AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control...AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.展开更多
Multiple sclerosis(MS)is an autoimmune disorder of the central nervous system(CNS)and is primarily characterized by immune cell infiltration leading to relapses followed by remission phases and a disease course turnin...Multiple sclerosis(MS)is an autoimmune disorder of the central nervous system(CNS)and is primarily characterized by immune cell infiltration leading to relapses followed by remission phases and a disease course turning progressive over time with neurodegenerative processes taking over(Amin and Hersh,2023).Of note,beyond relapse-associated worsening early in disease progression independent of relapse activity may arise independently of relapse activity and can occur in all phenotypes.Autoimmune-mediated damage of myelin sheaths and the subsequent loss of mature oligodendrocytes are resulting in impaired axonal integrity,neurodegeneration and accounts for irreversible neuronal damage(Kuhlmann et al.,2023).The current landscape of available disease-modifying therapies comprises mainly immunomodulatory drugs that effectively diminish relapses and slow down progression at the onset form of the disease,namely relapsing MS(RMS).In this regard,a number of drugs have been approved as disease-modifying therapies for MS by US Food and Drug Administration and European Medicines Agencies(Box 1).展开更多
Astrocytes are indispensable for central nervous system development and homeostasis.In response to injury and disease,astrocytes are integral to the immunological-and the,albeit limited,repair response.In this review,...Astrocytes are indispensable for central nervous system development and homeostasis.In response to injury and disease,astrocytes are integral to the immunological-and the,albeit limited,repair response.In this review,we will examine some of the functions reactive astrocytes play in the context of multiple sclerosis and related animal models.We will consider the heterogeneity or plasticity of astrocytes and the mechanisms by which they promote or mitigate demyelination.Finally,we will discuss a set of biomedical strategies that can stimulate astrocytes in their promyelinating response.展开更多
The adult mammalian central nervous system(CNS) coordinates essential functions such as sensation,movement,autonomic control,thought processes,and communication.Consequently,injuries or diseases of the CNS are often a...The adult mammalian central nervous system(CNS) coordinates essential functions such as sensation,movement,autonomic control,thought processes,and communication.Consequently,injuries or diseases of the CNS are often associated with devastating and permanent functional impairments because damaged axons normally fail to regenerate.An insufficient neuron-intrinsic growth capacity and an inhibitory environment at the injury site are the leading causes of this regenerative failure.展开更多
This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivot...This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivotal role in neurodegenerative diseases like Parkinson's disease,encompassing diverse components such as the gut microbiota,immune system,metabolism,and neural pathways.The gut microbiome,profoundly influenced by dietary factors,emerges as a key player.Nutrition during the first 1000 days of life shapes the gut microbiota composition,influencing immune responses and impacting both child development and adult health.High-fat,high-sugar diets can disrupt this delicate balance,contributing to inflammation and immune dysfunction.Exploring nutritional strategies,the Mediterranean diet's anti-inflammatory and antioxidant properties show promise in reducing Parkinson's disease risk.Microbiome-targeted dietary approaches and the ketogenic diet hold the potential in improving brain disorders.Beyond nutrition,emerging research uncovers potential interactions between steroid hormones,nutrition,and Parkinson's disease.Progesterone,with its anti-inflammatory properties and presence in the nervous system,offers a novel option for Parkinson's disease therapy.Its ability to enhance neuroprotection within the enteric nervous system presents exciting prospects.The review addresses the hypothesis thatα-synuclein aggregates originate from the gut and may enter the brain via the vagus nerve.Gastrointestinal symptoms preceding motor symptoms support this hypothesis.Dysfunctional gut-brain signaling during gut dysbiosis contributes to inflammation and neurotransmitter imbalances,emphasizing the potential of microbiota-based interventions.In summary,this review uncovers the complex web of interactions between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the gut-brain axis framework.Understanding these connections not only offers novel therapeutic insights but also illuminates the origins of neurodegenerative diseases such as Parkinson's disease.展开更多
BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progr...BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.展开更多
In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesit...In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.展开更多
Immune-checkpoint inhibitor-mediated colitis(IMC)is an increasingly recognized adverse event in cancer immunotherapy,particularly associated with immune checkpoint inhibitors(ICIs)such as anti-cytotoxic T-lymphocyte a...Immune-checkpoint inhibitor-mediated colitis(IMC)is an increasingly recognized adverse event in cancer immunotherapy,particularly associated with immune checkpoint inhibitors(ICIs)such as anti-cytotoxic T-lymphocyte antigen-4 and anti-programmed cell death protein-1 antibodies.As this revolutionary immunotherapy gains prominence in cancer treatment,understanding,diagnosing,and effectively managing IMC becomes paramount.IMC represents a unique challenge due to its immune-mediated nature and potential for severe complications.However,a precise picture of IMC pathophysiology is currently unavailable.Therefore,we aimed to summarize the existing data while acknowledging the need for further research.This comprehensive review explores the mechanisms underlying ICIs,gastrointestinal adverse effects,and,in particular,IMC’s incidence,prevalence,and features.Our review also emphasizes the importance of recognizing IMC’s distinct clinical and histopathological features to differentiate it from other forms of colitis.Furthermore,this paper highlights the urgentneed for evolving diagnostic methods,therapeutic strategies,and a multidisciplinary approach to effectively manage IMC.展开更多
Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with ...Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.展开更多
BACKGROUND The management of tongue carcinoma is excision and radical neck dissection followed with reconstruction.This is a case report of a patient with tongue squamous cell carcinoma(SCC)who underwent the procedure...BACKGROUND The management of tongue carcinoma is excision and radical neck dissection followed with reconstruction.This is a case report of a patient with tongue squamous cell carcinoma(SCC)who underwent the procedure with sternocleidomastoid(SCM)flap reconstruction.CASE SUMMARY A 52-year-old woman without smoking history complained tongue ulcer since 3 years ago.Based on the histopathological examination,the patient was diagnosed with T2N2M0 right tongue SCC and underwent wide excision of tumor;right mandibular;neck dissection and were reconstructed with SCM flap.CONCLUSION SCC of the tongue requires wide excision and dissection of the neck and mandible if infiltration into the surrounding lymph nodes has been found.The SCM flap reconstruction could be used post-surgery.展开更多
BACKGROUND Adolescent idiopathic scoliosis remains a major problem due to its high incidence,high risk,and high cost.One of the aims of the management in scoliosis is to correct the deformity.Many techniques are avail...BACKGROUND Adolescent idiopathic scoliosis remains a major problem due to its high incidence,high risk,and high cost.One of the aims of the management in scoliosis is to correct the deformity.Many techniques are available to correct scoliosis deformity;however,they are all far from ideal to achieve three-dimensional correction in scoliosis.AIM To develop a set of tools named Scoliocorrector Fatma-UI(SCFUI)to aid threedimensional correction and to evaluate the efficacy,safety,and functional outcome.METHODS This study consists of two stages.In the first stage,we developed the SCFUI and tested it in finite element and biomechanical tests.The second stage was a single-blinded randomized clinical trial to evaluate the SCFUI compared to direct vertebral rotation(DVR).Forty-four subjects with adolescent idiopathic scoliosis were randomly allocated into the DVR group(n=23)and SCFUI group(n=21).Radiological,neurological,and functional outcome was compared between the groups.RESULTS Finite element revealed the maximum stress of the SCFUI components to be between 31.2-252 MPa.Biomechanical analysis revealed the modulus elasticity of SCFUI was 9561324±633277 MPa.Both groups showed improvement in Cobb angle and sagittal profile,however the rotation angle was lower in the SCFUI group(11.59±7.46 vs 18.23±6.39,P=0.001).Neurological and functional outcome were comparable in both groups.CONCLUSION We concluded that SCFUI developed in this study resulted in similar coronal and sagittal but better rotational correction compared to DVR.The safety and functional outcomes were also similar to DVR.展开更多
