available Intestinal obstruction is a common disease requiring abdominal surgery with significant morbidity and mortality. Currently, an effective medical treatment for obstruction, other than surgical resection or decompression, does not exist. Si-Jun-Zi Decoction is a famous Chinese medicine used to replenish qi and invigorate the functions of the spleen. Modern pharmacological studies show that this prescription can improve gastrointestinal function and strengthen immune function. In this study, we investigated the effects of a famous Chinese herbal formula, Si-Jun-Zi Decoction, on the restoration of intestinal function after the relief of obstruction in a rabbit model. We found that Si-Jun-Zi Decoction could reduce intestinal mucosal injury while promoting the recovery of the small intestine. Further, Si-Jun-Zi Decoction could regulate the intestinal immune system. Our results suggest that Si-Jun-Zi Decoction promotes the restoration of intestinal function after obstruction by regulating intestinal homeostasis. Our observations indicate that Si-Jun-Zi Decoction is potentially a therapeutic drug for intestinal obstruction.

  7. Autonomic nervous system function in chronic exogenous subclinical thyrotoxicosis and the effect of restoring euthyroidism.

    Eustatia-Rutten, Carmen F A; Corssmit, Eleonora P M; Heemstra, Karen A; Smit, Johannes W A; Schoemaker, Rik C; Romijn, Johannes A; Burggraaf, Jacobus

    2008-07-01

    Knowledge on the relationship between the autonomic nervous system and subclinical hyperthyroidism is mainly based upon cross-sectional studies in heterogeneous patient populations, and the effect of restoration to euthyroidism in subclinical hyperthyroidism has not been studied. We investigated the long-term effects of exogenous subclinical hyperthyroidism on the autonomic nervous system and the potential effects of restoration of euthyroidism. This was a prospective single-blinded, placebo-controlled, randomized trial. The study was performed at a university hospital. A total of 25 patients who were on more than 10-yr TSH suppressive therapy after thyroidectomy was examined. Patients were studied at baseline and subsequently randomized to a 6-month thyroid hormone substitution regimen to obtain either euthyroidism or maintenance of the subclinical hyperthyroid state. Urinary excretion of catecholamines and heart rate variability were measured. Baseline data of the subclinical hyperthyroidism patients were compared with data obtained in patients with hyperthyroidism and controls. Urinary excretion of norepinephrine and vanillylmandelic acid was higher in the subclinical hyperthyroidism patients compared with controls and lower compared with patients with overt hyperthyroidism. Heart rate variability was lower in patients with hyperthyroidism, intermediate in subclinical hyperthyroidism patients, and highest in the healthy controls. No differences were observed after restoration of euthyroidism. Long-term exogenous subclinical hyperthyroidism has effects on the autonomic nervous system measured by heart rate variability and urinary catecholamine excretion. No differences were observed after restoration to euthyroidism. This may indicate the occurrence of irreversible changes or adaptation during long-term exposure to excess thyroid hormone that is not remedied by 6-month euthyroidism.

  8. Restoration of Muscle Mitochondrial Function and Metabolic Flexibility in Type 2 Diabetes by Exercise Training Is Paralleled by Increased Myocellular Fat Storage and Improved Insulin Sensitivity

    Meex, R.C.R.; Schrauwen-Hinderling, V.B.; Moonen-Kornips, E.; Schaart, G.; Mensink, M.R.; Phielix, E.; Weijer, van de T.; Sels, J.P.; Schrauwen, P.; Hesselink, M.K.C.

    2010-01-01

    OBJECTIVE-Mitochondrial dysfunction and fat accumulation in skeletal muscle (increased intramyocellular lipid [IMCL]) have been linked to development of type 2 diabetes. We examined whether exercise training could restore mitochondrial function and insulin sensitivity in patients with type 2

  9. Gene therapy restores auditory and vestibular function in a mouse model of Usher syndrome type 1c.

    Pan, Bifeng; Askew, Charles; Galvin, Alice; Heman-Ackah, Selena; Asai, Yukako; Indzhykulian, Artur A; Jodelka, Francine M; Hastings, Michelle L; Lentz, Jennifer J; Vandenberghe, Luk H; Holt, Jeffrey R; Géléoc, Gwenaëlle S

    2017-03-01

    Because there are currently no biological treatments for hearing loss, we sought to advance gene therapy approaches to treat genetic deafness. We focused on Usher syndrome, a devastating genetic disorder that causes blindness, balance disorders and profound deafness, and studied a knock-in mouse model, Ush1c c.216G>A, for Usher syndrome type IC (USH1C). As restoration of complex auditory and balance function is likely to require gene delivery systems that target auditory and vestibular sensory cells with high efficiency, we delivered wild-type Ush1c into the inner ear of Ush1c c.216G>A mice using a synthetic adeno-associated viral vector, Anc80L65, shown to transduce 80-90% of sensory hair cells. We demonstrate recovery of gene and protein expression, restoration of sensory cell function, rescue of complex auditory function and recovery of hearing and balance behavior to near wild-type levels. The data represent unprecedented recovery of inner ear function and suggest that biological therapies to treat deafness may be suitable for translation to humans with genetic inner ear disorders.

  10. Effects of corticosteroids on hyposmia in persistent allergic rhinitis.

    Catana, Iuliu V; Chirila, Magdalena; Negoias, Simona; Bologa, Ramona; Cosgarea, Marcel

    2013-01-01

    To asses the effects of two topical nasal corticosteroids sprays on hyposmia in patients with persistent allergic rhinitis. The study was a prospective clinical trial and it included twenty four patients with persistent allergic rhinitis (PER) and hyposmia (H). The patients were divided into two groups depending on the type of corticosteroid topical nasal spray treatment: group A, 200 micrograms dose of mometasone furoate (MF) and group B, 110 micrograms dose of fluticasone furoate (FF) both administered in the morning for 4 weeks. The olfactory function of the patients was evaluated with the extended Test battery "Sniffin' Sticks". The visual analogue scale (VAS) was used for the assessment of hyposmia, nasal discharge. The level of the nasal obstruction, before and after the treatment, was evaluated through the anterior rhinomanometry. The comparisons between the two types of topical corticosteroids showed a significant improvement separately between scores of the odor threshold (OT), odor discrimination (OD) and odor identification (OI) and also on the final olfactory score (SDI) before and after 4 weeks of the treatment. The comparisons of the VAS scores pre and post treatment showed a significant improvement in hyposmia and nasal obstruction. The nasal airflow and the nasal discharge scores were improved, but the differences were not statistically significant between the groups. The final statistical analysis found no significant differences between the two patients groups. The study concludes that fluticasone furoate and mometasone furoate have quite the same effects on hyposmia and on the classical symptoms from PER.

  11. 2-Deoxyadenosine triphosphate restores the contractile function of cardiac myofibril from adult dogs with naturally occurring dilated cardiomyopathy.

    Cheng, Yuanhua; Hogarth, Kaley A; O'Sullivan, M Lynne; Regnier, Michael; Pyle, W Glen

    2016-01-01

    Dilated cardiomyopathy (DCM) is a major type of heart failure resulting from loss of systolic function. Naturally occurring canine DCM is a widely accepted experimental paradigm for studying human DCM. 2-Deoxyadenosine triphosphate (dATP) can be used by myosin and is a superior energy substrate over ATP for cross-bridge formation and increased systolic function. The objective of this study was to evaluate the beneficial effect of dATP on contractile function of cardiac myofibrils from dogs with naturally occurring DCM. We measured actomyosin NTPase activity and contraction/relaxation properties of isolated myofibrils from nonfailing (NF) and DCM canine hearts. NTPase assays indicated replacement of ATP with dATP significantly increased myofilament activity in both NF and DCM samples. dATP significantly improved maximal tension of DCM myofibrils to the NF sample level. dATP also restored Ca(2+) sensitivity of tension that was reduced in DCM samples. Similarly, dATP increased the kinetics of contractile activation (kACT), with no impact on the rate of cross-bridge tension redevelopment (kTR). Thus, the activation kinetics (kACT/kTR) that were reduced in DCM samples were restored for dATP to NF sample levels. dATP had little effect on relaxation. The rate of early slow-phase relaxation was slightly reduced with dATP, but its duration was not, nor was the fast-phase relaxation or times to 50 and 90% relaxation. Our findings suggest that myosin utilization of dATP improves cardiac myofibril contractile properties of naturally occurring DCM canine samples, restoring them to NF levels, without compromising relaxation. This suggests elevation of cardiac dATP is a promising approach for the treatment of DCM. Copyright © 2016 the American Physiological Society.

  12. Corticosteroid injection in early treatment of lateral epicondylitis.

    Newcomer, K L; Laskowski, E R; Idank, D M; McLean, T J; Egan, K S

    2001-10-01

    To analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation. Randomized, controlled, double-blind study. Sports medicine center in a tertiary care center. Subjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old. 19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated. Outcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks. There were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales. A corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.

  13. Prolonged treatment with N-acetylcysteine and L-arginine restores gonadal function in patients with polycystic ovary syndrome.

    Masha, A; Manieri, C; Dinatale, S; Bruno, G A; Ghigo, E; Martina, V

    2009-12-01

    Nitric oxide (NO) plays a wide spectrum of biological actions including a positive role in oocyte maturation and ovulation. Free radicals levels have been shown elevated in polycystic ovary syndrome (PCOS) and therefore would be responsible for quenching NO that, in turn, would play a role in determining oligo- or amenorrhea connoting PCOS. Eight patients with PCOS displaying oligo-amenorrhea from at least 1 yr underwent a combined treatment with N-acetylcysteine (NAC) (1200 mg/die) plus L-arginine (ARG) (1600 mg/die) for 6 months. Menstrual function, glucose and insulin levels, and, in turn, homeostasis model assessment (HOMA) index were monitored. Menstrual function was at some extent restored as indicated by the number of uterine bleedings under treatment (3.00, 0.18-5.83 vs 0.00, 0.00-0.83; p<0.02). Also, a well-defined biphasic pattern in the basal body temperature suggested ovulatory cycles. The HOMA index decreased under treatment (2.12, 1.46-4.42 vs 3.48, 1.62-5.95; p<0.05). In conclusion, this preliminary, open study suggests that prolonged treatment with NAC+ARG might restore gonadal function in PCOS. This effect seems associated to an improvement in insulin sensitivity.

  14. Behavioural changes in dogs treated with corticosteroids.

    Notari, Lorella; Burman, Oliver; Mills, Daniel

    2015-11-01

    In human medicine, psychiatric side effects among patients on corticosteroid therapy are widely reported, but this appears to have been largely overlooked in the animal literature despite glucocorticoids being widely used in veterinary medicine. Therefore the aim of the current study was to identify possible psycho-behavioural changes in dogs treated with corticosteroids. Two different methodologies were used. Firstly, dog owners were asked to fill a 12 item questionnaire aimed at further validating the initial results of a previous survey relating to changes seen when their dog was receiving corticosteroid treatment. In a second study, a population of dogs undertook behavioural tests aimed at objectively identifying changes when receiving corticosteroid therapy. In the first study, a sample of owners whose dogs were receiving treatment for dermatological, orthopaedic or other conditions evaluated their dogs' behaviour on and off therapy, using a seven point scale. The survey was completed by 44 dog owners with dogs receiving treatment with a range of corticosteroid preparations (mainly prednisolone and methylprednisolone) and 54 dog owners with dogs receiving treatment with other drugs, mainly antibiotics and non-steroidal anti-inflammatory drugs. Dogs under corticosteroid treatment were reported to be significantly less playful, more nervous/restless, more fearful/less confident, more aggressive in the presence of food, more prone to barking, more prone to startle, more prone to reacting aggressively when disturbed, and more prone to avoiding people or unusual situations. In the second study, eleven “treatment” dogs were tested both before and during corticosteroid treatment with either methyl-prednisolone or prednisolone to assess their sensitivity to a potentially aversive sound stimulus. Eleven control dogs were also tested at the same time intervals in the same environment. Dogs were exposed to a brief dog growl while they explored bowls containing food

  15. A chronic low dose of Δ9-tetrahydrocannabinol (THC) restores cognitive function in old mice.

    Bilkei-Gorzo, Andras; Albayram, Onder; Draffehn, Astrid; Michel, Kerstin; Piyanova, Anastasia; Oppenheimer, Hannah; Dvir-Ginzberg, Mona; Rácz, Ildiko; Ulas, Thomas; Imbeault, Sophie; Bab, Itai; Schultze, Joachim L; Zimmer, Andreas

    2017-06-01

    The balance between detrimental, pro-aging, often stochastic processes and counteracting homeostatic mechanisms largely determines the progression of aging. There is substantial evidence suggesting that the endocannabinoid system (ECS) is part of the latter system because it modulates the physiological processes underlying aging. The activity of the ECS declines during aging, as CB1 receptor expression and coupling to G proteins are reduced in the brain tissues of older animals and the levels of the major endocannabinoid 2-arachidonoylglycerol (2-AG) are lower. However, a direct link between endocannabinoid tone and aging symptoms has not been demonstrated. Here we show that a low dose of Δ 9 -tetrahydrocannabinol (THC) reversed the age-related decline in cognitive performance of mice aged 12 and 18 months. This behavioral effect was accompanied by enhanced expression of synaptic marker proteins and increased hippocampal spine density. THC treatment restored hippocampal gene transcription patterns such that the expression profiles of THC-treated mice aged 12 months closely resembled those of THC-free animals aged 2 months. The transcriptional effects of THC were critically dependent on glutamatergic CB1 receptors and histone acetylation, as their inhibition blocked the beneficial effects of THC. Thus, restoration of CB1 signaling in old individuals could be an effective strategy to treat age-related cognitive impairments.

  16. Grazer Functional Roles, Induced Defenses, and Indirect Interactions: Implications for Eelgrass Restoration in San Francisco Bay

    Jeffrey T. Lewis

    2014-11-01

    Full Text Available Understanding the individual and interactive roles of consumer species is more than academic when the host plant is a subject of intense conservation interest. In a mesocosm experiment, we compared effects of common invertebrate grazers in San Francisco Bay seagrass (Zostera marina, eelgrass beds, finding that some species (a native opisthobranch, Phyllaplysia taylori; a native isopod, Idotea resecata; and an introduced gastropod, Ilyanassa obsoleta enhanced eelgrass growth through removal of epiphytic algae, as is often predicted for small invertebrate grazers on seagrasses, while one (an introduced caprellid amphipod, Caprella cf. drepanochir had neutral effects. In contrast, the putatively-introduced gammaridean amphipod, Ampithoe valida, had strong negative effects on eelgrass (in addition to epiphytes through consumption, as we had previously observed in the field during restoration programs. We tested whether other common grazer species could influence the effects of the eelgrass-grazing Ampithoe, and found that Idotea induced production of phenolic compounds and limited eelgrass damage by Ampithoe, without affecting Ampithoe abundance. These results have implications for restoration strategies, and contribute to a growing awareness of the importance of trait-mediated indirect grazer interactions through grazer-induced changes in plant traits, providing the first example in a seagrass system.

  17. Skin-derived mesenchymal stem cells help restore function to ovaries in a premature ovarian failure mouse model.

    Dongmei Lai

    Full Text Available Skin-derived mesenchymal stem cells (SMSCs can differentiate into the three embryonic germ layers. For this reason, they are considered a powerful tool for therapeutic cloning and offer new possibilities for tissue therapy. Recent studies showed that skin-derived stem cells can differentiate into cells expressing germ-cell specific markers in vitro and form oocytes in vivo. The idea that SMSCs may be suitable for the treatment of intractable diseases or traumatic tissue damage has attracted attention. To determine the ability of SMSCs to reactivate injured ovaries, a mouse model with ovaries damaged by busulfan and cyclophosphamide was developed and is described here. Female skin-derived mesenchymal stem cells (F-SMSCs and male skin-derived mesenchymal stem cells (M-SMSCs from red fluorescence protein (RFP transgenic adult mice were used to investigate the restorative effects of SMSCs on ovarian function. Significant increases in total body weight and the weight of reproductive organs were observed in the treated animals. Both F-SMSCs and M-SMSCs were shown to be capable of partially restoring fertility in chemotherapy-treated females. Immunostaining with RFP and anti-Müllerian hormone (AMH antibodies demonstrated that the grafted SMSCs survived, migrated to the recipient ovaries. After SMSCs were administered to the treated mice, real-time PCR showed that the expression levels of pro-inflammatory cytokines TNF-α, TGF-β, IL-8, IL-6, IL-1β, and IFNγ were significantly lower in the ovaries than in the untreated controls. Consistent with this observation, expression of oogenesis marker genes Nobox, Nanos3, and Lhx8 increased in ovaries of SMSCs-treated mice. These findings suggest that SMSCs may play a role within the ovarian follicle microenvironment in restoring the function of damaged ovaries and could be useful in reproductive health.

  18. Amino acid derivative-mediated detoxification and functionalization of dual cure dental restorative material for dental pulp cell mineralization.

    Minamikawa, Hajime; Yamada, Masahiro; Iwasa, Fuminori; Ueno, Takeshi; Deyama, Yoshiaki; Suzuki, Kuniaki; Yawaka, Yasutaka; Ogawa, Takahiro

    2010-10-01

    Current dental restorative materials are only used to fill the defect of hard tissues, such as dentin and enamel, because of their cytotoxicity. Therefore, exposed dental pulp tissues in deep cavities must be first covered by a pulp capping material like calcium hydroxide to form a layer of mineralized tissue. However, this tissue mineralization is based on pathological reaction and triggers long-lasting inflammation, often causing clinical problems. This study tested the ability of N-acetyl cysteine (NAC), amino acid derivative, to reduce cytotoxicity and induce mineralized tissue conductivity in resin-modified glass ionomer (RMGI), a widely used dental restorative material having dual cure mechanism. Rat dental pulp cells were cultured on untreated or NAC-supplemented RMGI. NAC supplementation substantially increased the percentage of viable cells from 46.7 to 73.3% after 24-h incubation. Cell attachment, spreading, proliferative activity, and odontoblast-related gene and protein expressions increased significantly on NAC-supplemented RMGI. The mineralization capability of cells, which was nearly suppressed on untreated RMGI, was induced on NAC-supplemented RMGI. These improved behaviors and functions of dental pulp cells on NAC-supplemented RMGI were associated with a considerable reduction in the production of intracellular reactive oxygen species and with the increased level of intracellular glutathione reserves. These results demonstrated that NAC could detoxify and functionalize RMGIs via two different mechanisms involving in situ material detoxification and antioxidant cell protection. We believe that this study provides a new approach for developing dental restorative materials that enables mineralized tissue regeneration.

  19. Restoring ecosystem functions and services by overcoming soil threats - The case of Mt. Hekla area in Iceland

    Thorsson, Johann; Petursdottir, Thorunn

    2015-04-01

    Soils are one of the main fundamental bodies of terrestrial ecosystems. Soil functions contribute substantially to the ecosystem services humans and all other living beings depend on. Current soil threats are in most cases related to anthropogenic impacts and derived environmental pressures. For instance, overexploitation has in many cases damaged ecosystem resilience, affected current equilibrium and caused severe soil degradation. The resulting dysfunctional ecosystems are incapable of providing necessary ecosystem services. In such cases ecosystem restoration is necessary to restore ecosystem functions and ecological succession. The Mt. Hekla area in Iceland is an example of land suffering from accelerated erosion amplified by anthropogenic impacts. The area is 900 km2 located in South Iceland in the vicinity of the volcano Mt. Hekla. Today over 40% of the area is classified as eroded but historical documents indicate that vast part of the area were fertile and vegetated at the time of settlement, 1100 years ago; hence was able to withstand the geological disturbances occurring prior to the arrival of man as is obvious from the pristine woody patches still remaining. Severe soil degradation followed the large-scale deforestation and overgrazing that took place within the area. The initial land degradation event is considered to have occurred in the 11th century, but has been ongoing since then in several episodes. The Þjórsá glacial river flows through the area and carries enormous amounts of sediments every year. After the deforestation, the ecosystem resilience was damaged and the land left exposed to the elements. Eventually large scale wind erosion started, followed with water erosion and increased impact of freeze-thaw processes. The Soil Conservation Service of Iceland started working in the area in the early 20th century and land reclamation operations have been ongoing until this day. Considerable successes have been made as is manifested in the fact

  20. Exploring applications of GPR methodology and uses in determining floodplain function of restored streams in the Gulf Coastal Plain, Alabama

    Eckes, S. W.; Shepherd, S. L.

    2017-12-01

    Accurately characterizing subsurface structure and function of remediated floodplains is indispensable in understanding the success of stream restoration projects. Although many of these projects are designed to address increased storm water runoff due to urbanization, long term monitoring and assessment are often limited in scope and methodology. Common monitoring practices include geomorphic surveys, stream discharge, and suspended sediment loads. These data are comprehensive for stream monitoring but they do not address floodplain function in terms of infiltration and through flow. Developing noninvasive methods for monitoring floodplain moisture transfer and distribution will aid in current and future stream restoration endeavors. Ground penetrating radar (GPR) has been successfully used in other physiographic regions for noninvasive and continuous monitoring of (1) natural geomorphic environments including subsurface structure and landform change and (2) soil and turf management to monitor subsurface moisture content. We are testing the viability of these existing methods to expand upon the broad capabilities of GPR. Determining suitability will be done in three parts using GPR to (1) find known buried objects of typical materials used in remediation at measured depths, (2) understand GPR functionality in varying soil moisture content thresholds on turf plots, and (3) model reference, remediated, and impacted floodplains in a case study in the D'Olive Creek watershed located in Baldwin County, Alabama. We hypothesize that these methods will allow us to characterize moisture transfer from precipitation and runoff to the floodplain which is a direct function of floodplain health. The need for a methodology to monitor floodplains is widespread and with increased resolution and mobility, expanding GPR applications may help streamline remediation and monitoring practices.

  1. Restoration of orbicularis oculi muscle function in rabbits with peripheral facial paralysis via an implantable artificial facial nerve system.

    Sun, Yajing; Jin, Cheng; Li, Keyong; Zhang, Qunfeng; Geng, Liang; Liu, Xundao; Zhang, Yi

    2017-12-01

    The purpose of the present study was to restore orbicularis oculi muscle function using the implantable artificial facial nerve system (IAFNS). The in vivo part of the IAFNS was implanted into 12 rabbits that were facially paralyzed on the right side of the face to restore the function of the orbicularis oculi muscle, which was indicated by closure of the paralyzed eye when the contralateral side was closed. Wireless communication links were established between the in vivo part (the processing chip and microelectrode) and the external part (System Controller program) of the system, which were used to set the working parameters and indicate the working state of the processing chip and microelectrode implanted in the body. A disturbance field strength test of the IAFNS processing chip was performed in a magnetic field dark room to test its electromagnetic radiation safety. Test distances investigated were 0, 1, 3 and 10 m, and levels of radiation intensity were evaluated in the horizontal and vertical planes. Anti-interference experiments were performed to test the stability of the processing chip under the interference of electromagnetic radiation. The fully implanted IAFNS was run for 5 h per day for 30 consecutive days to evaluate the accuracy and precision as well as the long-term stability and effectiveness of wireless communication. The stimulus intensity (range, 0-8 mA) was set every 3 days to confirm the minimum stimulation intensity which could indicate the movement of the paralyzed side was set. Effective stimulation rate was also tested by comparing the number of eye-close movements on both sides. The results of the present study indicated that the IAFNS could rebuild the reflex arc, inducing the experimental rabbits to close the eye of the paralyzed side. The System Controller program was able to reflect the in vivo part of the artificial facial nerve system in real-time and adjust the working pattern, stimulation intensity and frequency, range of wave

  2. Corticosteroid injections for lateral epicondylitis: a systematic review.

    Smidt, Nynke; Assendelft, Willem J J; van der Windt, Danielle A W M; Hay, Elaine M; Buchbinder, Rachelle; Bouter, Lex M

    Patients with lateral epicondylitis (tennis elbow) are frequently treated with corticosteroid injections, in order to relieve pain and diminish disability. The objective of this review was to evaluate the effectiveness of corticosteroid injections for lateral epicondylitis. Randomised controlled

  3. Restoring a functional and mobile shoulder following reconstruction of the sternoclavicular joint with a free vascularized fibular flap

    Abby Choke

    2018-06-01

    Full Text Available Infection of the sternoclavicular joint (SCJ is rare and often missed at early stage. In extensive disease with bony and soft tissue destruction, radical excision is indicated. The loss of SCJ results in exposure of vital structures of the anterior mediastinum and instability of the shoulder girdle. SCJ reconstruction using locoregional muscle flaps like the pectoralis major or latissimus dorsi flap has been well described. While these options can provide soft tissue coverage, they do not restore the structural framework of the SCJ which is important for shoulder excursion and chest wall movement. We describe a case of SCJ reconstruction using a free vascularized fibular flap following the resection of sternoclavicular tubercular osteomyelitis. The fibula bone was used to restore the clavicular strut by anchoring it to the remaining manubrium with a steel wire and by plating the lateral end to the remnant clavicle. The steel wire served as a “defunctioning” cerclage that allowed motion of the joint to induce fibrous union. A strict post-operative rehabilitation protocol keeping the shoulder adducted at the initial phase was prescribed. At one year follow up, the patient achieved good shoulder function with 140 degrees of shoulder abduction and 110 degrees flexion.

  4. Local gene therapy durably restores vestibular function in a mouse model of Usher syndrome type 1G.

    Emptoz, Alice; Michel, Vincent; Lelli, Andrea; Akil, Omar; Boutet de Monvel, Jacques; Lahlou, Ghizlene; Meyer, Anaïs; Dupont, Typhaine; Nouaille, Sylvie; Ey, Elody; Franca de Barros, Filipa; Beraneck, Mathieu; Dulon, Didier; Hardelin, Jean-Pierre; Lustig, Lawrence; Avan, Paul; Petit, Christine; Safieddine, Saaid

    2017-09-05

    Our understanding of the mechanisms underlying inherited forms of inner ear deficits has considerably improved during the past 20 y, but we are still far from curative treatments. We investigated gene replacement as a strategy for restoring inner ear functions in a mouse model of Usher syndrome type 1G, characterized by congenital profound deafness and balance disorders. These mice lack the scaffold protein sans, which is involved both in the morphogenesis of the stereociliary bundle, the sensory antenna of inner ear hair cells, and in the mechanoelectrical transduction process. We show that a single delivery of the sans cDNA by the adenoassociated virus 8 to the inner ear of newborn mutant mice reestablishes the expression and targeting of the protein to the tips of stereocilia. The therapeutic gene restores the architecture and mechanosensitivity of stereociliary bundles, improves hearing thresholds, and durably rescues these mice from the balance defects. Our results open up new perspectives for efficient gene therapy of cochlear and vestibular disorders by showing that even severe dysmorphogenesis of stereociliary bundles can be corrected.

  5. CORTICOSTEROID MICROVESICLES FOR TREATMENT OF CARDIOVASCULAR DISEASES

    Fayad, Zahi A.; Mulder, W.J.M.; Storm, Gerrit; Metselaar, J.M.

    2009-01-01

    The invention provides a use of a long-circulating microvesicle comprising a sterol, partially synthetic or wholly synthetic vesicle- forming phospholipids, and a corticosteroid in water soluble form, which microvesicle has a mean particle diameter size range of between about 75 and 150 nm and which

  6. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  7. The IAEA's functions and policies on the restoration of environments with radioactive residues

    Gonzalez, A.J.

    2000-01-01

    A global regime for the regulation of radiation sources is being established by the international community. A general agreement has already been achieved in the current international radiation protection recommendations, which should be resolutely applied. Protection against radioactive residues delivering relatively low level radiation doses can be regulated within the framework provided by the growing international regime based on these recommendations and composed of international conventions, safety standards and provisions for the application of these standards. It is to be noted, however, that the international safety regime is not more than a provider of a decision aiding mechanism based mainly on a global scientific consensus on radiation protection. Its outcome can only serve as input to a final (usually wider) decision making process, which may take into account societal and other concerns at a national, or even local, level. Many situations involving radioactive residues arise in the human habitant and, therefore, the decision making process should involve the participation of all relevant stakeholders in that habitant, rather than radiation protection specialists alone. The combination of decision aiding regulations based on the international regime being catalyzed under the IAEA and a decision making process that takes account of local circumstances and stakeholders' interests should prevent the current problems in the regulation of radioactive residues and in the restoration of the affected environments

  8. The Immediate Aesthetic and Functional Restoration of Maxillary Incisors Compromised by Periodontitis Using Short Implants with Single Crown Restorations: A Minimally Invasive Approach and Five-Year Follow-Up

    Mauro Marincola

    2015-01-01

    Full Text Available The functional and aesthetic restoration of teeth compromised due to aggressive periodontitis presents numerous challenges for the clinician. Horizontal bone loss and soft tissue destruction resulting from periodontitis can impede implant placement and the regeneration of an aesthetically pleasing gingival smile line, often requiring bone augmentation and mucogingival surgery, respectively. Conservative approaches to the treatment of aggressive periodontitis (i.e., treatments that use minimally invasive tools and techniques have been purported to yield positive outcomes. Here, we report on the treatment and five-year follow-up of patient suffering from aggressive periodontitis using a minimally invasive surgical technique and implant system. By using the methods described herein, we were able to achieve the immediate aesthetic and functional restoration of the maxillary incisors in a case that would otherwise require bone augmentation and extensive mucogingival surgery. This technique represents a conservative and efficacious alternative to the aesthetic and functional replacement of teeth compromised due to aggressive periodontitis.

  9. A phase III, open-label, single-arm study of tenecteplase for restoration of function in dysfunctional central venous catheters.

    Tebbi, Cameron; Costanzi, John; Shulman, Robert; Dreisbach, Luke; Jacobs, Brian R; Blaney, Martha; Ashby, Mark; Gillespie, Barbara S; Begelman, Susan M

    2011-08-01

    To evaluate, in a phase III, single-arm study, the safety and efficacy of the thrombolytic agent tenecteplase in restoring function to dysfunctional central venous catheters (CVCs). Pediatric and adult patients with dysfunctional CVCs were eligible to receive as much as 2 mL (2 mg) of intraluminal tenecteplase, which was left to dwell in the CVC lumen for a maximum of 120 minutes. If CVC function was not restored at 120 minutes, a second dose was instilled for an additional 120 minutes. Tenecteplase was administered to 246 patients. Mean patient age was 44 years (range, 0-92 y); 72 patients (29%) were younger than 17 years of age. Chemotherapy was the most common reason for catheter insertion. Restoration of CVC function was achieved in 177 patients (72%) within 120 minutes after the first dose. After instillation of a maximum of two doses of tenecteplase, CVC function was restored in 200 patients (81%), with similar frequencies in pediatric (83%) and adult (80%) patients. Adverse events (AEs) were reported in 31 patients (13%); fever (2%), neutropenia (1%), and nausea (0.8%) were most common. One serious AE, an allergic hypersensitivity reaction, was judged to be related to tenecteplase and/or a chemotherapeutic agent that the patient was receiving concurrently. Consecutive administration of one or two doses of tenecteplase into CVCs showed efficacy in the restoration of catheter function in patients with dysfunctional CVCs. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  10. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.

    Jobe, Alan H; Goldenberg, Robert L

    2018-04-07

    Antenatal corticosteroids are standard of care for pregnancies at risk of preterm delivery between 24-34 weeks' gestational age. Recent trials demonstrate modest benefits from antenatal corticosteroids for late preterm and elective cesarean deliveries, and antenatal corticosteroids for periviable deliveries should be considered with family discussion. However, many women with threatened preterm deliveries receive antenatal corticosteroids but do not deliver until >34 weeks or at term. The net effect is that a substantial fraction of the delivery population will be exposed to antenatal corticosteroids. There are gaps in accurate assessments of benefits of antenatal corticosteroids because the randomized controlled trials were performed prior to about 1990 in pregnancies generally >28 weeks. The care practices for the mother and infant survival were different than today. The randomized controlled trial data also do not strongly support the optimal interval from antenatal corticosteroid treatment to delivery of 1-7 days. Epidemiology-based studies using large cohorts with >85% of at-risk pregnancies treated with antenatal corticosteroids probably overestimate the benefits of antenatal corticosteroids. Although most of the prematurity-associated mortality is in low-resource environments, the efficacy and safety of antenatal corticosteroids in those environments remain to be evaluated. The short-term benefits of antenatal corticosteroids for high-risk pregnancies in high-resource environments certainly justify antenatal corticosteroids as few risks have been identified over many years. However, cardiovascular and metabolic abnormalities have been identified in large animal models and cohorts of children exposed to antenatal corticosteroids that are consistent with fetal programming for adult diseases. These late effects of antenatal corticosteroids suggest caution for the expanded use of antenatal corticosteroids beyond at-risk pregnancies at 24-34 weeks. A way forward

  11. Medical adherence to topical corticosteroid preparations prescribed for psoriasis

    Svendsen, Mathias Tiedemann; Andersen, Flemming; Hansen, Jakob

    2017-01-01

    OBJECTIVE: Topical corticosteroids and corticosteroid combinations are the principal treatments in psoriasis. The aim of this study was to investigate published literature dealing with medical adherence to topical corticosteroid or corticosteroid combinations in patients with psoriasis. MATERIALS...... health outcome in topical treatment of psoriasis, further studies should be conducted addressing determinants of nonadherence and test interventions to improve adherence. Validated measurements of medical nonadherence, prescription registers, or medication-weight are needed....

  12. Corticosteroids as adjuvant therapy for ocular toxoplasmosis.

    Jasper, Smitha; Vedula, Satyanarayana S; John, Sheeja S; Horo, Saban; Sepah, Yasir J; Nguyen, Quan Dong

    2017-01-26

    Ocular infection caused by Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea, and consequently lead to complications such as glaucoma, cataract, and posterior synechiae. The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids to anti-parasitic therapy versus anti-parasitic therapy alone for ocular toxoplasmosis. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register (2016; Issue 11)), MEDLINE Ovid, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE Ovid Daily (January 1946 to December 2016), Embase (January 1980 to December 2016), Latin American and Caribbean Literature on Health Sciences (LILACS (January 1982 to December 2016)), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/search/en). We used no date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 7 December 2016. We had planned to include randomized and quasi-randomized controlled trials. Eligible trials would have enrolled participants of any age who were immunocompetent and were diagnosed with acute ocular toxoplasmosis. Included trials would have compared anti-parasitic therapy plus corticosteroids versus anti-parasitic therapy alone, different doses or times of initiation of corticosteroids. Two authors independently screened titles and abstracts retrieved through the electronic searches. We retrieved full-text reports of studies categorized as 'unsure' or 'include' after we reviewed the abstracts. Two authors independently reviewed each full-text report for eligibility. Discrepancies were resolved through discussion. We identified no completed or ongoing trial that was eligible for this Cochrane review. Although research has identified a wide

  13. Land use/ land cover and ecosystem functions change in the grassland restoration program areas in China from 2000 to 2010

    Zhang, H.; Fan, J.

    2015-12-01

    The grassland restoration areas in China, most of which was located in arid and semi-arid areas, are affected by climate change and anthropogenic activities. Using the 3S (RS, GIS, GPS) technologies, quantitative analysis method of landscape patterns and ecological simulation, this study examines the spatiotemporal characteristics of land use/ land cover and ecosystem functions change in the grassland restoration areas in China from 2000 to 2010. We apply two parameters land use transfer matrix and land use dynamic degree to explore the speed and regional differentiation of land use change. We propose vegetation coverage, net primary production (NPP), soil and water conservation capacity to assess the ecosystem functions. This study analyzes the characteristics of landscape patterns at the class and landscape levels and explores the ecological effect of land use pattern and regional ecological processes. The results show that: (1) Grassland and others were the main landscape types in the study area in the past decade. The ecosystem structure was stable. About 0.37% of the total grassland area in 2000 experienced change in land use / land cover types. The area of woodlands, wetlands, farmlands, and built-up areas expanded. The area of others has declined. (2) The dynamic degree of regional land use was less than one percent in the recent ten years. The speed of land use and land cover change was low, and regional differentiation of change between the provinces was small. (3) The matrix of the landscape did not change in the study area. Landscape fragmentation index values decreased progressively; landscape diversity rose continuously; landscape aggregation and continuity decreased slightly; the landscape maintained relative integrity. (4) Ecosystem functions has increased as a whole. The vegetation coverages with significant increase (with a 1.99% yr-1 slope of regression) in the total study area; NPP has a fluctuating and increasing tendency, ranging from 218.23 g

  14. Restoration using Azolla imbricata increases nitrogen functional bacterial groups and genes in soil.

    Lu, Xiao-Ming; Lu, Peng-Zhen; Yang, Ke

    2017-05-01

    Microbial groups are major factors that influence soil function. Currently, there is a lack of studies on microbial functional groups. Although soil microorganisms play an important role in the nitrogen cycle, systematic studies of the effects of environmental factors on microbial populations in relation to key metabolic processes in the nitrogen cycle are seldom reported. In this study, we conducted a systematic analysis of the changes in nitrogen functional groups in mandarin orange garden soil treated with Azolla imbricata. The structures of the major functional bacterial groups and the functional gene abundances involved in key processes of the soil nitrogen cycle were analyzed using high-throughput sequencing (HTS) and quantitative real-time PCR, respectively. The results indicated that returning A. imbricata had an important influence on the composition of soil nitrogen functional bacterial communities. Treatment with A. imbricata increased the diversity of the nitrogen functional bacteria. The abundances of nitrogen functional genes were significantly higher in the treated soil compared with the control soil. Both the diversity of the major nitrogen functional bacteria (nifH bacteria, nirK bacteria, and narG bacteria) and the abundances of nitrogen functional genes in the soil showed significant positive correlations with the soil pH, the organic carbon content, available nitrogen, available phosphorus, and NH 4 + -N and NO 3 - -N contents. Treatment with 12.5 kg fresh A. imbricata per mandarin orange tree was effective to improve the quality of the mandarin orange garden soil. This study analyzed the mechanism of the changes in functional bacterial groups and genes involved in key metabolic processes of the nitrogen cycle in soil treated by A. imbricata.

  15. Corticosteroid-exacerbated symptoms in an Andersen's syndrome kindred.

    Bendahhou, Saïd; Fournier, Emmanuel; Gallet, Serge; Ménard, Dominique; Larroque, Marie-Madeleine; Barhanin, Jacques

    2007-04-15

    Periodic paralysis, cardiac arrhythmia and bone features are the hallmark of Andersen's syndrome (AS), a rare disorder caused by mutations in the KCNJ2 gene that encodes for the inward rectifier K(+)-channel Kir2.1. Rest following strenuous physical activity, carbohydrate ingestion, emotional stress and exposure to cold are the precipitating triggers. Most of the mutations act in a dominant-negative fashion, either through a trafficking dysfunction or through Kir2.1-phosphatidyl inositol bisphosphate binding defect. We have identified two families that were diagnosed with periodic paralysis and cardiac abnormalities, but only discrete development features. The proband in one of the two families reported having his symptoms occurring twice within the day following corticosteroids ingestion, and alleviated after stopping the corticosteroid treatment. Electromyographic evaluations pointed out to a typical hypokalemic periodic paralysis pattern. Molecular screening of the KCNJ2 gene identified two mutations leading to C54F and T305P substitutions in the Kir2.1 protein. Functional expression in mammalian cells revealed a loss-of-function of the mutated channels and a dominant-negative effect when both mutants and wild-type channels are present in the same cell. However, channel trafficking and assembly are not affected. Substitutions at these residues may interfere with phosphatidyl inositol bisphosphate binding to Kir2.1 channels. Sensitivity of our patients to multiple corticosteroid administrations shows that care must be taken in the use of such treatments in AS patients. Taken together, our data suggest the inclusion of the KCNJ2 gene in the molecular screening of patients with periodic paralysis, even when the classical AS dysmorphic features are not present.

  16. Restoration of CFTR function in patients with cystic fibrosis carrying the F508del-CFTR mutation.

    De Stefano, Daniela; Villella, Valeria R; Esposito, Speranza; Tosco, Antonella; Sepe, Angela; De Gregorio, Fabiola; Salvadori, Laura; Grassia, Rosa; Leone, Carlo A; De Rosa, Giuseppe; Maiuri, Maria C; Pettoello-Mantovani, Massimo; Guido, Stefano; Bossi, Anna; Zolin, Anna; Venerando, Andrea; Pinna, Lorenzo A; Mehta, Anil; Bona, Gianni; Kroemer, Guido; Maiuri, Luigi; Raia, Valeria

    2014-01-01

    Restoration of BECN1/Beclin 1-dependent autophagy and depletion of SQSTM1/p62 by genetic manipulation or autophagy-stimulatory proteostasis regulators, such as cystamine, have positive effects on mouse models of human cystic fibrosis (CF). These measures rescue the functional expression of the most frequent pathogenic CFTR mutant, F508del, at the respiratory epithelial surface and reduce lung inflammation in Cftr(F508del) homozygous mice. Cysteamine, the reduced form of cystamine, is an FDA-approved drug. Here, we report that oral treatment with cysteamine greatly reduces the mortality rate and improves the phenotype of newborn mice bearing the F508del-CFTR mutation. Cysteamine was also able to increase the plasma membrane expression of the F508del-CFTR protein in nasal epithelial cells from F508del homozygous CF patients, and these effects persisted for 24 h after cysteamine withdrawal. Importantly, this cysteamine effect after washout was further sustained by the sequential administration of epigallocatechin gallate (EGCG), a green tea flavonoid, both in vivo, in mice, and in vitro, in primary epithelial cells from CF patients. In a pilot clinical trial involving 10 F508del-CFTR homozygous CF patients, the combination of cysteamine and EGCG restored BECN1, reduced SQSTM1 levels and improved CFTR function from nasal epithelial cells in vivo, correlating with a decrease of chloride concentrations in sweat, as well as with a reduction of the abundance of TNF/TNF-alpha (tumor necrosis factor) and CXCL8 (chemokine [C-X-C motif] ligand 8) transcripts in nasal brushing and TNF and CXCL8 protein levels in the sputum. Altogether, these results suggest that optimal schedules of cysteamine plus EGCG might be used for the treatment of CF caused by the F508del-CFTR mutation.

  17. A multi-pad electrode based functional electrical stimulation system for restoration of grasp

    Malešević Nebojša M

    2012-09-01

    Full Text Available Abstract Background Functional electrical stimulation (FES applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. To improve the stimulation effectiveness of conventional FES, we introduce multi-pad electrodes and a new stimulation paradigm. Methods The new FES system comprises an electrode composed of small pads that can be activated individually. This electrode allows the targeting of motoneurons that activate synergistic muscles and produce a functional movement. The new stimulation paradigm allows asynchronous activation of motoneurons and provides controlled spatial distribution of the electrical charge that is delivered to the motoneurons. We developed an automated technique for the determination of the preferred electrode based on a cost function that considers the required movement of the fingers and the stabilization of the wrist joint. The data used within the cost function come from a sensorized garment that is easy to implement and does not require calibration. The design of the system also includes the possibility for fine-tuning and adaptation with a manually controllable interface. Results The device was tested on three stroke patients. The results show that the multi-pad electrodes provide the desired level of selectivity and can be used for generating a functional grasp. The results also show that the procedure, when performed on a specific user, results in the preferred electrode configuration characteristics for that patient. The findings from this study are of importance for the application of transcutaneous stimulation in the clinical and home environments.

  18. Transfer function restoration in 3D electron microscopy via iterative data refinement

    Sorzano, C O S; Marabini, R; Herman, G T; Censor, Y; Carazo, J M

    2004-01-01

    Three-dimensional electron microscopy (3D-EM) is a powerful tool for visualizing complex biological systems. As with any other imaging device, the electron microscope introduces a transfer function (called in this field the contrast transfer function, CTF) into the image acquisition process that modulates the various frequencies of the signal. Thus, the 3D reconstructions performed with these CTF-affected projections are also affected by an implicit 3D transfer function. For high-resolution electron microscopy, the effect of the CTF is quite dramatic and limits severely the achievable resolution. In this work we make use of the iterative data refinement (IDR) technique to ameliorate the effect of the CTF. It is demonstrated that the approach can be successfully applied to noisy data

  19. Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study.

    Kapadia, Naaz; Zivanovic, Vera; Popovic, Milos R

    2013-01-01

    Functional electrical stimulation (FES) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury (SCI). To determine the effectiveness of FES therapy, as compared to conventional occupational therapy (COT), in improving voluntary hand function in individuals with chronic (≥24 months post injury), incomplete (American Spinal Injury Association Impairment Scale [AIS] B-D), C4 to C7 SCI. Eight participants were randomized to the intervention group (FES therapy; n = 5) or the control group (COT; n = 3). Both groups received 39 hours of therapy over 13 to 16 weeks. The primary outcome measure was the Toronto Rehabilitation Institute-Hand Function Test (TRI-HFT), and the secondary outcome measures were Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Functional Independence Measure (FIM) self-care subscore, and Spinal Cord Independence Measure (SCIM) self-care subscore. Outcome assessments were performed at baseline, after 39 sessions of therapy, and at 6 months following the baseline assessment. After 39 sessions of therapy, the intervention group improved by 5.8 points on the TRI-HFT's Object Manipulation Task, whereas the control group changed by only 1.17 points. Similarly, after 39 sessions of therapy, the intervention group improved by 4.6 points on the FIM self-care subscore, whereas the control group did not change at all. The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.

  20. Dehydroepiandrosterone restores hepatocellular function and prevents liver damage in estrogen-deficient females following trauma and hemorrhage.

    Kuebler, J F; Jarrar, D; Wang, P; Bland, K I; Chaudry, I H

    2001-05-15

    Recent studies have shown that administration of the sex steroid dehydroepiandrosterone (DHEA) in males following trauma-hemorrhagic shock has salutary effects on the depressed cardiovascular and immunological functions under those conditions. Since the effects of sex steroids are gender specific, we examined whether administration of DHEA has any beneficial effects on hepatocellular function in female rats with low estrogen levels following trauma-hemorrhage. Ovariectomy was performed in female Sprague-Dawley rats 14 days prior to the experiments. The animals then underwent a 5-cm midline laparotomy and were subjected to hemorrhagic shock (40 mm Hg for 90 min). This was followed by fluid resuscitation (Ringer's lactate over 60 min) and administration of DHEA (30 mg/kg BW) or vehicle subcutaneously at the end of resuscitation. At 24 h after resuscitation hepatocellular function, i.e., clearance of indocyanine green (ICG), and hepatocyte damage (serum alanine aminotransferase) were measured. Plasma levels of DHEA and 17beta-estradiol were also assayed. Vehicle-treated rats had significantly reduced hepatocellular function, increased ALT activity, and decreased levels of 17beta-estradiol following trauma-hemorrhage compared to sham-operated animals (P trauma-hemorrhage, hepatocellular function and ALT activity were similar to those of shams. However, administration of DHEA did not influence the plasma levels of 17beta-estradiol. Administration of DHEA following trauma-hemorrhage restored hepatocellular function and reduced hepatic damage that was observed in ovariectomized female rats under such conditions. This salutary effect of DHEA did not appear to be due to elevated levels of plasma 17beta-estradiol. We therefore propose that DHEA should be considered a novel, safe, and useful adjunct in the treatment of trauma-induced hepatocellular dysfunction in ovariectomized and postmenopausal females. Copyright 2001 Academic Press.

  1. Taenia solium tapeworms synthesize corticosteroids and sex steroids in vitro.

    Valdez, R A; Jiménez, P; Fernández Presas, A M; Aguilar, L; Willms, K; Romano, M C

    2014-09-01

    Cysticercosis is a disease caused by the larval stage of Taenia solium cestodes that belongs to the family Taeniidae that affects a number of hosts including humans. Taeniids tapeworms are hermaphroditic organisms that have reproductive units called proglottids that gradually mature to develop testis and ovaries. Cysticerci, the larval stage of these parasites synthesize steroids. To our knowledge there is no information about the capacity of T. solium tapeworms to metabolize progesterone or other precursors to steroid hormones. Therefore, the aim of this paper was to investigate if T. solium tapeworms were able to transform steroid precursors to corticosteroids and sex steroids. T. solium tapeworms were recovered from the intestine of golden hamsters that had been orally infected with cysticerci. The worms were cultured in the presence of tritiated progesterone or androstenedione. At the end of the experiments the culture media were analyzed by thin layer chromatography. The experiments described here showed that small amounts of testosterone were synthesized from (3)H-progesterone by complete or segmented tapeworms whereas the incubation of segmented tapeworms with (3)H-androstenedione, instead of (3)H-progesterone, improved their capacity to synthesize testosterone. In addition, the incubation of the parasites with (3)H-progesterone yielded corticosteroids, mainly deoxicorticosterone (DOC) and 11-deoxicortisol. In summary, the results described here, demonstrate that T. solium tapeworms synthesize corticosteroid and sex steroid like metabolites. The capacity of T. solium tapeworms to synthesize steroid hormones may contribute to the physiological functions of the parasite and also to their interaction with the host. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Transplantation of adult mouse iPS cell-derived photoreceptor precursors restores retinal structure and function in degenerative mice.

