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These citations are obtained from the National Library of Medicine's PubMed Database
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Direct labeling and visualization of blood vessels with lipophilic carbocyanine dye DiI.
Nat Protoc. 2008;3(11):1703-8
Authors: Li Y, Song Y, Zhao L, Gaidosh G, Laties AM, Wen R
We describe a protocol to rapidly and reliably visualize blood vessels in experimental animals. Blood vessels are directly labeled by cardiac perfusion using a specially formulated aqueous solution containing 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI), a lipophilic carbocyanine dye, which incorporates into endothelial cell membranes upon contact. By lateral diffusion, DiI also stains membrane structures, including angiogenic sprouts and pseudopodial processes that are not in direct contact. Tissues can be immediately examined by conventional and confocal fluorescence microscopy. High-quality serial optical sections using confocal microscopy are obtainable from thick tissue sections, especially at low magnification, for three-dimensional reconstruction. It takes less than 1 h to stain the vasculature in a whole animal. Compared with alternative techniques to visualize blood vessels, including space-occupying materials such as India ink or fluorescent dye-conjugated dextran, the corrosion casting technique, endothelial cell-specific markers and lectins, the present method simplifies the visualization of blood vessels and data analysis.
PMID: 18846097 [PubMed - in process]
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Construction-related Differences Seen in Ureteral Access Sheaths: Comparison of Reinforced Versus Nonreinforced Ureteral Access Sheaths.
Urology. 2008 Oct 7;
Authors: Shields JM, Tunuguntla HS, Bhalani VK, Ayyathurai R, Bird VG
OBJECTIVES: Ureteral access sheaths (UASs) are used to facilitate ureteroscopic procedures. Difficulties with use have been reported. Manufacturers have redesigned these devices to ameliorate these problems, including reinforcement of the sheath wall. This study compared reinforced (RUASs) and nonreinforced UASs (NRUASs) of the same manufacturer to determine whether RUASs expedite ureteroscopy and how relevant the reinforced structure is in terms of overall success. METHODS: We prospectively followed up patients undergoing ureteroscopy for urolithiasis with 1 of 2 UASs; the Applied NRUAS and the Applied RUAS. The demographics, operative parameters, and outcomes were assessed. Statistical analysis was performed. RESULTS: A total of 98 UASs were used in 68 male and 30 female patients (47 NRUASs and 51 RUASs). No significant differences were found between the groups in terms of demographic parameters, operative parameters, or successful sheath deployment. The overall success rate for sheath deployment was 95%. A pre-existing stent was significantly associated with successful deployment (P = .004). The sheath-specific limitations included kinking (NRUASs, 10%) and sheath angulation/deformity (RUASs, 21%). The mean follow-up time was 43.4 months; and 93.9% of the patients had radiologic follow-up. No ureteral strictures were noted. CONCLUSIONS: No significant difference was found in the overall success rates between the use of Applied NRUASs and RUASs. The presence of a pre-existing stent was significantly associated with successful sheath deployment. Each UAS design had its own unique limitations, seen with low frequency. Successful sheath use might relate to both the sheath itself and the patient/operative parameters.
PMID: 18845320 [PubMed - as supplied by publisher]
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Collaborative Practice - A Collaborative Approach to Providing Care for HIV-Infected Adolescents.
J Spec Pediatr Nurs. 2008 Oct;13(4):295-6
Authors: Major-Wilson H, Sanchez K, Maturo D
PMID: 18844948 [PubMed - in process]
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Effects of leptin on lipid metabolism.
Horm Metab Res. 2008 Aug;40(8):572-4
Authors: Paz-Filho GJ, Ayala A, Esposito K, Erol HK, Delibasi T, Hurwitz BE, Barry EH, Wong ML, Licinio J
PMID: 18622890 [PubMed - indexed for MEDLINE]
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Role of the lens capsule on the mechanical accommodative response in a lens stretcher.
Invest Ophthalmol Vis Sci. 2008 Oct;49(10):4490-6
Authors: Ziebarth NM, Borja D, Arrieta E, Aly M, Manns F, Dortonne I, Nankivil D, Jain R, Parel JM
PURPOSE: To determine whether changes in elastic properties of the lens capsule ex vivo with age contribute to the forces necessary for accommodation. METHODS: Postmortem human (n = 22; age average: 41 +/- 17 years; range: 6-7) and cynomolgus monkey (n = 19; age average: 7.7 +/- 1.8 years, range: 4.2-10) tissues including the lens, capsule, zonules, ciliary body, and sclera were mounted in an optomechanical lens-stretching system. Starting at 0 load, the sclera was symmetrically stretched to 2 mm in 0.25-mm steps at a speed of 0.1 mm x s(-1). The load and lens diameter were measured at each step. The lens contents were removed through a mini-capsulorhexis. The stretching cycles were repeated on the empty capsular bag. The forces necessary to stretch the natural lens and empty bag were quantified as a function of age and compared. RESULTS: The force needed to stretch the empty lens capsule was independent of age (human, 2.6-34.9 g/mm [25.2-342.7 mN/mm]; monkey, 8.2-21.3 g/mm [80.3-208.6 mN/mm]). The ratio of the force necessary to stretch the empty lens capsule to the force necessary to stretch the natural lens decreased with age in the human and monkey lenses (P = 0.003, P = 0.72, respectively). CONCLUSIONS: The mechanical properties of the empty lens capsule assessed ex vivo in a lens stretcher remain constant with age, suggesting that the changes in elasticity of the lens capsule do not play a significant role in presbyopia. In young eyes, the lens capsule determines the force necessary to stretch the whole lens. The age-related increase in force needed to stretch the lens is due to changes in the lens contents.
PMID: 18515568 [PubMed - indexed for MEDLINE]
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Local Recurrence of Disease after Unplanned Excisions of High-grade Soft Tissue Sarcomas.
