IC Group Research Articles

Delirious behavior or mild reduction of consciousness mimicking influenza‐associated encephalopathy

During the A/H1N1 pandemic, patients suffered from impaired consciousness. They were suspected of or diagnosed as having influenza-associated encephalopathy (IAE) in an emergency situation. Their symptoms resembled those of a recently described 'unique clinical group', which were reported to have a favorable prognosis. We retrospectively examined 46 patients and divided them into two groups. Group IC contained the 26 patients with persisting impaired consciousness. The remainder of the patients were categorized into group R, consisting of patients with only neurological symptoms without impaired consciousness. Male predominance (22 male/four female) was noted in group IC. Patient age ranged from 5 to 12 years old (mean ± SD, 7.7 ± 2.3 years). Impaired consciousness such as delirious behavior or mild reduction of consciousness lasted continuously or intermittently from 5 min to 2.5 days. On electroencephalogram, semi-rhythmic high-voltage slow waves in the parieto-occipital regions and diffuse high-voltage slow waves were observed in eight and in two patients, respectively. In group R, there was no gender predominance. Patient age ranged from 1 to 9 years old (mean ± SD, 4.1 ± 2.5 years). All group R patients were clinically diagnosed with febrile seizure. Some of the characteristics in group IC resembled those of the unique clinical group, and are part of a continuous clinical spectrum. Some patients may have favorable outcome without specific treatment.

Comportamento biomecânico do sistema prótese/implante em região anterior de maxila: análise pelo método de ciclagem mecânica

INTRODUÇÃO : O adequado posicionamento tridimensional dos implantes é indispensável para garantir a previsibilidade no tratamento com implantes dentários. OBJETIVO : Analisar comparativamente o comportamento mecânico do sistema prótese/implante em região anterior de maxila, diferindo os sistemas de encaixe e posicionamento dos implantes. MATERIAL E MÉTODO : Utilizando um modelo prototipado de maxila, as situações estudadas foram: Grupo IC - implantes nos incisivos centrais e cantilever nos incisivos laterais; Grupo IL - implantes nos incisivos laterais e pônticos nos incisivos centrais; Grupo ICIL - implantes no incisivo central e no incisivo lateral, intercalados com elementos suspensos. Para cada situação estudada, foram utilizadas as três conexões protéticas: hexágono externo, hexágono interno e cone-Morse. O ensaio de ciclagem mecânica foi realizado com a aplicação de 100 N de carga e frequência de 15 Hz no cíngulo dos incisivos a 45° com o longo eixo do dente, para simular o movimento mastigatório. RESULTADO : No ensaio de ciclagem mecânica, todos os modelos de todos os grupos com os três tipos de conexões protéticas atingiram um milhão de ciclos sem que ocorresse ruptura do parafuso, do componente protético ou da estrutura metálica. CONCLUSÃO : Com a metodologia e as condições empregadas, pode-se concluir que o comportamento mecânico das reabilitações implantossuportadas foi semelhante para os diferentes posicionamentos dos implantes e diferentes conexões protéticas.

Path Finding for Multiple Platforms

With the increasing complexity of today's SOCs and the growth in multi-die packaging, companies are recognizing the value of cross-domain collaboration between the IC, package substrate and PCB design groups. High pin count devices coupled with cost sensitivity drive engineers to reconsider how they plan, optimize and automate the I/O placement on their chips, while targeting multiple packaging variables, which have direct impact on how the PCB will be designed. In some instances, informal design flows based on multiple EDA design tools have been pieced together. This is a step in the right direction; however, without a central repository for the data or accurate device modeling and rule-based optimization, design intent is often misinterpreted or lost and redundancy is often introduced into the flow. This presentation outlines a co-design methodology that allows design teams the ability to easily plan and optimize I/O and connectivity from a chip(s), through multiple packaging variables while targeting multiple different system platforms (PCBs). Using this planning, optimization and design methodology, engineering teams for the IC, the Package and the PCB would drive rule-based I/O level optimization and perform ball-out studies from their respective domains, all while visualizing the impact across the complete system. Key features and advantages of this methodology are:Multi-mode connectivity management for cross-domain pin/signal mapping/shortingUser definable rules for I/O and ball-out assignmentsRobust support for feasibility analysis and rapid prototypingFully automated library developmentDirect integration to multi-mode physical layout toolSeamless interface to 2D and 3D EM analysis enginesTight interface with CFD based thermal analysis solutionEDA vendor neutral flow The result of implementing this methodology will be a chip(s) that is fully optimized for its package(s) and PCB(s). This solution drives down the cost of the package and PCB through layer reduction and tighter control of the design process without impacting the cost of the chip.

