The effects of cognitive loading on balance control in patients with multiple sclerosis

The aim of this study was to compare the effects of concurrent cognitive task (silent backward counting) on balance performance between two groups of multiple sclerosis (MS) (n = 23) and healthy (n = 23) participates. Three levels of postural difficulty were studied on a force platform, i.e. rigid surface with eyes open, rigid surface with eyes closed, and foam surface with eyes closed. A mixed model analysis of variance showed that under difficult sensory condition of foam surface with eyes closed, execution of concurrent cognitive task caused a significant decrement in variability of sway velocity in anteroposterior direction for the patient group (P < 0.01) while this was not the case for healthy participants (P = 0.22). Also, the variability of sway velocity in mediolateral direction was significantly decreased during concurrent execution of cognitive task in patient group (P < 0.01) and not in healthy participants (P = 0.39). Furthermore, in contrast to single tasking, dual tasking had the ability to discriminate between the 2 groups in all conditions of postural difficulty. In conclusion, findings of variability in sway velocity seem to confirm the different response to cognitive loading between two groups of MS and healthy participants.     

Review of pharmacological effects of Glycyrrhiza sp. and its bioactive compounds

The roots and rhizomes of licorice (Glycyrrhiza) species have long been used worldwide as a herbal medicine and natural sweetener. Licorice root is a traditional medicine used mainly for the treatment of peptic ulcer, hepatitis C, and pulmonary and skin diseases, although clinical and experimental studies suggest that it has several other useful pharmacological properties such as antiinflammatory, antiviral, antimicrobial, antioxidative, anticancer activities, immunomodulatory, hepatoprotective and cardioprotective effects. A large number of components have been isolated from licorice, including triterpene saponins, flavonoids, isoflavonoids and chalcones, with glycyrrhizic acid normally being considered to be the main biologically active component. This review summarizes the phytochemical, pharmacological and pharmacokinetics data, together with the clinical and adverse effects of licorice and its bioactive components.     

Coadministration of liposomal methylglyoxal increases the activity of amphotericin B against Candida albicans in leukopoenic mice

Abstract

In this study, we investigated the therapeutic efficacy of a combination of liposomal amphotericin B (Lip-Amp B) and Methylglyoxal (Lip-MG) against Candida albicans in the leukopoenic mice. The antifungal efficacy of Lip-Amp B or Lip-MG or a combination of Lip-Amp B and Lip-MG was evaluated by the analysis of the survival rate and the fungal load in the treated mice. The immune-stimulatory effect of Lip-MG on macrophages was evaluated by analysing the secretion of proinflammatory cytokines. C. albicans infected mice treated at the doses of 1 and 2?mg/kg of Lip-Amp B showed 20% and 50% survival rates, respectively. Whereas the mice treated with free Amp B at the same doses died within 40?days of treatment. Interestingly, C. albicans infected mice treated with a combination of Lip-Amp B and Lip-MG had 70% survival rate on day 40 postinfection. Moreover, treatment of macrophages with Lip-MG increased their fungicidal activity and the secretion of proinflammatory cytokines, including TNF-α and IL-1β. These findings suggested that co-treatment with Lip-Amp B and Lip-MG had a synergistic effect and could be effective against C. albicans in immunocompromised subjects.     

Differentiating reactive mesothelial cells from metastatic adenocarcinoma in serous effusions: The utility of immunocytochemical panel in the differential diagnosis

Differentiating reactive mesothelial cells (RMs) from metastatic adenocarcinoma cells (MAC) in serous fluids based on cytomorphologic features alone can be very challenging. Various immunocytochemical (ICC) markers have been used to maximize the diagnostic accuracy, however, cytopathologists still encounter difficulties in effusion cytologic diagnosis. The aim of this study was to evaluate previous and recent ICC stains to identify the most sensitive and specific markers and the best panel for differentiating RM from MAC. Cell block sections from 41 MAC and 43 RM effusions cases were subjected to ICC staining for MOC‐31, BerEp4, carcinoembryonic antigen (CEA), calretinin, HBME‐1, CK5/6, and D2‐40. For the MAC cases, the sensitivity of BerEp4, MOC‐31, and CEA was 82.9, 92.6, and 17%, respectively, and the specificity was 95.3, 93, and 100%, respectively. For the RM cases, the sensitivity of calretinin, CK5/6, D2‐40, and HBME‐1 was 95.3, 27.9, 58.1, and 93%, respectively, and the specificity was 70.7, 73.1, 75.6, and 82.9%, respectively. The results show that BerEp4 and MOC‐31 are highly sensitive and specific for detecting MAC, whereas calretinin and HBME1 are highly sensitive but only modestly specific for detecting RM cases (P < 0.05). Forced entry logistic regression revealed that using MOC‐31, BerEp4, HBME‐1, and calretinin, is an excellent panel for making correct diagnosis with 97.6% sensitivity in detecting MAC and 90.7% specificity in detecting RM. We conclude that adding a panel of MOC‐31, BerEp4, calretinin, and HBME‐1 immunostains to routine cytomorphologic features can greatly enhance the diagnostic accuracy of serous effusions. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Echocardiography in Patients with Complications Related to Pacemakers and Cardiac Defibrillators