Clin Orthop Relat Res. 2008 Sep 26;
Authors: Potter BK, Adams SC, Pitcher JD, Temple HT
Unplanned excisions of soft tissue sarcomas occur with alarming frequency and result in high rates of residual disease, potentially affecting patient prognosis. To determine if unplanned excisions and residual disease status at tumor bed excision increased local recurrence rates and predicted disease-specific patient survival, we retrospectively reviewed 203 consecutive patients with high-grade soft tissue sarcomas treated operatively and followed for at least 2 years (mean, 4.8 years) or until patient death. Among the 64 patients (32%) who had undergone previous unplanned excisions, six had gross residual disease and 40 of the remaining 58 (69%) had microscopic residual disease in the tumor bed. We observed subsequent local recurrence in nine of the 139 patients (6%) after planned excision compared with 22 patients (34%) after unplanned excision. More patients with unplanned excisions who underwent limb salvage procedures required flap coverage and/or skin grafting with their definitive resection (30% versus 5%). In the unplanned excision cohort, residual disease status at tumor bed excision predicted increased rates of local recurrence and decreased disease-specific survival. Unplanned excisions of high-grade soft tissue sarcomas resulted in increased rates of local recurrence but not disease-specific survival. Residual disease at reexcision predicted the likelihood of local recurrence. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
PMID: 18818981 [PubMed - as supplied by publisher]
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Dexamethasone Base Conserves Hearing from Electrode Trauma-Induced Hearing Loss.
Laryngoscope. 2008 Sep 24;
Authors: Vivero RJ, Joseph DE, Angeli S, He J, Chen S, Eshraghi AA, Balkany TJ, Van De Water TR
OBJECTIVE/HYPOTHESIS:: Local treatment of the cochlea after electrode insertion trauma with dexamethasone base conserves hearing against trauma-induced loss. STUDY DESIGN:: Laboratory animal study. METHODS:: A guinea pig model of electron insertion trauma (EIT)-induced hearing loss (HL) used 44 guinea pigs sub-divided into four groups: 1) unoperated, controls (Controls, n = 44); 2) EIT, untreated (EIT, n = 15); 3) EIT plus artificial perilymph (EIT + AP, n = 15); and 4) EIT plus dexamethasone base (EIT + DXMb, n = 14). Cochleae that received EIT were randomly selected with contralateral, unoperated cochleae as internal controls. Auditory brainstem responses (ABRs) in response to 0.5 to 16 kHz pure tones were obtained before surgery, immediately after surgery (0 day), and on post-EIT days 3, 7, 14, and 30. Hair cell counts were obtained from stained organ of Corti specimens from all four groups (n = 3/group). Data were analyzed using analysis of variance and a Tukey-Kramer honestly significant difference post hoc test with significance alpha set at <0.05 (hearing) and <0.001 (hair cells). RESULTS:: There were significant differences (<0.05) between the ABR thresholds of unoperated (control) and contralateral operated (experimental) ears of EIT and of EIT + AP groups for all tested frequencies. There was no statistical difference (>0.05) in ABR thresholds in the EIT + DXMb versus control groups for 0.5 to 4 kHz tones. DXMb treatment protected hair cells from EIT-induced damage and loss while AP treatment did not. CONCLUSION:: The absence of significant differences in hearing thresholds between the EIT + DXMb group and control ears in response to 0.5 to 4 kHz tones demonstrates that DXMb is as effective as the aqueous form of dexamethasone in conserving hearing against EIT-induced loss.
PMID: 18818553 [PubMed - as supplied by publisher]
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Biopolymer-released dexamethasone prevents tumor necrosis factor alpha-induced loss of auditory hair cells in vitro: implications toward the development of a drug-eluting cochlear implant electrode array.
Otol Neurotol. 2008 Oct;29(7):1012-9
Authors: Dinh C, Hoang K, Haake S, Chen S, Angeli S, Nong E, Eshraghi AA, Balkany TJ, Van De Water TR
HYPOTHESIS: Polymer-eluted dexamethasone (DXM) will retain its ability to protect against tumor necrosis factor alpha (TNFalpha)-induced hair cell (HC) loss. BACKGROUND: TNFalpha has been shown to be associated with trauma-induced hearing loss. DXM has been demonstrated to protect the cochlea against trauma-induced hearing loss. DXM is currently administered either systemically or locally to treat patients with sudden hearing loss of unknown cause. METHODS: P-3 organ of Corti explants challenged with an ototoxic level of TNFalpha was the experimental system, and the base form of DXM (DXMb) incorporated into a biorelease polymer (i.e., SIBS) was the otoprotection molecule tested. The efficacy of otoprotection was determined by counts of fluorescein isothiocyanate-phalloidin-stained HCs and changes in gene expression. RESULTS: HC counts show 1) SIBS alone did not protect HCs from TNFalpha ototoxicity (SIBS versus SIBS + TNFalpha; p < 0.001), and 2) SIBS with DXMb provides a significant level of protection against TNFalpha-induced loss of HCs (TNFalpha + SIBS versus TNFalpha + SIBS/DXMb, 299 mug; p < 0.001). Gene expression results show that polymer-eluted DXMb 1) upregulates antiapoptotic genes (i.e., Bcl-2, Bcl-xl) and downregulates a proapoptotic gene (i.e., Bax) in TNFalpha-challenged explants and 2) downregulates TNFR1 in these explants. CONCLUSION: Polymer-eluted DXMb retains its otoprotection capabilities in our in vitro test system of TNFalpha-challenged organ of Corti explants by altering the pattern of gene expression to favor survival of TNFalpha-exposed HCs. These results, although in vitro, support the application of polymer containing DXMb to electrode arrays for the conservation of hearing during cochlear implantation.
PMID: 18818545 [PubMed - in process]
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Longitudinal relationships between cognitive functioning and depressive symptoms among Hispanic older adults.
J Gerontol B Psychol Sci Soc Sci. 2008 Sep;63(5):P309-17
Authors: Perrino T, Mason CA, Brown SC, Spokane A, Szapocznik J
This study examines the relationship between cognitive functioning and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between depressive symptoms and cognitive functioning over time and by examining the relationship between these variables among Hispanics, an understudied population at risk of developing depressive symptoms and cognitive impairments. Structural equation modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent cognitive functioning. However, cognitive functioning was related to subsequent depressive symptoms at every time point, such that poorer cognitive functioning was related to higher depressive symptoms. Findings suggest that cognitive declines may predict depressive symptoms in community-dwelling Hispanic older adults.
