Σάββατο, 29 Οκτωβρίου 2016

The Results of Single Bundle Versus Double Bundle ACL Reconstruction Surgery, a Retrospective Study and Review of Literature

2016-10-29T18-46-28Z
Source: Medical Archives
Ali Torkaman, Hamidreza Yazdi, Mohammad Ghorban Hosseini.
Objective: The purpose of this study was to evaluate the results of single bundle and double bundle surgical techniques for anterior cruciate ligament (ACL) reconstruction. Methods: In this study, all single bundle and double bundle ACL reconstruction surgeries that were done in our university hospital from January 2008 to December 2012 were enrolled. All patients were followed at 2,6,12, 24 weeks and 1 a 2 years post operatively. On last follow up all patients were evaluated by clinical examination, KT-1000 and Lysholm questionnaire. Results: Seventy five patients were operated using single bundle and eighty five patients with double bundle technique. Fifty seven percent of patients in single bundle and 80% of patients in double bundle group had experienced pain during follow-up period. None of cases had knee extension or flexion loss. The average side to side differences using KT-1000 was 3.5 ± 0.38 (2.9-4.1) millimeters in single bundle group and 3.39 ± 0.39 (2.8-4) millimeters in double bundle group. These results showed no significant difference between two groups (P= 0.31). Lysholm score improved significantly in both groups, but there was no significant difference between them. Conclusion: According to this study the clinical results of single bundle ACL reconstruction was similar to double bundle reconstruction in short term follow up. Further studies are needed to evaluate the long term results.


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Association of Beta-2 Microglobulin with Inflammation and Dislipidemia in High-Flux Membrane Hemodialysis Patients

2016-10-29T18-46-28Z
Source: Medical Archives
Valdete TopçiuShufta, Ramë Miftari, Valdete Haxhibeqiri, Shpend Haxhibeqiri.
Background: Higher than expected cardiovascular mortality in hemodialysis patients, has been attributed to dyslipidemia as well as inflammation. Beta2-Microglobulin (β2M) is an independent predictor of outcome for hemodialysis patients and a representative substance of middle molecules. Results: In 40 patients in high-flux membrane hemodialysis, we found negative correlation of β2M with high density lipoprotein (r=-0.73, p


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Distinguishing spinocerebellar ataxia with pure cerebellar manifestation from multiple system atrophy (MSA-C) through saccade profiles

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Publication date: Available online 29 October 2016
Source:Clinical Neurophysiology
Author(s): Yasuo Terao, Hideki Fukuda, Shin-ichi Tokushige, Satomi Inomata-Terada, Akihiro Yugeta, Masashi Hamada, Yoshikazu Ugawa
ObjectivePatients with spinocerebellar ataxia with pure cerebellar presentation (SCD) and multiple system atrophy (MSA-C) show similar symptoms at early stages, although cerebellofugal pathology predominates in SCD, and cerebellopetal pathology in MSA-C. We studied whether saccade velocity profiles, which reflect the accelerating and braking functions of the cerebellum, can differentiate these two disorders.MethodsWe recorded visually guided (VGS) and memory guided saccades (MGS) in 29 MSA-C patients, 12 SCD patients, and 92 age-matched normal subjects, and compared their amplitude, peak velocity and duration (accelerating and decelerating phases).ResultsHypometria predominated in VGS and MGS of MSA-C, whereas hypometria was less marked in SCD, with hypermetria frequently noted in MGS. Peak velocity was reduced, and deteriorated with advancing disease both in SCD and MSA-C groups at smaller target eccentricities. The deceleration phase was prolonged in SCD compared to MSA-C and normal groups at larger target eccentricities, which deteriorated with advancing disease.ConclusionSaccades in MSA-C were characterized by a more prominent acceleration deficit and those in SCD by a more prominent braking defect, possibly caused by the cerebellopetal and cerebellofugal pathologies, respectively.SignificanceSaccade profiles provide important information regarding the accelerating and braking signals of the cerebellum in spinocerebellar ataxia.