    Budd A Tucker

    2011-04-01

    Full Text Available This study was designed to determine whether adult mouse induced pluripotent stem cells (iPSCs, could be used to produce retinal precursors and subsequently photoreceptor cells for retinal transplantation to restore retinal function in degenerative hosts. iPSCs were generated using adult dsRed mouse dermal fibroblasts via retroviral induction of the transcription factors Oct4, Sox2, KLF4 and c-Myc. As with normal mouse ES cells, adult dsRed iPSCs expressed the pluripotency genes SSEA1, Oct4, Sox2, KLF4, c-Myc and Nanog. Following transplantation into the eye of immune-compromised retinal degenerative mice these cells proceeded to form teratomas containing tissue comprising all three germ layers. At 33 days post-differentiation a large proportion of the cells expressed the retinal progenitor cell marker Pax6 and went on to express the photoreceptor markers, CRX, recoverin, and rhodopsin. When tested using calcium imaging these cells were shown to exhibit characteristics of normal retinal physiology, responding to delivery of neurotransmitters. Following subretinal transplantation into degenerative hosts differentiated iPSCs took up residence in the retinal outer nuclear layer and gave rise to increased electro retinal function as determined by ERG and functional anatomy. As such, adult fibroblast-derived iPSCs provide a viable source for the production of retinal precursors to be used for transplantation and treatment of retinal degenerative disease.

  3. Brain machine interface and limb reanimation technologies: restoring function after spinal cord injury through development of a bypass system.

    Lobel, Darlene A; Lee, Kendall H

    2014-05-01

    Functional restoration of limb movement after traumatic spinal cord injury (SCI) remains the ultimate goal in SCI treatment and directs the focus of current research strategies. To date, most investigations in the treatment of SCI focus on repairing the injury site. Although offering some promise, these efforts have met with significant roadblocks because treatment measures that are successful in animal trials do not yield similar results in human trials. In contrast to biologic therapies, there are now emerging neural interface technologies, such as brain machine interface (BMI) and limb reanimation through electrical stimulators, to create a bypass around the site of the SCI. The BMI systems analyze brain signals to allow control of devices that are used to assist SCI patients. Such devices may include a computer, robotic arm, or exoskeleton. Limb reanimation technologies, which include functional electrical stimulation, epidural stimulation, and intraspinal microstimulation systems, activate neuronal pathways below the level of the SCI. We present a concise review of recent advances in the BMI and limb reanimation technologies that provides the foundation for the development of a bypass system to improve functional outcome after traumatic SCI. We also discuss challenges to the practical implementation of such a bypass system in both these developing fields. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. Full restoration of Brucella-infected dendritic cell functionality through Vγ9Vδ2 T helper type 1 crosstalk.

    Ming Ni

    Full Text Available Vγ9Vδ2 T cells play an important role in the immune response to infectious agents but the mechanisms contributing to this immune process remain to be better characterized. Following their activation, Vγ9Vδ2 T cells develop cytotoxic activity against infected cells, secrete large amounts of cytokines and influence the function of other effectors of immunity, notably cells playing a key role in the initiation of the adaptive immune response such as dendritic cells. Brucella infection dramatically impairs dendritic cell maturation and their capacity to present antigens to T cells. Herein, we investigated whether V T cells have the ability to restore the full functional capacities of Brucella-infected dendritic cells. Using an in vitro multicellular infection model, we showed that: 1/Brucella-infected dendritic cells activate Vγ9Vδ2 T cells through contact-dependent mechanisms, 2/activated Vγ9Vδ2 T cells induce full differentiation into IL-12 producing cells of Brucella-infected dendritic cells with functional antigen presentation activity. Furthermore, phosphoantigen-activated Vγ9Vδ2 T cells also play a role in triggering the maturation process of dendritic cells already infected for 24 h. This suggests that activated Vγ9Vδ2 T cells could be used to modulate the outcome of infectious diseases by promoting an adjuvant effect in dendritic cell-based cellular therapies.

  5. Towards a miniaturized brain-machine-spinal cord interface (BMSI) for restoration of function after spinal cord injury.

    Shahdoost, Shahab; Frost, Shawn; Van Acker, Gustaf; DeJong, Stacey; Dunham, Caleb; Barbay, Scott; Nudo, Randolph; Mohseni, Pedram

    2014-01-01

    Nearly 6 million people in the United States are currently living with paralysis in which 23% of the cases are related to spinal cord injury (SCI). Miniaturized closed-loop neural interfaces have the potential for restoring function and mobility lost to debilitating neural injuries such as SCI by leveraging recent advancements in bioelectronics and a better understanding of the processes that underlie functional and anatomical reorganization in an injured nervous system. This paper describes our current progress towards developing a miniaturized brain-machine-spinal cord interface (BMSI) that is envisioned to convert in real time the neural command signals recorded from the brain to electrical stimuli delivered to the spinal cord below the injury level. Specifically, the paper reports on a corticospinal interface integrated circuit (IC) as a core building block for such a BMSI that is capable of low-noise recording of extracellular neural spikes from the cerebral cortex as well as muscle activation using intraspinal microstimulation (ISMS) in a rat with contusion injury to the thoracic spinal cord. The paper further presents results from a neurobiological study conducted in both normal and SCI rats to investigate the effect of various ISMS parameters on movement thresholds in the rat hindlimb. Coupled with proper signal-processing algorithms in the future for the transformation between the cortically recorded data and ISMS parameters, such a BMSI has the potential to facilitate functional recovery after an SCI by re-establishing corticospinal communication channels lost due to the injury.

  6. Restoration of Endothelial Function in Pparα−/− Mice by Tempol

    Neerupma Silswal

    2015-01-01

    Full Text Available Peroxisome proliferator activated receptor alpha (PPARα is one of the PPAR isoforms belonging to the nuclear hormone receptor superfamily that regulates genes involved in lipid and lipoprotein metabolism. PPARα is present in the vascular wall and is thought to be involved in protection against vascular disease. To determine if PPARα contributes to endothelial function, conduit and cerebral resistance arteries were studied in Pparα−/− mice using isometric and isobaric tension myography, respectively. Aortic contractions to PGF2α and constriction of middle cerebral arteries to phenylephrine were not different between wild type (WT and Pparα−/−; however, relaxation/dilation to acetylcholine (ACh was impaired. There was no difference in relaxation between WT and Pparα−/− aorta to treatment with a nitric oxide (NO surrogate indicating impairment in endothelial function. Endothelial NO levels as well as NO synthase expression were reduced in Pparα−/− aortas, while superoxide levels were elevated. Two-week feeding with the reactive oxygen species (ROS scavenger, tempol, normalized ROS levels and rescued the impaired endothelium-mediated relaxation in Pparα−/− mice. These results suggest that Pparα−/− mice have impaired endothelial function caused by decreased NO bioavailability. Therefore, activation of PPARα receptors may be a therapeutic target for maintaining endothelial function and protection against cardiovascular disease.

  7. Evolution of ligand specificity in vertebrate corticosteroid receptors

    Deitcher David L

    2011-01-01

    Full Text Available Abstract Background Corticosteroid receptors include mineralocorticoid (MR and glucocorticoid (GR receptors. Teleost fishes have a single MR and duplicate GRs that show variable sensitivities to mineralocorticoids and glucocorticoids. How these receptors compare functionally to tetrapod MR and GR, and the evolutionary significance of maintaining two GRs, remains unclear. Results We used up to seven steroids (including aldosterone, cortisol and 11-deoxycorticosterone [DOC] to compare the ligand specificity of the ligand binding domains of corticosteroid receptors between a mammal (Mus musculus and the midshipman fish (Porichthys notatus, a teleost model for steroid regulation of neural and behavioral plasticity. Variation in mineralocorticoid sensitivity was considered in a broader phylogenetic context by examining the aldosterone sensitivity of MR and GRs from the distantly related daffodil cichlid (Neolamprologus pulcher, another teleost model for neurobehavioral plasticity. Both teleost species had a single MR and duplicate GRs. All MRs were sensitive to DOC, consistent with the hypothesis that DOC was the initial ligand of the ancestral MR. Variation in GR steroid-specificity corresponds to nine identified amino acid residue substitutions rather than phylogenetic relationships based on receptor sequences. Conclusion The mineralocorticoid sensitivity of duplicate GRs in teleosts is highly labile in the context of their evolutionary phylogeny, a property that likely led to neo-functionalization and maintenance of two GRs.

  8. Assessing the Effects of the Urban Forest Restoration Effort of MillionTreesNYC on the Structure and Functioning of New York City Ecosystems

    P. Timon McPhearson

    2010-01-01

    Full Text Available Current forest restoration practices for New York City’s (NYC MillionTreesNYC Initiative on public parkland include site preparation with extensive invasive species removal and tree and shrub planting with the goal of creating new multi-layered forests. We have launched a long-term investigation of these sites in order to understand the primary physical, chemical, and biological responses of urban ecosystems to MillionTreesNYC forest restoration practices. This research will examine high and low diversity tree and understory planting combinations in permanent experimental forest restoration plots across NYC. The study assesses how the interactions between soil heterogeneity, plant population dynamics, and forest restoration management strategies drive urban forest ecosystem structure and functioning. Working in collaboration with the NYC Department of Parks & Recreation (NYC Parks and the MillionTreesNYC tree planting campaign, we are examining different restoration strategies to assess how restoration practices affect the ecological development trajectories of newly established forests in NYC.

  9. Chromosome 17: association of a large inversion polymorphism with corticosteroid response in asthma.

    Tantisira, Kelan G; Lazarus, Ross; Litonjua, Augusto A; Klanderman, Barbara; Weiss, Scott T

    2008-08-01

    A 900-kb inversion exists within a large region of conserved linkage disequilibrium (LD) on chromosome 17. CRHR1 is located within the inversion region and associated with inhaled corticosteroid response in asthma. We hypothesized that CRHR1 variants are in LD with the inversion, supporting a potential role for natural selection in the genetic response to corticosteroids. We genotyped six single nucleotide polymorphisms (SNPs) spanning chromosome 17: 40,410,565-42,372,240, including four SNPs defining inversion status. Similar allele frequencies and strong LD were noted between the inversion and a CRHR1 SNP previously associated with lung function response to inhaled corticosteroids. Each inversion-defining SNP was strongly associated with inhaled corticosteroid response in adult asthma (P values 0.002-0.005). The CRHR1 response to inhaled corticosteroids may thus be explained by natural selection resulting from inversion status or by long-range LD with another gene. Additional pharmacogenetic investigations into regions of chromosomal diversity, including copy number variation and inversions, are warranted.

  10. Effect of antenatal corticosteroids on postmortem brain weight of preterm babies.

    Murphy, D J

    2001-07-01

    To investigate the effects of single and repeated courses of antenatal corticosteroids on brain growth in very preterm babies. Retrospective study of 110 very preterm babies delivered at a single University Teaching Hospital between 1992 and 1999 who had a full necropsy including detailed examination of the brain. Mean brain weight did not differ significantly between babies who received corticosteroids and those who did not 160 vs. 157 g, (p=0.82), nor was there a difference between mean brain weight of stillborn or liveborn babies in relation to steroid use 164 vs. 159 g, (p=0.84) and 156 vs. 152g (p=0.81). There was no apparent dose-response relationship between the total number of doses of corticosteroids or timing since the first dose of corticosteroids and brain weight, p=0.95 and p=0.87. Single and multiple courses of antenatal corticosteroids had no significant effect on brain growth in babies delivered preterm who died but long-term follow-up studies are required to evaluate the functional neurological outcome of surviving children.

  11. Short- and long-term response to corticosteroid therapy in chronic beryllium disease.

    Marchand-Adam, S; El Khatib, A; Guillon, F; Brauner, M W; Lamberto, C; Lepage, V; Naccache, J-M; Valeyre, D

    2008-09-01

    Chronic beryllium disease (CBD) is a granulomatous disorder that affects the lung after exposure to beryllium. The present study reports short- and long-term evolution of granulomatous and fibrotic components in eight patients with severe CBD receiving corticosteroid therapy. Eight patients with confirmed CBD were studied at baseline, after initial corticosteroid treatment (4-12 months), at relapse and at the final visit. Beryllium exposure, Glu(69) (HLA-DPB1 genes coding for glutamate at position beta69) polymorphism, symptoms, pulmonary function tests (PFT), serum angiotensin-converting enzyme (SACE) and high-resolution computed tomography (HRCT) quantification of pulmonary lesions were analysed. The CBD patients were observed for a median (range) of 69 (20-180) months. After stopping beryllium exposure, corticosteroids improved symptoms and PFT (vital capacity +26%, diffusing capacity of the lung for carbon monoxide +15%), and decreased SACE level and active lesion HRCT score. In total, 18 clinical relapses occurred after the treatment was tapered and these were associated with SACE and active lesion HRCT score impairment. At the final visit, corticosteroids had completely stabilised all parameters including both HRCT scores of active lesions and fibrotic lesions in six out of eight patients. Corticosteroids were beneficial in chronic beryllium disease. They were effective in suppressing granulomatosis lesions in all cases and in stopping the evolution to pulmonary fibrosis in six out of eight patients.

  12. Oral administration of soybean peptide Vglycin normalizes fasting glucose and restores impaired pancreatic function in Type 2 diabetic Wistar rats.

    Jiang, Hua; Feng, Jueping; Du, Zhongxia; Zhen, Hui; Lin, Mei; Jia, Shaohui; Li, Tao; Huang, Xinyuan; Ostenson, Claes-Goran; Chen, Zhengwang

    2014-09-01

    Vglycin, a natural 37-residue polypeptide isolated from pea seeds in which six half-cysteine residues are embedded in three pairs of disulfide bonds, is resistant to digestive enzymes and has antidiabetic potential. To investigate the pharmacological activity of Vglycin in vivo and to examine the mechanisms involved, the therapeutic effect of Vglycin in diabetic rats was examined. Diabetes was induced in Wistar rats by high-fat diet and multiple streptozotocin intraperitoneal injections. Diabetic rats were treated daily with Vglycin for 4 weeks. Body weight, food intake, fasting plasma glucose and insulin levels were assayed weekly. Glucose and insulin tolerance tests were conducted on Day 29. Subsequently, levels of p-Akt in the liver and pancreas and cleaved PARP, Pdx-1 and insulin in the pancreas were detected by immunoblotting. The morphology of the pancreas and the insulin expression in the pancreas were analyzed by hematoxylin-eosin staining and immunohistochemistry, respectively. Furthermore, human liver-derived cell lines were used to explore the in vitro effects of Vglycin on insulin sensitivity and glucose uptake. Chronic treatment with Vglycin normalized fasting glucose levels in diabetic rats. The improvement in glucose homeostasis and the increased insulin sensitivity mediated by restored insulin signaling likely contributed to decreased food intake and reduced body weight. Vglycin protected pancreatic cells from damage by streptozotocin. Although insulin synthesis and secretion in impaired β-cell were not significantly elevated, islets morphology was improved in the Vglycin-treated groups. These results suggest that Vglycin could be useful in Type 2 diabetes for restoring impaired insulin signaling, glucose tolerance and pancreatic function. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Asthma and Adherence to Inhaled Corticosteroids

    Bårnes, Camilla Boslev; Ulrik, Charlotte Suppli

    2015-01-01

    Inhaled corticosteroids (ICS) are the cornerstone of maintenance asthma therapy. However, in spite of this, adherence to ICS remains low. The aim of this systematic literature review was to provide an overview of the current knowledge of adherence to ICS, effects of poor adherence, and means...... was found to be between 22 and 63%, with improvement up to and after an exacerbation. Poor adherence was associated with youth, being African-American, having mild asthma, ... prescribed fixed-combination therapy (ICS and long-acting β2 agonists). Good adherence was associated with higher FEV1, a lower percentage of eosinophils in sputum, reduction in hospitalizations, less use of oral corticosteroids, and lower mortality rate. Overall, 24% of exacerbations and 60% of asthma...

  14. Abdominal wall reconstruction for large incisional hernia restores expiratory lung function

    Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N

    2017-01-01

    BACKGROUND: Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities...... of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life. METHODS: Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia...... (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow...

  15. Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation

    Sahil eBajaj

    2015-03-01

    Full Text Available Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (< 0.1 Hz, even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP or both mental practice and physical therapy (MP + PT within 14-51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1, the right primary motor area (RM1, the left pre-motor cortex (LPMC, the right pre-motor cortex (RPMC and the supplementary motor area (SMA. We discovered that (i the network activity dominated in the frequency range 0.06 Hz – 0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii the flow did not increase significantly after MP alone and (iv the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke

  16. Restoration of Function With Acupuncture Following Severe Traumatic Brain Injury: A Case Report

    Wolf, Jacob; Sparks, Linda; Deng, Yong; Langland, Jeffrey

    2015-01-01

    This case report illustrates the improvement of an acupuncture-treated patient who incurred a severe traumatic brain injury (TBI) from a snowboarding accident. Over 4 years, the patient progressed from initially not being able to walk, having difficulty with speech, and suffering from poor eyesight to where he has now regained significant motor function, speech, and vision and has returned to snowboarding. A core acupuncture protocol plus specific points added to address the patient's ongoing...

  17. Physical exercise restores microvascular function in obese rats with metabolic syndrome.

    Machado, Marcus Vinicius; Vieira, Aline Bomfim; Nascimento, Alessandro Rodrigues; Martins, Rômulo Lanza; Daleprane, Julio Beltrame; Lessa, Marcos Adriano; Tibiriçá, Eduardo

    2014-11-01

    Obesity and metabolic syndrome are related to systemic functional microvascular alterations, including a significant reduction in microvessel density. The aim of this study was to investigate the effects of exercise training on functional capillary density in the skeletal muscle and skin of obese rats with metabolic syndrome. We used male Wistar-Kyoto rats that had been fed a standard commercial diet (CON) or high-fat diet (HFD) for 32 weeks. Animals receiving the HFD were randomly divided into sedentary (HFD+SED) and training groups (HFD+TR) at the 20(th) week. After 12 weeks of aerobic treadmill training, the maximal oxygen uptake (VO2max); hemodynamic, biochemical, and anthropometric parameters; and functional capillary density were assessed. In addition, a maximal exercise test was performed. Exercise training increased the VO2max (69 ± 3 mL/kg per min) and exercise tolerance (30 ± 1 min) compared with the HFD+SED (41 ± 6 mL/kg per min, P Exercise training also increased the number of spontaneously perfused capillaries in the skeletal muscle (252 ± 9 vs. 207 ± 9 capillaries/mm(2)) of the training group compared with that in the sedentary animals (260 ± 15 capillaries/mm(2)). These results demonstrate that exercise training reverses capillary rarefaction in our experimental model of metabolic syndrome and obesity.

  18. Functional restoration of penis with partial defect by scrotal skin flap.

    Zhao, Yue-Qiang; Zhang, Jie; Yu, Mo-Sheng; Long, Dao-Chou

    2009-11-01

    We investigated a reconstructive method with better sensory and erectile function for partial penile defects and report our long-term results of surgical correction using scrotal skin flaps. We retrospectively analyzed the records of 18 patients with penile defects referred to us between 1992 and 2007. All cases were treated with a scrotal skin flap initially to repair the secondary defect after penile elongation. Of the 18 cases treated during the 15-year period the mechanism of primary injury was circumcision in 3, animal bite in 9 and penile tumor dissection in 6. Penile elongation, division of the suspensory ligament and scrotal skin flaps achieved penile augmentation and enhancement. Six cases were treated with a bilateral scrotal skin flap supplied by the anterior scrotal artery and 12 were repaired with a total anterior scrotal skin flap supplied by the anterior and posterior scrotal arteries. Penile length in the flaccid and erectile states was obviously increased postoperatively (p <0.05). All patients were followed 1 to 9 years (mean 2.3) postoperatively. Deep and superficial sensation recovered and erectile function was retained. Of the 18 patients 15 reported satisfied sexual intercourse during the 0.5 to 5-year followup. The method of correcting partial penile defect using scrotal skin flaps is effective and simple according to our long-term experience. This method achieves reasonable cosmesis and penile length in most cases with better sensory and erectile function.

  19. Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve.

    Yang, Ming-liang; Li, Jian-jun; Zhang, Shao-cheng; Du, Liang-jie; Gao, Feng; Li, Jun; Wang, Yu-ming; Gong, Hui-ming; Cheng, Liang

    2011-08-01

    The authors report a case of functional improvement of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization using a functional spinal accessory nerve. Complete spinal cord injury at the C-2 level was diagnosed in a 44-year-old man. Left diaphragm activity was decreased, and the right diaphragm was completely paralyzed. When the level of metabolism or activity (for example, fever, sitting, or speech) slightly increased, dyspnea occurred. The patient underwent neurotization of the right phrenic nerve with the trapezius branch of the right spinal accessory nerve at 11 months postinjury. Four weeks after surgery, training of the synchronous activities of the trapezius muscle and inspiration was conducted. Six months after surgery, motion was observed in the previously paralyzed right diaphragm. The lung function evaluation indicated improvements in vital capacity and tidal volume. This patient was able to sit in a wheelchair and conduct outdoor activities without assisted ventilation 12 months after surgery.

  20. Schwann cell-mediated delivery of glial cell line-derived neurotrophic factor restores erectile function after cavernous nerve injury.

    May, Florian; Buchner, Alexander; Schlenker, Boris; Gratzke, Christian; Arndt, Christian; Stief, Christian; Weidner, Norbert; Matiasek, Kaspar

    2013-03-01

    To evaluate the time-course of functional recovery after cavernous nerve injury using glial cell line-derived neurotrophic factor-transduced Schwann cell-seeded silicon tubes. Sections of the cavernous nerves were excised bilaterally (5 mm), followed by immediate bilateral surgical repair. A total of 20 study nerves per group were reconstructed by interposition of empty silicon tubes and silicon tubes seeded with either glial cell line-derived neurotrophic factor-overexpressing or green fluorescent protein-expressing Schwann cells. Control groups were either sham-operated or received bilateral nerve transection without nerve reconstruction. Erectile function was evaluated by relaparotomy, electrical nerve stimulation and intracavernous pressure recording after 2, 4, 6, 8 and 10 weeks. The animals underwent re-exploration only once, and were killed afterwards. The nerve grafts were investigated for the maturation state of regenerating nerve fibers and the fascular composition. Recovery of erectile function took at least 4 weeks in the current model. Glial cell line-derived neurotrophic factor-transduced Schwann cell grafts restored erectile function better than green fluorescent protein-transduced controls and unseeded conduits. Glial cell line-derived neurotrophic factor-transduced grafts promoted an intact erectile response (4/4) at 4, 6, 8 and 10 weeks that was overall significantly superior to negative controls (P cell line-derived neurotrophic factor-transduced grafts compared with negative controls (P = 0.018) and unseeded tubes (P = 0.034). Return of function was associated with the electron microscopic evidence of preganglionic myelinated nerve fibers and postganglionic unmyelinated axons. Schwann cell-mediated delivery of glial cell line-derived neurotrophic factor presents a viable approach for the treatment of erectile dysfunction after cavernous nerve injury. © 2013 The Japanese Urological Association.

  1. Dapsone versus corticosteroids in lichen planus

    Chopra Adarsh

    1999-01-01

    Full Text Available Seventy five patients with Lichen Planus (LP were enrolled from out-patient department for screening the therapeutic effect of dapsone. Patients were divided into two groups of 50 and 25. In regimen - 1 (RI 25 patients were given local corticosteroids and oral chlorpheniramine maleate. In regimen - 2 (R2 50 patients were given oral dapsone and chlorpheniramine maleate and topical coconut oil. It was found that total efficacy of R2 was 18% higher than R1.

  2. Endogenous synthesis of corticosteroids in the hippocampus.

    Shimpei Higo

    Full Text Available BACKGROUND: Brain synthesis of steroids including sex-steroids is attracting much attention. The endogenous synthesis of corticosteroids in the hippocampus, however, has been doubted because of the inability to detect deoxycorticosterone (DOC synthase, cytochrome P450(c21. METHODOLOGY/PRINCIPAL FINDINGS: The expression of P450(c21 was demonstrated using mRNA analysis and immmunogold electron microscopic analysis in the adult male rat hippocampus. DOC production from progesterone (PROG was demonstrated by metabolism analysis of (3H-steroids. All the enzymes required for corticosteroid synthesis including P450(c21, P450(2D4, P450(11β1 and 3β-hydroxysteroid dehydrogenase (3β-HSD were localized in the hippocampal principal neurons as shown via in situ hybridization and immunoelectron microscopic analysis. Accurate corticosteroid concentrations in rat hippocampus were determined by liquid chromatography-tandem mass spectrometry. In adrenalectomized rats, net hippocampus-synthesized corticosterone (CORT and DOC were determined to 6.9 and 5.8 nM, respectively. Enhanced spinogenesis was observed in the hippocampus following application of low nanomolar (10 nM doses of CORT for 1 h. CONCLUSIONS/SIGNIFICANCE: These results imply the complete pathway of corticosteroid synthesis of 'pregnenolone →PROG→DOC→CORT' in the hippocampal neurons. Both P450(c21 and P450(2D4 can catalyze conversion of PROG to DOC. The low nanomolar level of CORT synthesized in hippocampal neurons may play a role in modulation of synaptic plasticity, in contrast to the stress effects by micromolar CORT from adrenal glands.

  3. Cognitive outcome in adolescents and young adults after repeat courses of antenatal corticosteroids.

    Stålnacke, Johanna; Diaz Heijtz, Rochellys; Norberg, Hanna; Norman, Mikael; Smedler, Ann-Charlotte; Forssberg, Hans

    2013-08-01

    To investigate whether repeat courses of antenatal corticosteroids have long-term effects on cognitive and psychological functioning. In a prospective cohort study, 58 adolescents and young adults (36 males) who had been exposed to 2-9 weekly courses of betamethasone in utero were assessed with neuropsychological tests and behavior self-reports. Unexposed subjects (n = 44, 25 males) matched for age, sex, and gestational age at birth served as a comparison group. In addition, individuals exposed in utero to a single course (n = 25, 14 males) were included for dose-response analysis. Group differences were investigated using multilevel linear modeling. Mean scores obtained in 2 measures of attention and speed were significantly lower in subjects exposed to 2 or more antenatal corticosteroids courses (Symbol Search, P = .009; Digit Span Forward, P = .02), but these were not dose-dependent. Exposure to repeat courses of antenatal corticosteroids was not associated with general deficits in higher cognitive functions, self-reported attention, adaptability, or overall psychological function. Although this study indicates that repeat exposure to antenatal corticosteroids may have an impact on aspects of executive functioning, it does not provide support for the prevailing concern that such fetal exposure will have a major adverse impact on cognitive functions and psychological health later in life. Copyright © 2013 Mosby, Inc. All rights reserved.

  4. Corticosteroid Treatment in Diabetic Macular Edema

    Burcu Nurözler Tabakcı

    2017-06-01

    Full Text Available Diabetic macular edema is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of macular edema is complex and multifactorial. For many years, laser photocoagulation has been considered the standard therapy for the treatment of diabetic macular edema; however, few patients achieve significant improvements in visual acuity. Today the intravitreal administration of anti-inflammatory or anti-angiogenic agents together with the use of laser photocoagulation represents the standard of care for the treatment of this complication. The intravitreal route of administration minimizes the systemic side effects of corticosteroids. Steroid-related ocular side effects are elevated intraocular pressure and cataract, while injection-related complications include endophthalmitis, vitreous hemorrhage, and retinal detachment. In order to reduce the risks and complications, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated injections for the management of diabetic macular edema. In this review, the efficacy, safety, and therapeutic potential of intravitreal corticosteroids in diabetic macular edema are discussed with a review of recent literature.

  5. Human Salivary Gland Stem Cells Functionally Restore Radiation Damaged Salivary Glands

    Pringle, Sarah; Maimets, Martti; van der Zwaag, Marianne

    2016-01-01

    Adult stem cells are often touted as therapeutic agents in the regenerative medicine field, however data detailing both the engraftment and functional capabilities of solid tissue derived human adult epithelial stem cells is scarce. Here we show the isolation of adult human salivary gland (SG) st...... for the first time that salispheres cultured from human SGs contain stem/progenitor cells capable of self-renewal and differentiation and rescue of saliva production. Our study underpins the therapeutic promise of salisphere cell therapy for the treatment of xerostomia....

  6. Restoration of Function With Acupuncture Following Severe Traumatic Brain Injury: A Case Report.

    Wolf, Jacob; Sparks, Linda; Deng, Yong; Langland, Jeffrey

    2015-11-01

    This case report illustrates the improvement of an acupuncture-treated patient who incurred a severe traumatic brain injury (TBI) from a snowboarding accident. Over 4 years, the patient progressed from initially not being able to walk, having difficulty with speech, and suffering from poor eyesight to where he has now regained significant motor function, speech, and vision and has returned to snowboarding. A core acupuncture protocol plus specific points added to address the patient's ongoing concerns was used. This case adds to the medical literature by demonstrating the potential role of acupuncture in TBI treatment.

  7. Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty.

    Kisku, Sundeep; Varghese, Lilly; Kekre, Aruna; Sen, Sudipta; Karl, Sampath; Mathai, John; Thomas, Reju Joseph; Barla, Ravi Kishore

    2014-10-01

    Cervicovaginal atresia is a rare Mullerian anomaly. The management of cervicovaginal atresia has evolved from historical recommendations of hysterectomy to various reconstructive procedures more recently. The latter carries a risk of significant morbidity and unknown fertility. We present our experience in the management of this complex anomaly. Twenty patients with cervicovaginal atresia were operated in our hospital from January 2004 through December 2013. The details of their anatomical variations and functional outcomes were analyzed. Eighteen out of twenty patients had cervical agenesis. Two patients had cervical hypoplasia. All patients underwent utero-coloneovaginoplasty. Post operatively, all patients have regular menstrual cycles. One patient is married, sexually active and has satisfactory coital function. One patient had a bowel anastomotic leak that required a diversion ileostomy. Two patients developed mild stenosis. One patient has mild neovaginal mucosal prolapse. No patient has developed pyometra. Patients with cervicovaginal atresia need to be counselled about the various reconstructive options available and the potential risks. Social and economic factor play a significant role in determining the plan of management. For patients from conservative societies, utero-coloneovaginoplasty provides a safe conduit for the passage of menstrual flow and coitus, at the cost of permanent infertility.

  8. Plant functional groups of potential restoration use in advancing edges of high Andean forests

    Castellanos Castro, Carolina; Bonilla, Maria Argenis

    2011-01-01

    The study of plant functional groups constitutes a useful tool in the identification of ecological characteristics relevant in community regeneration. The aim of this study was to identify plant's functional groups in high Andean forest advance edges and to evaluate their role during secondary succession in abandoned pasture lands. Based on 10 x 10 m vegetation relevees for the shrubby-arboreal stratum and 1 x 1 m plots for the herbaceous stratum and the revision of vital attributes for each of the species found, this study uses a multivariate approach to construct a trait-based emergent group's classification. The most important attributes in the definition of the groups were the dispersion mechanism and the presence of basal trunk ramification in woody species; in addition differences in the presence of vegetative propagation, specific leaf area index and the ratio height/diameter at breast height were found between groups of the shrubby-arboreal stratum. Four distinct groups were defined in the herbaceous layer and five in the shrubby-arboreal layer, each group contains species with similar colonization strategies. Among the defined groups, the herbaceous species dispersed by various abiotic factors, the shrubby species with basal ramification and dispersed by wind and the species dispersed by birds constitute key strategies in forest recovery in adjacent abandoned pasture lands dominated by Holcus lanatus, and facilitate the establishment of secondary forest species.

  9. Mechanism of Restoration of Forelimb Motor Function after Cervical Spinal Cord Hemisection in Rats: Electrophysiological Verification

    Takumi Takeuchi

    2017-01-01

    Full Text Available The objective of this study was to electrophysiologically assess the corticospinal tracts of adult rats and the recovery of motor function of their forelimbs after cervical cord hemisection. Of 39 adult rats used, compound muscle action potentials (CMAPs of the forelimbs of 15 rats were evaluated, before they received left C5 segmental hemisection of the spinal cord, by stimulating the pyramid of the medulla oblongata on one side using an exciting microelectrode. All 15 rats exhibited contralateral electrical activity, but their CMAPs disappeared after hemisection. The remaining 24 rats received hemisection first, and CMAPs of 12 rats were assessed over time to study their recovery time. All of them exhibited electrical activity of the forelimbs in 4 weeks after surgery. The remaining 12 rats received additional right C2 segmental hemisection, and variation of CMAPs between before and after surgery was examined. The right side of the 12 rats that received the additional hemisection exhibited no electrical activity in response to the stimulation of the pyramids on both sides. These results suggest that changes in path between the resected and healthy sides, activation of the ventral corticospinal tracts, and propriospinal neurons were involved in the recovery of motor function after cervical cord injury.

  10. T cells in chronic lymphocytic leukaemia display an exhausted phenotype and impaired functionality that can be restored by chemotherapy

    Gassner, F.

    2012-01-01

    In chronic lymphocytic leukaemia (CLL), beside a massive accumulation of neoplastic B cells, tumour-induced deficiencies in autologous T cells have been reported that impede efficient tumour control and might even support survival of the malignant clone. Here, we investigated our hypothesis that T cells in CLL, due to the persistent availability of tumour antigen, are exhausted, and that reduction of tumour load by chemotherapy might restore T cell functions. We could show that T cells in CLL patients and in a CLL mouse model display an exhausted phenotype, with high expression of the inhibitory surface receptor PD-1, that is clearly induced by the presence of tumour cells. Although the PD-1 ligand PD-L1 is not expressed on peripheral CLL cells, abundant expression could be shown in lymph node sections. Intriguingly, blocking the PD-1/PD-L1 pathway increased short term tumour lysis in a murine in vivo cytotoxicity assay. Furthermore, we present data that after cytoreduction by fludarabine, a standard chemotherapy agent for CLL, the surviving T cell pool consists mainly of fully functional memory T cells with high proliferative potential and increased secretion of pro-inflammatory Th1 cytokines. Taken together, we conclude that the impaired tumour surveillance observed in CLL might be rooted in the exhaustion of tumour-specific effector T cells. A combination of cytodepletion by chemotherapy and blockade of PD-1 might hence represent a novel therapeutic approach for CLL. (author) [de

  11. Morphology of Donor and Recipient Nerves Utilised in Nerve Transfers to Restore Upper Limb Function in Cervical Spinal Cord Injury

    Aurora Messina

    2016-09-01

    Full Text Available Loss of hand function after cervical spinal cord injury (SCI impacts heavily on independence. Multiple nerve transfer surgery has been applied successfully after cervical SCI to restore critical arm and hand functions, and the outcome depends on nerve integrity. Nerve integrity is assessed indirectly using muscle strength testing and intramuscular electromyography, but these measures cannot show the manifestation that SCI has on the peripheral nerves. We directly assessed the morphology of nerves biopsied at the time of surgery, from three patients within 18 months post injury. Our objective was to document their morphologic features. Donor nerves included teres minor, posterior axillary, brachialis, extensor carpi radialis brevis and supinator. Recipient nerves included triceps, posterior interosseus (PIN and anterior interosseus nerves (AIN. They were fixed in glutaraldehyde, processed and embedded in Araldite Epon for light microscopy. Eighty percent of nerves showed abnormalities. Most common were myelin thickening and folding, demyelination, inflammation and a reduction of large myelinated axon density. Others were a thickened perineurium, oedematous endoneurium and Renaut bodies. Significantly, very thinly myelinated axons and groups of unmyelinated axons were observed indicating regenerative efforts. Abnormalities exist in both donor and recipient nerves and they differ in appearance and aetiology. The abnormalities observed may be preventable or reversible.

  12. Cortical control of intraspinal microstimulation: Toward a new approach for restoration of function after spinal cord injury.

    Shahdoost, Shahab; Frost, Shawn; Dunham, Caleb; DeJong, Stacey; Barbay, Scott; Nudo, Randolph; Mohseni, Pedram

    2015-08-01

    Approximately 6 million people in the United States are currently living with paralysis in which 23% of the cases are related to spinal cord injury (SCI). Miniaturized closed-loop neural interfaces have the potential for restoring function and mobility lost to debilitating neural injuries such as SCI by leveraging recent advancements in bioelectronics and a better understanding of the processes that underlie functional and anatomical reorganization in an injured nervous system. This paper describes our current progress toward developing a miniaturized brain-machine-spinal cord interface (BMSI) that converts in real time the neural command signals recorded from the cortical motor regions to electrical stimuli delivered to the spinal cord below the injury level. Using a combination of custom integrated circuit (IC) technology for corticospinal interfacing and field-programmable gate array (FPGA)-based technology for embedded signal processing, we demonstrate proof-of-concept of distinct muscle pattern activation via intraspinal microstimulation (ISMS) controlled in real time by intracortical neural spikes in an anesthetized laboratory rat.

  13. Engineered disulfide bonds restore chaperone-like function of DJ-1 mutants linked to familial Parkinson's disease.

    Logan, Todd; Clark, Lindsay; Ray, Soumya S

    2010-07-13

    Loss-of-function mutations such as L166P, A104T, and M26I in the DJ-1 gene (PARK7) have been linked to autosomal-recessive early onset Parkinson's disease (PD). Cellular and structural studies of the familial mutants suggest that these mutations may destabilize the dimeric structure. To look for common dynamical signatures among the DJ-1 mutants, short MD simulations of up to 1000 ps were conducted to identify the weakest region of the protein (residues 38-70). In an attempt to stabilize the protein, we mutated residue Val 51 to cysteine (V51C) to make a symmetry-related disulfide bridge with the preexisting Cys 53 on the opposite subunit. We found that the introduction of this disulfide linkage stabilized the mutants A104T and M26I against thermal denaturation, improved their ability to scavenge reactive oxygen species (ROS), and restored a chaperone-like function of blocking alpha-synuclein aggregation. The L166P mutant was far too unstable to be rescued by introduction of the V51C mutation. The results presented here point to the possible development of pharmacological chaperones, which may eventually lead to PD therapeutics.

  14. Restoration of tryptophan hydroxylase functions and serotonin content in the Atlantic croaker hypothalamus by antioxidant treatment during hypoxic stress

    Md. Saydur Rahman

    2014-05-01

    Full Text Available Antioxidants are prototypical scavengers of oxygen-free radicals and have been shown to prevent neuroendocrine dysfunction in vertebrates during oxidative stress. In the present study, we investigated whether antioxidant treatment can reverse hypoxia-induced down-regulation of hypothalamic tryptophan hydroxylase (TPH and serotonergic functions in Atlantic croaker. Hypothalamic neuronal contents of TPH-1 and TPH-2 proteins, serotonin (5-hydroxytryptamine, 5-HT and its precursor, 5-hydroxytryptophan (5-HTP as well as hypothalamic TPH-1 and TPH-2 mRNA expression and TPH activity were measured in croaker after exposure to hypoxia and treatment with pharmacological agents. Multiple injections of N-ethylmaleimide, a sulfhydryl alkylating agent, caused comparable decreases in hypothalamic TPHs functions and 5-HT contents to that induced by hypoxia exposure (dissolved oxygen: 1.7 mg/L for 4 weeks which were partially restored by repeated injections with a nitric oxide synthase (NOS-inhibitor and/or vitamin E. Double-labeled immunohistochemical results showed that TPHs and 5-HT neurons were co-expressed with neuronal NOS (nNOS, a neuroenzyme that catalyzes the production of nitric oxide, a free radical, in hypothalamic neurons. These results suggest that hypoxia-induced impairment of TPH and serotonergic functions are mediated by nNOS and involve the generation of free radicals and a decrease in the antioxidant status. This study provides, to our knowledge, the first evidence of a protective role for an antioxidant in maintaining neural TPHs functions and 5-HT regulation in an aquatic vertebrate during hypoxic stress.

  15. Satisfaction After Restoring Aesthetics and Function in a Child with Amelogenesis Imperfecta: A Case Report

    Nihal Özcan

    2016-08-01

    Full Text Available Amelogenesis imperfecta (AI is a hereditary disorder that disrupts the formation of enamel in both primary and permanent dentition. Management of AI is a challenge for the patient and the clinician. This case report presents the management of AI in a six-year-old female patient. Considering the patient’s age, we decided to make removable dentures in order to avoid growth and development problems. Conventional complete dentures were made, vertical dimension was increased, and the desired aesthetics and function were gained. Additionally, satisfaction with prosthodontic rehabilitation was evaluated using a questionnaire. A high level of patient and parent satisfaction was obtained. Treatment planning for patients with AI is related to many factors including the age and socioeconomic status of the patient, the type and severity of the disorder, the intraoral situation at the time the treatment is planned and most importantly, cooperation of the patient plays a major role.

  16. Restoration of Liver Function and Portosystemic Pressure Gradient after TIPSS and Late TIPSS Occlusion

    Maedler, U.; Hansmann, J.; Duex, M.; Noeldge, G.; Sauer, P.; Richter, G.M.

    2002-01-01

    TIPSS (transjugular intrahepatic portosystemic shunt) may be indicated to control bleeding from esophageal and gastric varicose veins, to reduce ascites, and to treat patients with Budd-Chiari syndrome and veno-occlusive disease. Numerous measures to improve the safety and methodology of the procedure have helped to increase the technical and clinical success. Follow-up of TIPSS patients has revealed shunt stenosis to occur more often in patients with preserved liver function (Child A, Child B). In addition, the extent of liver cirrhosis is the main factor that determines prognosis in the long term. Little is known about the effects of TIPSS with respect to portosystemic hemodynamics. This report deals with a cirrhotic patient who stopped drinking 7 months prior to admission. He received TIPSS to control ascites and recurrent esophageal bleeding. Two years later remarkable hypertrophy of the left liver lobe and shunt occlusion was observed. The portosystemic pressure gradient dropped from 24 mmHg before TIPSS to 11 mmHg and remained stable after shunt occlusion. The Child's B cirrhosis prior to TIPSS turned into Child's A cirrhosis and remained stable during the follow-up period of 32 months. This indicates that liver function of TIPSS patients may recover due to hypertrophy of the remaining non-cirrhotic liver tissue. In addition the hepatic hemodynamics may return to normal. In conclusion, TIPSS cannot cure cirrhosis but its progress may be halted if the cause can be removed. This may result in a normal portosystemic gradient, leading consequently to shunt occlusion

  17. Functional outcome and quality of life following restorative proctocolectomy for ulcerative colitis in Indians.

    Somashekar, Uday; Gupta, Subash; Soin, Arvinder; Nundy, Samiran

    2010-08-01

    The functional outcome and quality of life after sphincter-saving operations for ulcerative colitis have not been previously assessed in Indian patients whose dietary habits and socio-cultural practices differ considerably from those in western countries. Between 1996 and 2002, we performed 46 J-pouch ileoanal anastomoses (IPAA), for patients with ulcerative colitis. Thirty-eight of these patients had had their ileostomy closure more than 4 years previously of whom 31 could be assessed by interviews and a telephonic questionnaire. Their quality of life was objectively assessed using the Cleveland Global Quality of Life (CGQL) index, a validated index for IPAA, the score being 1 in normal people. There were 20 males and 11 females with a mean age of 38 years. In the same period, six of the nine patients who did not opt to have an IPAA (permanent stoma) were assessed. These included four males and two females, mean age 45 years (36-52). One patient died in the postoperative period and another died 3 months after surgery from multiple small bowel perforations. Other complications included intestinal obstruction in seven, pouchitis in four and incisional hernia in two. One pouch had to be converted to a permanent ileostomy following development of a fistula because of Crohn's disease. The mean daily postoperative stool frequency was seven (range 2-20). Eighty-one percent had perfect daytime continence and 81% used dietary restrictions. Eighty-four percent rated their pouch function to be excellent or good. All patients preferred IPAA to an ileostomy citing mainly social and cultural reasons and were willing to choose it again. The mean preoperative CGQL score (0.27) increased significantly after colectomy (0.50) and after closure of ileostomy (0.77; p quality of life in Indians with ulcerative colitis and may be the most appropriate procedure for such patients in developing countries.

  18. Reach-scale stream restoration in agricultural streams of southern Minnesota alters structural and functional responses of macroinvertebrates

    Dolph, Christine L.; Eggert, Susan L.; Magner, Joe; Ferrington, Leonard C.; Vondracek, Bruce C.

    2015-01-01

    Recent studies suggest that stream restoration at the reach scale may not increase stream biodiversity, raising concerns about the utility of this conservation practice. We examined whether reach-scale restoration in disturbed agricultural streams was associated with changes in macroinvertebrate community structure (total macroinvertebrate taxon richness, total macroinvertebrate density, Ephemeroptera, Plecoptera, Trichoptera [EPT] taxon richness, % abundance of EPT taxa) or secondary production (macroinvertebrate biomass over time). We collected macroinvertebrate samples over the course of 1 y from restored and unrestored reaches of 3 streams in southern Minnesota and used generalized least-square (GLS) models to assess whether measures of community structure were related to reach type, stream site, or sampling month. After accounting for effects of stream site and time, we found no significant difference in total taxon richness or % abundance of EPT taxa between restored and unrestored reaches. However, the number of EPT taxa and macroinvertebrate density were significantly higher in restored than in unrestored reaches. We compared secondary production estimates among study reaches based on 95th-percentile confidence intervals generated via bootstrapping. In each study stream, secondary production was significantly (2–3×) higher in the restored than in the unrestored reach. Higher productivity in the restored reaches was largely a result of the disproportionate success of a few dominant, tolerant taxa. Our findings suggest that reach-scale restoration may have ecological effects that are not detected by measures of total taxon richness alone.

  19. Dynamics of Corticosteroid Receptors: Lessons from Live Cell Imaging

    Nishi, Mayumi

    2011-01-01

    Adrenal corticosteroids (cortisol in humans or corticosterone in rodents) exert numerous effects on the central nervous system that regulates the stress response, mood, learning and memory, and various neuroendocrine functions. Corticosterone (CORT) actions in the brain are mediated via two receptor systems: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR). It has been shown that GR and MR are highly colocalized in the hippocampus. These receptors are mainly distributed in the cytoplasm without hormones and translocated into the nucleus after treatment with hormones to act as transcriptional factors. Thus the subcellular dynamics of both receptors are one of the most important issues. Given the differential action of MR and GR in the central nervous system, it is of great consequence to clarify how these receptors are trafficked between cytoplasm and nucleus and their interactions are regulated by hormones and/or other molecules to exert their transcriptional activity. In this review, we focus on the nucleocytoplasmic and subnuclear trafficking of GR and MR in neural cells and non-neural cells analyzed by using molecular imaging techniques with green fluorescent protein (GFP) including fluorescence recovery after photobleaching (FRAP) and fluorescence resonance energy transfer (FRET), and discuss various factors affecting the dynamics of these receptors. Furthermore, we discuss the future directions of in vivo molecular imaging of corticosteroid receptors at the whole brain level

  20. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    Kongsgaard, M.; Kovanen, V.; Aagaard, P.

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male...

  1. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    Peters-Veluthamaningal, Cyriac; Winters, Jan C.; Groenier, Klaas H.; Meyboom-deJong, Betty

    2009-01-01

    Background: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local

  2. Corticosteroid injection for tennis elbow or lateral epicondylitis: a review of the literature

    Saccomanni, Bernardino

    2010-01-01

    Lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons. Corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow. Here, a review of the medical literature on this treatment is presented.

  3. TROPICS 1: a phase III, randomized, double-blind, placebo-controlled study of tenecteplase for restoration of function in dysfunctional central venous catheters.