PMID: 18818446 [PubMed - in process]
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The Origin of Post-Injury Neointimal Cells in the Rat Balloon Injury Model.
Cardiovasc Res. 2008 Sep 25;
Authors: Rodriguez-Menocal L, St Pierre M, Wei Y, Khan S, Mateu D, Calfa M, Rahnemai-Azar AA, Striker G, Pham S, Vazquez-Padron RI
AIMS: The origin of post-injury neointimal cells is still a matter of debate. This study aims to determine the anatomic source of neointimal cells in one of the most important animal models for the study of vascular stenosis in response to injury, the rat balloon injury model. Methods and Results Chimeric rats were generated by rescuing lethally irradiated animals with green fluorescent protein (GFP)(+) bone marrow cells (BM) from transgenic rats. Neointimal formation was induced in the right iliac artery of these animals using a balloon angioplasty catheter. Injured and non-injured contra lateral arteries were harvested at 7, 14 and 30 days post-surgery. Bone marrow-derived monocytes /macrophages (CD68(+) GFP(+)) were abundant in the media and adventitia of injured vessels harvested at 7 days as determined by immunofluorescence and confocal microscopy. The number of GFP(+) cells declined in the vascular wall with time. Post-injury neointimal cells were mostly GFP(-)/ smooth muscle actin (SMA)(+), which indicated that those cells originated in the recipient. Only a few neointimal cells seemed to come from circulating progenitors (GFP(+) SMA(+), 2.34 %+/-1.61). The vascular origin of cells in the neointima was further confirmed by transplanting injured GFP arteries into wild-type recipients. In these grafts 94.23+/-0.44 % of medial and 92.95+/-19.34 % of neointimal cells were GFP(+) SMA(+). Finally, we tested the capacity of vascular smooth muscle cells (VSMC) to migrate through the vascular wall using a novel in vivo assay. As expected, VSMC migrated and populated the neointima only in response to injury. CONCLUSION: Our results suggest that neointimal cells in the rat balloon injury model mostly derive from pre-existing vascular cells and that only a small population of those cells come from BM-derived progenitors.
PMID: 18818213 [PubMed - as supplied by publisher]
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Generation of the 40-Hz auditory steady-state response (ASSR) explained using convolution.
Clin Neurophysiol. 2008 Sep 23;
Authors: Bohórquez J, Ozdamar O
OBJECTIVE: In this study, the superposition theory of the 40-Hz auditory steady-state response (ASSR) generation is investigated using auditory brainstem response (ABR) and middle latency responses (MLRs) obtained with 40Hz jittered sequences with the continuous loop averaging deconvolution (CLAD) algorithm. METHODS: Click sequences at around 40Hz with high (maximum length sequence), medium and low jitters were presented to normal hearing awake adult subjects monaurally. Overlapping MLR responses were deconvolved using the frequency domain CLAD method. In addition, conventional auditory MLRs at 4.88Hz and ASSRs at 39.1Hz were obtained in all subjects. Synthetic ASSRs were constructed using different rate and jitter MLRs as base recordings. Contributions of the primary components were investigated by wave elimination using phasors. RESULTS: Findings indicate that the generation of the 40-Hz ASSRs can be explained successfully by the superposition of the ABR and MLR waves generated at that stimulation rate. N(a)-P(a) and N(b)-P(b) components of the MLR contribute about equally (45% each), while the wave V of the ABR contributes a lesser amount (10%). CONCLUSIONS: Forty-Hertz ASSRs are composite responses generated by the superposition of the major waves of the ABR and the MLR. Dramatic amplitude increase of the ASSR at 40Hz is primarily due to the superposition of the resonating P(b) component to the P(a) wave. SIGNIFICANCE: Several unexplained properties of the 40-Hz ASSR can be explained by the stimulus and brain state dependent characteristics of the slow ABR, the P(a) and the P(b) components of the MLR.
PMID: 18818122 [PubMed - as supplied by publisher]
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A confirmatory study of rating scale category effectiveness for the Coaching Efficacy Scale.
Res Q Exerc Sport. 2008 Sep;79(3):300-11
Authors: Myers ND, Feltz DL, Wolfe EW
This study extended validity evidence for measures of coaching efficacy derived from the Coaching Efficacy Scale (CES) by testing the rating scale categorizations suggested in previous research. Previous research provided evidence for the effectiveness of a four-category (4-CAT) structure for high school and collegiate sports coaches; it also suggested that a five-category (5-CAT) structure may be effective for youth sports coaches, because they may be more likely to endorse categories on the lower end of the scale. Coaches of youth sports (N = 492) responded to the CES items with a 5-CAT structure. Across rating scale category effectiveness guidelines, 32 of 34 evidences (94%) provided support for this structure. Data were condensed to a 4-CAT structure by collapsing responses in Category 1 (CAT-1) and Category 2 (CAT-2). Across rating scale category effectiveness guidelines, 25 of 26 evidences (96%) provided support for this structure. Findings provided confirmatory, cross-validation evidence for both the 5-CAT and 4-CAT structures. For empirical, theoretical, and practical reasons, the authors concluded that the 4-CAT structure was preferable to the 5-CAT when CES items are used to measure coaching efficacy. This conclusion is based on the findings of this confirmatory study and the more exploratory findings of Myers, Wolfe, and Feltz (2005).
PMID: 18816941 [PubMed - in process]
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Temporal and spatial expression of collagens during murine atrioventricular heart valve development and maintenance.
Dev Dyn. 2008 Sep 24;237(10):3051-3058
Authors: Peacock JD, Lu Y, Koch M, Kadler KE, Lincoln J
Heart valve function is achieved by organization of matrix components including collagens, yet the distribution of collagens in valvular structures is not well defined. Therefore, we examined the temporal and spatial expression of select fibril-, network-, beaded filament-forming, and FACIT collagens in endocardial cushions, remodeling, maturing, and adult murine atrioventricular heart valves. Of the genes examined, col1a1, col2a1, and col3a1 transcripts are most highly expressed in endocardial cushions. Expression of col1a1, col1a2, col2a1, and col3a1 remain high, along with col12a1 in remodeling valves. Maturing neonate valves predominantly express col1a1, col1a2, col3a1, col5a2, col11a1, and col12a1 within defined proximal and distal regions. In adult valves, collagen protein distribution is highly compartmentalized, with ColI and ColXII observed on the ventricular surface and ColIII and ColVa1 detected throughout the leaflets. Together, these expression data identify patterning of collagen types in developing and maintained heart valves, which likely relate to valve structure and function. Developmental Dynamics 237:3051-3058, 2008. (c) 2008 Wiley-Liss, Inc.
