Partial Atrophy Research Articles

Эффективность применения комплексной терапии в лечении частичной атрофии зрительного нерва различного генеза

Regional drugs injection is а promising method of partial optic atrophy treatment. The therapy involves the introduction of drugs into the microcirculation region on the side of the affected organ, in the area corresponding to the topographic projection of the lymph node. Purpose: To evaluate the effectiveness of treatment of partial optic atrophy of various origins using regional combination therapy. Material and Methods: Complex therapy was applied in hospital environment of The S. Fyodorov Eye Microsurgery Federal State Institution in treatment of 38 patients (38 eyes) with partial optic atrophy of various origins. The patients were divided into two groups: group I (27 eyes), diagnosed with partial optic atrophy of glaucomatous origin, group II (11 eyes), diagnosed with partial optic atrophy of mixed genesis. Before and after treatment, all the patients passed standard ophthalmological examination, as well as optical coherence tomography (OCT).The parameters of the optic disk were assessed using Cirrus 5000 retinal tomograph by Carl Zeiss Meditecinc (Germany). Results: After 12 months of complex treatment, administered 2 times a year and included injections in the pterygopalatine fossa and submastoid region, in patients of group I the following indices were registered: an increase in visual acuity by 0.1-0.2, a decrease in relative scotoma number by13%, stability of the nerve fiber layer thickness and excavation of the optic disc. Total visual field expanded up to 220-335. After 12 months of treatment, administered 2 times a year in patients of group II the following indices were registered: an increase in visual acuity by 0.1-0.3, a decrease in relative scotoma number by 9%, stability of the nerve fiber layer thickness and excavation of the optic disc. The total visual field after treatment expanded up to 310-450. Conclusion: the application of complex therapy in treatment of patients with partial optic atrophy of various origins has positive effect on visual function.

Prenatal treatment with metronidazole induces cerebellar folia alteration in guinea pig fetuses

The most sensitive period in brain development is during prenatal life. The use of antibiotics in pregnancy is still controversial. Recent studies revealed the high neurotoxic potential of the antibiotic and antiprotozoal medication, metronidazole. However, there are insufficient data from animal studies about prenatal treatment effects. We investigated the effect of prenatal treatment with metronidazole on cerebellar development in guinea pigs. Treatment with metronidazole was performed from the 42nd to the 49th day of gestation. On the 50th day of pregnancy, all dams were killed, and the cerebella of the fetuses were analyzed. Gross cerebellar changes characterized by malposition of the folia with partial atrophy were found in 12 of 19 fetuses in the experimental group, but in none of 20 control fetuses that received saline. The most affected were folia VII with depletion of the areal fraction of the external granular layer, molecular layer and the internal granular layer. Purkinje cells displayed cell distortion with loss of normal dendritic polarity. The investigation revealed cell depletion, with a disturbance of the cytoarchitectonic of the cerebellar cortex and folia alteration.

Wolfram syndrome with childhood glaucoma: A rare case report with review of literature

Wolfram syndrome (WFS) is a rare neurodegenerative disorder characterized by young-onset diabetes mellitus, central diabetes insipidus, optic nerve atrophy, and hearing loss. The ophthalmic association of this order has been limited to optic nerve atrophy. We report here a case of WFS and its disease course with childhood glaucoma as a rare ophthalmic manifestation which has been reported just once earlier. The patient had young-onset diabetes mellitus (insulin dependent), diabetes insipidus, and optic-disc pallor suggestive of partial optic atrophy. However, hearing assessment was normal at the time of presentation and in due course of disease. Glaucoma is one of the rare possible ocular manifestations of WFS which should be highly considered while evaluating patient with this disorder.