The evolving indications and uses for implantable cardiac devices have led to a significant increase in the number of implanted devices each year. Implantation of endocardial leads for permanent pacemakers and cardiac defibrillators can cause many delayed complications. Complications may be mechanical and related to the interaction of the device leads with the valves and endomyocardium, e.g., perforation, infection, and thrombosis, or due to the electrical pacing of the myocardium and conduction abnormalities, e.g., left ventricular dyssynchrony. Tricuspid regurgitation, another delayed complication in these patients, may be secondary to both mechanical and pacing effects of the device leads. Echocardiography plays an important role in the diagnosis of these device‐related complications. Both two‐dimensional transthoracic echocardiography and transesophageal echocardiography provide useful diagnostic information. Real time three‐dimensional echocardiography is a novel technique that can further enhance the detection of lead‐related complications.     

Anxiogenic-like behavioral phenotype of mice deficient in phosphodiesterase 4B (PDE4B).

Phosphodiesterase-4 (PDE4), an enzyme that catalyzes the hydrolysis of cyclic AMP and plays a critical role in controlling its intracellular concentration, has been implicated in depression- and anxiety-like behaviors. However, the functions of the four PDE4 subfamilies (PDE4A, PDE4B, PDE4C, and PDE4D) remain largely unknown. In animal tests sensitive to anxiolytics, antidepressants, memory enhancers, or analgesics, we examined the behavioral phenotype of mice deficient in PDE4B (PDE4B-/-). Immunoblot analysis revealed loss of PDE4B expression in the cerebral cortex and amygdala of PDE4B-/- mice. The reduction of PDE4B expression was accompanied by decreases in PDE4 activity in the brain regions of PDE4B-/- mice. Compared to PDE4B+/+ littermates, PDE4B-/- mice displayed anxiogenic-like behavior, as evidenced by decreased head-dips and time spent in head-dipping in the holeboard test, reduced transitions and time on the light side in the light-dark transition test, and decreased initial exploration and rears in the open-field test. Consistent with anxiogenic-like behavior, PDE4B-/- mice displayed increased levels of plasma corticosterone. In addition, these mice also showed a modest increase in the proliferation of neuronal cells in the hippocampal dentate gyrus. In the forced-swim test, PDE4B-/- mice exhibited decreased immobility; however, this was not supported by the results from the tail-suspension test. PDE4B-/- mice did not display changes in memory, locomotor activity, or nociceptive responses. Taken together, these results suggest that the PDE4B subfamily is involved in signaling pathways that contribute to anxiogenic-like effects on behavior.     

Waldenstrom's macroglobulinaemia with intracerebral haemorrhage

A 65-year-old male was admitted for evaluation of severe anaemia, recurrent epistaxis, axillary lymphadenopathy, and hepatomegaly. The diagnosis of Waldenstrom's macroglobulinaemia was made on the basis of clinical and laboratory findings. The patient developed intracerebral haemorrhage without associated hypertension and with normal coagulation profile.     

Topical mitomycin C for extensive, recurrent conjunctival-corneal squamous cell carcinoma

PURPOSE: To evaluate the efficacy of topical mitomycin C for extensive recurrent conjunctival and corneal squamous cell carcinoma (SCC). DESIGN: Interventional case series. METHODS: A prospective study was conducted in a single institution. Ten patients (ten eyes) with extensive recurrent conjunctival and corneal SCC were studied. The patients received topical mitomycin C 0.04% one drop four times daily in the eye with SCC. Treatment cycles were defined as 1 week using medication followed by 1 week without medication. Such treatment cycles were repeated until resolution of the conjunctival malignancy was clinically evident. The main outcome measures were tumor response and medication-related complications. RESULTS: Of the ten patients, the median age was 66 years (range 33-77 years). Before referral, the patients had undergone a median of two previous conjunctival tumor resections revealing the diagnosis of in situ SCC in three cases and locally invasive SCC in six cases. At presentation, the tumor involved the limbus and cornea in all ten eyes, forniceal conjunctiva in three eyes, and tarsal conjunctiva in one eye. The extensive tumor affected a median of 10 clock hours of limbal conjunctiva and 10 clock hours of cornea, with corneal epithelial invasion for a median of 50% (range 20%-100%) of its surface. Mitomycin C 0.04% four times daily was applied for a median of three cycles (range 1-4 cycles). Complete tumor regression was documented in all ten cases (100%). There was no recurrence over a mean follow up of 22 months (range 6-50 months). Mitomycin C caused moderate temporary local irritation and conjunctival erythema and chemosis, but no long-term intraocular or extraocular complications. CONCLUSIONS: Based on this small series, topical mitomycin C 0.04% appears to be a safe and effective therapy for conjunctival or corneal SCC, even when there is extensive recurrent tumor.     

Short report: Crimean-Congo hemorrhagic fever outbreak in Rawalpindi, Pakistan, February 2002

A nosocomial outbreak of Crimean-Congo hemorrhagic fever occurred in Rawalpindi, Pakistan in February 2002. The identified index case died shortly after admission to a hospital. Two of the health care workers became secondary cases; one of them died on day 13 after coming in contact with the index case. The other secondary case was successfully treated with oral ribavirin.