PMID: 18816857 [PubMed - as supplied by publisher]
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What are toll-like receptors and what role may they have in IBD?
Inflamm Bowel Dis. 2008 Sep 24;14(S2):S90-S92
Authors: Fukata M, Abreu MT
PMID: 18816733 [PubMed - as supplied by publisher]
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To preserve and strengthen medicare.
Med Care. 2008 Oct;46(10):1017-9
Authors: Socolar SJ
PMID: 18815521 [PubMed - in process]
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Suppression of renin-angiotensin gene expression in the kidney by paricalcitol.
Kidney Int. 2008 Aug 27;
Authors: Freundlich M, Quiroz Y, Zhang Z, Zhang Y, Bravo Y, Weisinger JR, Li YC, Rodriguez-Iturbe B
The renal renin-angiotensin system plays a major role in determining the rate of chronic renal disease progression. Treatment with activators of the vitamin D receptor retards the progression of experimental chronic renal disease, and vitamin D is known to suppress the renin-angiotensin system in other organs. Here we determined if the beneficial effects of paricalcitol (19-nor 1,25-dihydroxyvitamin D(2)) were associated with suppression of renin-angiotensin gene expression in the kidney. Rats with the remnant kidney model of chronic renal failure (5/6 nephrectomy) were given two different doses of paricalcitol thrice weekly for 8 weeks. Paricalcitol was found to decrease angiotensinogen, renin, renin receptor, and vascular endothelial growth factor mRNA levels in the remnant kidney by 30-50 percent compared to untreated animals. Similarly, the protein expression of renin, renin receptor, the angiotensin type 1 receptor, and vascular endothelial growth factor were all significantly decreased. Glomerular and tubulointerstitial damage, hypertension, proteinuria, and the deterioration of renal function resulting from renal ablation were all similarly and significantly improved with both treatment doses. These studies suggest that the beneficial effects of vitamin D receptor activators in experimental chronic renal failure are due, at least in part, to down-regulation of the renal renin-angiotensin system.Kidney International advance online publication, 27 August 2008; doi:10.1038/ki.2008.408.
PMID: 18813285 [PubMed - as supplied by publisher]
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Anthropometry of the external ear in children with cleft lip and palate in comparison to age-matched controls.
J Craniofac Surg. 2008 Sep;19(5):1391-5
Authors: Nathan N, Latham K, Cooper J, Perlyn C, Gozlan I, Thaller SR
Comprehensive anthropometric measures in children with cleft lip (CL) and cleft palate (CP) have suggested that similar qualitative growth disturbances may be present in the auricle. We propose a study to evaluate and better understand auricular development in nonsyndromic children born with CL/CP. Our institution is a tertiary referral center for children with craniofacial anomalies. During a 4-year period, we randomly selected 50 nonsyndromic children, aged 5 to 18 years, with CL or CP. Fifty age-matched control children without craniofacial anomalies were selected as a control group. Anthropometric measurement analysis was conducted to compare auricular length (sa-sba), width (pra-pa), attachment to the cranium (obs-obi), and degree protrusion. Auricular index was also calculated for each group. Using a multivariate analysis of variance, statistical analysis with a P < 0.001 demonstrates group differences when comparing ear length and ear protrusion in nonsyndromic children with CL/CP to age-matched controls. Ear length was greater in the control group, whereas ear protrusion (distance from the mastoid process to helical rim) was found to be decreased in the experimental group. Age and sex did not demonstrate significant differences in ear protrusion or length between the control and experimental groups. In nonsyndromic children with CL/CP, greater sensitivity should be given to the timing of auricular surgery. Comparisons of age-matched auricular measurements suggest that ear development may be altered in children with CL or CP. Further research is needed to investigate anthropological differences between nonsyndromic children with cleft and the normal population.
PMID: 18812870 [PubMed - in process]
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Prevalence and impact of depression in cystic fibrosis.
Curr Opin Pulm Med. 2008 Nov;14(6):582-8
Authors: Quittner AL, Barker DH, Snell C, Grimley ME, Marciel K, Cruz I
PURPOSE OF REVIEW: Numerous studies have demonstrated that patients with chronic illnesses are at an increased risk for depression, with serious direct and indirect consequences for health outcomes. The few studies examining rates of depression in patients with cystic fibrosis (CF) or parent caregivers have found clinically significant elevations. Given the importance of identifying and treating symptoms of depression, the purpose of this review was to highlight recent data on the prevalence and impact of depression in CF patients and to propose recommendations for screening and treatment. RECENT FINDINGS: Recent studies in CF have revealed higher rates of depression in children, adolescents, adults, and parent caregivers than in healthy populations. Evidence also suggests that depression has negative effects on treatment adherence, family functioning, and health-related quality of life. Briefly, well validated screening tools for depression are available but are not currently utilized in routine CF care. Effective psychological and pharmacological interventions are available to treat depression, but have not yet been evaluated in patients with CF. SUMMARY: Depression is a significant risk factor for the effective management of CF. Screening and treatment of depression in CF centers is recommended and holds promise for improving social, emotional, and physical health outcomes.
PMID: 18812836 [PubMed - in process]
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Initial experience with the TandemHeart circulatory support system in children.
ASAIO J. 2008 Sep-Oct;54(5):542-5
Authors: Ricci M, Gaughan CB, Rossi M, Andreopoulos FM, Novello C, Salerno TA, Rosenkranz ER, Panos AL
Options for mechanical ventricular assistance in pediatric patients are limited. Extracorporeal membrane oxygenation is used in most cases for short-term support. The TandemHeart circulatory support system is an established device that is used in adult patients to provide short-term ventricular support. In this article, we report three children in whom a TandemHeart ventricular assist device was used for right ventricular support, two after heart transplantation and another for failed Fontan physiology. Herein, we report the novel application of this technology to pediatric patients, and we discuss the lessons learned from its utilization.