Подбор производственно-контрольных штаммов Bordetella bronchiseptica для производства вакцины против бордетеллиоза свиней

Respiratory diseases of pigs are widespread in all countries of the world with developed pig farming and cause significant economic damage to the industry. Bordetelliosis (atrophic rhinitis) is an infectious disease of pigs characterized by partial or complete atrophy of the nasal septum bones, curvature or shortening of the nose, nasal discharge and bleeding, sneezing, and stunting. Against the background of the development and spread of antibiotic resistance, one of the most effective ways to combat this disease is specific prevention. However, domestic vaccines against swine atrophic rhinitis have not been developed. In view of this, the purpose of our work is to study the properties of field isolates of Bordetella bronchiseptica and select production and control strains suitable for the manufacture and control of the effectiveness of vaccines against atrophic rhinitis. To achieve this goal, 15 strains of B. bronchiseptica were isolated using bacteriological methods from various livestock enterprises in Russia. All strains had typical cultural, morphological, tinctorial and biochemical properties. When studying the pathogenicity of field isolates, the method of intraperitoneal infection of white mice at a dose of 1,5×109 microbe cell was used.it was found that only 3 strains out of 15 studied cultures have pathogenicity: № 134-VIEV, 144-VIEV and 194-VIEV. The remaining strains did not cause the death of experimental mice even with a twofold increase in the infecting dose to 3,0×109 microbe cell when determining the virulence of these cultures, expressed in the LD50 index, it was found that the LD50 of strain № 134-VIEV is 4,6×107 microbe cell, № 144-VIEV – 2,9×108 microbe cell, № 194-VIEV – 7,1×107 microbe cell, respectively. The selected strains were used in further studies as the most promising, since the severity of virulence factors should contribute to the high immunogenic activity of the drug. In the course of determining the antigenic properties of strains (in RA), it was found that after the first vaccination of animals, the antibody titer is at the level of 1:153,6±57,24 – 1:204,8±70,10, the second vaccination increased the antibody titer by 4–4,5 times – from 1:614,4±228,93 to 1: 921,6±228,97, respectively. When determining cross-antigenic activity, it was assumed that all three strains have at least one common antigenic determinant, and at least one heterologous one. The severity of cross-antigenic activity was further confirmed during the evaluation of the immunogenic activity of monovaccins. Thus, the mortality rate of animals in the control, non-vaccinated groups was 100%, while in the groups of vaccinated animals, the survival rate reached 80% or higher. This level of immunogenic protection suggests that the protective level of antibodies in the agglutination reaction for white mice with bordetelliosis should be at least 1:358.4. Analyzing the results of this work, we can conclude that specific prevention of pig bordetelliosis can be effective due to careful selection of production strains of the pathogen.

Structural and functional changes in the retina and optic nerve in patients with toxic optic neuropathy caused by acute methanol poisoning

To identify the specifics of structural and functional changes in patients with toxic optical neuropathy caused by acute methanol poisoning. One female patient with toxic optic neuropathy (TON), 2 male patients with partial optic atrophy caused by methanol poisoning, and 1 male patient with methanol intoxication after ethanol containing alcohol use were examined with kinetic perimetry and optical coherence tomography. Patients with TON caused by acute methanol poisoning were observed to have decreasing visual acuity to the extent of complete blindness. OCT follow-up studies revealed thinning of the retinal nerve fiber layer (RNFL) as well as formation of microcysts in the inner retinal layers, destruction of ellipsoid zone and outer segments of photoreceptors. The patient with methanol intoxication after use of ethanol containing alcohol had retained his visual functions; he was found to have microcysts and RNFL thinning during the first few months after the intoxication, but they were within normal range of OCT parameters. Patients with TON caused by acute methanol poisoning are common to have optic atrophy with either residual visual functions or complete blindness as well as microcysts formation, structural changes and destruction of the ellipsoid zone and outer segments of photoreceptors. In patient with methanol intoxication after use of ethanol, which is known to be an antidote, complete visual recovery was observed, although some microcystic changes and ganglion cells layer thinning were noted.