    Gabrail, Nashat; Sandler, Eric; Charu, Veena; Anas, Nick; Lim, Eduardo; Blaney, Martha; Ashby, Mark; Gillespie, Barbara S; Begelman, Susan M

    2010-12-01

    To evaluate the efficacy and safety of the thrombolytic tenecteplase, a fibrin-specific recombinant tissue plasminogen activator, for restoring function to dysfunctional central venous catheters (CVCs). In this double-blind, placebo-controlled study, eligible patients with dysfunctional nonhemodialysis CVCs were randomly assigned to two treatment arms. In the first arm (TNK-TNK-PBO), patients received an initial dose of intraluminal tenecteplase (TNK) (up to 2 mg), a second dose of tenecteplase if indicated, and a third placebo (PBO) dose. In the PBO-TNK-TNK arm, placebo was instilled first followed by up to two doses of tenecteplase, if needed, for restoration of catheter function. After administration of each dose, CVC function was assessed at 15, 30, and 120 minutes. There were 97 patients who received either TNK-TNK-PBO (n = 50) or PBO-TNK-TNK (n = 47). Within 120 minutes of initial study drug instillation, catheter function was restored to 30 patients (60%) in the TNK-TNK-PBO arm and 11 patients (23%) in the PBO-TNK-TNK arm, for a treatment difference of 37 percentage points (95% confidence interval 18-55; P = .0002). Cumulative restoration rates for CVC function increased to 87% after the second dose of tenecteplase in both study arms combined. Two patients developed a deep vein thrombosis (DVT) after exposure to tenecteplase; one DVT was considered to be drug related. No cases of intracranial hemorrhage, major bleeding, embolic events, catheter-related bloodstream infections, or catheter-related complications were reported. Tenecteplase was efficacious for restoration of catheter function in these study patients with dysfunctional CVCs. Copyright © 2010 SIR. Published by Elsevier Inc. All rights reserved.

  4. Effects of overstory retention, herbicides, and fertilization on sub-canopy vegetation structure and functional group composition in loblolly pine forests restored to longleaf pine

    Benjamin O. Knapp; Joan L. Walker; G. Geoff Wang; Huifeng Hu; Robert N.  Addington

    2014-01-01

    The desirable structure of longleaf pine forests, which generally includes a relatively open canopy of pines, very few woody stems in the mid-story, and a well-developed, herbaceous ground layer, provides critical habitat for flora and fauna and contributes to ecosystem function. Current efforts to restore longleaf pine to upland sites dominated by second-growth...

  5. Corticosteroid hypersensitivity studies in a skin allergy clinic.

    Berbegal, L; DeLeon, F J; Silvestre, J F

    2015-12-01

    Corticosteroids can cause hypersensitivity reactions, particularly delayed-type allergic reactions. A new classification system for testing hypersensitivity to corticosteroids distributes the drugs into 3 groups according to molecular structure; patients are classified according to whether they are allergic to agents in 1 or more of the groups. We aimed to describe the clinical characteristics of corticosteroid-allergic patients treated at our clinic and apply the new classification system to them; we also compared these patients' characteristics to those of others treated at our clinic. Retrospective study of cases of delayed-type corticosteroid hypersensitivity treated in the skin allergy clinic of a tertiary level hospital over an 11-year period. We reviewed the records of 2857 patients, finding 33 with at least one positive patch test result showing corticosteroid hypersensitivity. Atopic dermatitis and hand involvement were less common in our corticosteroid-allergic patients. All were allergic to a group 1 corticosteroid (most often, budesonide, the culprit in 87.9%). Testing with a specific corticosteroid series revealed that 14 (42.4%) were also allergic to corticosteroids in group 2 and/or group 3. None were allergic exclusively to group 2 or group 3 agents. Twenty-one patients were exposed to a corticosteroid cream from a group their patch test results indicated allergy to; 13 of them (61.9%) did not develop a hypersensitivity reaction. The Spanish standard series only contains group 1 corticosteroids. In the interest of improving allergy management, we recommend testing with a specific corticosteroid series and a patient's own creams whenever patch testing with a standard series reveals a hypersensitivity reaction to corticosteroids. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  6. Regenerating reptile retinas: a comparative approach to restoring retinal ganglion cell function.

    Williams, D L

    2017-02-01

    Transection or damage to the mammalian optic nerve generally results in loss of retinal ganglion cells by apoptosis. This cell death is seen less in fish or amphibians where retinal ganglion cell survival and axon regeneration leads to recovery of sight. Reptiles lie somewhere in the middle of this spectrum of nerve regeneration, and different species have been reported to have a significant variation in their retinal ganglion cell regenerative capacity. The ornate dragon lizard Ctenophoris ornatus exhibits a profound capacity for regeneration, whereas the Tenerife wall lizard Gallotia galloti has a more variable response to optic nerve damage. Some individuals regain visual activity such as the pupillomotor responses, whereas in others axons fail to regenerate sufficiently. Even in Ctenophoris, although the retinal ganglion cell axons regenerate adequately enough to synapse in the tectum, they do not make long-term topographic connections allowing recovery of complex visually motivated behaviour. The question then centres on where these intraspecies differences originate. Is it variation in the innate ability of retinal ganglion cells from different species to regenerate with functional validity? Or is it variances between different species in the substrate within which the nerves regenerate, the extracellular environment of the damaged nerve or the supporting cells surrounding the regenerating axons? Investigations of retinal ganglion cell regeneration between different species of lower vertebrates in vivo may shed light on these questions. Or perhaps more interesting are in vitro studies comparing axon regeneration of retinal ganglion cells from various species placed on differing substrates.

  7. Evolutionary and functional mitogenomics associated with the genetic restoration of the Florida panther

    Ochoa, Alexander; Onorato, David P.; Fitak, Robert R.; Roelke-Parker, Melody; Culver, Melanie

    2017-01-01

    Florida panthers are endangered pumas that currently persist in reduced patches of habitat in South Florida, USA. We performed mitogenome reference-based assemblies for most parental lines of the admixed Florida panthers that resulted from the introduction of female Texas pumas into South Florida in 1995. With the addition of 2 puma mitogenomes, we characterized 174 single nucleotide polymorphisms (SNPs) across 12 individuals. We defined 5 haplotypes (Pco1–Pco5), one of which (Pco1) had a geographic origin exclusive to Costa Rica and Panama and was possibly introduced into the Everglades National Park, Florida, prior to 1995. Haplotype Pco2 was native to Florida. Haplotypes Pco3 and Pco4 were exclusive to Texas, whereas haplotype Pco5 had an undetermined geographic origin. Phylogenetic inference suggests that haplotypes Pco1–Pco4 diverged ~202000 (95% HPDI = 83000–345000) years ago and that haplotypes Pco2–Pco4 diverged ~61000 (95% HPDI = 9000–127000) years ago. These results are congruent with a south-to-north continental expansion and with a recent North American colonization by pumas. Furthermore, pumas may have migrated from Texas to Florida no earlier than ~44000 (95% HPDI = 2000–98000) years ago. Synonymous mutations presented a greater mean substitution rate than other mitochondrial functional regions: nonsynonymous mutations, tRNAs, rRNAs, and control region. Similarly, all protein-coding genes were under predominant negative selection constraints. We directly and indirectly assessed the presence of potential deleterious SNPs in the ND2 and ND5 genes in Florida panthers prior to and as a consequence of the introduction of Texas pumas. Screenings for such variants are recommended in extant Florida panthers.

  8. Aerobic Swim Training Restores Aortic Endothelial Function by Decreasing Superoxide Levels in Spontaneously Hypertensive Rats

    Camila P. Jordão

    endothelial function.

  9. Treatment with salvianolic acid B restores endothelial function in angiotensin II-induced hypertensive mice.

    Ling, Wei Chih; Liu, Jian; Lau, Chi Wai; Murugan, Dharmani Devi; Mustafa, Mohd Rais; Huang, Yu

    2017-07-15

    Salvianolic acid B (Sal B) is one of the most abundant phenolic acids derived from the root of Danshen with potent anti-oxidative properties. The present study examined the vasoprotective effect of Sal B in hypertensive mice induced by angiotensin II (Ang II). Sal B (25mg/kg/day) was administered via oral gavage for 11days to Ang II (1.2mg/kg/day)-infused C57BL/6J mice (8-10weeks old). The vascular reactivity (both endothelium-dependent relaxations and contractions) in mouse arteries was examined by wire myography. The production of reactive oxygen species (ROS), protein level and localization of angiotensin AT 1 receptors and the proteins involved in ROS formation were evaluated using dihydroethidium (DHE) fluorescence, lucigenin-enhanced chemiluminescence, immunohistochemistry and Western blotting, respectively. The changes of ROS generating proteins were also assessed in vitro in human umbilical vein endothelial cells (HUVECs) exposed to Ang II with and without co-treatment with Sal B (0.1-10nM). Oral administration of Sal B reversed the Ang II-induced elevation of arterial systolic blood pressure in mice, augmented the impaired endothelium-dependent relaxations and attenuated the exaggerated endothelium-dependent contractions in both aortas and renal arteries of Ang II-infused mice. In addition, Sal B treatment normalized the elevated levels of AT 1 receptors, NADPH oxidase subunits (NOx-2 and NOx-4) and nitrotyrosine in arteries of Ang II-infused mice or in Ang II-treated HUVECs. In summary, the present study provided additional evidence demonstrating that Sal B treatment for 11days reverses the impaired endothelial function and with a marked inhibition of AT 1 receptor-dependent vascular oxidative stress. This vasoprotective and anti-oxidative action of Sal B most likely contributes to the anti-hypertensive action of the plant-derived compound. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Neutrophil degranulation and immunosuppression in patients with GBM: restoration of cellular immune function by targeting arginase I.

    Sippel, Trisha R; White, Jason; Nag, Kamalika; Tsvankin, Vadim; Klaassen, Marci; Kleinschmidt-DeMasters, B K; Waziri, Allen

    2011-11-15

    The source of glioblastoma (GBM)-associated immunosuppression remains multifactorial. We sought to clarify and therapeutically target myeloid cell-derived peripheral immunosuppression in patients with GBM. Direct ex vivo T-cell function, serum Arginase I (ArgI) levels, and circulating myeloid lineage populations were compared between patients with GBM and normal donors or patients with other intracranial tumors. Immunofunctional assays were conducted using bulk and sorted cell populations to explore the potential transfer of myeloid cell-mediated immunosuppression and to identify a potential mechanism for these effects. ArgI-mediated immunosuppression was therapeutically targeted in vitro through pharmacologic inhibition or arginine supplementation. We identified a significantly expanded population of circulating, degranulated neutrophils associated with elevated levels of serum ArgI and decreased T-cell CD3ζ expression within peripheral blood from patients with GBM. Sorted CD11b(+) cells from patients with GBM were found to markedly suppress normal donor T-cell function in coculture, and media harvested from mitogen-stimulated GBM peripheral blood mononuclear cell (PBMC) or GBM-associated mixed lymphoid reactions showed ArgI levels that were significantly higher than controls. Critically, T-cell suppression in both settings could be completely reversed through pharmacologic ArgI inhibition or with arginine supplementation. These data indicate that peripheral cellular immunosuppression in patients with GBM is associated with neutrophil degranulation and elevated levels of circulating ArgI, and that T-cell function can be restored in these individuals by targeting ArgI. These data identify a novel pathway of GBM-mediated suppression of cellular immunity and offer a potential therapeutic window for improving antitumor immunity in affected patients.

  11. Poststroke upper-limb rehabilitation using 5 to 7 inserted microstimulators: implant procedure, safety, and efficacy for restoration of function.

    Davis, Ross; Sparrow, Owen; Cosendai, Gregoire; Burridge, Jane H; Wulff, Christian; Turk, Ruth; Schulman, Joseph

    2008-10-01

    To investigate the feasibility of implanting microstimulators to deliver programmed nerve stimulation for sequenced muscle activation to recover arm-hand functions. By using a minimally invasive procedure and local anesthesia, 5 to 7 microstimulators can be safely and comfortably implanted adjacent to targeted radial nerve branches in the arm and forearm of 7 subjects with poststroke paresis. The microstimulators' position should remain stable with no tissue infection and can be programmed to produce effective personalized functional muscle activity with no discomfort for a preliminary 12-week study. Clinical testing, before and after the study, is reported in the accompanying study. Microstimulator implantations in a sterile operating room. Seven adults, with poststroke hemiparesis of 12 months or more. Under local anesthesia, a stimulating probe was inserted to identify radial nerve branches. Microstimulators were inserted by using an introducer and were retrievable for 6 days by attached suture. Each device was powered via a radiofrequency link from 2 external cuff coils connected to a control unit. To achieve low threshold values at the target sites with minimal implant discomfort. Microstimulators and external equipment were monitored over 12 weeks of exercise. Seven subjects were implanted with 41 microstimulators, 5 to 7 per subject, taking 3.5 to 6 hours. Implantation pain levels were 20% more than anticipated. No infections or microstimulator failures occurred. Mean nerve thresholds ranged between 4.0 to 7.7 microcoulomb/cm(2)/phase over 90 days, indicating that cathodes were within 2 to 4 mm of target sites. In 1 subject, 2 additional microstimulators were inserted. Microstimulators were safely implanted with no infection or failure. The system was reliable and programmed effectively to perform exercises at home for functional restoration.

  12. Restoration of muscle mitochondrial function and metabolic flexibility in type 2 diabetes by exercise training is paralleled by increased myocellular fat storage and improved insulin sensitivity.

    Meex, Ruth C R; Schrauwen-Hinderling, Vera B; Moonen-Kornips, Esther; Schaart, Gert; Mensink, Marco; Phielix, Esther; van de Weijer, Tineke; Sels, Jean-Pierre; Schrauwen, Patrick; Hesselink, Matthijs K C

    2010-03-01

    Mitochondrial dysfunction and fat accumulation in skeletal muscle (increased intramyocellular lipid [IMCL]) have been linked to development of type 2 diabetes. We examined whether exercise training could restore mitochondrial function and insulin sensitivity in patients with type 2 diabetes. Eighteen male type 2 diabetic and 20 healthy male control subjects of comparable body weight, BMI, age, and VO2max participated in a 12-week combined progressive training program (three times per week and 45 min per session). In vivo mitochondrial function (assessed via magnetic resonance spectroscopy), insulin sensitivity (clamp), metabolic flexibility (indirect calorimetry), and IMCL content (histochemically) were measured before and after training. Mitochondrial function was lower in type 2 diabetic compared with control subjects (P = 0.03), improved by training in control subjects (28% increase; P = 0.02), and restored to control values in type 2 diabetic subjects (48% increase; P type 2 diabetic subjects (delta Rd 63% increase; P type 2 diabetic subjects was restored (delta respiratory exchange ratio 63% increase; P = 0.01) but was unchanged in control subjects (delta respiratory exchange ratio 7% increase; P = 0.22). Starting with comparable pretraining IMCL levels, training tended to increase IMCL content in type 2 diabetic subjects (27% increase; P = 0.10), especially in type 2 muscle fibers. Exercise training restored in vivo mitochondrial function in type 2 diabetic subjects. Insulin-mediated glucose disposal and metabolic flexibility improved in type 2 diabetic subjects in the face of near-significantly increased IMCL content. This indicates that increased capacity to store IMCL and restoration of improved mitochondrial function contribute to improved muscle insulin sensitivity.

  13. Capsule-Preserving Hydrodilatation With Corticosteroid Versus Corticosteroid Injection Alone in Refractory Adhesive Capsulitis of Shoulder: A Randomized Controlled Trial.

    Lee, Doo-Hyung; Yoon, Seung-Hyun; Lee, Michael Y; Kwack, Kyu-Sung; Rah, Ueon Woo

    2017-05-01

    To determine whether capsule-preserved hydrodilatation with corticosteroid improves pain and function in patients with refractory adhesive capsulitis (AC) better than intra-articular corticosteroid injection (IACI) alone. Prospective randomized controlled study. University-affiliated tertiary care hospital. Subjects with primary AC (N=64) with shoulder pain level of visual analog scale (VAS) score ≥5, even after the initial administration of IACI alone. Participants randomly received ultrasound-guided IACI alone with 1mL of 40mg/mL triamcinolone acetonide and 3mL of 1% lidocaine (n=32) or ultrasound-guided capsule-preserved hydrodilatation with corticosteroid with a mixture of 1mL of 40mg/mL triamcinolone acetonide, 6mL of 1% lidocaine, and normative saline (n=32). The primary outcome measure was the Shoulder Pain and Disability Index score. Secondary outcomes were the VAS of shoulder pain level and angles of shoulder passive range of motion, including flexion, abduction, extension, external rotation, and internal rotation at pretreatment and weeks 3, 6, and 12 of posttreatment. There were no significant differences between the 2 groups in terms of demographic characteristics (age, sex, duration of symptoms, shoulder affected, and body mass index) at baseline. Repeated-measures analysis of variance showed significant effect of time in all outcome measurements in both groups. However, group-by-time interactions were not significantly different for any of the outcomes between groups. This study shows that compared with pretreatment, all outcome measures improved significantly in both groups by time; however, there was no significant difference between the 2 groups. Therefore, we recommend IACI alone over capsule-preserved hydrodilatation with corticosteroid when considering the corticosteroid injection as a secondary option after the initial IACI fails to improve symptoms for patients with refractory AC. Copyright © 2016 American Congress of Rehabilitation

  14. Ecosystem Restoration: Fact or Fancy?

    John A. Stanturf; Callie J. Schweitzer; Stephen H. Schoenholtz; James P. Barnett; Charles K. McMahon; Donald J. Tomszak

    1998-01-01

    Ecological restoration is generally accepted as the reestablishment of natural ecological processes that produce certain dynamic ecosystem properties of structure, function, and processes. But restore to what? The most frequently used conceptual model for the restoration process is the shift of conditions from some current (degraded) dynamic state to some past dynamic...

  15. Monitoring long-term oral corticosteroids.

    Mundell, Lewis; Lindemann, Roberta; Douglas, James

    2017-01-01

    Corticosteroids are synthetic analogues of human hormones normally produced by the adrenal cortex. They have both glucocorticoid and mineralocorticoid properties. The glucocortoid components are anti-inflammatory, immunosuppressive, anti-proliferative and vasoconstrictive. They influence the metabolism of carbohydrate and protein, in addition to playing a key role in the body's stress response. Mineralocorticoid's main significance is in the balance of salt and water concentrations. Due to the combination of these effects, corticosteroids can cause many adverse effects. Oral corticosteroids are absorbed systemically and are therefore more likely to cause adverse effects than topical or inhaled corticosteroids. Furthermore, it is assumed that greater duration of treatment will lead to a greater number of adverse effects, and therefore the most at risk group are those taking high dose, long-term oral corticosteroids (LTOC). High dose is defined as a prescription of >5 mg oral prednisolone and long term as duration of treatment >1 month (based on National Institute for Health and Care Excellence guidance for patient's 'at risk' of systemic side effects). Parameters to be monitored in primary care include weight, blood pressure, triglycerides, glucose and urea and electrolytes. From clinical experience within the general practice setting, the authors propose that these patients do not receive adequate baseline monitoring before starting corticosteroids nor are these markers monitored consistently thereafter. This project intended to evidence this claim, evaluate the adverse effect profile and improve monitoring in this patient group. The initial audit of 22 patients, within a single general practice, detected at least one documented adverse effect in 64% of patients, while 41% reported more than one adverse effect. 45% had recorded weight gain, 18% had recorded osteoporosis, 18% had at least one recorded cataract, 14% had recorded Hypertension, 14% had recorded

  16. Intake of vinegar beverage is associated with restoration of ovulatory function in women with polycystic ovary syndrome.

    Wu, Di; Kimura, Fuminori; Takashima, Akiko; Shimizu, Yoshihiko; Takebayashi, Akie; Kita, Nobuyuki; Zhang, Guangmei; Murakami, Takashi

    2013-05-01

    Polycystic ovary syndrome (PCOS) is one of major causes of irregular menstruation. It is defined as a condition involving the combination of hyperandrogenism and chronic oligomenorrhea or anovulation, and is thought to have a variety of etiologies. Insulin resistance (impaired insulin sensitivity) has been suggested to be one of the etiologies of PCOS. PCOS patients often need to take medication to treat anovulation and infertility. Therefore, it would be beneficial to patients if simple non-pharmacological treatments can be developed. Recently the efficacy of vinegar to improve insulin resistance has been reported. To study the effect of vinegar on metabolic and hormonal indices and ovulatory function in PCOS, seven patients seeking a non-pharmacological treatment for PCOS took a beverage containing 15 g of apple vinegar daily for 90 to 110 days. Ovulation, the menstrual interval, fasting serum glucose level, fasting serum insulin level, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone were compared before and after intake of the vinegar beverage. Intake of the vinegar beverage resulted in a decrease of the homeostasis model assessment insulin resistance index (HOMA-R) in six patients, as well as a decrease of the LH/FSH ratio in five of seven patients. Ovulatory menstruation was observed within 40 day in four of seven patients. These findings suggest the possibility of vinegar to restore ovulatory function through improving insulin sensitivity in PCOS patients, thus, avoiding pharmacological treatment. Intake of vinegar might reduce medical cost and treatment time for insulin resistance, anovulation, and infertility in patients with PCOS.

  17. Paracrine effects of bone marrow soup restore organ function, regeneration, and repair in salivary glands damaged by irradiation.

    Simon D Tran

    Full Text Available BACKGROUND: There are reports that bone marrow cell (BM transplants repaired irradiated salivary glands (SGs and re-established saliva secretion. However, the mechanisms of action behind these reports have not been elucidated. METHODS: To test if a paracrine mechanism was the main effect behind this reported improvement in salivary organ function, whole BM cells were lysed and its soluble intracellular contents (termed as "BM Soup" injected into mice with irradiation-injured SGs. The hypothesis was that BM Soup would protect salivary cells, increase tissue neovascularization, function, and regeneration. Two minor aims were also tested a comparing two routes of delivering BM Soup, intravenous (I.V. versus intra-glandular injections, and b comparing the age of the BM Soup's donors. The treatment-comparison group consisted of irradiated mice receiving injections of living whole BM cells. Control mice received irradiation and injections of saline or sham-irradiation. All mice were followed for 8 weeks post-irradiation. RESULTS: BM Soup restored salivary flow rates to normal levels, protected salivary acinar, ductal, myoepithelial, and progenitor cells, increased cell proliferation and blood vessels, and up-regulated expression of tissue remodeling/repair/regenerative genes (MMP2, CyclinD1, BMP7, EGF, NGF. BM Soup was as an efficient therapeutic agent as injections of live BM cells. Both intra-glandular or I.V. injections of BM Soup, and from both young and older mouse donors were as effective in repairing irradiated SGs. The intra-glandular route reduced injection frequency/dosage by four-fold. CONCLUSION: BM Soup, which contains only the cell by-products, can be advantageously used to repair irradiation-damaged SGs rather than transplanting whole live BM cells which carry the risk of differentiating into unwanted/tumorigenic cell types in SGs.

  18. Paracrine effects of bone marrow soup restore organ function, regeneration, and repair in salivary glands damaged by irradiation.

    Tran, Simon D; Liu, Younan; Xia, Dengsheng; Maria, Ola M; Khalili, Saeed; Wang, Renee Wan-Jou; Quan, Vu-Hung; Hu, Shen; Seuntjens, Jan

    2013-01-01

    There are reports that bone marrow cell (BM) transplants repaired irradiated salivary glands (SGs) and re-established saliva secretion. However, the mechanisms of action behind these reports have not been elucidated. To test if a paracrine mechanism was the main effect behind this reported improvement in salivary organ function, whole BM cells were lysed and its soluble intracellular contents (termed as "BM Soup") injected into mice with irradiation-injured SGs. The hypothesis was that BM Soup would protect salivary cells, increase tissue neovascularization, function, and regeneration. Two minor aims were also tested a) comparing two routes of delivering BM Soup, intravenous (I.V.) versus intra-glandular injections, and b) comparing the age of the BM Soup's donors. The treatment-comparison group consisted of irradiated mice receiving injections of living whole BM cells. Control mice received irradiation and injections of saline or sham-irradiation. All mice were followed for 8 weeks post-irradiation. BM Soup restored salivary flow rates to normal levels, protected salivary acinar, ductal, myoepithelial, and progenitor cells, increased cell proliferation and blood vessels, and up-regulated expression of tissue remodeling/repair/regenerative genes (MMP2, CyclinD1, BMP7, EGF, NGF). BM Soup was as an efficient therapeutic agent as injections of live BM cells. Both intra-glandular or I.V. injections of BM Soup, and from both young and older mouse donors were as effective in repairing irradiated SGs. The intra-glandular route reduced injection frequency/dosage by four-fold. BM Soup, which contains only the cell by-products, can be advantageously used to repair irradiation-damaged SGs rather than transplanting whole live BM cells which carry the risk of differentiating into unwanted/tumorigenic cell types in SGs.

  19. Asthma, inhaled corticosteroid treatment, and growth.

    Ninan, T K; Russell, G

    1992-01-01

    To evaluate the effects on growth of inhaled corticosteroid treatment (ICT) and of the quality of control of asthma, height velocity was studied in 58 prepubertal children attending a specialist asthma clinic because of chronic asthma that was difficult to control. The height velocity standard deviation (SD) score was maximal when the asthma was well controlled both before (0.01) and after (-0.07) starting ICT. It was least when the asthma was poorly controlled both before (-1.50) and after (...

  20. Perioperative corticosteroids for intermittent and mild persistent asthma

    Hiroto Matsuse

    2002-01-01

    Conclusions: Our results suggest that perioperative corticosteroids are effective in preventing perioperative bronchospasm in stable asthmatics during surgery under general anesthesia by suppressing airway hyperresponsiveness.

  1. Corticosteroid use in management of pediatric emergency conditions [digest].

    Thabet, Asalim; Greenfield, Tyler; Cantor, Richard M; Wilson, Bryan

    2018-03-01

    Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  2. Corticosteroids for treating hypotension in preterm infants.

    Ibrahim, Hafis; Sinha, Ian P; Subhedar, Nimish V

    2011-12-07

    Systemic hypotension is a relatively common complication of preterm birth and is associated with periventricular haemorrhage, periventricular white matter injury and adverse neurodevelopmental outcome. Corticosteroid treatment has been used as an alternative or an adjunct to conventional treatment with volume expansion and vasopressor/inotropic therapy. To determine the effectiveness and safety of corticosteroids used either as primary treatment of hypotension or for the treatment of refractory hypotension in preterm infants. Randomized or quasi-randomised controlled trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2011), MEDLINE (1996 to Jan 2011), EMBASE (1974 to Jan 2011), CINAHL (1981 to 2011), reference lists of published papers and abstracts from the Pediatric Academic Societies and the European Society for Pediatric Research meetings published in Pediatric Research (1995 to 2011). We included all randomised or quasi-randomised controlled trials investigating the effect of corticosteroid therapy in the treatment of hypotension in preterm infants (babies with hypotension resistant to inotropes/pressors and volume therapy. We included studies comparing oral/intravenous corticosteroids with placebo, other drugs used for providing cardiovascular support or no therapy in this review. Methodological quality of eligible studies was assessed according to the methods used for minimising selection bias, performance bias, attrition bias and detection bias. Studies that evaluated corticosteroids (1) as primary treatment for hypotension or (2) for refractory hypotension unresponsive to prior use of inotropes/pressors and volume therapy, were analysed using separate comparisons. Data were analysed using the standard methods of the Neonatal Review Group using Rev Man 5.1.2. Treatment effect was analysed using relative risk, risk reduction, number needed to treat for categorical outcomes and

  3. TNF Lectin-Like Domain Restores Epithelial Sodium Channel Function in Frameshift Mutants Associated with Pseudohypoaldosteronism Type 1B

    Anita Willam

    2017-05-01

    abundance varied between mutants. Solnatide restored function in α-ENaC frameshift mutants to current density levels of wild type ENaC or higher despite their lacking a binding site for solnatide, previously located to the region between TM2 and the C-terminus of the α-subunit. TNF similarly restored current density to wild type levels in the mutant αR448fs. Activation of βγ-ENaC may contribute to this moderate current enhancement, but whatever the mechanism, experimental data indicate that solnatide could be a new strategy to treat PHA1B.

  4. TNF-α protein synthesis inhibitor restores neuronal function and reverses cognitive deficits induced by chronic neuroinflammation

    Belarbi Karim

    2012-01-01

    Full Text Available Abstract Background Chronic neuroinflammation is a hallmark of several neurological disorders associated with cognitive loss. Activated microglia and secreted factors such as tumor necrosis factor (TNF-α are key mediators of neuroinflammation and may contribute to neuronal dysfunction. Our study was aimed to evaluate the therapeutic potential of a novel analog of thalidomide, 3,6'-dithiothalidomide (DT, an agent with anti-TNF-α activity, in a model of chronic neuroinflammation. Methods Lipopolysaccharide or artificial cerebrospinal fluid was infused into the fourth ventricle of three-month-old rats for 28 days. Starting on day 29, animals received daily intraperitoneal injections of DT (56 mg/kg/day or vehicle for 14 days. Thereafter, cognitive function was assessed by novel object recognition, novel place recognition and Morris water maze, and animals were euthanized 25 min following water maze probe test evaluation. Results Chronic LPS-infusion was characterized by increased gene expression of the proinflammatory cytokines TNF-α and IL-1β in the hippocampus. Treatment with DT normalized TNF-α levels back to control levels but not IL-1β. Treatment with DT attenuated the expression of TLR2, TLR4, IRAK1 and Hmgb1, all genes involved in the TLR-mediated signaling pathway associated with classical microglia activation. However DT did not impact the numbers of MHC Class II immunoreactive cells. Chronic neuroinflammation impaired novel place recognition, spatial learning and memory function; but it did not impact novel object recognition. Importantly, treatment with DT restored cognitive function in LPS-infused animals and normalized the fraction of hippocampal neurons expressing the plasticity-related immediate-early gene Arc. Conclusion Our data demonstrate that the TNF-α synthesis inhibitor DT can significantly reverse hippocampus-dependent cognitive deficits induced by chronic neuroinflammation. These results suggest that TNF-α is a

  5. [Intratympanic corticosteroid perfusion in the therapy of Meniere's disease].

    Sanković-Babić, Snezana; Kosanović, Rade; Ivanković, Zoran; Babac, Snezana; Tatović, Milica

    2014-01-01

    Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere's disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere's disease who are resistant to conservative treatment. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere's disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Intratympanic perfusion of dexamethasone in patients with Meniere's disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere's disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic

  6. Chronic Cardiac-Targeted RNA Interference for the Treatment of Heart Failure Restores Cardiac Function and Reduces Pathological Hypertrophy

    Suckau, Lennart; Fechner, Henry; Chemaly, Elie; Krohn, Stefanie; Hadri, Lahouaria; Kockskämper, Jens; Westermann, Dirk; Bisping, Egbert; Ly, Hung; Wang, Xiaomin; Kawase, Yoshiaki; Chen, Jiqiu; Liang, Lifan; Sipo, Isaac; Vetter, Roland; Weger, Stefan; Kurreck, Jens; Erdmann, Volker; Tschope, Carsten; Pieske, Burkert; Lebeche, Djamel; Schultheiss, Heinz-Peter; Hajjar, Roger J.; Poller, Wolfgang Ch.

    2009-01-01

    Background RNA interference (RNAi) has the potential to be a novel therapeutic strategy in diverse areas of medicine. We report on targeted RNAi for the treatment of heart failure (HF), an important disorder in humans resulting from multiple etiologies. Successful treatment of HF is demonstrated in a rat model of transaortic banding by RNAi targeting of phospholamban (PLB), a key regulator of cardiac Ca2+ homeostasis. Whereas gene therapy rests on recombinant protein expression as its basic principle, RNAi therapy employs regulatory RNAs to achieve its effect. Methods and Results We describe structural requirements to obtain high RNAi activity from adenoviral (AdV) and adeno-associated virus (AAV9) vectors and show that an AdV short hairpin RNA vector (AdV-shRNA) silenced PLB in cardiomyocytes (NRCMs) and improved hemodynamics in HF rats 1 month after aortic root injection. For simplified long-term therapy we developed a dimeric cardiotropic AAV vector (rAAV9-shPLB) delivering RNAi activity to the heart via intravenous injection. Cardiac PLB protein was reduced to 25% and SERCA2a suppression in the HF groups was rescued. In contrast to traditional vectors rAAV9 shows high affinity for myocardium, but low affinity for liver and other organs. rAAV9-shPLB therapy restored diastolic (LVEDP, dp/dtmin, Tau) and systolic (fractional shortening) functional parameters to normal range. The massive cardiac dilation was normalized and the cardiac hypertrophy, cardiomyocyte diameter and cardiac fibrosis significantly reduced. Importantly, there was no evidence of microRNA deregulation or hepatotoxicity during these RNAi therapies. Conclusion Our data show, for the first time, high efficacy of an RNAi therapeutic strategy in a cardiac disease. PMID:19237664

  7. Epigenetic modulation of the biophysical properties of drug-resistant cell lipids to restore drug transport and endocytic functions.

    Vijayaraghavalu, Sivakumar; Peetla, Chiranjeevi; Lu, Shan; Labhasetwar, Vinod

    2012-09-04

    In our recent studies exploring the biophysical characteristics of resistant cell lipids, and the role they play in drug transport, we demonstrated the difference of drug-resistant breast cancer cells from drug-sensitive cells in lipid composition and biophysical properties, suggesting that cancer cells acquire a drug-resistant phenotype through the alteration of lipid synthesis to inhibit intracellular drug transport to protect from cytotoxic effect. In cancer cells, epigenetic changes (e.g., DNA hypermethylation) are essential to maintain this drug-resistant phenotype. Thus, altered lipid synthesis may be linked to epigenetic mechanisms of drug resistance. We hypothesize that reversing DNA hypermethylation in resistant cells with an epigenetic drug could alter lipid synthesis, changing the cell membrane's biophysical properties to facilitate drug delivery to overcome drug resistance. Herein we show that treating drug-resistant breast cancer cells (MCF-7/ADR) with the epigenetic drug 5-aza-2'-deoxycytidine (decitabine) significantly alters cell lipid composition and biophysical properties, causing the resistant cells to acquire biophysical characteristics similar to those of sensitive cell (MCF-7) lipids. Following decitabine treatment, resistant cells demonstrated increased sphingomyelinase activity, resulting in a decreased sphingomyelin level that influenced lipid domain structures, increased membrane fluidity, and reduced P-glycoprotein expression. Changes in the biophysical characteristics of resistant cell lipids facilitated doxorubicin transport and restored endocytic function for drug delivery with a lipid-encapsulated form of doxorubicin, enhancing the drug efficacy. In conclusion, we have established a new mechanism for efficacy of an epigenetic drug, mediated through changes in lipid composition and biophysical properties, in reversing cancer drug resistance.

  8. Restoration of Functional Integrity After Evacuation of Chronic Subdural Hematoma-An Age-Adjusted Analysis of 697 Patients.

    Schoedel, Petra; Bruendl, Elisabeth; Hochreiter, Andreas; Scheitzach, Judith; Bele, Sylvia; Brawanski, Alexander; Schebesch, Karl-Michael

    2016-10-01

    Although chronic subdural hematoma (CSH) can be treated by surgery, little is known about age-dependent symptoms and age-adjusted rates of restoring functional integrity. To evaluate the clinical symptoms and the course of CSH in patients of different age groups (AGs), we reviewed patients with CSH treated at our department over the past 22 years. This retrospective analysis included 697 patients with CSH (461 men, 236 women; mean age 70.1 years). Subgroup analysis was done according to AG 1) 95 years. Most patients had been treated with burr-hole trephination and implantation of a subdural drain (96.5%; n = 673). No significant difference concerning surgical morbidity and mortality was found between the AGs, but patients >75 years more frequently required reoperation (P = 0.001). Preoperatively, the most common symptoms were headache in AGs 1 and 2 (56.3% and 48.5%) and mnestic deficits in AGs 3-5 (54.9%, 51.9%, and 50.0%). After surgery, the clinical symptoms of CSH had significantly abated in all age groups. The most common clinical residuals were motor deficits in AG 1 (10.4%), mnestic deficits in AG 2 (10.7%), AG 4 (24.1%), and AG 5 (50.0%), and organic brain syndrome in AG 3 (15.0%). CSH predominantly caused unspecific symptoms such as headache and cognitive decline. CSH surgery immediately relieved symptoms in patients of all AGs. However, improvement rates significantly depended on patient age. This should be taken into consideration when advising on surgical treatment of CSH. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The Initial Response To Corticosteroid Therapy in Childhood ...

    Background: Nephrotic syndrome (NS) in African children is associated with poor response to corticosteroids. There is disparity in treatment response on the African continent. The aim of this present study was to describe the initial response to corticosteroid therapy of childhood NS in Côte d'ivoire. Materials and methods: ...

  10. Corticosteroids reduce the tensile strength of isolated collagen fascicles

    Haraldsson, Bjarki Thor; Langberg, Henning; Aagaard, Per

    2006-01-01

    Overuse tendon injuries are frequent. Corticosteroid injections are commonly used as treatment, although their direct effects on the material properties of the tendon are poorly understood.......Overuse tendon injuries are frequent. Corticosteroid injections are commonly used as treatment, although their direct effects on the material properties of the tendon are poorly understood....

  11. Evidence-based management of nasal polyposis by intranasal corticosteroids: from the cause to the clinic.

    Bachert, Claus

    2011-01-01

    Nasal polyposis is an inflammatory disorder involving the mucosa of the nose and paranasal sinuses and affecting approximately 2-4% of the general population. A literature search of Medline and Embase was conducted to obtain an overview of the epidemiology, pathophysiology, and current treatment of nasal polyposis, focusing on evidence-based efficacy of intranasal corticosteroids (INSs) as primary and postoperative therapy. Recent research on INSs in nasal polyp treatment, along with notable historic findings, was reviewed. Nasal polyps are mostly characterized by eosinophil infiltration, a complex inflammation of nasal mucosa, and possibly production of polyclonal IgE. Current treatment modalities include INSs, oral corticosteroids, and surgery; surgery is generally limited to those with an insufficient response to medical treatment. Because of their effects on eosinophil-dominated inflammation, INSs and oral corticosteroids are the primary medical treatment strategies. The very low (≤1%) systemic bioavailability of newer INSs minimizes the systemic adverse effects seen with oral corticosteroids. Based on randomized, controlled trials, guidelines recommend INSs as first-line therapy for nasal polyps and for care after polypectomy. Clinical data suggest INSs are effective in reducing polyp size and relieving nasal symptoms. INS treatment has also reduced nasal polyp recurrence in patients undergoing functional endoscopic sinus surgery. Treatment with these mainstay options has been found to improve quality of life, which, along with symptom improvement, is a key factor in disease treatment. Copyright © 2011 S. Karger AG, Basel.

  12. Adrenomedullin and angiopoietin-1 additively restore erectile function in diabetic rats: comparison with the combination therapy of vascular endothelial growth factor and angiopoietin-1.

    Nishimatsu, Hiroaki; Suzuki, Etsu; Nomiya, Akira; Niimi, Aya; Suzuki, Motofumi; Fujimura, Tetsuya; Fukuhara, Hiroshi; Homma, Yukio

    2013-07-01

    Erectile dysfunction (ED) is a major health problem. We have shown that adrenomedullin (AM) restores erectile function in diabetic rats. The aim of this study is to explore a better treatment for ED, we examined whether combination of AM and angiopoietin-1 (Ang-1) was more effective to treat ED than treatment with AM alone or Ang-1 alone. We also compared the effect of the combination therapy with that of treatment with vascular endothelial growth factor-A (VEGF-A). Male Wistar rats were injected with streptozotocin (STZ) to induce diabetes. Adenoviruses expressing AM (AdAM), Ang-1 (AdAng-1), and VEGF-A (AdVEGF-A) were injected into the penis 6 weeks after STZ administration. Erectile function, penile histology, and protein expression were analyzed 4 weeks after the injection of the adenoviruses. Intracavernous pressure and mean arterial pressure were measured to evaluate erectile function. The morphology of the penis was analyzed by Elastica van Gieson stain and immunohistochemistry. The expression of α-smooth muscle actin (SMA), VE-cadherin and type I collagen was assessed by Western blot analysis. Infection with AdAM plus AdAng-1 more effectively restored erectile function than infection with AdAM alone or AdAng-1 alone. This combination therapy restored erectile function to a level similar to that observed in the age-matched Wistar rats. Expression of SMA and VE-cadherin increased more significantly in the AdAM plus AdAng-1-treated group than in the AdAM- or AdAng-1-treated group. Although AdVEGF-A infection restored erectile function significantly, it also caused enlargement of the trabeculae of the cavernous body, aberrant angiogenesis, and overproduction of type I collagen. These results suggested that combination therapy with AM and Ang-1 potently restored erectile function and normal morphology of the cavernous body compared with VEGF-A administration. This combination therapy will be useful to treat ED patients with a severely damaged cavernous body.

  13. ASTM lights the way for tissue engineered medical products standards: jump start for combination medical products that restore biological function of human tissues.

    Picciolo, G L; Stocum, D L

    2001-01-01

    Everybody hopes for better health and restoration of impaired bodily function, and now that hope is illuminated by the promise of powerful biological tools that make human cells grow and replace human tissue. ASTM Committee F04 on Medical and Surgical Materials and Devices is taking the lead by defining some of those tools as standards that can be used for the development, production, testing, and regulatory approval of medical products.

  14. The Sabah Biodiversity Experiment: a long-term test of the role of tree diversity in restoring tropical forest structure and functioning

    Hector, Andy; Philipson, Christopher; Saner, Philippe; Chamagne, Juliette; Dzulkifli, Dzaeman; O'Brien, Michael; Snaddon, Jake L.; Ulok, Philip; Weilenmann, Maja; Reynolds, Glen; Godfray, H. Charles J.

    2011-01-01

    Relatively, little is known about the relationship between biodiversity and ecosystem functioning in forests, especially in the tropics. We describe the Sabah Biodiversity Experiment: a large-scale, long-term field study on the island of Borneo. The project aims at understanding the relationship between tree species diversity and the functioning of lowland dipterocarp rainforest during restoration following selective logging. The experiment is planned to run for several decades (from seed to adult tree), so here we focus on introducing the project and its experimental design and on assessing initial conditions and the potential for restoration of the structure and functioning of the study system, the Malua Forest Reserve. We estimate residual impacts 22 years after selective logging by comparison with an appropriate neighbouring area of primary forest in Danum Valley of similar conditions. There was no difference in the alpha or beta species diversity of transect plots in the two forest types, probably owing to the selective nature of the logging and potential effects of competitive release. However, despite equal total stem density, forest structure differed as expected with a deficit of large trees and a surfeit of saplings in selectively logged areas. These impacts on structure have the potential to influence ecosystem functioning. In particular, above-ground biomass and carbon pools in selectively logged areas were only 60 per cent of those in the primary forest even after 22 years of recovery. Our results establish the initial conditions for the Sabah Biodiversity Experiment and confirm the potential to accelerate restoration by using enrichment planting of dipterocarps to overcome recruitment limitation. What role dipterocarp diversity plays in restoration only will become clear with long-term results. PMID:22006970

  15. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France

    Isabelle Caby

    2016-04-01

    Full Text Available Study Design: A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. Objective: Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP, during 6 and 12 months follow up. Summary of background data: Chronic low back pain disease has a multifactor nature, involving physical, psychological professional and social factors. A functional restoration program (FRP has been included in a multidisciplinary training program which provides an efficient therapeutic solution. However, the effectiveness of an FRP has not been yet established. Methods: 144 subjects (71 males, 73 females with chronic low back pain were included in a functional restoration program. The FRP includes physiotherapy and occupational therapy interventions together with psychological counselling. Patients participated as in- or outpatients 6 h per day, 5 days a week over 5 weeks. Pain intensity, trunk flexibility, trunk strength, lifting ability, quality of life and return to work were recorded before, immediately after, and at 6 months and 12 months after the treatment period. Results: All outcome measures were significantly higher just after the FRP (144 patients and at 6 and 12 months (from available data in 31 subjects compared to pre-treatment values. This FRP for chronic low back pain maintained its benefits whatever the patient’s activities. Conclusions: The effects reflected on all outcome measures, both on short and long term follow-up. The multidisciplinary FRP for chronic low back pain patients durably stopped the de-conditioning syndrome and involved new life-style habits for the patient, daily pain management and a return to work.

  16. Determination of point spread function for a flat-panel X-ray imager and its application in image restoration

    Jeon, Sungchae; Cho, Gyuseong; Huh, Young; Jin, Seungoh; Park, Jongduk

    2006-01-01

    We investigate the image blur estimation methods, namely modified the Richardson-Lucy (R-L) estimator and the Wiener estimator. Based on the empirical model of the PSF, an image restoration is applied to radiological images. The accuracy of the PSF estimation under the Poisson noise and readout electronic noise is significantly better for the R-L estimator than the Wiener estimator. In the image restoration using the 2-D PSF from the R-L estimator, the result shows a good improvement in the low and middle range of spatial frequency

  17. End-to-side neurotization with the phrenic nerve in restoring the function of toe extension: an experimental study in a rat model.

    Jia, Xiaotian; Chen, Chao; Yang, Jianyun; Yu, Cong

    2018-06-01

    The phrenic nerve being transferred to the posterior division of the lower trunk with end-to-end neurorrhaphy is reported to be effective in restoring the function of digit extension in literature. However, the phrenic nerve is extremely important in respiration. We designed an animal experiment to discover whether the phrenic nerve being transferred to the posterior division of the lower trunk with end-to-side neurotization was feasible and provided the theoretical basis. A sum of 36 Sprague-Dawley rats was randomly assigned to one of two groups. In Group A, the phrenic nerve was transferred to the posterior division of the lower trunk with end-to-side neurotization. In Group B, the posterior division of the lower trunk was directly sutured. The results of behavioral assessment, electrophysiology, histology and nerve fiber count and muscle weight at 12 weeks postoperatively were recorded. In Group A, none of the rats experienced tachypnea. The motion of slight toe extension was observed. The results of electrophysiology, histology and nerve fiber count and muscle weight in Group A were not as well as those of Group B, but gradually improved with time. The phrenic nerve being transferred to the posterior division of lower trunk with end-to-side neurotization can partially restore the function of toe extension in a rat model. Whether the function of digit extension can be restored by the phrenic nerve with end-to-side neurotization in humans still needs more practice in clinic.

  18. Asthma, inhaled corticosteroid treatment, and growth.

    Ninan, T K; Russell, G

    1992-06-01

    To evaluate the effects on growth of inhaled corticosteroid treatment (ICT) and of the quality of control of asthma, height velocity was studied in 58 prepubertal children attending a specialist asthma clinic because of chronic asthma that was difficult to control. The height velocity standard deviation (SD) score was maximal when the asthma was well controlled both before (0.01) and after (-0.07) starting ICT. It was least when the asthma was poorly controlled both before (-1.50) and after (-1.55) starting ICT. The effectiveness of control correlated significantly with the height velocity SD score, both before and after ICT was started. No evidence was found that the administration of ICT has an adverse effect on growth.

  19. Targeting the Plantar Fascia for Corticosteroid Injection.

    Salvi, Andrea Emilio

    2015-01-01

    Plantar fasciitis is often a difficult condition to treat. It is related to repetitive strain of the fascia at its attachment to the heel bone. This condition quite often appears with the concomitant presence of a plantar calcaneal heel spur. Corticosteroid injection is a popular treatment choice for plantar fasciitis, and accurate localization of the injected medication is essential for successful resolution of symptoms after the injection. In the present brief technical communication, a method for targeting the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus is described. The targeting method uses the lateral radiograph of the foot to aid in localization of the proximal attachment of the plantar fascia to the calcaneus. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Corticosteroids In Infections Of Central Nervous System

    Meena AK

    2003-01-01

    Full Text Available Infections of central nervous system are still a major problem. Despite the introduction of newer antimicrobial agents, mortality and long-term sequelace associated with these infections is unacceptably high. Based on the evidence that proinflammtory cytokines have a role in pathophysiology of bacterial and tuberculous meningitis, corticosteroids with a potent anti-inflammatory and immunomodulating effect have been tested and found to be of use in experimental and clinical studies, Review of the available literature suggests steroid administration just prior to antimicrobial therapy is effective in decreasing audiologic and neurologic sequelae in childern with H. influenzae nenigitis. Steroid use for bacterial meningitis in adults is found to be beneficial in case of S. pneumoniae. The value of adjunctive steroid therapy for other bacterial causes of meningitis remains unproven. Corticocorticoids are found to be of no benefit in viral meningitis, Role of steroids in HIV positive patients needs to be studied.

  1. Effects of Vision Restoration Training on Early Visual Cortex in Patients With Cerebral Blindness Investigated With Functional Magnetic Resonance Imaging

    Raemaekers, M.; Bergsma, D.P.; van Wezel, Richard Jack Anton; van der Wildt, G.J.; van den Berg, A.V.