PMID: 18812750 [PubMed - in process]
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Identification of two conserved aspartic acid residues required for DNA digestion by a novel thermophilic Exonuclease VII in Thermotoga maritima.
Nucleic Acids Res. 2008 Sep 23;
Authors: Larrea AA, Pedroso IM, Malhotra A, Myers RS
Exonuclease VII was first identified in 1974 as a DNA exonuclease that did not require any divalent cations for activity. Indeed, Escherichia coli ExoVII was identified in partially purified extracts in the presence of EDTA. ExoVII is comprised of two subunits (XseA and XseB) that are highly conserved and present in most sequenced prokaryotic genomes, but are not seen in eukaryotes. To better understand this exonuclease family, we have characterized an ExoVII homolog from Thermotoga maritima. Thermotoga maritima XseA/B homologs TM1768 and TM1769 were co-expressed and purified, and show robust nuclease activity at 80 degrees C. This activity is magnesium dependent and is inhibited by phosphate ions, which distinguish it from E. coli ExoVII. Nevertheless, both E. coli and T. maritima ExoVII share a similar putative active site motif with two conserved aspartate residues in the large (XseA/TM1768) subunit. We show that these residues, Asp235 and Asp240, are essential for the nuclease activity of T. maritima ExoVII. We hypothesize that the ExoVII family of nucleases can be sub-divided into two sub-families based on EDTA resistance and that T. maritima ExoVII is the first member of the branch that is characterized by EDTA sensitivity and inhibition by phosphate.
PMID: 18812402 [PubMed - as supplied by publisher]
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Tumor volume reduction using combined phacoemulsification and intravitreal triamcinolone injection for the management of cataract with treated uveal melanoma and atypical nevi.
J Cataract Refract Surg. 2008 Oct;34(10):1669-73
Authors: Cebulla CM, Alegret AM, Feuer WJ, Shi W, Schefler AC, Murray TG
PURPOSE: To study the reduction in tumor size and the safety and efficacy of combined phacoemulsification and intravitreal triamcinolone acetonide injection (phaco-IVTA) in patients with treated melanoma and atypical nevi. SETTING: Bascom Palmer Eye Institute, Miami, Florida, USA. METHODS: The medical records of 49 consecutive patients (51 eyes) with treated melanoma or atypical nevi treated with phaco-IVTA were evaluated retrospectively for changes in Snellen visual acuity, tumor volume, and frequency of complications. Main outcome measures included a postsurgical change in tumor size greater than or equal to 0.5 mm of height or 1.0 mm of basal diameter by echographic analysis, improvement in visual acuity at 6 months and final follow-up, and complications including endophthalmitis, cystoid macular edema, epiretinal membrane, increased intraocular pressure, and persistent corneal edema. RESULTS: The median baseline visual acuity was 20/80 in the affected eye. At the 6-month follow-up examination, 13 (68%) of 19 eyes had achieved better than 20/40 visual acuity. Treated uveal melanomas (n = 30) and atypical choroidal nevi (n = 21) were stable with combined therapy, and echographic measurements improved in 12 eyes. Intraocular pressure increased from baseline to 25 mm Hg or more postoperatively in 4 of 51 eyes (8%). No other significant complications occurred. CONCLUSIONS: Combined phacoemulsification and IVTA was reasonably safe in patients with treated melanoma and atypical nevi. Tumors remained stable or decreased slightly in size. Intravitreal triamcinolone acetonide injection at the time of cataract surgery in patients with treated melanoma or nevus may reduce rates of tumor progression in these patients.
PMID: 18812116 [PubMed - in process]
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A single percutaneous access and flexible nephroscopy is the best treatment for a full staghorn calculus.
J Endourol. 2008 Sep;22(9):1835-7; discussion 1839
Authors: Williams SK, Leveillee RJ
PMID: 18811459 [PubMed - in process]
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Visual disengagement in the infant siblings of children with an autism spectrum disorder (ASD).
Autism. 2008 Sep;12(5):473-85
Authors: Ibanez LV, Messinger DS, Newell L, Lambert B, Sheskin M
Children with autism spectrum disorders (ASDs) are impaired in visually disengaging attention in both social and non-social contexts. These impairments may, in subtler form, also affect the infant siblings of children with ASD (ASD-sibs). We investigated patterns of visual attention (gazing) in 6-month-old ASD-sibs (n = 17) and the siblings of typically developing children (COMP-sibs: n =17) during the Face-to-Face/Still-Face Protocol (FFSF), in which parents are sequentially responsive, non-responsive, and responsive to their infants. Throughout the protocol, ASD-sibs shifted their gaze to and from their parents' faces less frequently than did COMP-sibs. The mean durations of ASD-sibs' gazes away from their parents' faces were longer than those of COMP-sibs. ASD-sibs and COMP-sibs did not differ in the mean durations of gazes at their parents' faces. In sum, ASD-sibs showed no deficits in visual interest to their parents' faces, but greater interest than COMP-sibs in non-face stimuli.
PMID: 18805943 [PubMed - in process]
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Stress management effects on perceived stress and cervical neoplasia in low-income HIV-infected women.
