PSP Groups Research Articles

Comparison of Patient-Specific Plates and Pre-Bent Plates for Preserving Condylar Position in Mandible Reconstruction.

To compare the efficacy of patient-specific 3-dimensional (3D)-printed plates (PSP) and pre-bent universal reconstruction plates (PBP) in preserving the 3D position of the mandibular condyle and total operation time during mandibular reconstruction with a fibula-free flap. This retrospective study included 18 patients who underwent mandibular reconstruction using fibular free flaps. Both groups utilized virtual surgical planning (VSP) and 3D-printed surgical guides. Nine patients received PSP, and 9 received PBP. Postoperative and computed tomography (CT) scans were analyzed to assess 3D deviations of the mandibular condyles and operation times. PSP demonstrated superior accuracy in medial-lateral condylar displacement (2.5 ± 1.42 versus 4.92 ± 2.42mm, P = 0.02) and better angular accuracy in the coronal (1.46 ± 1.16 deg versus 5.45 ± 2.75 deg, P = 0.001) and transverse planes (3.55 ± 2.82 deg versus 8.99 ± 5.56 deg, P = 0.023). There was no significant difference in total operation time between PSP and PBP groups (487.7 ± 90.1 versus 547.3 ± 110.1 min, P = 0.226), despite all PSP patients having additional immediate implant placement and prosthesis delivery. PSP offers better condylar accuracy and allows immediate implant placement without increasing surgical time compared with PBP.

Ice-cold storage or controlled hypothermia to preserve marginal grafts in high-risk heart transplantation.

To evaluate the effectiveness of the Paragonix SherpaPak cardiac transport system (PSP) compared to the standard ice-cold storage (ICS) in extended-criteria donor grafts implanted in high-risk recipients. Data of all HTx at the University Centers of Udine and Bologna, between January 2020 and December 2023, employing extended-criteria donors in high-risk HTx conditions were retrospectively analyzed. Patient outcomes and complications after HTx were assessed. Endomyocardial biopsies were performed in donor hearts immediately after retrieval (T0), before implantation (T1) and at reperfusion (T2) to evaluate signs of myocardial damage. Overall, 90 patients who had heart transplantation (HTx) with a donor graft preserved with either ICS (n = 60) or PSP (n = 30) were included in the study. The 30-day mortality was 3% in both groups (p = 0.99), and 1-year survival 90% and 88% (p = 0.89) for recipients transplanted with PSP and ICS preserved grafts. Rates of moderate-to-severe graft dysfunction and bradi-arrhythmias for PSP and ICS groups were 7% versus 20% (p = 0.08), and 3% versus 15% (p = 0.09). Histologically, severe degrees of cellular and endothelial damage were absent in all PSP grafts while severe degree of contraction bands were higher in ICS hearts at T2. In high-risk donor-recipient matching, donor heart preservation with PSP seems to show a tendency toward better graft protection.

The molecular spectrum of amyloid-beta (Aβ) in neurodegenerative diseases beyond Alzheimer's disease.

This study investigated the molecular spectrum of amyloid-beta (Aβ) in neurodegenerative diseases beyond Alzheimer's disease (AD). We analyzed Aβ deposition in the temporal cortex and striatum in 116 autopsies, including Lewy body disease (LBD; N = 51), multiple system atrophy (MSA; N = 10), frontotemporal lobar degeneration-TDP-43 (FTLD-TDP; N = 16), and progressive supranuclear palsy (PSP; N = 39). The LBD group exhibited the most Aβ deposition in the temporal cortex and striatum (90/76%, respectively), followed by PSP (69/28%), FTLD-TDP (50/25%), and the MSA group (50/10%). We conducted immunohistochemical analysis using antibodies targeting eight Aβ epitopes in the LBD and PSP groups. Immunohistochemical findings were evaluated semi-quantitatively and quantitatively using digital pathology. Females with LBD exhibited significantly more severe Aβ deposition, particularly Aβ42 and Aβ43 , along with significantly more severe tau pathology. Furthermore, a quantitative analysis of all Aβ peptides in the LBD group revealed an association with the APOE-ε4 genotypes. No significant differences were observed between males and females in the PSP group. Finally, we compared striatal Aβ deposition in cases with LBD (N = 15), AD without α-synuclein pathology (N = 6), and PSP (N = 5). There were no differences in the pan-Aβ antibody (6F/3D)-immunolabeled deposition burden among the three groups, but the deposition burden of peptides with high aggregation capacity, especially Aβ43 , was significantly higher in the AD and LBD groups than in the PSP group. Furthermore, considerable heterogeneity was observed in the composition of Aβ peptides on a case-by-case basis in the AD and LBD groups, whereas it was relatively uniform in the PSP group. Cluster analysis further supported these findings. Our data suggest that the type of concomitant proteinopathies influences the spectrum of Aβ deposition, impacted also by sex and APOE genotypes.