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Pathological and Physiological Muscle Co-activation during Active Elbow Extension in Children with Unilateral Cerebral Palsy

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Publication date: Available online 29 October 2016
Source:Clinical Neurophysiology
Author(s): A. Sarcher, M. Raison, F. Leboeuf, B. Perrouin-Verbe, S. Brochard, R. Gross
[Objective]To address the roles and mechanisms of co-activation in two flexor/extensor pairs during elbow extension in children with cerebral palsy (CP).[Methods]13 typically developing (TD) and 13 children with unilateral spastic CP performed elbow extension/flexion at different speeds. Elbow angle and velocity were recorded using a 3D motion analysis system. The acceleration and deceleration phases of extension were analyzed. Co-activation of the brachioradialis/triceps and biceps/triceps pairs was computed for each phase from surface electromyographic signals. Statistical analysis involved linear mixed effects models and Spearman rank correlations.[Results]During the acceleration phase, there was strong co-activation in both muscle pairs in the children with CP, which increased with speed. Co-activation was weak in the TD children and it was not speed-dependent. During the deceleration phase, co-activation was strong and increased with speed in both groups; co-activation of brachioradialis/triceps was stronger in children with CP, and was negatively correlated with extension range and positively correlated with flexor spasticity.[Conclusions]Abnormal patterns of co-activation in children with CP were found throughout the entire movement. Co-activation was specific to the movement phase and to each flexor muscle.[Significance]Co-activation in children with CP is both physiological and pathological.



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Frequency-independent characteristics of high-frequency oscillations in epileptic and non-epileptic regions

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Publication date: Available online 29 October 2016
Source:Clinical Neurophysiology
Author(s): Martin Pail, Pavel Řehulka, Jan Cimbálník, Irena Doležalová, Jan Chrastina, Milan Brázdil
ObjectiveThe purpose of the presented study is to determine whether there are frequency-independent high-frequency oscillation (HFO) parameters which may differ in epileptic and non-epileptic regions.MethodsWe studied 31 consecutive patients with medically intractable focal (temporal and extratemporal) epilepsies who were examined by either intracerebral or subdural electrodes. Automated detection was used to detect HFO. The characteristics (rate, amplitude, and duration) of HFO were statistically compared within three groups: the seizure onset zone (SOZ), the irritative zone (IZ), and areas outside the IZ and SOZ (nonSOZ/nonIZ).ResultsIn all patients, fast ripples (FR) and ripples (R) were significantly more frequent and shorter in the SOZ than in the nonSOZ/nonIZ region. In the group of patients with favorable surgical outcomes, the relative amplitude of FR was higher in the SOZ than in the IZ and nonIZ/nonSOZ regions; in patients with poor outcomes, the results were reversed. The relative amplitude of R was significantly higher in the SOZ, with no difference between patients with poor and favorable surgical outcomes.ConclusionsFR are more frequent, shorter, and have higher relative amplitudes in the SOZ area than in other regions. The study suggests a worse prognosis in patients with higher amplitudes of FR outside the SOZ.SignificanceVarious HFO parameters, especially of FR, differ in epileptic and non-epileptic regions. The amplitude and duration may be as important as the frequency band and rate of HFO in marking the seizure onset region or the epileptogenic area and may provide additional information on epileptogenicity.



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Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS)

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Publication date: Available online 29 October 2016
Source:Clinical Neurophysiology
Author(s): Jean-Pascal Lefaucheur, Andrea Antal, Samar S. Ayache, David H. Benninger, Jérôme Brunelin, Filippo Cogiamanian, Maria Cotelli, Dirk De Ridder, Roberta Ferrucci, Berthold Langguth, Paola Marangolo, Veit Mylius, Michael A. Nitsche, Frank Padberg, Ulrich Palm, Emmanuel Poulet, Alberto Priori, Simone Rossi, Martin Schecklmann, Sven Vanneste, Ulf Ziemann, Luis Garcia-Larrea, Walter Paulus
A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform tDCS in a therapeutic setting. In addition, the easy management and low cost of tDCS devices allow at home use by the patient, but this might raise ethical and legal concerns with regard to potential misuse or overuse. We must be careful to avoid inappropriate applications of this technique by ensuring rigorous training of the professionals and education of the patients.