J Psychosom Res. 2008 Oct;65(4):389-401
Authors: Antoni MH, Pereira DB, Marion I, Ennis N, Andrasik MP, Rose R, McCalla J, Simon T, Fletcher MA, Lucci J, Efantis-Potter J, O'Sullivan MJ
OBJECTIVE: Risk for developing cervical neoplastic disease is greatly increased in women infected with oncogenic sexually transmitted human papillomaviruses (HPVs) and who have lowered cellular immunity due to coinfection with human immunodeficiency virus (HIV) infection. The majority of these individuals are low-income minority women. Factors associated with promotion of HPV to cervical neoplasia in HIV-infected populations include degree of immunosuppression as well as behavioral factors such as tobacco smoking and psychological stress. This study examined the effects of a cognitive behavioral stress management (CBSM) intervention on life stress and cervical neoplasia in HIV+ minority women. METHODS: Participants were 39 HIV+ African-American, Caribbean, and Hispanic women with a recent history of an abnormal Papanicolaou smear. Participants underwent colposcopic examination, psychosocial interview, and peripheral venous blood draw at study entry and 9 months after being randomly assigned to either a 10-week CBSM group intervention (n=21) or a 1-day CBSM workshop (n=18). RESULTS: Women assigned to the 10-week group-based CBSM intervention reported decreased perceived life stress and had significantly lower odds of cervical neoplasia over a 9-month follow-up. CBSM effects on life stress and neoplasia appeared independent of presence of neoplasia at study entry, HPV type, CD4+CD3+ cell count, HIV viral load, and substance use. Furthermore, CBSM intervention effects on cervical neoplasia were especially pronounced among women with residual life stress at follow-up. CONCLUSION: These findings suggest that stress management decreases perceived life stress and may decrease the odds of cervical neoplasia in women with HIV and a history of abnormal Papanicolaou smears. Although preliminary, these findings suggest the utility of stress management as a cancer prevention strategy in this high-risk population.
PMID: 18805249 [PubMed - in process]
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Interferon-gamma Release Assays in the Diagnosis of Tuberculous Uveitis.
Am J Ophthalmol. 2008 Oct;146(4):486-8
Authors: Albini TA, Karakousis PC, Rao NA
PMID: 18804561 [PubMed - in process]
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Arrhythmias in Children Having a Single Left Superior Vena Cava and Minimal Structural Heart Disease.
J Cardiovasc Electrophysiol. 2008 Sep 17;
Authors: Ratnasamy C, Idriss SF, Carboni MP, Kanter RJ
Background: The presence of a single left superior vena cava in the absence of complex congenital heart disease is uncommon, and, in the absence of hemodynamic consequences, it would not be expected to result in cardiovascular signs or symptoms. Single case reports and our anecdotal experience suggested to us that this anomaly is highly associated with cardiac arrhythmias. Objective: We sought to describe the clinically important arrhythmias in a population of young patients having this anomaly. Methods: A retrospective chart review was performed from all patients <20 years old and who were determined by echocardiography over an 11-year-period to have a single left superior vena cava and minor or no coexisting congenital heart defects. The prevalence of nonsinus pacemaker, age-corrected sinus rate percentile, and prevalence of brady- or tachyarrhythmias was compared with a control group of patients having bilateral superior vena cavae. Results: Eight patients having a single left and 55 patients having bilateral superior vena cava(e) were identified. The existence of this anomaly tended to be associated with a lower age-corrected sinus rate percentile (17.5% vs 75%, P = 0.09), and was associated with a higher prevalence of arrhythmias (50% vs 7%, P = 0.014) compared with the control group. In the study group, one patient each had clinically relevant sinus node dysfunction, third-degree AV block, Wolff-Parkinson-White syndrome and atrial fibrillation, and AV nodal reentrant tachycardia. Conclusion: Even in the absence of symptoms, patients found to have a single left superior vena cava should be monitored long-term for clinically important arrhythmias.
PMID: 18803560 [PubMed - as supplied by publisher]
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Current management of venous ulcers: an evidence-based review.
Surg Technol Int. 2008;17:77-83
Authors: Herschthal J, Kirsner RS
Chronic venous ulceration is a common and important medical problem that causes significant morbidity. Venous ulcers are expensive to treat, have substantial economic effects in terms of days of work lost, and adversely impact the patient's quality of life. Relying on evidence allows for a rationale of clinical decision making. The objectives of venous ulcer management include the healing of the ulcer, prevention of recurrence, and improvement of edema. Compression is the cornerstone of venous ulcer therapy. Adjunctive modalities such as surgery, growth factors, grafting, biologic skin substitutes, dressings, and oral medication have differing levels of evidence supporting their use, and may also facilitate the healing process.
PMID: 18802885 [PubMed - in process]
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Conflicts of interest in bioethics: a response to our critics.
Am J Bioeth. 2008 Aug;8(8):1-2
Authors: Landy DC, Sharp RR
PMID: 18802847 [PubMed - in process]
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Radiation Therapy for Prostate Cancer Increases Subsequent Risk of Bladder and Rectal Cancer: A Population Based Cohort Study.
J Urol. 2008 Sep 16;
Authors: Nieder AM, Porter MP, Soloway MS
PURPOSE: Pre-prostate specific antigen era series demonstrated an increased risk of bladder cancer and rectal cancer in men who received radiotherapy for prostate cancer. We estimated the risk of secondary bladder cancer and rectal cancer after prostate radiotherapy using a contemporary population based cohort. MATERIALS AND METHODS: We identified 243,082 men in the Surveillance, Epidemiology and End Results database who underwent radical prostatectomy or radiotherapy for prostate cancer between 1988 and 2003. We estimated the incidence rate, standardized incidence ratio and age adjusted incidence rate ratio of subsequent bladder cancer and rectal cancer associated with radical prostatectomy, external beam radiotherapy, brachytherapy, and a combination of external beam radiotherapy and brachytherapy. RESULTS: The relative risk of bladder cancer developing after external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy compared to radical prostatectomy was 1.88, 1.52 and 1.85, respectively. Compared to the general United States population the standardized incidence ratio for bladder cancer developing after radical prostatectomy, external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was 0.99, 1.42, 1.10 and 1.39, respectively. The relative risk of rectal cancer developing after external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy compared to radical prostatectomy was 1.26, 1.08 and 1.21, respectively. The standardized incidence ratio for rectal cancer developing after radical prostatectomy, external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was 0.91, 0.99, 0.68 and 0.86, respectively. CONCLUSIONS: Men who receive radiotherapy for localized prostate cancer have an increased risk of bladder cancer compared to patients undergoing radical prostatectomy and compared to the general population. The risk of rectal cancer is increased in patients who receive external beam radiotherapy compared to radical prostatectomy. Patients should be counseled appropriately regarding these risks.
PMID: 18801517 [PubMed - as supplied by publisher]
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PKA-mediated gating of neuregulin-dependent ErbB2-ErbB3 activation underlies the synergistic action of cAMP on Schwann cell proliferation.
