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21.
Katrijn Smulders Marlies van Nimwegen Marten Munneke Bastiaan R. Bloem Roy P.C. Kessels Rianne A.J. Esselink 《Parkinsonism & related disorders》2013,19(1):126-128
Postural instability and gait disorders (PIGD) in Parkinson's disease (PD) seem to be associated with executive dysfunction. We investigated which specific executive functions are associated with functional mobility in mildly affected PD patients. Functional mobility (Timed Up&Go Test, TUG), PIGD score, (spatial) working memory, set shifting, response inhibition and response generation were assessed in a large cohort of 232 non-demented PD patients. Both performance on the TUG and PIGD score were weakly associated with working memory and response generation (semantic and phonemic fluency). TUG also correlated with semantic fluency when corrected for disease severity and age. These results indicate that response generation and working memory are associated with (and possibly also causally related to) gait and balance deficits. In order to fully interpret gait and postural stability of PD patients in everyday situations, the role of impairments in working memory and response generation should be taken into account. 相似文献
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Nynke A. Jager Bastiaan M. Wallis de Vries Jan-Luuk Hillebrands Niels J. Harlaar René A. Tio Riemer H. J. A. Slart Gooitzen M. van Dam Hendrikus H. Boersma Clark J. Zeebregts Johanna Westra 《Molecular imaging and biology》2016,18(2):283-291
Purpose
In this study, the potential of matrix metalloproteinase (MMP) sense for detection of atherosclerotic plaque instability was explored. Secondly, expression of MMPs by macrophage subtypes and smooth muscle cells (SMCs) was investigated.Procedures
Twenty-three consecutive plaques removed during carotid endarterectomy were incubated in MMPSense? 680 and imaged with IVIS® Spectrum. mRNA levels of MMPs, macrophage markers, and SMCs were determined in plaque specimens, and in in vitro differentiated M1 and M2 macrophages.Results
There was a significant difference between autofluorescence signals and MMPSense signals, both on the intraluminal and extraluminal sides of plaques. MMP-9 and CD68 messenger RNA (mRNA) expression was higher in hot spots, whereas MMP-2 and αSMA expression was higher in cold spots. In vitro M2 macrophages had higher mRNA expression of MMP-1, MMP-9, MMP-12, and TIMP-1 compared to M1 macrophages.Conclusion
MMP-9 is most dominantly MMP present in atherosclerotic plaques and is produced by M2 rather than M1 macrophages.25.
Meredith Achey BM Jason L. Aldred MD Noha Aljehani MD Bastiaan R. Bloem MD PhD Kevin M. Biglan MD MPH Piu Chan MD PhD Esther Cubo MD PhD E. Ray Dorsey MD MBA Christopher G. Goetz MD Mark Guttman MD Anhar Hassan MB BCh FRACP Suketu M. Khandhar MD Zoltan Mari MD Meredith Spindler MD Caroline M. Tanner MD PhD Pieter van den Haak MSc Richard Walker MD Jayne R. Wilkinson MD 《Movement disorders》2014,29(7):871-883
Travel distance, growing disability, and uneven distribution of doctors limit access to care for most Parkinson's disease (PD) patients worldwide. Telemedicine, the use of telecommunications technology to deliver care at a distance, can help overcome these barriers. In this report, we describe the past, present, and likely future applications of telemedicine to PD. Historically, telemedicine has relied on expensive equipment to connect single patients to a specialist in pilot programs in wealthy nations. As the cost of video conferencing has plummeted, these efforts have expanded in scale and scope, now reaching larger parts of the world and extending the focus from care to training of remote providers. Policy, especially limited reimbursement, currently hinders the growth and adoption of these new care models. As these policies change and technology advances and spreads, the following will likely develop: integrated care networks that connect patients to a wide range of providers; education programs that support patients and health care providers; and new research applications that include remote monitoring and remote visits. Together, these developments will enable more individuals with PD to connect to care, increase access to expertise for patients and providers, and allow more‐extensive, less‐expensive participation in research. © 2014 International Parkinson and Movement Disorder Society 相似文献
