Prenatal morphine exposure alters the layer II/III pyramidal neurons morphology in lateral secondary visual cortex of juvenile rats

Altered cortical neuronal morphology and juvenle behavior manifestation by prenatal morphine exposure were well documented. However, this developmental morphine exposure affect the lateral secondary visual area (V2L), which may be critically involved in the multisensory of auditory and visual stimulus, remained poorly understood. To clarify the neuronal architecture changes possibly occurring in the V2L, Golgi‐Cox staining was used in this study to count dendritic length and the spine density of the layer II/III pyramidal neurons in the V2L of the juvenile rats (postnatal day 25, PND25) prenatally exposed to morphine (gestation days 11–18). Quantitative analysis showed that prenatal morphine exposure decreased the total length, branch number, and spine density of the layer II/III pyramidal neurons in the V2L, and selectively altered the total length of the basal dendrites but not of the apical dendrites. The findings may provide the mechanistic understanding of the behavioral changes in the children whose mothers abuse opiates during pregnancy. Synapse 63:1154–1161, 2009. © 2009 Wiley‐Liss, Inc.     

Standard of Practice for the Endovascular Treatment of Thoracic Aortic Aneurysms and Type B Dissections

Thoracic endovascular aortic repair (TEVAR) represents a minimally invasive technique alternative to conventional open surgical reconstruction for the treatment of thoracic aortic pathologies. Rapid advances in endovascular technology and procedural breakthroughs have contributed to a dramatic transformation of the entire field of thoracic aortic surgery. TEVAR procedures can be challenging and, at times, extraordinarily difficult. They require seasoned endovascular experience and refined skills. Of all endovascular procedures, meticulous assessment of anatomy and preoperative procedure planning are absolutely paramount to produce optimal outcomes. These guidelines are intended for use in quality-improvement programs that assess the standard of care expected from all physicians who perform TEVAR procedures.     

Multi-institutional pivotal trial of the Zenith TX2 thoracic aortic stent-graft for treatment of descending thoracic aortic aneurysms: clinical study design

Despite significant improvements in surgical techniques and perioperative management, the repair of descending thoracic aortic aneurysms remains a challenge with the potential for substantial morbidity and mortality. Over the past several years, buoyed by the technical success of endovascular repair of infrarenal abdominal aortic aneurysms, several case series reports of endovascular stent-graft placement for descending thoracic aortic aneurysms have demonstrated the potential safety and efficacy of this treatment modality. Several single-institution studies have documented promising results with these devices, but without controlled clinical trials, the data are insufficient to determine if thoracic aortic endografts provide equivalent or improved outcomes compared with standard open repair. We describe a study design of an ongoing prospective, nonrandomized, multi-institutional, investigational device exemption phase II pivotal clinical trial investigating the safety and effectiveness of the Zenith TX2 thoracic aortic endovascular graft in the elective treatment of patients with descending thoracic aortic aneurysms.     

Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach

The minimally invasive percutaneous plate osteosynthesis (MIPPO) technique through the anterior approach has been successfully used in the treatment of humeral shaft fractures and has gained satisfactory clinical outcome. An anatomical study and a preliminary clinic report were performed to evaluate the feasibility of applying the MIPPO technique in the treatment of humeral shaft distal fractures through the lateral approach. This study was done on 14 arms from seven fresh cadavers. The results of this study showed that it is possible to treat humeral shaft distal fractures by using the MIPPO technique through the lateral approach. The results of using the MIPPO technique through the lateral approach in the treatment of humeral shaft fractures in 22 patients were also reviewed.

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Résumé  L’ostéosynthèse par plaques par voie mini-invasive (technique MIPPO), après abord antérieur est utilisée avec succès dans le traitement des fractures diaphysaires humérales et permet d’obtenir un bon résultat clinique. Une étude anatomique et une étude clinique préliminaires ont été réalisées pour évaluer la faisabilité de l’utilisation de la technique MIPPO dans le traitement de ces fractures distales par voie latérale. Cette étude a été réalisée sur 14 membres supérieurs de 7 cadavres frais. Les résultats de cette étude montrent qu’il est possible de traiter la fracture de l’humérus distal en utilisant la technique MIPPO par voie latérale. Cette technique, transposée chez 22 patients présentant une fracture de ce type a également été réalisée et évaluée.