J Biol Chem. 2008 Sep 17;
Authors: Monje PV, Athauda G, Wood PM
In Schwann cells (SCs), cyclic adenosine monophosphate (cAMP) enhances the action of neuregulin, the most potent known mitogen for SCs, by synergistically increasing the activation of two crucial signaling pathways: ERK and Akt. However, the underlying mechanism of cross-talk between neuregulin and cAMP signaling remains mostly undefined. Here, we report that the activation of protein kinase A (PKA), but not that of exchange protein activated by cAMP (EPAC), enhances S-phase entry of SCs by synergistically enhancing the ligand-dependent tyrosine phosphorylation /activation of the neuregulin co-receptor, ErbB2-ErbB3. The role of PKA in neuregulin-ErbB signaling was confirmed using PKA inhibitors, pathway-selective cAMP analogs, and natural ligands stimulating PKA activity in SCs, such as adenosine and epinephrine. Two basic observations defined the synergistic action of PKA as "gating" for neuregulin-ErbB signaling: 1. The activation of PKA was not sufficient to induce S-phase entry or the activation of either ErbB2 or ErbB3. 2. The presence of neuregulin was strictly required to ignite ErbB activation and thereby ERK and Akt signaling. However, PKA directly phosphorylated ErbB2 on Thr-686, a highly conserved intracellular regulatory site which is required for the PKA-mediated synergistic enhancement of neuregulin-induced ErbB2-ErbB3 activation and proliferation in SCs. The gating action of PKA on neuregulin-induced ErbB2-ErbB3 activation has important biological significance because it insures signal amplification into the ERK and Akt pathways without compromising either the neuregulin dependence or the high specificity of ErbB signaling pathways.
PMID: 18799465 [PubMed - as supplied by publisher]
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Novel combination strategies to repair the injured mammalian spinal cord.
J Spinal Cord Med. 2008;31(3):262-9
Authors: Bunge MB
Due to the varied and numerous changes in spinal cord tissue following injury, successful treatment for repair may involve strategies combining neuroprotection (pharmacological prevention of some of the damaging intracellular cascades that lead to secondary tissue loss), axonal regeneration promotion (cell transplantation, genetic engineering to increase growth factors, neutralization of inhibitory factors, reduction in scar formation), and rehabilitation. Our goal has been to find effective combination strategies to improve outcome after injury to the adult rat thoracic spinal cord. Combination interventions tested have been implantation of Schwann cells (SCs) plus neuroprotective agents and growth factors administered in various ways, olfactory ensheathing cell (OEC) implantation, chondroitinase addition, or elevation of cyclic AMP. The most efficacious strategy in our hands for the acute complete transection/SC bridge model, including improvement in locomotion [Basso, Beattie, Bresnahan Scale (BBB)], is the combination of SCs, OECs, and chondroitinase administration (BBB 2.1 vs 6.6, 3 times more myelinated axons in the SC bridge, increased serotonergic axons in the bridge and beyond, and significant correlation between the number of bridge myelinated axons and functional improvement). We found the most successful combination strategy for a subacute spinal cord contusion injury (12.5-mm, 10-g weight, MASCIS impactor) to be SCs and elevation of cyclic AMP (BBB 10.4 vs 15, significant increases in white matter sparing, in myelinated axons in the implant, and in responding reticular formation and red and raphe nuclei, and a significant correlation between the number of serotonergic fibers and improvement in locomotion). Thus, in two injury paradigms, these combination strategies as well as others studied in our laboratory have been found to be more effective than SCs alone and suggest ways in which clinical application may be developed.
PMID: 18795474 [PubMed - in process]
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Renin-angiotensin system blockade and diabetes: moving the adipose organ from the periphery to the center.
Kidney Int. 2008 Oct;74(7):851-3
Authors: Lenz O, Fornoni A
Lee et al. report that an angiotensin II type 1 receptor blocker (ARB) improved glucose intolerance in OLETF rats, an experimental model of type 2 diabetes. ARB treatment resulted in modulation of the adipose tissue, leading to an increased number of small, differentiated adipocytes able to produce more adiponectin and less monocyte chemoattractant protein-1 and plasminogen activator inhibitor-1. This supports the relevance of the functional interplay between adipose tissue and the renin-angiotensin system in states of insulin resistance.
PMID: 18794817 [PubMed - in process]
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Cutaneous tumors, massive lymphadenopathy, and secondary lymphedema in a 16-year-old boy--quiz case. African/endemic Kaposi sarcoma (KS): lymphadenopathic form.
Arch Dermatol. 2008 Sep;144(9):1217-22
Authors: Patel AR, Charles CA, Ricotti CA, Romanelli P, Connelly EA
PMID: 18794470 [PubMed - in process]
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Psoriasis in the patient with human immunodeficiency virus, part 1: review of pathogenesis.
Cutis. 2008 Aug;82(2):117-22
Authors: Patel RV, Weinberg JM
Psoriasis is a chronic, immune-mediated skin disease affecting approximately 1% to 3% of the human immunodeficiency virus (HIV)-infected population. The presentation of psoriasis in patients with HIV varies. It either presents as the first clinical manifestation of HIV or, less commonly, appears in the advanced stages of HIV when it has progressed to AIDS. This 2-part series reviews the pathogenesis of HIV-associated psoriasis as well as the various therapeutic regimens that have effectively treated psoriasis in patients with HIV These therapies address the profound immune dysregulation that defines psoriasis. The first part of the series focuses on the pathogenesis of HIV-associated psoriasis.
PMID: 18792543 [PubMed - in process]
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Of cardiovascular illness and diversity of biological response.
