Pemphigus vulgaris is the most common autoimmune bullous disease in Northwestern Romania

Background  Autoimmune bullous diseases are organ‐specific diseases characterized by autoreactive T and B cells specific for structural proteins of the skin. The incidence and prevalence of autoimmune blistering diseases vary in different countries and their epidemiology has not yet been addressed in Romania. Methods  In this study between 2001 and 2007, we prospectively investigated a total of 116 patients with autoimmune blistering diseases from the Northwestern region of Romania. The diagnosis was based on the clinical, histo‐ and immunohistological as well as serological findings. Results  Pemphigus was the most common disease representing 58.6% of the case (68 cases); 40 cases (34.5%) were diagnosed with bullous pemphigoid (BP) and eight cases (6.9%) with other autoimmune sub‐epidermal diseases. The incidence and prevalence of pemphigus diseases were four patients/1 000 000 inhabitants/year and 0.00248%, respectively. BP occurred in 2.5/1 000 000 inhabitants/year and its prevalence was 0.00146%. While the average onset age for pemphigus vulgaris was 53 years, BP patients were first diagnosed at a mean age of 73.6 years. Conclusion  The genetic background of the local population may explain why pemphigus occurs more commonly than BP in Northwestern Romania compared with the population of Western Europe. In addition, the shorter life expectancy in Romania (71.3 years) compared with Western Europe (>80 years) may contribute to this phenomenon.     

Pleiotrophin is highly expressed by myeloma cells and promotes myeloma tumor growth

Pleiotrophin (PTN) is an important developmental cytokine that is highly expressed during embryogenesis but shows very limited expression in adult tissues, where it is largely restricted to the brain. High PTN serum levels are associated with a variety of solid tumors. We recently showed that patients with multiple myeloma (MM) also have elevated serum levels of this protein and the amount of PTN correlated with the patients' disease status and response to treatment. In this study, we demonstrate that MM cell lines and the malignant cells from MM patients' bone marrow produced PTN and secreted PTN protein into the supernatants during short-term culture. Moreover, Ptn gene expression correlated with the patients' disease status. Inhibition of PTN with a polyclonal anti-PTN antibody reduced growth and enhanced apoptosis of MM cell lines and freshly isolated bone marrow tumor cells from MM patients in vitro. Importantly, this antibody also markedly suppressed the growth of MM in vivo using a severe combined immunodeficiency (SCID)-hu murine model. This represents the first study showing the importance of PTN in the growth of any hematological disorder. Because the expression of this protein is very limited in normal adult tissues, PTN may represent a new target for the treatment of MM.     

Less smoke and minimal tissue carbonization using a thulium laser for laparoscopic partial nephrectomy without hilar clamping in a porcine model

PURPOSE: We evaluated the utility of a thulium laser and a novel implementation of its use for laparoscopic partial nephrectomy to achieve precise, smokeless, and hemostatic dissection without hilar clamping and with minimal charring in a porcine model. MATERIALS AND METHODS: Laparoscopic transperitoneal lower-pole partial nephrectomy was performed in five Yorkshire farm pigs without clamping of the renal hilum. All animals were kept alive for 1 week. Using a 365-mum laser fiber, a 30 W thulium laser was used to produce full-thickness cortical excisions of the lower-pole renal cortex. The laser fiber was delivered through the working channel of a 16F flexible cystoscope inserted through a 10-mm laparoscopic port. The laser incision was directed by manual deflection of the cystoscope along with low-pressure saline irrigation through the cystoscope. RESULTS: Laparoscopic partial nephrectomy was completed in all cases without perioperative complications and with an estimated blood loss of <50 mL. The thulium laser was able to cut tissue and simultaneously to coagulate vessels as large as 1.6 mm. The flexible cystoscope with concurrent saline irrigation permitted precise laser control for dissection with minimal tissue charring and no smoke to obscure visibility. At 1 week, the cut edge of the tissue showed minimal necrosis with preservation of histologic architecture. CONCLUSIONS: Laparoscopic partial nephrectomy with the thulium laser provides precise dissection and hemostasis without hilar clamping. Minimal tissue charring and no smoke generation improve visibility.     