    Cerebral blindness is a loss of vision as a result of postchiasmatic damage to the visual pathways. Parts of the lost visual field can be restored through training. However, the neuronal mechanisms through which training effects occur are still unclear. We therefore assessed training-induced changes

  2. Fatty acid analogue N-arachidonoyl taurine restores function of IKs channels with diverse long QT mutations

    Liin, Sara I; Larsson, Johan E; Barro-Soria, Rene

    2016-01-01

    . Finally, we find that the fatty acid analogue N-arachidonoyl taurine restores channel gating of many different mutant channels, even though the mutations are in different domains of the IKs channel and affect the channel by different molecular mechanisms. N-arachidonoyl taurine is therefore an interesting...

  3. Knee functional recovery and limb-to-limb symmetry restoration after anterior cruciate ligament (ACL) rupture and ACL reconstruction

    Nawasreh, Zakariya Hussein

    perturbation training using mechanical device provides effects similar to manual perturbation training on knee mechanics, knee functional performance, and neuromuscular activation pattern in patients with ACL rupture. The second aim of this study was to measure whether the mechanical perturbation training provides an effect similar to that of manual perturbation training on gait mechanics, knee functional performance, muscle co-contraction, and neuromuscular activation pattern in athletes with an acute ACL rupture who are managed non-surgically. The findings of this work revealed that mechanical perturbation training provides effects similar to the manual perturbation training on knee kinematics and kinetics during walking and performance-based and patient-reported measures. Gait limb-to-limb asymmetries continue persist after the training regardless of the treatment group which may indicate that patients require participating in an extended rehabilitation program. Additionally, Perturbation training attempts to resolve the neuromuscular deficits and restore a balance in muscle activation and strength between knee flexors and extensors to enhance the dynamic stability of the knee joint. There are moderate to strong relationships between time duration of muscles' activities and the muscle co-contraction that may reflect neuromuscular adaptations to provide dynamic knee stability.

  4. EFFECT OF SHOCK WAVE THERAPYVERSUS CORTICOSTEROID INJECTION IN MANAGEMENT OFKNEE OSTEOARTHRITIS

    Ahmed Ebrahim Elerian

    2016-04-01

    Full Text Available Background: knee Osteoarthritis is the most common cause of musculoskeletal pain and disability. Shockwaves have been used as an alternative treatment for musculoskeletal disorders; intra-articular injection of steroid is a common treatment for osteoarthritis of the knee. This study aimed to investigate the efficacy of Shock wave therapy versus Corticosteroid intra articular injection in case of knee osteoarthritis. Methods: Sixty patients were diagnosed mild to moderate knee osteoarthritis; they were included in the study. Their ages were 43:65 years with mean age 50 ± 3.5 years. Patients were divided randomly into three equal groups, group (A received shock wave therapy, group (B received two intra-articular injections of corticosteroid at 1-month intervals and group (C received sham shock wave. The outcome measurements were Western Ontario and McMaster Universities arthritis index (WOMAC values, knee ROM, and pain severity using the visual analogue scale (VAS were recorded. The patients were evaluated for these parameters before allocated in their groups then after 1, 2, and 6months later. Results: compared to sham group there were significant improvement of VAS and ROM of shock wave group and corticosteroid injection group than sham (placebo group (p<0.000, (p<0.006, and 0.02 respectively. Furthermore there was significant improve of shock wave group than corticosteroid injection group where p was <0.000 for VAS, ROM and (WOMAC. Conclusion: The results of this study suggested that shock wave therapy may provide effective modality for relieving pain, increase Range of motion and improve function in knee osteoarthritis patient than intra articular corticosteroid injection.

  5. Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep

    Kallapur Suhas G

    2009-12-01

    Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.

  6. Restoring forests

    Jacobs, Douglass F.; Oliet, Juan A.; Aronson, James

    2015-01-01

    of land requiring restoration implies the need for spatial prioritization of restoration efforts according to cost-benefit analyses that include ecological risks. To design resistant and resilient ecosystems that can adapt to emerging circumstances, an adaptive management approach is needed. Global change......, in particular, imparts a high degree of uncertainty about the future ecological and societal conditions of forest ecosystems to be restored, as well as their desired goods and services. We must also reconsider the suite of species incorporated into restoration with the aim of moving toward more stress resistant...... and competitive combinations in the longer term. Non-native species may serve an important role under some circumstances, e.g., to facilitate reintroduction of native species. Propagation and field establishment techniques must promote survival through seedling stress resistance and site preparation. An improved...

  7. Analysis of inflammation-induced depression of home cage wheel running in rats reveals the difference between opioid antinociception and restoration of function

    Kandasamy, Ram; Calsbeek, Jonas J.; Morgan, Michael M.

    2016-01-01

    Opioids are effective at inhibiting responses to noxious stimuli in rodents, but have limited efficacy and many side effects in chronic pain patients. One reason for this disconnect is that nociception is typically assessed using withdrawal from noxious stimuli in animals, whereas chronic pain patients suffer from abnormal pain that disrupts normal activity. We hypothesized that assessment of home cage wheel running in rats would provide a much more clinically relevant method to assess opioid efficacy to restore normal behavior. Intraplantar injection of Complete Freund’s Adjuvant (CFA) into the right hindpaw depressed wheel running and caused mechanical allodynia measured with the von Frey test in both male and female rats. Administration of an ED50 dose of morphine (3.2 mg/kg) reversed mechanical allodynia, but did not reverse CFA-induced depression of wheel running. In contrast, administration of a low dose of morphine (1.0 mg/kg) restored running for one hour in both sexes, but had no effect on mechanical allodynia. Administration of the atypical opioid buprenorphine had no effect on inflammation-induced depression of wheel running in male or female rats, but attenuated mechanical allodynia in male rats. Administration of buprenorphine and higher doses of morphine depressed wheel running in non-inflamed rats, suggesting that the side effects of opioids interfere with restoration of function. These data indicate that restoration of pain-depressed function requires antinociception in the absence of disruptive side effects. The disruptive side effects of opioids are consistent with the major limitation of opioid use in human pain patients. PMID:27746208

  8. Molecularly imprinted polymers for corticosteroids: impact of polymer format on recognition behaviour

    Fitzhenry, Laurence; Duggan, Patrick; McLoughlin, Peter; Manesiotis, Panagiotis

    2013-01-01

    A comparative study was performed on different polymeric formats for targeting corticosteroids, focusing on the use of bulk monolith and precipitation polymerisation strategies. Hydrocortisone-17-butyrate was selected as the template and methacrylic acid as the functional monomer, following 1 H NMR investigation of the pre-polymerisation mixture. Three different cross-linkers were tested, ranging from moderate to highly hydrophobic. The synthesised bulk and precipitated imprinted polymers were physically characterised by nitrogen sorption and evaluated by means of HPLC and frontal chromatography against a range of template analogues. While some degree of selectivity for the template was achieved for all tested polymers, the ones based on the tri-functional cross-linking monomer trimethylolpropane trimethacrylate exhibited the longest retention for all corticosteroids, especially in the precipitated format, which suggested broader group selectivity. (author)

  9. Is it restoration or reconciliation? California's experience restoring the Sacramento - San Joaquin River Delta provides lessons learned and pathways forward to sustain critical ecosystem functions and services in a highly managed riverine delta.

    Viers, J. H.; Kelsey, R.

    2014-12-01

    Reconciling the needs of nature and people in California's Sacramento - San Joaquin River Delta represents one of the most critical ecosystem management imperatives in western North America. Over 150 years the Delta has been managed for near-term human benefits and in the process 95% of riverine and deltaic wetlands have been lost throughout the region. Despite extensive land conversion and alteration of hydrological and physical processes, the Delta remains important habitat for migratory birds and is home to over 60% of California's native fish species. It is also the waterwheel for the state's vast water distribution network and is maintained by a system of constructed levees that are at risk from catastrophic failure due to sea level rise, floods, and/or seismic activity. Such a collapse would have dire consequences for > 25M humans and world's 10th largest economy that depend on its freshwater. Thus, the ultimate cost of this ecosystem alteration and simplification is a riverscape that is no longer reliable for nature or people. For 30 years, attempts to 'restore' Delta ecosystems and improve reliability have met with mixed results. For example, reconnection of floodplains to floodwaters has resulted in improved ecological health for native fishes and recharge to localized aquifers. Uncoordinated releases of discharges below dams, however, have resulted in diminished water quality and populations of indicator species. Attempts to create wildlife friendly farms have been countered by an increase in perennial agriculture and commensurate increases in irrigation water demand. From these lessons learned, we demonstrate three key components of a reconciled Delta that will be necessary in the future: 1) full restoration of critical habitats, reconnecting land and water to rebuild ecosystem function; 2) landscape redesign, incorporating natural and engineered infrastructure to create a biologically diverse, resilient landscape to support both agriculture and natural

  10. Clinical decisions for anterior restorations: the concept of restorative volume.

    Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

    2012-12-01

    The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

  11. Severe renal failure in acute bacterial pyelonephritis: Do not forget corticosteroids

    Sqalli Tarik

    2010-01-01

    Full Text Available Acute renal failure (ARF is a rare complication of acute pyelonephritis in adult immunocompetent patients. Recovery of renal function usually occurs if antibiotics are promptly initiated. However, long-term consequences of renal scarring due to acute pyelonephritis are probably underestimated, and some patients present with prolonged renal failure despite adequate antibiotic therapy. We report two cases of severe ARF complicating bacterial pyelonephritis successfully treated with corticosteroids in association with conventional antibiotics.

  12. Restoration of motor function following spinal cord injury via optimal control of intraspinal microstimulation: toward a next generation closed-loop neural prosthesis.

    Peter Jonas Grahn

    2014-09-01

    Full Text Available Movement is planned and coordinated by the brain and carried out by contracting muscles acting on specific joints. Motor commands initiated in the brain travel through descending pathways in the spinal cord to effector motor neurons before reaching target muscles. Damage to these pathways by spinal cord injury (SCI can result in paralysis below the injury level. However, the planning and coordination centers of the brain, as well as peripheral nerves and the muscles that they act upon, remain functional. Neuroprosthetic devices can restore motor function following SCI by direct electrical stimulation of the neuromuscular system. Unfortunately, conventional neuroprosthetic techniques are limited by a myriad of factors that include, but are not limited to, a lack of characterization of non-linear input/output system dynamics, mechanical coupling, limited number of degrees of freedom, high power consumption, large device size, and rapid onset of muscle fatigue. Wireless multi-channel closed-loop neuroprostheses that integrate command signals from the brain with sensor-based feedback from the environment and the system’s state offer the possibility of increasing device performance, ultimately improving quality of life for people with SCI. In this manuscript, we review neuroprosthetic technology for improving functional restoration following SCI and describe brain-machine interfaces suitable for control of neuroprosthetic systems with multiple degrees of freedom. Additionally, we discuss novel stimulation paradigms that can improve synergy with higher planning centers and improve fatigue-resistant activation of paralyzed muscles. In the near future, integration of these technologies will provide SCI survivors with versatile closed-loop neuroprosthetic systems for restoring function to paralyzed muscles.

  13. Fluticasone furoate: A new intranasal corticosteroid

    R Kumar

    2012-01-01

    Full Text Available Intranasal corticosteroids are recommended as one of the first-line therapies for the treatment of allergic rhinitis (AR, especially when associated with nasal congestion and recurrent symptoms. Fluticasone furoate is a novel enhanced-affinity glucocorticoid for the treatment of AR approved by the Food and Drug Administration in 2007 and recently introduced in India. Fluticasone furoate nasal spray is indicated for the treatment of the symptoms of seasonal and perennial AR in patients aged two years and older. This review summarizes the clinical data on fluticasone furoate nasal spray and discusses its role in the management of AR. Important attributes of fluticasone furoate include low systemic bioavailability (<0.5%, 24-h symptom relief with once-daily dosing, comprehensive coverage of both nasal and ocular symptoms, safety and tolerability with daily use, and availability in a side-actuated device that makes medication delivery simple and consistent. With these properties, fluticasone furoate nasal spray has the potential to enhance patient satisfaction and compliance, thus making it a good choice amongst available intranasal steroids.

  14. Intradiscal corticosteroid injections in spondylotic cervical radiculopathy

    Fayad, Fouad; Rannou, Francois; Rahmani, Lamia; Lefevre-Colau, Marie-Martine; Nys, Alain; Poiraudeau, Serge; Ledoux, Michel; Revel, Michel; Drape, Jean L.; Chevrot, Alain

    2007-01-01

    The purpose of this study was to evaluate treatment outcomes with intradiscal injection of corticosteroids (IDIC) in cervical spondylotic radiculopathy. Twenty consecutive patients were treated with intradiscal injection of 25 mg of acetate of prednisolone under fluoroscopic control. All patients had previously received a nonsurgical treatment for at least 3 months without success. Outcomes were assessed 1, 3 and 6 months after IDIC. Radicular pain reduction as scored on a visual analogue scale (VAS 100-mm length) was statistically significant at 1 month (19.0±28.0 mm; p=0.008), 3 months (25.2±27.5 mm; p=0.002), and 6 months (24.6±28.4 mm; p=0.001). In all, 40% of treated patients described at least 50% pain improvement 6 months after treatment. Four patients had complete relief of radicular pain. In conclusion, IDIC should be an alternative in the nonsurgical management of cervical spondylotic radiculopathy. (orig.)

  15. Emerging corticosteroid agonists for the treatment of asthma

    Westergaard, Christian G; Porsbjerg, Celeste; Backer, Vibeke

    2015-01-01

    INTRODUCTION: Asthma is one of the most frequent chronic diseases worldwide. For decades, asthma has been treated with bronchodilators and inhaled corticosteroids (ICS). However, adverse effects of ICS and disease heterogeneity necessitate improvements in the existing treatment regimes. Recently...

  16. Limitations of quantitative CT in corticosteroid induced osteopenia

    Karantanas, A.H.; Kalef-Ezra, J.; Glaros, D.; Ioannina Univ.

    1991-01-01

    Single energy spectrum quantitative CT (SES-QCT) was applied for the assessment of the trabecular bone mineral status in patients under long-term corticosteroid treatment. Seventeen renal graft recipients (RGR) and 12 patients receiving corticosteroid treatment for collagen disease were studied. A reduction of about 40% in the spinal trabecular bone density relative to matched controls was found, associated with the corticosteroid administration. Repeated measurements showed significant reduction in density 4 months after transplantation, and an increase in density after graft rejection. Radiologic or clinical evidence of osteopenia in the spine was not found. Other noninvasive techniques, applied in the upper extremities of the RGR, showed only minor bone reduction compared to controls. The findings of the present study suggest that adipose tissue deposition in the spinal trabeculae can introduce errors in the measurements. Therefore, SES-QCT should not be applied during corticosteroid therapy. (orig.)

  17. Pharmacogenomics of inhaled corticosteroids and leukotriene modifiers : a systematic review

    Farzan, N.|info:eu-repo/dai/nl/412501929; Vijverberg, S.J.H.|info:eu-repo/dai/nl/325847460; Arets, H.G.M.; Raaijmakers, J.A.M.|info:eu-repo/dai/nl/072763299; van der Zee, A.H.|info:eu-repo/dai/nl/255164688

    BACKGROUND Pharmacogenetics studies of anti-inflammatory medication of asthma have expanded rapidly in recent decades, but the clinical value of their findings remains limited. OBJECTIVE To perform a systematic review of pharmacogenomics and pharmacogenetics of inhaled corticosteroids (ICS) and

  18. Incidence of plantar fascia ruptures following corticosteroid injection.

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

  19. Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease

    Sin, DD; Wu, L; Anderson, JA; Anthonisen, NR; Buist, AS; Burge, PS; Calverley, PM; Connett, JE; Lindmark, B; Pauwels, RA; Postma, DS; Soriano, JB; Szafranski, W; Vestbo, J

    2005-01-01

    Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from

  20. Prednisone and Other Corticosteroids: Balance the Risks and Benefits

    ... transplant recipients. You can take corticosteroids: By mouth. Tablets, capsules or syrups help treat the inflammation and ... Firestein GS, et al. Glucocorticoid therapy. In: Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; ...

  1. Hair restoration.

    Rawnsley, Jeffrey D

    2008-08-01

    The impact of male hair loss as a personal and social marker of aging is tremendous and its persistence as a human concern throughout recorded history places it in the forefront of male concern about the physical signs of aging. Restoration of the frontal hairline has the visual effect of re-establishing facial symmetry and turning back time. Follicular unit transplantation has revolutionized hair restoration, with its focus on redistributing large numbers of genetically stable hair to balding scalp in a natural distribution. Follicular unit hair restoration surgery is a powerful tool for the facial plastic surgeon in male aesthetic facial rejuvenation because it offers high-impact, natural-appearing results with minimal downtime and risk for adverse outcome.

  2. Zonal corticosteroid hormone biosynthesis in the adrenal cortex in rats exposed to emotional stress combined with salt loading

    Shul'ga, V.A.

    1987-01-01

    The authors study the pattern of biosynthesis of corticosteroid hormones in the zona glomerulosa and the combined zona fasciculata + zona reticularis of the adrenals, which are responsible for the mineralocorticoid and glucocorticoid function of the glands, during simultaneous exposure of animals to salt loading and emotional stress. Experiments were carried out on rats. The adrenals were divided into parts and samples were incubated in vitro with the addition of 3 H-progesterone to each sample. The specific activity of the 3 H-labeled corticosteroids decreased significantly in rats with a normal salt intake exposed to emotional stress

  3. Restoration of CFTR Activity in Ducts Rescues Acinar Cell Function and Reduces Inflammation in Pancreatic and Salivary Glands of Mice.

    Zeng, Mei; Szymczak, Mitchell; Ahuja, Malini; Zheng, Changyu; Yin, Hongen; Swaim, William; Chiorini, John A; Bridges, Robert J; Muallem, Shmuel

    2017-10-01

    Sjögren's syndrome and autoimmune pancreatitis are disorders with decreased function of salivary, lacrimal glands, and the exocrine pancreas. Nonobese diabetic/ShiLTJ mice and mice transduced with the cytokine BMP6 develop Sjögren's syndrome and chronic pancreatitis and MRL/Mp mice are models of autoimmune pancreatitis. Cystic fibrosis transmembrane conductance regulator (CFTR) is a ductal Cl -  channel essential for ductal fluid and HCO 3 - secretion. We used these models to ask the following questions: is CFTR expression altered in these diseases, does correction of CFTR correct gland function, and most notably, does correcting ductal function correct acinar function? We treated the mice models with the CFTR corrector C18 and the potentiator VX770. Glandular, ductal, and acinar cells damage, infiltration, immune cells and function were measured in vivo and in isolated duct/acini. In the disease models, CFTR expression is markedly reduced. The salivary glands and pancreas are inflamed with increased fibrosis and tissue damage. Treatment with VX770 and, in particular, C18 restored salivation, rescued CFTR expression and localization, and nearly eliminated the inflammation and tissue damage. Transgenic overexpression of CFTR exclusively in the duct had similar effects. Most notably, the markedly reduced acinar cell Ca 2+ signaling, Orai1, inositol triphosphate receptors, Aquaporin 5 expression, and fluid secretion were restored by rescuing ductal CFTR. Our findings reveal that correcting ductal function is sufficient to rescue acinar cell function and suggests that CFTR correctors are strong candidates for the treatment of Sjögren's syndrome and pancreatitis. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Factors Affecting Antenatal Corticosteroid Administration from the Obstetricians’ Viewpoint

    Emel Kurtoğlu

    2016-02-01

    Full Text Available OBJECTIVE: We aimed to investigate the factors affecting antenatal corticosteroid administration from the obstetricians’ viewpoint. STUDY DESIGN: The pregnant women who delivered between 24 and 34 weeks of gestation were divided into two groups: Group 1, pregnant patients given corticosteroid therapy; Group 2, pregnant patients who were not given corticosteroid therapy. The indications for delivery, gestational week at administration, dosing, residence and manner of transfer of the patients to the tertiary center, and the interval between admission to hospital and delivery were evaluated. RESULTS: The percentage of patients who received antenatal corticosteroid treatment was 68.4%, whereas 31.6% of the pregnant women didn’t receive corticosteroid therapy. The most common indications for preterm delivery were preterm labor and severe preeclampsia. The interval between admission to hospital and delivery was significantly higher in group 1. CONCLUSION: Even though obstetricians are aware of the importance of corticosteroid treatment in preterm deliveries, indications for impending delivery can affect administration of the therapy.

  5. Misuse of topical corticosteroids: A clinical study of adverse effects

    Vivek Kumar Dey

    2014-01-01

    Full Text Available Background: Misuse of topical corticosteroids is a widespread phenomenon among young people in India, especially women. The practice is associated with significant adverse effects and poor awareness of these effects among the general public. Aim: This study was conducted to examine the misuse and adverse effects of topical corticosteroids among the people in Bastar region in Chhattisgarh state of India. Materials and Methods: Data collected from patients presenting with at least one of the adverse effects of topical corticosteroids as the chief complaint, from November 2010 to October 2011. Results: Out of the 6723 new patients, 379 (5.63% had presented with misuse and adverse effects of topical corticosteroids, of whom 78.89% were females. More than 65% of the patients were in the age group 10-29 years. The main reason for using the topical corticosteroids was to lighten skin colour and treat melasma and suntan. Acne (37.99% and telangiectasia (18.99% were the most common adverse effects noted. Conclusions: Misuse of topical corticosteroids has a huge impact on dermatological practice, leading to a significant proportion of visits to the dermatologist. This hydra-headed problem needs multi-dimensional interventions, involving educational, legal and managerial approaches with cooperation from different sectors of society.

  6. Transparent Restoration

    Barou, L.; Bristogianni, T.; Oikonomopoulou, F.

    2017-01-01

    This paper investigates the application of structural glass in restoration and conservation practices in order to highlight and safeguard our built heritage. Cast glass masonry is introduced in order to consolidate a half-ruined historic tower in Greece, by replacing the original parts of the façade

  7. Site Restoration

    Noynaert, L.; Bruggeman, A.; Cornelissen, R.; Massaut, V.; Rahier, A

    2001-04-01

    The objectives, the programme, and the achievements of the Site Restoration Department of SCK-CEN in 2000 are summarised. Main activities include the decommissioning of the BR3 PWR-reactor as well as other clean-up activities, projects on waste minimisation and activities related to the management of decommissioning projects. The department provides consultancy and services to external organisations.

  8. Site Restoration

    Noynaert, L.; Bruggeman, A.; Cornelissen, R.; Massaut, V.; Rahier, A.

    2001-01-01

    The objectives, the programme, and the achievements of the Site Restoration Department of SCK-CEN in 2000 are summarised. Main activities include the decommissioning of the BR3 PWR-reactor as well as other clean-up activities, projects on waste minimisation and activities related to the management of decommissioning projects. The department provides consultancy and services to external organisations

  9. Environmental Restoration

    Zeevaert, T.; Vanmarcke, H

    1998-07-01

    The objectives of SCK-CEN's programme on environmental restoration are (1) to optimize and validate models for the impact assessment from environmental, radioactive contaminations, including waste disposal or discharge; (2) to support the policy of national authorities for public health and radioactive waste management. Progress and achievements in 1997 are reported.

  10. Upregulation of PDZK1 by Calculus Bovis Sativus May Play an Important Role in Restoring Biliary Transport Function in Intrahepatic Cholestasis

    Dong Xiang

    2017-01-01

    Full Text Available Intrahepatic cholestasis is a main cause of hepatic accumulation of bile acids leading to liver injury, fibrosis, and liver failure. Our previous studies proved that Calculus Bovis Sativus (CBS can restore biliary transport function through upregulating the multidrug resistance-associated protein 2 (MRP2 and breast cancer resistance protein (BCRP in 17α-ethynylestradiol- (EE- induced intrahepatic cholestasis rats. The regulation mechanism of CBS on these transporters, however, remains unclear. This study was designed to evaluate the possible relationship between the effect of CBS on transport activities and the regulation of CBS on the expression of PDZK1, a mainly scaffold protein which can regulate MRP2 and BCRP. Intrahepatic cholestasis model was induced in rats with injection of EE for five consecutive days and then the biliary excretion rates and cumulative biliary excretions were measured. The mRNA and protein expression levels of PDZK1 were detected by reverse transcription-quantitative real-time polymerase chain reaction, western blot, and immunohistochemical analysis. When treated with CBS, cumulative biliary excretions and mRNA and protein expressions of PDZK1 were significantly increased in intrahepatic cholestasis rats. This study demonstrated that CBS exerted a beneficial effect on EE-induced intrahepatic cholestasis rats by restoring biliary transport function, which may result from the upregulation of PDZK1 expression.

  11. Direct Coaptation of the Phrenic Nerve With the Posterior Division of the Lower Trunk to Restore Finger and Elbow Extension Function in Patients With Total Brachial Plexus Injuries.

    Wang, Shu-feng; Li, Peng-cheng; Xue, Yun-hao; Zou, Ji-yao; Li, Wen-jun; Li, Yucheng

    2016-02-01

    To overcome the mismatch in nerve sizes in phrenic nerve transfer to the radial nerve for elbow and finger extension reanimation for patients with total brachial plexus injuries (TBPI), a selective neurotization procedure was designed. To investigate the long-term results of phrenic nerve transfer to the posterior division of the lower trunk with direct coaptation in restoring elbow and finger extension after TBPI. Phrenic nerve was transferred to and directly coapted with the posterior division of the lower trunk in 27 patients with TBPI. Seven patients were <18 years old (adolescent group), and the remaining 20 patients ≥18 years (adult group). Postoperative mean follow-up period was 54 ± 9 months (range, 48-85 months). The motor function attained M3 or greater in 81.5% of patients for elbow extension and in 48% of patients for finger extension. The percentage of patients who regained M3 or greater muscle power of finger extension in the adolescent group and the adult group was 71.4%, and 40%, respectively. Meanwhile, 85.7% in the adolescent group and 80% in the adult group achieved M3 or greater muscle power of elbow extension. There were no significant differences between the 2 groups. The elbow extension and finger extension were synchronous contractions and did not become independent of respiratory effort. This procedure simultaneously and effectively restores the function of elbow and finger extension in patients after TBPI. However, the patients could not do elbow and finger extension separately.

  12. Redox biology in normal cells and cancer: restoring function of the redox/Fyn/c-Cbl pathway in cancer cells offers new approaches to cancer treatment.

    Noble, Mark; Mayer-Pröschel, Margot; Li, Zaibo; Dong, Tiefei; Cui, Wanchang; Pröschel, Christoph; Ambeskovic, Ibro; Dietrich, Joerg; Han, Ruolan; Yang, Yin Miranda; Folts, Christopher; Stripay, Jennifer; Chen, Hsing-Yu; Stevens, Brett M

    2015-02-01

    This review discusses a unique discovery path starting with novel findings on redox regulation of precursor cell and signaling pathway function and identification of a new mechanism by which relatively small changes in redox status can control entire signaling networks that regulate self-renewal, differentiation, and survival. The pathway central to this work, the redox/Fyn/c-Cbl (RFC) pathway, converts small increases in oxidative status to pan-activation of the c-Cbl ubiquitin ligase, which controls multiple receptors and other proteins of central importance in precursor cell and cancer cell function. Integration of work on the RFC pathway with attempts to understand how treatment with systemic chemotherapy causes neurological problems led to the discovery that glioblastomas (GBMs) and basal-like breast cancers (BLBCs) inhibit c-Cbl function through altered utilization of the cytoskeletal regulators Cool-1/βpix and Cdc42, respectively. Inhibition of these proteins to restore normal c-Cbl function suppresses cancer cell division, increases sensitivity to chemotherapy, disrupts tumor-initiating cell (TIC) activity in GBMs and BLBCs, controls multiple critical TIC regulators, and also allows targeting of non-TICs. Moreover, these manipulations do not increase chemosensitivity or suppress division of nontransformed cells. Restoration of normal c-Cbl function also allows more effective harnessing of estrogen receptor-α (ERα)-independent activities of tamoxifen to activate the RFC pathway and target ERα-negative cancer cells. Our work thus provides a discovery strategy that reveals mechanisms and therapeutic targets that cannot be deduced by standard genetics analyses, which fail to reveal the metabolic information, isoform shifts, protein activation, protein complexes, and protein degradation critical to our discoveries. Copyright © 2015. Published by Elsevier Inc.

  13. Corticosteroid therapy in patients with non-arteritic anterior ischemic optic neuropathy.

    Vidović, Tomislav; Cerovski, Branimir; Perić, Sanja; Kordić, Rajko; Mrazovac, Danijela

    2015-03-01

    Non-arteritic anterior ischemic optic neuropathy is one of the most common conditions affecting the optic nerve in the elderly. It may lead to severe visual loss. Typical symptoms are painless impairment of visual function accompanied by relative afferent pupillary defect, edema of the optic disc and visual field defects. Aim is to present 38 patients with nonarteritic anterior ischemic optic neuropathy who were treated with corticosteroid therapy. This prospective study involved 38 patients, 20 men and 18 women aged 60-75 years who were treated with corticosteroid therapy. The study included patients with visual acuity in the affected eye from 0.1 to 0.8 according to Snellen. Every patient underwent clinical examination, the Octopus 900 perimetry in G program, laboratory testing, while the compressive optic neuropathy was rule out with MSCT of the brain and orbits. The most common forms of visual field defect are altitudinal defect and diffuse depression. Corticosteroid therapy led to recovery in 65% of patient, in 30% of patients did not change, while the deterioration occurred in 5% of patients.

  14. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications.

    Derendorf, H; Meltzer, E O

    2008-10-01

    Intranasal corticosteroids (INSs) are effective treatments for allergic rhinitis, rhinosinusitis, and nasal polyposis. In recent years, increased understanding of corticosteroid and glucocorticoid receptor pharmacology has enabled the development of molecules designed specifically to achieve potent, localized activity with minimal risk of systemic exposure. Pharmacologic potency studies using affinity and other assessments have produced similar rank orders of potency, with the most potent being mometasone furoate, fluticasone propionate, and its modification, fluticasone furoate. The furoate and propionate ester side chains render these agents highly lipophilic, which may facilitate their absorption through nasal mucosa and uptake across phospholipid cell membranes. These compounds demonstrate negligible systemic absorption. Systemic absorption rates are higher among the older corticosteroids (flunisolide, beclomethasone dipropionate, triamcinolone acetonide, and budesonide), which have bioavailabilities in the range of 34-49%. Studies, including 1-year studies with mometasone furoate, fluticasone propionate, and budesonide that evaluated potential systemic effects of INSs in children have generally found no adverse effects on hypothalamic-pituitary-adrenal axis function or growth. Clinical data suggest no significant differences in efficacy between the INSs. Theoretically, newer agents with lower systemic availability may be preferable, and may come closer to the pharmacokinetic/pharmacologic criteria for the ideal therapeutic choice.

  15. Regulation of the corticosteroid signalling system in rainbow trout HPI axis during confinement stress.

    Kiilerich, Pia; Servili, Arianna; Péron, Sandrine; Valotaire, Claudiane; Goardon, Lionel; Leguen, Isabelle; Prunet, Patrick

    2018-03-01

    This study aims to shed light on corticosteroid regulation of stress in teleost fish with focus on the corticosteroid signalling system. The role of the mineralocorticoid-like hormone 11-deoxycorticosterone (DOC) in fish is still enigmatic, as is the function of the mineralocorticoid receptor, MR. Low plasma DOC levels and ubiquitous tissue distribution of MR question the physiological relevance of the mineralocorticoid-axis. Furthermore, the particular purpose of each of the three corticosteroid receptors in fish, the glucocorticoid receptors, GR1 and GR2, and the MR, is still largely unknown. Therefore we investigate the regulation of cortisol and DOC in plasma and mRNA levels of MR, GR1 and GR2 in the HPI-axis tissues (hypothalamus, pituitary and interrenal gland) during a detailed confinement stress time-course. Here we show a sustained up-regulation of plasma DOC levels during a confinement stress time-course. However, the low DOC levels compared to cortisol measured in the plasma do not favour an activity of DOC through MR receptors. Furthermore, we show differential contribution of the CRs in regulation and control of HPI axis activity following confinement stress. Judged by the variation of mRNA levels negative feedback regulation of cortisol release occurs on the level of the pituitary via MR and on the level of the interrenal gland via GR2. Finally, asa significant effect of confinement stress on CR expressions was observed in the pituitary gland, we completed this experiment by demonstrating that corticosteroid receptors (GR1, GR2 and MR) are co-expressed in the ACTH cells located in the adenohypophysis. Overall, these data suggest the involvement of these receptors in the regulation of the HPI axis activity by cortisol. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Restoring penis sensation in patients with low spinal cord lesions: the role of the remaining function of the dorsal nerve in a unilateral or bilateral TOMAX procedure.

    Overgoor, Max L E; Braakhekke, Jan P; Kon, Moshe; De Jong, Tom P V M

    2015-04-01

    The recently developed TOMAX-procedure restores unilateral genital sensation, improving sexual health in men with a low spinal lesion (LSL). It connects one dorsal nerve of the penis (DNP) to the intact ipsilateral ilioinguinal nerve. We proposed bilateral neurotization for full sensation of the glans but this entails cutting both DNPs, risking patients' erection/ejaculation ability. The objective was to select patients for a bilateral TOMAX-procedure by measuring remaining DNP function, and perform the first bilateral cases. In 30 LSL patients with no penile- but normal groin sensation selected for a unilateral TOMAX-procedure the integrity of the sacral-reflex-arc and DNP function was tested pre-operatively using bilateral needle electromyography (EMG)-bulbocavernosus reflex (BCR) measurements, and an interview about reflex erections (RE) ability. In 13 spina bifida- and 17 spinal cord injury patients [median age 29.5 years (range 13-59 years), spinal lesion T12 (incomplete) to sacral], seven (23%) patients reported RE, four (57%) with intact BCR, and of nine (30%) patients with intact BCR, four reported RE (44%). Even patients with a LSL and no penile sensation can have signs of remaining DNP function, but cutting both DNPs to restore full glans sensation in a bilateral TOMAX-procedure might interfere with their RE/ejaculation. To avoid this risk, we propose a selecting-protocol for a unilateral- or bilateral procedure using RE and BCR measurements. Using this protocol, three patients were bilaterally operated with promising preliminary results. Full sensation of the glans could lead to further improvement in sexual function. © 2014 Wiley Periodicals, Inc.

  17. Systemic corticosteroids for acute otitis media in children.

    Ranakusuma, Respati W; Pitoyo, Yupitri; Safitri, Eka D; Thorning, Sarah; Beller, Elaine M; Sastroasmoro, Sudigdo; Del Mar, Chris B

    2018-03-15

    Acute otitis media (AOM) is a common acute infection in children. Pain is its most prominent and distressing symptom. Antibiotics are commonly prescribed for AOM, although they have only a modest effect in reducing pain at two to three days. There is insufficient evidence for benefits of other treatment options, including systemic corticosteroids. However, systemic corticosteroids are potent anti-inflammatory drugs, and so theoretically could be effective, either alone or as an addition to antibiotics. To assess the effects of systemic corticosteroids (oral or parenteral), with or without antibiotics, for AOM in children. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane ARI Group's Specialised Register, MEDLINE (Ovid), Embase (Elsevier), CINAHL (EBSCO), Web of Science (Thomson Reuters), and LILACS (BIREME) for published studies, and ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) for completed and ongoing studies, to 20 February 2018. We checked the reference lists of all primary studies and review articles for additional references and contacted experts in the field to identify additional unpublished materials. We included randomised controlled trials of children with AOM that compared any systemic corticosteroid (oral or parenteral) with placebo, either with antibiotics (corticosteroid plus antibiotic versus placebo plus antibiotic) or without antibiotics (corticosteroid versus placebo). Three review authors (EDS, RR, YP) independently screened the titles and abstracts and retrieved the full texts of potentially relevant studies. We independently extracted study characteristics and outcome data from the included studies, and assessed the risk of bias for each study using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We assessed study quality using the GRADE method. We included two studies involving 252

  18. Restoration of Failed Renal Graft Function After Successful Angioplasty of Pressure-Resistant Renal Artery Stenosis Using a Cutting Balloon: A Case Report

    Peregrin, J. H.; Buergelova, M.

    2009-01-01

    This study is the report of a 37-year-old male with a transplanted kidney from a 3.5-year-old donor: the graft had two arteries transplanted with an aortic patch to an external iliac artery. Four months after transplantation, the graft function deteriorated, together with the development of hypertension. Stenosis of both graft arteries was detected and the patient was referred for angioplasty. The angiographic result was suboptimal, nevertheless, the graft function improved and was more or less stable (serum creatinine, 160-200 μmol/l) for 4 years, along with persistently difficult-to-control hypertension. Five years after transplantation, the graft function deteriorated again and severe graft artery restenosis was detected. The restenosis did not respond to dilatation, graft function failed, hypertension decompensated, and left ventricular failure developed. The patient required dialysis. A cutting balloon angioplasty opened the artery, and kidney function was restored after a few days: the serum creatinine level dropped to 140-160 μmol/l, and the glomerular filtration rate (creatinine clearance) to 0.65 ml/min/1.73 m 2 . The graft function has now been stable for more than 2 years, however, the hypertension is still difficult to control.

  19. Corticosteroids in the treatment of dengue shock syndrome.

    Rajapakse, Senaka; Rodrigo, Chaturaka; Maduranga, Sachith; Rajapakse, Anoja Chamarie

    2014-01-01

    Dengue infection causes significant morbidity and mortality in over 100 countries worldwide, and its incidence is on the rise. The pathophysiological basis for the development of severe dengue, characterized by plasma leakage and the "shock syndrome" are poorly understood. No specific treatment or vaccine is available, and careful monitoring and judicious administration of fluids forms the mainstay of management at present. It is postulated that vascular endothelial dysfunction, induced by cytokine and chemical mediators, is an important mechanism of plasma leakage. Although corticosteroids are potent modulators of the immune system, their role in pharmacological doses in modulating the purported immunological effects that take place in severe dengue has been a subject of controversy. The key evidence related to the role of corticosteroids for various manifestations of dengue are reviewed here. In summary, there is currently no high-quality evidence supporting the beneficial effects of corticosteroids for treatment of shock, prevention of serious complications, or increasing platelet counts. Non-randomized trials of corticosteroids given as rescue medication for severe shock have shown possible benefit. Nonetheless, the evidence base is small, and good-quality trials are lacking. We reiterate the need for well-designed and adequately powered randomized controlled trials of corticosteroids for the treatment of dengue shock.

  20. Predictable repair of provisional restorations.

    Hammond, Barry D; Cooper, Jeril R; Lazarchik, David A

    2009-01-01

    The importance of provisional restorations is often downplayed, as they are thought of by some as only "temporaries." As a result, a less-than-ideal provisional is sometimes fabricated, in part because of the additional chair time required to make provisional modifications when using traditional techniques. Additionally, in many dental practices, these provisional restorations are often fabricated by auxillary personnel who may not be as well trained in the fabrication process. Because provisionals play an important role in achieving the desired final functional and esthetic result, a high-quality provisional restoration is essential to fabricating a successful definitive restoration. This article describes a method for efficiently and predictably repairing both methacrylate and bis-acryl provisional restorations using flowable composite resin. By use of this relatively simple technique, provisional restorations can now be modified or repaired in a timely and productive manner to yield an exceptional result. Successful execution of esthetic and restorative dentistry requires attention to detail in every aspect of the case. Fabrication of high-quality provisional restorations can, at times, be challenging and time consuming. The techniques for optimizing resin provisional restorations as described in this paper are pragmatic and will enhance the delivery of dental treatment.

  1. Assessment and restoring soil functionality in degraded areas of organic vineyards. The preliminary results of the ReSolVe project in Italy

    Priori, Simone; Agnelli, Alessandro; Castaldini, Maurizio; D'Avino, Lorenzo; D'Errico, Giada; Gagnarli, Elena; Giudi, Silvia; Goggioli, Donatella; Lagomarsino, Alessandra; Landi, Silvia; Leprini, Marco; Pellegrini, Sergio; Perria, Rita; Puccioni, Sergio; Simoni, Sauro; Storchi, Paolo; Valboa, Giuseppe; Zombardo, Alessandra; Costantini, Edoardo

    2016-04-01

    In both conventional and organic Italian vineyards, it is quite common to have areas characterized by problems in vine health, grape production and quality, often caused by improper land preparation before vine plantation and/or management. Causes for soil malfunctioning can include: reduced contribution of the soil fauna to the ecosystem services (i.e. nutrient cycles), poor organic matter content, imbalance of some element ratio, altered pH, water deficiency, soil compaction and/or scarce oxygenation. ReSolVe is a transnational and interdisciplinary 3-years research project aimed at testing the effects of selected organic strategies for restoring optimal soil functionality in degraded areas within vineyard. The different restoring strategies implemented in each plot will be: i) compost produced on farm by manure + pruning residue + grass, ii) faba bean and barley green manure, iii) sowing and dry mulching with Trifolium squarrosum L. During two years of such treatments, the trend of the soil features and the grapevine status will be monitored in detail, to reveal the positive and negative effects of such treatments. The project involves 8 research groups in 6 different EU countries (Italy, France, Spain, Sweden, Slovenia, and Turkey), with experts from several disciplines, including soil science, ecology, microbiology, grapevine physiology, viticulture, and biometry. The experimental vineyards are situated in Italy (Chianti hills and Maremma plain, Tuscany), France (Bordeaux and Languedoc), Spain (La Rioja) and Slovenia (Primorska) for winegrape, and in Turkey (Adana and Mersin) for table grape. Soil features before implementing restoring strategies showed lower content of soil organic matter and enzyme activities, and higher carbonates in degraded areas than in the non-degraded areas. The Biological Soil Quality values of microarthropods were always high, in comparison with data registered in similarly managed vineyards or stable ecosystems, and the data showed

  2. Hybrid brain-computer interfaces and hybrid neuroprostheses for restoration of upper limb functions in individuals with high-level spinal cord injury.

    Rohm, Martin; Schneiders, Matthias; Müller, Constantin; Kreilinger, Alex; Kaiser, Vera; Müller-Putz, Gernot R; Rupp, Rüdiger

    2013-10-01

    The bilateral loss of the grasp function associated with a lesion of the cervical spinal cord severely limits the affected individuals' ability to live independently and return to gainful employment after sustaining a spinal cord injury (SCI). Any improvement in lost or limited grasp function is highly desirable. With current neuroprostheses, relevant improvements can be achieved in end users with preserved shoulder and elbow, but missing hand function. The aim of this single case study is to show that (1) with the support of hybrid neuroprostheses combining functional electrical stimulation (FES) with orthoses, restoration of hand, finger and elbow function is possible in users with high-level SCI and (2) shared control principles can be effectively used to allow for a brain-computer interface (BCI) control, even if only moderate BCI performance is achieved after extensive training. The individual in this study is a right-handed 41-year-old man who sustained a traumatic SCI in 2009 and has a complete motor and sensory lesion at the level of C4. He is unable to generate functionally relevant movements of the elbow, hand and fingers on either side. He underwent extensive FES training (30-45min, 2-3 times per week for 6 months) and motor imagery (MI) BCI training (415 runs in 43 sessions over 12 months). To meet individual needs, the system was designed in a modular fashion including an intelligent control approach encompassing two input modalities, namely an MI-BCI and shoulder movements. After one year of training, the end user's MI-BCI performance ranged from 50% to 93% (average: 70.5%). The performance of the hybrid system was evaluated with different functional assessments. The user was able to transfer objects of the grasp-and-release-test and he succeeded in eating a pretzel stick, signing a document and eating an ice cream cone, which he was unable to do without the system. This proof-of-concept study has demonstrated that with the support of hybrid FES

  3. Curcumin restores mitochondrial functions and decreases lipid peroxidation in liver and kidneys of diabetic db/db mice

    María G Soto-Urquieta

    2014-01-01

    Full Text Available BACKGROUND: Nitrosative and oxidative stress play a key role in obesity and diabetes-related mitochondrial dysfunction. The objective was to investigate the effect of curcumin treatment on state 3 and 4 oxygen consumption, nitric oxide (NO synthesis, ATPase activity and lipid oxidation in mitochondria isolated from liver and kidneys of diabetic db/db mice. RESULTS: Hyperglycaemia increased oxygen consumption and decreased NO synthesis in liver mitochondria isolated from diabetic mice relative to the control mice. In kidney mitochondria, hyperglycaemia increased state 3 oxygen consumption and thiobarbituric acid-reactive substances (TBARS levels in diabetic mice relative to control mice. Interestingly, treating db/db mice with curcumin improved or restored these parameters to normal levels; also curcumin increased liver mitochondrial ATPase activity in db/db mice relative to untreated db/db mice. CONCLUSIONS: These findings suggest that hyperglycaemia modifies oxygen consumption rate, NO synthesis and increases TBARS levels in mitochondria from the liver and kidneys of diabetic mice, whereas curcumin may have a protective role against these alterations.

  4. Membrane Lipid Replacement for chronic illnesses, aging and cancer using oral glycerolphospholipid formulations with fructooligosaccharides to restore phospholipid function in cellular membranes, organelles, cells and tissues.

    Nicolson, Garth L; Ash, Michael E

    2017-09-01

    Membrane Lipid Replacement is the use of functional, oral supplements containing mixtures of cell membrane glycerolphospholipids, plus fructooligosaccharides (for protection against oxidative, bile acid and enzymatic damage) and antioxidants, in order to safely replace damaged, oxidized, membrane phospholipids and restore membrane, organelle, cellular and organ function. Defects in cellular and intracellular membranes are characteristic of all chronic medical conditions, including cancer, and normal processes, such as aging. Once the replacement glycerolphospholipids have been ingested, dispersed, complexed and transported, while being protected by fructooligosaccharides and several natural mechanisms, they can be inserted into cell membranes, lipoproteins, lipid globules, lipid droplets, liposomes and other carriers. They are conveyed by the lymphatics and blood circulation to cellular sites where they are endocytosed or incorporated into or transported by cell membranes. Inside cells the glycerolphospholipids can be transferred to various intracellular membranes by lipid globules, liposomes, membrane-membrane contact or by lipid carrier transfer. Eventually they arrive at their membrane destinations due to 'bulk flow' principles, and there they can stimulate the natural removal and replacement of damaged membrane lipids while undergoing further enzymatic alterations. Clinical trials have shown the benefits of Membrane Lipid Replacement in restoring mitochondrial function and reducing fatigue in aged subjects and chronically ill patients. Recently Membrane Lipid Replacement has been used to reduce pain and other symptoms as well as removing hydrophobic chemical contaminants, suggesting that there are additional new uses for this safe, natural medicine supplement. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights

  5. Acromion types and role of corticosteroid with shoulder impingement syndrome

    Akram, M.; Gillani, S.F.U.S.; Awais, S.M.

    2016-01-01

    To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. Study Design: A descriptive study. Place and Duration of Study: Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014. Methodology: All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p<0.05. Among the 101 cases, there was no case of tear of rotator cuff tendon on clinical assessment. Majority of the patients (58.4%) were females with mean age of 31.38 +-1.13 years. Majority 57 (56.4%) of the patients had acromion type II (curved), which was the most common cause of shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them. Conclusion: Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification. (author)

  6. Antibody induction versus corticosteroid induction for liver transplant recipients

    Penninga, Luit; Wettergren, André; Wilson, Colin H

    2014-01-01

    BACKGROUND: Liver transplantation is an established treatment option for end-stage liver failure. To date, no consensus has been reached on the use of immunosuppressive T-cell specific antibody induction compared with corticosteroid induction of immunosuppression after liver transplantation....... OBJECTIVES: To assess the benefits and harms of T-cell specific antibody induction versus corticosteroid induction for prevention of acute rejection in liver transplant recipients. SEARCH METHODS: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register...... to identify additional trials. SELECTION CRITERIA: We included all randomised clinical trials assessing immunosuppression with T-cell specific antibody induction versus corticosteroid induction in liver transplant recipients. Our inclusion criteria stated that participants within each included trial should...

  7. Restoration of a fractured central incisor.

    Olson, Bradley J

    2012-03-01

    The treatment of a traumatically damaged single central incisor poses significant challenges relative to function and esthetics to the restoring clinician. Providing a good long-term prognosis is paramount when determining whether to maintain or extract a structurally compromised tooth. Successful restoration demands timely and thorough risk assessment along with excellent communication with both the patient and the laboratory fabricating the restoration.