The original online version of this article (Kamenarova, K., Cherninkova, S., Mihova, K., Georgiev, R., Nikolaeva, Y. and Kaneva, R. (2022) Identification of Novel Nonsense RPGR Variant Causing Mild X-Linked Cone-Rod ...The original online version of this article (Kamenarova, K., Cherninkova, S., Mihova, K., Georgiev, R., Nikolaeva, Y. and Kaneva, R. (2022) Identification of Novel Nonsense RPGR Variant Causing Mild X-Linked Cone-Rod Dystrophy and Myopia. Case Reports in Clinical Medicine, 11, 422-434. DOI: 10.4236/crcm.2022.1110059) unfortunately contains a mistake. The authors need to replace Figure 1.展开更多
Ionizing radiation(IR)is a potential carcinogen.Evidence for the carcinogenic effect of IR radiation has been shown after long-term animal investigations and observations on survivors of the atom bombs in Hiroshima an...Ionizing radiation(IR)is a potential carcinogen.Evidence for the carcinogenic effect of IR radiation has been shown after long-term animal investigations and observations on survivors of the atom bombs in Hiroshima and Nagasaki.However,IR has been widely used in a controlled manner in the medical imaging for diagnosis and展开更多
Causality assessment of suspected drug induced liver injury(DILI) and herb induced liver injury(HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent eva...Causality assessment of suspected drug induced liver injury(DILI) and herb induced liver injury(HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences(CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. 2014 Baishideng Publishing Group Co., Limited. All展开更多
AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)pat...AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)patients with POAG were included in the study.Each patient underwent a limbus-based trabeculectomy.The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at-80t until they were assayed.Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years(53-68 years)vs 58.9±8.9 years(47-70 years)in group 1and group 2(P=0.859).The mean treatment time in group 2 was 22.2±7.3 months(12-34 months).Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication(group 2)compared to treatment-naive POAG patients(group 1)(P=0.004,0.015;respectively).CONCLUSION:Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.展开更多
Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and costly.The development of foot ulcer in a diabetic pati...Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and costly.The development of foot ulcer in a diabetic patient has been estimated to be 19%-34%through their lifetime.The pathophysiology of diabetic foot ulcer consist of neuropathy,trauma and,in many patients,additional peripheral arterial disease.In particular,diabetic neuropathy leads to foot deformity,callus formation,and insensitivity to trauma or pressure.The standard algorithms in diabetic foot ulcer management include assessing the ulcer grade classification,surgical debridement,dressing to facilitate wound healing,offloading,vascular assessment(status and presence of a chance for interventional vascular correction),and infection and glycemic control.Although especially surgical procedures are sometimes inevitable,they are poor predictive factors for the prognosis of diabetic foot ulcer.Different novel treatment modalities such as nonsurgical debridement agents,oxygen therapies,and negative pressure wound therapy,topical drugs,cellular bioproducts,human growth factors,energy-based therapies,and systematic therapies have been available for patients with diabetic foot ulcer.However,it is uncertain whether they are effective in terms of promoting wound healing related with a limited number of randomized controlled trials.This review aims at evaluating diabetic foot ulcer with regard to all aspects.We will also focus on conventional and novel adjunctive therapy in diabetic foot management.展开更多
Since the 1980s, various techniques have been used in the field of medicine for the post-processing of medical imaging data from computed tomography (CT) and magnetic resonance (MR). They include multiplanar reformati...Since the 1980s, various techniques have been used in the field of medicine for the post-processing of medical imaging data from computed tomography (CT) and magnetic resonance (MR). They include multiplanar reformations (MPR), maximum intensity projection (MIP) and Volume Rendering (VR). This paper presents the prototype of a new means of post-processing radiological examinations such as CT and MR, a technique that, for the first time, provides photorealistic visualizations of the human body. This new procedure was inspired by the quality of images achieved by animation software such as programs used in the entertainment industry, particularly to produce animated films. Thus, the name: Cinematic Rendering. It is already foreseeable that this new method of depiction will quickly be incorporated into the set of instruments employed in socalled virtual anatomy (teaching anatomy through the use of radiological depictions of the human body via X-ray, CT and MR in addition to the use of computer animation programs designed especially for human anatomy). Its potential for medical applications will have to be evaluated by future scientific investigations.展开更多