Mechanical behavior of dental implants in different positions in the rehabilitation of the anterior maxilla

In dental rehabilitations that involve implants, the number of implants is sometimes smaller than the number of lost teeth. This fact can affect the biomechanical behavior and success of the implants. The purpose of this study was to investigate the mechanical behavior of different implant positions in the rehabilitation of the anterior maxilla. Three-dimensional models of the maxilla were created based on computed tomography images for 3different anterior prosthetic rehabilitations. In group IL, the implants were placed in the lateral incisor positions with pontics in the central incisor positions; in group IC, the implants were in the central incisor positions with cantilevers in the lateral incisor positions; and, in group ILIC, one implant was in a lateral incisor position and one was in a central incisor position, with a pontic and a cantilever in the remaining positions. A 150 N load was distributed and applied at the center of the palatal surface of each tooth at a 45-degree angle to the long axis of the tooth. The resulting stress-strain distribution was analyzed for each group. The lowest displacement of the prosthetic structure was observed in group IC, although the same group exhibited the largest displacement of the bone tissue. In the bone tissue, the von Mises stress was mainly observed in the cortical bone in all groups. The maximum value of the von Mises stress shown in the cortical tissue was 35 MPa in the implant that neighbors the cantilever in group ILIC. The maximum von Mises stress in the trabecular bone was 3.5 MPa. The prosthetic configuration of group IC limited the displacement of the prosthetic structure but led to greater displacement of the bone structure. The use of a cantilever increased the stress concentration in the implant and in the bone structure adjacent to the cantilever under the conditions studied here.

A comparative histological, immunohistochemical, and biochemical study of the effect of green tea extracts or chromium picolinate administration on the white visceral adipose tissue and liver in albino rats fed on high-fat diet

Background Obesity has become a major health problem, as a growing proportion of the population worldwide is overweight. The coincidence of obesity, insulin resistance, hypertension, dyslipidemia, and hepatic steatosis is commonly referred to as the ‘metabolic syndrome’. The investigation of the antiobesity properties of food components is a popular field of research and one of these natural agents of interest is green tea extract (GTE). Nevertheless, chromium picolinate (CP) is also postulated to have an effect on the body fat composition. Objective The present study aimed to assess the changes in the visceral white adipose tissue and the liver of adult male albino rats that are fed on high-fat diet (HFD) following administration of GTE or CP supplements histologically, immunohistochemically, and biochemically. Materials and methods A total of 60 adult male albino rats (120–150g) were randomly assigned into four groups. Group I (the control group) included 30 rats and were subdivided into three equal subgroups (Ia, Ib, Ic); all were fed on standard rat chow. Groups Ib and Ic were given GTE and CP, respectively, orally through an orogastric tube. Group II included 10 rats that were allowed a free access to HFD. Group III (the GTE and HFD group) included 10 rats that received GTE orally (200 mg/kg body weight/day) in conjunction with HFD. Group IV (the CP and HFD group) included 10 rats that received CP orally (80 μg/kg body weight/day) in conjunction with HFD. The experiment continued for 3 months. Perinephric white adipose tissue (PWAT) and liver specimens were dissected from all rats at the end of the experiment for histological and immunohistochemical examination. Blood samples were taken for estimation of fasting blood glucose (FBG) and fasting blood insulin (FBI) levels. Results Histologically, groups Ib and Ic revealed almost the control pattern of the liver and PWAT similar to group Ia. Group II showed focal areas of cellular infiltration and congestion of the blood vessels of the liver sections. Most hepatocytes appeared swollen with cytoplasmic vacuolation. PWAT revealed a marked increase in the amount and size of the adipocytes. Groups III and IV revealed almost the control pattern of the liver except for few areas of cellular infiltrations in group IV. Groups III and IV showed a marked decrease in the amount of PWAT, which was more remarkable in group IV. Decrease in the size of many adipocytes was more manifested in group IV. Immunohistochemically, increased expression of insulin receptors in the adipocytes of PWAT and to a lesser extent in the hepatocytes of group III was noticed. Group IV showed more noticeable increased expression of insulin receptors compared with group III. Biochemically, FBI in the obesity group was higher as compared with the control group. Groups III and IV revealed a significant decrease in the FBI level. Fasting blood glucose level showed significant increase in group II only. Conclusion Supplementation with either GTE or CP may be useful as antiobesity agents and can be used to prevent the impact of obesity on the liver and to improve insulin resistance.