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Psychophysiological relationships between a multi-component self-report measure of mood, stress and behavioural signs and symptoms, and physiological stress responses during a simulated firefighting deployment

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Publication date: Available online 29 October 2016
Source:International Journal of Psychophysiology
Author(s): Alexander Wolkow, Brad Aisbett, Sally A Ferguson, John Reynolds, Luana C Main
Physical work and sleep loss are wildland firefighting demands that elicit psychological and physiological stress responses. Research shows that these responses are statistically related which presents an opportunity to use subjective psychological questionnaires to monitor physiological changes among firefighters; an approach used extensively in sport settings. The aim of the present study was to investigate if changes in self-reported psychological factors on the multi-component training distress scale (MTDS), relate to cytokines and cortisol levels among firefighters completing three days of simulated physical firefighting work separated by an 8-h or restricted 4-h sleep each night. Each day firefighters completed the MTDS in the morning and salivary cortisol and inflammatory cytokines were measured throughout the day. When sleep restricted, firefighters demonstrated increases in MTDS factors of general fatigue, perceived stress and depressed mood that were related to elevated cytokines (TNF-α, IL-8, IL-10, IL-6) and cortisol. Conversely, firefighters who had an 8-h sleep demonstrated a positive relationship between physical signs and symptoms and elevated IL-6, while depressed mood was inversely related to decreasing cortisol and cytokines (IL-6, TNF-α, IL-10). Findings highlight the utility of the MTDS to detect psychological changes that reflect physiological responses among firefighters. Future research that establishes thresholds for specific factors which predict health-related physiological changes, will allow fire agencies implement multi-component measures to monitor and manage the health of personnel on the fire-ground.



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Imaging of Paranasal Sinuses and Anterior Skull Base and Relevant Anatomic Variations

Publication date: Available online 25 October 2016
Source:Radiologic Clinics of North America
Author(s): Estushi Iida, Yoshimi Anzai

Teaser

This article reviews the normal anatomy and variants of the anterior skull base and sinonasal cavities that are relevant to endoscopic sinus and skull base surgery. Radiologists should be aware of sinonasal anatomy that can be impediments to surgical access and increase risk of vascular or cranial nerve injury during surgery. Imaging features of the paranasal sinuses and anterior skull base pathologies are also discussed.


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Imaging Evaluation and Treatment of Vascular Lesions at the Skull Base

Publication date: Available online 25 October 2016
Source:Radiologic Clinics of North America
Author(s): Gaurav Jindal, Timothy Miller, Prashant Raghavan, Dheeraj Gandhi

Teaser

A wide range of congenital and acquired vascular entities may occur in the skull base. Although some are diagnosed incidentally and merit no treatment, others may require surgical or image-guided endovascular or percutaneous approaches for management. The complex anatomy of the skull base can make diagnosis challenging. A combination of computed tomography scans and MR imaging, and catheter angiography may be required for diagnosis and mapping. Endovascular treatment plays an important part in many of the acquired vascular lesions, such as vascular neoplasms and traumatic dissections/aneurysms. Endovascular treatment is generally considered the gold standard for the treatment of vascular shunts at the skull base.


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Advanced Imaging Techniques of the Skull Base

Publication date: Available online 21 October 2016
Source:Radiologic Clinics of North America
Author(s): Elliot Dickerson, Ashok Srinivasan

Teaser

Although conventional imaging can depict the anatomy of the head and neck with exquisite detail, it often falls short in its ability to characterize tissue physiology and abnormality; this is especially seen in the posttherapy setting where benign posttreatment changes and recurrent tumors can show intense postcontrast enhancement and similar features on conventional imaging. Advanced imaging can evaluate tissue physiology and, along with conventional imaging, provide a more accurate assessment of the skull base. This article describes the technical details and clinical applications of different advanced imaging techniques with a primary focus on diffusion-weighted imaging.