Diagnosis and surgical treatment of patients with tethered cord syndrome in adulthood

Objective — to analyze the results of tethered cord syndrome surgery in adult patients.Methods and subjects. The study enrolled 8 patients with a tethered cord syndrome who underwent the treatment from 2013 to 2019 in Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine. Patients had the following forms of the disease: 2 patients had thickening or sclerosis of the filum terminale, 4 — lipomielocele, 1 — lipomielomeningocelle, 1 — lipomielocystocele. Among the clinical manifestations there were: pain in the lumbar spine, pain in the feet, movement disorders, partial muscular atrophy and complete disruption of the pelvic organs (no erection in men, urination and defecation dysfunction).The indications for the operation were the presence of a tethered cord syndrome, severe neurological deficiency and neuroimaging (roentgen, CT, MRI).A standard clinical examination was performed to all patients, including an examination by a neurologist and neurosurgeon. The diagnostic complex included the roentgen of spine, CT, MRI. Roentgenograms were performed in standard (direct and lateral) projection. MRI was performed to all patients in sagittal, axial, and in the frontal plane in standard T1 and T2 regimens.Results. 2 patients, who had thickening or tissue sclerosis of the filum terminale, demonstrated a regression of neurological symptoms in the form of restoration of sensitivity in the perineum region and partial restoration of the pelvic organs. 4 patients with lipomielocele demonstrated the regression of pain syndrome in the lumbar spine and increased strength in the lower extremities. Patients with lipomielomeningocelle and lipomielocystocele had the regression of pain syndrome in the feet and in the lumbar spine.Conclusions. It is recommended to perform a surgery to adult patients with tethered cord syndrome especially in case of progression of clinical symptoms and existing organic disorders to improve the quality of life and partial restoration of sensitivity and functioning of the pelvic organs.

Adipocyte differentiation impairment as well as lipid metabolism and transport problems – major causes of genetic lipodystrophies

Lipodystrophies are heterogenic group of adipose tissue disorders with its general or partial atrophy. In case of congenital lipodystrophies disturbances of adipogenesis or/and alterations of adipocyte differentiation often occur leading to thermogenic adipocytes formation. Basic adipocyte functions can be perturbed, including improper synthesis of triacylglycerols and phospholipids of lipid droplet, but also impaired fatty acids release and intracellular lipid traffic. Lipodystrophy can result from weakening of adipose tissue structure, but also from improper function of both cytoskeleton and nuclear lamina leading to cell dysfunction. Lack of adipose tissue leads to a) increased plasma triacylglycerols level and ectopic fat accumulation in other tissues; b) total plasma cholesterol increase; c) plasma HDL-cholesterol decrease. Ectopic fat accumulation in liver can cause fatty liver and with time can lead to hepatomegaly and liver cirrhosis. Dysfunctions are proportional to the extent of fat tissue loss with generalized lipodystrophies patients developing complications at early ages. Diabetes and insulin resistance are common comorbidities. Improvement of diagnostic methods of medical genetics allows precise determination of their genotypes and correct diagnosis of patients suffering from lipodystrophy. For that reason number of described cases increased in recent years, also in Poland. New lipodystrophy types were described. Therefore there is a need to bring lipodystrophy syndromes for the attention of primary care physicians, pediatricians and endocrinologists.

Diagnostic and therapeutic approaches in rehabilitation correlated to a case of tetraparesis (with predominance of paraparesis) after severe CCT - bifronto - basal and bitemporal contusion.