Toward an evidence-based proposal for the best minimal immunohistochemical panel to infer lung carcinoma in metastatic supraclavicular lymph node

Carcinomas from either pulmonary or extrapulmonary sites can metastatise to supraclavicular lymph nodes. Immunohistochemistry (IHC) is invaluable to comment on the possible primary site. However, the optimal number of antibodies to be tested is debatable. Seven antibodies were tested on 135 metastatic supraclavicular lymph node biopsies to propose a "best minimal" IHC panel to infer lung carcinoma, incorporating the principles of "evidence-based medicine." The 135 cases were divided into the following: category I (110 cases), wherein the primary was in the lung based on histologic analysis (Ia, n = 14 [12.7%]), cytologic analysis (Ib, n = 43 [39.1%]), or strong clinicoradiologic evidence (Ic, n = 53 [48.2%]), and category II (25 cases) with a histologically proven extrapulmonary primary site. Categories Ia and Ib were together designated as the "control group," and category Ic was designated as the "test group." The antibodies tested were cytokeratin (CK 7, CK20), epithelial membrane antigen, carcinoembryonic antigen, thyroid transcription factor-1 (TTF-1), surfactant protein B (SPB), and vimentin. Results of both individual and panels of antibodies were statistically evaluated. The sensitivity and specificity of single antibodies for inferring a lung primary was as follows: CK7 (90%/56%), CK20 (98%/40%), epithelial membrane antigen (90.9%/4%), carcinoembryonic antigen (80.9%/36%), TTF-1 (62.7%/100%), SPB (65.6%/100%), and vimentin (60.9%/60%). The highest sensitivity (85%) and specificity (100%) were seen with a 4-antibody panel: CK7, CK20, TTF-1, and SPB. This panel revealed the highest binomial probability (.8), for diagnosing lung cancer. The results were validated using a "split sample method," and a high concordance was noted between the control and test groups. To conclude, such evidence-based validated studies analyzing IHC results would be invaluable to guide the practice of surgical pathology in the future.

The Cold-Induced Two-Component System CBO0366/CBO0365 Regulates Metabolic Pathways with Novel Roles in Group I Clostridium botulinum ATCC 3502 Cold Tolerance

The two-component system CBO0366/CBO0365 was recently demonstrated to have a role in cold tolerance of group I Clostridium botulinum ATCC 3502. The mechanisms under its control, ultimately resulting in increased sensitivity to low temperature, are unknown. A transcriptomic analysis with DNA microarrays was performed to identify the differences in global gene expression patterns of the wild-type ATCC 3502 and a derivative mutant with insertionally inactivated cbo0365 at 37 and 15°C. Altogether, 150 or 141 chromosomal coding sequences (CDSs) were found to be differently expressed in the cbo0365 mutant at 37 or 15°C, respectively, and thus considered to be under the direct or indirect transcriptional control of the response regulator CBO0365. Of the differentially expressed CDSs, expression of 141 CDSs was similarly affected at both temperatures investigated, suggesting that the putative CBO0365 regulon was practically not affected by temperature. The regulon involved genes related to acetone-butanol-ethanol (ABE) fermentation, motility, arsenic resistance, and phosphate uptake and transport. Deteriorated growth at 17°C was observed for mutants with disrupted ABE fermentation pathway components (crt, bcd, bdh, and ctfA), arsenic detoxifying machinery components (arsC and arsR), or phosphate uptake mechanism components (phoT), suggesting roles for these mechanisms in cold tolerance of group I C. botulinum. Electrophoretic mobility shift assays showed recombinant CBO0365 to bind to the promoter regions of crt, arsR, and phoT, as well as to the promoter region of its own operon, suggesting direct DNA-binding transcriptional activation or repression as a means for CBO0365 in regulating these operons. The results provide insight to the mechanisms group I C. botulinum utilizes in coping with cold.