The foundational chronology of Torsadogenic Index is introduced to explain the relationship between impending death situations and drug prescription, combination, self-indication, or abuse of torsadogenic pharmacologi...The foundational chronology of Torsadogenic Index is introduced to explain the relationship between impending death situations and drug prescription, combination, self-indication, or abuse of torsadogenic pharmacological products. The pathophysiological basis of Torsade de Pointes is presented with the most frequent causes of Long QT syndrome. Traditional Chinese Medical principles are exposed in order to help people to understand its para-logical sequence, providing another view of medical explanations upon scientific evidence. Development of Torsadogenic Risk Management Project and Torsadogenic Traceability concepts derived from these Chinese Medical perpetual axioms are presented in this paper.展开更多
Introduction: With the introduction of a new curriculum “Modellstudiengang Medizin” in Aachen, the education in medical psychology was also restructured. This paper presents data from the students’ evaluations of t...Introduction: With the introduction of a new curriculum “Modellstudiengang Medizin” in Aachen, the education in medical psychology was also restructured. This paper presents data from the students’ evaluations of the Basic Course in Medical Psychology and the new teaching format “Systemblock Psyche” over a three-year time span. Method: All students were asked to evaluate the courses anonymously online. Effect sizes [1] were calculated to compare acceptance of the different course types and also changes across time. Results: Both the Basic Course in Medical Psychology and the Systemblock Psyche were rated as “good” to “satisfactory” and were in their overall acceptance comparable to other courses and system blocks. Continuous improvement in acceptance was found for the Basic Course (d = 0.30 - 0.57). The Systemblock Psyche received varying evaluations but achieved higher scores on comprehensibility (d = 0.20) and communication among teachers (d = 0.34) than other system blocks. On the other hand, students rated the education in medical psychology as less relevant than other courses (d = 0.28 and 0.77, respectively). Conclusion: Overall, the acceptance rating was satisfactory and comparable to other evaluation studies conducted in earlier curricula. However, ratings of the relevance of the courses in medical psychology were disappointing and indicate the difficulty of teaching a biopsychosocial model to medical students.展开更多
Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World ...Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World Congress of Ophthalmology(WOC);Member of the German Academy of Sciences,former President of German Society of Ophthalmology(DOG);Former Executive Vice President of University of Leipzig and Director of the Eye Hospital;Member of the Club Jules Gonin Executive Committee(2000-2006)。展开更多
文摘AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.
文摘Multiple sclerosis(MS)is an autoimmune disorder of the central nervous system(CNS)and is primarily characterized by immune cell infiltration leading to relapses followed by remission phases and a disease course turning progressive over time with neurodegenerative processes taking over(Amin and Hersh,2023).Of note,beyond relapse-associated worsening early in disease progression independent of relapse activity may arise independently of relapse activity and can occur in all phenotypes.Autoimmune-mediated damage of myelin sheaths and the subsequent loss of mature oligodendrocytes are resulting in impaired axonal integrity,neurodegeneration and accounts for irreversible neuronal damage(Kuhlmann et al.,2023).The current landscape of available disease-modifying therapies comprises mainly immunomodulatory drugs that effectively diminish relapses and slow down progression at the onset form of the disease,namely relapsing MS(RMS).In this regard,a number of drugs have been approved as disease-modifying therapies for MS by US Food and Drug Administration and European Medicines Agencies(Box 1).