Appearance-related concerns in individuals with pathological skin picking-a comparison with individuals with dermatological conditions and skin-healthy controls.

Pathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls. The present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups. The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks' Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks' Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores. The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

Role of Multivoxel MR Spectroscopy Progressive Supranuclear Palsy - A Preliminary Study.

Progressive supranuclear palsy [PSP] is a neurodegenerative condition with characteristic clinical and imaging features. This is an exploratory MRS study to look at metabolic changes that occur due to the disease by using MR spectroscopic methods in subtypes of the PSP, that is, classic [PSP-c] and Parkinsonian [PSP-p]. A total of 12 PSPs subjects were included in this study, of which 8 subjects were clinically diagnosed as PSP-C and 4 subjects with PSP-P. We also included 6 healthy controls to compare metabolites between PSP groups. A multi-voxel MRS was performed using the Philips 3T MRI system, and postprocessing and metabolic peak fitting and quantification were performed using the Tarquin spectroscopic data-processing software. Individual patient MRS ratios of various metabolites were tabulated and analyzed to look for metabolic differences between these groups. Significant differences were noted in various neurometabolites including GABA, Glutamate, Glutamine, Tau and NAA / creatinine ratio. Our preliminary findings indicate that MRS may act as an in vivo metabolic biomarker in various pathological conditions. Alteration and distribution of these metabolites may act as a marker for symptomatology and clinical presentation. MRS also has the potential for use in prognostic or in assessing the treatment response.

Articular Cartilage Regeneration Utilizing Decellularized Human Placental Scaffold, Mesenchymal Stem Cells and Platelet Rich Plasma.

Articular cartilage repair has been a challenge in orthopedic practice due to the limited self-regenerative capability. Optimal treatment method for cartilage defects has not been defined. We investigated the effect of decellularized human placental (DHP) scaffold, mesenchymal stem cells (MSC) and platelet-rich plasma (PRP) on hyaline cartilage regeneration in a rat model. An osteochondral defect was created in trochlea region of the femur in all groups, bilaterally. No additional procedure was performed in control group (n = 14). Only the DHP scaffold was applied to the P group (n = 14). The DHP scaffold and 1 × 106 MSCs were applied to the PS group (n = 14). The DHP scaffold and PRP were applied to the PP group (n = 14). The DHP scaffold, 1 × 106 MSCs and PRP were applied to the PSP group (n = 14). Outcome measures at 12weeks included Pineda histology score and qualitative histology. The mean Pineda scores of P, PS, PP, and PSP groups were significantly better than the control group (p = 0.031, p = 0.002, p < 0.001, p < 0001, respectively). There was no statistically difference in mean Pineda scores of P, PS, PP, and PSP groups (p > 0.05). In conclusion, the DHP scaffold appears to be a promising scaffold on hyaline cartilage regeneration. The augmentation of DHP scaffold with MSCs and PRP combinations did not enhance its efficacy on articular cartilage regeneration.

