Traumatic optic neuropathy treatment trial (TONTT): open label,phase 3, multicenter,semi-experimental trial

Graefe's Archive for Clinical and Experimental Ophthalmology - Intravenously administered erythropoietin (EPO) was firstly commenced (phase 1) in patients with indirect traumatic optic...     

Homocysteine,vitamin B12 and folate levels in Iranian patients with Multiple Sclerosis: A case control study

Background

Recently, homocysteine (Hcy), folate, and vitamin B12 have been proposed to have several roles on MS pathogenesis.

Objective

We performed this study to determine the role of serum levels of Hcy, vitamin B12, and folate in patients with relapsing remitting MS (RRMS) and compared them with healthy controls.

Methods

We recruited 75 RRMS patients and 75 subjects as controls with the same age and sex. Homocysteine was measured using fluorimetric high-performance liquid chromatography. Plasma folate and vitamin B12 levels were measured through ion-capture method.

Results

Mean plasma levels of vitamin B12, folate, and Hcy in cases were 342.64 ± 210.66 pg/ml, 9.74 ± 4.77 ng/ml, and 22.73 ± 11.63 μM/L, respectively, which showed significant difference in comparison with the controls. In addition, there were significant correlations between mean serum Hcy levels and duration of disease (r = 0.2, p = 0.05) and treatment with interferon (r = 0.21, p = 0.01). In cases, Hcy level was higher among those on β interferon (24.56 ± 11.87 vs. 19.71 ± 10.75, p = 0.01).

Conclusions

We concluded that serum levels of vitamin B12 and folate decreased in RRMS patients, but Hcy levels increased significantly. It seems necessary to conduct prospective trials to determine whether the treatment with supplements and correct biomarker levels in the early stage of the disease can change the course of the disease. We recommend regular checking of the serum level of Hcy in patients who use disease-modifying drugs.     

Predicting residual disease after excision of cervical dysplasia

Dysplastic epithelium at the resection margin after a cervical cone is known to predict persisting disease. We followed 702 women for 30 months after cervical excision to see which resection margin was predictive. The risk of persisting cytological abnormalities was doubled when CIN extended to the endocervical resection margin and was doubled when there was evidence of HPV. In contrast, disease at the ectocervical resection margin and the grade of CIN were not associated with a higher risk of residual disease.     

The vectorcardiogram as an aid to diagnosis in left ventricular-right atrial communication

Frank vectorcardiograms (VCGs) in four patients with left ventricular-right atrial (LV-RA) communication were analyzed and compared with published values of VCGs of normal individuals and those from a group of patients with membranous ventricular septal defect. It was observed that the QRS-loops in the frontal and sagittal planes of the patients with LV-RA communication are shifted more superiorly than usual. Thus, almost 50% of the QRS-loop area was superior to the X- and Z-coordinates in the frontal and sagittal planes, whereas in the controls less than 10% of the frontal and sagittal plane QRS-loops were superior to the horizontal axes. The QRS-loops of patients with LV-RA communication thus seem to be halfway between normal and endocardial cushion defect loops. An unusual degree of superior orientation of the QRS-loop in a patient with clinical findings of a ventricular septal defect should arouse suspicion of a LV-RA communication. Also in patients with an isolated ventricular septal defect but with an exaggerated superior orientation of the QRS-loop in the frontal and sagittal planes, the interatrial septum should be examined at the time of operation to exclude the possibility of an associated LV-RA communication.     

Exfoliation and simultaneous formation of condylar process following chronic osteomyelitis of the mandible

A 26-year-old physically challenged man with a history of 7 months' infection and pus discharge was referred to the oral and maxillofacial department. He had undergone right mandibular teeth extraction 1 year ago, which was followed by pus discharge from an extraoral submandibular fistula after 2 months. Again, incision and drainage and wide-spectrum antibiotic were prescribed, which subsided the symptoms for a short period but did not cure the condition. So, sequestrectomy, complete debridements, and antibiotic therapy were planned for him. In the operating room, it was revealed that the sequestrum was the condylar process, and in follow-up cone-beam computed tomography scan, the condyle was being regenerated simultaneously. One-year follow-up showed successful treatment of the condition.     