Abstract Introduction. Cranio-cerebral trauma (CCT) can be defined as a brain damage caused by an external factor. It may or may not penetrate the skull. Examples of CCT causing sources can be: car accidents, falls (from height or same level), blows with blunt objects, shooting, etc. The diagnosis is generally easy to establish through anamnesis with the patient or witnesses, then by tomography. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethic committee’s approval, N.O. 17464 per 14.06.2019, this article presents the evolution of a 32-year-old male, tetraparetic with predominance of paraparesis, bradylalia and cerebrastenia (with significant improvement) and disgraphy, following a severe CCT - bifronto-basal and bitemporal contusion. Operated temporo-parieto-occipital fracture (right parietal decompression flap) - all by falling off the horse (affirmative). Joint stiffness in the knees (by Pellegrin-Shida heterotopic periosteal calcifications). Total post-traumatic optic atrophy RE and partial optic atrophy LE. Multiple bedsores. Neurogenic bladder (carrier of indwelling urinary catheter). UTI with Proteus Mirabiris (etiologically treated) was admitted in the Neurorehabilitation Clinic of the Teaching Emergency Hospital”Bagdasar Arseni” (TEHBA) for tetraparesis motor deficit, retention sphincter disorders, locomotor and severe auto-care dysfunctions, specialized recovery and nursing treatment with favorable development. Discussion: The peculiarity of this case is the good evolution of a patient with severe CCT and multiple associated complications. Last but not least, we can highlight how the CCT was produced, namely by falling off the horse. This tells a lot about the importance of the precautions and equipment needed during a sport, in our case wearing a helmet. Key words: cerebral cranial trauma, tetraparesis, paraparesis, recovery,

571 Diagnostic Accuracy of Narrow Band Imaging on Endoscopy in Detection of Duodenal Villous Atrophy Using Histopathology as a Gold Standard in Patients Presenting With Chronic Diarrhea

INTRODUCTION: Celiac disease and tropical sprue are common causes of chronic diarrhea & duodenal villous atrophy (DVA). Narrow band imaging (NBI) is chromoendoscopic technique which facilitates detailed visualization of the mucosal surface & allows targeted biopsy and thus increases the diagnostic yield of the biopsy specimen. Hence, we aimed to determine the diagnostic accuracy of NBI in detection of DVA using histopathology as a gold standard in chronic diarrhea patients. METHODS: All patients with diarrhea for >4weeks were enrolled. Endoscopy was performed in all the patients to take duodenal biopsy and simultaneously NBI villous pattern was noted. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and diagnostic accuracy of NBI were calculated comparing histopathology. RESULTS: Baseline characteristics are shown in Table 1. NBI findings of total patients were finger shaped (normal villi), gyriform (partial villi atrophy) and flat surface (complete villous atrophy) mucosa as 22.6%, 59.7% and 17.7% respectively. NBI has sensitivity, specificity; PPV, NPV, and diagnostic accuracy were 84.9%, 45.2%, 82.3%, 50.0%, and 75% respectively for the detection of DVA as depicted in Table 2. CONCLUSION: This study showed 93 (75%) of participants had DVA in contrast to another study from Pakistan which revealed DVA in 49.8% of patients. This disparity is likely due to difference in study population. Our patients had normal villi, partial and complete villous atrophy in 31 (25%), 72 (58.1%) & 21 (16.9%) respectively with P value 0.001. Dutta AK et al. found that NBI has sensitivity 81-87%, specificity 93%, NPV 96% and PPV 68-77% to detect DVA. We found sensitivity 85%, specificity 45%, NPV 50% & PPV 82.3%. In our study specificity & NPV were lower than in others as we included mild villous atrophy while most of the studies had a greater proportion of patients with moderate to severe villous atrophy. We found that duration of diarrhea is associated with presence of villous atrophy, as disease duration of >5 months had sensitivity 92.1% and specificity 60% while 5 months had sensitivity & specificity 80% & 31.3% respectively. This association was not observed in previous studies. So we conclude NBI is a promising technique for assessment of duodenal mucosal details in patients with longstanding chronic diarrhea.