Acute cholecystitis: the golden 72-h period is not a strict limit to perform early cholecystectomy. Results from 316 consecutive patients

Early laparoscopic cholecystectomy (ELC) is the treatment of choice for acute cholecystitis (AC), but the optimal surgical timing is controversial. The aim of this study was to retrospectively verify the outcome of patients with AC according to different timing of cholecystectomy. Patients undergoing cholecystectomy for AC from 2006 to 2012 were stratified into two groups: initial admission cholecystectomy (IAC) and delayed cholecystectomy (DC, after at least 4 weeks). Among IAC, a subgroup undergoing immediate cholecystectomy (IC, within 72 h of symptom onset) was further analyzed. Three-hundred and sixteen consecutive patients were studied. IAC group included 262 patients (82.9 %) and DC group included 54 patients (17.1 %). The two groups were similar in conversion rate, operation length, and overall complication rate. The total length of hospitalization was longer in DC patients (p = 0.005). Among DC patients, 25.9 % required re-hospitalization while waiting an elective procedure. In the group undergoing IC (66 patients), conversion rate, length of operation, and postoperative morbidity were similar to that of the IAC group. Length of stay was shorter in IC group (p < 0.001). Multivariate analysis identified moderate-severe AC grading and ASA score ≥ 3 as predictors of postoperative complications. The timing of cholecystectomy for AC does not seem to affect conversion rate and postoperative morbidity. Therefore the 72-h period should not be considered a strict limit to perform LC, provided that the operation is carried out during the initial hospital admission.

Establishing a Lymphedema Rat Model for Vascularized Lymph Nodes Transfer

INTRODUCTION: This study was aimed to establish a lower limb lymphedema animal model for vascularized lymph nodes (VLN) flap transfer. METHODS: Lymphedema in the lower extremity was created by removing the unilateral groin lymph nodes followed by treatment with 20, 30, and 40 Gy (group IA, IB, and IC, respectively) radiations or removing both inguinal groin lymph nodes and popliteal lymph nodes followed by treatment with 20 Gy (group IIA) radiation in the Sprague-Dawleys rat (10-12 weeks old, weighted 350 g to 400 g). The vascularized LN flap from periaortic lymph nodes was transferred to the groin site of the lymphedematous limb. The volume differentiation was assessed by micro-CT and defined as the volume of lesion limb minus health limb and divided by the health limb. The lymph flow was assessed by Tc99 nano-collid lymphoscintigraphy for 30 minutes, 5 hours and 24 hours at 3 months after LN transfer. RESULTS: At 4 weeks after lymph nodes removal followed by radiation, 0 % in group IA (n=3), 37.5 % in group IB (n=16), and 50 % in group IC (n=26) developed lymphedema in the lower limb. But 40 Gy and 30 Gy radiation treatment would cause higher mortality and mobility. However, the success rate of group IIA was 80 % (n=27). The volume differentiation of the lymphedematous limb compared to the health limb was 7.14 ± 0.46 % in the group IIA. Tc99 nano-collid was accumulated in the lymphedematous limb in the sham group, but was not accumulated in the VLN group on lymphoscintigraphy image. In addition, the more lymph nodes transferred, Tc99 clearance time was quicker. CONCLUSION: Removal of both inguinal groin lymph nodes and popliteal lymph nodes and followed by radiation of 20 Gy may develop the lymphedema in the lower limb in 4 weeks. Vascularized lymph node transfer can effectively drain the lymph in Tc99 nano-collid lymphoscintigraphy.

Prediction of disease reactivation in asymptomatic hepatitis B e antigen-negative chronic hepatitis B patients using baseline serum measurements of HBsAg and HBV-DNA

Differentiating ‘inactive carriers’ (ICs) of hepatitis B virus (HBV) from hepatitis B e antigen-negative (HBeAg[−]) patients in remission is challenging. We investigated whether serum-based monitoring of hepatitis B surface antigen (HBsAg) and HBV-DNA in asymptomatic HBeAg(−) patients could distinguish these groups. Design129 HBeAg(−) chronic hepatitis B (CHB) patients (HBV genotypes A–E) with normal alanine aminotransferase (ALT) levels at baseline were classified after 1 year of follow-up as either IC (HBV-DNA ≤2000IU/mL) or ‘active carrier’ (AC, HBV-DNA >2000IU/mL) if they exhibited normal ALT throughout, or classified as ‘reactivation patient’ (RP) if they exhibited marked, transient increases in ALT and HBV-DNA. ResultsThere were 64%, 18%, and 19% patients in the IC, AC, and RP groups, respectively. Combined HBsAg and HBV-DNA cutoffs (>1000IU/mL and >200IU/mL, respectively) differentiated RPs with 92% sensitivity and negative predictive value (NPV) of 96%. HBsAg sero-clearance was associated with baseline HBsAg <1000IU/mL, annual decrease of ≥0.3logIU/mL (NPV 95%: PPV 89%) and IFNL3 genotype CC. ConclusionApplying combined HBsAg and HBV-DNA cutoffs to baseline measurements accurately differentiated RPs. These results suggest that HBsAg should be included in the monitoring of asymptomatic HBeAg(−) CHB patients.

