Transient Global Amnesia After Ablation of the Left Lateral Accessory Pathway

Transient global amnesia (TGA) could be encountered in many situations even during invasive procedures. In ablation therapy for arrhythmia, there was only one reported case in the ablation of premature ventricular beats. We report a 31-year-old man having paroxysmal supraventricular tachycardia who underwent TGA at the end of ablation and recovered quickly after 8-9 hours later. Long-term follow-up showed no neurologic deficits for 8 months

Interleaved EPI based fMRI improved by multiplexed sensitivity encoding (MUSE) and simultaneous multi-band imaging

© 2014 Chang et al. Functional magnetic resonance imaging (fMRI) is a non-invasive and powerful imaging tool for detecting brain activities. The majority of fMRI studies are performed with single-shot echo-planar imaging (EPI) due to its high temporal resolution. Recent studies have demonstrated that, by increasing the spatial-resolution of fMRI, previously unidentified neuronal networks can be measured. However, it is challenging to improve the spatial resolution of conventional single-shot EPI based fMRI. Although multi-shot interleaved EPI is superior to single-shot EPI in terms of the improved spatial-resolution, reduced geometric distortions, and sharper point spread function (PSF), interleaved EPI based fMRI has two main limitations: 1) the imaging throughput is lower in interleaved EPI; 2) the magnitude and phase signal variations among EPI segments (due to physiological noise, subject motion, and B0 drift) are translated to significant in-plane aliasing artifact across the field of view (FOV). Here we report a method that integrates multiple approaches to address the technical limitations of interleaved EPI-based fMRI. Firstly, the multiplexed sensitivity-encoding (MUSE) post-processing algorithm is used to suppress in-plane aliasing artifacts resulting from time-domain signal instabilities during dynamic scans. Secondly, a simultaneous multi-band interleaved EPI pulse sequence, with a controlled aliasing scheme incorporated, is implemented to increase the imaging throughput. Thirdly, the MUSE algorithm is then generalized to accommodate fMRI data obtained with our multi-band interleaved EPI pulse sequence, suppressing both in-plane and through-plane aliasing artifacts. The blood-oxygenation-level-dependent (BOLD) signal detectability and the scan throughput can be significantly improved for interleaved EPI-based fMRI. Our human fMRI data obtained from 3 Tesla systems demonstrate the effectiveness of the developed methods. It is expected that future fMRI studies requiring high spatial-resolvability and fidelity will largely benefit from the reported techniques.published_or_final_versio

Properties of Lactobacillus reuteri chitosan-calcium-alginate encapsulation under simulated gastrointestinal conditions

The protective effects of encapsulation on the survival of Lactobacillus reuteri and the retention of the bacterium’s probiotic properties under simulated gastrointestinal conditions were investigated. Viable counts and the remaining probiotic properties of calcium (Ca)-alginate encapsulated (A group), chitosan-Ca-alginate encapsulated (CA group), and unencapsulated, free L. reuteri (F group) were determined. Encapsulation improved the survival of L. reuteri subjected to simulated gastrointestinal conditions, with the greatest protective effect achieved in the CA group. The degree of cell membrane injury increased with increasing bile salt concentrations at constant pH, but the extent of injury was less in the encapsulated than in the free cells. Adherence rates were, in descending order: CA (0.524%) > A (0.360%) > F (0.275%). Lactobacillus reuteri cells retained their antagonistic activity toward Listeria monocytogenes even after incubation of the lactobacilli under simulated gastrointestinal conditions. Displacement of the pathogen by cells released from either of the encapsulation matrices was higher than that by free cells. The safety of L. reuteri was demonstrated in an in vitro invasion assay. [Int Microbiol 2015; 18(1):61-69]Keywords: Lactobacillus reuteri · Listeria monocytogenes · chitosan–calcium-alginate encapsulation · probiotic properties · simulated gastrointestinal condition

Is clopidogrel better than aspirin following breakthrough strokes while on aspirin? A retrospective cohort study.