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Genitourinary Imaging: An Update

Publication date: Available online 20 October 2016
Source:Radiologic Clinics of North America
Author(s): Andrew B. Rosenkrantz




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Comparing performance of Bonfils fiberscope and GlideScope videolaryngoscope for awake intubation

The recent article by Nassar et al [1] comparing performance of Bonfils fiberscope and GlideScope videolaryngoscope for awake intubation in the morbidly obese patients with expected difficult airways was of great interest to us. They showed that Bonfils fiberscope was more tolerated by patients with statistical difference, whereas GlideScope videolaryngoscope provided shorter intubation time and less intubation attempts but without statistical significance. Given that the airway management of morbidly obese patients often presents a unique challenge to the anesthesiologists, their findings have potential implications.

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Sudden cardiorespiratory collapse associated with Takotsubo cardiomyopathy upon transferring a patient to the operation bed

Here, we report a case of cardiopulmonary collapse associated with Takotsubo cardiomyopathy after moving a patient to the operation bed.

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Rapid-sequence intubation of a patient with difficult airway using a double-lumen endotracheal tube with the Pentax-AWS Airwayscope and a soft-tipped tube exchanger

Rapid-sequence intubation of a double-lumen tube is difficult, especially in patients with difficult airway [1]. Here we report successful rapid-sequence intubation of a patient with difficult airway using a double-lumen endotracheal tube (DLT) with the Pentax-AWS Airwayscope (AWS) (HOYA, Tokyo, Japan) videolaryngoscope equipped with a newly developed Intlock for DLT (ITL-LL) (HOYA), combined with a soft-tipped tube exchange catheter (TE-Soft) (Cook Medical, IN, USA).

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NF-Y and the immune response: Dissecting the complex regulation of MHC genes

Publication date: Available online 29 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Nikoleta Sachini, Joseph Papamatheakis
Nuclear Factor Y (NF-Y) was first described as one of the CCAAT binding factors. Although CCAAT motifs were found to be present in various genes, NF-Y attracted a lot of interest early on, due to its role in Major Histocompatibility Complex (MHC) gene regulation. MHC genes are crucial in immune response and show peculiar expression patterns. Among other conserved elements on MHC promoters, an NF-Y binding CCAAT box was found to contribute to MHC transcriptional regulation. NF-Y along with other DNA binding factors assembles in a stereospecific manner to form a multiprotein scaffold, the MHC enhanceosome, which is necessary but not sufficient to drive transcription. Transcriptional activation is achieved by the recruitment of yet another factor, the class II transcriptional activator (CIITA). In this review, we briefly discuss basic findings on MHCII transcription regulation and we highlight NF-Y different modes of function in MHCII gene activation.



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The multifaceted roles of NUCLEAR FACTOR-Y in Arabidopsis thaliana development and stress responses

Publication date: Available online 29 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Swadhin Swain, Zachary A. Myers, Chamindika L. Siriwardana, Ben F. Holt
NUCLEAR FACTOR-Y (NF-Y) is a heterotrimeric transcription factor (TF) consisting of evolutionarily distinct NF-YA, NF-YB and NF-YC subunits. The functional NF-Y heterotrimer binds to CCAAT elements in eukaryotic gene promoters and influences their expression. The genome of the model organism Arabidopsis thaliana encodes 10 distinct NF-YA, NF-YB, and NF-YC proteins, allowing for enormous combinatorial and functional diversity. Two decades of research have elucidated the importance of NF-Ys in plant growth, development and stress responses; however, the molecular mechanisms of action remain largely unexplored. Intriguingly, recent evidence suggests that NF-Ys are frequently associated with other groups of TFs, expanding the potential NF-Y combinatorial complexity. Further, information regarding the regulation of individual NF-Y subunits at the transcriptional and post-transcriptional level is beginning to emerge. In this review, we will identify developing trends within the NF-Y field and discuss recent progress towards a better understanding of NF-Y function, molecular action, and regulation in the context of Arabidopsis.



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Thirty years of the HAP2/3/4/5 complex

Publication date: Available online 28 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): M. Bolotin-Fukuhara




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Transcription factors that influence RNA polymerases I and II: To what extent is mechanism of action conserved?