PHYSIOLOGICAL RACES OF RICE BLAST PATHOGEN AND HOST RESISTANT GENES UNDER EGYPTIAN CONDITIONS

Experiments were carried out at Rice Research and Training Center during 2009 to 2012 growing seasons. This study aimed at evaluation of some commercial Egyptian rice cultivars and some promising lines against blast disease, identification of effective rice blast resistant genes, and distribution of physiological races and common races of Pyricularia grisea. One hundred and thirty two of P. grisea isolates were collected from rice-cultivating governorates in Egypt, namely Kafr EL-Sheikh (36 isolates), Gharbia (48 isolates), Dakahlia (18 isolates), Sharkia (12 isolates), Damietta (6 isolates) and Beheira (12 isolates). IH race group was the most common race (47.69%), followed by IC (26.58%) and IF (12.15%) groups, While IG, ID and IE (6.06, 6.04 and 1.49%, respectively) were the minor race groups during this study period. The promising line GZ 9057-6-1-3-2 revealed the highest level of resistance against most isolates tested (98.48%) followed by Giza 178 and GZ 9523-2-1-1-1 (96.22% for each). On the other hand, the susceptible rice cultivars, Sakha 101 and Sakha104, were infected with the most tested isolates (25.76 and 61.36 % resistance, respectively).Pi-z-5 gene found in IRBLz5-CA and IRBLz5-CA (R) lines scored the highest effective gene of blast resistance (97.76 and 95.50%, respectively). This gene was followed by pita-2 gene, found in the monogenic line IRBLta2-Re (91.70%). On the other hand, Pia gene found in IRBLa-A and IRBLa-C lines was the lowest effective resistant gene with zero efficacy against the tested isolates. The highest percentage of race groups from the total identified isolates were obtained from Gharbia and Kafr El-Sheikh governorates (36.53 and 27.27%, respectively). On other hand, Damietta governorate had the lowest percentage of race groups (4.56% from the total identified races).

A Comparative Study of Risk Factors and the Occurrence Rate of Coronary Atherosclerosis in Extra- and Intracranial Atherosclerotic Lesions

The risk factors and epidemiology of extracranial and intracranial atherosclerotic lesions may be different. We evaluated the importance of perioperative management of coronary atherosclerotic lesions in carotid endarterectomy (CEA) or carotid artery stenting (CAS) for extracranial cervical carotid artery stenosis and superior temporal artery (STA)-middle cerebral artery (MCA) bypass for intracranial severe MCA stenosis/occlusion. The medical records of patients who underwent cerebrovascular surgery at Aizu Chuo Hospital between January 2000 and September 2010 were retrospectively analyzed. Preoperative cardiovascular screening was performed for all patients to prevent perioperative ischemic heart disease-related complications. The number of patients requiring preoperative treatment of the coronary artery was compared. A total of 320 patients underwent surgery for cervical carotid stenosis (IC group; 259 patients with CEA and 61 patients with CAS), and 92 patients underwent STA-MCA bypass for MCA stenosis/occlusion (MC group). Treatment for coronary lesions was required in 35 of 320 patients (10.9%) in the IC group and 14 of 92 patients (15.2%) in the MC group. Surgery was safely performed in both groups without any ischemic heart disease-related complications during the perioperative period. This study shows the importance of perioperative management of coronary atherosclerotic lesions for STA-MCA bypass, similar to that for CEA/CAS.

SLOSHING COLD FRONTS IN GALAXY GROUPS AND THEIR PERTURBING DISK GALAXIES: AN X-RAY, OPTICAL, AND RADIO CASE STUDY

We present a combined X-ray, optical, and radio analysis of the galaxy group IC 1860 using the currently available Chandra and XMM data, literature multi-object spectroscopy data and GMRT data. The Chandra and XMM imaging and spectroscopy reveal two surface brightness discontinuities at 45 and 76 kpc shown to be consistent with a pair of cold fronts. These features are interpreted as due to sloshing of the central gas induced by an off-axis minor merger with a perturber. This scenario is further supported by the presence of a peculiar velocity of the central galaxy IC 1860 and the identification of a possible perturber in the optically disturbed spiral galaxy IC 1859. The identification of the perturber is consistent with the comparison with numerical simulations of sloshing. The GMRT observation at 325 MHz shows faint, extended radio emission contained within the inner cold front, as seen in some galaxy clusters hosting diffuse radio mini-halos. However, unlike mini-halos, no particle reacceleration is needed to explain the extended radio emission, which is consistent with aged radio plasma redistributed by the sloshing. There is strong analogy of the X-ray and optical phenomenology of the IC 1860 group with two other groups, NGC 5044 and NGC 5846, showing cold fronts. The evidence presented in this paper is among the strongest supporting the currently favored model of cold-front formation in relaxed objects and establishes the group scale as a chief environment to study this phenomenon.