基金supported by the Heart and Stroke Foundation and Ontario Institute of Regenerative Medicine (New Ideas Grant)Canada First Research Excellence Fund(Medicine by Design)+2 种基金the National Sciences and Engineering Research Councilthe Jurgen Manchot Foundationthe Christiane and Claudia Hempel Foundation for Clinical Stem Cell Research and the James and Elisabeth Cloppenburg,Peek and Cloppenburg Düsseldorf Stiftung (to PK)
文摘Astrocytes are indispensable for central nervous system development and homeostasis.In response to injury and disease,astrocytes are integral to the immunological-and the,albeit limited,repair response.In this review,we will examine some of the functions reactive astrocytes play in the context of multiple sclerosis and related animal models.We will consider the heterogeneity or plasticity of astrocytes and the mechanisms by which they promote or mitigate demyelination.Finally,we will discuss a set of biomedical strategies that can stimulate astrocytes in their promyelinating response.
文摘The adult mammalian central nervous system(CNS) coordinates essential functions such as sensation,movement,autonomic control,thought processes,and communication.Consequently,injuries or diseases of the CNS are often associated with devastating and permanent functional impairments because damaged axons normally fail to regenerate.An insufficient neuron-intrinsic growth capacity and an inhibitory environment at the injury site are the leading causes of this regenerative failure.
文摘This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivotal role in neurodegenerative diseases like Parkinson's disease,encompassing diverse components such as the gut microbiota,immune system,metabolism,and neural pathways.The gut microbiome,profoundly influenced by dietary factors,emerges as a key player.Nutrition during the first 1000 days of life shapes the gut microbiota composition,influencing immune responses and impacting both child development and adult health.High-fat,high-sugar diets can disrupt this delicate balance,contributing to inflammation and immune dysfunction.Exploring nutritional strategies,the Mediterranean diet's anti-inflammatory and antioxidant properties show promise in reducing Parkinson's disease risk.Microbiome-targeted dietary approaches and the ketogenic diet hold the potential in improving brain disorders.Beyond nutrition,emerging research uncovers potential interactions between steroid hormones,nutrition,and Parkinson's disease.Progesterone,with its anti-inflammatory properties and presence in the nervous system,offers a novel option for Parkinson's disease therapy.Its ability to enhance neuroprotection within the enteric nervous system presents exciting prospects.The review addresses the hypothesis thatα-synuclein aggregates originate from the gut and may enter the brain via the vagus nerve.Gastrointestinal symptoms preceding motor symptoms support this hypothesis.Dysfunctional gut-brain signaling during gut dysbiosis contributes to inflammation and neurotransmitter imbalances,emphasizing the potential of microbiota-based interventions.In summary,this review uncovers the complex web of interactions between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the gut-brain axis framework.Understanding these connections not only offers novel therapeutic insights but also illuminates the origins of neurodegenerative diseases such as Parkinson's disease.
文摘BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.
文摘In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘Immune-checkpoint inhibitor-mediated colitis(IMC)is an increasingly recognized adverse event in cancer immunotherapy,particularly associated with immune checkpoint inhibitors(ICIs)such as anti-cytotoxic T-lymphocyte antigen-4 and anti-programmed cell death protein-1 antibodies.As this revolutionary immunotherapy gains prominence in cancer treatment,understanding,diagnosing,and effectively managing IMC becomes paramount.IMC represents a unique challenge due to its immune-mediated nature and potential for severe complications.However,a precise picture of IMC pathophysiology is currently unavailable.Therefore,we aimed to summarize the existing data while acknowledging the need for further research.This comprehensive review explores the mechanisms underlying ICIs,gastrointestinal adverse effects,and,in particular,IMC’s incidence,prevalence,and features.Our review also emphasizes the importance of recognizing IMC’s distinct clinical and histopathological features to differentiate it from other forms of colitis.Furthermore,this paper highlights the urgentneed for evolving diagnostic methods,therapeutic strategies,and a multidisciplinary approach to effectively manage IMC.
基金Supported by The European Union-NextGenerationEU,Through The National Recov-ery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008。
文摘Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.