Publication date: Available online 27 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Yinfeng Zhang, Saman M. Najmi, David A. Schneider
In eukaryotic cells, nuclear RNA synthesis is accomplished by at least three unique, multisubunit RNA polymerases. The roles of these enzymes are generally partitioned into the synthesis of the three major classes of RNA: rRNA, mRNA, and tRNA for RNA polymerases I, II, and III respectively. Consistent with their unique cellular roles, each enzyme has a complement of specialized transcription factors and enzymatic properties. However, not all transcription factors have evolved to affect only one eukaryotic RNA polymerase. In fact, many factors have been shown to influence the activities of multiple nuclear RNA polymerases. This review focuses on a subset of these factors, specifically addressing the mechanisms by which these proteins influence RNA polymerases I and II.



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Y flowering? Regulation and activity of CONSTANS and CCT-domain proteins in Arabidopsis and crop species

Publication date: Available online 26 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Vittoria Brambilla, Fabio Fornara
Changes in day length regulate the proper timing of flowering in several plant species. The genetic architecture of this process is based on CCT-domain proteins, many of which interact with NF-Y subunits to regulate transcription of target genes. In the model plant Arabidopsis thaliana, the CONSTANS CCT-domain protein is a central photoperiodic sensor. We will discuss how the diurnal rhythms of its transcription and protein accumulation are generated, and how the protein engages into multiple complexes to control production of a systemic flowering signal. Regulatory parallels will be drawn between Arabidopsis and major crops that indicate conservation of some CCT/NF-Y modules during plant evolution.



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NF-Y in invertebrates

Publication date: Available online 26 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Masamitsu Yamaguchi, Md. Saheb Ali, Yasuhide Yoshioka, Luong Linh Ly, Hideki Yoshida
Both Drosophila melanogaster and Caenorhabditis elegans (C. elegans) are useful model organisms to study in vivo roles of NF-Y during development. Drosophila NF-Y (dNF-Y) consists of three subunits dNF-YA, dNF-YB and dNF-YC. In some tissues, dNF-YC-related protein Mes4 may replace dNF-YC in dNF-Y complex. Studies with eye imaginal disc-specific dNF-Y-knockdown flies revealed that dNF-Y positively regulates the sevenless gene encoding a receptor tyrosine kinase, a component of the ERK pathway and negatively regulates the Sensless gene encoding a transcription factor to ensure proper development of R7 photoreceptor cells together with proper R7 axon targeting. dNF-Y also controls the Drosophila Bcl-2 (debcl) to regulate apoptosis. In thorax development, dNF-Y is necessary for both proper Drosophila JNK (basket) expression and JNK signaling activity that is responsible for thorax development. Drosophila p53 gene was also identified as one of the dNF-Y target genes in this system. C. elegans contains two forms of NF-YA subunit, CeNF-YA1 and CeNF-YA2. C. elegans NF-Y (CeNF-Y) therefore consists of CeNF-YB, CeNF-YC and either CeNF-YA1 or CeNF-YA2. CeNF-Y negatively regulates expression of the Hox gene egl-5 (ortholog of Drosophila Abdominal-B) that is involved in tail patterning. CeNF-Y also negatively regulates expression of the tbx-2 gene that is essential for development of the pharyngeal muscles, specification of neural cell fate and adaptation in olfactory neurons. Negative regulation of the expression of egl-5 and tbx-2 by CeNF-Y provides new insight into the physiological meaning of negative regulation of gene expression by NF-Y during development. In addition, studies on NF-Y in platyhelminths are also summarized.



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Modulation of topoisomerase IIα expression and chemosensitivity through targeted inhibition of NF-Y:DNA binding by a diamino p-anisyl-benzimidazole (Hx) polyamide