Magnetic Resonance Parkinsonism Index for evaluating disease progression rate in progressive supranuclear palsy: A longitudinal 2-year study

IntroductionWe investigated the disease progression rate in patients with progressive supranuclear palsy-Richardson syndrome (PSP-RS) and PSP-parkinsonism (PSP-P) in comparison with Parkinson disease (PD) patients, using MRPI (Magnetic Resonance Parkinsonism Index), and MRPI 2.0. MethodsFifteen PSP-RS patients (disease duration, y, mean ± SD: 2.5 ± 1.1), 16 PSP-P patients (disease duration, y, mean ± SD: 6.5 ± 3.2) and 19 PD patients (disease duration, y, mean ± SD: 3.2 ± 2.3) were enrolled. All patients underwent clinical assessment and MRI at baseline, 1-year, and 2-year follow-up. MRPI, MRPI 2.0 and clinical scores over 1 and 2-years were used to evaluate disease progression rate, and to calculate sample sizes required to power placebo-controlled trials. ResultsAll groups showed increased clinical motor scores over time whereas only PSP groups had increased MRPI and MRPI 2.0 values over T1 and T2 intervals. The percentage increase over 1 and 2-years of MRPI and MRPI 2.0 values was significantly higher in PSP groups than in PD group, and in PSP-RS than in PSP-P patients while no difference between patient groups was observed when clinical motor scores were considered. Sample size estimates showed that MRPI 2.0 performed better than MRPI and clinical scales. Treatment trials with MRPI 2.0 could be performed over 2-years both in PSP-RS and PSP-P with a sample size per treatment arm of 89 and 170 patients, respectively. ConclusionsOur results demonstrate that MRPI 2.0 was more powerful than MRPI and clinical motor scales in evaluating PSP progression, and in providing the best sample size estimates for clinical trials.

Evaluation of two dental digital imaging systems based on quality scorings, burn-out effects and cervical width determination

Background/Aim: The aim of the present study is to evaluate diagnostic accuracy of two generic image receptors with CMOS and PSP sensors for image quality scoring (IQS), burnout incidences (BI) and cervical widths (CW) with regard to four different exposure times. Material and Methods: 43 incisor teeth within 15 paraffin block models were exposed at 4 different exposure times both for the CMOS and PSP groups, and a total number of 120 images were obtained. All images were evaluated by 3 dentomaxillofacial radiologists via 3 different criteria; IQS, BI, CW. Results: Diagnostic quality scorings between groups displayed statistically significant difference for 0,1; 0,125 and 0,16 SEC exposure times. PSP group revealed higher IQS. For 0,125 and 0,16 seconds exposure times, PSP group showed higher percentages of BI. Average CW were lower in PSP group. Although no statistically significant difference was found between average CW vs. exposure times in the CMOS group; PSP group revealed significant differences among exposure times. We can state that, the PSP system displayed higher image quality so exposure times can be reduced, alas, the same conclusion is not possible with CMOS system used. Conclusions: Image quality perception is higher in PSP system we used, compared with CMOS system. PSP system display more burnout effects with increasing exposure times, while CMOS system is constant.

Automated Brainstem Segmentation Detects Differential Involvement in Atypical Parkinsonian Syndromes.

ObjectiveBrainstem segmentation has been useful in identifying potential imaging biomarkers for diagnosis and progression in atypical parkinsonian syndromes (APS). However, the majority of work has been performed using manual segmentation, which is time consuming for large cohorts.MethodsWe investigated brainstem involvement in APS using an automated method. We measured the volume of the medulla, pons, superior cerebellar peduncle (SCP) and midbrain from T1-weighted MRIs in 67 patients and 42 controls. Diagnoses were corticobasal syndrome (CBS, n = 14), multiple system atrophy (MSA, n = 16: 8 with parkinsonian syndrome, MSA-P; 8 with cerebellar syndrome, MSA-C), progressive supranuclear palsy with a Richardson’s syndrome (PSP-RS, n = 12), variant PSP (n = 18), and APS not otherwise specified (APS-NOS, n = 7).ResultsAll brainstem regions were smaller in MSA-C (19–42% volume difference, p < 0.0005) and in both PSP groups (18–33%, p < 0.0005) than in controls. MSA-P showed lower volumes in all regions except the SCP (15–26%, p < 0.0005). The most affected region in MSA-C and MSA-P was the pons (42% and 26%, respectively), while the most affected regions in both the PSP-RS and variant PSP groups were the SCP (33% and 23%, respectively) and midbrain (26% and 24%, respectively). The brainstem was less affected in CBS, but nonetheless, the pons (14%, p < 0.0005), midbrain (14%, p < 0.0005) and medulla (10%, p = 0.001) were significantly smaller in CBS than in controls. The brainstem was unaffected in APS-NOS.ConclusionAutomated methods can accurately quantify the involvement of brainstem structures in APS. This will be important in future trials with large patient numbers where manual segmentation is unfeasible.