文摘BACKGROUND The management of tongue carcinoma is excision and radical neck dissection followed with reconstruction.This is a case report of a patient with tongue squamous cell carcinoma(SCC)who underwent the procedure with sternocleidomastoid(SCM)flap reconstruction.CASE SUMMARY A 52-year-old woman without smoking history complained tongue ulcer since 3 years ago.Based on the histopathological examination,the patient was diagnosed with T2N2M0 right tongue SCC and underwent wide excision of tumor;right mandibular;neck dissection and were reconstructed with SCM flap.CONCLUSION SCC of the tongue requires wide excision and dissection of the neck and mandible if infiltration into the surrounding lymph nodes has been found.The SCM flap reconstruction could be used post-surgery.
基金The study was reviewed and approved by the Ethical Committee Faculty of Medicine,University of Indonesia(Approval No.KET-615/UN2.F1/ETIK/PPM.00.02/2020)Ethical Committee of Fatmawati General Hospital(Approval No.DM 01.01/VIII.2/1294/2020).
文摘BACKGROUND Adolescent idiopathic scoliosis remains a major problem due to its high incidence,high risk,and high cost.One of the aims of the management in scoliosis is to correct the deformity.Many techniques are available to correct scoliosis deformity;however,they are all far from ideal to achieve three-dimensional correction in scoliosis.AIM To develop a set of tools named Scoliocorrector Fatma-UI(SCFUI)to aid threedimensional correction and to evaluate the efficacy,safety,and functional outcome.METHODS This study consists of two stages.In the first stage,we developed the SCFUI and tested it in finite element and biomechanical tests.The second stage was a single-blinded randomized clinical trial to evaluate the SCFUI compared to direct vertebral rotation(DVR).Forty-four subjects with adolescent idiopathic scoliosis were randomly allocated into the DVR group(n=23)and SCFUI group(n=21).Radiological,neurological,and functional outcome was compared between the groups.RESULTS Finite element revealed the maximum stress of the SCFUI components to be between 31.2-252 MPa.Biomechanical analysis revealed the modulus elasticity of SCFUI was 9561324±633277 MPa.Both groups showed improvement in Cobb angle and sagittal profile,however the rotation angle was lower in the SCFUI group(11.59±7.46 vs 18.23±6.39,P=0.001).Neurological and functional outcome were comparable in both groups.CONCLUSION We concluded that SCFUI developed in this study resulted in similar coronal and sagittal but better rotational correction compared to DVR.The safety and functional outcomes were also similar to DVR.
文摘The original online version of this article (Kamenarova, K., Cherninkova, S., Mihova, K., Georgiev, R., Nikolaeva, Y. and Kaneva, R. (2022) Identification of Novel Nonsense RPGR Variant Causing Mild X-Linked Cone-Rod Dystrophy and Myopia. Case Reports in Clinical Medicine, 11, 422-434. DOI: 10.4236/crcm.2022.1110059) unfortunately contains a mistake. The authors need to replace Figure 1.
文摘Ionizing radiation(IR)is a potential carcinogen.Evidence for the carcinogenic effect of IR radiation has been shown after long-term animal investigations and observations on survivors of the atom bombs in Hiroshima and Nagasaki.However,IR has been widely used in a controlled manner in the medical imaging for diagnosis and
文摘Causality assessment of suspected drug induced liver injury(DILI) and herb induced liver injury(HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences(CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. 2014 Baishideng Publishing Group Co., Limited. All
文摘AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)patients with POAG were included in the study.Each patient underwent a limbus-based trabeculectomy.The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at-80t until they were assayed.Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years(53-68 years)vs 58.9±8.9 years(47-70 years)in group 1and group 2(P=0.859).The mean treatment time in group 2 was 22.2±7.3 months(12-34 months).Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication(group 2)compared to treatment-naive POAG patients(group 1)(P=0.004,0.015;respectively).CONCLUSION:Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.