Publication date: Available online 24 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Luke Pett, Konstantinos Kiakos, Vijay Satam, Pravin Patil, Sarah Laughlin-Toth, Matthew Gregory, Michael Bowerman, Kevin Olson, Mia Savagian, Megan Lee, Moses Lee, W. David Wilson, Daniel Hochhauser, John A. Hartley
BackgroundSequence specific polyamide HxIP 1, targeted to the inverted CCAAT Box 2 (ICB2) on the topoisomerase IIα (topo IIα) promoter can inhibit NF-Y binding, re-induce gene expression and increase sensitivity to etoposide. To enhance biological activity, diamino-containing derivatives (HxI*P 2 and HxIP* 3) were synthesised incorporating an alkyl amino group at the N1-heterocyclic position of the imidazole/pyrrole.MethodsDNase I footprinting was used to evaluate DNA binding of the diamino Hx-polyamides, and their ability to disrupt the NF-Y:ICB2 interaction assessed using EMSAs. Topo IIα mRNA (RT-PCR) and protein (Immunoblotting) levels were measured following 18h polyamide treatment of confluent A549 cells. γH2AX was used as a marker for etoposide-induced DNA damage after pre-treatment with HxIP* 3 and cell viability was measured using Cell-Titer Glo®.ResultsIntroduction of the N1-alkyl amino group reduced selectivity for the target sequence 5′-TACGAT-3′ on the topo IIα promoter, but increased DNA binding affinity. Confocal microscopy revealed both fluorescent diamino polyamides localised in the nucleus, yet HxI*P 2 was unable to disrupt the NF-Y:ICB2 interaction and showed no effect against the downregulation of topo IIα. In contrast, inhibition of NF-Y binding by HxIP* 3 stimulated dose-dependent (0.1–2μM) re-induction of topo IIα and potentiated cytotoxicity of topo II poisons by enhancing DNA damage.ConclusionsPolyamide functionalisation at the N1-position offers a design strategy to improve drug-like properties. Dicationic HxIP* 3 increased topo IIα expression and chemosensitivity to topo II-targeting agents.General significancePharmacological modulation of topo IIα expression has the potential to enhance cellular sensitivity to clinically-used anticancer therapeutics. This article is part of a Special Issue entitled: Nuclear Factor Y in Development and Disease, edited by Prof. Roberto Mantovani.

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Genome wide features, distribution and correlations of NF-Y binding sites

Publication date: Available online 18 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Federico Zambelli, Giulio Pavesi
NF-Y is a trimeric transcription factor that binds on DNA the CCAAT-box motif. In this article we reviewed and complemented with additional bioinformatic analysis existing data on genome-wide NF-Y binding characterization in human, reaching the following main conclusions: (1) about half of NF-Y binding sites are located at promoters, about 60–80 base pairs from transcription start sites; NF-Y binding to distal genomic regions takes place at inactive chromatin loci and/or DNA repetitive elements more often than active enhancers; (2) on almost half of its binding sites, regardless of their genomic localization (promoters or distal regions), NF-Y finds on DNA more than one CCAAT-box, and most of those multiple CCAAT binding loci present precise spacing and organization of the elements composing them; (3) there exists a well defined class of transcription factors that show genome-wide co-localization with NF-Y. Some of them lack their canonical binding site in binding regions overlapping with NF-Y, hence hinting at NF-Y mediated recruitment, while others show a precise positioning on DNA of their binding sites with respect to the CCAAT box bound by NF-Y. This article is part of a Special Issue entitled: Nuclear Factor Y in Development and Disease, edited by Prof. Roberto Mantovani.



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Arsenic induced squamous cell carcinoma of skin – atypical presentation with aggressiveness.

2016-10-29T04-45-55Z
Source: The Southeast Asian Journal of Case Report and Review
Santu Mondal, Soumita Poddar, Mridul Kanti Biswas.
A 68 year old gentleman from arsenic affected area presented with an ulceration at skin at the junction of neck and thorax (left side) and a lump at left upper neck. On examination, ulcer was 3×3 cm. In size. There was an enlarged lymph node at level I I cervical region. There were hyperkeratoses and hyperpigmentation at multiple site. Patient had lost one finger at left upper extremity. Biopsy and histopathological examination from the ulcer revealed squamous cell carcinoma. CT scan of whole abdomen showed multiple hypodence space occupying lesion in liver, consistent with metastasis. Patient was treated with chemotherapy with palliative intent. This case has atypical presentation with aggressiveness in behaviour. The case is described along with a review of literature.