The Study of Phosphene Illusion in Students with Partial Atrophy of the Optic Nerve and a Normal Fundus

We studied phosphene illusions in children with partial atrophy of the optic nerve (PAON) and children with normal retina and optic nerve. We observed 22 students with PAON and 24 students with a normal fundus (control group). We used test images in the variants of “scintillating grid” with disks of different diameters displayed on the computer screen. In children with PAON, we observed a shift of the maximum values of the illusion force in the direction of increasing diameters of the discs in the test images. In contrast to the control group, there was no significant difference in the severity of the illusion in students with PAON when the test image was rotated by 45°. The extinction illusion in children with PAON is more pronounced than in children with normal fundus.

Structure of Neurological Pathology in Children with Impaired Visual Functions

In children’s neurology, problems of diagnosis and correction of the effects of perinatal lesions of the central nervous system, having a different structure and severity depending on the age of patients, are relevant. Comorbid conditions, to which, to a certain extent, neurological diseases in children associated with functional and structural disorders of the visual system can be attributed.Aim. To study the features of neurological pathology, concomitant to violation of visual functions in children of different age groups.Methods. A neurological examination of 549 children from 3 to 16 years old with various diseases of the visual system was performed. To assess the age characteristics the patients were divided into three groups of preschool, junior and senior school age. The study included a retrospective analysis of ambulatory cards, an interview with parents and an assessment of objective neurological status. If there were indications, additional examination was prescribed (spondylography with functional tests, electroencephalography and others).Results. The features of the structural distribution of neurological pathology in children, which differed from those in the general population, were identified. The dominant disorders are neuro-orthopedic disorders in the form of dorsopathies at the level of the cervical spine.Conclusion. In the structure of neurological pathology in children with structural and functional changes in the visual system, the symptom complex prevails, which is typical for minimal effects of natal damage to the cervical spine, confirmed by X-ray studies. Also a certain relationship of neurological and ophthalmic pathology was identified. The consequences of perinatal central nervous system damage and peripheral cervical insufficiency, as manifestations of dorsopathy, were more often associated with strabismus. In the same group, the maximum number of children with partial atrophy of the optic nerve was revealed.

Relationship between motivation, adherence to diet, anxiety symptoms, depression symptoms and quality of life in individuals with celiac disease

ObjectiveCeliac disease is an immuno-mediated pathogenesis disease characterised by a malabsorption of nutrients that causes partial or total atrophy of intestinal villi and the alteration of the absorbing epithelium. Several studies have demonstrated the presence of anxiety and depression symptoms and poor quality of life in people with celiac disease and emphasised the importance of diet in modulating these effects. However, few studies have investigated the role of motivation and the relationship it has with these factors. The purpose of this study was to fill this gap and investigate the relationship between motivation, diet adherence, anxiety symptoms, depression symptoms and physical functioning in people with celiac disease. MethodsQuestionnaires were administered to 433 people with celiac disease aged between 18 and 79 years (M = 32.73, DS = 11.54) to measure anxiety symptoms (State-Trait Anxiety Inventory-Y2), depression symptoms (Beck Depression Inventory), physical functioning (Scale of Physical Functioning), adherence to diet (Celiac Dietary Adherence Test) and motivation (Treatment Self-Regulation Questionnaire). ResultsWe used Structural Equation Modelling to examine the relationships of variables. Results revealed a direct relationship between motivation and diet adherence, anxiety symptoms, depression symptoms and physical functioning. They also illustrated the role played by diet adherence in mediating the relationship between motivation and anxiety symptoms, depression symptoms and physical functioning. ConclusionThe results highlight the vital role played by motivation in people; indeed, analysis showed that motivation correlated to adherence to diet. It is therefore necessary to take this factor into account in the treatment of individuals with celiac disease.