Effect of polysaccharides from Polygonatum sibiricum on lipid-metabolism related mRNA and protein expression in hyperlipidemic mice

To study the effect of polysaccharides from Polygonatum sibiricum on mRNA and protein expressions of blood lipid metabolism in hyperlipidemic mice. The mice were randomly divided into 6 groups, namely the blank control group, the hyperlipidemia model group, the simvastatin group, and low, middle and high-dose PSP groups (200, 400, 800 mg·kg⁻¹·d⁻¹). Each group of the mice was administrated intragastrically for 14 days, respectively. Subsequently, every group of mice, except for the blank control group, was intraperitoneally injected with 75% fresh egg yolk emulsion for establishing the hyperlipidemic mice model. Upon completion of the administration, the contents of TC, TG, LDL-C and HDL-C in serum of each group were investigated in details. In particular, the mRNA expression levels of PPAR-α, PPAR-β, PPAR-γ, SREBP-1c, IL-6 and TNF-α of the liver tissues were detected by Real-time PCR, and the protein expression levels (including PPAR-α, PPAR-β, PPAR-γ, SREBP-1c, IL-6, TNF-α) were examined by Western blot. Consequently, the obtained results showed that the contents of the serum TC, TG, LDL-C of low, middle and high-dose PSP groups significantly decreased compared with those of the hyperlipidemia model group. Simultaneously, there were significant differences between middle-dose and high-dose PSP groups (P<0.01). In striking contrast, the contents of serum HDL-C of low, middle and high-dose PSP groups significantly increased, while obvious differences were also observed between middle-dose and high-dose PSP groups (P<0.01). Moreover, middle-dose and high-dose PSR groups could up-regulate the protein and mRNA expressions of PPAR-α, PPAR-β (P<0.05) compared with those of the hyperlipidemia model group, and down-regulate the expressions of PPAR-γ,SREBP-1c, IL-6 and TNF-α(P<0.05) compared with those of liver tissues of the hyperlipidemia model group. In conclusion, all of the above results suggested that PSP could inhibit the oxidation of the liver lipid, and regulate the expression levels of the corresponding genes and proteins relating to the lipid metabolism, so as to play a critical role for preventing hyperlipidemia.

The police, social services, and psychiatry (PSP) cooperation as a platform for dealing with concerns of radicalization

The police, social services, and psychiatry (PSP) is a structured cooperation between the police, social services, and the psychiatric system in Denmark. The aim of PSP is to ensure that relevant information is shared and supportive measures enhanced concerning citizens at risk, and it involves PSP representatives from each sector meeting frequently. PSP is implemented nationwide by law. In recent years, dealing with radicalization and the threat of terrorism have become key issues in society. The PSP cooperation already facilitates the identification of citizens at many kinds of risk (e.g. suicide, substance abuse, social decline, mental illness), and coordinates relevant intervention and treatment. The existing PSP cooperation is, therefore, an obvious forum for identifying and handling concerns of radicalization and extremism. The new working model includes an upgrade of all local PSP groups and an implementation of a nationwide evaluation of the initiative. This is a presentation of the working model and the experiences in practice.

