Specific cerebellar reductions in children with chromosome 22q11.2 deletion syndrome

Children with chromosome 22q11.2 deletion syndrome commonly are found to have morphological brain changes, cognitive impairments, and elevated rates of psychopathology. One of the most commonly and consistently reported brain changes is reduced cerebellar volume. Here, we demonstrate that, in addition to the global cerebellum reductions previously reported, volumetric reductions of the anterior lobule and the vermal region of the neo-cerebellum in the mid-sagittal plane best differentiate children with the deletion from typically developing children. These results suggest that the morphological changes of specific portions of the cerebellum may be an important underlying substrate of cognitive impairments and increased incidence of psychopathology in this group.     

Author’s Reply: Radiofrequency Ablation for Benign Thyroid Nodules: 1-Year Follow-Up in 184 Patients

World Journal of Surgery -     

Combinative Effects of Thanh Hao Miet Giap Thang (Sweet Wormwood and Tortoise Shell Decoction) Ingredients on Antioxidative Activity In Vitro

Background

Traditional formulae usually exhibit therapeutic effects through the combinations of different ingredients. The purpose of this study was to investigate in vitro anti-oxidative activity of Thanh Hao Miet Giap Thang (THMGT) (Sweet Wormwood and Tortoise Shell Decoction) formula and the interactions of its ingredients leading to the overall anti-oxidative effect.

Materials and Methods

We prepared 31 combinations containing two to four of the five ingredients including Herba Artemisia apiacea L (HbA), Carapax Trionycis (Tryonix sinensis) (CT), Rhizoma Anemarrhenae (Anemarrhena asphodeloides) (RzA), Radix Rehmanniae (Rehmannia glutinosa Libosch) (RdR), Moutan Cortex (Paeonia suffruticosa) (MC). These combinations were tested for anti-oxidative activity using DCFH-DA and DPPH assays on Hep G2 cells. We also analyzed changes in expression of genes involved in antioxidant defense system including Nuclear Factor Erythroid-Derived 2-Like 2 (NFE2L2), catalase (CAT), heme oxygenase-1 (HO-1), glutathione peroxidase (GPx), cytoplasmic superoxide dismutase (SOD1), mitochondrial superoxide dismutase (SOD2).

Results

The complete formula and all combinations containing Moutan Cortex showed high antioxidant activity in both radical solution-based chemical assay and cellular-based assay. On the contrary, Carapax Trionycis displayed inhibitory effect on the overall antioxidant activity when present in a combination, an effect clearly emphasized in cellular-based assay. Hep G2 cells treated with the formula showed increased gene expression of HO-1 and SOD2 while expression of CAT, SOD1, GPx was unchanged.

Conclusion

Our results suggested that THMGT had anti-oxidative activity essentially through intrinsic reducing capacities and the overall activity of the formula resulted from enhancing and inhibiting interactions of ingredients.     

Thalamic reductions in children with chromosome 22q11.2 deletion syndrome

Children with chromosome 22q11.2 deletion syndrome (22q) suffer from physical and behavioral dysfunctions, including neuroanatomical anomalies, visuo-spatial processing deficits, and increased risk for psychopathology. Reduced total brain volume, parietal lobe volume, and cerebellar volumes, enlarged ventricles, and increased basal ganglia volumes have been reported. Since previous literature has related the pulvinar nucleus of the thalamus to visuo-spatial processing, we compared the thalamic volume in children with 22q to typically developing controls. Children with 22q showed a significant reduction of the thalamus compared with normally developing children, specifically in the posterior portion of the thalamus, including the pulvinar nucleus. These results provide the first evidence for a potential relationship between posterior thalamic reductions and the characteristic visuo-spatial deficits demonstrated in this group.     

Rest Premature Ventricular Contractions on Routine ECG and Prognosis in Heart Failure Patients

Background: Premature ventricular contractions (PVC) at rest are frequently seen in heart failure (HF) patients but conflicting data exist regarding their importance for cardiovascular (CV) mortality. This study aims to evaluate the prognostic value of rest PVCs on an electrocardiogram (ECG) in patients with a history of clinical HF. Methods and Results: We considered 352 patients (64 ± 11 years; 7 females) with a history of clinical HF undergoing treadmill testing for clinical reasons at the Veterans Affairs Palo Alto Health Care System (VAPAHCS) (1987–2007). Patients with rest PVCs were defined as having ≥1 PVC on the ECG prior to testing (n = 29; 8%). During a median follow‐up period of 6.2 years, there were 178 deaths of which 76 (42.6%) were due to CV causes. At baseline, compared to patients without rest PVCs, those with rest PVCs had a lower ejection fraction (EF) (30% vs 45%) and the prevalence of EF ≤ 35% was higher (75% vs 41%). They were more likely to have smoked (76% vs 55%).The all‐cause and CV mortality rates were significantly higher in the rest PVCs group (72% vs 49%, P = 0.01 and 45% vs 20%, P = 0.002; respectively). After adjusting for age, beta‐blocker use, rest ECG findings, resting heart rate (HR), EF, maximal systolic blood pressure, peak HR, and exercise capacity, rest PVC was associated with a 5.5‐fold increased risk of CV mortality (P = 0.004). Considering the presence of PVCs during exercise and/or recovery did not affect our results. Conclusion: The presence of PVC on an ECG is a powerful predictor of CV mortality even after adjusting for confounding factors. Ann Noninvasive Electrocardiol 2010;15(1):56–62     

Orbital trauma

Assessment of the orbit for orbital trauma is best achieved expeditiously with CT in the determination of extent of injury and the presence of foreign body. MR imaging has a limited role but is valuable in examining the optic nerve and globe for injury and has proven to be an adjunct modality in the assessment of orbital injury.     

A descriptive study of persistent oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer

Background

Prolonged neurotoxicity after systemic chemotherapy has the potential to impact on quality of life. We explored the frequency of persistent peripheral neuropathy in patients who received oxaliplatin for colorectal cancer at two local centres.

Patients and methods

Questionnaires were sent to patients who completed treatment with oxaliplatin for colorectal cancer at least 20 months prior to entering the study. Neuropathy questions were adapted from the FACT/GOG-Ntx (V.4) questionnaire.

Results

Of the 56 eligible patients, 27 returned the questionnaire. Twenty-five patients (93 %) experienced neuropathic symptoms during their treatment; 11 had grade-2, and two had grade-3 symptoms. At the time of completing the questionnaire, 17 patients (63.0 %; 95%CI 43.9–79.4 %) were still symptomatic with 12 patients (44.4 %; 95%CI 26.8–63.3) having grade-2 or grade-3 symptoms and three patients (11.1 %; 95%CI 2.9–27.3) having grade-3 neuropathic symptoms. Participants who received more than 900 mg/m² oxaliplatin had a significantly higher risk of persistent grade-2 or grade-3 neuropathy (p?=?0.031, RR?=?8.3 95%CI?=?1.2–57.4). There was a trend toward increased risk of persistent neuropathy of any grade among participants with a history of regular alcohol use (p?=?0.051; RR?=?1.7 95%CI 1.0–2.8).

Conclusion

Persistent oxaliplatin-induced neuropathy is not as uncommon as previously suggested, and the rate of grade-2 and grade-3 symptoms could be considerably higher than previous reports.