Dependence of the Stereokinetic Effect on the Rotational Speed and Eccentricity of the Test Image in Children with Partial Optic Atrophy

We studied the influence of the rotational speed and eccentricity of the ring image on the severity of the stereokinetic effect (SE) in a group of 36 children aged 8 to 16 years with partial optic atrophy and in the control group of 44 age-matched children with a normal fundus. Four variants of the ring image with the eccentricity of 0.2, 0.4, 0.6 or 0.8 were used as a test image. The rotational speed of the ring image was 2, 10, 30, 60 or 90 rpm. It was found that the stereokinetic effect was absent in the majority of children (63.9%) with optic atrophy at a combination of eccentricity of 0.2 and a rotational speed of 2 rpm, in contrast to the control group, where the stereokinetic effect was only absent in 9.1% of children under the same conditions of stimulus presentation. The stereokinetic effect was observed with all eccentricities when the speed of rotation of the test image was 30–90 rpm in children with optic atrophy and 10–90 rpm in children from the control group. The number of children with alternate perception of the virtual cone and the virtual funnel was significantly higher in the control group than in the group of children with optic atrophy at all the test image eccentricities and rotational speeds used. The binocular figure size estimates were equal to the monocular estimates in the group of children with optic atrophy for all the image eccentricities and rotation speeds in contrast to the control group with a general tendency for the virtual cone size estimate to increase under the monocular conditions of observation. An increase in the test image rotation speed from 2 to 60 rpm was accompanied by an increase in the size of a virtual figure and a significant decrease in the duration of alternate dominance of virtual cone and virtual funnel perception in both groups of subjects with all the eccentricities used. The difference between the results obtained in the group of children with POA and in the control group may be explained by reduction of afferent visual information flow. These differences are partially offset by increased speed and increased eccentricity of the test image.

Features of the visual analyzer change in the primary progressive type of multiple sclerosis

The article deals with the features of visual disturbances in patient with primary progressive type of multiple sclerosis (MS). On the basis of clinical observations, it was found that, in contrast to the relapsing-remitting type of MS, the visual disturbances are accompanied by a rapidly progressive decrease in visual and oculomotor functions. The process of development of descending partial atrophy of the optic nerve with primary progressive type of MS is symmetric, in contrast to the relapsing-remitting type of the course of MS and is determined by the increase in the severity of brain structures atrophy according to MRI.

Brain atrophy in primary age-related tauopathy is linked to transactive response DNA-binding protein of 43 kDa

IntroductionPrimary age-related tauopathy (PART) is characterized by the presence of neurofibrillary tangles and absent-minimal β-amyloid deposition. Transactive response DNA-binding protein of 43 kDa (TDP-43), a third protein, has recently garnished a lot of attention in Alzheimer's disease where it is associated with memory loss and amygdala and hippocampal atrophy. We aimed to determine whether TDP-43 is associated with brain atrophy in PART. MethodsWe assessed the frequency of TDP-43 in PART and performed voxel-level analysis in SPM12, as well as region-of-interest analysis using linear regression modeling, controlling for variables of interest, to assess for associations between TDP-43 and brain atrophy. ResultsOf 116 PART cases, 31 (26.7%) had TDP-43. The presence of TDP-43 was associated with significantly greater amygdala, hippocampal, and anterior temporal atrophy in both the region-of-interest and the voxel level analyses. DiscussionTDP-43 is associated with greater brain atrophy in PART.

Compound heterozygous POMGNT1 mutations leading to muscular dystrophy-dystroglycanopathy type A3: a case report

BackgroundDystroglycanopathies, which are caused by reduced glycosylation of alpha-dystroglycan, are a heterogeneous group of neurodegenerative disorders characterized by variable brain and skeletal muscle involvement. Muscle-eye-brain disease (or muscular dystrophy-dystroglycanopathy type 3 A) is an autosomal recessive disorder characterized by congenital muscular dystrophy, ocular abnormalities, and lissencephaly.Case presentationWe report clinical and genetic characteristics of a 6-year-old boy affected by muscular dystrophy-dystroglycanopathy. He has severe a delay in psychomotor and speech development, muscle hypotony, congenital myopia, partial atrophy of the optic nerve disc, increased level of creatine kinase, primary-muscle lesion, polymicrogyria, ventriculomegaly, hypoplasia of the corpus callosum, cysts of the cerebellum. Exome sequencing revealed compound heterozygous mutations in POMGNT1 gene (transcript NM_001243766.1): c.1539 + 1G > A and c.385C > T.ConclusionsThe present case report shows diagnostic algorithm step by step and helps better understand the clinical and genetic features of congenital muscular dystrophy.

