Asymmetrically hypointense veins on T2~*w imaging and susceptibility-weighted imaging in ischemic stroke

AIM:To review the literature on the assessment of venous vessels to estimate the penumbra on T2*w imaging and susceptibility-weighted imaging (SWI). METHODS:Literature that reported on the assessment of penumbra by T2*w imaging or SWI and used a validation method was included. PubMed and relevant stroke and magnetic resonance imaging (MRI) related conference abstracts were searched. Abstracts that had overlapping content with full text articles were excluded. The retrieved literature was scanned for further relevant references. Only clinical literature published in English was considered, patients with Moya-Moya syndrome were disregarded. Data is given as cumulative absolute and relative values, ranges are given where appropriate. RESULTS:Forty-three publications including 1145 patients could be identified. T2*w imaging was used in 16 publications (627 patients), SWI in 26 publications (453 patients). Only one publication used both (65 patients). The cumulative presence of hypointense vessel sign was 54% (range 32%-100%) for T2* (668 patients) and 81% (range 34%-100%) for SWI (334 patients). There was rare mentioning of interrater agreement (6 publications, 210 patients) and reliability (1 publication, 20 patients) but the numbers reported ranged from good to excellent. In most publications (n = 22) perfusion MRI was used as a validation method (617 patients). More patients were scanned in the subacute than in the acute phase (596 patients vs 320 patients). Clinical outcome was reported in 13 publications (521 patients) but was not consistent. CONCLUSION:The low presence of vessels signs on T2*w imaging makes SWI much more promising. More research is needed to obtain formal validation and quantification.

Mobilization of hematopoietic progenitor cells in patients with liver cirrhosis

AIM:To test the hypothesis that liver cirrhosis is associated with mobilization of hematopoietic progenitor cells. METHODS:Peripheral blood samples from 72 patients with liver cirrhosis of varying etiology were analyzed by flow cytometry.Identified progenitor cell subsets were immunoselected and used for functional assays in vitro. Plasma levels of stromal cell-derived factor-1(SDF-1) were measured using an enzyme linked immunosorbent assay.RESULTS:Progenitor cells with a CD133 + /CD45 + CD14 + phenotype were observed in 61%of th patients.Between 1%and 26%of the peripheral bloo mononuclear cells(MNCs)displayed this phenotype Furthermore,a distinct population of c-kit + progenito cells(between 1%and 38%of the MNCs)could b detected in 91%of the patients.Additionally,18% of the patients showed a population of progenito cells(between 1%and 68%of the MNCs)that wa characterized by expression of breast cancer resistanc protein-1.Further phenotypic analysis disclosed tha the circulating precursors expressed CXC chemokin receptor 4,the receptor for SDF-1.In line with thi finding,elevated plasma levels of SDF-1 were presen in all patients and were found to correlate with th number of mobilized CD133 + progenitor cells.

Correction to“Asymmetrically hypointense veins on T2*w imaging and susceptibility-weighted imaging in ischemic stroke”[World J Radiol 2013;5(4):156-165]

Correction to:Jensen-Kondering U,B?hm R.Asymmetrically hypointense veins on T2*w imaging and susceptibility-weighted imaging in ischemic stroke.World J Radiol 2013;5(4):156-165 PMID:23671751 DOI:10.4329/wjr.v5.i4.156[1].Results Third paragraph:(1)(n=17441 patients)should read(n=441 patients)instead;(2)(n=4111 patients)should read(n=111 patients)instead.Fourth paragraph:(1)(>6 h,n=15579 patients)should read(>6 h,n=579 patients)instead;(2)(≤6 h=11337 patients)should read(≤6 h=337 patients)instead;(3)(170 patients)should read(180 patients)instead.

Effect of <i>Morinda citrifolia</i>L. fruit juice on gingivitis/periodontitis

The majority of the world’s population suffers from gingivitis/periodontitis. This inflammatory process is caused by several bacterial species inside the dental plaque. In vivo and in vitro experiments were set up. The patients of the in vivo group were divided into a noni and a control group. Both groups contained patients that suffered from gingivitis/periodontitis who were introduced to practice standardized, good oral hygiene. The patients in the noni group additionally used noni juice for mouth wash two times a day. The Papillae-Bleeding-Index (PBI) was evaluated comparing the status of inflammation in both groups. Bacterial probes were isolated from the patient’s gingival pouches for species identification and to carry out in vitro experiments for possible antimicrobial effects of noni juice. The Papillae-Bleeding-Index (PBI) in the noni group has “highly significantly” improved from an average of 2.25 at the beginning of the observation period (t0) to 1.01 after four weeks of noni treatment (t1), compared to a change from 2.11 at t0 to 1.95 at t1 inthe control group. A comparison of the differences of the PBI-values (t0-t1) between the noni and the control group was highly significant using a t-test on a level of p = 0.01. Only small inhibition zones were observed in the agar diffusion test on agar plates coated with aerobic, anaerobic and Candida cultures isolated from the patients gingival pouches after treatment with original or neutralized noni juice in different concentrations. Weak bacteriostatic effects occurred in the agar dilution experiments with noni juice in higher concentrations (native and neutralized noni juice). The present investigation has shown that the combination of good oral hygiene and the administration of noni juice was a promising treatment for gingivitis and periodontitis. The additional treatment with noni juice significantly mitigated the gingival inflammation.