ObjectiveThere is insufficient evidence on which to base a recommendation for optimal antiplatelet therapy following a stroke while on aspirin. The objective was to compare clopidogrel initiation vs aspirin reinitiation for vascular risk reduction among patients with ischaemic stroke on aspirin at the time of their index stroke.DesignRetrospective.SettingWe conducted a nationwide cohort study by retrieving all hospitalised patients (≥18 years) with a primary diagnosis of ischaemic stroke between 2003 and 2009 from Taiwan National Health Insurance Research Database.ParticipantsAmong 3862 patients receiving aspirin before the index ischaemic stroke and receiving either aspirin or clopidogrel after index stroke during follow-up period, 1623 were excluded due to a medication possession ratio <80%. Also, 355 were excluded due to history of atrial fibrillation, valvular heart disease or coagulopathy. Therefore, 1884 patients were included in our final analysis.InterventionsPatients were categorised into two groups based on whether clopidogrel or aspirin was prescribed during the follow-up period. Follow-up was from time of the index stroke to admission for recurrent stroke or myocardial infarction, death or the end of 2010.Primary and secondary outcome measuresThe primary end point was hospitalisation due to a new-onset major adverse cardiovascular event (MACE: composite of any stroke or myocardial infarction). The leading secondary end point was any recurrent stroke.ResultsCompared to aspirin, clopidogrel was associated with a lower occurrence of future MACE (HR=0.54, 95% CI 0.43 to 0.68, p<0.001, number needed to treat: 8) and recurrent stroke (HR=0.54, 95% CI 0.42 to 0.69, p<0.001, number needed to treat: 9) after adjustment of relevant covariates.ConclusionsAmong patients with an ischaemic stroke while taking aspirin, clopidogrel initiation was associated with fewer recurrent vascular events than aspirin reinitiation

The Observation for Ocular Surface Diseases in Respiratory Care Center in One Regional Teaching Hospital in Southern Taiwan

Abstract: Purpose: To discover the incidence of ocular surface diseases in the RCC in one region hospital in southern Taiwan. Methods: A prospective study was performed from January 2014 to May 2014. We recorded the causes of admission, eyelid position, abnormal findings of the conjunctiva and cornea. Besides, we also collected data about age, sex, sedation score, the intubation or not, the ventilator setting, date of admission, endotracheal tube or tracheostomy used et al. Results: Total 30 patients were examined in RCC. The mean age of the patients was 60.5 years (range 32-82). 18 patients were male and 12 were female. 24 patients had been sedated or non-sedated with various ventilators. 6 patients were in T-piece trial. 22 patients had tube intubation and 8 patients had received tracheostomy. Mean stay time was 20.5 days. The percent of ocular surface diseases were 33.3% (10/30), and lagophthalmos was observed about 33.3% due to sedation. 23.3% (7/30) patients had conjunctival problems and 26.6% (8/30) had keratopathy. We found that 80% (8/10) patients with lagophthalmos had eye disorders. The endotracheal tube intubation group had a relatively higher incidence of ocular surface diseases (7/22；32%). If the sedation score lower than 8, 26 % patients may have eye diseases. Conclusion: The incidence of ocular surface diseases is closely related to heavy sedation or muscle relaxants. The assessment of eyelid position in relation to the ocular surface disease is the most important observation required in RCC. How to set up the routine protocol for eye care for the staff in ICU becomes valuable and serious today. We must keep in mind that prevention is always better than cure

Recent Advances in Tungsten-Oxide-Based Materials and Their Applications

Among several active photothermal nanomaterials, tungsten-oxide-based materials have received considerable attention recently because of their ability to absorb near-infrared (NIR) light and their efficient light-to-heat conversion properties. In addition, tungsten-oxide-based materials have an unusual oxygen defect structure and strong local surface plasma resonance (LSPR), which offers strong photoabsorption in a broad wavelength range of the NIR region. In the past, several light-absorbing nanomaterials such as noble metals, polymeric materials, and other inorganic nanomaterials were of interest for their use in photothermal therapy for cancer treatment. In this study, we review the synthesis, properties, and applications of tungsten-oxide-based nanomaterials as a new type of photothermal material. The basic ideas behind photothermal nanomaterial development as well as the factors that influence their structural designs are also discussed in this study. In addition, recent progress in various fields such as NIR light-shielding, pyroelectric, water evaporation, photocatalysis, gas sensors, and energy-related applications for WO3−x- and MxWO3-based nanomaterials (including their hybrids) are highlighted. Finally, this review presents promising insights into this rapidly growing field that may inspire additional research leading to practical applications