  8. Lower corticosteroid skin blanching response is associated with severe COPD.

    Susan J M Hoonhorst

    Full Text Available Chronic obstructive pulmonary disease (COPD is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive to steroids in COPD than in asthma. The underlying mechanisms are yet unclear. This study aimed to assess whether skin corticosteroid insensitivity is associated with COPD and COPD severity using the corticosteroid skin blanching test.COPD patients GOLD stage I-IV (n = 27, 24, 22, and 16 respectively and healthy never-smokers and smokers (n = 28 and 56 respectively were included. Corticosteroid sensitivity was assessed by the corticosteroid skin blanching test. Budesonide was applied in 8 logarithmically increasing concentrations (0-100 μg/ml on subject's forearm. Assessment of blanching was performed after 7 hours using a 7-point scale (normal skin to intense blanching. All subjects performed spirometry and body plethysmography.Both GOLD III and GOLD IV COPD patients showed significantly lower skin blanching responses than healthy never-smokers and smokers, GOLD I, and GOLD II patients. Their area under the dose-response curve values of the skin blanching response were 586 and 243 vs. 1560, 1154, 1380, and 1309 respectively, p<0.05. Lower FEV1 levels and higher RV/TLC ratios were significantly associated with lower skin blanching responses (p = 0.001 and p = 0.004 respectively. GOLD stage I, II, III and IV patients had similar age and packyears.In this study, severe and very severe COPD patients had lower skin corticosteroid sensitivity than mild and moderate COPD patients and non-COPD controls with comparable age and packyears. Our findings together suggest that the reduced skin blanching response fits with a subgroup of COPD patients that has an early-onset COPD phenotype.

  9. The effects of oral and topical corticosteroid in rabbit corneas.

    Araki-Sasaki, Kaoru; Katsuta, Osamu; Mano, Hidetoshi; Nagano, Takashi; Nakamura, Masatsugu

    2016-09-05

    To determine the most effective route of administration of corticosteroids in the treatment of ocular surface disease, by characterizing the difference between oral prednisolone and topical dexamethasone administration using an animal model. Pharmacokinetic analyses determined the corticosteroid concentrations in the normal ocular tissues of rabbits after oral or topical administration of corticosteroids using LC-MS/MS. In wound healing analyses, the area of the epithelial defect created by keratectomy using a 6-mm trephine was calculated with an image analyzer using an orally or topically steroid-administrated animal model. The average size of basal epithelial cells, the frequency of mitotic basal epithelial cells, the number of squamous cells, and the number of hypertrophic stromal fibroblasts were determined in the enucleated corneal tissues after wound closure. By slit lamp examination, no remarkable differences were observed between orally and topically administered groups. Pharmacokinetic analyses showed that the distribution of dexamethasone after topical administration was superior to that after oral administration in the cornea. In contrast, both concentrations of corticosteroid applied topically and orally were similar with regards to AUCs (area under the concentration-time curve) in the conjunctiva. Although the healing rate was slower in the topical group, all corneas were almost healed within 96 h in the wound healing analysis. According to the histological analyses of epithelial cells, the average basal cell size was larger, the frequency of mitotic basal cells was greater, and the number of squamous epithelial cell layers was lower in the topically administered group although all of these differences were with no statistical significance. However, the number of hypertrophic stromal fibroblasts in the topically administered group was significantly lower than that in the orally administered group. There are different distributions and effects between

  10. A rapid screen for four corticosteroids in equine synovial fluid.

    Agrawal, Karan; Ebel, Joseph G; Bischoff, Karyn

    2014-06-01

    Most antidoping method development in the equine industry has been for plasma and urine, though there has been recent interest in the analysis of synovial fluid for evidence of doping by intra-articular corticosteroid injection. Published methods for corticosteroid analysis in synovial fluid are primarily singleplex methods, do not screen for all corticosteroids of interest and are not adequately sensitive. The purpose of this study is to develop a rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS-MS) screening method for the detection of four of the most common intra-articularly administered corticosteroids--betamethasone, methylprednisolone, methylprednisolone acetate and triamcinolone acetonide. Sample preparation consisted of protein precipitation followed by a basified liquid-liquid extraction. LC-MS-MS experiments consisted of a six-min isocratic separation using a Phenomenex Polar-RP stationary phase and a mobile phase consisting of 35% acetonitrile, 5 mM ammonium acetate and 0.1% formic acid in nanopure water. The detection system used was a triple quadrupole mass analyzer with thermospray ionization, and compounds were identified using selective reaction monitoring. The method was validated to the ISO/IEC 17025 standard, and real synovial fluid samples were analyzed to demonstrate the application of the method in an antidoping context. The method was highly selective for the four corticosteroids with limits of detection of 1-3 ng/mL. The extraction efficiency was 50-101%, and the matrix effects were 14-31%. These results indicate that the method is a rapid and sensitive screen for the four corticosteroids in equine synovial fluid, fit for purpose for equine antidoping assays.

  11. Corticosteroids in the treatment of dengue shock syndrome

    Rajapakse S

    2014-05-01

    Full Text Available Senaka Rajapakse,1 Chaturaka Rodrigo,1 Sachith Maduranga,1 Anoja Chamarie Rajapakse21Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; 2Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Sutton-in-Ashfield, Nottinghamshire, UKAbstract: Dengue infection causes significant morbidity and mortality in over 100 countries worldwide, and its incidence is on the rise. The pathophysiological basis for the development of severe dengue, characterized by plasma leakage and the “shock syndrome” are poorly understood. No specific treatment or vaccine is available, and careful monitoring and judicious administration of fluids forms the mainstay of management at present. It is postulated that vascular endothelial dysfunction, induced by cytokine and chemical mediators, is an important mechanism of plasma leakage. Although corticosteroids are potent modulators of the immune system, their role in pharmacological doses in modulating the purported immunological effects that take place in severe dengue has been a subject of controversy. The key evidence related to the role of corticosteroids for various manifestations of dengue are reviewed here. In summary, there is currently no high-quality evidence supporting the beneficial effects of corticosteroids for treatment of shock, prevention of serious complications, or increasing platelet counts. Non-randomized trials of corticosteroids given as rescue medication for severe shock have shown possible benefit. Nonetheless, the evidence base is small, and good-quality trials are lacking. We reiterate the need for well-designed and adequately powered randomized controlled trials of corticosteroids for the treatment of dengue shock.Keywords: dengue, dengue shock, shock, corticosteroids, vascular leak, thrombocytopenia

  12. The modern view of the idea of gamma-aminobutyric acid and its metabolite use to restore the motor function

    А. G. Rodinskij

    2015-08-01

    Full Text Available Aim. The literature review is devoted to the idea of using gamma-aminobutyric acid and its metabolites as medicines in conditions of peripheral nervous system injury. We examined the modern problems of denervated muscles restoration and a wide range of GABA effects which could be useful in conditions of injury. GABA and its metabolites have elements of nootropic, antihypoxic, organoprotective and anabolic activity. It is obvious that traumas of peripheral nerves lead to degeneration of injured fibers and significant disorders of metabolism at a number of regulatory levels. Regeneration of the nerve and the rate of recovery of muscle activity depend significantly on the level of resistivity of the injured nerve tissue and on possibilities for supply of this tissue by additional energetic reserves. Under the above-mentioned conditions, disorders are determined, to a significant extent, by the development of hypoxia. This is why elucidation of the phenomenology and mechanisms of action of GABA and its metabolites (agent are having, as was mentioned above, protective and antihypoxic properties on the nerve/muscle apparatus and its links under conditions of traumatization of a large nerve is urgent. GABA and its metabolites have an antinociceptive activity which helps not only in inhibition of central and spinal neurons, but also helps to decrease pain sensitivity of patient after traumatic neuropathy to forming of motivation to recovery rehabilitation. Besides above mentioned, the ability of GABA to increase concentration of Ca2 + after injury was discussed. This ability may affect the expression of genes, the direction of the growth cone, and, perhaps, reduce cell death. Conclusion. This indicates that the GABA has a selectivity of action to the damaged structure and can be prospective agent for regenerative therapy.

  13. Nerve transfers for restoration of upper extremity motor function in a child with upper extremity motor deficits due to transverse myelitis: case report.

    Dorsi, Michael J; Belzberg, Allan J

    2012-01-01

    Transverse myelitis (TM) may result in permanent neurologic dysfunction. Nerve transfers have been developed to restore function after peripheral nerve injury. Here, we present a case report of a child with permanent right upper extremity weakness due to TM that underwent nerve transfers. The following procedures were performed: double fascicle transfer from median nerve and ulnar nerve to the brachialis and biceps branches of the musculocutaneous nerve, spinal accessory to suprascapular nerve, and medial cord to axillary nerve end-to-side neurorraphy. At 22 months, the patient demonstrated excellent recovery of elbow flexion with minimal improvement in shoulder abduction. We propose that the treatment of permanent deficits from TM represents a novel indication for nerve transfers in a subset of patients. Copyright © 2011 Wiley Periodicals, Inc.

  14. Hypothermia-induced loss of endothelial barrier function is restored after dopamine pretreatment : Role of p42/p44 activation

    Brinkkoetter, Paul-Thomas; Beck, Grietje C.; Gottmann, Uwe; Loesel, Ralf; Schnetzke, Ulf; Rudic, Boris; Hanusch, Christine; Rafat, Neysan; Liu, Zhenzi; Weiss, Christel; Leuvinik, Henri G. D.; Ploeg, Rutger; Braun, Claude; Schnuelle, Peter; van der Woude, Fokko J.; Yard, Benito A.

    2006-01-01

    Background. Donor dopamine usage is associated with improved immediate graft function after renal transplantation. Although prolonged cold preservation results in an increased vascular permeability, the present study was conducted to examine in vitro and in vivo if dopamine Pretreatment influences

  15. Role of reclamation in the formation of functional structure of beetle communities: A different approach to restoration

    Hodeček, J.; Kuras, T.; Šipoš, Jan; Dolný, A.

    2016-01-01

    Roč. 94, 1 SEPTEMBER (2016), s. 537-544 ISSN 0925-8574 Institutional support: RVO:67985939 Keywords : epigeic beetle * functional diversity * post- industrial habitat Subject RIV: EH - Ecology, Behaviour Impact factor: 2.914, year: 2016

  16. Iloprost preserves renal oxygenation and restores kidney function in endotoxemia-related acute renal failure in the rat

    Johannes, Tanja; Ince, Can; Klingel, Karin; Unertl, Klaus E.; Mik, Egbert G.

    2009-01-01

    Objective: To investigate that exogenous prostacyclin would counterbalance an endotoxemia-induced intrarenal vasoconstriction and would therefore have beneficial effects on kidney function. Design: Prospective, randomized, controlled study. Setting: University medical center research laboratory.

  17. Can workers with chronic back pain shift from pain elimination to function restore at work? Qualitative evaluation of an innovative work related multidisciplinary programme.

    Buijs, Peter C; Lambeek, Ludeke C; Koppenrade, Vera; Hooftman, Wendela E; Anema, Johannes R

    2009-01-01

    Workers with chronic low back pain (LBP) mean a heavy human and social-economic burden. Their medical histories often include different treatments without attention to work-relatedness or communication with occupational health providers, leaving them passive and medicalized in (outpatient) health care. So we developed and implemented an innovative, patient-activating alternative: the multidisciplinary outpatient care (MOC) programme, including work(place) intervention and graded activity. It aims at function restore (instead of pain elimination), return to work (RTW) and coordinated communication. To qualitatively explore how patients and health care providers perceive the programme effectiveness and which factors influence its implementation. In-depth, semi structured interview with patients and focus groups of health care providers are used, all recorded, transformed into verbatim transcript and analysed. This qualitative study shows that although patients' expectations were low at the start of the program, and despite long LBP histories, including many different therapies, (primarily) directed at pain reduction, the MOC programme was successful in changing patients' goal setting from pain oriented towards function restore and RTW. The programme was therefore perceived as applicable and effective. Patient compliance was influenced by barriers - despair, supervisory and subordinate resistance at work, waiting period, medicalisation in health care - and facilitators: disciplinary motivation, protocolled communication, information supply, tailor-made exercises. For some patients the barriers were too high. Several improvement suggestions were given. This qualitative study shows that generally, patients and professionals perceived the multidisciplinary outpatient care programme as applicable and effective. After incorporating improvement suggestions this program seems promising for further, broader application and hypothesis testing. For those, negatively evaluating

  18. Optimal timing and frequency of bone marrow soup therapy for functional restoration of salivary glands injured by single-dose or fractionated irradiation.

    Fang, Dongdong; Shang, Sixia; Liu, Younan; Bakkar, Mohammed; Sumita, Yoshinori; Seuntjens, Jan; Tran, Simon D

    2018-02-01

    Injections of bone marrow (BM) cell extract, known as 'BM soup', were previously reported to mitigate ionizing radiation (IR) injury to salivary glands (SGs). However, the optimal starting time and frequency to maintain BM soup therapeutic efficacy remains unknown. This study tested the optimal starting time and frequency of BM soup injections in mice radiated with either a single dose or a fractionated dose. First, BM soup treatment was started at 1, 3 or 7 weeks post-IR; positive (non-IR) and negative (IR) control mice received injections of saline (vehicle control). Second, BM soup-treated mice received injections at different frequencies (1, 2, 3 and 5 weekly injections). Third, a 'fractionated-dose radiation' model to injure mouse SGs was developed (5 Gy × 5 days) and compared with the single high dose radiation model. All mice (n = 65) were followed for 16 weeks post-IR. The results showed that starting injections of BM soup between 1 and 3 weeks mitigated the effect of IR-induced injury to SGs and improved the restoration of salivary function. Although the therapeutic effect of BM soup lessens after 8 weeks, it can be sustained by increasing the frequency of weekly injections. Moreover, both single-dose and fractionated-dose radiation models are efficient and comparable in inducing SG injury and BM soup treatments are effective in restoring salivary function in both radiation models. In conclusion, starting injections of BM soup within 3 weeks post-radiation, with 5 weekly injections, maintains 90-100% of saliva flow in radiated mice. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Soil-covered strategy for ecological restoration alters the bacterial community structure and predictive energy metabolic functions in mine tailings profiles.

    Li, Yang; Sun, Qingye; Zhan, Jing; Yang, Yang; Wang, Dan

    2017-03-01

    Native soil amendment has been widely used to stabilize mine tailings and speed up the development of soil biogeochemical functions before revegetation; however, it remains poorly understood about the response of microbial communities to ecological restoration of mine tailings with soil-covered strategy. In this study, microbial communities along a 60-cm profile were investigated in mine tailings during ecological restoration of two revegetation strategies (directly revegetation and native soil covered) with different plant species. The mine tailings were covered by native soils as thick as 40 cm for more than 10 years, and the total nitrogen, total organic carbon, water content, and heavy metal (Fe, Cu, and Zn) contents in the 0-40 cm intervals of profiles were changed. In addition, increased microbial diversity and changed microbial community structure were also found in the 10-40 cm intervals of profiles in soil-covered area. Soil-covered strategy rather than plant species and soil depth was the main factor influencing the bacterial community, which explained the largest portion (29.96%) of the observed variation. Compared directly to revegetation, soil-covered strategy exhibited the higher relative abundance of Acidobacteria and Deltaproteobacteria and the lower relative abundance of Bacteroidetes, Gemmatimonadetes, Betaproteobacteria, and Gammaproteobacteria. PICRUSt analysis further demonstrated that soil-covered caused energy metabolic functional changes in carbon, nitrogen, and sulfur metabolism. Given all these, the soil-covered strategy may be used to fast-track the establishment of native microbial communities and is conducive to the rehabilitation of biogeochemical processes for establishing native plant species.

  20. Salmosan, a β-galactomannan-rich product, in combination with Lactobacillus plantarum contributes to restore intestinal epithelial barrier function by modulation of cytokine production.

    Brufau, M Teresa; Campo-Sabariz, Joan; Carné, Sergi; Ferrer, Ruth; Martín-Venegas, Raquel

    2017-03-01

    Mannan-oligosaccharides (MOSs) are mannose-rich substrates with several intestinal health-promoting properties. The aim of this study was to investigate the potential capacity of Salmosan (S-βGM), a β-galactomannan-rich MOS product, to restore epithelial barrier function independently from its capacity to reduce bacterial invasion. In addition, the combination of S-βGM with the proven probiotic Lactobacillus plantarum (LP) was also tested. Paracellular permeability was assessed by transepithelial electrical resistance (TER) in co-cultures of Caco-2 cells and macrophages (differentiated from THP-1 cells) stimulated with LPS of Salmonella Enteritidis and in Caco-2 cell cultures stimulated with TNF-α in the absence or presence of 500 μg/ml S-βGM, LP (MOI 10) or a combination of both. In both culture models, TER was significantly reduced up to 25% by LPS or TNF-α stimulation, and the addition of S-βGM or LP alone did not modify TER, whereas the combination of both restored TER to values of nonstimulated cells. Under LPS stimulation, TNF-α production was significantly increased by 10-fold, whereas IL-10 and IL-6 levels were not modified. The combination of S-βGM and LP reduced TNF-α production to nonstimulated cell values and significantly increased IL-10 and IL-6 levels (5- and 7.5-fold, respectively). Moreover, S-βGM has the capacity to induce an increase of fivefold in LP growth. In conclusion, we have demonstrated that S-βGM in combination with LP protects epithelial barrier function by modulation of cytokine secretion, thus giving an additional value to this MOS as a potential symbiotic. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Tc-99m technegas scintigraphy to evaluate the lung ventilation in patients with oral corticosteroid-dependent bronchial asthma

    Fujita, Jiro; Okada, Hiroki; Momoi, Atsuko; Yamadori, Ichiro; Takahara, Jiro; Tanabe, Masatada; Takahashi, Kazue; Satoh, Katashi; Ohkawa, Motoomi

    1999-01-01

    Bronchial asthma is a clinical syndrome characterized by the reversibility of airway obstruction. Recently it has been suggested that remodeling of the airway causes irreversible airway obstruction which may be responsible for the patient's symptoms. With this background, the purpose of the present study was to assess patients with corticosteroid-dependent asthma by Tc-99m Technegas scintigraphy (Technegas) in both planar and SPECT images. Twelve patients (7 females and 5 males aged 36-72 years with a median age of 60 years: 4 smokers and 8 non-smokers) with oral corticosteroid-dependent asthma were enrolled in this study. Lung ventilation scanning with Technegas in both planar and SPECT images, high-resolution computed tomography, and pulmonary function tests were performed in all patients. The results of Technegas scanning were graded and correlations with other clinical parameters were evaluated. Significant abnormalities were detected by ventilation scintigraphy with Technegas in patients with corticosteroid-dependent bronchial asthma even during remission. Our data demonstrate that airflow obstruction took place in patients with corticosteroid-dependent asthma even during remission. Technegas scanning appears to be a useful radiopharmaceutical for demonstrating airflow obstruction in patients with bronchial asthma. (author)

  2. Tc-99m technegas scintigraphy to evaluate the lung ventilation in patients with oral corticosteroid-dependent bronchial asthma

    Fujita, Jiro; Okada, Hiroki; Momoi, Atsuko; Yamadori, Ichiro; Takahara, Jiro; Tanabe, Masatada [Kagawa Medical Univ., Miki (Japan); Takahashi, Kazue; Satoh, Katashi; Ohkawa, Motoomi

    1999-08-01

    Bronchial asthma is a clinical syndrome characterized by the reversibility of airway obstruction. Recently it has been suggested that remodeling of the airway causes irreversible airway obstruction which may be responsible for the patient's symptoms. With this background, the purpose of the present study was to assess patients with corticosteroid-dependent asthma by Tc-99m Technegas scintigraphy (Technegas) in both planar and SPECT images. Twelve patients (7 females and 5 males aged 36-72 years with a median age of 60 years: 4 smokers and 8 non-smokers) with oral corticosteroid-dependent asthma were enrolled in this study. Lung ventilation scanning with Technegas in both planar and SPECT images, high-resolution computed tomography, and pulmonary function tests were performed in all patients. The results of Technegas scanning were graded and correlations with other clinical parameters were evaluated. Significant abnormalities were detected by ventilation scintigraphy with Technegas in patients with corticosteroid-dependent bronchial asthma even during remission. Our data demonstrate that airflow obstruction took place in patients with corticosteroid-dependent asthma even during remission. Technegas scanning appears to be a useful radiopharmaceutical for demonstrating airflow obstruction in patients with bronchial asthma. (author)

  3. The Dilemma of Irrational Antibiotic and Corticosteroid Prescription in Iran: How Much It Can Affect the Medicine Expenditures?

    Mehdizadeh, Parisa; Dopeykar, Nooredin; Meskarpour-Amiri, Mohammad; Zekri, Hediyeh; Salesi, Mahmoud

    2017-10-01

    In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures. We used the data of 91,994,667 selected prescription letters that were collected by the Ministry of the Health and Medical Education (MOHME) throughout the country in the year 2011 which was analyzed through a logarithmic regression model and OLS estimator. The average number of prescription items in each prescription letter were varied from 2.7 to 3.6, and the average price of each letter was varied from 30223 to 69986 Rials. Between 39 to 61 percent of prescription letters containing antibiotic items and between 15 and 35% of them contain corticosteroids. Also, the impact of antibiotic and corticosteroid prescriptions on the average expenditure of prescription letters were -1.4 and 0.032 respectively. Excessive and irrational prescribing had the greatest impact on medicine expenditures. On the other hand, the expenditure of prescription letters had the negative elasticity to antibiotics prescription and relatively inelastic for corticosteroids. So, raising the price of medications to reduce the use of them could not play a successful role in a control policy.

  4. Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation.

    Giannotti, S; Giovannelli, D; Dell'Osso, G; Bottai, V; Bugelli, G; Celli, F; Citarelli, C; Guido, G

    2016-04-01

    The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures. From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint. No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images. Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.

  5. Human CD4 restores normal T cell development and function in mice deficient in murine CD4

    1994-01-01

    The ability of a human coreceptor to function in mice was investigated by generating human CD4 (hCD4)-expressing transgenic mice on a mouse CD4-deficient (mCD4-/-) background. From developing thymocyte to matured T lymphocyte functions, hCD4 was shown to be physiologically active. By examining the expansion and deletion of specific V beta T cell families in mutated mice with and without hCD4, it was found that hCD4 can participate in positive and negative selection. Mature hCD4 single positiv...

  6. EFFECTS OF CORTICOSTEROIDS ON BRONCHODILATOR ACTION IN CHRONIC OBSTRUCTIVE LUNG-DISEASE

    WEMPE, JB; POSTMA, DS; BREEDERVELD, N; KORT, E; VANDERMARK, TW; KOETER, GH

    Background Short term treatment corticosteroids does not usually reduce airflow limitation and airway responsiveness in patients with chronic obstructive lung disease. We investigated whether corticosteroids modulate the effects of inhaled salbutamol and ipratropium bromide. Methods Ten non-allergic

  7. Corticosteroid administration alters the mechanical properties of isolated collagen fascicles in rat-tail tendon

    Haraldsson, B T; Aagaard, P; Crafoord-Larsen, D

    2009-01-01

    Overload tendon injuries are frequent in recreational and elite sports. The optimal treatment strategy remains unknown, but local administration of corticosteroids is one common treatment option. The direct effects of the corticosteroid administration on the tissue are not fully understood...

  8. Acidic nanoparticles are trafficked to lysosomes and restore an acidic lysosomal pH and degradative function to compromised ARPE-19 cells.

    Gabriel C Baltazar

    Full Text Available Lysosomal enzymes function optimally in acidic environments, and elevation of lysosomal pH can impede their ability to degrade material delivered to lysosomes through autophagy or phagocytosis. We hypothesize that abnormal lysosomal pH is a key aspect in diseases of accumulation and that restoring lysosomal pH will improve cell function. The propensity of nanoparticles to end up in the lysosome makes them an ideal method of delivering drugs to lysosomes. This study asked whether acidic nanoparticles could traffic to lysosomes, lower lysosomal pH and enhance lysosomal degradation by the cultured human retinal pigmented epithelial cell line ARPE-19. Acidic nanoparticles composed of poly (DL-lactide-co-glycolide (PLGA 502 H, PLGA 503 H and poly (DL-lactide (PLA colocalized to lysosomes of ARPE-19 cells within 60 min. PLGA 503 H and PLA lowered lysosomal pH in cells compromised by the alkalinizing agent chloroquine when measured 1 hr. after treatment, with acidification still observed 12 days later. PLA enhanced binding of Bodipy-pepstatin-A to the active site of cathepsin D in compromised cells. PLA also reduced the cellular levels of opsin and the lipofuscin-like autofluorescence associated with photoreceptor outer segments. These observations suggest the acidification produced by the nanoparticles was functionally effective. In summary, acid nanoparticles lead to a rapid and sustained lowering of lysosomal pH and improved degradative activity.

  9. A bovine papillomavirus-1 based vector restores the function of the low-density lipoprotein receptor in the receptor-deficient CHO-ldlA7 cell line

    Ustav Mart

    2002-04-01

    Full Text Available Abstract Background The rationale of using bovine papillomavirus-1 (BPV-1 derived vectors in gene therapy protocols lies in their episomal maintenance at intermediate to high copy number, and stable, high-level expression of the gene products. We constructed the BPV-1 based vector harbouring the human low-density lipoprotein receptor (LDLR gene cDNA and tested its ability to restore the function of the LDLR in the receptor-deficient cell line CHO-ldlA7. Results The introduced vector p3.7LDL produced functionally active LDL receptors in the receptor-deficient cell line CHO-ldlA7 during the 32-week period of observation as determined by the internalisation assay with the labelled LDL particles. Conclusion Bovine papillomavirus type-1 (BPV-1-derived vectors could be suitable for gene therapy due to their episomal maintenance at intermediate to high copy number and stable, high-level expression of the gene products. The constructed BPV-1 based vector p3.7LDL produced functionally active LDL receptors in the LDLR-deficient cell line CHO-ldlA7 during the 32-week period of observation. In vivo experiments should reveal, whether 1–5% transfection efficiency obtained in the current work is sufficient to bring about detectable and clinically significant lowering of the amount of circulating LDL cholesterol particles.

  10. Site Restoration

    Noynaert, L.; Bruggeman, A.; Cornelissen, R.; Massaut, V.; Rahier, A

    2002-04-01

    The objectives, the programme, and the achievements of SCK-CEN's Site Restoration Department for 2001 are described. Main activities include the decommissioning of the BR3 PWR-reactor as well as other clean-up activities, projects on waste minimisation and the management of spent fuel and the flow of dismantled materials and the recycling of materials from decommissioning activities based on the smelting of metallic materials in specialised foundries. The department provides consultancy and services to external organisations and performs R and D on new techniques including processes for the treatment of various waste components including the reprocessing of spent fuel, the treatment of tritium, the treatment of liquid alkali metals into cabonates through oxidation, the treatment of radioactive organic waste and the reconditioning of bituminised waste products.

  11. Conceptual and functional approach to the design of optimized strategies of intervention for environmental restoration after a serious nuclear accident

    Vazquez, C.; Gutierrez, J.

    1997-01-01

    This work constitutes an approach to defining methodologies to deal with environmental recovery after an accident. This is a complex issue which has neither been conceptually nor functionally solved. This report summarizes the developments of the operating research projects of the Radiological Protection Programme for Intervention at CIEMAT

  12. Knowledge of health care workers on corticosteroid adverse drug ...

    The questions were open ended and the answers given were first analysed into total number of correct answers. Further analysis was done by grouping the correct answers into categories as per the systems affected by corticosteroids. A cut-off point of 6 correct answers was deemed adequate knowledge of ADRs. Correct ...

  13. Grizzly bear corticosteroid binding globulin: Cloning and serum protein expression.

    Chow, Brian A; Hamilton, Jason; Alsop, Derek; Cattet, Marc R L; Stenhouse, Gordon; Vijayan, Mathilakath M

    2010-06-01

    Serum corticosteroid levels are routinely measured as markers of stress in wild animals. However, corticosteroid levels rise rapidly in response to the acute stress of capture and restraint for sampling, limiting its use as an indicator of chronic stress. We hypothesized that serum corticosteroid binding globulin (CBG), the primary transport protein for corticosteroids in circulation, may be a better marker of the stress status prior to capture in grizzly bears (Ursus arctos). To test this, a full-length CBG cDNA was cloned and sequenced from grizzly bear testis and polyclonal antibodies were generated for detection of this protein in bear sera. The deduced nucleotide and protein sequences were 1218 bp and 405 amino acids, respectively. Multiple sequence alignments showed that grizzly bear CBG (gbCBG) was 90% and 83% identical to the dog CBG nucleotide and amino acid sequences, respectively. The affinity purified rabbit gbCBG antiserum detected grizzly bear but not human CBG. There were no sex differences in serum total cortisol concentration, while CBG expression was significantly higher in adult females compared to males. Serum cortisol levels were significantly higher in bears captured by leg-hold snare compared to those captured by remote drug delivery from helicopter. However, serum CBG expression between these two groups did not differ significantly. Overall, serum CBG levels may be a better marker of chronic stress, especially because this protein is not modulated by the stress of capture and restraint in grizzly bears. Copyright 2010 Elsevier Inc. All rights reserved.

  14. Antenatal corticosteroid use in preterm birth at Kenyatta National ...

    Background: Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malformations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO ...

  15. Bradycardia Following Oral Corticosteroid Use: Case Report and ...

    Introduction: Corticosteroids are used in various clinical conditions that include many immune-mediated inflammatory diseases. Different side effects were described including cardiac arrhythmias. Most of those arrhythmias were in the form of bradycardia which usually occurs with high intravenous steroid doses.

  16. The effects of corticosteroids and nonsteroidal anti-inflammatory ...

    The direct effects of corticosteroids on coagulation are difficult to separate from ... changes in coagulation which cannot be explained by reduced inflammation.6 ... vessel patency.11 Aspirin for CV prophylaxis is given at a low dose of 80–120 ...

  17. Effect of corticosteroid therapy in acute pain edema caused by ...

    Purpose: To evaluate the curative effect of corticosteroids in the treatment of acute pain, local edema, and skin lesions caused by herpes zoster, and to develop some pertinent therapeutic guidelines. Methods: A total of 48 cases of patients diagnosed with herpes zoster from 2010 to 2011 in the dermatology clinic of Shan ...

  18. Corticosteroids in sports-related injuries: Friend or Foe | Rotunno ...

    Corticosteroids act as potent anti-inflammatory drugs and have been used in various sport settings for the treatment of both acute and chronic injuries. Basic physiology and mechanisms of action for gluco- and mineralocorticoids are discussed. Methods of administration, the action on the inflammatory response, and ...

  19. Atopic dermatitis: tacrolimus vs. topical corticosteroid use | Langa ...

    Despite this, the US Food and Drug Administration (FDA) black box warning of possible malignancies has resulted in much debate among experts. The main focus of this article is to compare the safety and efficacy of topical corticosteroids to calcineurin inhibitors, particularly tacrolimus. Furthermore, the aim is to evaluate ...

  20. Corticosteroid Induced Decoupling of the Amygdala in Men

    Henckens, Marloes J. A. G.; van Wingen, Guido A.; Joëls, Marian; Fernández, Guillén

    2012-01-01

    The amygdala is a key regulator of vigilance and heightens attention toward threat. Its activity is boosted upon threat exposure and contributes to a neuroendocrine stress response via the hypothalamic-pituitary-adrenal (HPA) axis. Corticosteroids are known to control brain activity as well as HPA

  1. Local corticosteroid injections: Rational use in common orthopaedic ...

    The use of local corticosteroid injections in orthopaedic practice is common due to their anti- inflammatory and analgesic effect. However, the use may result in local or systemic complications. Moreover, the conflicting reports on their benefits versus side effects, throws the average user in confusion or fear. This review ...

  2. Genetics Home Reference: corticosteroid-binding globulin deficiency

    ... There may also be other genetic or environmental factors that influence whether an affected individual is more likely to develop pain or fatigue. Learn more about the gene associated with corticosteroid-binding globulin deficiency SERPINA6 Related Information What is a gene? What is a ...

  3. Corticosteroid therapy in Henoch-Schönlein gastritis

    Pavlović Momčilo

    2007-01-01

    Full Text Available Introduction. Henoch-Schönlein purpura (HSP is the most common vascular disease of childhood. It is a multisystem disease most commonly affecting the skin, joints, gastrointestinal tract, and kidneys, but other organs may be affected, too. Gastrointestinal involvement occurs in approximately 65-90% of patients, ranging from mild symptoms such as abdominal pain, nausea, and vomiting, to more severe manifestations such as gastrointestinal bleeding and intussusception. In most cases, HSP spontaneously resolves without treatment. The use of corticosteroids is controversial and usually reserved for severe systemic manifestations. Some authors suggest that the abdominal pain and gastrointestinal hemorrhage of HSP may respond to steroids, with some suggesting that there is a benefit in their use and describing a regimen. Case outline. This is a case report of HSP in a fourteen year-old boy with abdominal pain and hematemesis. Upper endoscopy showed an edematous and erythematous change in the body of the stomach and purpuric lesions in the duodenum, while multiple erosions were found in the antral area. Parenteral corticosteroid therapy with gastric acid secretion inhibitor administration led to regression of gastrointestinal symptoms on the seventh day, with relapses on the fourth and sixth day. Peroral administration of corticosteroids and gradual decrease of daily doses started on the eighth day of abdominal symptoms. New purpuric skin rashes appeared during six weeks. Conclusion. Corticosteroid therapy with gastric acid secretion inhibitors showed a positive effect in our patient with a severe form of HSP accompanied by abdominal pain and gastrointestinal hemorrhage. .

  4. Corticosteroids for prevention of postextubation laryngeal edema in adults.

    Roberts, Russel J; Welch, Shannon M; Devlin, John W

    2008-05-01

    To evaluate the efficacy and safety of prophylactic corticosteroid therapy in preventing postextubation laryngeal edema (PELE) and the need for reintubation in adults. Literature was accessed through MEDLINE (1966-January 2008) and the Cochrane Library using the terms laryngeal edema, airway obstruction, postextubation stridor, intubation, glucocorticoids, and corticosteroids. Bibliographies of cited references were reviewed and a manual search of abstracts from recent pulmonary and critical care meetings was completed. All English-language, placebo-controlled, randomized studies evaluating the use of prophylactic corticosteroids for the prevention of postextubation laryngeal edema or postextubation stridor (PES) in adults were reviewed. Although laryngoscopy is the gold standard method for diagnosing PELE, PES is more commonly used for diagnosis in clinical practice. While 3 older studies failed to demonstrate benefit with the prophylactic administration of corticosteroid therapy in terms of reducing PELE, PES, or the need for reintubation, each of these studies evaluated only a single dose of steroid therapy that was initiated only 30-60 minutes prior to a planned extubation in a population of patients at low-risk for PELE. In comparison, 3 newer studies, each using 4 doses of corticosteroid therapy initiated 12-24 hours prior to a planned extubation in patients deemed to be at high baseline risk for developing PELE, demonstrated a reduction in PELE, PES, and the need for reintubation; no safety concerns were identified. Current evidence therefore suggests that prophylactic intravenous methylprednisolone therapy (20-40 mg every 4-6 h) should be considered 12-24 hours prior to a planned extubation in patients at high-risk for PELE (eg, mechanical ventilation > 6 days). Data from the most recent well-designed clinical trials suggest that prophylactic corticosteroid therapy can reduce the incidence of PELE and the subsequent need for reintubation in mechanically

  5. Orthotopic transplantation of cryopreserved mouse ovaries and gonadotrophin releasing hormone analogues in the restoration of function following chemotherapy-induced ovarian damage.

    Qing Li

    Full Text Available Therapy advances are constantly improving survival rates of cancer patients, however the toxic effects of chemotherapy drugs can seriously affect patients' quality of life. In women, fertility and premature ovarian endocrine dysfunction are of particular concern. It is urgently we find methods to preserve or reconstruct ovarian function for these women. This study compares GnRHa treatment with ovarian tissue cryopreservation and orthotopic transplantation in a chemotherapy-induced ovarian damage murine model. 56 inbred Lewis rats were divided into 4 treatment groups: Saline control (group I; cyclophosphamide only (group II; cyclophosphamide plus GnRHa (group III; cyclophosphamide and grafting of thawed cryopreserved ovaries (group IV. Body weight, estrous cycle recovery time, ovarian weight, morphology and follicle count, as well as breeding and fertility were compared among groups. Only group IV was able to restore to normal body weight by the end of the observation period and resumed normal estrous cycles in a shorter time compared to other treatment groups. There was a decrease in primordial follicles in all treatment groups, but group III had the greatest reduction. Although, there was no difference in pregnancy, only one animal littered normal pups in group II, none littered in group III and four littered in group IV. Thus, cryopreservation and orthotopic transplantation of ovarian tissue can restore the fertility of rats subjected to chemotherapy in a manner that is superior to GnRHa treatment. We also observed increased rates of hepatic, splenic and pulmonary haemorrhage in group III, suggesting there may be synergistic toxicity of GnRHa and cyclophosphamide.

  6. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial.

    Anderson, Roger T; Kimmick, Gretchen G; McCoy, Thomas P; Hopkins, Judith; Levine, Edward; Miller, Gary; Ribisl, Paul; Mihalko, Shannon L

    2012-06-01

    This study aimed to determine the effect of a moderate, tailored exercise program on health-related quality of life, physical function, and arm volume in women receiving treatment for nonmetastatic breast cancer. Women who were within 4-12 weeks of surgery for stage I-III breast cancer were randomized to center-based exercise and lymphedema education intervention or patient education. Functional assessment of cancer therapy-breast cancer (FACT-B), 6-min walk, and arm volume were performed at 3-month intervals through 18 months. Repeated measures analysis of covariance was used to model the total meters walked over time, FACT-B scores, and arm volume. Models were adjusted for baseline measurement, baseline affected arm volume, number of nodes removed, age, self-reported symptoms, baseline SF-12 mental and physical component scores, visit, and treatment group. Of the recruited 104 women, 82 completed all 18 months. Mean age (range) was 53.6 (32-82) years; 88% were Caucasian; 45% were employed full time; 44% were overweight; and 28% obese. Approximately, 46% had breast-conserving surgery; 79% had axillary node dissection; 59% received chemotherapy; and 64% received radiation. The intervention resulted in an average increase of 34.3 ml (SD = 12.8) versus patient education (p = 0.01). Changes in FACT-B scores and arm volumes were not significantly different. With this early exercise intervention after breast cancer diagnosis, a significant improvement was achieved in physical function, with no decline in health-related quality of life or detrimental effect on arm volume. Starting a supervised exercise regimen that is tailored to an individual's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning.

  7. Equivalency of Galápagos giant tortoises used as ecological replacement species to restore ecosystem functions.

    Hunter, Elizabeth A; Gibbs, James P; Cayot, Linda J; Tapia, Washington

    2013-08-01

    Loss of key plant-animal interactions (e.g., disturbance, seed dispersal, and herbivory) due to extinctions of large herbivores has diminished ecosystem functioning nearly worldwide. Mitigating for the ecological consequences of large herbivore losses through the use of ecological replacements to fill extinct species' niches and thereby replicate missing ecological functions has been proposed. It is unknown how different morphologically and ecologically a replacement can be from the extinct species and still provide similar functions. We studied niche equivalency between 2 phenotypes of Galápagos giant tortoises (domed and saddlebacked) that were translocated to Pinta Island in the Galápagos Archipelago as ecological replacements for the extinct saddlebacked giant tortoise (Chelonoidis abingdonii). Thirty-nine adult, nonreproductive tortoises were introduced to Pinta Island in May 2010, and we observed tortoise resource use in relation to phenotype during the first year following release. Domed tortoises settled in higher, moister elevations than saddlebacked tortoises, which favored lower elevation arid zones. The areas where the tortoises settled are consistent with the ecological conditions each phenotype occupies in its native range. Saddlebacked tortoises selected areas with high densities of the arboreal prickly pear cactus (Opuntia galapageia) and mostly foraged on the cactus, which likely relied on the extinct saddlebacked Pinta tortoise for seed dispersal. In contrast, domed tortoises did not select areas with cactus and therefore would not provide the same seed-dispersal functions for the cactus as the introduced or the original, now extinct, saddlebacked tortoises. Interchangeability of extant megaherbivores as replacements for extinct forms therefore should be scrutinized given the lack of equivalency we observed in closely related forms of giant tortoises. Our results also demonstrate the value of trial introductions of sterilized individuals to test

  8. Programming effects of antenatal corticosteroids exposure in male sexual behavior.

    Oliveira, Mário; Leão, Pedro; Rodrigues, Ana-João; Pêgo, José-Miguel; Cerqueira, João-José; Sousa, Nuno

    2011-07-01

    Brain regions implicated in sexual behavior begin to differentiate in the last trimester of gestation. Antenatal therapy with corticosteroids is often used in clinical practice during this period to accelerate lung maturation in preterm-risk pregnancies. Clinical and animal studies highlighted major behavioral impairments induced later in life by these treatments, especially when synthetic corticosteroids are used. To evaluate the implications of acute prenatal treatment with natural vs. synthetic corticosteroids on adult male rat sexual behavior and its neurochemical correlates. Twelve pregnant Wistar rats were injected with dexamethasone (DEX-1 mg/kg), corticosterone (CORT-25 mg/kg), or saline on late gestation (pregnancy days 18 and 19). Following this brief exposure to corticosteroids, we assessed the sexual behavior of the adult male progeny and subsequently associated these behaviors with the levels of catecholamines and mRNA of dopamine and androgen receptors (AR) in brain regions relevant for sexual behavior. Sexual behavior of adult male offspring was assessed by exposure to receptive females. This was associated with serum testosterone levels and levels of catecholamines (determined by high-performance liquid chromatography) and dopamine and AR mRNA expression (real-time polymerase chain reaction [PCR]) in brain regions implicated in sexual behavior. Prenatal DEX exposure resulted in a decreased number and increased mounts and intromissions latencies in adulthood. These findings were associated with decreased levels of serum testosterone and increased hypothalamic expression of AR mRNA. DEX animals also displayed lower dopamine levels and higher dopamine receptor mRNA expression both in hypothalamus and nucleus accumbens (NAcc). The milder phenotype of CORT animals was associated only with decreased dopamine levels in NAcc. Antenatal corticotherapy programs adult male sexual behavior through changes in specific neuronal and endocrine mediators

  9. Chimeric PD-1:28 Receptor Upgrades Low-Avidity T cells and Restores Effector Function of Tumor-Infiltrating Lymphocytes for Adoptive Cell Therapy.

    Schlenker, Ramona; Olguín-Contreras, Luis Felipe; Leisegang, Matthias; Schnappinger, Julia; Disovic, Anja; Rühland, Svenja; Nelson, Peter J; Leonhardt, Heinrich; Harz, Hartmann; Wilde, Susanne; Schendel, Dolores J; Uckert, Wolfgang; Willimsky, Gerald; Noessner, Elfriede

    2017-07-01

    Inherent intermediate- to low-affinity T-cell receptors (TCR) that develop during the natural course of immune responses may not allow sufficient activation for tumor elimination, making the majority of T cells suboptimal for adoptive T-cell therapy (ATT). TCR affinity enhancement has been implemented to provide stronger T-cell activity but carries the risk of creating undesired cross-reactivity leading to potential serious adverse effects in clinical application. We demonstrate here that engineering of low-avidity T cells recognizing a naturally processed and presented tumor-associated antigen with a chimeric PD-1:28 receptor increases effector function to levels seen with high-avidity T cells of identical specificity. Upgrading the function of low-avidity T cells without changing the TCR affinity will allow a large arsenal of low-avidity T cells previously thought to be therapeutically inefficient to be considered for ATT. PD-1:28 engineering reinstated Th1 function in tumor-infiltrating lymphocytes that had been functionally disabled in the human renal cell carcinoma environment without unleashing undesired Th2 cytokines or IL10. Involved mechanisms may be correlated to restoration of ERK and AKT signaling pathways. In mouse tumor models of ATT, PD-1:28 engineering enabled low-avidity T cells to proliferate stronger and prevented PD-L1 upregulation and Th2 polarization in the tumor milieu. Engineered T cells combined with checkpoint blockade secreted significantly more IFNγ compared with T cells without PD-1:28, suggesting a beneficial combination with checkpoint blockade therapy or other therapeutic strategies. Altogether, the supportive effects of PD-1:28 engineering on T-cell function make it an attractive tool for ATT. Cancer Res; 77(13); 3577-90. ©2017 AACR . ©2017 American Association for Cancer Research.

  10. Associations between timing of corticosteroid treatment initiation and clinical outcomes in Duchenne muscular dystrophy.

    Kim, Sunkyung; Zhu, Yong; Romitti, Paul A; Fox, Deborah J; Sheehan, Daniel W; Valdez, Rodolfo; Matthews, Dennis; Barber, Brent J

    2017-08-01

    The long-term efficacy of corticosteroid treatment and timing of treatment initiation among Duchenne muscular dystrophy (DMD) patients is not well-understood. We used data from a longitudinal, population-based DMD surveillance program to examine associations between timing of treatment initiation (early childhood [before or at age 5 years], late childhood [after age 5 years], and naïve [not treated]) and five clinical outcomes (age at loss of ambulation; ages at onset of cardiomyopathy, scoliosis, and first fracture; and pulmonary function). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using survival analysis. DMD patients who initiated corticosteroid treatment in early childhood had a higher risk of earlier onset cardiomyopathy compared to cases who initiated treatment in late childhood (HR = 2.0, 95% CI = [1.2, 3.4]) or treatment naïve patients (HR = 1.9, 95% CI = [1.1, 3.2]), and higher risk of suffering a fracture (HR = 2.3, 95% CI = [1.4, 3.7] and HR = 2.6, 95% CI = [1.6, 4.2], respectively). Patients with early childhood treatment had slightly decreased respiratory function compared with those with late childhood treatment. Ages at loss of ambulation or scoliosis diagnosis did not differ statistically among treatment groups. We caution that the results from our study are subject to several limitations, as they were based on data abstracted from medical records. Further investigations using improved reporting of disease onset and outcomes are warranted to obtain a more definitive assessment of the association between the timing of corticosteroid treatment and disease severity. Published by Elsevier B.V.

  11. Lower leukotriene C4 levels in bronchoalveolar lavage fluid of asthmatic subjects after 2.5 years of inhaled corticosteroid therapy

    Y. Oosterhoff

    1995-01-01

    Full Text Available Long-term treatment with inhaled corticosteroids has been shown to result in improvement of symptoms and lung function in subjects with asthma. Arachidonic acid (AA metabolites are thought to play a role in the pathophysiology of asthma. It was assessed whether differences could be found in bronchoalveolar lavage (BAL AA metabolite levels between subjects with asthma who were treated for 2.5 years with inhaled bronchodilators alone or in combination with inhaled corticosteroids. Prostaglandin (PGD2, PGF2α, 6-keto-PGF1α, thromboxane B2, leukotriene (LTC4 and LTB4 levels and cell numbers were assessed in BAL fluid from 22 non-smoking asthmatic subjects. They were participating in a randomized, double-blind multicentre drug trial over a period of 2.5 years. Results of the group treated with inhaled corticosteroids (CS+: beclomethasone 200 μg four times daily were compared with the other group (CS− which was treated with either ipratropium bromide (40 μg four times daily or placebo. BAL LTC4 levels of asthmatic subjects were significantly lower after 2.5 years inhaled corticosteroid therapy (CS+, 9(1–17 pg/ml vs. CS−, 16(6-53 pg/ml; p = 0.01. The same trend was observed for the PGD2 levels. The results suggest that inhaled corticosteroids may exert their beneficial effect on lung function via a mechanism in which inhibition of LTC4 synthesis in the airways is involved.

  12. Toward the restoration of hand use to a paralyzed monkey: brain-controlled functional electrical stimulation of forearm muscles.

    Eric A Pohlmeyer

    2009-06-01

    Full Text Available Loss of hand use is considered by many spinal cord injury survivors to be the most devastating consequence of their injury. Functional electrical stimulation (FES of forearm and hand muscles has been used to provide basic, voluntary hand grasp to hundreds of human patients. Current approaches typically grade pre-programmed patterns of muscle activation using simple control signals, such as those derived from residual movement or muscle activity. However, the use of such fixed stimulation patterns limits hand function to the few tasks programmed into the controller. In contrast, we are developing a system that uses neural signals recorded from a multi-electrode array implanted in the motor cortex; this system has the potential to provide independent control of multiple muscles over a broad range of functional tasks. Two monkeys were able to use this cortically controlled FES system to control the contraction of four forearm muscles despite temporary limb paralysis. The amount of wrist force the monkeys were able to produce in a one-dimensional force tracking task was significantly increased. Furthermore, the monkeys were able to control the magnitude and time course of the force with sufficient accuracy to track visually displayed force targets at speeds reduced by only one-third to one-half of normal. Although these results were achieved by controlling only four muscles, there is no fundamental reason why the same methods could not be scaled up to control a larger number of muscles. We believe these results provide an important proof of concept that brain-controlled FES prostheses could ultimately be of great benefit to paralyzed patients with injuries in the mid-cervical spinal cord.