Outcome of Patients Having Heart Transplantation for Lymphocytic Myocarditis

Heart transplantation (HT) for myocarditis has been controversial because of earlier reports of a poor prognosis after the procedure. We sought to determine whether lymphocytic myocarditis (LM) at the time of HT affects cardiac allograft rejection and survival after HT compared with other patients without LM in the current era of HT. We retrospectively reviewed 759 consecutive patients who underwent de novo HT at Columbia University Medical Center between 2000 and 2010 and compared prognosis after HT of the patients with pathologically proven LM in their explanted hearts with that of age- and gender-matched patients with idiopathic dilated cardiomyopathy (IDC group; n = 96) and with ischemic cardiomyopathy (IC group; n = 64). Thirty-two patients (4.2%) had LM in the explanted hearts pathologically. Among the 3 groups, no statistically significant difference was observed in the number of biopsy-diagnosed acute cellular rejection (ACR; International Society for Heart & Lung Transportation grade ≥2R) events during the first year after HT. In contrast, the frequency of biopsy-diagnosed ACR in subsequent years was greater in the LM group (n = 8, 3.8%) than in IC group (n = 3, 0.5%, p = 0.006), although no different from that of patients with IDC. The frequency of antibody-mediated rejection and posttransplant survival did not differ among the 3 groups. In conclusion, patients with pre-HT LM have an increased frequency of late ACR after HT compared with patients with IC. Nevertheless, survival of LM patients after HT is comparable to that of patients transplanted for IDC or IC.

Effects on performance and carcass and meat quality attributes following immunocastration with the gonadotropin releasing factor vaccine Bopriva or surgical castration of Bos indicus bulls raised on pasture in Brazil

Bos indicus bulls 20months of age grazed on pasture in Minas Gerais, Brazil either received 2 doses of the GnRF vaccine Bopriva at d0 and d91 (group IC, n=144) or were surgically castrated on d91 (group SC, n=144). Slaughter on d280, was 27weeks after castration. Adverse safety issues in 8% of group SC bulls following surgery contrasted with 0% in group IC bulls. At d105 testosterone levels were suppressed to similar levels in both groups. Importantly, group IC bulls had higher live weight, hot carcass weight, ADG (P<0.005) and dressing percentage (P<0.0001) compared to group SC animals. There were no negative effects on carcass or meat quality traits, thus immunocastration was concluded to offer a safe and effective method that provides production gains, and improves animal welfare in Bos indicus beef bulls without impacting meat and carcass quality.

Effects of Serenoa Repens, Selenium and Lycopene (Profluss®) on chronic inflammation associated with Benign Prostatic Hyperplasia: results of “FLOG” (Flogosis and Profluss in Prostatic and Genital Disease), a multicentre Italian study

To evaluate the efficacy of Profluss® on prostatic chronic inflammation (PCI). We prospectively enrolled 168 subjects affected by LUTS due to bladder outlet obstruction submitted to 12 cores prostatic biopsy for suspected prostate cancer + 2 cores collected for PCI valuation. First group consisted of 108 subjects, with histological diagnosis of PCI associated with BPH and high grade PIN and/or ASAP, randomly assigned to 1:1 ratio to daily Profluss® (group I) for 6 months or to control group (group Ic). Second group consisted of 60 subjects, with histological diagnosis of BPH, randomly assigned to 1:1 ratio to daily Profluss® + a-blockers treatment (group II) for 3 months or to control group (group IIc). After 6 months first group underwent 24 cores prostatic re-biopsy + 2 cores for PCI while after 3 months second group underwent two-cores prostatic for PCI. Specimens were evaluated for changes in inflammation parameters and for density of T-cells (CD3, CD8), B-cells (CD20) and macrophages (CD68). At follow-up there were statistical significant reductions of extension and grading of flogosis, mean values of CD20, CD3, CD68 and mean PSA value in group I compared to Ic, while extension and grading of flogosis in group II were inferior to IIc but not statistical significant. A statistically significant reduction in the density of CD20, CD3, CD68, CD8 was demonstrated in group II in respect to control IIc. Serenoa repens+Selenium+Lycopene may have an anti-inflammatory activity that could be of interest in the treatment of PCI in BPH and/or PIN/ASAP patients.

