Hearing outcome of sudden sensorineural hearing loss: long-term follow-up.

OBJECTIVE: To evaluate the time-dependent progress and delayed improvement in patients who were treated with combination therapy including oral corticosteroid for idiopathic sudden sensorineural hearing loss. STUDY DESIGN AND SETTING: This retrospective study at a secondary referral and university-based center included 156 patients who were treated by 10-day course of admission therapy and followed for at least three months. RESULTS: Of 121 patients who recovered over three months of follow-up, 45.5% showed a delayed recovery after the end of 10-day course of therapy. Of these 55 patients, 78.2% recovered within one month, 5.5% recovered within one to two months, 12.7% recovered in two to three months, and 3.6% recovered later than three months after discharge. CONCLUSIONS: This study describes the long-term results for a three-month retrospective series of 156 patients diagnosed with idiopathic sudden sensorineural hearing loss, although this result should be further studied by additional research.     

Systemic inflammation response index predicts all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis

International Urology and Nephrology - A systemic inflammation response index (SIRI) has been recently introduced as a tool for the assessment of the prognosis of several critical medical...     

BVAS version 3 and BVAS/GPA: standing on the same line?

Clinical Rheumatology - Birmingham vasculitis activity score (BVAS) version 3 (BVAS 3.0) and BVAS/granulomatosis with polyangiitis (BVAS/GPA) are used as indicators of disease activity in...     

Fibrosis-5 predicts end-stage renal disease in patients with microscopic polyangiitis and granulomatosis with polyangiitis without substantial liver diseases

Clinical and Experimental Medicine - We previously reported that fibrosis-4 (FIB-4) was associated with poor outcomes of microscopic polyangiitis (MPA) and granuloma with polyangiitis (GPA). We...     

Delta Neutrophil Index as an Early Marker for Differential Diagnosis of Adult-Onset Still's Disease and Sepsis

Purpose

To investigate clinical implications of delta neutrophil index (DNI) to discriminate adult onset Still''s disease (AOSD) from sepsis.

Materials and Methods

We reviewed the medical records of 13 patients with AOSD and 33 gender and age-matched patients with sepsis. In all subjects, microbial tests were performed to exclude or confirm sepsis. All laboratory data were measured two or three times during the first 3 days and represented by their mean levels. DNI was measured automatically by ADVIA 2120 for the first 3 days.

Results

There were no significant differences in white blood cell counts, neutrophil proportion, erythrocyte sedimentation rate and C-reactive protein between two groups. AOSD patients had notably lower DNI than sepsis patients regardless of the presence of bacteremia or not. However, both DNI and ferritin were not significant independent factors for predicting sepsis in the multivariate logistic regression analysis. Meanwhile, the area under the receiver operating characteristic curve (AUROC) of DNI was slightly higher than that of ferritin. When we set DNI of 2.75% as the cut-off value for predicting sepsis, 11 (84.6%) of AOSD patients had a DNI value below 2.75% and 2 (15.4%) of them had a DNI over 2.75% (relative risk for sepsis 176).

Conclusion

We suggest that DNI may be a useful marker for differential diagnosis of AOSD from sepsis in the early phase as supplementary to ferritin.     

Gallic acid,a natural polyphenolic acid,induces apoptosis and inhibits proinflammatory gene expressions in rheumatoid arthritis fibroblast-like synoviocytes

ObjectivesTo investigate whether gallic acid (3, 4, 5-trihydroxybenzoic acid), a natural polyphenolic acid found in gall nuts, sumac, oak bark, tea leaves, grapes and wine, has pro-apoptotic and anti-inflammatory effects on fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA).MethodsViability of RA FLS was assessed using a MTT assay after gallic acid treatment. Apoptosis was assessed by TUNEL assay and caspase-3 activity was determined by a colorimetric assay. The levels of apoptosis-related proteins including Bcl-2, p-Akt, p53, and Bax were determined using western blot analyses, and the mRNA expressions of various pro-inflammatory mediators were measured using quantitative real-time PCR.ResultsCell viability of RA FLS was significantly decreased by treatment with 10 or more μM of gallic acid. Gallic acid treatment at the concentrations that do not affect cell viability (0.1 and 1 μM) induced cellular apoptosis of RA FLS. Treatment with 0.1 and 1 μM of gallic acid also resulted in a significant increase in caspase-3 activity and regulated the productions of Bcl-2, Bax, p53 and pAkt. The mRNA expression levels of pro-inflammatory cytokines (IL-1β, IL-6), chemokines (CCL-2/MCP-1, CCL-7/MCP-3), cyclooxygenase-2, and matrix metalloproteinase-9 from RA FLS were suppressed by the gallic acid treatment in dose-dependent manners.ConclusionGallic acid treatment was found to induce apoptosis of RA FLS through regulation of apoptosis-related protein expressions and to reduce the expression of pro-inflammatory genes in RA FLS. These data suggest that pro-apoptotic and anti-inflammatory activities of gallic acid may be used as a possible therapeutic option for RA.     

Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates

Objective

The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity.

Methods

A total of 168 premature neonates whose birth weight ≤1500 g or gestational age ≤34 weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed.

Results

In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10).

Conclusion

Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.     

Protective humoral immune response induced by an inactivated porcine reproductive and respiratory syndrome virus expressing the hypo-glycosylated glycoprotein 5

Porcine reproductive and respiratory syndrome (PRRS) causes significant economic losses to the swine industry worldwide. Although inactivated and live vaccines are commercially available for the control of PRRS, both types of vaccine have not always proven successful in terms of generating a protective immune response, particularly in the case of inactivated vaccines. In this study, we tested whether an inactivated vaccine could induce a humoral immune response to PRRS during a homologous challenge. Amino acid substitutions were introduced into glycoprotein (GP) 5 of the FL12 strain of the PRRS virus (PRRSV) using site-directed mutagenesis with a pFL12 infectious clone. The substitutions led to double deglycosylation in the putative glycosylation moieties on GP5. The mutant virus was subsequently inactivated with binary ethylenimine. The efficacy of the inactivated mutant virus was compared with that of the inactivated wild-type PRRSV. Only the inactivated mutant PRRSV induced serum neutralizing antibodies at six weeks post-vaccination. The group that was administered the inactivated mutant virus twice exhibited a significantly increased neutralizing antibody titer after a challenge with the virulent homologous strain and exhibited more rapid clearing of viremia compared to other groups, including the groups that were administered either the inactivated mutant or wild-type virus only once and the group that was administered the inactivated wild-type virus twice. Histopathological examination of lung tissue sections revealed that the group that was administered the inactivated mutant virus twice exhibited significantly thinner alveolar septa, whereas the thickness of the alveolar septa of the other groups were markedly increased due to lymphocyte infiltration. These results indicated that the deglycosylation of GP5 enhanced the immunogenicity of the inactivated mutant PRRSV and that twice administrations of the inactivated mutant virus conferred better protection against the homologous challenge. These findings suggest that the inactivated PRRSV that expresses a hypo-glycosylated GP5 is a potential inactivated vaccine candidate and a valuable tool for controlling PRRS for the swine industry.     

Shear Performance of RC Beams Reinforced with Fe-Based Shape Memory Alloy Stirrups

In this study, the shear performance of a reinforced concrete (RC) beam with Fe-based shape memory alloy (Fe-SMA) stirrups was evaluated experimentally and analytically. Five specimens that had a possibility of shear failure under four-point loading were prepared. The major experimental variables were the spacings (300 and 200 mm) between the Fe-SMA stirrups and whether the stirrups were activated or non-activated. The shear strength of the specimen reinforced with the Fe-SMA stirrups at a spacing of 200 mm was 27.1% higher than that of the specimen reinforced at a spacing of 300 mm. The activation of the Fe-SMA stirrups, which produced active confining pressure, increased the shear strength by up to 7.6% and decreased the number of shear cracks compared to the case of the non-activated specimen. Therefore, the use of Fe-SMA stirrups could significantly improve the usability of concrete members by increasing their shear strength and initial stiffness and by controlling crack formation. Furthermore, finite element method (FEM) analysis was conducted using LS-DYNA, a commercial software program, to predict the shear performance of the RC beam reinforced with the Fe-SMA stirrups. The ultimate load and displacement of each specimen were predicted with errors less than 1.4 and 9.4%, respectively. Furthermore, the FEM predicted the change in failure mode and the stiffness improvement due to the activation of the Fe-SMA stirrups. Therefore, the proposed finite element analysis model can effectively predict the behavior of an RC beam reinforced with Fe-SMA stirrups.