文摘Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and costly.The development of foot ulcer in a diabetic patient has been estimated to be 19%-34%through their lifetime.The pathophysiology of diabetic foot ulcer consist of neuropathy,trauma and,in many patients,additional peripheral arterial disease.In particular,diabetic neuropathy leads to foot deformity,callus formation,and insensitivity to trauma or pressure.The standard algorithms in diabetic foot ulcer management include assessing the ulcer grade classification,surgical debridement,dressing to facilitate wound healing,offloading,vascular assessment(status and presence of a chance for interventional vascular correction),and infection and glycemic control.Although especially surgical procedures are sometimes inevitable,they are poor predictive factors for the prognosis of diabetic foot ulcer.Different novel treatment modalities such as nonsurgical debridement agents,oxygen therapies,and negative pressure wound therapy,topical drugs,cellular bioproducts,human growth factors,energy-based therapies,and systematic therapies have been available for patients with diabetic foot ulcer.However,it is uncertain whether they are effective in terms of promoting wound healing related with a limited number of randomized controlled trials.This review aims at evaluating diabetic foot ulcer with regard to all aspects.We will also focus on conventional and novel adjunctive therapy in diabetic foot management.
文摘Since the 1980s, various techniques have been used in the field of medicine for the post-processing of medical imaging data from computed tomography (CT) and magnetic resonance (MR). They include multiplanar reformations (MPR), maximum intensity projection (MIP) and Volume Rendering (VR). This paper presents the prototype of a new means of post-processing radiological examinations such as CT and MR, a technique that, for the first time, provides photorealistic visualizations of the human body. This new procedure was inspired by the quality of images achieved by animation software such as programs used in the entertainment industry, particularly to produce animated films. Thus, the name: Cinematic Rendering. It is already foreseeable that this new method of depiction will quickly be incorporated into the set of instruments employed in socalled virtual anatomy (teaching anatomy through the use of radiological depictions of the human body via X-ray, CT and MR in addition to the use of computer animation programs designed especially for human anatomy). Its potential for medical applications will have to be evaluated by future scientific investigations.
文摘The foundational chronology of Torsadogenic Index is introduced to explain the relationship between impending death situations and drug prescription, combination, self-indication, or abuse of torsadogenic pharmacological products. The pathophysiological basis of Torsade de Pointes is presented with the most frequent causes of Long QT syndrome. Traditional Chinese Medical principles are exposed in order to help people to understand its para-logical sequence, providing another view of medical explanations upon scientific evidence. Development of Torsadogenic Risk Management Project and Torsadogenic Traceability concepts derived from these Chinese Medical perpetual axioms are presented in this paper.
文摘Introduction: With the introduction of a new curriculum “Modellstudiengang Medizin” in Aachen, the education in medical psychology was also restructured. This paper presents data from the students’ evaluations of the Basic Course in Medical Psychology and the new teaching format “Systemblock Psyche” over a three-year time span. Method: All students were asked to evaluate the courses anonymously online. Effect sizes [1] were calculated to compare acceptance of the different course types and also changes across time. Results: Both the Basic Course in Medical Psychology and the Systemblock Psyche were rated as “good” to “satisfactory” and were in their overall acceptance comparable to other courses and system blocks. Continuous improvement in acceptance was found for the Basic Course (d = 0.30 - 0.57). The Systemblock Psyche received varying evaluations but achieved higher scores on comprehensibility (d = 0.20) and communication among teachers (d = 0.34) than other system blocks. On the other hand, students rated the education in medical psychology as less relevant than other courses (d = 0.28 and 0.77, respectively). Conclusion: Overall, the acceptance rating was satisfactory and comparable to other evaluation studies conducted in earlier curricula. However, ratings of the relevance of the courses in medical psychology were disappointing and indicate the difficulty of teaching a biopsychosocial model to medical students.
文摘Immediate Past President of International Council of Ophthalmology(ICO);Academician and former Secretary General of Academia Ophthalmologica Internationalis(AOI);Former Chairman of the Scientific Program of the World Congress of Ophthalmology(WOC);Member of the German Academy of Sciences,former President of German Society of Ophthalmology(DOG);Former Executive Vice President of University of Leipzig and Director of the Eye Hospital;Member of the Club Jules Gonin Executive Committee(2000-2006)。