Mineral and Trace Element Concentrations in <i>Morinda citrifolia</i>L. (Noni) Leaf, Fruit and Fruit Juice

Fruit and leaf of noni (Morinda citrifolia L.) have been used traditionally as food and for medicinal purposes by South Pacific populations since over two thousand years. Recently noni fruit juice became very popular as health beverage worldwide. Manufacturers and distributors of noni juice often praise the high content of minerals and trace elements in conjunction with the geological situation of the origin of the raw noni material. We therefore performed an investigation about the metal concentration of noni fruit, leaf and soil samples from 42 different locations in French Polynesia, and of 16 commercial noni juices. Median concentrations of metals in noni fruit, leaf and fruit juice appeared in a normal range compared to other fruits, however, the variance between different locations was considerable. Noni fruits from lime soil were poorer compared to volcanic soil in most metals. Self-prepared noni juices did generally not serve for more then 10% of the daily requirement of trace elements and minerals per 100 ml. The metal concentration in noni fruit puree was higher compared to clear juice and reached 10% and 34% of the daily requirement in 100 ml for manganese and chromium respectively. The concentrations of toxic metals (As, Cd, Pb) were below 2% of the maximum permitted levels (MPL) in all of these juices. For one of the commercial noni juices the MPL for lead was exceeded (170%) and some others were close to it. Most metals showed a good correlation regarding the concentration in noni fruit versus leaf, but not for soil versus fruit or juice. The concentration of magnesium, manganese, zinc and germanium in the commercial juices was highly correlated to the potassium concentration, indicating that these elements are useful to detect a dilution of noni juices.

Pharmacogenomics in oncology

Precision therapy in the field of oncology is rapidly developing. Numerous somatic genetic markers in eg tyrosine kinase receptors or transcription factors have been identified to be indicative for the treatment with anti-cancer drugs. In contrast, only some recommendations have been developed considering hereditary variants in drug metabolizing enzymes such as TPMT, DYPD or UGT1A1. Although a huge knowledge has been gained on the association of drug transporters variants such as ABCB1 or ABCG2 and clinical outcome, the overall data is inconsistent and the predictability of the related phenotype is low. However, there is increasing evidence that individual phenotypic differences may result not only from genetics, but also from epigenetic alterations such as histone-acetylation or DNA-methylation. Moreover,interactions with non-coding RNAs contribute to protein expression and may modulate drug action. Currently intriguing developments of novel therapeutic approaches through epigenetic drugs are emerging. The overall complexity of epigenetics in drug action is so far only little understood. Of significant importance are the consequences of mi RNA interaction for drug resistance in cancer by regulating target genes and efflux transporters. Further intriguing findings address DNAmethylation as modifier of transporter function and its consequences in cancer development and treatment. The progress of science may lead to the discovery of rare, but functionally relevant SNPs and a better understanding of multiple genomic, epigenomic as well as phenotypic factors, contributing to drug response in malignancies.

Acupotomy versus sodium hyaluronate for treatment of knee osteoarthritis in rabbits

OBJECTIVE: To investigate the possible advantages of acupotomy over sodium hyaluronate injection for the treatment of knee osteoarthritis(KOA).METHODS: Twenty rabbits were divided randomly into four groups(n = 5 in each): a control group,model group, acupotomy group, and sodium hyaluronate injection group. The model, acupotomy,and sodium hyaluronate groups underwent anterior cruciate ligament transection plus partial medial meniscectomy. Sodium hyaluronate injection and acupotomy were administered to the respective groups from weeks 5 to 8, and samples of the tibial plateau and medial condyle of the femur were collected in week 9. Vascular endothelial growth factor(VEGF) expression was assessed in cartilage and subchondral bone by immunohistochemical staining.RESULTS: Articular cartilage degeneration was less pronounced in the acupotomy compared with the model and sodium hyaluronate groups. VEGF expression levels in cartilage and subchondral bone were increased in the model group compared with the control group(P < 0.01), and acupotomy had a more pronounced therapeutic effect than sodium hyaluronate injection(P < 0.01).CONCLUSION: Acupotomy and sodium hyaluronate injection may both reduce degeneration in the cartilage and subchondral bone in KOA based on the results from a rabbit model, but acupotomy improved the histopathology and reduced the VEGF content more effectively than sodium hyaluronate injection, probably by reducing venous stasis and intraosseous pressure. Acupotomy may improve KOA by lowering VEGF.

Semaphorins or Frizzled–it is the receptor that direct the action of clostridial glucosylating toxins

In a recent article in Cell,Lee et al.1 establish semaphorins SEMA6A and SEMA6B as physiologically relevant receptors for Paeniclostridium sordellii lethal toxin(TcsL)which can cause lethal toxic shock syndrome and reveal the molecular basis for the difference in tissue targeting and disease pathogenesis between highly related toxins TcsL and C.difficile TcdB.

Another surprise in receptor binding of C.difficile toxins

Clostridioides difficile(formerly named Clostridium difficile)is the dominant causative agent of a spectrum of illnesses,which frequently occur as the consequence of antibiotic treatment of patients.C.difficile infections(CDIs)causemild to severe diarrhea(so-called antibiotic-associated diarrhea)but also pseudomembranous enterocolitis with complications like toxicmegacolon,bowel perforation,and death.Three protein toxins are involved in the pathology of CDIs,toxin A(TcdA)and toxin B(TcdB),which are the prototypes of large clostridial glucosylating toxins,and C.difficile ADP-ribosyltransferase CDT.TcdB is most likely the driving toxin responsible for the major pathology of the infection.