     

Predictors of survival following open and endovascular repair of abdominal aortic aneurysms

Clinical decision making for asymptomatic abdominal aortic aneurysms (AAAs) weighs risk of aneurysm rupture, treatment hazards, and overall survival expectations. AAA diameter is the primary parameter in assessing rupture risk. Perioperative risk assessment has been extensively studied, and in-hospital mortality has been reduced to less than 8% with higher-risk open repair and less than 3% with endovascular repair. The purpose of this report is to determine risk factors that predict 2-year survival following open and endovascular AAA repair. We studied 334 patients enrolled in a multicenter clinical trial evaluating an endovascular graft in comparison to standard open repair of infrarenal AAA. Demographic, medical history, physical examination, laboratory, anatomic, procedural, and standardized risk score system variables were analyzed in a multivariable Cox proportional hazard model. Overall survival was 89% at 2 years. Heart disease, cancer, and stroke were the most common causes of death, and no deaths were due to AAA rupture. Cox modeling demonstrated that there were several independent predictors for death after AAA repair: smaller body mass index (p=0.005), Society for Vascular Surgery pulmonary risk score >or=1 (p=0.005), history of erectile dysfunction (p=0.008), history of heart valve replacement (p=0.008), lower preoperative platelet count (p=0.012), larger ratio of AAA diameter/proximal neck diameter (p=0.020), and lower ankle-brachial index (p=0.031). Age, gender, and open or endovascular treatment group are not significant independent risk factors for 2-year mortality in this study. Clinical, laboratory, and anatomic factors predict survival after open and endovascular repair of AAAs. With progressive reduction of in-hospital mortality, assessment of patient longevity after AAA repair has become a more important factor in clinical decision making. Use of valid predictors of patient survival will optimize resource utilization and improve overall patient outcomes. Better selection of patients for any method of repair may improve overall utility more than choice of open or endovascular techniques.     

MicroRNA-630 is a prognostic marker for patients with colorectal cancer

MicroRNAs are noncoding RNAs that regulate multiple cellular processes during cancer progression. Among various microRNAs, miR-630 has recently been identified to be implicated in many critical processes in human malignancies. We investigated the expression pattern and prognostic value of miR-630 in human colorectal cancer by utilizing cancer and adjacent normal specimens from 206 patients. Quantitative real-time PCR assay was used to detect the expression of miR-630, and appropriate statistical analysis was used to evaluate the association of miR-630 with overall survival. It was found that miR-630 expression was significantly increased in colorectal cancer specimens compared with that in adjacent normal specimens. It was also proved that miR-630 expression in colorectal cancer was associated with tumor invasion, lymph node metastasis, distant metastasis, and tumor-node-metastasis (TNM) stage. The Kaplan-Meier survival analysis proved that increased miR-630 expression was associated with poor overall survival of patients with colorectal cancer. Multivariate analysis proved that miR-630 was an independent prognostic marker after adjusted for known prognostic factors. These results confirmed the overexpression of miR-630 in human colorectal cancer and its association with tumor progression. It also suggested that miR-630 expression might serve as a prognostic biomarker for patients with colorectal cancer.     

Comparison of responses of melanocyte lineages from p75(+) and p75(−) human scalp-derived neural crest stem cells under phototherapy

Lasers in Medical Science - Phototherapy is an effective therapeutic option in the treatment of vitiligo; however, responses varied among the different types. The underlying mechanism has scarcely...     

癫痫患儿PBMC分泌IL-10、IFN-γ的研究

目的　探讨癫痫与细胞因子之间的关系。方法　应用ＥＬＩＳＡ 方法测定了５３ 例癫痫患儿（ 其中２０例服用ＰＢ，１３ 例服用ＣＢＺ，２０ 例未服药）及１６ 例对照的外周血单个核细胞分泌的白细胞介素－ １０（ＩＬ－ １０） 及干扰素－ γ（ＩＦＮ－ γ）。结果　ＩＬ－ １０、ＩＦＮ－ γ显著高于对照组（Ｐ＜０ ．０１），并且两者呈正相关（ｒｓ＝ ０．６２０２，Ｐ＜０ ．００１） ，ＩＬ－ １０／ＩＦＮ－ γ的比值降低，上述各项指标与患儿是否服药无关。结论　癫痫患儿处于免疫调节网络失衡状态，ＩＦＮ－ γ可能参与了惊厥的发生，而ＩＬ－ １０ 起负反馈调节的作用。