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Jorik Nonnekes Alexander C. H. Geurts Lars B. Oude Nijhuis Karin van Geel Anke H. Snijders Bastiaan R. Bloem Vivian Weerdesteyn 《Journal of neurology》2014,261(5):943-950
Freezing of gait (FOG) is a disabling feature of Parkinson’s disease. Emerging evidence suggests that dysfunction of the pedunculopontine nucleus (PPN) and pontomedullary reticular formation (pmRF) plays a role in the causation of FOG. These brainstem structures can be examined by the StartReact paradigm, which utilizes a startling stimulus to accelerate reaction times (StartReact). Here, we examined gait initiation in PD patients with and without FOG using this paradigm. Twenty-six patients with Parkinson’s disease (12 freezers and 14 non-freezers) and 15 controls performed two tasks: rapid gait initiation in response to an imperative ‘go’ signal; and a control condition, involving a simple reaction-time task involving ankle dorsiflexion. During both tasks, a startling acoustic stimulus was combined with the imperative signal in 25 % of trials. In controls, the startle accelerated gait initiation and shortened the onset latency of tibialis anterior responses during ankle dorsiflexion. This acceleration was intact in non-freezers, but was significantly attenuated in the freezers. Independent of the occurrence of a startle, freezers showed a reduced length of the first step compared to non-freezers and controls. The diminished StartReact effect in freezers probably reflects deficient representation or release of motor programs at the brainstem reticular level due to dysfunction of the PPN, the pmRF, or both. These brainstem structures are presumably involved in integrating anticipatory postural adjustments with subsequent stepping movements. We suggest that with time-varying demands, these structures may no longer be able to coordinate the integration of anticipatory postural adjustments with steps, leading to FOG episodes. 相似文献
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Roopa Rajan MD Laura Brennan PhD Bastiaan R. Bloem MD PhD Nabila Dahodwala MD Joan Gardner RN BSN Jennifer G. Goldman MD MS David A. Grimes MD Robert Iansek PhD Norbert Kovács MD PhD Jennifer McGinley PhD Sotirios A. Parashos MD PhD Maria E.P. Piemonte PT PhD Carsten Eggers MD 《Movement disorders》2020,35(9):1509-1531
29.
Arjan P Schouten van der Velden Carla Boetes Peter Bult Theo Wobbes 《BMC medical imaging》2009,9(1):5-8
Background
Breast-conserving treatment of invasive breast carcinoma with an extensive intraductal component (EIC) is associated with DCIS-involved surgical margins and therefore it has an increased recurrence rate. EIC is a non-palpable lesion of which the size is frequently underestimated on mammography. This study was undertaken to evaluate the accuracy of MRI in size assessment of breast cancer with EIC. 相似文献30.
Abbink EJ de Galan BE van Ginneken EE van Rosendaal AJ Smits P 《European journal of clinical pharmacology》2002,58(1):7-10
OBJECTIVE: Recent reports show that heparin induces vasodilation. This heparin-induced vasodilation might interfere with the results of vascular studies using the perfused-forearm technique because the arterial catheter is often flushed with a heparin solution in those experiments. Therefore, we investigated the vascular effects of flushing an arterial catheter with a heparin solution compared with a placebo solution (NaCl 0.9%) in six healthy volunteers. METHODS: During the first half of each experiment, the arterial catheter was flushed several times with the placebo solution. In the second half, identical flushes were performed with a solution of heparin diluted in NaCl 0.9% (4U x ml(-1)). RESULTS: Forearm blood flow (venous occlusion plethysmography) response was similar with heparin and placebo after all flushes. CONCLUSION: We conclude that low-dose heparin in the solution to flush an arterial catheter has no short-term vasodilator effect in the human forearm vascular bed. Therefore, the results of studies using the perfused-forearm technique are not confounded by flushes with a low-dose heparin solution. 相似文献