Potential multisystem degeneration in Asidan patients

ObjectiveTo evaluate a potential multisystem involvement of neurodegeneration in Asidan, in addition to cerebellar ataxia and signs of motor neuron disease. MethodsWe compared the new Asidan patients and those identified in previous studies with Parkinson's disease (PD, n=21), and progressive supranuclear palsy (PSP, n=13) patients using 123I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT-SPECT) and 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy (Asidan, DAT: n=10; MIBG: n=15). ResultsBoth the PD and PSP groups served as positive controls for DAT decline. The PD and PSP groups served as a positive and negative control, respectively, of MIBG decline in the early phase H/M ratio. Of the Asidan patients, 60.0% showed DAT decline without evident parkinsonian features and 6.7% showed impaired MIBG in only the delayed phase H/M ratio. Combined with a normal range of the early phase H/M ratio, this phenotype was newly named Declined DAT Without Evident Parkinsonism (DWEP). InterpretationThe results of present study including DWEP suggest a wider spectrum of neurodegeneration for extrapyramidal and autonomic systems in Asidan patients than expected, involving cerebellar, motor system and cognitive functioning.

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality.

Background. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP). Methods. We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis. Results. In the SSP group (n = 327; 34.9%), patient age, requirement for emergency transport, and length of stay were greater (all, p < 0.001), while the prevalence of smoking (p = 0.023) and number of surgical interventions (p < 0.001) were lower compared to those in the PSP group (n = 611; 65.1%). Among the 16 in-hospital deceased patients, 12 (75.0%) received emergency transportation and 10 (62.5%) exhibited performance status (PS) of 3-4. In the SSP group, emergency transportation was an independent factor for in-hospital mortality (odds ratio 16.37; 95% confidence interval, 4.85–55.20; p < 0.001). Conclusions. The prevalence and clinical characteristics of PSP and SSP differ considerably. Patients with SSP receiving emergency transportation should receive careful attention.

Chronic pain among public safety personnel in Canada

ABSTRACTBackground: Chronic pain is highly prevalent in the general population and may be even higher among public safety personnel (PSP; e.g., correctional officers, dispatchers, firefighters, paramedics, police). Comprehensive data on chronic pain among diverse Canadian PSP are relatively sparse.Aims: The current study was designed to provide initial estimates of chronic pain frequency and severity among Canadian PSP.Methods: Estimates of chronic pain frequency and severity (i.e., intensity and duration) at different bodily locations were derived from self-reported data collected through an online survey. Participants included 5093 PSP (32.5% women) grouped into six categories (i.e., call center operators/dispatchers, correctional officers, firefighters, municipal/provincial police, paramedics, Royal Canadian Mounted Police [RCMP]).Results: Substantial proportions of participants reported chronic pain, with estimates ranging from 35.3% to 45.4% across the diverse PSP categories. Across PSP categories, chronic lower back pain was the most prevalent. For some pain locations, firefighters and municipal/provincial police reported lower prevalence, but paramedics reported lower intensity, and duration, than some other PSP groups. Over 50% of RCMP and paramedics reporting chronic pain indicated that the pain was associated with an injury related to active duty.Conclusions: Discrepancies emerged across PSP members with respect to prevalence, location, and severity. The current data suggest that additional resources and research are necessary to mitigate the development and maintenance of distressing or disabling chronic pain for Canadian PSP.

61. Patients with progressive supranuclear palsy show abnormal response to conditioned and unconditioned TMS stimuli compared to patients with Parkinson’s disease and healthy subjects

Progressive supranuclear palsy-PSP is the second most common parkinsonian syndrome after Parkinson’s disease-PD, with some overlapping clinical features in the early phases. Non-invasive neurophysiological techniques, such as transcranial magnetic stimulation-TMS, could be useful for the differential diagnosis. Seventeen PD, 13 PSP and 11 healthy controls-HC subjects were included in this study. TMS evaluation included resting motor threshold-RMT, motor evoked potentials-MEP amplitude and latency, response to inhibitory-SICI and facilitating-ICF conditioned stimuli, cortical silent period-CSP, and ipsilateral silent period-iSP. Statistical analysis was performed using either parametric or non-parametric ANOVA according to data distribution. PSP and PD groups did not significantly differ in UPDRS. TMS assessment showed different distribution of RMT across the groups (p.008), with PSP patients showing the highest values and PD the lowest (PSP vs PD p.002). Group also affected iSP duration (p.016), being longest in PSP and lowest in HC (PSP vs HC p.005). On paired-pulse inhibition and facilitation, a significant effect for ISI ( p