Estrogen paradox in pulmonary hypertension: current controversies and future perspectives

Although the incidence of pulmonary hypertension is higher in female patients, numerous experimental studies have demonstrated better outcome in female animals, exacerbation of the disease after ovariectomy, and a strong protective effect of estrogen: a phenomenon known as the "estrogen paradox" of pulmonary hypertension. On the other hand, some clinical studies have indirectly linked estrogen to increased risk of portopulmonary hypertension, whereas others implicate increased estrogen metabolism and high levels of certain estrogen metabolites in promoting pulmonary vascular remodeling in familial pulmonary arterial hypertension. In this review we investigate the estrogen paradox through highlighting the differential receptor-mediated effects of estrogen. Although estrogen and estrogen receptor-based therapies have shown promise in rescuing preexisting pulmonary hypertension in animals, their role is yet to be defined in humans.     

Malignant transformation alters intracellular trafficking of lysosomal cathepsin D in human breast epithelial cells

Increased expression and alteration of intracellular trafficking of lysosomal cathepsins have been reported in malignant tumors, or in cells transformed by the transfection with the ras oncogene. In the present study, immortal MCF-10A human breast epithelial cells were transformed with the mutated ras oncogene. Both cell lines were investigated for changes in the intracellular localization of lysosomal cathepsin D and lamp-1 (lysosome-associated membrane protein) employing specific antibodies and confocal immunofluorescence microscopy. The results revealed that staining for cathepsin D along with for lamp-1 was mostly localized in the perinuclear region of MCF-10A cells. In contrast, the staining for these proteins was found to be widely distributed throughout the cytoplasm and at the cell periphery in MCF-10AneoT cells. The organization of microtubules, but not actin, appeared to differ between MCF-10A cells and their oncogenic ras transfectants. When the microtubules were depoly-merized by treatment of MCF-10A cells with nocodazole, vesicles containing the lysosomal cathepsin D were dispersed in the cytoplasm and translocation of these vesicles to the cell periphery was observed. The intracellular localization of cathepsin D in the nocodazole-treated MCF-10A cells seemed to be similar to that observed in the oncogenic ras transfectants of these cells. When taxol, which inhibits microtubule depolymerization, was added to the culture medium of neoT cells, a polymerized microtubule network was observed, and the reclustering of cathepsin D and lamp-1 occurred in a unidirectional manner towards the perinuclear region. These findings support a model in which cytoskeletal microtubule organization is closely related to the trafficking of lysosomes/endodomes, and in which oncogenic ras interferes with such organization in human breast epithelial cells.     

Health Survey Instrument Development Through a Community-Based Participatory Research Approach: Health Promoting Lifestyle Profile (HPLP-II) and Brazilian Immigrants in Greater Boston

Brazilians are among the fastest growing segment of immigrant populations in several states of the United States. Culturally appropriate and validated health survey instruments do not exist to adequately assess the health needs of this population. Through a community-based participatory research (CBPR) approach, a cross-cultural pilot project was conducted to develop and test a culturally-adapted Brazilian Portuguese-version of the health-promoting lifestyle profile II (HPLP-II) instrument with a convenience sample of 60 bilingual and bicultural Brazilian immigrants using a combined quasi experimental and focus group design. The project evaluated HPLP-II instrument’s psychometric properties of equivalency, reliability, and score distribution in Portuguese and English. This pilot test supports equivalency, consistency, and reliability of the English and culturally-adapted Brazilian Portuguese versions of the instrument. CBPR is an effective approach in health instrument development. This instrument is an important first step in designing other appropriate instruments to explore health conditions of Brazilian immigrants in the U.S.