A Quantitative Assessment of Left Ventricular Assist Device Inflow Cannula Position with Contrast Enhanced Gated Cardiac Multislice Computed Tomography and Its Clinical Correlation

<h3>Purpose</h3> Inflow cannula malposition (ICM) is a major concern in Left Ventricular Assist Device patients (LVAD).We propose a quantitative classification of IC position by cardiac Computed Tomography (CCT) to assist in the diagnosis of IC malposition. <h3>Methods and Materials</h3> In 16 consecutive LVADs-Pts (14 Heart-Mate II) underwent 64 slices CCT. IC position was measured during mid diastole by: 1) acute angle between the long axis of the IC and the long axis of the left heart perpendicular to the mitral annulus plane and 2) distance between the IC tip and the opposing LV wall. The IC position was deemed: 1) Appropriate: if angle is < 30° and the distance > 1cm. 2) Intermediate: if angle is between 31-60° and the distance > 1cm. 3) Malposition: if angle is >60° or the distance <1cm. CT measurement and the clinical presentation were determined independently by a cardiac CT cardiologist and a LVAD/transplant cardiologist respectively. <h3>Results</h3> The mean age was 55±14 yrs, 50 % male and 60% had ischemic cardiomyopathy. Pts were divided into 2 groups according to the clinical presentation. Group 1 were 6 pts with suspected IC malposition (frequent LVAD alarm, low output, recurrent VT, and hemolysis ) and group 2 were 10 pts with non IC related indication (source of emboli/infection, effusion/hematoma, and 2 LV function/aortic valve assessment). Group 1 had higher LVAD-LV angle and shorter LVAD-LV distance as compared to Group 2 (63±6° vs 35 ± 12 ° p=0.001, 0.6±0.5 cm vs 3.5±2.3 cm P=0.02). All pts with clinically suspected ICM were deemed to have ICM as determined by CCT. [figure 1] <h3>Conclusions</h3> ICM can be detected by quantitative measurements in CCT, further studies are needed.

Life activities improve heart rate variability in patients with mild hypertension and/or the initial stage of heart failure

To determine the effects on heart rate variability of home-based daily activity in patients with mild hypertension and/or stable angina pectoris and to clarify the relationship between daily activity and sympathovagal balance. Several prior studies have assessed the ability of exercise training to improve functional capacity and produce beneficial effects on mortality and physical capacity in patients with cardiovascular disease. A non-randomised six-month prospective longitudinal study. This study consisted of 41 patients (59-83 years old) with mild hypertension and/or stable angina pectoris. The home-based daily activity and heart rate variability were measured at the start of the study (BASE) and six months after the start of the study (6MoA). At 6MoA, the active mass increased in 23 patients (the IC group), while it decreased in the remaining 18 patients (the DC group). There were significant increases in the high-frequency component in the IC group between the data at BASE and 6MoA. There were significant decreases in the low frequency to high-frequency ratio (low frequency/high-frequency) during sleep in the IC group between the data at BASE and 6MoA. The active mass was classified into life activities and walk activities in terms of intensity of activity. In a multivariate model, increased life activitiesrevealed a trend towards an association with increased high-frequency. In patients with mild hypertension and/or stable angina pectoris, an increase in active mass improved heart rate variability outcomes with increased high-frequency and decreased low frequency/high-frequency during sleep. To increase life activitiesmight improve heart rate variability and prognosis in patients. This study demonstrated that the potential importance of low-intensity daily activities in patients with mild hypertension and/or stable angina pectoris.

876 “VOIDING DYSFUNCTION PHENOTYPING OF WOMEN WITH CHRONIC PELVIC PAIN SYNDROMES: RESULTS FROM THE ICEPAC TRIAL”