Complete Nucleotide Sequence of IT-227/82, An Avian Paramyxovirus Type-1 Strain of Pigeons (Columba Livia)

This paper describes the complete genome sequence of IT-227/82, a strain of avian paramyxovirus type-1 of pigeon (PPMV-1). IT-227/82 is an antigenic variant of Newcastle disease virus (NDV) of chickens. The genome is 15,192 nucleotides (nt) long, similarly to the previously published NDV strain ZJ1. It is, however, six nt longer than the genomes of NDV strains LaSota/46 and Beaudette C. The six-nt insertion was located in the 5′ non-coding region of the nucleoprotein (NP) gene. The presence of this six-nt insertion showed no correlation with the virulence or the reservoir of the NDV strains sequenced so far. The genome length of 15,186 or 15,192 nt can be connected however, to “old” (I, II, III and IV) and “new” (V, VI, VII and VIII) NDV genotypes, respectively. Comparison of open reading frames indicated that the PPMV-1 strain IT-227/82 encodes the longest W protein, (227 amino acids). The length of the W protein showed remarkable differences even within genotypes and cannot be regarded, therefore, as a phylogenetic feature. The haemagglutinin-neuraminidase protein of strain IT-227/82 consists of 571 amino acids, similarly to genotypes IV, V and VII NDV strains, while genotype I and II strains have longer HN proteins, 616 and 577 amino acids, respectively. The length of the haemagglutinin-neuraminidase protein possesses phylogenetic importance.     

Traumatic dental injuries in an urban adolescent population in Tirana,Albania

Abstract – Aim: The aim of this study was to gather information about traumatic dental injuries (TDI) in an urban adolescent Albanian population. Material & methods: A cross‐sectional survey was carried out to acquire epidemiological data about TDI in the permanent incisors of Albanian adolescents. Participants (n = 2789) were adolescents of both genders, aged 16–18 years, attending public high schools in Tirana. Results: The occurrence of TDI in the incisors ranged from 8.9% of 16‐year‐olds to 10.5% of 18‐year‐olds. A greater proportion of boys (12.4%) had TDI compared with girls (7.7). The most commonly reported causes were collisions (27.5%) followed by physical leisure activities and sports (mainly cycling and swimming/diving) (14.1%) and falls (13.4%). Of the adolescents affected by TDI, 32% had unmet treatment need because of no or inadequate treatment. Adolescents living in districts with low socio‐economic level had significantly more TDI with unmet treatment need than those living in districts with high socio‐economic level. Conclusion: The occurrence of TDI among Albanian adolescents was moderate. Adolescents who came from low socio‐economic districts had a greater probability of having TDI with unmet treatment need.     

Mirror movements in patients with Parkinson's disease

Mirror movements (MM) refer to ipsilateral involuntary movements that appear during voluntary activity in contralateral homologous body regions. This study aimed to compare the frequency and distribution of MM in an unselected sample of 274 patients with Parkinson's disease (PD) and 100 healthy subjects, and to check a possible relationship between MM and parkinsonian features. MM of the hand were scored according to the Woods and Teuber scale. The frequency of MM was lower in PD patients than in healthy subjects (29% vs. 71%, P < 0.0001). The distribution of MM also differed in the two groups being often bilateral in healthy subjects, invariably unilateral in PD patients. When parkinsonian signs were unilateral, MM always manifested on the unaffected side; when parkinsonian signs were bilateral, MM manifested on the less affected side. PD patients manifesting MM scored significantly lower on Hohen and Yahr staging than patients without MM. Likewise, there was a significant inverse correlation between the intensity of MM as rated by the Woods and Teuber score and HY staging (r = ?0.16, P < 0.01). The low frequency of MM in PD probably relates to the complex interactions between the pathophysiological mechanisms leading to parkinsonian signs and the mechanisms responsible for movement lateralization. © 2007 Movement Disorder Society     

Lagophthalmy of VII nerve palsy--therapeutical approaches

Facial nerve palsy is impairing orbicular muscle function leading to lagophthalmos. This disease impairs patients' quality of life by exposure keratopathy which is accompanied by ocular pain and deteriorate visual acuity at a variable degree. The paper's aim is to show up the place of lagophthalmos in anterior ocular segment pathology and to evidence the results obtained by us with a new therapeutical method applied in several cases. All cases with lagophthalmos have ocular complications like exposure kerato-conjunctivitis. The treatment was both conservative and surgical which consisted in majority of cases in blepharoraphy with its inconveniencies, aesthetical and functional. We have applied a new surgical method--gold weight superior lid implantation--in 4 cases and the results are promising.