  13. Methodology for ranking restoration options

    Jensen, Per Hedemann

    1999-01-01

    techniques as a function of contamination and site characteristics. The project includes analyses of existing remediation methodologies and contaminated sites, and is structured in the following steps:-characterisation of relevant contaminated sites -identication and characterisation of relevant restoration...... techniques -assessment of the radiological impact -development and application of a selection methodology for restoration options -formulation ofgeneric conclusions and development of a manual The project is intended to apply to situations in which sites with nuclear installations have been contaminated...

  14. Restoration of longitudinal images.

    Hu, Y; Frieden, B R

    1988-01-15

    In this paper, a method of restoring longitudinal images is developed. By using the transfer function for longitudinal objects, and inverse filtering, a longitudinal image may be restored. The Fourier theory and sampling theorems for transverse images cannot be used directly in the longitudinal case. A modification and reasonable approximation are introduced. We have numerically established a necessary relationship between just-resolved longitudinal separation (after inverse filtering), noise level, and the taking conditions of object distance and lens diameter. An empirical formula is also found to well-fit the computed results. This formula may be of use for designing optical systems which are to image longitudinal details, such as in robotics or microscopy.

  15. Use of inhaled corticosteroids in pediatric asthma

    Bisgaard, H

    1997-01-01

    to normal when introduced for moderately severe asthma. This finding highlights the need to improve treatment strategy in pediatric asthma. The natural progression of persistent asthma may lead to loss of lung function and chronic bronchial hyperreactivity for children and adults. There is evidence...

  16. The gut microbiome restores intrinsic and extrinsic nerve function in germ-free mice accompanied by changes in calbindin.

    McVey Neufeld, K A; Perez-Burgos, A; Mao, Y K; Bienenstock, J; Kunze, W A

    2015-05-01

    The microbiome is essential for normal myenteric intrinsic primary afferent neuron (IPAN) excitability. These neurons control gut motility and modulate gut-brain signaling by exciting extrinsic afferent fibers innervating the enteric nervous system via an IPAN to extrinsic fiber sensory synapse. We investigated effects of germ-free (GF) status and conventionalization on extrinsic sensory fiber discharge in the mesenteric nerve bundle and IPAN electrophysiology, and compared these findings with those from specific pathogen-free (SPF) mice. As we have previously shown that the IPAN calcium-dependent slow afterhyperpolarization (sAHP) is enhanced in GF mice, we also examined the expression of the calcium-binding protein calbindin in these neurons in these different animal groups. IPAN sAHP and mesenteric nerve multiunit discharge were recorded using ex vivo jejunal gut segments from SPF, GF, or conventionalized (CONV) mice. IPANs were excited by adding 5 μM TRAM-34 to the serosal superfusate. We probed for calbindin expression using immunohistochemical techniques. SPF mice had a 21% increase in mesenteric nerve multiunit firing rate and CONV mice a 41% increase when IPANs were excited by TRAM-34. For GF mice, this increase was barely detectable (2%). TRAM-34 changed sAHP area under the curve by -77 for SPF, +3 for GF, or -54% for CONV animals. Calbindin-immunopositive neurons per myenteric ganglion were 36% in SPF, 24% in GF, and 52% in CONV animals. The intact microbiome is essential for normal intrinsic and extrinsic nerve function and gut-brain signaling. © 2015 John Wiley & Sons Ltd.

  17. COGNITIVE COMPUTER GRAPHICS AS A MEANS OF "SOFT" MODELING IN PROBLEMS OF RESTORATION OF FUNCTIONS OF TWO VARIABLES

    A.N. Khomchenko

    2016-08-01

    Full Text Available The paper considers the problem of bi-cubic interpolation on the final element of serendipity family. With cognitive-graphical analysis the rigid model of Ergatoudis, Irons and Zenkevich (1968 compared with alternative models, obtained by the methods: direct geometric design, a weighted averaging of the basis polynomials, systematic generation of bases (advanced Taylor procedure. The emphasis is placed on the phenomenon of "gravitational repulsion" (Zenkevich paradox. The causes of rising of inadequate physical spectra nodal loads on serendipity elements of higher orders are investigated. Soft modeling allows us to build a lot of serendipity elements of bicubic interpolation, and you do not even need to know the exact form of the rigid model. The different interpretations of integral characteristics of the basis polynomials: geometrical, physical, probability are offered. Under the soft model in the theory of interpolation of function of two variables implies the model amenable to change through the choice of basis. Such changes in the family of Lagrangian finite elements of higher orders are excluded (hard simulation. Standard models of serendipity family (Zenkevich were also tough. It was found that the "responsibility" for the rigidity of serendipity model rests on ruled surfaces (zero Gaussian curvature - conoids that predominate in the base set. Cognitive portraits zero lines of standard serendipity surfaces suggested that in order to "mitigate" of serendipity pattern conoid should better be replaced by surfaces of alternating Gaussian curvature. The article shows the alternative (soft bases of serendipity models. The work is devoted to solving scientific and technological problems aimed at the creation, dissemination and use of cognitive computer graphics in teaching and learning. The results are of interest to students of specialties: "Computer Science and Information Technologies", "System Analysis", "Software Engineering", as well as

  18. Corticosteroid Receptors, Their Chaperones and Cochaperones: How Do They Modulate Adipogenesis?

    Judith Toneatto

    2014-11-01

    Full Text Available It is well known that glucocorticoids and mineralocorticoids are part of the list of hormones that control adipogenesis as well as different aspects of the physiology of the adipose tissue. Their actions are mediated through their binding to the glucocorticoid and the mineralocorticoid receptors (GR and MR, respectively, in complex with heat shock proteins (Hsps and high molecular weight immunophilins (IMMs. Albeit many aspects of the molecular mechanism of the corticosteroid receptors are not fully elucidated yet, it was not until recently that the first evidences of the functional importance of Hsps and IMMs in the process of adipocyte differentiation have been described. Hsp90 and the high molecular weight IMM FKBP51 modulate GR and MR activity at multiple levels, that is, hormone binding affinity, their subcellular distribution, and the transcriptional status, among other aspects of the NR function. Interestingly, it has recently been described that Hsp90 and FKBP51 also participate in the control of PPARγ, a key transcription factor in the control of adipogenesis and the maintenance of the adipocyte phenotype. In addition, novel roles have been uncovered for FKBP51 in the organization of the nuclear architecture through its participation in the reorganization of the nuclear lamina and the control of the subnuclear distribution of GR. Thus, the aim of this review is to integrate and discuss the actual understanding of the role of corticosteroid receptors, their chaperones and cochaperones, in the process of adipocyte differentiation.

  19. Spirometry Findings Following Treatment with Oral and Inhalant Corticosteroids in Mild to Moderate Asthma Exacerbation in Children

    Nemat Bilan

    2014-12-01

    Full Text Available Introduction:  Asthma exacerbation is common in children. Treatment with oral corticosteroids (OCS and inhaled corticosteroids are suggested for asthma exacerbation. It is shown that inhaled corticosteroids has similar outcome in reducing asthma symptoms compared to OCS. But few studies have evaluated the pulmonary function changes in these two treatments. In this study, we evaluated the changes in pulmonary function tests in children with mild-to-moderate asthma exacerbation receiving oral prednisolone and inhaled Budesonide. Methods and Materials: Forty-four children with mild-to-moderate asthma exacerbation were randomly assigned to receive oral prednisolone (2 mg/kg or Budesonide spray (2 puffs every 12 hours, each puff contains 200 microgram Budesonide using a spacer for one week. The first dose of the treatment was given in the emergency department. Children were followed for seven days and spirometry findings before and after treatment were evaluated. Results: There was no significant difference between pulmonary function tests before and after treatment between groups. Children receiving oral prednisolone had significantly more improvement in PEF (p=0.01. There was significant improvement in all respiratory parameters after treatment in both groups (p

  20. The effectiveness of injections of hyaluronic acid or corticosteroid in patients with subacromial impingement: a three-arm randomised controlled trial.

    Penning, L I F; de Bie, R A; Walenkamp, G H I M

    2012-09-01

    A total of 159 patients (84 women and 75 men, mean age of 53 (20 to 87)) with subacromial impingement were randomised to treatment with subacromial injections using lidocaine with one of hyaluronic acid (51 patients), corticosteroid (53 patients) or placebo (55 patients). Patients were followed up for 26 weeks. The primary outcome was pain on a visual analogue score (VAS), and secondary outcomes included the Constant Murley score, shoulder pain score, functional mobility score, shoulder disability questionnaire and pain-specific disability score. The different outcome measures showed similar results. After three, six and 12 weeks corticosteroid injections were superior to hyaluronic acid injections and only at six weeks significantly better than placebo injections. The mean short-term reduction in pain on the VAS score at 12 weeks was 7% (SD 2.7; 97.5% confidence interval (CI) 0.207 to 1.55; p = 0.084) in the hyaluronic acid group, 28% (SD 2.8; 97.5% CI 1.86 to 3.65; p hyaluronic acid group, 72% (38 of 53) of those in the corticosteroid group and 69% (38 of 55) of those in the placebo group. We were not able to show a convincing benefit from hyaluronic acid injections compared with corticosteroid or placebo injections. Corticosteroid injections produced a significant reduction in pain in the short term (three to 12 weeks), but in the long term the placebo injection produced the best results.

  1. A Debilitating Orthopaedic Complication following Corticosteroid Therapy for Polymyalgia Rheumatica

    Paul Rai

    2014-01-01

    Full Text Available Avascular necrosis (AVN of the scaphoid secondary to corticosteroid use is a rare entity. Previous reports in the literature refer to chronic steroid intake. We report a case secondary to low dose, short term use. AVN has a multifactorial cellular and genetic aetiology and most frequently affects the femoral head. Diagnosis relies on a high index of suspicion and early magnetic resonance (MR scanning. Treatment options are similar to those of traumatic scaphoid nonunions and include vascularised bone grafting and scaphoid excision. Polymyalgia Rheumatica is a common condition and its treatment is led by corticosteroid use. Mild to moderate strengths are advocated. However in our report we show that even with small doses serious adverse effects can be encountered.

  2. Multiple courses of antenatal corticosteroids for preterm birth study: outcomes in children at 5 years of age (MACS-5).

    Asztalos, Elizabeth V; Murphy, Kellie E; Willan, Andrew R; Matthews, Stephen G; Ohlsson, Arne; Saigal, Saroj; Armson, B Anthony; Kelly, Edmond N; Delisle, Marie-France; Gafni, Amiram; Lee, Shoo K; Sananes, Renee; Rovet, Joanne; Guselle, Patricia; Amankwah, Kofi; Saleem, Mariam; Sanchez, Johanna

    2013-12-01

    A single course of antenatal corticosteroid therapy is recommended for pregnant women at risk of preterm birth between 24 and 33 weeks' gestational age. However, 50% of women remain pregnant 7 to 14 days later, leading to the question of whether additional courses should be given to women remaining at risk for preterm birth. The Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) was an international randomized clinical trial that compared multiple courses of antenatal corticosteroids with a single course in women at risk of preterm birth. To determine the effects of single vs multiple courses of antenatal corticosteroid therapy on death or neurodevelopmental disability (neuromotor, neurosensory, or neurocognitive/neurobehavioral function) at 5 years of age in children whose mothers participated in MACS. Our secondary aims were to determine the effect on height, weight, head circumference, blood pressure, intelligence, and specific cognitive (visual, spatial, and language) skills. Cohort follow-up study of children seen between June 2006 and May 2012 at 55 centers. In total, 1724 women (2141 children) were eligible for the study, of whom 1728 children (80.7% of the 2141 eligible children) participated and 1719 children contributed to the primary outcome. Single and multiple courses of antenatal corticosteroid therapy. The primary outcome was death or survival with a neurodevelopmental disability in 1 of the following domains: neuromotor (nonambulatory cerebral palsy), neurosensory (blindness, deafness, or need for visual/hearing aids), or neurocognitive/neurobehavioral function (abnormal attention, memory, or behavior). There was no significant difference between the groups in the risk of death or neurodevelopmental disability: 217 of 871 children (24.9%) in the multiple-courses group vs 210 of 848 children (24.8%) in the single-course group (odds ratio, 1.02 [95% CI, 0.81 to 1.29]; P = .84). Multiple courses, compared with a single

  3. Some considerations on the restoration of Galilei invariance in the nuclear many-body problem. Pt. I. Mathematical tools, spectral functions and spectroscopic factors of simple bound states

    Schmid, K.W.

    2001-01-01

    The mathematical tools to restore Galilei invariance in the nuclear many-body problem with the help of projection techniques are presented. For simple oscillator configurations recursion relations for the various elementary contractions are derived. The method is then applied to simple configurations for the ground states of 4 He, 16 O and 40 Ca as well as to the corresponding one-hole and one-particle states. As a first application the spectral functions and spectroscopic factors for the above-mentioned doubly even nuclei are investigated. It turns out that the conventional picture of an uncorrelated system underestimates the single-particle strengths of the hole states from the last occupied shell while that of the higher excited hole states is overestimated considerably. These results are in complete agreement with those derived by Dieperink and de Forest using different methods. Similar effects are seen for the particle states which have not been studied before. All the calculations presented here are performed analytically and thus can be checked explicitly by the interested reader. (orig.)

  4. PD-1 Blockade Can Restore Functions of T-Cells in Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma In Vitro.

    Lina Quan

    Full Text Available Epstein-Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL is an aggressive malignancy that is largely resistant to current therapeutic regimens, and is an attractive target for immune-based therapies. Anti-programmed death-1 (PD-1 antibodies showed encouraging anti-tumor effects in both preclinical models and advanced solid and hematological malignancies, but its efficacy against EBV+DLBCL is unknown. Herein, we performed experiments using co-culture system with T cells and lymphoma cell lines including EBV+DLBCL and EBV-DLBCL [including germinal center B-cell like (GCB-DLBCL and non-GCB-DLBCL] in vitro. We show that lymphoma cells augmented the expression of PD-1 on T cells, decreased the proliferation of T cells, and altered the secretion of multiple cytokines. However, through PD-1 blockade, these functions could be largely restored. Notbaly, the effect of PD-1 blockade on antitumor immunity was more effective in EBV+DLBCL than that in EBV-DLBCL in vitro. These results suggest that T-cell exhaustion and immune escape in microenvironment is one of the mechanisms underlying DLBCL; and PD-1 blockade could present as a efficacious immunotherapeutic treatment for EBV+DLBCL.

  5. Nebulized corticosteroids in the management of acute exacerbation of COPD

    Gaude G

    2010-01-01

    Full Text Available Acute exacerbations in chronic onstructive pulmonary disease (COPD are common and systemic steroids play an important role in the management of these cases along with the bronchodilators. Nebulized budesonide is being used in the acute attacks of bronchial asthma either in children or in adults. But the role of nebulized steroids in acute exacerbation of COPD is not much studied in the literature. In this clinical review we have evaluated the role of nebulized corticosteroids in the management of acute exacerbation of COPD (AECOPD. Through Medline, Pubmed and Embase we analyzed the various studies that has been done to study the role of nebulized corticosteroids in the management of acute exacerbation of COPD. The key words used for the search criteria were: acute exacerbation, COPD, nebulized corticosteroids, budesonide, fluticasone. Only eight studies were found which had evaluated the role of nebulized corticosteroids in acute exacerbations of COPD. All these studies had used nebulized budesonide in AECOPD in different dosages, and had been compared with both either parental or oral steroids, and standard bronchodilator therapy. All the studies had found the clinical efficacy of nebulized budesonide to be of similar extent to that of either parental or oral steroids in AECOPD. Side effects profile of nebulized budesonide was minimal and acceptable as compared to systemic steroids. Nebulized budesonide may be an alternative to parental/oral prednisolone in the treatment of acute exacerbations of COPD but further studies should be done to evaluate its long-term impact on clinical outcomes after an initial episode of COPD exacerbation.

  6. Perioperative corticosteroids for intermittent and mild persistent asthma

    Hiroto Matsuse; Terufumi Shimoda; Ikuko Machida; Yuki Kondo; Tetsuya Kawano; Sachiko Saeki; Shinya Tomari; Kazuko Mitsuta; Chizu Fukushima; Yasushi Obase; Shigeru Kohno

    2002-01-01

    Objectives: Asthmatics are considered to be at high risk for pulmonary complications during general anesthesia with tracheal intubation. The purpose of the present study was to determine the usefulness of perioperative corticosteroids for mild asthmatics in preventing perioperative exacerbation of asthma. Methods: Airway hyperresponsiveness to inhaled methacholine was determined in patients with intermittent (n = 27) and mild persistent (n = 48) asthma before general anesthesia who underwe...

  7. Neurosarcoidosis associated with hypersomnolence treated with corticosteroids and brain irradiation

    Rubinstein, I.; Gray, T.A.; Moldofsky, H.; Hoffstein, V.

    1988-01-01

    Narcoleptic features developed in a young man with CNS sarcoidosis. This was associated with a structural lesion in the hypothalamus as demonstrated on CT scans of the head. The diagnosis of narcolepsy was established by compatible clinical history and the Multiple Sleep Latency Test. Treatment with high-dose corticosteroids was ineffective, but when the low-dose, whole-brain irradiation was added, complete resolution of the narcoleptic features ensued

  8. Pseudomonas aeruginosa keratitis: outcomes and response to corticosteroid treatment.

    Sy, Aileen; Srinivasan, Muthiah; Mascarenhas, Jeena; Lalitha, Prajna; Rajaraman, Revathi; Ravindran, Meenakshi; Oldenburg, Catherine E; Ray, Kathryn J; Glidden, David; Zegans, Michael E; McLeod, Stephen D; Lietman, Thomas M; Acharya, Nisha R

    2012-01-25

    To compare the clinical course and effect of adjunctive corticosteroid therapy in Pseudomonas aeruginosa with those of all other strains of bacterial keratitis. Subanalyses were performed on data collected in the Steroids for Corneal Ulcers Trial (SCUT), a large randomized controlled trial in which patients were treated with moxifloxacin and were randomly assigned to 1 of 2 adjunctive treatment arms: corticosteroid or placebo (4 times a day with subsequent reduction). Multivariate analysis was used to determine the effect of predictors, organism, and treatment on outcomes, 3-month best-spectacle-corrected visual acuity (BSCVA), and infiltrate/scar size. The incidence of adverse events over a 3-month follow-up period was compared using Fisher's exact test. SCUT enrolled 500 patients. One hundred ten patients had P. aeruginosa ulcers; 99 of 110 (90%) enrolled patients returned for follow-up at 3 months. Patients with P. aeruginosa ulcers had significantly worse visual acuities than patients with other bacterial ulcers (P = 0.001) but showed significantly more improvement in 3-month BSCVA than those with other bacterial ulcers, adjusting for baseline characteristics (-0.14 logMAR; 95% confidence interval, -0.23 to -0.04; P = 0.004). There was no significant difference in adverse events between P. aeruginosa and other bacterial ulcers. There were no significant differences in BSCVA (P = 0.69), infiltrate/scar size (P = 0.17), and incidence of adverse events between patients with P. aeruginosa ulcers treated with adjunctive corticosteroids and patients given placebo. Although P. aeruginosa corneal ulcers have a more severe presentation, they appear to respond better to treatment than other bacterial ulcers. The authors did not find a significant benefit with corticosteroid treatment, but they also did not find any increase in adverse events. (ClinicalTrials.gov number, NCT00324168.).

  9. Nocardia keratitis: clinical course and effect of corticosteroids.

    Lalitha, Prajna; Srinivasan, Muthiah; Rajaraman, Revathi; Ravindran, Meenakshi; Mascarenhas, Jeena; Priya, Jeganathan Lakshmi; Sy, Aileen; Oldenburg, Catherine E; Ray, Kathryn J; Zegans, Michael E; McLeod, Stephen D; Lietman, Thomas M; Acharya, Nisha R

    2012-12-01

    To compare the clinical course of Nocardia species keratitis with keratitis resulting from other bacterial organisms and to assess the effect of corticosteroids as adjunctive therapy using data collected from the Steroids for Corneal Ulcers Trial. Subgroup analysis of a randomized controlled trial. setting: Multicenter randomized controlled trial. study population: Five hundred patients with bacterial keratitis randomized 1:1 to topical corticosteroid or placebo who had received at least 48 hours of topical moxifloxacin. intervention/observation procedure: Topical prednisolone phosphate 1% or placebo and clinical course of Nocardia keratitis. main outcome measures: Best spectacle-corrected visual acuity and infiltrate or scar size at 3 months from enrollment. Of 500 patients enrolled in the trial, 55 (11%) had a Nocardia corneal ulcer. Patients with Nocardia ulcers had better presentation visual acuity compared with non-Nocardia ulcers (median Snellen visual acuity, 20/45, compared with 20/145; P < .001) and comparable 3-month visual acuity (median, 20/25, vs 20/40; P = .25). Nocardia ulcers had approximately 2 lines less of improvement in visual acuity compared with non-Nocardia ulcers (0.21 logarithm of the minimal angle of resolution; 95% confidence interval, 0.09 to 0.33 logarithm of the minimal angle of resolution; P = .001). This difference may reflect the better starting visual acuity in patients with Nocardia ulcers. In Nocardia ulcers, corticosteroids were associated with an average 0.4-mm increase in 3-month infiltrate or scar size (95% confidence interval, 0.03 to 0.77 mm; P = .03). Nocardia ulcers responded well to treatment. They showed less overall improvement in visual acuity than non-Nocardia ulcers, but had better presentation acuity. Corticosteroids may be associated with worse outcomes. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Corticosteroid-dependent plasticity mediates compulsive alcohol drinking in rats

    Vendruscolo, Leandro F.; Barbier, Estelle; Schlosburg, Joel E.; Misra, Kaushik K.; Whitfield, Timothy W.; Logrip, Marian L.; Rivier, Catherine; Repunte-Canonigo, Vez; Zorrilla, Eric P.; Sanna, Pietro P.; Heilig, Markus; Koob, George F.

    2012-01-01

    Alcoholism is characterized by a compulsion to seek and ingest alcohol, loss of control over intake, and the emergence of a negative emotional state during abstinence. We hypothesized that sustained activation of neuroendocrine stress systems (e.g., corticosteroid release via the hypothalamic-pituitary-adrenal [HPA] axis) by alcohol intoxication and withdrawal and consequent alterations in glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) activation drive compulsive alcohol dri...

  11. Corticosteroid-Induced MKP-1 Represses Pro-Inflammatory Cytokine Secretion by Enhancing Activity of Tristetraprolin (TTP) in ASM Cells.

    Prabhala, Pavan; Bunge, Kristin; Ge, Qi; Ammit, Alaina J

    2016-10-01

    Exaggerated cytokine secretion drives pathogenesis of a number of chronic inflammatory diseases, including asthma. Anti-inflammatory pharmacotherapies, including corticosteroids, are front-line therapies and although they have proven clinical utility, the molecular mechanisms responsible for their actions are not fully understood. The corticosteroid-inducible gene, mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1, DUSP1) has emerged as a key molecule responsible for the repressive effects of steroids. MKP-1 is known to deactivate p38 MAPK phosphorylation and can control the expression and activity of the mRNA destabilizing protein-tristetraprolin (TTP). But whether corticosteroid-induced MKP-1 acts via p38 MAPK-mediated modulation of TTP function in a pivotal airway cell type, airway smooth muscle (ASM), was unknown. While pretreatment of ASM cells with the corticosteroid dexamethasone (preventative protocol) is known to reduce ASM synthetic function in vitro, the impact of adding dexamethasone after stimulation (therapeutic protocol) had not been explored. Whether dexamethasone modulates TTP in a p38 MAPK-dependent manner in this cell type was also unknown. We address this herein and utilize an in vitro model of asthmatic inflammation where ASM cells were stimulated with the pro-asthmatic cytokine tumor necrosis factor (TNF) and the impact of adding dexamethasone 1 h after stimulation assessed. IL-6 mRNA expression and protein secretion was significantly repressed by dexamethasone acting in a temporally distinct manner to increase MKP-1, deactivate p38 MAPK, and modulate TTP phosphorylation status. In this way, dexamethasone-induced MKP-1 acts via p38 MAPK to switch on the mRNA destabilizing function of TTP to repress pro-inflammatory cytokine secretion from ASM cells. J. Cell. Physiol. 231: 2153-2158, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Discontinuation of Hemodialysis in a Patient with Anti-GBM Disease by the Treatment with Corticosteroids and Plasmapheresis despite Several Predictors for Dialysis-Dependence

    Yoshihide Fujigaki

    2017-01-01

    Full Text Available A 26-year-old man highly suspected of having antiglomerular basement membrane (GBM disease was treated with corticosteroid pulse therapy 9 days after initial infection-like symptoms with high procalcitonin value. The patient required hemodialysis the next day of the treatment due to oliguria. In addition to corticosteroid therapy, plasmapheresis was introduced and the patient could discontinue hemodialysis 43 days after the treatment. Kidney biopsy after initiation of hemodialysis confirmed anti-GBM disease with 86.3% crescent formation. Physician should keep in mind that active anti-GBM disease shows even high procalcitonin value in the absence of infection. To pursue recovery of renal function, the challenge of the immediate and persistent treatment with high-dose corticosteroids plus plasmapheresis for highly suspected anti-GBM disease is vitally important despite the presence of reported predictors for dialysis-dependence including oliguria and requiring hemodialysis at presentation.

  13. A silk peptide fraction restores cognitive function in AF64A-induced Alzheimer disease model rats by increasing expression of choline acetyltransferase gene

    Cha, Yeseul [College of Veterinary Medicine, Veterinary Medical Center, Chungbuk National University, Cheongju (Korea, Republic of); Lee, Sang Hoon [Department of Food Science and Technology, Chungbuk National University, Cheongju (Korea, Republic of); Jang, Su Kil [Division of Marine Molecular Biotechnology, Gangneung-Wonju National University, Gangneung (Korea, Republic of); Guo, Haiyu; Ban, Young-Hwan; Park, Dongsun [College of Veterinary Medicine, Veterinary Medical Center, Chungbuk National University, Cheongju (Korea, Republic of); Jang, Gwi Yeong; Yeon, Sungho [Department of Food Science and Technology, Chungbuk National University, Cheongju (Korea, Republic of); Lee, Jeong-Yong [Worldway Co., Ltd., Sejong (Korea, Republic of); Choi, Ehn-Kyoung [College of Veterinary Medicine, Veterinary Medical Center, Chungbuk National University, Cheongju (Korea, Republic of); Joo, Seong Soo [Division of Marine Molecular Biotechnology, Gangneung-Wonju National University, Gangneung (Korea, Republic of); Jeong, Heon-Sang, E-mail: hsjeong@cbu.ac.kr [Department of Food Science and Technology, Chungbuk National University, Cheongju (Korea, Republic of); Kim, Yun-Bae, E-mail: solar93@cbu.ac.kr [College of Veterinary Medicine, Veterinary Medical Center, Chungbuk National University, Cheongju (Korea, Republic of)

    2017-01-01

    This study investigated the effects of a silk peptide fraction obtained by incubating silk proteins with Protease N and Neutrase (SP-NN) on cognitive dysfunction of Alzheimer disease model rats. In order to elucidate underlying mechanisms, the effect of SP-NN on the expression of choline acetyltransferase (ChAT) mRNA was assessed in F3.ChAT neural stem cells and Neuro2a neuroblastoma cells; active amino acid sequence was identified using HPLC-MS. The expression of ChAT mRNA in F3.ChAT cells increased by 3.79-fold of the control level by treatment with SP-NN fraction. The active peptide in SP-NN was identified as tyrosine-glycine with 238.1 of molecular weight. Male rats were orally administered with SP-NN (50 or 300 mg/kg) and challenged with a cholinotoxin AF64A. As a result of brain injury and decreased brain acetylcholine level, AF64A induced astrocytic activation, resulting in impairment of learning and memory function. Treatment with SP-NN exerted recovering activities on acetylcholine depletion and brain injury, as well as cognitive deficit induced by AF64A. The results indicate that, in addition to a neuroprotective activity, the SP-NN preparation restores cognitive function of Alzheimer disease model rats by increasing the release of acetylcholine. - Highlights: • Cognition-enhancing effects of SP-NN, a silk peptide preparation, were investigated. • SP-NN enhanced ChAT mRNA expression in F3.ChAT neural stem cells and Neuro-2a neuroblastoma cells. • Active molecule was identified as a dipeptide composed of tyrosine-glycine. • SP-NN reversed cognitive dysfunction elicited by AF64A. • Neuroprotection followed by increased acetylcholine level was achieved with SP-NN.

  14. Inhaled corticosteroid treatment for 6 months was not sufficient to normalize phagocytosis in asthmatic children.

    da Silva-Martins, Carmen Lívia Faria; Couto, Shirley Claudino; Muniz-Junqueira, Maria Imaculada

    2013-08-30

    Corticosteroids are the first-line therapy for asthma; however, the effect of corticosteroids on the innate immune system remains unclear. This study's objective was to evaluate the effect of inhaled corticosteroid therapy (ICT) on phagocytic functions. To evaluate the impact of ICT, the phagocytosis of Saccharomyces cerevisiae by blood monocytes and neutrophils and the production of superoxide anions were assessed before and after three and six months of ICT treatment in 58 children with persistent asthma and 21 healthy controls. We showed that the phagocytic capacity of monocytes and neutrophils that occurred via pattern recognition receptors or was mediated by complement and immunoglobulin receptors in asthmatic children before treatment was significantly lower than in healthy controls (pICT for 6 months was not sufficient to normalize phagocytosis by the phagocytes. Superoxide anion production was also decreased in the asthmatic children before treatment, and ICT normalized the O- production only for children with mild persistent asthma when assessed at baseline but caused this function to decrease after stimulation (p<0.05, Kruskal-Wallis test). Our data suggest that an immunodeficiency in phagocytes remained even after treatment. However, this immunodeficiency does not appear to correspond with the clinical evolution of asthma because an improvement in clinical parameters occurred.

  15. The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis

    A. Fassio

    2016-09-01

    Full Text Available Osteoporosis is a well-known extra-articular complication in rheumatoid arthritis (RA. The chronic corticosteroid treatment, the functional impairment associated with RA and the disease itself appear to be the most relevant determinants. Most of the previous studies involved postmenopausal women, in whom the estrogenic deficiency might amplify the negative effect towards bone of both RA and corticosteroid therapy. We decided to evaluate bone health in a cohort of premenopausal RA patients. The study population includes 47 premenopausal women attending our outpatient clinic for RA and twice as many healthy age-matched control women selected from the hospital personnel. The bone density at the spine and femoral neck were significantly lower in patients with RA as compared with controls. When spine bone mineral density (BMD values were adjusted for the cumulative glucocorticoid (GC dose alone and for the cumulative GC dose plus body mass index (BMI the mean differences between two groups decreased but they remained statistically significant. We found no difference when the spine BMD was adjusted for cumulative GC dose, BMI and health assessment questionnaire. The difference in femoral neck BMD remained statistically significant also after all the same adjustments. In conclusion, our study shows that a BMD deficiency is frequent also in premenopausal women affected by RA, especially at femoral site and that the main determinants of this bone loss are not only the disease-related weight loss, corticosteroid therapy and functional impairment, but also the systemic effects of the disease itself.

  16. The science and practice of river restoration

    Wohl, Ellen; Lane, Stuart N.; Wilcox, Andrew C.

    2015-08-01

    River restoration is one of the most prominent areas of applied water-resources science. From an initial focus on enhancing fish habitat or river appearance, primarily through structural modification of channel form, restoration has expanded to incorporate a wide variety of management activities designed to enhance river process and form. Restoration is conducted on headwater streams, large lowland rivers, and entire river networks in urban, agricultural, and less intensively human-altered environments. We critically examine how contemporary practitioners approach river restoration and challenges for implementing restoration, which include clearly identified objectives, holistic understanding of rivers as ecosystems, and the role of restoration as a social process. We also examine challenges for scientific understanding in river restoration. These include: how physical complexity supports biogeochemical function, stream metabolism, and stream ecosystem productivity; characterizing response curves of different river components; understanding sediment dynamics; and increasing appreciation of the importance of incorporating climate change considerations and resiliency into restoration planning. Finally, we examine changes in river restoration within the past decade, such as increasing use of stream mitigation banking; development of new tools and technologies; different types of process-based restoration; growing recognition of the importance of biological-physical feedbacks in rivers; increasing expectations of water quality improvements from restoration; and more effective communication between practitioners and river scientists.

  17. Evaluation of factors that allow the clinician to taper inhaled corticosteroids in childhood asthma

    Kentaro Matsuda

    1999-01-01

    Full Text Available Inhaled corticosteroids are potent and effective treatment agents for controlling symptoms of childhood asthma. However, there are no predictive factors that help to determine which patients with asthma are likely to be tapered off inhaled corticosteroids successfully. We examined whether any factor or combination of factors could help the clinician safely discontinue inhaled steroid therapy. Thirty-six asthmatic children whose symptoms were stable on low-dose beclomethasone dipropionate (BDP were divided by parental choice into two groups: maintenance BDP (n = 11 and no BDP (n = 25. Methacholine inhalation tests were performed at the beginning of the study and after 1 month. Twelve children (48% who had BDP discontinued developed exacerbations after 2–3 months, whereas there were no problems in the maintenance group. The no BDP group was retrospectively divided into two subgroups: exacerbation (+ and (−. The threshold to methacholine in the exacerbation (+ subgroup decreased significantly in advance of clinical symptoms. The two subgroups were analyzed statistically by two-group discriminant function analysis. The change in threshold to methacholine, the dose and potency of drugs, duration of asthma and gender (female correlated with exacerbation. These results suggest that discontinuation of inhaled steroids should be done carefully, even in stable asthmatic children. The methacholine inhalation test, gender, drugs and history may be used as references for discontinuing inhaled steroids.

  18. Landscaping Considerations for Urban Stream Restoration Projects

    Bailey, Pam

    2004-01-01

    ... after restoration and its functionality for public use. The landscaping component of such stream and riparian restoration projects must be emphasized given its importance of visual success and public perception. The purpose of this technical note is to address landscaping considerations associated with urban stream and riparian restoration projects, and provide ideas to managers for enhancing the visual appeal and aesthetic qualities of urban projects.

  19. Use of the Central Sensitization Inventory (CSI) as a treatment outcome measure for patients with chronic spinal pain disorder in a functional restoration program.

    Neblett, Randy; Hartzell, Meredith M; Williams, Mark; Bevers, Kelley R; Mayer, Tom G; Gatchel, Robert J

    2017-12-01

    The Central Sensitization Inventory (CSI) is a valid and reliable patient-reported instrument designed to identify patients whose presenting symptoms may be related to central sensitization (CS). Part A of the CSI measures a full array of 25 somatic and emotional symptoms associated with CS, and Part B asks if patients have previously been diagnosed with one or more specific central sensitivity syndromes (CSSs) and related disorders. The CSI has previously been validated in a group of patients with chronic pain who were screened by a trained psychiatrist for specific CSS diagnoses. It is currently unknown if the CSI can be a useful treatment-outcome assessment tool for patients with chronic spinal pain disorder (CSPD) who are not screened for comorbid CSSs. It is known, however, that previous studies have identified CS-related symptoms, and comorbid CSSs, in subsets of patients with CSPDs. Studies have also shown that CS-related symptoms can be influenced by cognitive and psychosocial factors, including abuse history in both childhood and adulthood, sleep disturbance, catastrophic and fear-avoidant cognitions, and symptoms of depression and anxiety. This study aimed to evaluate CSI scores, and their associations with other clinically relevant psychosocial variables, in a cohort of patients with CSPD who entered and completed a functional restoration program. A retrospective study of prospectively collected data from a cohort study of patients with CSPD, who completed the CSI at admission to, and discharge from, an interdisciplinary function restoration program (FRP) was carried out. A cohort of 763 patients with CSPD comprised the study sample. Clinical interviews evaluated mood disorders and abuse history. A series of self-reported measures evaluated comorbid psychosocial symptoms, including pain intensity, pain-related anxiety, depressive symptoms, somatization symptoms, perceived disability, and sleep disturbance, at FRP admission and discharge. Patients were

  20. Far infra-red therapy promotes ischemia-induced angiogenesis in diabetic mice and restores high glucose-suppressed endothelial progenitor cell functions

    Huang Po-Hsun

    2012-08-01

    Full Text Available Abstract Background Far infra-red (IFR therapy was shown to exert beneficial effects in cardiovascular system, but effects of IFR on endothelial progenitor cell (EPC and EPC-related vasculogenesis remain unclear. We hypothesized that IFR radiation can restore blood flow recovery in ischemic hindlimb in diabetic mice by enhancement of EPCs functions and homing process. Materials and methods Starting at 4 weeks after the onset of diabetes, unilateral hindlimb ischemia was induced in streptozotocine (STZ-induced diabetic mice, which were divided into control and IFR therapy groups (n = 6 per group. The latter mice were placed in an IFR dry sauna at 34°C for 30 min once per day for 5 weeks. Results Doppler perfusion imaging demonstrated that the ischemic limb/normal side blood perfusion ratio in the thermal therapy group was significantly increased beyond that in controls, and significantly greater capillary density was seen in the IFR therapy group. Flow cytometry analysis showed impaired EPCs (Sca-1+/Flk-1+ mobilization after ischemia surgery in diabetic mice with or without IFR therapy (n = 6 per group. However, as compared to those in the control group, bone marrow-derived EPCs differentiated into endothelial cells defined as GFP+/CD31+ double-positive cells were significantly increased in ischemic tissue around the vessels in diabetic mice that received IFR radiation. In in-vitro studies, cultured EPCs treated with IFR radiation markedly augmented high glucose-impaired EPC functions, inhibited high glucose-induced EPC senescence and reduced H2O2 production. Nude mice received human EPCs treated with IFR in high glucose medium showed a significant improvement in blood flow recovery in ischemic limb compared to those without IFR therapy. IFR therapy promoted blood flow recovery and new vessel formation in STZ-induced diabetic mice. Conclusions Administration of IFR therapy promoted collateral flow recovery and new vessel formation in STZ

  1. Topical corticosteroids as adjunctive therapy for bacterial keratitis

    Herretes, Samantha; Wang, Xue; Reyes, Johann MG

    2014-01-01

    Background Bacterial keratitis is a serious ocular infectious disease that can lead to severe visual disability. Risk factors for bacterial corneal infection include contact lens wear, ocular surface disease, corneal trauma, and previous ocular or eyelid surgery. Topical antibiotics constitute the mainstay of treatment in cases of bacterial keratitis, whereas the use of topical corticosteroids as an adjunctive therapy to antibiotics remains controversial. Topical corticosteroids are usually used to control inflammation using the smallest amount of the drug. Their use requires optimal timing, concomitant antibiotics, and careful follow-up. Objectives The objective of the review was to assess the effectiveness and safety of corticosteroids as adjunctive therapy for bacterial keratitis. Secondary objectives included evaluation of health economic outcomes and quality of life outcomes. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2014), EMBASE (January 1980 to July 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to July 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 July 2014. We also searched the Science Citation Index to identify additional studies that had cited the only trial included in the original version of this review, reference lists of included trials, earlier reviews, and the American Academy of Ophthalmology guidelines. We also contacted experts to identify any unpublished and

  2. Dietary omega-3 polyunsaturated fatty acids improve the neurolipidome and restore the DHA status while promoting functional recovery after experimental spinal cord injury.

    Figueroa, Johnny D; Cordero, Kathia; Llán, Miguel S; De Leon, Marino

    2013-05-15

    Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) confer multiple health benefits and decrease the risk of neurological disorders. Studies are needed, however, to identify promising cellular targets and to assess their prophylactic value against neurodegeneration. The present study (1) examined the efficacy of a preventive diet enriched with ω-3 PUFAs to reduce dysfunction in a well-established spinal cord injury (SCI) animal model and (2) used a novel metabolomics data analysis to identify potential neurolipidomic targets. Rats were fed with either control chow or chow enriched with ω-3 PUFAs (750 mg/kg/day) for 8 weeks before being subjected to a sham or a contusion SCI operation. We report new evidence showing that rats subjected to SCI after being pre-treated with a diet enriched with ω-3 PUFAs exhibit significantly better functional outcomes. Pre-treated animals exhibited lower sensory deficits, autonomic bladder recovery, and early improvements in locomotion that persisted for at least 8 weeks after trauma. We found that SCI triggers a robust alteration in the cord PUFA neurolipidome, which was characterized by a marked docosahexaenoic acid (DHA) deficiency. This DHA deficiency was associated with dysfunction and corrected with the ω-3 PUFA-enriched diet. Multivariate data analyses revealed that the spinal cord of animals consuming the ω-3 PUFA-enriched diet had a fundamentally distinct neurolipidome, particularly increasing the levels of essential and long chain ω-3 fatty acids and lysolipids at the expense of ω-6 fatty acids and its metabolites. Altogether, dietary ω-3 PUFAs prophylaxis confers resiliency to SCI mediated, at least in part, by generating a neuroprotective and restorative neurolipidome.

  3. Dietary Omega-3 Polyunsaturated Fatty Acids Improve the Neurolipidome and Restore the DHA Status while Promoting Functional Recovery after Experimental Spinal Cord Injury

    Figueroa, Johnny D.; Cordero, Kathia; llán, Miguel S.

    2013-01-01

    Abstract Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) confer multiple health benefits and decrease the risk of neurological disorders. Studies are needed, however, to identify promising cellular targets and to assess their prophylactic value against neurodegeneration. The present study (1) examined the efficacy of a preventive diet enriched with ω-3 PUFAs to reduce dysfunction in a well-established spinal cord injury (SCI) animal model and (2) used a novel metabolomics data analysis to identify potential neurolipidomic targets. Rats were fed with either control chow or chow enriched with ω-3 PUFAs (750 mg/kg/day) for 8 weeks before being subjected to a sham or a contusion SCI operation. We report new evidence showing that rats subjected to SCI after being pre-treated with a diet enriched with ω-3 PUFAs exhibit significantly better functional outcomes. Pre-treated animals exhibited lower sensory deficits, autonomic bladder recovery, and early improvements in locomotion that persisted for at least 8 weeks after trauma. We found that SCI triggers a robust alteration in the cord PUFA neurolipidome, which was characterized by a marked docosahexaenoic acid (DHA) deficiency. This DHA deficiency was associated with dysfunction and corrected with the ω-3 PUFA-enriched diet. Multivariate data analyses revealed that the spinal cord of animals consuming the ω-3 PUFA-enriched diet had a fundamentally distinct neurolipidome, particularly increasing the levels of essential and long chain ω-3 fatty acids and lysolipids at the expense of ω-6 fatty acids and its metabolites. Altogether, dietary ω-3 PUFAs prophylaxis confers resiliency to SCI mediated, at least in part, by generating a neuroprotective and restorative neurolipidome. PMID:23294084

  4. Successful haploidentical donor hematopoietic stem cell transplant and restoration of STAT3 function in an adolescent with autosomal dominant hyper-IgE syndrome.

    Patel, N C; Gallagher, J L; Torgerson, T R; Gilman, A L

    2015-07-01

    Autosomal dominant hyper-IgE syndrome (AD-HIES), caused by mutations in Signal Transducer and Activator of Transcription 3 (STAT3) is associated with defective STAT3 signaling and Th17 differentiation and recurrent bacterial and fungal infections. Most patients suffer significant morbidity and premature mortality. Hematopoietic stem cell transplantation (HSCT) has been reported in a small number of cases, with mixed outcomes. We report successful haploidentical donor HSCT in a patient with AD-HIES. Evaluation of lymphocyte subsets, STAT3 signaling, and Th17 cells was performed pre- and post-HSCT. A 14-year old female with AD-HIES developed recurrent methicillin-resistant Staphylococcus aureus (MRSA) abscesses. Immunologic analysis showed elevated IgE (4331 kU/L), absent Th17 cells, and markedly decreased STAT3 phosphorylation in cytokine stimulated peripheral blood mononuclear cells. She had breakthrough abscesses despite clindamycin and trimethoprim-sulfamethoxazole prophylaxis, and developed steroid refractory autoimmune hemolytic anemia. She underwent T-cell depleted haploidentical HSCT from her father following reduced intensity conditioning. She developed one MRSA hand abscess after transplant. Twenty-four months post transplant, she had complete donor chimerism (>95 % donor), normal absolute T cell numbers, and a normal percentage of Th17 cells. IgE was normal at 25 kU/L. She remains well 42 months after transplantation off all antibacterial prophylaxis. Haploidentical HSCT led to successful bone marrow engraftment, normalization of STAT3 signaling in hematopoietic cells, normalization of IgE, and restoration of immune function in this patient with AD-HIES.

  5. Using MODIS-NDVI for the Modeling of Post-Wildfire Vegetation Response as a Function of Environmental Conditions and Pre-Fire Restoration Treatments

    Grant M. Casady

    2012-03-01

    Full Text Available Post-fire vegetation response is influenced by the interaction of natural and anthropogenic factors such as topography, climate, vegetation type and restoration practices. Previous research has analyzed the relationship of some of these factors to vegetation response, but few have taken into account the effects of pre-fire restoration practices. We selected three wildfires that occurred in Bandelier National Monument (New Mexico, USA between 1999 and 2007 and three adjacent unburned control areas. We used interannual trends in the Normalized Difference Vegetation Index (NDVI time series data derived from the Moderate Resolution Imaging Spectroradiometer (MODIS to assess vegetation response, which we define as the average potential photosynthetic activity through the summer monsoon. Topography, fire severity and restoration treatment were obtained and used to explain post-fire vegetation response. We applied parametric (Multiple Linear Regressions-MLR and non-parametric tests (Classification and Regression Trees-CART to analyze effects of fire severity, terrain and pre-fire restoration treatments (variable used in CART on post-fire vegetation response. MLR results showed strong relationships between vegetation response and environmental factors (p < 0.1, however the explanatory factors changed among treatments. CART results showed that beside fire severity and topography, pre-fire treatments strongly impact post-fire vegetation response. Results for these three fires show that pre-fire restoration conditions along with local environmental factors constitute key processes that modify post-fire vegetation response.

  6. Correlation between ultrasonographic findings and the response to corticosteroid injection in pes anserinus tendinobursitis syndrome in knee osteoarthritis patients.

    Yoon, Ho Sung; Kim, Sung Eun; Suh, Young Ran; Seo, Young-Il; Kim, Hyun Ah

    2005-02-01

    The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Seventeen patients were injected locally with tramcinolone acetonide in the anserine bursa area. Response to local corticosteroid injection was evaluated by pain visual analog scale (VAS), Western Ontario and MacMaster (WOMAC) osteoarthritis index and Global patient/physician assessment using Likert scale. On US examination, only 2 patients (8.7%) showed evidence of PATB. Pain VAS, WOMAC pain index and WOMAC physical function index improved significantly after corticosteroid injection. Global patient assessment revealed that 2 patients showed best response, 6 good, 1 fair, 8 the same, and none worse. It is of note that the 2 patients who showed the best response were those who showed US evidence of PATB. This finding shows that US can serve as a useful diagnostic tool for guiding treatment in PATB syndrome of OA patients.

  7. The Dilemma of Irrational Antibiotic and Corticosteroid Prescription in Iran: How Much It Can Affect the Medicine Expenditures?

    Parisa Mehdizadeh

    2017-12-01

    Full Text Available In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures. We used the data of 91,994,667 selected prescription letters that were collected by the Ministry of the Health and Medical Education (MOHME throughout the country in the year 2011 which was analyzed through a logarithmic regression model and OLS estimator. The average number of prescription items in each prescription letter were varied from 2.7 to 3.6, and the average price of each letter was varied from 30223 to 69986 Rials. Between 39 to 61 percent of prescription letters containing antibiotic items and between 15 and 35% of them contain corticosteroids. Also, the impact of antibiotic and corticosteroid prescriptions on the average expenditure of prescription letters were -1.4 and 0.032 respectively. Excessive and irrational prescribing had the greatest impact on medicine expenditures. On the other hand, the expenditure of prescription letters had the negative elasticity to antibiotics prescription and relatively inelastic for corticosteroids. So, raising the price of medications to reduce the use of them could not play a successful role in a control policy.