Somatosensory and auditory startle reaction in patients with movement disorders

Background Startle reflex (SR) is a generalized defense reaction which is elicited by unexpected stimuli. To elicit SR, auditory and electrical stimulations are used in electrophysiological investigations. Somatosensory startle reflex (SS-SR) is recently described in healthy volunteers after median and tibial stimulation. Studies in patients with brainstem lesions showed importance of upper brainstem in development of SS-SR. Here, we aim to investigate SS-SR systematically in various movement disorders to address its characteristics in comparison to ASR. Methods We have examined ASR and SS-SR in patients with dystonia ( n = 12), multiple system atrophy ( n = 8), corticobasal degeneration ( n = 5), restless legs syndrome ( n = 14), progressive supranuclear palsy ( n = 11), essential tremor ( n = 18) and idiopathic PD (n = 16) and healthy volunteers ( n = 35) under the same conditions. ASR and SS-SR were recorded over orbicularis oculi (o.oc), sternocleidomastoid (SCM), and biceps brachii (BB) after bilateral auditory and median nerve electrical stimulations, respectively. Results The pattern and probability rates over each three muscle of ASR were similar in MSA, RLS, ET, PD and healthy individuals. Probability rates of responses over each muscle and total ASR probability were the highest in dystonia group whereas they were the lowest in CBD and PSP ( p o.oc = 0.016, p scm = 0.036, p bb = 0.000, p total = 0.009). Onset latencies of O.oc responses were also longer in CBD and PSP groups ( p = 0.001). Presence of SSR was also the highest in dystonia and lowest in PSP group similar to ASR. Latency of O.oc response was longest in CBD group. Pattern of SS-SR was similar to healthy individuals in all disease groups except dystonia and MSA in which BB responses were more common than SCM responses. Conclusions The findings of ASR parallel the previous findings. Dystonia patients are known to have exaggerated ASRs. The decreased response in PSP was previously suggested as a support to show extent of pathology. Findings regarding SS-SR also parallel ASR. SS-SR is also exaggerated in dystonia. Different pattern of response appears to be a reflection of overflow phenomenon. However, development of withdrawal reaction is a possibility. Shorter onset latencies in dystonia group probably also reflect increased excitability. Absence of SS-SR or longer latencies in PSP reflects impairment of its pathway which supports the opinion that it may share pathway with ASR and its generator is possibly in the upper brainstem.

ID 278 – Motor cortical disinhibition is more pronounced in Progressive Supranuclear Palsy than in Parkinson’s disease: Evidence from TMS

Objective Progressive Supranuclear Palsy-PSP is the second most common parkinsonian syndrome after Parkinson’s disease-PD. Non-invasive neurophysiological techniques, such as transcranial magnetic stimulation-TMS, could prove useful to gain insight into these pathologies and for differential diagnosis. Methods Seventeen PD, 13 PSP and 11 healthy controls-CT were included in this study. TMS evaluation included resting motor threshold-RMT, motor evoked potentials-MEP amplitude, response to inhibitory-SICI and facilitating-ICF conditioning stimuli, cortical-CSP and ipsilateral silent period-iSP. Statistical analysis was performed using either parametric or non-parametric ANOVA and post-hoc tests according to data distribution. Results PSP and PD groups did not significantly differ in UPDRS. RMT distributed differently across groups (p.008), with PSP patients showing highest values and PD lowest (PSPvs.PD p.002). Group also affected iSP duration (p.016), being longest in PSP and lowest in HC (PSPvs.CT p.005). On paired-pulse inhibition and facilitation, a significant effect for inter-stimulus interval-ISI ( p Conclusions This study suggests that TMS can help differentiate PD and PSP. PSP patients displayed different response to the perturbation induced by conditioning stimuli and iSP elongation, probably due to impairment of GABA-mediated neurotransmission.

