Sclerosing mesenteritis: A real manifestation or histological mimic of IgG4‐related disease?

We present three cases of sclerosing mesenteritis and review the literature to learn whether or not sclerosing mesenteritis is an IgG4‐related disease (IgG4‐RD). Our patients were all adult males. Their mesenteric masses ranged from 6.5 to 14.5 cm in the greatest diameter. Tissue specimens showed moderate to severe lymphoplasmacytic infiltration with occasional eosinophils against a background of irregular fibrosis. Both obliterative phlebitis and storiform fibrosis were noted in all cases. IgG4+ plasma cells were moderately increased in number (46 to 85 cells/high‐power field). However, unlike IgG4‐RD, the IgG4+/IgG+ plasma cell ratio was <40% (28% to 35%). Serum IgG4 concentrations were also within the normal range (43.2 to 105 mg/dL; normal range <135 mg/dL). Two biopsy cases showed spontaneous regression on imaging approximately 5 months later. No sclerosing conditions were found in other organs. The literature review identified 11 additional cases of sclerosing mesenteritis with IgG4+ plasma cell infiltration. However, conclusive cases with four characteristic features (high serum IgG4 levels, tissue IgG4 elevation, multi‐organ involvement, and effective response to glucocorticoid therapy) have never been reported. In conclusion, although sclerosing mesenteritis shares histological features with IgG4‐RD, most cases are less likely to be IgG4‐related. IgG4‐RD seemingly seldom, if ever, affects this anatomical site.     

Shall We Inject Superficial or Deep to the Plantar Fascia? An Ultrasound Study of the Treatment of Chronic Plantar Fasciitis

We compared the effectiveness of ultrasound (US)-guided corticosteroid, injected superficial or deep to the fascia, in patients with plantar fasciitis. Thirty patients (24 females [75%] and 6 males [25%]) with unilateral chronic plantar fasciitis were divided into 2 groups according to the corticosteroid injection site: superficial (n = 15) or deep (n = 15) to the plantar fascia. Patient heel pain was measured using a Likert pain scale and the Foot Ankle Outcome Scale (FAOS) for foot disability, evaluated at baseline and repeated in the first and sixth weeks. The plantar fascia and heel pad thicknesses were assessed on US scans at baseline and the sixth week. The groups were similar in age, gender, and body mass index (p > .05 for all). Compared with the baseline values, the Likert pain scale (p < .001 for all) and FAOS subscale (p < .01 for all) scores had improved at the first and sixth week follow-up visits in both groups. Although the plantar fascia thickness had decreased significantly in both groups at the sixth week (p < .001 for both), the heel pad thickness remained unchanged (p > .05 for both). The difference in the FAOS subscales (pain, p = .002; activities of daily living, p = .003; sports/recreational activities, p = .008; quality of life, p = .009) and plantar fascia thickness (p = .049) showed better improvement in the deep than in the superficial injection group. US-guided corticosteroid injections are safe and effective in the short-term therapeutic outcome of chronic plantar fasciitis. Additionally, injection of corticosteroid deep to the fascia might result in greater reduction in plantar fascia thickness, pain, and disability and improved foot-related quality of life.     

Sulcus vocalis in monozygotic twins

Sulcus vocalis is the presence of a groove extending along the vibratory surface of a vocal fold and may result in dysphonia. Depending on the level of severity, this condition may require treatment involving complicated surgical techniques. Cases of sulcus vocalis are classified as physiological, vergeture, or pouch type. A clear explanation of the etiology has not been established, and the currently proposed congenital origin, as described in the literature, remains controversial. This paper presents findings from monozygotic twin sisters with bilateral sulcus vocalis; these patients had similar morphologies, vibratory characteristics, and vocal quality measurements, which support the theory of a congenital etiology.     

Characterisation of congenital nystagmus waveforms in terms of periodic orbits

Because the oscillatory eye movements of congenital nystagmus vary from cycle to cycle, there is no clear relationship between the waveform produced and the underlying abnormality of the ocular motor system. We consider the durations of successive cycles of nystagmus which could be (1) completely determined by the lengths of the previous cycles, (2) completely independent of the lengths of the previous cycles or (3) a mixture of the two. The behaviour of a deterministic system can be characterised in terms of a collection of (unstable) oscillations, referred to as periodic orbits, which make up the system. By using a recently developed technique for identifying periodic orbits in noisy data, we find evidence for periodic orbits in nystagmus waveforms, eliminating the possibility that each cycle is independent of the previous cycles. The technique also enables us to identify the waveforms which correspond to the deterministic behaviour of the ocular motor system. These waveforms pose a challenge to our understanding of the ocular motor system because none of the current extensions to models of the normal behaviour of the ocular motor system can explain the range of identified waveforms.     