  8. Effectiveness of platelets rich plasma versus corticosteroids in lateral epicondylitis.

    Khaliq, Abdul; Khan, Imran; Inam, Muhammad; Saeed, Mohammad; Khan, Husnain; Iqbal, Malik Javed

    2015-11-01

    To compare the treatment modalities of lateral epicondylitis in terms of pain relief. The randomised controlled study was conducted at Hayatabad Medical Complex, Peshawar, Pakistan, from April 2013 to March 2014, and comprised cases of lateral epicondylitis. The patients were selected through consecutive sampling from the outpatient department and were randomly allocated to two equal groups; group A receiving corticosteroid injections, and group B receiving injection of platelet-rich plasma. The patients were followed up for three weeks to determine the effectiveness of intervention. The 102 patients in the study were divided into two groups of 51(50%) each. The over mean age was 33.9±10.3 years. Mean age of patients in the corticosteroid group was 34.2±10.2 years and in the other group it was 33.6±10.5 years. Mean baseline visual analogue score in group A were 6.5±1.2 and in group B it was 6.7±1.4. In group A, 74.5% of patients presented in moderate pain category and 25.5% presented in severe pain category. In group B, 70.6% presented in moderate with 29.4% presented in severe pain category. On follow-up, the mean pain score in group A was 4.0±2.6 and in group B it was 3.5±2.61. Group A showed effectiveness in 52.9% patients and group B showed effectiveness in 82.3% (p=0.001). PRP is an effective alternate to corticosteroid in the treatment of lateral epicondylitis (tennis elbow).

  9. Experimental corticosteroid induction of Pneumocystis carinii pneumonia in piglets

    Nielsen, Jens; Bille-Hansen, Vivi; Settnes, O.P.

    1999-01-01

    Animal models of Pneumocystis carinii (Pc) pneumonia (PCP) play a central role in research on the Pc microorganism itself and the disease, especially the pathogenesis and the host defence. The classic rat model with corticosteroid-induced reactivation of a latent infection has been most widely used...... of the frontal lung lobes and/or atelectatic looking diaphragmatic lobes. Histopathologically, there was a focal interstitial pneumonia. Alveolar walls and interstitia had mononuclear cell infiltrations and the alveolar lumina were occluded by foamy acidophilic honeycomb material with a varying number of Pc...

  10. The role of nasal corticosteroids in the treatment of rhinitis.

    Meltzer, Eli O

    2011-08-01

    Intranasal corticosteroids (INSs) are the first choice for rhinitis pharmacotherapy. This preference is because of their broad range of actions that result in reductions of proinflammatory mediators, cytokines, and cells. Over the past 30 years, INSs have been modified to improve their pharmacodynamic, pharmacokinetic, and delivery system properties, with attention to improving characteristics such as receptor binding affinity, lipophilicity, low systemic bioavailability, and patient preference. Clinically, they have been shown to be the most effective class of nasal medications for treating allergic rhinitis and nonallergic rhinopathy, with no clear evidence that any specific INS is superior to others. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Use of Inhaled and Oral Corticosteroids in Pregnancy and the Risk of Malformations or Miscarriage

    Bjørn, Anne-Mette Bay; Ehrenstein, Vera; Nøhr, Ellen Aagaard

    2015-01-01

    databases, this MiniReview provides an overview of inhaled and oral corticosteroid use in pregnancy with specific emphasis on the association between use of corticosteroids during pregnancy and risk of miscarriage and congenital malformations in offspring. Use of corticosteroids among pregnant women ranged...... from 0.2% to 10% and increased nearly two-fold in recent years. Taken together, the evidence suggests that use of corticosteroids in early pregnancy is not associated with an increased risk of congenital malformations overall or oral clefts in offspring; at the same time, published estimates...

  12. Self-reported osteoporosis prevention in inhaled corticosteroid users in community pharmacy setting

    Valerie Chan

    2015-05-01

    Full Text Available Objectives: The use of inhaled corticosteroids is the standard maintenance therapy in asthma therapy and as adjunct therapy in moderate to severe chronic obstructive pulmonary disease. A dose-related increase in fracture risk is associated with inhaled corticosteroid use; there is an inverse relationship between bone mineral density and duration and cumulative dose of inhaled corticosteroid. Adequate intake of calcium and vitamin D are cornerstones of osteoporosis prevention. The objectives are to assess whether the proportion of patients receiving inhaled corticosteroids are taking calcium and vitamin D; the association between long-term inhaled corticosteroid use and abnormal bone mineral density or fractures; and how many qualified patients received bone mineral density scans. Methods: Patients who filled a prescription for inhaled corticosteroids at selected community pharmacies across Alberta were recruited for a survey of their osteoporosis prevention activities. Results: A total of 256 patients from 12 community pharmacies were included. The average age was 60 ± 17.4 years with 65% female. There were 21%, 51%, and 28% of patients on high, medium, and low dose inhaled corticosteroids, respectively. Only 17% of patients >50 years old received recommended calcium and vitamin D supplementation and 87 (73% of the qualified patients received bone mineral density scan. Conclusion: Osteoporosis prevention in inhaled corticosteroid users is currently poorly addressed. More promotion is needed to raise pharmacist awareness of the risks of inhaled corticosteroids.

  13. High doses of corticosteroid suppress resistance to Ichthyophonus in starry flounder

    Perry, J.A.; Kocan, R.M.; Winton, J.R.; Hershberger, P.K.

    2004-01-01

    Application of pharmacological doses of the corticosteroid dexamethasone phosphate to starry flounder Platichthys stellatus resulted in a predisposition to clinical ichthyophoniasis and a progression from latent Ichthyophonus infections to patent, histologically identifiable infections. Among Ichthyophonus-challenged starry flounder, the prevalences of clinical infections and histologically identifiable infections were significantly greater in two groups that received dexamethasone (100% and 31%, respectively) than in the respective control groups (8% and 0%). Proliferation of Ichthyophonus infections in corticosteroid-treated groups may have resulted from suppression of the cellular immune response that typically follows corticosteroid application; however, further studies are needed to determine whether these effects occur at lower, physiological concentrations of corticosteroids.

  14. Plant succession and approaches to community restoration

    Bruce A. Roundy

    2005-01-01

    The processes of vegetation change over time, or plant succession, are also the processes involved in plant community restoration. Restoration efforts attempt to use designed disturbance, seedbed preparation and sowing methods, and selection of adapted and compatible native plant materials to enhance ecological function. The large scale of wildfires and weed invasion...

  15. Decreased Serum Vitamin D Levels in Children with Asthma are Associated with Increased Corticosteroid Usage

    Searing, Daniel A.; Zhang, Yong; Murphy, James R.; Hauk, Pia J.; Goleva, Elena; Leung, Donald Y. M.

    2010-01-01

    Background There is little knowledge about clinical variables associated with vitamin D (vitD) insufficiency in asthmatic children. Objective To investigate disease variables associated with vitD insufficiency in childhood asthma and interaction of vitD with corticosteroid-mediated anti-inflammatory responses. Methods We analyzed 25-hydroxyvitamin D serum levels in 100 asthmatic children to investigate relationships between 25-hydroxyvitamin D levels and patient characteristics. We determined vitD effects on dexamethasone (DEX) induction of mitogen-activated protein kinase phosphatase-1 (MKP-1) and IL-10 in peripheral blood mononuclear cells (PBMC). Results The median 25-hydroxyvitamin D serum level was 31 ng/mL. 47% of subjects had vitD levels in the insufficient range (<30 ng/mL), while 17% were vitD deficient (<20 ng/mL). Log10 IgE (p=0.01, ρ=−0.25) and the number of positive aeroallergen skin prick tests (p=0.02, ρ=−0.23) showed a significant inverse correlation with vitD, whereas FEV1% predicted (p =0.004, ρ=0.34) and FEV1/FVC ratio (p=0.01, ρ=0.30) showed a significant positive correlation with vitD. The use of inhaled steroids (p=0.0475), oral steroids (p=0.02), and total steroid dose (p=0.001), all showed significant inverse correlations with vitD. The amount of MKP-1 and IL-10 mRNA induced by vitD plus DEX was significantly greater than that induced by DEX alone (p<0.01). In an experimental model of steroid resistance where DEX alone did not inhibit T cell proliferation, addition of vitD to DEX resulted in significant dose dependent suppression of cell proliferation. Conclusions Corticosteroid use and worsening airflow limitation is associated with lower vitD serum levels in asthmatics. VitD enhances glucocorticoid action in asthmatic PBMC and enhances the immunosuppressive function of DEX in vitro. Clinical Implications Our study suggests that vitD supplementation may potentiate anti-inflammatory function of corticosteroids in asthmatics and

  16. Intermittent inhaled corticosteroids in infants with episodic wheezing

    Bisgaard, Hans; Hermansen, Mette Northman; Loland, Lotte

    2006-01-01

    BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one-month-old ......BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one......-month-old infants to treatment with two-week courses of inhaled budesonide (400 mug per day) or placebo, initiated after a three-day episode of wheezing, in this single-center, randomized, double-blind, prospective study of three years' duration. The primary outcome was the number of symptom-free days; key...... secondary outcomes were the time to discontinuation due to persistent wheezing and safety, as evaluated by height and bone mineral density at the end of the study. RESULTS: We enrolled 411 infants and randomly assigned 294 to receive budesonide at a first episode of wheezing. The proportion of symptom...

  17. Protective effect of corticosteroids on radiation pneumonitis in mice

    Gross, N.J.; Narine, K.R.; Wade, R.

    1988-01-01

    We explored the protective effect of corticosteroids on the mortality of mice that received thoracic irradiation. Methylprednisolone, 100 mg/kg/week, given from 11 weeks after gamma irradiation of the thorax resulted in an increase in the LD50 (11-26 weeks) from 14.3 +/- 0.3 (mean +/- SE) Gy to 17.6 +/- 0.4 Gy, P less than 0.001, a protection factor of 1.2. Withdrawal of steroids at various times during the period of radiation pneumonitis resulted in accelerated mortality in the next 2-4 weeks, so that the cumulative mortality caught up with that of control animals by 4 weeks after steroid withdrawal. However, after the end of the usual period of pneumonitis withdrawal of steroids did not result in accelerated mortality, suggesting that the time when steroids are protective corresponds to the duration of pneumonitis. A smaller dose of steroids, 25 mg/kg/week, was found to be as protective as the larger dose used in the above experiments. The possibility that corticosteroids reduce mortality, even when given many weeks after radiation, may have important practical and theoretical implications

  18. Protein kinase activity associated with the corticosteroid binder IB

    Vujicic, M.; Djordjevic-Markovic, R.; Radic, O.; Krstic, M.; Kanazir, D.

    1997-01-01

    The physiological effects elicited by glucocorticoids are mediated via glucocorticoid receptors (GR). Analysis of specific glucocorticoid binding to radioactively labelled [ 3 H] triamcinolone acetonide in rat liver cytosol and analysis by ion exchange chromatography have revealed the presence of two distinct molecular species. The major form, designated as binder II appears to correspond to the well characterized glucocorticoid receptor by virtue of its size, charge, steroid binding characteristics and ability to bind to DNA.The second form, designated as corticosteroid binder IB, is a minor binding component in the liver. The binder IB differs from the binder II receptor by virtue of its lower molecular weight and its elution in the pre gradient of DEAE-Sephadex A-50 column which retains the un activated binder II receptor complexes. We examined the kinase activity of partially purified corticosteroid binder IB. Using (γ 3 2 P) ATP we detected kinase activity associated with the IB fraction from the rat liver. This kinase phosphorylate mixed histones and and dose not phosphorylate IB protein in vitro. The kinase activity is completely inhibited by the addition of Mg 2 + ions and is partially inhibited by the addition of Ca 2 +ions. (author)

  19. Brain sites mediating corticosteroid feedback inhibition of stimulated ACTH secretion

    Jacobson, L.

    1989-01-01

    There is substantial evidence that the brain mediates stress-induced and circadian increases in ACTH secretion and that corticosteroid concentrations which normalize basal plasma ACTH are insufficient to normalize ACTH responses to circadian or stressful stimuli in adrenalectomized rats. To identify brain sites mediating corticosteroid inhibition of stimulated ACTH secretion, two approaches were used. The first compared brain [ 14 C]-2-deoxyglucose uptake in rats with differential ACTH responses to stress. Relative to sham-adrenalectomized (SHAM) rats, adrenalectomized rats replaced with low, constant corticosterone levels via a subcutaneous corticosterone pellet (B-PELLET) exhibited elevated and prolonged ACTH responses to a variety of stimuli. Adrenalectomized rate given a circadian corticosterone rhythm via corticosterone in their drinking water exhibited elevated ACTH levels immediately after stress, but unlike B-PELLET rats, terminated stress induced ACTH secretion normally relative to SHAMS. Therefore, the abnormal ACTH responses to stress in B-PELLET rats were due to the lack of both circadian variations and stress-induced increases in corticosterone. Hypoxia was selected as a standardized stimulus for correlating brain [ 14 C]-2-deoxyglucose uptake with ACTH secretion. In intact rats, increases in plasma ACTH and decreases in arterial PO 2 correlated with the severity of hypoxia at arterial PCO 2 below 60 mm Hg. Hypoxia PELLET vs. SHAM rats. However, in preliminary experiments, although hypoxia increased brain 2-deoxyglucose uptake in most brain regions, plasma ACTH correlated poorly with 2-deoxyglucose uptake at 12% and 10% O 2

  20. Restoring Penis Sensation in Patients With Low Spinal Cord Lesions: The Role of the Remaining Function of the Dorsal Nerve in a Unilateral or Bilateral TOMAX Procedure

    Overgoor, Max L. E.; Braakhekke, Jan P.; Kon, Moshe; de Jong, Tom P. V. M.

    2015-01-01

    Aims: The recently developed TOMAX-procedure restores unilateral genital sensation, improving sexual health in men with a low spinal lesion (LSL). It connects one dorsal nerve of the penis (DNP) to the intact ipsilateral ilioinguinal nerve. We proposed bilateral neurotization for full sensation of

  1. Modulating lysosomal function through lysosome membrane permeabilization or autophagy suppression restores sensitivity to cisplatin in refractory non-small-cell lung cancer cells.

    Circu, Magdalena; Cardelli, James; Barr, Martin; O'Byrne, Kenneth; Mills, Glenn; El-Osta, Hazem

    2017-01-01

    Lung cancer is the leading cause of cancer-related deaths. Most patients develop resistance to platinum within several months of treatment. We investigated whether triggering lysosomal membrane permeabilization (LMP) or suppressing autophagy can restore cisplatin susceptibility in lung cancer with acquired chemoresistance. Cisplatin IC50 in A549Pt (parental) and A549cisR (cisplatin resistant) cells was 13 μM and 47 μM, respectively. Following cisplatin exposure, A549cisR cells failed to elicit an apoptotic response. This was manifested by diminished Annexin-V staining, caspase 3 and 9, BAX and BAK activation in resistant but not in parental cells. Chloroquine preferentially promoted LMP in A549cisR cells, revealed by leakage of FITC-dextran into the cytosol as detected by immunofluorescence microscopy. This was confirmed by increased cytosolic cathepsin D signal on Immunoblot. Cell viability of cisplatin-treated A549cisR cells was decreased when co-treated with chloroquine, corresponding to a combination index below 0.8, suggesting synergism between the two drugs. Notably, chloroquine activated the mitochondrial cell death pathway as indicated by increase in caspase 9 activity. Interestingly, inhibition of lysosomal proteases using E64 conferred cytoprotection against cisplatin and chloroquine co-treatment, suggesting that chloroquine-induced cell death occurred in a cathepsin-mediated mechanism. Likewise, blockage of caspases partially rescued A549cisR cells against the cytotoxicity of cisplatin and chloroquine combination. Cisplatin promoted a dose-dependent autophagic flux induction preferentially in A549cisR cells, as evidenced by a surge in LC3-II/α-tubulin following pre-treatment with E64 and increase in p62 degradation. Compared to untreated cells, cisplatin induced an increase in cyto-ID-loaded autophagosomes in A549cisR cells that was further amplified by chloroquine, pointing toward autophagic flux activation by cisplatin. Interestingly, this effect

  2. Modulating lysosomal function through lysosome membrane permeabilization or autophagy suppression restores sensitivity to cisplatin in refractory non-small-cell lung cancer cells.

    Magdalena Circu

    Full Text Available Lung cancer is the leading cause of cancer-related deaths. Most patients develop resistance to platinum within several months of treatment. We investigated whether triggering lysosomal membrane permeabilization (LMP or suppressing autophagy can restore cisplatin susceptibility in lung cancer with acquired chemoresistance. Cisplatin IC50 in A549Pt (parental and A549cisR (cisplatin resistant cells was 13 μM and 47 μM, respectively. Following cisplatin exposure, A549cisR cells failed to elicit an apoptotic response. This was manifested by diminished Annexin-V staining, caspase 3 and 9, BAX and BAK activation in resistant but not in parental cells. Chloroquine preferentially promoted LMP in A549cisR cells, revealed by leakage of FITC-dextran into the cytosol as detected by immunofluorescence microscopy. This was confirmed by increased cytosolic cathepsin D signal on Immunoblot. Cell viability of cisplatin-treated A549cisR cells was decreased when co-treated with chloroquine, corresponding to a combination index below 0.8, suggesting synergism between the two drugs. Notably, chloroquine activated the mitochondrial cell death pathway as indicated by increase in caspase 9 activity. Interestingly, inhibition of lysosomal proteases using E64 conferred cytoprotection against cisplatin and chloroquine co-treatment, suggesting that chloroquine-induced cell death occurred in a cathepsin-mediated mechanism. Likewise, blockage of caspases partially rescued A549cisR cells against the cytotoxicity of cisplatin and chloroquine combination. Cisplatin promoted a dose-dependent autophagic flux induction preferentially in A549cisR cells, as evidenced by a surge in LC3-II/α-tubulin following pre-treatment with E64 and increase in p62 degradation. Compared to untreated cells, cisplatin induced an increase in cyto-ID-loaded autophagosomes in A549cisR cells that was further amplified by chloroquine, pointing toward autophagic flux activation by cisplatin

  3. Linking restoration ecology with coastal dune restoration

    Lithgow, D.; Martínez, M. L.; Gallego-Fernández, J. B.; Hesp, P. A.; Flores, P.; Gachuz, S.; Rodríguez-Revelo, N.; Jiménez-Orocio, O.; Mendoza-González, G.; Álvarez-Molina, L. L.

    2013-10-01

    Restoration and preservation of coastal dunes is urgently needed because of the increasingly rapid loss and degradation of these ecosystems because of many human activities. These activities alter natural processes and coastal dynamics, eliminate topographic variability, fragment, degrade or eliminate habitats, reduce diversity and threaten endemic species. The actions of coastal dune restoration that are already taking place span contrasting activities that range from revegetating and stabilizing the mobile substrate, to removing plant cover and increasing substrate mobility. Our goal was to review how the relative progress of the actions of coastal dune restoration has been assessed, according to the ecosystem attributes outlined by the Society of Ecological Restoration: namely, integrity, health and sustainability and that are derived from the ecological theory of succession. We reviewed the peer reviewed literature published since 1988 that is listed in the ISI Web of Science journals as well as additional references, such as key books. We exclusively focused on large coastal dune systems (such as transgressive and parabolic dunefields) located on natural or seminatural coasts. We found 150 articles that included "coastal dune", "restoration" and "revegetation" in areas such as title, keywords and abstract. From these, 67 dealt specifically with coastal dune restoration. Most of the studies were performed in the USA, The Netherlands and South Africa, during the last two decades. Restoration success has been assessed directly and indirectly by measuring one or a few ecosystem variables. Some ecosystem attributes have been monitored more frequently (ecosystem integrity) than others (ecosystem health and sustainability). Finally, it is important to consider that ecological succession is a desirable approach in restoration actions. Natural dynamics and disturbances should be considered as part of the restored system, to improve ecosystem integrity, health and

  4. Early addition of topical corticosteroids in the treatment of bacterial keratitis.

    Ray, Kathryn J; Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Glidden, David V; Oldenburg, Catherine E; Sun, Catherine Q; Zegans, Michael E; McLeod, Stephen D; Acharya, Nisha R; Lietman, Thomas M

    2014-06-01

    Scarring from bacterial keratitis remains a leading cause of visual loss. To determine whether topical corticosteroids are beneficial as an adjunctive therapy for bacterial keratitis if given early in the course of infection. The Steroids for Corneal Ulcers Trial (SCUT) was a randomized, double-masked, placebo-controlled trial that overall found no effect of adding topical corticosteroids to topical moxifloxacin hydrochloride in bacterial keratitis. Here, we assess the timing of administration of corticosteroids in a subgroup analysis of the SCUT. We define earlier administration of corticosteroids (vs placebo) as addition after 2 to 3 days of topical antibiotics and later as addition after 4 or more days of topical antibiotics. We assess the effect of topical corticosteroids (vs placebo) on 3-month best spectacle-corrected visual acuity in patients who received corticosteroids or placebo earlier vs later. Further analyses were performed for subgroups of patients with non-Nocardia keratitis and those with no topical antibiotic use before enrollment. Patients treated with topical corticosteroids as adjunctive therapy within 2 to 3 days of antibiotic therapy had approximately 1-line better visual acuity at 3 months than did those given placebo (-0.11 logMAR; 95% CI, -0.20 to -0.02 logMAR; P = .01). In patients who had 4 or more days of antibiotic therapy before corticosteroid treatment, the effect was not significant; patients given corticosteroids had 1-line worse visual acuity at 3 months compared with those in the placebo group (0.10 logMAR; 95% CI, -0.02 to 0.23 logMAR; P = .14). Patients with non-Nocardia keratitis and those having no topical antibiotic use before the SCUT enrollment showed significant improvement in best spectacle-corrected visual acuity at 3 months if corticosteroids were administered earlier rather than later. There may be a benefit with adjunctive topical corticosteroids if application occurs earlier in the course of bacterial

  5. Intratympanic corticosteroid perfusion in the therapy of Meniere’s disease

    Sanković-Babić Snežana

    2014-01-01

    Full Text Available Introduction. Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere’s disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. Objective. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere’s disease who are resistant to conservative treatment. Methods. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere’s disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. Results. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Conclusion. Intratympanic perfusion of dexamethasone in patients with Meniere’s disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere’s disease who are contraindicted for

  6. Success and Failure Rates of 1,344 6- to 9-mm-Length Rough-Surface Implants Placed at the Time of Transalveolar Sinus Elevations, Restored with Single Crowns, and Followed for 60 to 229 Months in Function.

    Fugazzotto, Paul A

    To assess the success and stability of 6-, 7-, 8-, and 9-mm-long, 6.5-mm-wide-neck tissue-level implants placed at the time of transalveolar sinus augmentation therapy, utilizing a trephine and osteotome approach, which were restored with single crowns. In total, 1,344 implants were placed by the author, varying in length from 6 to 9 mm, with parallel-wall 4.8-mm-diameter implant bodies and 6.5-mm-diameter implant necks. The implants were restored with single abutments and crowns by a variety of practitioners. They were followed for 60 to 229 months in function, with a mean time of 121.1 months in function. Implant success was evaluated by the author utilizing a combination of the Albrektsson et al criteria, and buccal and palatal/lingual bone sounding under anesthesia. The overall cumulative success rate was 98.8%. One hundred ninety 6-mm-long implants demonstrated a cumulative success rate of 97.5% at a mean time of 109.2 months in function. Eleven 7-mm-long implants demonstrated a cumulative success rate of 100% at a mean time of 218.5 months in function. One thousand ninety-four 8-mm-long implants demonstrated a cumulative success rate of 98.9% at a mean time of 112.3 months in function. Forty-nine 9-mm-long implants demonstrated a cumulative success rate of 100% at a mean time of 212.1 months in function. Implants of 6 to 9 mm in length, placed at the time of trephine and osteotome transalveolar sinus elevation procedures and restored with abutments and single crowns, demonstrate a high level of long-term clinical success, assuming specific comprehensive treatment criteria are met.

  7. Minocycline in leprosy patients with recent onset clinical nerve function impairment.

    Narang, Tarun; Arshdeep; Dogra, Sunil

    2017-01-01

    Nerve function impairment (NFI) in leprosy may occur and progress despite multidrug therapy alone or in combination with corticosteroids. We observed improvement in neuritis when minocycline was administered in patients with type 2 lepra reaction. This prompted us to investigate the role of minocycline in recent onset NFI, especially in corticosteroid unresponsive leprosy patients. Leprosy patients with recent onset clinical NFI (Minocycline 100mg/day was given for 3 months to these patients. The primary outcome was the proportion of patients with 'restored,' 'improved,' 'stabilized,' or 'deteriorated' NFI. Secondary outcomes included any improvement in nerve tenderness and pain. In this pilot study, 11 patients were recruited. The progression of NFI was halted in all; with 9 out of 11 patients (81.82%) showing ?restored? or ?improved? sensory or motor nerve functions, on assessment with MFT and VMT. No serious adverse effects due to minocycline were observed. Our pilot study demonstrates the efficacy and safety of minocycline in recent onset NFI in leprosy patients. However, larger and long term comparative trials are needed to validate the efficacy of minocycline in leprosy neuropathy. © 2016 Wiley Periodicals, Inc.

  8. Effects of intranasal corticosteroids on radiated nasal mucosa of guinea pig

    Zhu Xinhua; Liu Yuehui

    2009-01-01

    Objective: To investigate a mechanism protected radiation-induce injure for radiated guinea pigs'nasal mucosa treated with intranasal corticosteroids(fluticasone nasal cavity spray). Methods: 50 health guinea pigs were divided into 2 groups randomly: the irradiated group (control group) with 25 guinea pigs and the administration group after irradiation (test group)with 25 guinea pigs. The nasal part of all guinea pigs were performed irradiation by the 6 MV X-ray with single 5 Gy, one time each week for three weeks. The guinea pigs of test group received intranasal corticosteroids with one time every day and one spray each side nasal cavity on the second day after three weeks irradiation. Five guinea pigs in each group were sacrificed randomly at 1 week, 1 month, 2 months, 3 months and 4 months after irradiation, and the histopathologic changes were observed under optical microscope and electron microscope. At the same time, blood were drawn from the heart and the concentration of IL-1, IL-6 and TNF-α in serum were measured by ELISA. Results: The early nasal mucosa inflammatory reaction of the test group was less than the control group. The coverage rate of cilia of the test group was much than that of the control group (72.9% vs 50.2%) at four months after irradiation. The atrophy of submucosal glandular organ was lessened and they displayed some extent secretory function. The concentration of IL-1 in serum was increased very much in the test group compared with the control group after irradiation and kept higher level in the first two months. After two months, it began to decrease; on four months, it still kept equivalency level with the control group. The concentration of IL-6 and TNF-α in serum were reduced all the while. Conclusions: The intranasal corticosteroids with fluticasone nasal cavity spray can reduce radiation- induced injury of guinea pigs' nasal mucosa. The concentration change of IL-1, IL-6 and TNF-α in serum may be one of mechanism protected

  9. Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo.

    Martin-Sanz, Eduardo; Rueda, Almudena; Esteban-Sanchez, Jonathan; Yanes, Joaquin; Rey-Martinez, Jorge; Sanz-Fernandez, Ricardo

    2017-08-01

    To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo. Prospective. Tertiary referral center. Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled. After treatment with oral corticosteroids, patients were followed up for 6 months. Functional recovery of the facial nerve was scored according to the House-Brackman grading system. Caloric and video head impulse tests were performed in every patient at the time of enrolment. Subsequently, successive video head impulse test (vHIT) exploration was performed at the 1, 3, and 6-month follow-up. Eighteen patients with vestibular neuritis and 13 with Ramsay Hunt syndrome and associated vertigo were included. Vestibular function was significantly worse in patients with Ramsay Hunt syndrome than in those with vestibular neuritis. Similar compensatory saccades velocity and latency values were observed in both groups, in both the caloric and initial vHIT tests. Successive vHIT results showed a significantly higher vestibulo-ocular reflex gain recovery in vestibular neuritis patients than in Ramsay Hunt syndrome patients. A significantly faster reduction in the latency, velocity, and organization of the compensatory saccades was observed in neuritis than in Ramsay Hunt syndrome patients. In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.

  10. Can Viral Videos Help Beaver Restore Streams?

    Castro, J. M.; Pollock, M. M.; Lewallen, G.; Jordan, C.; Woodruff, K.

    2015-12-01

    Have you watched YouTube lately? Did you notice the plethora of cute animal videos? Researchers, including members of our Beaver Restoration Research team, have been studying the restoration potential of beaver for decades, yet in the past few years, beaver have gained broad acclaim and some much deserved credit for restoration of aquatic systems in North America. Is it because people can now see these charismatic critters in action from the comfort of their laptops? While the newly released Beaver Restoration Guidebook attempts to answer many questions, sadly, this is not one of them. We do, however, address the use of beaver (Castor canadensis) in stream, wetland, and floodplain restoration and discuss the many positive effects of beaver on fluvial ecosystems. Our team, composed of researchers from NOAA National Marine Fisheries Service, US Fish and Wildlife Service, US Forest Service, and Portland State University, has developed a scientifically rigorous, yet accessible, practitioner's guide that provides a synthesis of the best available science for using beaver to improve ecosystem functions. Divided into two broad sections -- Beaver Ecology and Beaver Restoration and Management -- the guidebook focuses on the many ways in which beaver improve habitat, primarily through the construction of dams that impound water and retain sediment. In Beaver Ecology, we open with a discussion of the general effects that beaver dams have on physical and biological processes, and we close with "Frequently Asked Questions" and "Myth Busters". In Restoration and Management, we discuss common emerging restoration techniques and methods for mitigating unwanted beaver effects, followed by case studies from pioneering practitioners who have used many of these beaver restoration techniques in the field. The lessons they have learned will help guide future restoration efforts. We have also included a comprehensive beaver ecology library of over 1400 references from scientific journals

  11. Topical corticosteroids do not revert the activated phenotype of eosinophils in eosinophilic esophagitis but decrease surface levels of CD18 resulting in diminished adherence to ICAM-1, ICAM-2, and endothelial cells.

    Lingblom, Christine; Bergquist, Henrik; Johnsson, Marianne; Sundström, Patrik; Quiding-Järbrink, Marianne; Bove, Mogens; Wennerås, Christine

    2014-12-01

    Swallowed topical corticosteroids are the standard therapy for eosinophilic esophagitis (EoE) in adults. Eosinophils in the blood of untreated EoE patients have an activated phenotype. Our aim was to determine if corticosteroids restore the phenotype of eosinophils to a healthy phenotype and if certain cell-surface molecules on blood eosinophils correlate with eosinophilic infiltration of the esophagus. Levels of eight surface markers on eosinophils from treated and untreated EoE patients were determined by flow cytometry and analyzed using multivariate methods of pattern recognition. Corticosteroid-treated EoE patients' eosinophils had decreased levels of CD18 compared to both untreated patients and healthy controls, but maintained their activated phenotype. CD18 expression correlated positively with eosinophil numbers in the esophagus and promoted the adherence of eosinophils to ICAM-1, ICAM-2, and to endothelial cells. The diminished expression of CD18 may be one mechanism behind the reduced entry of eosinophils into the esophagus in corticosteroid-treated EoE patients.

  12. Corticosteroids reduce IL-6 in ASM cells via up-regulation of MKP-1.

    Quante, Timo; Ng, Yee Ching; Ramsay, Emma E; Henness, Sheridan; Allen, Jodi C; Parmentier, Johannes; Ge, Qi; Ammit, Alaina J

    2008-08-01

    The mechanisms by which corticosteroids reduce airway inflammation are not completely understood. Traditionally, corticosteroids were thought to inhibit cytokines exclusively at the transcriptional level. Our recent evidence, obtained in airway smooth muscle (ASM), no longer supports this view. We have found that corticosteroids do not act at the transcriptional level to reduce TNF-alpha-induced IL-6 gene expression. Rather, corticosteroids inhibit TNF-alpha-induced IL-6 secretion by reducing the stability of the IL-6 mRNA transcript. TNF-alpha-induced IL-6 mRNA decays at a significantly faster rate in ASM cells pretreated with the corticosteroid dexamethasone (t(1/2) = 2.4 h), compared to vehicle (t(1/2) = 9.0 h; P ASM cells.

  13. A new signal restoration method based on deconvolution of the Point Spread Function (PSF) for the Flat-Field Holographic Concave Grating UV spectrometer system

    Dai, Honglin; Luo, Yongdao

    2013-12-01

    In recent years, with the development of the Flat-Field Holographic Concave Grating, they are adopted by all kinds of UV spectrometers. By means of single optical surface, the Flat-Field Holographic Concave Grating can implement dispersion and imaging that make the UV spectrometer system design quite compact. However, the calibration of the Flat-Field Holographic Concave Grating is very difficult. Various factors make its imaging quality difficult to be guaranteed. So we have to process the spectrum signal with signal restoration before using it. Guiding by the theory of signals and systems, and after a series of experiments, we found that our UV spectrometer system is a Linear Space- Variant System. It means that we have to measure PSF of every pixel of the system which contains thousands of pixels. Obviously, that's a large amount of calculation .For dealing with this problem, we proposes a novel signal restoration method. This method divides the system into several Linear Space-Invariant subsystems and then makes signal restoration with PSFs. Our experiments turn out that this method is effective and inexpensive.

  14. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis

    Ayhan, Egemen; Kesmezacar, Hayrettin; Akgun, Isik

    2014-01-01

    Osteoarthritis (OA) is a complex “whole joint” disease pursued by inflammatory mediators, rather than purely a process of “wear and tear”. Besides cartilage degradation, synovitis, subchondral bone remodeling, degeneration of ligaments and menisci, and hypertrophy of the joint capsule take parts in the pathogenesis. Pain is the hallmark symptom of OA, but the extent to which structural pathology in OA contributes to the pain experience is still not well known. For the knee OA, intraarticular (IA) injection (corticosteroids, viscosupplements, blood-derived products) is preferred as the last nonoperative modality, if the other conservative treatment modalities are ineffective. IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA. IA hyaluronic acid (HA) injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk. But for HA injections, the cost-effectiveness is an important concern that patients must be informed about the efficacy of these preparations. Although more high-quality evidence is needed, recent studies indicate that IA platelet rich plasma injections are promising for relieving pain, improving knee function and quality of life, especially in younger patients, and in mild OA cases. The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction. But, there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage. PMID:25035839

  15. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  16. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A.

    1989-01-01

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment

  17. Practical Considerations for Dysphonia Caused by Inhaled Corticosteroids

    Galván, César A.; Guarderas, Juan Carlos

    2012-01-01

    Inhaled corticosteroid (ICS) therapy has become standard in the treatment of asthma. A common local adverse effect of ICS therapy is dysphonia, which has been reported to affect 5% to 58% of patients. Although causes of dysphonia associated with ICS therapy have been underinvestigated, it may result from deposition of an active ICS in the oropharynx during administration, which then causes myopathy or a mucosal effect in the laryngopharynx. Use of ICS should be considered during any evaluation of dysphonia. We recommend using the lowest effective dosage of ICS, administering medication with a spacer, gargling, rinsing the mouth and washing the face after inhalation, and washing the spacer. If dysphonia develops despite these interventions, ICS use should be suspended until symptoms resolve, provided that asthma control is not compromised. PMID:22958993

  18. short history of anti-rheumatic therapy. IV. Corticosteroids

    P. Marson

    2011-06-01

    Full Text Available In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA. He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.

  19. Risks of pneumonia in patients with asthma taking inhaled corticosteroids

    O'Byrne, Paul M; Pedersen, Soren; Carlsson, Lars-Göran

    2011-01-01

    Rationale: Inhaled corticosteroids (ICS) are the mainstay of asthma treatment. Studies in chronic obstructive pulmonary disease reported increased rates of pneumonia with ICS. Concerns exist about an increased pneumonia risk in patients with asthma taking ICS. Objectives: To evaluate the risks...... of pneumonia in patients with asthma taking ICS. Methods: A retrospective analysis evaluated studies of the ICS budesonide in asthma. The primary data set were all double-blind, placebo-controlled trials lasting at least 3 months, involving budesonide (26 trials, n = 9,067 for budesonide; n = 5...... effect of ICS on pneumonia adverse events (AEs) or serious adverse events (SAEs). Measurements and Main Results: In the primary data set, the occurrence of pneumonia AEs was 0.5% (rate 10.0 events/1,000 patient-years [TPY]) for budesonide and 1.2% (19.3 per TPY) for placebo (hazard ratio, 0.52; 95...

  20. Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids.

    Hosaka, Takashi; Nakamagoe, Kiyotaka; Tamaoka, Akira

    2017-11-01

    The encephalopathy that occurs in association with hemolytic uremic syndrome (HUS), which is caused by enterohemorrhagic Escherichia coli (E. coli), has a high mortality rate and patients sometimes present sequelae. We herein describe the case of a 20-year-old woman who developed encephalopathy during the convalescent stage of HUS caused by E.coli O26. Hyperintense lesions were detected in the pons, basal ganglia, and cortex on diffusion-weighted brain MRI. From the onset of HUS encephalopathy, we treated the patient with methylprednisolone (mPSL) pulse therapy alone. Her condition improved, and she did not present sequelae. Our study shows that corticosteroids appear to be effective for the treatment of some patients with HUS encephalopathy.

  1. Intranasal corticosteroids topical characteristics: side effects, formulation, and volume.

    Petty, David A; Blaiss, Michael S

    2013-01-01

    Guidelines from throughout the world recommend intranasal corticosteroids (INSs) as first-line treatment for most patients with moderate to severe allergic rhinitis. In general, limited comparative studies between different INSs have not indicated that one particular steroid moiety is more effective than another in controlling symptoms of allergic rhinitis. However, there are numerous formulations available with different ingredients that may influence a patient's adherence to treatment. This article looks at topical features with these agents, specifically, formulations, vehicles (aqueous vs aerosol), and side effects such as epistaxis and nasal septal perforation. Topical side effects are minimal with INSs with the exception of epistaxis. There are major differences in formulations, volumes, and vehicles between INSs, which could affect adherence. Physicians need to be aware of the different INS attributes to try to match patients' preferences in order to achieve better adherence and improve outcomes in sufferers of allergic rhinitis.

  2. The site of action of corticosteroid antipyresis in the rabbit.

    Willies, G H; Woolf, C J

    1980-01-01

    1. The antipyretic effects of corticosteroids on the fevers produced by bacterial and endogenous pyrogens in the rabbit were investigated. 2. Intravenous infusions of hydrocortisone and methyl prednisolone, when administered simultaneously with bacterial or endogenous pyrogens, failed to produce an antipyresis. 3. Pretreatment of rabbits with methyl prednisolone for 3 days diminished the febrile effect of both bacterial and endogenous pyrogens. 4. The fever produced by intrahypothalamic micro-injections of endogenous pyrogen was significantly attenuated by the simultaneous micro-injection of methyl prednisolone. 5. These results indicate that the antipyretic effect of steroids in the rabbit is the result not of a peripheral inhibition of endogenous pyrogen production, but rather of an action on the central nervous system. PMID:7381781

  3. Polymyalgia rheumatica: observations of disease evolution without corticosteroid treatment

    Brawer AE

    2016-04-01

    Full Text Available Arthur E Brawer Division of Rheumatology, Department of Medicine, Monmouth Medical Center, Long Branch, NJ, USA Objectives: The diagnostic diversity of polymyalgia rheumatica (PMR can easily be obscured by the widespread use of corticosteroids (CSs early in the disease course. This study observed the course of PMR without CSs and determined whether alternative medication could be useful. Methods: Seventy patients with new-onset PMR comprised phase 1. Eight were removed with specific diagnoses (four with giant cell arteritis [GCA]. The remaining 62 were treated with nonsteroidal anti-inflammatory drugs (NSAIDs alone until enough time had elapsed to ascertain whether their PMR had evolved into another rheumatologic inflammatory condition. Hydroxychloroquine (HCQ was then added to their regimen. Twenty-five additional patients with PMR comprised phase 2. Twenty-two were immediately treated with HCQ prior to the anticipated disease progression. Results: In phase 1, 52/62 developed synovitis in multiple other joints 9 months from PMR onset; 48/52 received HCQ, and 42/48 (87.5% achieved complete remission. In phase 2, during HCQ induction, 21 patients developed similar synovitis; after 6 months of HCQ use, 80% achieved remission. In 73/95 (77%, a definite diagnosis of rheumatoid arthritis (RA could be made on average 8.5 months from PMR onset. Only 12/95 (13% stayed true to form with their PMR and did not develop another specific diagnosis. Conclusion: In this study, true PMR was infrequent in the absence of GCA. PMR in most patients evolved into seronegative RA, which was dramatically responsive to HCQ use. Treatment of acute PMR with HCQ was a rational alternative to CS use even if progressive additive synovitis had not yet occurred. Keywords: polymyalgia rheumatica, rheumatoid arthritis, corticosteroids

  4. Dextrose prolotherapy and corticosteroid injection into rat Achilles tendon.

    Martins, C A Q; Bertuzzi, R T; Tisot, R A; Michelin, A F; do Prado, J M; Stroher, A; Burigo, M

    2012-10-01

    To assess the mechanical behavior and the histology of collagen fibers after prolotherapy with 12.5% dextrose into rat Achilles tendons and to compare with those of corticosteroid treatment. Out of 60 adult female Wistar rats (70 tendons), 15 received 12.5% dextrose (group I); 15 were treated with corticosteroid injection (group II); and 15 were given 0.9% saline injection (group III), all into the right Achilles tendon, whereas 13 animals received no injections (group IV). Three doses of each substance (groups I, II, and III) were given at a 5-day interval. Collagen fiber color was quantitatively assessed in three samples from each group and in five samples from the control group using picrosirius red staining under polarized and nonpolarized light. Twelve tendons from each group treated with the test substance and 20 tendons from the control group were submitted to the tensile strength test. There was no statistical difference across the groups with respect to maximum load at failure (n.s.) and absorbed energy (n.s.). With respect to tendon rupture, there was no difference between the myotendinous and the tendinous regions (n.s.). However, hematoxylin-eosin staining revealed statistical significance in lymphocytic inflammatory infiltrate (P = 0.008) and in parallel fiber orientation (P = 0.003) when comparing groups to the control group, without significance for either neovascularization (n.s.) or the presence of fibroblasts (n.s.). Likewise, there was no significant difference between the percentage of mature (n.s.) and immature (n.s.) fibers. Dextrose was not deleterious to the tendinous tissue, as it did not change the mechanical and histological properties of Achilles tendons in rats. The data obtained in this study may help clinicians in their daily work as they suggest that injections of 12.5% dextrose caused no harm to the tendons, although the clinical importance in humans still needs to be defined.

  5. Technologies for lake restoration

    Helmut KLAPPER

    2003-09-01

    Full Text Available Lakes are suffering from different stress factors and need to be restored using different approaches. The eutrophication remains as the main water quality management problem for inland waters: both lakes and reservoirs. The way to curb the degradation is to stop the nutrient sources and to accelerate the restoration with help of in-lake technologies. Especially lakes with a long retention time need (eco- technological help to decrease the nutrient content in the free water. The microbial and other organic matter from sewage and other autochthonous biomasses, causes oxygen depletion, which has many adverse effects. In less developed countries big reservoirs function as sewage treatment plants. Natural aeration solves problems only partly and many pollutants tend to accumulate in the sediments. The acidification by acid rain and by pyrite oxidation has to be controlled by acid neutralizing technologies. Addition of alkaline chemicals is useful only for soft waters, and technologies for (microbial alkalinization of very acidic hardwater mining lakes are in development. The corrective measures differ from those in use for eutrophication control. The salinization and water shortage mostly occurs if more water is used than available. L. Aral, L. Tschad, the Dead Sea or L. Nasser belong to waters with most severe environmental problems on a global scale. Their hydrologic regime needs to be evaluated. The inflow of salt water at the bottom of some mining lakes adds to stability of stratification, and thus accumulation of hydrogen sulphide in the monimolimnion of the meromictic lakes. Destratification, which is the most used technology, is only restricted applicable because of the dangerous concentrations of the byproducts of biological degradation. The contamination of lakes with hazardous substances from industry and agriculture require different restoration technologies, including subhydric isolation and storage, addition of nutrients for better self

  6. Study of effect of inhaled versus oral corticosteroids on sputum granzyme B in patients with moderate persistent bronchial asthma

    Walaa K. Shoeib

    2015-01-01

    Conclusion: Granzyme B levels are elevated in bronchial asthma. Granzyme B could play a role in the pathogenesis of bronchial asthma. Both inhaled and oral corticosteroids lowered granzyme B levels significantly. The lowering effect of inhaled corticosteroids on sputum granzyme B is more than that of the oral corticosteroids.

  7. Techniques of forest restoration in restingas

    Liliane Garcia da Silva Morais Rodrigues

    2016-03-01

    Full Text Available Restinga is an ecosystem of the Atlantic Forest Biome vegetation which has ecological functions and is undergoing anthropogenic occupations that result in the disturbance and its suppression of these environments. But to be the restoration of degraded restinga is necessary to know the different formations of the ecosystem and their respective characteristics. From this diagnosis, one can choose the most appropriate techniques to apply for its restoration. Thus, this study aims to conduct a literature on restoration techniques in restinga environments. It was found that forest restoration on restinga, in most cases there is use of natural regeneration techniques nucleation, and these studies highlight the successional advances and establishments of life forms preserved features of the area, thus making the restoration in these environments.

  8. Review: Mangrove ecosystem in Java: 2. Restoration

    PURIN CANDRA PURNAMA

    2004-07-01

    Full Text Available R E V I E W:Ekosistem Mangrove di Jawa: 2. RestorasiThe restoration of mangroves has received a lot of attentions world wide for several reasons. Mangrove ecosystem is very important in term of socio-economic and ecology functions. Because of its functions, wide range of people paid attention whenever mangrove restoration taken place. Mangrove restoration potentially increases mangrove resource value, protect the coastal area from destruction, conserve biodiversity, fish production and both of directly and indirectly support the life of surrounding people. This paper outlines the activities of mangrove restoration on Java island. The extensive research has been carried out on the ecology, structure and functioning of the mangrove ecosystem. However, the findings have not been interpreted in a management framework, thus mangrove forests around the world continue to be over-exploited, converted to aquaculture ponds, and polluted. We strongly argue that links between research and sustainable management of mangrove ecosystem should be established.

  9. Short-Term Prognosis of Mechanically Ventilated Patients With Guillain-Barré Syndrome Is Worsened by Corticosteroids as an Add-On Therapy.

    Wu, Xiujuan; Zhang, Bing; Li, Chunrong; Shen, Donghui; Liu, Kangding; Zhu, Jie; Zhang, Hong-Liang

    2015-10-01

    Intravenous immunoglobulin (IVIg) has been proven most effective in treating Guillain-Barré syndrome (GBS). Corticosteroids as an add-on therapy have been prescribed in severe GBS cases. However, the efficacy of intravenous corticosteroids combined with IVIg in dealing with severe GBS remains unclear. We explored the therapeutic effects of different therapeutic regimens on the short-term prognosis of GBS patients, especially the severe cases.We retrospectively analyzed the clinical data of 527 adult patients with GBS who were prescribed to different treatments from 2003 to 2014. The therapeutic effect of a treatment was evaluated by the improvement of Hughes Functional Grading Scale (HFGS) and Medical Research Council (MRC) sum score.With comparable incidence of infectious complications (P > 0.05), more mechanically ventilated patients were found improvement after IVIg treatment than combination IVIg with intravenous corticosteroids (MRC: 97% vs. 72.4%, P bedridden patients without mechanical ventilation, incidence of infectious complications (P > 0.05) and ratio of patients who were improved after IVIg were insignificantly different from the combination therapy (MRC: 89.6% vs. 86.5%; HFGS: 69.6% vs. 61.5%; both P > 0.05), even if the intravenous corticosteroids were initiated within 7 days after onset (P > 0.05). In addition, supportive treatment was sufficient for patients who were able to walk with help (HFGS = 3) and mildly affected (HFGS  3), while corticosteroids are detrimental for short-term prognosis in mechanically ventilated patients when used in combination with IVIg. Further prospective and randomized studies are warranted to validate this finding.