Proteomic analysis of rhein-induced cyt: ER stress mediates cell death in breast cancer cells

Rhein is a natural product purified from herbal plants such as Rheum palmatum, which has been shown to have anti-angiogenesis and anti-tumor metastasis properties. However, the biological effects of rhein on the behavior of breast cancers are not completely elucidated. To evaluate whether rhein might be useful in the treatment of breast cancer and its cytotoxic mechanism, we analyzed the impact of rhein treatment on differential protein expression as well as redox regulation in a non-invasive breast cancer cell line, MCF-7, and an invasive breast cancer cell line, MDA-MB-231, using lysine- and cysteine-labeling two-dimensional difference gel electrophoresis (2D-DIGE) combined with MALDI-TOF/TOF mass spectrometry. This proteomic study revealed that 73 proteins were significantly changed in protein expression; while 9 proteins were significantly altered in thiol reactivity in both MCF-7 and MDA-MB-231 cells. The results also demonstrated that rhein-induced cytotoxicity in breast cancer cells mostly involves dysregulation of cytoskeleton regulation, protein folding, the glycolysis pathway and transcription control. A further study also indicated that rhein promotes misfolding of cellular proteins as well as unbalancing of the cellular redox status leading to ER-stress. Our work shows that the current proteomic strategy offers a high-through-put platform to study the molecular mechanisms of rhein-induced cytotoxicity in breast cancer cells. The identified differentially expressed proteins might be further evaluated as potential targets in breast cancer therapy

The prediction of Alzheimer’s disease through multi-trait genetic modeling

To better capture the polygenic architecture of Alzheimer’s disease (AD), we developed a joint genetic score, MetaGRS. We incorporated genetic variants for AD and 24 other traits from two independent cohorts, NACC (n = 3,174, training set) and UPitt (n = 2,053, validation set). One standard deviation increase in the MetaGRS is associated with about 57% increase in the AD risk [hazard ratio (HR) = 1.577, p = 7.17 E-56], showing little difference from the HR for AD GRS alone (HR = 1.579, p = 1.20E-56), suggesting similar utility of both models. We also conducted APOE-stratified analyses to assess the role of the e4 allele on risk prediction. Similar to that of the combined model, our stratified results did not show a considerable improvement of the MetaGRS. Our study showed that the prediction power of the MetaGRS significantly outperformed that of the reference model without any genetic information, but was effectively equivalent to the prediction power of the AD GRS

Using the computer-based feedback (CBF) system to investigate the juniorphysicians’s and clinical-instructors perceptions for the benefits of general medicine clinical-instructors training program

Background: The purpose of this study is to examine the clinical-instructors and junior-physicians (residents and interns) perceptions for the general-medicine training program by using bi-directional interactive and self-assessments computer-based feedback (CBF) and paper-based multisource feedback assessment (PBMFA) systems for the efficiency and benefit evaluation.Methods: Between 2011 January to 2013 December, junior-physicians and their clinical-instructors in the same medical team were enrolled consecutively for monitoring the CBF scores gave by each other after each clinical course. A total of 321 residents, 298 interns and 110 clinical-instructors who participated in the core competency general-medicine training program in 6-months period were included in the study. The CBF and PBMFA evaluations are undergone paralleled to gather the suggested information in different levels of Kirkpatrick evolutional theory.Results: The results showed that lecturers, being 5-10 years as attending physicians, internal medicine sub-specialty clinical-instructors are most benefit from the general medicine training program. Accordingly, the CBF scores of junior-physicians was positively correlated with the times (> 3-times) of exposure to the medical teams that leaded by qualified clinical-instructors. Both clinical-instructors and junior-physicians have positive attitude to the value of the general-medicine training program. Interestingly, a good consistency was existed between residents CBF scores and PBMFA grades for their core-competency performance. Comparatively, the overall perception of clinical-instructors and junior-physicians for the general-medicine training was very positive.Conclusions: Clinical-instructors and junior-physicians had positive perception of CBF and PBMFA systems which could give us different information to improve and strength the further core-competency general-medicine training program by appropriate utilization