Dimensional changes and water sorption of two acrylic polymer materials reinforced with glass fibres

The purpose of this study was to examine the effect of glass fibre reinforcement on the dimensional changes and water sorption of a heat-polymerising denture acrylic polymer and a microwave-polymerising denture acrylic polymer. Fifteen specimens from each group were prepared with 2% by weight (18 mg) E-glass fibre and 15 without glass fibre. The dimensional change measurements were made at three different stages on the 60 specimens. The water sorption calculations were made on specimens immersed in distilled water at 37 degrees C +/- 1 degree C for 0, 1 and 7 days. Glass fibre reinforcement and processing method do not affect the dimensional change of test specimens, but as the time increased the dimensional change decreased. The glass fibre reinforcement decreased water sorption, but the two processing methods failed to show a significant difference.     

Resveratrol protects against 4-hydroxynonenal-induced apoptosis by blocking JNK and c-JUN/AP-1 signaling.

In the present study we have studied the effect of resveratrol in signal transduction mechanisms leading to apoptosis in 3T3 fibroblasts when exposed to 4-hydroxynonenal (HNE). In order to gain insight into the mechanisms of apoptotic response by HNE, we followed MAP kinase and caspase activation pathways; HNE induced early activation of JNK and p38 proteins but downregulated the basal activity of ERK (1/2). We were also able to demonstrate HNE-induced release of cytochrome c from mitochondria, caspase-9, and caspase-3 activation. Resveratrol effectively prevented HNE-induced JNK and caspase activation, and hence apoptosis. Activation of AP-1 along with increased c-Jun and phospho-c-Jun levels could be inhibited by pretreatment of cells with resveratrol. Moreover, Nrf2 downregulation by HNE could also be blocked by resveratrol. Overexpression of dominant negative c-Jun and JNK1 in 3T3 fibroblasts prevented HNE-induced apoptosis, which indicates a role for JNK-c-Jun/AP-1 pathway. In light of the JNK-dependent induction of c-Jun/AP-1 activation and the protective role of resveratrol, these data may show a critical potential role for JNK in the cellular response against toxic products of lipid peroxidation. In this respect, resveratrol acting through MAP kinase pathways and specifically on JNK could have a role other than acting as an antioxidant-quenching reactive oxygen intermediate.     

Relation of ferritin levels with symptom ratings and cognitive performance in children with attention deficit–hyperactivity disorder

Background: The aim of the present paper was to investigate the relationship between behavioral symptoms and attentional and executive functions and hematological variables related to iron deficiency and anemia, ferritin, hemoglobin, mean corpuscular volume (MCV), and red cell distribution width (RDW) in children and adolescents with attention deficit–hyperactivity disorder (ADHD). Methods: The sample consisted of 52 ADHD children (42 boys, 10 girls; age 7–13 years; mean ± SD, 9.9 ± 2.1 years). Conners Parent and Teacher Rating Scales were obtained. The neuropsychological test battery included Wisconsin Card‐Sorting Test (WCST), Stroop, Continuous Performance Test, Digit Symbol and Digit Span subtests of the Wechsler Intelligence Scale for Children Revised (WISC‐R), and Trail Making Test A and B, which taps abstraction–flexilibity (WCST), sustained attention (CPT), mental tracking and complex attention (WISC‐R Digit Span, Digit Symbol, Trail Making A and B) and interference control (Stroop). Multiple linear regression was used to evaluate the relation of ferritin, hemoglobin, MCV, RDW, age, gender, and presence of comorbidity. Results: While seven children had iron deficiency, none of them was anemic. Lower ferritin levels were associated with higher hyperactivity scores in parental ratings. While performance increased with age for most of the neuropsychological tests utilized, ferritin, hemoglobin, MCV and RDW and gender were not significantly related with cognitive performance in this sample. Conclusions: At least for the present clinical sample, ferritin levels might be related with behavioral but not cognitive measures in ADHD cases.     

High responders are not exempt from detrimental effects of prematurely rising progesterone levels in fresh embryo transfer cycles

Research question

Are high-responder IVF patients protected from the deleterious effect of prematurely elevated serum progesterone level on the probability of pregnancy?