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61.
Estradiol enhances neurogenesis following ischemic stroke through estrogen receptors alpha and beta 总被引:6,自引:0,他引:6
Suzuki S Gerhold LM Böttner M Rau SW Dela Cruz C Yang E Zhu H Yu J Cashion AB Kindy MS Merchenthaler I Gage FH Wise PM 《The Journal of comparative neurology》2007,500(6):1064-1075
Neurogenesis persists throughout life under normal and degenerative conditions. The adult subventricular zone (SVZ) generates neural stem cells capable of differentiating to neuroblasts and migrating to the site of injury in response to brain insults. In the present study, we investigated whether estradiol increases neurogenesis in the SVZ in an animal model of stroke to potentially promote the ability of the brain to undergo repair. Ovariectomized C57BL/6J mice were implanted with capsules containing either vehicle or 17beta-estradiol, and 1 week later they underwent experimental ischemia. We utilized double-label immunocytochemistry to identify the phenotype of newborn cells (5-bromo-2'-deoxyuridine-labeled) with various cellular markers; doublecortin and PSA-NCAM as the early neuronal marker, NeuN to identify mature neurons, and glial fibrillary acidic protein to identify astrocytes. We report that low physiological levels of estradiol treatment, which exert no effect in the uninjured state, significantly increase the number of newborn neurons in the SVZ following stroke injury. This effect of estradiol is limited to the dorsal region of the SVZ and is absent from the ventral SVZ. The proliferative actions of estradiol are confined to neuronal precursors and do not influence gliosis. Furthermore, we show that both estrogen receptors alpha and beta play pivotal functional roles, insofar as knocking out either of these receptors blocks the ability of estradiol to increase neurogenesis. These findings clearly demonstrate that estradiol stimulates neurogenesis in the adult SVZ, thus potentially facilitating the brain to remodel and repair after injury. 相似文献
62.
BACKGROUND Previous studies suggest that patients who are more involved in their medical care have better outcomes.
OBJECTIVES We sought to compare health care processes and outcomes for patients with HIV based on their preferred level of involvement
in health decisions.
DESIGN Cross-sectional analysis of audio computer-assisted interviews with patients at an urban HIV clinic.
PATIENTS One thousand and twenty-seven patients awaiting an appointment with their primary care provider.
MEASURES Patients were asked how they preferred to be involved in decisions (doctor makes most or all decisions, doctor and patient
share decisions, patient makes all decisions). We also asked patients to rate the quality of communication with their HIV
provider, and their self-reported receipt of and adherence to HAART.
RESULTS Overall, 23% patients preferred that their doctor make all or most decisions, 63% preferred to share decisions with their
doctor, and 13% preferred to make all final decisions alone. Compared to patients who prefer to share decisions with their
HIV provider, patients who prefer that their provider make all/most decisions were significantly less likely to adhere to
HAART (OR [odds ratio] 0.57, 95% CI 0.38–0.86) and patients who preferred to make decisions alone were significantly less
likely to receive HAART or to have undetectable HIV RNA in unadjusted analyses (OR 0.52, 95% CI 0.31–0.87 for receipt of HAART;
OR 0.64, 95% CI 0.44–0.95 for undetectable HIV RNA). After controlling for potentially confounding patient characteristics
and differences in patient ratings of communication quality, patients who preferred that their provider make all/most decisions
remained significantly less likely to adhere to HAART (OR 0.58, 95% CI 0.38–0.89); however, the associations with receipt
of HAART and undetectable HIV RNA were no longer significant (OR 0.60, 95% CI 0.34–1.05 for receipt of HAART; OR 0.80, 95%
C.I 0.53–1.20 for undetectable HIV RNA).
CONCLUSIONS Although previous research suggests that more patient involvement in health care decisions is better, this benefit may be
reduced when the patient wants to make decisions alone. Future research should explore the extent to which this preference
is modifiable so as to improve outcomes. 相似文献
63.
Quamar Azam MKA Sherwani Mazhar Abbas Rahul Gupta Naiyer Asif AB Sabir 《Indian Journal of Orthopaedics》2007,41(3):204-208
Objective:
Patients often reach the hospital late after passage of golden hours (initial 6 hours) after sustaining high-velocity injuries. The decision of internal fixation in Gustilo''s Type IIIA and IIIB fractures becomes a formidable challenge in patients reaching late. The purpose of the present study was to find out if internal fixation could be safely undertaken in these patients.Materials and Methods:
Sixty-three patients, having 70 compound fractures (46 Type IIIA and 24 IIIB), which were internally fixed after 6h but within 24h after injury, were included in the present analysis. Follow-up ranged from 18 to 48 months with mean of 28 months.Result:
Overall infection rate noted was (n = 11) 15.71% (8.7% in IIIA, and 29.16% in IIIB). The difference in deep infection rate between Type IIIA and Type IIIB was found to be statistically significant (P value < 0.01). Nonunion was seen in five fractures. Functional evaluation using Katenjian''s criteria, showed 62.85% (44 fractures of 70) good to excellent results.Conclusion:
Satisfactory results may be obtained in Gustilo''s Type IIIA and IIIB fractures even if fixed after the golden period, provided strict protocol such as aggressive debridement, prophylactic antibiotic coverage, early soft tissue reconstruction and timely bone grafting is followed. The primary coverage of the wound is discouraged. 相似文献64.
Treatment of vitiligo with topical imiquimod 总被引:1,自引:0,他引:1
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E Adışen J Yüksek O Erdem FN Aksakal AB Aksakal 《Journal of the European Academy of Dermatology and Venereology》2010,24(1):32-37
Background In acne vulgaris patients, the presence of a dysregulation of the production of innate and specific antimicrobial peptides has been postulated. Objective This study aims to determine whether human neutrophil proteins (HNP) 1–3 are expressed in acne patients. Materials and methods HNP 1–3 expression was investigated in 35 acne patients treated with isotretinoin and in 25 healthy subjects. At the beginning of the study, two skin biopsies were taken from acne patients; one biopsy was taken from an established pustule and one from uninvolved skin, and the biopsies were repeated after treatment. Only one biopsy was obtained from controls. Results The statistical analysis showed that pustular lesions of acne patients had significantly higher levels of perivascular and interstitial HNP 1–3 expression when compared with the biopsy of uninvolved skin of these patients (P = 0.003, P = 0.001, respectively) and with that of healthy controls (P = 0.007, P = 0.014, respectively). Isotretinoin treatment achieved a decrease in the perivascular and interstitial HNP 1–3 expression of pustular lesions (P = 0.01, P = 0.001, respectively). Conclusion Our current study demonstrates the novel observation that a recently identified antimicrobial peptide, HNP 1–3, is expressed in neutrophils of acne inflammation but not in uninvolved skin of these patients. These results suggest that HNP 1–3 may contribute to the development of inflammatory lesions of acne. 相似文献
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70.
MRMdaSA Rafael† CMBM Fernandes† JMdaC Machado‡ PAPA Rodrigues‡ OJP Cardoso‡ A Afonso§ AB Sousa¶ FMDdeA Pacheco† RM Proença ‡ 《Journal of the European Academy of Dermatology and Venereology》2003,17(4):449-451
We report a case of atypical bullous pyoderma gangrenosum associated with acute myeloid leukaemia in which we found atypical myeloid cells within the skin lesion. Although there have been many reported cases of leukaemia-associated pyoderma gangrenosum, the finding of myeloblasts in the skin has rarely been described. 相似文献