  10. Short-Term Prognosis of Mechanically Ventilated Patients With Guillain–Barré Syndrome Is Worsened by Corticosteroids as an Add-On Therapy

    Wu, Xiujuan; Zhang, Bing; Li, Chunrong; Shen, Donghui; Liu, Kangding; Zhu, Jie; Zhang, Hong-Liang

    2015-01-01

    Abstract Intravenous immunoglobulin (IVIg) has been proven most effective in treating Guillain–Barré syndrome (GBS). Corticosteroids as an add-on therapy have been prescribed in severe GBS cases. However, the efficacy of intravenous corticosteroids combined with IVIg in dealing with severe GBS remains unclear. We explored the therapeutic effects of different therapeutic regimens on the short-term prognosis of GBS patients, especially the severe cases. We retrospectively analyzed the clinical data of 527 adult patients with GBS who were prescribed to different treatments from 2003 to 2014. The therapeutic effect of a treatment was evaluated by the improvement of Hughes Functional Grading Scale (HFGS) and Medical Research Council (MRC) sum score. With comparable incidence of infectious complications (P > 0.05), more mechanically ventilated patients were found improvement after IVIg treatment than combination IVIg with intravenous corticosteroids (MRC: 97% vs. 72.4%, P bedridden patients without mechanical ventilation, incidence of infectious complications (P > 0.05) and ratio of patients who were improved after IVIg were insignificantly different from the combination therapy (MRC: 89.6% vs. 86.5%; HFGS: 69.6% vs. 61.5%; both P > 0.05), even if the intravenous corticosteroids were initiated within 7 days after onset (P > 0.05). In addition, supportive treatment was sufficient for patients who were able to walk with help (HFGS = 3) and mildly affected (HFGS  3), while corticosteroids are detrimental for short-term prognosis in mechanically ventilated patients when used in combination with IVIg. Further prospective and randomized studies are warranted to validate this finding. PMID:26512609

  11. Restorative dentistry for children.

    Donly, Kevin J

    2013-01-01

    This article discusses contemporary pediatric restorative dentistry. Indications and contraindications for the choice of different restorative materials in different clinical situations, including the risk assessment of the patient, are presented. The specific use of glass ionomer cement or resin-modified glass ionomer cement, resin-based composite, and stainless steel crowns is discussed so that preparation design and restoration placement is understood. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Topical corticosteroids in the treatment of acute sunburn: a randomized, double-blind clinical trial.

    Faurschou, Annesofie; Wulf, Hans C

    2008-05-01

    To examine the effect of topical corticosteroid treatment on acute sunburn. Randomized, double-blind clinical trial. University dermatology department. Twenty healthy volunteers with Fitzpatrick skin types I (highly sensitive, always burns easily, tans minimally) through III (sun-sensitive skin, sometimes burns, slowly tans to light brown). Seven 34-cm(2) areas were marked on the upper aspect of the back of each participant. An untreated area was tested to determine UV sensitivity. Two areas were treated with excess amounts (2 mg/cm(2)) of either a moderate-potency corticosteroid or a high-potency corticosteroid 30 minutes before UV-B exposure as controls. Six or 23 hours after exposure to radiation, the remaining areas were treated with the 2 corticosteroid preparations. The sunburn improvement factor (SIF) was determined by the following equation: SIF = MED (minimal erythema dose) on treated skin/MED on nontreated skin. An SIF greater than 1 indicated an effect of topical corticosteroids in sunburn relief. The SIFs in the areas treated with either topical corticosteroid 30 minutes before UV-B exposure or high-potency corticosteroid 6 hours after UV-B exposure were significantly different from SIFs in areas that received no treatment (SIF 1.1-1.7; P sunburn reaction when applied 6 or 23 hours after UV exposure.

  13. The Association of Industry Payments to Physicians with Prescription of Brand-Name Intranasal Corticosteroids.

    Morse, Elliot; Fujiwara, Rance J T; Mehra, Saral

    2018-06-01

    Objectives To examine the association of industry payments for brand-name intranasal corticosteroids with prescribing patterns. Study Design Cross-sectional retrospective analysis. Setting Nationwide. Subjects and Methods We identified physicians prescribing intranasal corticosteroids to Medicare beneficiaries 2014-2015 and physicians receiving payment for the brand-name intranasal corticosteroids Dymista and Nasonex. Prescription and payment data were linked by physician, and we compared the proportion of prescriptions written for brand-name intranasal corticosteroids in industry-compensated vs non-industry-compensated physicians. We associated the number and dollar amount of industry payments with the relative frequency of brand-name prescriptions. Results In total, 164,587 physicians prescribing intranasal corticosteroids were identified, including 7937 (5%) otolaryngologists; 10,800 and 3886 physicians received industry compensation for Dymista and Nasonex, respectively. Physicians receiving industry payment for Dymista prescribed more Dymista as a proportion of total intranasal corticosteroid prescriptions than noncompensated physicians (3.1% [SD = 9.6%] vs 0.2% [SD = 2.5%], respectively, P association was stronger in otolaryngologists than general practitioners ( P brand-name intranasal corticosteroids is significantly associated with prescribing patterns. The magnitude of association may depend on physician specialty and the drug's time on the market.

  14. Ecological restoration [book review

    Eric J. Gustafson

    2010-01-01

    Ecological restoration has increased in prominence in recent years as environmental policies have slowed the rate of environmental degradation in many parts of the world and practitioners have looked for active ways to reverse the damage. Because of the vast number of types and contexts of degraded ecological systems, the field of ecological restoration is still very...

  15. Current Concepts in Restorative Implant Dentistry

    Prof.Marchack

    2009-01-01

    Patients today are incteasingly aware of dental implants.and their expectations are for esthetically and functionally pleasingimplant restorations that mimic natural teeth.This presentation will give both the experienced and novice practitioner a better understand-ing of how restorative implant dentistry has evolved.Treatment planning and restorative options for single implants.multiple implants andfully edentulons arches will be discussed,and the use of modern materials and CADCAM technology in fabricating the most contemporaryfixed implant supported prostheses will be demonstrated.

  16. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    Groenier Klaas H

    2009-10-01

    Full Text Available Abstract Background De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local corticosteroid injections for de Quervain's tenosynovitis provided by general practitioners was assessed. Methods Participants with de Quervain's tenosynovitis were recruited by general practitioners. Short-term outcomes (one week after injections were assessed in a randomised, placebo-controlled trial. Long-term effectiveness was evaluated in an open prospective cohort-study of steroid responders during a follow-up period of 12 months. Participants were randomised to one or two local injections of 1 ml of triamcinolonacetonide (TCA or 1 ml of NaCl 0.9% (placebo. Non-responders to NaCl were treated with additional TCA injections. Main outcomes were immediate treatment response, severity of pain, improvement as perceived by participant and functional disability using sub items hand and finger function of the Dutch Arthritis Impact Measurement Scale (Dutch AIMS-2-HFF. Results 11 general practitioners included 21 wrists in 21 patients. The TCA-group had better results for short-term outcomes treatment response (78% vs. 25%; p = 0.015, perceived improvement (78% vs. 33%; p = 0.047 and severity of pain (4.27 vs. 1.33; p = 0.031 but not for the Dutch-AIMS-HFF (2.71 vs. 1.92; p = 0.112. Absolute risk reduction for the main outcome short-term treatment response was 0.55 (95% CI: 0.34, 0.76 with a number needed to treat of 2 (95% CI: 1, 3. In the cohort of steroid responders (n = 12 the beneficial effects of steroid injections were sustained during the follow-up of 12 months regarding severity of pain (p = 0.67 and scores of Dutch AIMS-2-HFF (p = 0.36, but not for patient perceived improvement (p = 0.02. No adverse events were observed during the 12

  17. Challenges of ecological restoration

    Halme, Panu; Allen, Katherine A.; Aunins, Ainars

    2013-01-01

    we introduce northern forests as an ecosystem, discuss the historical and recent human impact and provide a brief status report on the ecological restoration projects and research already conducted there. Based on this discussion, we argue that before any restoration actions commence, the ecology......The alarming rate of ecosystem degradation has raised the need for ecological restoration throughout different biomes and continents. North European forests may appear as one of the least vulnerable ecosystems from a global perspective, since forest cover is not rapidly decreasing and many...... on Biological Diversity. Several northern countries are now taking up this challenge by restoring forest biodiversity with increasing intensity. The ecology and biodiversity of boreal forests are relatively well understood making them a good model for restoration activities in many other forest ecosystems. Here...

  18. Retributive and restorative justice.

    Wenzel, Michael; Okimoto, Tyler G; Feather, Norman T; Platow, Michael J

    2008-10-01

    The emergence of restorative justice as an alternative model to Western, court-based criminal justice may have important implications for the psychology of justice. It is proposed that two different notions of justice affect responses to rule-breaking: restorative and retributive justice. Retributive justice essentially refers to the repair of justice through unilateral imposition of punishment, whereas restorative justice means the repair of justice through reaffirming a shared value-consensus in a bilateral process. Among the symbolic implications of transgressions, concerns about status and power are primarily related to retributive justice and concerns about shared values are primarily related to restorative justice. At the core of these processes, however, lies the parties' construal of their identity relation, specifically whether or not respondents perceive to share an identity with the offender. The specific case of intergroup transgressions is discussed, as are implications for future research on restoring a sense of justice after rule-breaking.

  19. Inhibition of central de novo ceramide synthesis restores insulin signaling in hypothalamus and enhances β-cell function of obese Zucker rats

    Mélanie Campana

    2018-02-01

    Full Text Available Objectives: Hypothalamic lipotoxicity has been shown to induce central insulin resistance and dysregulation of glucose homeostasis; nevertheless, elucidation of the regulatory mechanisms remains incomplete. Here, we aimed to determine the role of de novo ceramide synthesis in hypothalamus on the onset of central insulin resistance and the dysregulation of glucose homeostasis induced by obesity. Methods: Hypothalamic GT1-7 neuronal cells were treated with palmitate. De novo ceramide synthesis was inhibited either by pharmacological (myriocin or molecular (si-Serine Palmitoyl Transferase 2, siSPT2 approaches. Obese Zucker rats (OZR were intracerebroventricularly infused with myriocin to inhibit de novo ceramide synthesis. Insulin resistance was determined by quantification of Akt phosphorylation. Ceramide levels were quantified either by a radioactive kinase assay or by mass spectrometry analysis. Glucose homeostasis were evaluated in myriocin-treated OZR. Basal and glucose-stimulated parasympathetic tonus was recorded in OZR. Insulin secretion from islets and β-cell mass was also determined. Results: We show that palmitate impaired insulin signaling and increased ceramide levels in hypothalamic neuronal GT1-7 cells. In addition, the use of deuterated palmitic acid demonstrated that palmitate activated several enzymes of the de novo ceramide synthesis pathway in hypothalamic cells. Importantly, myriocin and siSPT2 treatment restored insulin signaling in palmitate-treated GT1-7 cells. Protein kinase C (PKC inhibitor or a dominant-negative PKCζ also counteracted palmitate-induced insulin resistance. Interestingly, attenuating the increase in levels of hypothalamic ceramides with intracerebroventricular infusion of myriocin in OZR improved their hypothalamic insulin-sensitivity. Importantly, central myriocin treatment partially restored glucose tolerance in OZR. This latter effect is related to the restoration of glucose-stimulated insulin

  20. Oral administration of royal jelly restores tear secretion capacity in rat blink-suppressed dry eye model by modulating lacrimal gland function.

    Toshihiro Imada

    Full Text Available Tears are secreted from the lacrimal gland (LG, a dysfunction in which induces dry eye, resulting in ocular discomfort and visual impairment. Honey bee products are used as a nutritional source in daily life and medicine; however, little is known about their effects on dry eye. The aim of the present study was to investigate the effects of honey bee products on tear secretion capacity in dry eye. We selected raw honey, propolis, royal jelly (RJ, pollen, or larva from commercially available honey bee products. Tear secretion capacity was evaluated following the oral administration of each honey bee product in a rat blink-suppressed dry eye model. Changes in tear secretion, LG ATP content, and LG mitochondrial levels were measured. RJ restored the tear secretion capacity and decrease in LG ATP content and mitochondrial levels to the largest extent. Royal jelly can be used as a preventative intervention for dry eye by managing tear secretion capacity in the LG.

  1. Remote sensing for restoration ecology: Application for restoring degraded, damaged, transformed, or destroyed ecosystems.

    Reif, Molly K; Theel, Heather J

    2017-07-01

    Restoration monitoring is generally perceived as costly and time consuming, given the assumptions of successfully restoring ecological functions and services of a particular ecosystem or habitat. Opportunities exist for remote sensing to bolster the restoration science associated with a wide variety of injured resources, including resources affected by fire, hydropower operations, chemical releases, and oil spills, among others. In the last decade, the role of remote sensing to support restoration monitoring has increased, in part due to the advent of high-resolution satellite sensors as well as other sensor technology, such as lidar. Restoration practitioners in federal agencies require monitoring standards to assess restoration performance of injured resources. This review attempts to address a technical need and provides an introductory overview of spatial data and restoration metric considerations, as well as an in-depth review of optical (e.g., spaceborne, airborne, unmanned aerial vehicles) and active (e.g., radar, lidar) sensors and examples of restoration metrics that can be measured with remotely sensed data (e.g., land cover, species or habitat type, change detection, quality, degradation, diversity, and pressures or threats). To that end, the present article helps restoration practitioners assemble information not only about essential restoration metrics but also about the evolving technological approaches that can be used to best assess them. Given the need for monitoring standards to assess restoration success of injured resources, a universal monitoring framework should include a range of remote sensing options with which to measure common restoration metrics. Integr Environ Assess Manag 2017;13:614-630. Published 2016. This article is a US Government work and is in the public domain in the USA. Published 2016. This article is a US Government work and is in the public domain in the USA.

  2. Fetal programming: prenatal testosterone treatment leads to follicular persistence/luteal defects; partial restoration of ovarian function by cyclic progesterone treatment.

    Manikkam, Mohan; Steckler, Teresa L; Welch, Kathleen B; Inskeep, E Keith; Padmanabhan, Vasantha

    2006-04-01

    Prenatal testosterone (T) excess during midgestation leads to estrous cycle defects and polycystic ovaries in sheep. We hypothesized that follicular persistence causes polycystic ovaries and that cyclic progesterone (P) treatment would overcome follicular persistence and restore cyclicity. Twice-weekly blood samples for P measurements were taken from control (C; n = 16) and prenatally T-treated (T60; n = 14; 100 mg T, im, twice weekly from d 30-90 of gestation) Suffolk sheep starting before the onset of puberty and continuing through the second breeding season. A subset of C and T60 sheep were treated cyclically with a modified controlled internal drug-releasing device for 13-14 d every 17 d during the first anestrus (CP, 7; TP, 6). Transrectal ovarian ultrasonography was performed for 8 d in the first and 21 d in the second breeding season. Prenatal T excess reduced the number, but increased the duration of progestogenic cycles, reduced the proportion of ewes with normal cycles, increased the proportion of ewes with subluteal cycles, decreased the proportion of ewes with ovulatory cycles, induced the occurrence of persistent follicles, and reduced the number of corpora lutea in those that cycled. Cyclic P treatment in anestrus, which produced one third the P concentration seen during luteal phase of cycle, did not reduce the number of persistent follicles, but increased the number of progestogenic cycles while reducing their duration. These findings suggested that follicular persistence might contribute to the polycystic ovarian morphology. Cyclic P treatment was able to only partially restore follicular dynamics, but this may be related to the low replacement concentrations of P achieved.

  3. CT findings in brain edema following the administration of corticosteroids

    Seki, Yojiro; Kumagai, Norimoto; Aiba, Tadashi

    1979-01-01

    Computed tomography (CT) is the first noninvasive method available for directly visualizing brain edema in man. On CT scans perifocal edema is shown as an area of low density surrounding a lesion. The purpose of this report is to evaluate the effect of corticosteroids on brain edema as seen by CT (HITACHI CT-H 250). Nine patients with brain-tumor and one with brain-abscess were treated with betamethasone for about ten days (dosage started with 12 - 16 mg/day, and tapered). In eight cases, and improvement in the neurological findings was observed. An impressive reduction of peritumoral edema was shown on CT scans in six of these eight cases. There was, however, no significant correlation between the degree of the reduction of edema on CT and that of the improvement in neurological findings. The mode of the CT number in the region of edema did not differ significantly between pre- and post-steroid treatment in the cases showing a recognizable reduction of edema on CT. This failure to change is probably due to the insufficient mechanical accuracy of the CT scanner at the present stage of technology. Through our experiences, it seems that CT is one of the most promising tools for a dynamic study of brain edema in man. (author)

  4. LOCAL CORTICOSTEROID VS. AUTOLOGOUS BLOOD FOR PLANTAR FASCIITIS

    Syam Sunder B

    2017-01-01

    Full Text Available BACKGROUND Plantar fasciitis is the most common cause of heel pain for which professional care is sought. Initially thought of as an inflammatory process, plantar fasciitis is a disorder of degenerative changes in the fascia and maybe more accurately termed plantar fasciosis. Traditional therapeutic efforts have been directed at decreasing the presumed inflammation. These treatments include icing, Nonsteroidal Anti-inflammatory Drugs (NSAIDs, rest and activity modification, corticosteroids, botulinum toxin type A, splinting, shoe modifications and orthosis. Other treatment techniques have been directed at resolving the degeneration caused by the disease process. In general, these techniques are designed to create an acute inflammatory reaction with the goal of restarting the healing process. These techniques include autologous blood injection, Platelet-Rich Plasma (PRP injection, nitroglycerin patches, Extracorporeal Shock Wave Therapy (ESWT and surgical procedures. Recently, research has focused on regenerative therapies with high expectations of success. The use of autologous growth factors is thought to heal through collagen regeneration and the stimulation of a well-ordered angiogenesis. These growth factors are administered in the form of autologous whole blood or Platelet-Rich Plasma (PRP. Platelets can be isolated using simple cell-separating systems. The degranulation of the alpha granules in the platelets releases many different growth factors that play a role in tissue regeneration processes. Platelet-derived growth factor, transforming growth factor-P, vascular-derived endothelial growth factor, epithelial growth factor, hepatocyte growth factor and insulin-like growth factor are examples of such growth factors. Injections with autologous growth factors are becoming common in clinical practice. The present study was an attempt to compare the efficacy of autologous blood injection in plantar fasciitis by comparing it with the local

  5. CT findings in brain edema following the administration of corticosteroids

    Seki, Y; Kumagai, N; Aiba, T [Toranomon Hospital, Tokyo (Japan)

    1979-03-01

    Computed tomography (CT) is the first noninvasive method available for directly visualizing brain edema in man. On CT scans perifocal edema is shown as an area of low density surrounding a lesion. The purpose of this report is to evaluate the effect of corticosteroids on brain edema as seen by CT (HITACHI CT-H 250). Nine patients with brain-tumor and one with brain-abscess were treated with betamethasone for about ten days (dosage started with 12 - 16 mg/day, and tapered). In eight cases, and improvement in the neurological findings was observed. An impressive reduction of peritumoral edema was shown on CT scans in six of these eight cases. There was, however, no significant correlation between the degree of the reduction of edema on CT and that of the improvement in neurological findings. The mode of the CT number in the region of edema did not differ significantly between pre- and post-steroid treatment in the cases showing a recognizable reduction of edema on CT. This failure to change is probably due to the insufficient mechanical accuracy of the CT scanner at the present stage of technology. Through our experiences, it seems that CT is one of the most promising tools for a dynamic study of brain edema in man.

  6. Functional bacteria and process metabolism of the Denitrifying Sulfur conversion-associated Enhanced Biological Phosphorus Removal (DS-EBPR) system: An investigation by operating the system from deterioration to restoration.

    Guo, Gang; Wu, Di; Hao, Tianwei; Mackey, Hamish Robert; Wei, Li; Wang, Haiguang; Chen, Guanghao

    2016-05-15

    A sulfur conversion-associated Enhanced Biological Phosphorus (P) Removal (EBPR) system is being developed to cater for the increasing needs to treat saline/brackish wastewater resulting from seawater intrusion into groundwater and sewers and frequent use of sulfate coagulants during drinking water treatment, as well as to meet the demand for eutrophication control in warm climate regions. However, the major functional bacteria and metabolism in this emerging biological nutrient removal system are still poorly understood. This study was thus designed to explore the functional microbes and metabolism in this new EBPR system by manipulating the deterioration, failure and restoration of a lab-scale system. This was achieved by changing the mixed liquor suspended solids (MLSS) concentration to monitor and evaluate the relationships among sulfur conversion (including sulfate reduction and sulfate production), P removal, variation in microbial community structures, and stoichiometric parameters. The results show that the stable Denitrifying Sulfur conversion-associated EBPR (DS-EBPR) system was enriched by sulfate-reducing bacteria (SRB) and sulfide-oxidizing bacteria (SOB). These bacteria synergistically participated in this new EBPR process, thereby inducing an appropriate level of sulfur conversion crucial for achieving a stable DS-EBPR performance, i.e. maintaining sulfur conversion intensity at 15-40 mg S/L, corresponding to an optimal sludge concentration of 6.5 g/L. This range of sulfur conversion favors microbial community competition and various energy flows from internal polymers (i.e. polysulfide or elemental sulfur (poly-S(2-)/S(0)) and poly-β-hydroxyalkanoates (PHA)) for P removal. If this range was exceeded, the system might deteriorate or even fail due to enrichment of glycogen-accumulating organisms (GAOs). Four methods of restoring the failed system were investigated: increasing the sludge concentration, lowering the salinity or doubling the COD

  7. Corticosteroid Therapy in Critical Illness due to Seasonal and Pandemic Influenza

    Philippe Yale

    2015-01-01

    Full Text Available BACKGROUND: Survey data suggest that Canadian intensivists administer corticosteroids to critically ill patients primarily in response to airway obstruction, perceived risk for adrenal insufficiency and hemodynamic instability.

  8. Corticosteroid-induced asthma: a manifestation of limited hyperinfection syndrome due to Strongyloides stercoralis.

    Sen, P; Gil, C; Estrellas, B; Middleton, J R

    1995-09-01

    Inadequate therapeutic response to parenteral corticosteroids in patients with acute bronchial asthma is infrequent. We report four patients whose bronchial asthma symptoms worsened after treatment with parenteral corticosteroids. All had larvae of Strongyloides stercoralis in the stool. The new attack or the exacerbation of asthma appeared to be precipitated by systemic corticosteroid administration. The paradoxic therapeutic response of asthma to glucocorticoides was the major pulmonary manifestation of Strongyloides superinfection; there was no evidence of other organ involvement. Individuals with new onset of bronchial asthma or worsening of asthmatic episodes concurrent with the use of systemic corticosteroids should have thorough investigation for possible superinfection due to Strongyloides stercoralis. This is particularly important for patients who have resided in areas where intestinal helminthic infections are endemic. Discontinuance of steroid therapy or reduction in dosage of parenteral steroids appears necessary. Treatment with thiabendazole appears to be effective in patients with limited hyperinfection syndrome.

  9. Fibrotic scar formation in central serous chorioretinopathy developed during systemic treatment with corticosteroids

    Hooymans, JMM

    1998-01-01

    Background: The purpose of the study is to demonstrate the development of subretinal fibrotic scar formation in central serous chorioretinopathy (CSCR) that developed during systemic corticosteroid treatment. Methods: The clinical and photographic records of a patient in whom an unusual

  10. Communication during counseling sessions about inhaled corticosteroids at the community pharmacy.

    Driesenaar, J.A.; Smet, P.A.G.M. de; Hulten, R. van; Hu, L.; Dulmen, A.M. van

    2016-01-01

    Background: Pharmaceutical care is one of the major tasks of pharmacists, which aims to improve patient outcomes. Counseling patients with asthma or chronic obstructive pulmonary disease about their use of inhaled corticosteroids (ICS) might enhance medication adherence and symptom control.

  11. Communication during counseling sessions about inhaled corticosteroids at the community pharmacy

    Driesenaar, J.A.; Smet, P.A. de; Hulten, R. van; Hu, L.; Dulmen, S. van

    2016-01-01

    BACKGROUND: Pharmaceutical care is one of the major tasks of pharmacists, which aims to improve patient outcomes. Counseling patients with asthma or chronic obstructive pulmonary disease about their use of inhaled corticosteroids (ICS) might enhance medication adherence and symptom control.

  12. In vitro toxicity of local anaesthetics and corticosteroids on supraspinatus tenocyte viability and metabolism

    Clayton W. Nuelle

    2017-01-01

    Conclusion: This data confirms that peritendinous injection of commonly used local anaesthetics and corticosteroids results in significant supraspinatus tenotoxicity in vitro. Further in vivo studies are required before making definitive clinical recommendations.

  13. The role of inhaled corticosteroids in management of asthma in infants and preschoolers

    Castro-Rodriguez, Jose A; Pedersen, Søren

    2013-01-01

    This review analyses published data on the treatment of wheezing in infants and preschoolers with inhaled corticosteroids (ICS), including the effect in subgroups of patients such as 'multiple trigger wheeze' and 'episodic viral wheeze'....

  14. High incidence of oral corticosteroids prescriptions in children with asthma in early childhood

    Arabkhazaeli, A.; Vijverberg, S.J.H.; Van Der Ent, C. Kors; Raaijmakers, J.A.M.; van der Zee, A.H.

    2016-01-01

    OBJECTIVE: Severe asthma exacerbations are often treated with short courses of oral corticosteroids (OCS). This study assessed the incidence of OCS being prescribed in asthmatic children of various age groups and calculated their chances of receiving subsequent OCS prescriptions. METHODS:

  15. CMTR1 is associated with increased asthma exacerbations in patients taking inhaled corticosteroids

    Dahlin, Amber; Denny, Joshua; Roden, Dan M

    2015-01-01

    Inhaled corticosteroids (ICS) are the most effective controller medications for asthma, and variability in ICS response is associated with genetic variation. Despite ICS treatment, some patients with poor asthma control experience severe asthma exacerbations, defined as a hospitalization or emerg...

  16. Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations.

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2018-06-01

    Little evidence is available on the relationship between oral corticosteroids use and hepatocellular carcinoma. The objective of this study was to investigate whether oral corticosteroids use correlates with the risk of hepatocellular carcinoma in high risk populations in Taiwan. Using representative claims database established from the Taiwan National Health Insurance Program with a population coverage rate of 99.6%, we identified 102,182 subjects aged 20-84 years with newly diagnosed hepatocellular carcinoma in 2000-2011 as the cases and 102,182 randomly selected subjects aged 20-84 years without hepatocellular carcinoma as the matched controls. In subjects with any one of comorbidities including alcohol-related disease, chronic liver disease, and diabetes mellitus, the adjusted OR of hepatocellular carcinoma was 29.9 (95% CI 28.7, 31.1) for subjects with never use of oral corticosteroids, and the adjusted OR would increase to 33.7 (95% CI 32.3, 35.3) for those with ever use of oral corticosteroids. The adjusted OR of hepatocellular carcinoma was 1.03 for subjects with increasing cumulative duration of oral corticosteroids use for every one year (95% CI 1.01, 1.06), with a duration-dependent effect. The largest OR occurred in subjects with ever use of oral corticosteroids and concurrently comorbid with alcohol-related disease, chronic liver disease, and diabetes mellitus (adjusted OR 122.7, 95% CI 108.5, 138.8). There is a synergistic effect between oral corticosteroids use and the traditional risk factors on the risk of hepatocellular carcinoma. People with risk factors for hepatocellular carcinoma should receive regular ultrasound surveillance, particularly when they currently use oral corticosteroids. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  17. Bell palsy in a neonate with rapid response to oral corticosteroids: a case report.

    Saini, Arushi; Singhi, Pratibha; Sodhi, K S; Gupta, Ajit

    2013-04-01

    Idiopathic facial nerve palsy, also known as Bell palsy is rare in the neonatal age group. Other more common causes such as birth trauma; infections, especially otitis media; and congenital malformations need to be excluded. We present here a 4-week-old neonate with Bell palsy who responded rapidly to oral corticosteroids. Such an early presentation of idiopathic facial nerve palsy and use of corticosteroids in neonates is scarcely reported in the literature.

  18. Efficacy and Safety of Topical Corticosteroids for Management of Oral Chronic Graft versus Host Disease

    Elsaadany, Basma Abdelaleem; Ahmed, Eman Magdy; Aghbary, Sana Maher Hasan

    2017-01-01

    Background. Oral chronic graft versus host disease (cGVHD) is a major complication in transplantation community, a problem that can be addressed with topical intervention. Topical corticosteroids are the first line of treatment although the choice remains challenging as none of the available treatments is supported by strong clinical evidence. Objective. This systematic review aims to determine the clinical efficacy and safety of topical corticosteroids for the management of the mucosal alter...

  19. Ritonavir and Topical Ocular Corticosteroid Induced Cushing's Syndrome in an Adolescent With HIV-1 Infection.

    Rainsbury, Paul G; Sharp, Jessica; Tappin, Alison; Hussey, Martin; Lenko, Alexandra; Foster, Caroline

    2017-05-01

    Cushing's syndrome after topical ocular corticosteroid use is extremely rare. We describe a case of symptomatic Cushing's syndrome in an adolescent male with sight-threatening vernal keratoconjunctivitis on antiretroviral therapy for HIV-1 infection that included ritonavir, a potent cytochrome p450 CYP3A4 inhibitor. CYP3A4 inhibition reduces the metabolism of exogenous corticosteroids leading to suppression of endogenous steroid production and Cushing's syndrome.

  20. Editorial Commentary: Intra-articular Corticosteroid Injection at the Time of Knee Arthroscopy Is Not Recommended.

    Hunt, Timothy J

    2016-01-01

    In a population of Medicare patients undergoing knee arthroscopy, a significant increase in the incidence of postoperative infection at 3 and 6 months was found in patients who received an intra-articular corticosteroid injection at the time of knee arthroscopy compared with a matched control group that did not receive an injection. Intra-articular corticosteroid injection at the time of knee arthroscopy is not recommended. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. Bearing restoration by grinding

    Hanau, H.; Parker, R. J.; Zaretsky, E. V.; Chen, S. M.; Bull, H. L.

    1976-01-01

    A joint program was undertaken by the NASA Lewis Research Center and the Army Aviation Systems Command to restore by grinding those rolling-element bearings which are currently being discarded at aircraft engine and transmission overhaul. Three bearing types were selected from the UH-1 helicopter engine (T-53) and transmission for the pilot program. No bearing failures occurred related to the restoration by grinding process. The risk and cost of a bearing restoration by grinding programs was analyzed. A microeconomic impact analysis was performed.

  2. Restoration of landfill sites

    Jones, A K; Chamley, M E

    1986-10-01

    Many excavated quarries are subsequently used for waste disposal operations and frequently imported landfill provides the only means of restoring a former quarry to some beneficial afteruse. Concentrating solely on the final surface cover, this paper sets out some of the principles, which should be considered by those involved in landfill operations to ensure the long term success of restoration schemes. With the emphasis on restoration to agriculture, factors such as availability of cover materials and depths necessary are discussed in terms of requirements to support plant growth, protect clay capping layers and prevent damage to agricultural implements. Soil handling and appropriate after care management are considered. 4 refs.

  3. [How does sleeping restore our brain?].

    Wigren, Henna-Kaisa; Stenberg, Tarja

    2015-01-01

    The central function of sleep is to keep our brain functional, but what is the restoration that sleep provides? Sleep after learning improves learning outcomes. According to the theory of synaptic homeostasis the total strength of synapses, having increased during the day, is restored during sleep, making room for the next day's experiences. According to the theory of active synaptic consolidation, repetition during sleep strengthens the synapses, and these strengthened synapses form a permanent engram. According to a recent study, removal of waste products from the brain may also be one of the functions of sleep.

  4. Transforming Ecosystems: When, Where, and How to Restore Contaminated Sites

    Rohr, Jason R; Farag, Aïda M; Cadotte, Marc W; Clements, William H; Smith, James R; Ulrich, Cheryl P; Woods, Richard

    2016-01-01

    Chemical contamination has impaired ecosystems, reducing biodiversity and the provisioning of functions and services. This has spurred a movement to restore contaminated ecosystems and develop and implement national and international regulations that require it. Nevertheless, ecological restoration remains a young and rapidly growing discipline and its intersection with toxicology is even more nascent and underdeveloped. Consequently, we provide guidance to scientists and practitioners on when, where, and how to restore contaminated ecosystems. Although restoration has many benefits, it also can be expensive, and in many cases systems can recover without human intervention. Hence, the first question we address is: “When should we restore contaminated ecosystems?” Second, we provide suggestions on what to restore—biodiversity, functions, services, all 3, or something else—and where to restore given expected changes to habitats driven by global climate change. Finally, we provide guidance on how to restore contaminated ecosystems. To do this, we analyze critical aspects of the literature dealing with the ecology of restoring contaminated ecosystems. Additionally, we review approaches for translating the science of restoration to on-the-ground actions, which includes discussions of market incentives and the finances of restoration, stakeholder outreach and governance models for ecosystem restoration, and working with contractors to implement restoration plans. By explicitly considering the mechanisms and strategies that maximize the success of the restoration of contaminated sites, we hope that our synthesis serves to increase and improve collaborations between restoration ecologists and ecotoxicologists and set a roadmap for the restoration of contaminated ecosystems. PMID:26033665

  5. Importance of including cultural practices in ecological restoration.

    Wehi, Priscilla M; Lord, Janice M

    2017-10-01

    Ecosystems worldwide have a long history of use and management by indigenous cultures. However, environmental degradation can reduce the availability of culturally important resources. Ecological restoration aims to repair damage to ecosystems caused by human activity, but it is unclear how often restoration projects incorporate the return of harvesting or traditional life patterns for indigenous communities. We examined the incorporation of cultural use of natural resources into ecological restoration in the context of a culturally important but protected New Zealand bird; among award-winning restoration projects in Australasia and worldwide; and in the peer-reviewed restoration ecology literature. Among New Zealand's culturally important bird species, differences in threat status and availability for hunting were large. These differences indicate the values of a colonizing culture can inhibit harvesting by indigenous people. In Australasia among award-winning ecological restoration projects, restored areas beyond aesthetic or recreational use, despite many projects encouraging community participation. Globally, restoration goals differed among regions. For example, in North America, projects were primarily conservation oriented, whereas in Asia and Africa projects frequently focused on restoring cultural harvesting. From 1995 to 2014, the restoration ecology literature contained few references to cultural values or use. We argue that restoration practitioners are missing a vital component for reassembling functional ecosystems. Inclusion of sustainably harvestable areas within restored landscapes may allow for the continuation of traditional practices that shaped ecosystems for millennia, and also aid project success by ensuring community support. © 2017 Society for Conservation Biology.

  6. Near Total Laryngectomy: A Versatile Approach for Voice Restoration in Advanced T3 and T4 Laryngeal Cancer: Functional Results and Survival

    Maamoun, S.I.; Amira, A.; Younis, A.

    2004-01-01

    Creation of a tunneled mucosal shunt between the trachea and pharynx that is controlled by remaining intrinsic laryngeal musculature with its nerve supply is an acceptable voice restoration procedure for advanced T3 and T4 laryngeal cancer. Such a tunnel will allow unilateral direction of air from lung to pharynx during phonation and will prevent aspiration since deglutition is a vagal mediated response which will induce contraction of tubed laryngeal musculature preventing aspiration. We previously reported our preliminary experience with the technique and we adopted the voice restoration approach based on the concept of the near total laryngectomy thereafter. Methods: Forty five patients with histologically proven squamous cell carcinoma of the larynx were included in this study (between January 1998 and February 2001). They were 42 males and 3 females with a mean age of 52.6 years. Criteria for selection were a normal vocal process and arytenoid cartilage on the opposite side of the lesion as evidenced by endoscopy and CT scan with no major sub glottic extension. In two patients supraglottic laryngectomy was carried out and in four other patients, complete tumor extirpation necessitated total laryngectomy. Accordingly, near total laryngectomy was carried out in the remaining 39 patients. Following a near total laryngectomy, where all laryngeal mucosa and cartilages are resected sparing the contralateral arytenoid cartilage with the overlying mucosa and surrounding musculature, the shunt was created by tubing the remaining mucosa with augmentation by pyroform sinus mucosa if necessary. The resulting tube was fashioned over 14 FG catheter for diameter control only and the remaining muscles were sutured over the tube. A permanent tracheostomy was established. Voice training was started postoperatively following resumption of oral feeding. Results: Only one patient died in the immediate postoperative period due to massive myocardial infarction. One patient developed

  7. Coastal Wetland Restoration Bibliography

    Yozzo, David

    1997-01-01

    This bibliography was compiled to provide biologists, engineers, and planners at Corps Districts and other agencies/ institutions with a guide to the diverse body of literature on coastal wetland restoration...

  8. Restoration of ailing wetlands.

    Oswald J Schmitz

    2012-01-01

    Full Text Available It is widely held that humankind's destructive tendencies when exploiting natural resources leads to irreparable harm to the environment. Yet, this thinking runs counter to evidence that many ecological systems damaged by severe natural environmental disturbances (e.g., hurricanes can restore themselves via processes of natural recovery. The emerging field of restoration ecology is capitalizing on the natural restorative tendencies of ecological systems to build a science of repairing the harm inflicted by humans on natural environment. Evidence for this, for example, comes from a new meta-analysis of 124 studies that synthesizes recovery of impacted wetlands worldwide. While it may take up to two human generations to see full recovery, there is promise, given human will, to restore many damaged wetlands worldwide.

  9. Principles of Wetland Restoration

    the return of a degraded ecosystem to a close approximation of its remaining natural potential - is experiencing a groundswell of support across the United States. The number of stream, river, lake, wetland and estuary restoration projects grows yearly

  10. Skjern River Restoration Counterfactual

    Clemmensen, Thomas Juel

    2014-01-01

    In 2003 the Skjern River Restoration Project in Denmark was awarded the prestigious Europa Nostra Prize for ‘conserving the European cultural heritage’ (Danish Nature Agency 2005). In this case, however, it seems that the conservation of one cultural heritage came at the expense of another cultural...... this massive reconstruction work, which involved moving more than 2,7 million cubic meters of earth, cause a lot of ‘dissonance’ among the local population, the resulting ‘nature’ and its dynamic processes are also constantly compromising the preferred image of the restored landscape (Clemmensen 2014......). The presentation offers insight into an on-going research and development project - Skjern River Restoration Counterfactual, which question existing trends and logics within nature restoration. The project explores how the Skjern River Delta could have been ‘restored’ with a greater sensibility for its cultural...

  11. based dynamic voltage restorer

    HOD

    operation due to presence of increased use of nonlinear loads (computers, microcontrollers ... simulations of a dynamic voltage restorer (DVR) was achieved using MATLAB/Simulink. ..... using Discrete PWM generator, then the IGBT inverter.

  12. 7 CFR 1415.11 - Restoration agreements.

    2010-01-01

    ... functions and values of the grassland to meet both USDA and the participant's objective and the purposes of... restoration agreement at that time to improve the functions and values with USDA approval and when funds are... grassland resources are adequate to meet the participant's objectives and the purposes of the program, or if...

  13. Effect of inhaled corticosteroids on bronchial asthma in Japanese athletes.

    Hoshino, Yoshifumi; Koya, Toshiyuki; Kagamu, Hiroshi; Tsukioka, Keisuke; Toyama, Mio; Sakagami, Takuro; Hasegawa, Takashi; Narita, Ichiei; Arakawa, Masaaki; Suzuki, Eiichi

    2015-04-01

    Asthma has a higher prevalence in athlete populations such as Olympic athletes than in the general population. Correct diagnosis and management of asthma in athletes is important for symptom control and avoidance of doping accusations. However, few reports are available on asthma treatment in the athlete population in clinical practice. In this study, we focused on the clinical efficacy of inhaled corticosteroid (ICS) for asthma in a Japanese athlete population. The study subjects included athletes who visited the Niigata Institute for Health and Sports Medicine, Niigata, Japan for athletic tests and who were diagnosed with asthma on the basis of respiratory symptoms and positive results in a bronchodilator or bronchial provocation test such as exercise, hypertonic saline, or methacholine provocation. The athletes received ICS alone for at least 3 months, and the clinical background, sports type, and treatment efficacy were analyzed. The study population comprised 80 athletes (59 men and 21 women) with a median age of 16.0 years. Regarding sports type, 28 athletes engaged in winter sports (35%), 22 in endurance sports (27.5%), and 25 in indoor sports (31.3%). Although ICS is the primary treatment in athlete asthma, 16.3% of the athletes showed an unsatisfactory response to treatment according to the Global Evaluation of Treatment Effectiveness (GETE). These subjects were characterized by a decreased response to methacholine and lower values for FEV1/FVC and type 2 helper T cell (Th2)-associated biomarkers relative to responsive athletes. In multivariate analysis, FEV1/FVC and the logarithm to the base 10 of the IgE level were independently associated with the ICS response. These data suggest that ICS is effective for asthma in most athletes. However, certain asthmatic athletes are less responsive to ICS than expected. The pathogenesis in these subjects may differ from that of conventional asthma characterized by chronic allergic airway inflammation. Copyright

  14. Pharmacokinetic interaction between corticosteroids and tacrolimus after renal transplantation.

    Anglicheau, Dany; Flamant, Martin; Schlageter, Marie Hélène; Martinez, Frank; Cassinat, Bruno; Beaune, Philippe; Legendre, Christophe; Thervet, Eric

    2003-11-01

    Tacrolimus is an immunosuppressive drug that is a substrate of cytochrome P450 3A (CYP3A) enzymes and P-glycoprotein (P-gp). After transplantation, many pharmacological interactions have been described. Corticosteroids induce both CYP3A and P-gp activity. This study was designed to investigate the presence of a clinically significant interaction between steroids and tacrolimus after renal transplantation. We studied 83 renal transplant recipients receiving tacrolimus after transplantation. Patients were divided into three groups, according to steroid dose (low: 0-0.15 mg/kg/day; intermediate: 0.16-0.25 mg/kg/day; and high: >0.25 mg/kg/day). All other medications, including those known to interact with CYP3A and/or P-gp, were recorded. Steroid dosage, tacrolimus dosage, tacrolimus trough concentration (C0) and tacrolimus concentration/dose ratio [C0 divided by the 24 h dosage (mg/kg)] were assessed for each dosage group after 1 and 3 months of tacrolimus treatment. The three groups were not different as regards the use of non-immunosuppressive treatments or clinical events. At 1 and 3 months, the tacrolimus doses and concentration/dose ratios differed significantly in the three steroid dosage groups. With the higher doses, higher tacrolimus doses were needed to achieve the blood tacrolimus targeted trough level. We demonstrated that pharmacokinetic interaction occurs between steroids and tacrolimus in renal transplant patients. The higher the steroid dosage, the higher the dosage of tacrolimus needed to achieve target trough levels in these patients. The most likely interaction mechanism is specific enzymatic induction of CYP3A and/or P-gp. Interaction is present, even when the steroid dosage is low. The clinical events liable to occur during steroid sparing or tapering must be taken into account because it may be associated with episodes of tacrolimus-related nephrotoxicity.

  15. Augmentation of failed human vertebrae with critical un-contained lytic defect restores their structural competence under functional loading: An experimental study.

    Alkalay, Ron N; von Stechow, Dietrich; Hackney, David B

    2015-07-01

    Lytic spinal lesions reduce vertebral strength and may result in their fracture. Vertebral augmentation is employed clinically to provide mechanical stability and pain relief for vertebrae with lytic lesions. However, little is known about its efficacy in strengthening fractured vertebrae containing lytic metastasis. Eighteen unembalmed human lumbar vertebrae, having simulated uncontained lytic defects and tested to failure in a prior study, were augmented using a transpedicular approach and re-tested to failure using a wedge fracture model. Axial and moment based strength and stiffness parameters were used to quantify the effect of augmentation on the structural response of the failed vertebrae. Effects of cement volume, bone mineral density and vertebral geometry on the change in structural response were investigated. Augmentation increased the failed lytic vertebral strength [compression: 85% (Paugmentation is effective in bolstering the failed lytic vertebrae compressive and axial structural competence, showing strength estimates up to 50-90% of historical values of osteoporotic vertebrae without lytic defects. This modest increase suggests that lytic vertebrae undergo a high degree of structural damage at failure, with strength only partially restored by vertebral augmentation. The positive effect of cement volume is self-limiting due to extravasation. Copyright © 2015. Published by Elsevier Ltd.

  16. Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use.

    Searing, Daniel A; Zhang, Yong; Murphy, James R; Hauk, Pia J; Goleva, Elena; Leung, Donald Y M

    2010-05-01

    There is little knowledge about clinical variables associated with vitamin D (VitD) insufficiency in asthmatic children. We sought to investigate disease variables associated with VitD insufficiency in patients with childhood asthma and interaction of VitD with corticosteroid-mediated anti-inflammatory responses. We analyzed 25-hydroxyvitamin D serum levels in 100 asthmatic children to investigate relationships between 25-hydroxyvitamin D levels and patients' characteristics. We determined VitD's effects on dexamethasone (DEX) induction of mitogen-activated protein kinase phosphatase 1 and IL-10 in PBMCs. The median 25-hydroxyvitamin D serum level was 31 ng/mL. Forty-seven percent of subjects had VitD levels in the insufficient range (<30 ng/mL), whereas 17% were VitD deficient (<20 ng/mL). Log(10) IgE (P = .01, rho = -0.25) and the number of positive aeroallergen skin prick test responses (P = .02, rho = -0.23) showed a significant inverse correlation with VitD levels, whereas FEV(1) percent predicted (P = .004, rho = 0.34) and FEV(1)/forced vital capacity ratio (P = .01, rho = 0.30) showed a significant positive correlation with VitD levels. The use of inhaled steroids (P = .0475), use of oral steroids (P = .02), and total steroid dose (P = .001) all showed significant inverse correlations with VitD levels. The amount of mitogen-activated protein kinase phosphatase 1 and IL10 mRNA induced by VitD plus DEX was significantly greater than that induced by DEX alone (P < .01). In an experimental model of steroid resistance in which DEX alone did not inhibit T-cell proliferation, addition of VitD to DEX resulted in significant dose-dependent suppression of cell proliferation. Corticosteroid use and worsening airflow limitation are associated with lower VitD serum levels in asthmatic patients. VitD enhances glucocorticoid action in PBMCs from asthmatic patients and enhances the immunosuppressive function of DEX in vitro. Copyright 2010 American Academy of Allergy

  17. Patient perspectives on fluticasone–vilanterol versus other corticosteroid combination products for the treatment of asthma

    Bollmeier SG

    2016-05-01

    Full Text Available Suzanne G Bollmeier, Theresa R Prosser St Louis College of Pharmacy, St Louis, MO, USA Objective: Fluticasone furoate (FF, an inhaled corticosteroid (ICS, and vilanterol (VI, a long-acting beta2 receptor agonist (LABA, is a new combination used in an Ellipta® device. This article compares FF–VI to other ICS–LABA combinations available, particularly emphasizing product selection from the patient perspective. Data sources: A PubMED and EMBASE search completed in October 2015 identified trials using the MeSH terms “fluticasone”, “vilanterol”, and “asthma”. Additional information was gathered from references cited in the identified publications, the manufacturer, package insert, and ClinicalTrials.gov registry. Study selection/data extraction: Preference was given to randomized controlled clinical trials. Animal trials, trials for COPD, and non-English sources were excluded. Data synthesis: Seven efficacy trials of FF–VI in asthma were identified. Only one (24 weeks trial compared FF–VI to another ICS–LABA combination (fluticasone propionate–salmeterol. Primary outcomes (usually lung function and secondary outcomes (eg, quality of life and symptom scores were comparable. In three FF–VI safety trials, the type and frequency of common adverse reactions (ie, thrush and dysphonia were similar to those in clinical trials. Over 90% of subjects rated the Ellipta® device as “easy to use” and demonstrated correct device technique initially and at 4 weeks. Conclusion: Individuals may have drug- and device-specific preferences that should be incorporated into therapeutic decision making. Limited data indicate that clinical and patient-oriented efficacy/safety outcomes of FF–VI are likely comparable to other available combinations for adults with asthma. Patient-friendly features include once-daily dosing, flexibility of dose timing, and design/ease of the use of the device. Additional larger and long-term comparative

  18. Methodology for ranking restoration options

    Hedemann Jensen, Per

    1999-04-01

    The work described in this report has been performed as a part of the RESTRAT Project FI4P-CT95-0021a (PL 950128) co-funded by the Nuclear Fission Safety Programme of the European Commission. The RESTRAT project has the overall objective of developing generic methodologies for ranking restoration techniques as a function of contamination and site characteristics. The project includes analyses of existing remediation methodologies and contaminated sites, and is structured in the following steps: characterisation of relevant c