Video-assisted thoracoscopic surgery management of spontaneous pneumothorax — long-term results

Although widely adopted, there is lack of immediate and long-term follow-up data for patients undergoing video-assisted thoracoscopic surgery (VATS) management of pneumothorax. Therefore, we have reviewed our experience with both primary (PSP) and secondary (SSP) spontaneous pneumothorax to assess the perioperative outcomes and long-term efficacy associated with different VATS operative strategies. A retrospective case series review was undertaken on all patients undergoing VATS procedures for PSP or SSP over a 17-year period. A total of 644 VATS pneumothorax procedures were performed between 1992 and 2008 on 569 patients, of which 550 procedures were performed for PSP and 94 for SSP. Mean age for PSP and SSP groups were 28.4 ± 10.4 and 58.2 ± 14.2 years, respectively. Surgical technique used bullectomy in combination with abrasion (273), poudrage (246) and pleurectomy (46). Isolated poudrage was used in 72 cases. Median postoperative stay was 3 and 4 days, respectively. Major complications occurred in 25 (4.6%) PSP and 18 (19.2%) SSP patients. Two patients in the SSP group died (2.1%). Median follow-up was 73 months. Freedom from further surgery for the two populations was PSP: 98.1% at 5 years (confidence interval (C.I.): 96.9-99.4) and 97.8% at 10 years (C.I.: 96.5-99.2); SSP: 96.1% at 5 years (C.I.: 91.5-1.006) and 96.1% at 10 years (C.I.: 91.5-1.006). Freedom from further operation at 10 years was independent of the pleurodesis technique employed: abrasion 96.4%, poudrage 98.9% and pleurectomy 97.5% (p=0.22). VATS management of both PSP and SSP offers good short-term results and excellent long-term freedom from repeat surgery. In combination with bullectomy, results of abrasion and poudrage do not significantly differ from pleurectomy. We recommend abrasion for pleurodesis in young patients reserving poudrage for the elderly. Pleurectomy may not be necessary.

Effects of Fermented Soy Protein on Nitrogen Balance and Apparent Fecal and Ileal Digestibility in Weaned Pigs

This study was conducted to evaluate the effects of providing fermented soy protein to weaned pigs on nitrogen balance and apparent fecal and apparent ileal digestibility (AID) of AA. Four weaned ((YorkshireLandrace)Duroc) barrows (BW = 6.580.98 kg), surgically fitted with a simple T-cannula approximately 15 cm prior to the ileo-cecal junction, were fed four diets according to 44 Latin square design. Diets were a basal diet supplemented with one of the following: 3% SDPP (spray dried plasma protein), 5% RBP (soy protein fermented by Lactobacillus spp.), 5% PSP (soy protein fermented by Aspergillus oryzae and Bacillus subtilis), and 2.5% RPP (2.5% RBP+2.5% PSP). No differences were observed in DM and N intakes among treatments. However, the level of urine excretion was greater in the RPP group than in the PSP group. Additionally, fecal DM excretion, fecal N concentration and fecal N excretion were increased in the RBP, PSP and RPP groups when compared with the SDPP group (p

Measurement of the midbrain diameter on routine magnetic resonance imaging: a simple and accurate method of differentiating between Parkinson disease and progressive supranuclear palsy.

Anteroposterior diameters of the suprapontine midbrain, the pons, and the collicular plate were measured in 50 patients with various parkinsonian syndromes (Parkinson disease [PD] [n = 20], progressive supranuclear palsy [PSP] [n = 16], and multiple-system atrophy of striatonigral type [n = 14]) and 12 age-matched healthy control subjects by means of axial T2-weighted magnetic resonance images. While no differences in midbrain diameter were found between patients with PD (mean, 18.5 mm) and control subjects (mean, 18.2 mm), patients with PSP had significantly lower midbrain diameters (mean, 13.4 mm) than patients with PD and control subjects (P<.001), without any overlap between these 2 groups. However, midbrain diameters of patients with multiple-system atrophy were also significantly lower than those of control subjects and patients with PD, with individual values showing overlap with the PSP, PD, and control groups. Pontine and collicular plate diameters did not contribute additional information. We therefore conclude that measurement of anteroposterior diameter of the midbrain on axial T2-weighted magnetic resonance images is a reliable means to differentiate patients with PSP from those with PD and should be incorporated into the diagnostic criteria for PSP.