Histopathologic False-positive Diagnoses of Prostate Cancer in the Age of Immunohistochemistry.

There are few studies into the rate and causes of histopathologic false-positive diagnosis of prostate cancer. Only 2 of these, including a previous one from our group, incorporate survival data. In addition, in none of the previous studies had immunohistochemistry (IHC) been originally requested on any of the misdiagnosed cases. Diagnostic biopsies (n=1080) and transurethral resection of prostate specimens (n=314) from 1394 men with clinically localized prostate cancer diagnosed in the United Kingdom but treated conservatively between 1990 and 2003 were reviewed by a panel of 3 genitourinary pathologists. Thirty-five cases were excluded for being potentially incomplete. Of the remaining 1359, 30 (2.2%) were reassigned to a nonmalignant category (26 benign and 4 suspicious for malignancy). IHC had been originally performed on 7 of these. The reasons for the errors were recorded on each case: adenosis (19), partial atrophy (3), prostatic intraepithelial neoplasia (2), seminal vesicle epithelium (1), and hyperplasia (1). Follow-up of these men revealed only one prostate cancer-related death, possibly due to unsampled tumor. In conclusion, a relatively small number of prostate cancer mimics were responsible for a large proportion of the false-positive prostate cancer diagnoses and the use of IHC did not prevent the overcall of benign entities as cancer in approximately a quarter of these cases. Targeting these mimics at educational events and raising awareness of the pitfalls in the interpretation of IHC in prostate cancer diagnosis, emphasizing that glands within a suspicious focus should be treated as a whole rather than individually, may be beneficial in lowering the rate of false-positive diagnosis.

Effect of feeding Chinese herb medicine ageratum-liquid on intestinal bacterial translocations induced by H9N2 AIV in mice

BackgroundAs a low pathogenic influenza virus, avian influenza virus subtype H9N2 (H9N2 AIV) often induces high morbidity in association with secondary bacterial infections in chickens or mammals. To explore this phenomenon, the relationship between intestinal microflora changes and bacterial translocations was studied post H9N2 AIV challenge and post AIV infection plus Ageratum-liquid treatment.MethodsIllumina sequencing, histological examination and Neongreen-tagged bacteria were used in this study to research the microbiota composition, intestinal barrier, and bacterial translocation in six weeks of BALB/c mice.ResultsH9N2 AIV infection caused intestinal dysbacteriosis and mucosal barrier damages. Notably, the villus length was significantly reduced (p < 0.01) at 12 dpi and the crypt depth was significantly increased (p < 0.01) at 5 dpi and 12 dpi with infection, resulting in the mucosal regular villus-length/crypt-depth (V/C) was significantly reduced (p < 0.01) at 5 dpi and 12 dpi. Moreover, degeneration and dissolution of the mucosal epithelial cells, loose of the connective tissue and partial glandular atrophy were found in infection group, indicating that intestinal barrier function was weakened. Eventually, intestinal microbiota (Staphylococcus, E. coli, etc.) overrun the intestinal barrier and migrated to liver and lung tissues of the mice at 5 and 12 dpi. Furthermore, the bacteria transferred in mesentery tissue sites from intestine at 36 h through tracking the Neongreen-tagged bacteria. Then the Neongreen-tagged bacteria were isolated from liver at 48 h post intragastrical administration. Simultaneously, Ageratum-liquid could inhibit the intestinal microbiota disorder post H9N2 AIV challenge via the respiratory tract. In addition, this study also illustrated that Ageratum-liquid could effectively prevent intestinal bacterial translocation post H9N2 AIV infection in mice.ConclusionIn this study, we report the discovery that H9N2 AIV infection could damage the ileal mucosal barrier and induce the disturbance of the intestinal flora in BALB/c mice resulting in translocation of intestinal bacteria. In addition, this study indicated that Ageratum-liquid can effectively prevent bacterial translocation following H9N2 infection. These findings are of important theoretical and practical significance in prevention and control of H9N2 AIV infection.