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2013876 “VOIDING DYSFUNCTION PHENOTYPING OF WOMEN WITH CHRONIC PELVIC PAIN SYNDROMES: RESULTS FROM THE ICEPAC TRIAL” Elias Veizi, Adonis Hijaz, Firouz Daneshgari, and Thomas Chelimsky Elias VeiziElias Veizi Cleveland, OH More articles by this author , Adonis HijazAdonis Hijaz Cleveland, OH More articles by this author , Firouz DaneshgariFirouz Daneshgari Cleveland, OH More articles by this author , and Thomas ChelimskyThomas Chelimsky Milwaukee, WI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.445AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Interstitial cystitis/Bladder pain syndrome (IC/BPS) and myofascial pelvic pain (MPP) are two of the most common forms of chronic pelvic pain (CPP). Cross organ sensitization in pelvis complicates the clinical diagnosis and treatment of IC/PBS as part of general CPP. ICEPAC trial aims to study the autonomic nervous dysfunction in patients with interstitial cystitis and myofascial pain and aims to assess the signature phenotypes of pain and voiding dynamic changes. METHODS ICEPAC supported by NIH-NIDDK was designed by an interdisciplinary team. Enrollment will include 76 women with IC, 76 women with myofascial pelvic pain disorder (MPP), 38 1st degree female relatives of IC subjects without pelvic pain, and 38 healthy age-matched women. Besides a detailed screening visit with comprehensive assessment of dysautonomias, pain intensity and disability scores, voiding dysfunction phenotype is assessed by Uroflow and a voiding diary. VAS scores, frequency, voiding volumes, flow parameters and timed flow assessment data are collected and analyzed. RESULTS This preliminary analysis includes the first 60 patients [29 healthy control (con) subjects; 23 IC/BPS patient and 8 chronic MPP]. Subjects enrolled in the study are age matched [con 40±15, IC 39.6±15, MPP 40.5±14 yo]. BMI in MPP patients is significantly higher than Hcon and IC subjects [42±5 vs 26±9 in con and 27±8 in IC]. Voiding volumes were lower in the IC group vs H con and MPP whether frequency was higher in the IC group with similar fluid intake. The peak flow [Qmax] was significantly lower in the IC cluster 16±2 ml/sec vs. 28±11 con, 23±4 MPP; while the average flow rate was lower in both IC and MPP vs. con. Similarly duration of flow was higher in IC and MPP vs. con. CONCLUSIONS This preliminary quantitative evaluation of voiding diary and uroflow metrics reveals distinct voiding phenotypes in IC and MPP. The decrease in Qmax in IC cluster in comparison to con and MPP could be an indication of the internal sphincter autonomic dysfunction while the prolonged voiding duration and avg flow in MPP patients could indicate external sphincter hypertonicity [incomplete relaxation]. Further details on voiding dysfunction could lead toward a better understanding of the pathogenesis in IC vs other pelvic floor dysfunction syndromes. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e361-e362 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elias Veizi Cleveland, OH More articles by this author Adonis Hijaz Cleveland, OH More articles by this author Firouz Daneshgari Cleveland, OH More articles by this author Thomas Chelimsky Milwaukee, WI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Avaliação histológica da biocompatibilidade de otólitos Cynoscion acoupa em ratos

O objetivo deste estudo foi avaliar a biocompatibilidade de otólitos de Cynoscion acoupa por ensaios in vivo realizados em ratos Wistar. O material utilizado foi preparado com 2 g de pó de otólitos de Cynoscion acoupa e 0,5 g de colágeno hidrolisado, diluídos em água destilada. O ensaio biológico consistiu na utilização de 24 ratos wistar nos quais foram implantados tubos de polietileno contendo otólitos (OI) no lado direito do dorso e tubos vazios (CI) no lado esquerdo. Após a cirurgia, os ratos foram medicados e sacrificados após 3, 7 e 30 dias. Após cada período os tubos foram removidos com o tecido circundante e submetido a processamento histológico clássico. As alterações inflamatórias foram avaliadas em uma escala de 0 a 4 e submetidas a análise estatística (nível de significância 5%). No CI após o 3º dia, foi observado um infiltrado inflamatório de moderado a severo. No 7º dia, formação de tecido de granulação maduro e com 30 dias presença de um tecido conjuntivo mais organizado. Em relação à OI, moderados leucócitos, infiltrado crônico sem necrose ou reação granulomatosa foi observada no dia 3. No 7º dia, a severidade da reação inflamatória foi atenuada, e um tecido de granulação bem desenvolvido foi observado. No dia 30, o tecido conjuntivo ao redor dos implantes era composto de novos fibroblastos e fibras colágenas onduladas. Não foram observadas diferenças significativas entre os grupos com relação à intensidade da resposta inflamatória em nenhum tempo experimental (p&gt;0,05). Como conclusão, a preparação otólitos foi considerada biocompatível, pois não houve diferenças significativas de reação tecidual entre os grupos experimentais.