Trends Cardiovasc Med. 2008 Jul;18(5):194-7
Authors: Goldschmidt-Clermont PJ, Dong C, West M, Seo DM
Noise in gene expression (stochastic variation in the composition of the transcriptome in response to stimuli) may play an important role in maintaining robustness and flexibility, which ensure the stability of normal physiology and provide adaptability to environmental changes for the living system. Broad-based technologies have allowed us to study with unprecedented accuracy the molecular profiles of various states of health and cardiovascular disease. In doing so, we have observed a correlation between the degree of variation in gene expression and the state of health. Specifically, the stochastic variation in gene expression in response to environmental and physiological factors is found in healthy mice, and tends to disappear in mice with advanced disease states. Although further evidence is needed to draw a solid conclusion with respect to the significance of decreased transcriptional noise in the disease state as a whole, it is tantalizing to introduce the concept that stochasticity may be linked to the organism's adaptability to a changing environment, and the "quiet" states of gene expression may indicate the loss of diversity in the organism's response.
PMID: 18790390 [PubMed - in process]
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Sirolimus: a potential chemopreventive agent.
J Invest Dermatol. 2008 Oct;128(10):2352
Authors: Fernandez A, Hu S, Kirsner RS
PMID: 18787541 [PubMed - in process]
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Comparison of epicardial and pericardial fat thickness assessed by echocardiography in African American and non-Hispanic White men: a pilot study.
Ethn Dis. 2008;18(3):311-6
Authors: Willens HJ, Gómez-Marín O, Chirinos JA, Goldberg R, Lowery MH, Iacobellis G
OBJECTIVES: Compared to non-Hispanic Whites, African American men have less intra-abdominal visceral adipose tissue (VAT) relative to total fat mass despite having a higher risk of obesity-related diseases. This study explores whether this racial pattern of VAT distribution extends to the intrathoracic VAT. METHODS: We used two-dimensional transthoracic echocardiography to measure pericardial and maximum and minimum epicardial fat thickness anterior to the right ventricle in 50 African American and 106 non-Hispanic White men, aged 40-75 years, consecutively referred for echocardiography for standard clinical indications. Age, coronary risk factors, height, and weight were recorded, and body mass index (BMI) was calculated. The two groups were compared with respect to pericardial and maximum, minimum, and average epicardial fat thicknesses. RESULTS: Among non-Hispanic Whites, pericardial and minimum epicardial fat measured at the mid-rightventricular wall were higher by 37% and 69%, respectively, than among African Americans (5.2+/-3.1 mm vs 3.8+/-3.1 mm, P<.011; 2.2+/-1.6 mm vs 1.3+/-1.2 mm, P<.001). Maximum epicardial fat along the distal right ventricular wall was 19% greater in non-Hispanic Whites, but this difference was not statistically significant (4.3+/-2.6 mm vs 3.6+/-2.0 mm, P=.133). The average epicardial fat measured at two sites was 26% greater in non-Hispanic Whites (2.9+/-2.0 mm vs 2.3+/-1.3 mm, P=.019). CONCLUSIONS: Among men referred for echocardiography, non-Hispanic Whites have more epicardial and pericardial fat than do African Americans. Echocardiography may be a useful research tool for investigating VAT distribution and its relationship to cardiovascular risk.
PMID: 18785445 [PubMed - in process]
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COMPARISON OF 2.5 MG/KG AND 5 MG/KG SYSTEMIC BEVACIZUMAB IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Twenty-Four Week Results of an Uncontrolled, Prospective Cohort Study.
Retina. 2008 Sep 10;
Authors: Geitzenauer W, Michels S, Prager F, Rosenfeld PJ, Kornek G, Vormittag L, Schmidt-Erfurth U
BACKGROUND:: To compare safety, visual acuity (VA), and anatomic outcomes of 2.5 mg/kg and 5 mg/kg intravenous bevacizumab in patients with neovascular age-related macular degeneration. METHODS:: In an institutional cohort study, 16 patients (2 cohorts, 27 eyes) with neovascular age-related macular degeneration were treated with 5 mg/kg intravenous bevacizumab and 2.5 mg/kg, respectively. All patients received 3 initial intravenous infusions at 2-week intervals. The main outcome measures were VA, optical coherence tomography, and fluorescein angiography. RESULTS:: No serious systemic or ocular adverse events were identified. By Day 7, mean VA increased from 56 letters (20/80) at baseline to 60 letters (20/63) in the 5 mg/kg group and mean central retinal thickness decreased by 83 mum. In the 2.5 mg/kg group, mean VA increased from 55 letters (20/80) to 66 letters (20/50) and mean central retinal thickness decreased by 93 mum. By Month 3, VA improved by 10 letters compared to baseline in the 5 mg/kg group and by 9 letters in the 2.5 mg/kg group. Central retinal thickness was reduced by 128 mum in the 5 mg/kg group and by 127 mum in the 2.5 mg/kg group. These benefits were sustained through 6 months. No statistically significant difference was found between both treatment groups regarding safety, VA, and anatomic outcomes. CONCLUSION:: Similar VA, optical coherence tomography, and angiographic improvements were observed in both treatment groups up to 6 months. Further follow-up is required to evaluate the long-term durability and safety of both treatment regimens.
PMID: 18784625 [PubMed - as supplied by publisher]
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CD38+CD8+ T-cells negatively correlate with CD4 central memory cells in virally suppressed HIV-1-infected individuals.
AIDS. 2008 Oct 1;22(15):1937-41
Authors: Kolber MA
OBJECTIVE: Studies have found that CD8 T-cell activation, as measured by CD38 expression, in HIV-1-infected individuals on suppressive therapy for longer than 12 months is not predictive of CD4 T-cell recovery. Owing to the fact that reconstitution of memory and naive T-cell populations occurs differentially over time, this study evaluated whether distinct memory/naive CD4 T-cell subsets correlated with CD38 on CD8 T-cells. MATERIALS AND METHODS: Whole blood from 13 participants was used to evaluate activation phenotypic markers on CD8 lymphocytes and memory/naive phenotypes on CD4 lymphocytes. These HIV-1-infected individuals had stable CD4 cell counts for more than 1 year while on suppressive combination antiretroviral therapy. RESULTS: The results demonstrate that CD4 central memory and naive cell populations contribute to the magnitude of CD4 T-cell reconstitution. CD4 central memory has a significant negative correlation with the percentage of CD38-activated CD8 T-cells. CONCLUSION: This suggests that CD8 activation is important in CD4 recovery from a low CD4 T-cell nadir.
PMID: 18784457 [PubMed - in process]
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