Narrow band imaging evaluation of duodenal villi in patients with and without celiac disease: A prospective study.

BACKGROUNDDuodenal biopsies are commonly obtained during esophagogastroduodenoscopy (EGD) but are very often histopathologically normal. Therefore, a more strategic method for evaluating the duodenal mucosa and avoiding unnecessary biopsies is needed.AIMTo examine the clinical utility of narrow band imaging (NBI) for evaluating duodenal villous morphology.METHODSWe performed a prospective cohort study of adult patients at Mayo Clinic Rochester from 2013-2014 who were referred for EGD with duodenal biopsies. A staff endoscopist scored, in real-time, the NBI-based appearance of duodenal villi into one of three categories (normal, partial villous atrophy, or complete villous atrophy), captured ≥ 2 representative duodenal NBI images, and obtained mucosal biopsies therein. Images were then scored by an advanced endoscopist and gastroenterology fellow, and biopsies (gold standard) by a pathologist, in a masked fashion using the same three-category classification. Performing endoscopist, advanced endoscopist, and fellow NBI scores were compared to histopathology to calculate performance characteristics [sensitivity, specificity, positive and negative, negative predictive value (NPV), and accuracy]. Inter-rater agreement was assessed with Cohen’s kappa.RESULTS112 patients were included. The most common referring indications were dyspepsia (47%), nausea (23%), and suspected celiac disease (14%). Duodenal histopathology scores were: 84% normal, 11% partial atrophy, and 5% complete atrophy. Performing endoscopist NBI scores were 79% normal, 14% partial atrophy, and 6% complete atrophy compared to 91%, 5%, and 4% and 70%, 24%, and 6% for advanced endoscopist and fellow, respectively. NBI performed favorably for all raters, with a notably high (92%-100%) NPV. NBI score agreement was best between performing endoscopist and fellow (κ = 0.65).CONCLUSIONNBI facilitates accurate, non-invasive evaluation of duodenal villi. Its high NPV renders it especially useful for foregoing biopsies of histopathologically normal duodenal mucosa.

Adipocytedifferentiationimpairment as well as lipid metabolism and trasportproblems – major causes of geneticlipodystrophies

Lipodystrophies are heterogenic group of adipose tissue disorders with its general or partial atrophy. In case of congenital lipodystrophies disturbances of adipogenesis or/and alterations of adipocyte differentiation often occur leading to thermogenic adipocytes formation. Basic adipocyte functions can be perturbed, including improper synthesis of triacylglycerols and phospholipids of lipid droplet, but also impaired fatty acids release and intracellular lipid traffic. Lipodystrophy can result from weakening of adipose tissue structure, but also from improper function of both cytoskeleton and nuclear lamina leading to cell dysfunction. Lack of adipose tissue leads to a) increased plasma triacylglycerols level and ectopic fat accumulation in other tissues; b) total plasma cholesterol increase; c) plasma HDL-cholesterol decrease. Ectopic fat accumulation in liver can cause fatty liver and with time can lead to hepatomegaly and liver cirrhosis. Dysfunctionsare proportional to the extent of fat tissue loss with generalized lipodystrophies patients developing complications at early ages. Diabetes and insulin resistance are common comorbidities. Improvement of diagnostic methods of medical genetics allows precise determination of their genotypes and correct diagnosis of patients suffering from lipodystrophy. For that reason number of described cases increased in recent years, also in Poland. New lipodystrophy types were described. Therefore there is a need to bring lipodystrophy syndromes for the attention of primary care physicians, pediatricians and endocrinologists.