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Retrogastric cyst due to perforated appendix

2016-10-29T04-45-55Z
Source: The Southeast Asian Journal of Case Report and Review
Digamber Chaubey, Anand Pandey, Archika Gupta, Shiv Narain Kureel.
Appendicitis is the most common abdominal emergency. The lifetime risk of having appendicitis is 8.6% for males and 6.7% for females; while the lifetime risk of appendicectomy is 12.0% for males and 23.1% for females. A very important complication of this entity is appendicular perforation. We treated a patient of appendicular perforation with extremely uncommon manifestation- retrogastric cyst leading to gastric outlet obstruction.


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Membranous Nephropathy With Transverse Myelitis

2016-10-29T04-45-55Z
Source: The Southeast Asian Journal of Case Report and Review
Mudasir Mushtaq, Maqbool Wani, Mushtaq Ahmed Wani, Rouf Asimi, Sawan Verma, Irfan Shah.
MGN is the most common form of glomerulonephritis causing nephritic syndrome in adults. Cases have been reported depicting association between MGN and neurological diseases like guillain-barre syndrome, multiple sclerosis and chronic inflammatory demyelinating polyneuropathy . However only one case has been reported with MGN and inflammatory myelopathy. Our patient was 36 yrs old female admitted with paraparesis and paresthesias in bilateral hands with bowel and bladder involvement and she had a biopsy documented episode of membranous nephropathy.


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Extracorporeal lung support.

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Purpose of review: The applications for extracorporeal membrane oxygenation for lung support are constantly evolving. This review highlights fundamental concepts in extracorporeal lung support and describes directions for future research. Recent findings: Since the 1950s, extracorporeal lung support has experienced continuous advancements in circuit design and safety in acute respiratory distress syndrome, chronic obstructive pulmonary disease exacerbations, as a bridge to transplantation, intraoperative cardiopulmonary support, and for transportation to referral centers. Patients on extracorporeal membrane oxygenation are now capable of being awake, extubated, and ambulatory for accelerated recovery or optimization for transplantation. Summary: Extracorporeal lung support is a safe and an easily implemented intervention for refractory respiratory failure. Recent advances have extended its use beyond acute illnesses and the developments for chronic support will facilitate the development of durable devices and possible artificial lung development. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Obesity hypoventilation syndrome, sleep apnea, overlap syndrome: perioperative management to prevent complications.

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Purpose of review: The prevalence of sleep disordered breathing (SDB) is increasing proportional to the prevalence of obesity. Although anesthesiologists are familiar with obstructive sleep apnea (OSA) - the most common SDB, anesthesiologists may not be aware of other SDB such as obesity hypoventilation syndrome (OHS) and overlap syndrome (combination of OSA and chronic obstructive pulmonary disease). The present review provides an update of information regarding the perioperative management of OHS and overlap syndrome. Recent findings: OHS and overlap syndrome are associated with significant comorbid conditions and more perioperative morbidity than OSA alone. Similar to OSA, most of the OHS patients are undiagnosed. An increase in serum bicarbonate level is a surrogate marker of hypercapnia. Because 90% of OHS patients have OSA, preoperative screening for OSA combined with estimation of serum bicarbonate level may detect the majority of the patients with OHS. In patients with OSA, OHS, and overlap syndrome, improvement in the perioperative outcome has been shown by initiating positive airway pressure therapy. Summary: Identification and preoperative optimization of these high-risk patients are most important. A protocol-based risk mitigation is necessary for improving the intraoperative and postoperative outcome of these patients. As a perioperative physician, anesthesiologists have a key role in the management of patients with SDB. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Sleep, sleep studies and sleep-disordered breathing: basic knowledge for the anesthesiologist.

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Purpose of review: To provide a basic understanding of sleep physiology, the pathophysiology of sleep-disordered breathing and the processes applied in undertaking and assessing sleep studies. Recent findings: It has become increasingly apparent that obstructive sleep apnoea is associated with heightened perioperative risk. Furthermore, the condition still remains under-diagnosed in patients presenting for surgery. Summary: This review describes the physiology of sleep including sleep stages, sleep monitoring, the normal hypnogram and investigation from simple overnight pulse oximetry to full polysomnography. The pathophysiology of sleep-disordered breathing is discussed; from simple snoring through obstructive sleep apnoea to obesity hypoventilation syndrome. The relationship to metabolic syndrome is explored. Salient points in the interpretation of sleep study reports are presented. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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