Clinical and Pathological Manifestations with Differential Diagnosis in Behçet's Disease

Behçet's disease is a multisystemic inflammatory disease of unknown etiology which usually occurs as a trait of symptoms: aphthous stomatitis, genital ulcerations, and ocular disease. At the beginning of the disease the diagnosis is uncertain because of various clinical manifestations and a long period up to the full clinical picture manifestation. Since neither the laboratory data nor the histopathological signs are truly pathognomonic in Behçet's disease, the differential diagnosis depends on a careful evaluation of the medical history and meticulous physical examination to detect concomitant systemic manifestations. Sometimes, some laboratory test may help establish the diagnosis. Subspecialty referral to ophthalmology, rheumatology, neurology, and gastroenterology should be considered when indicated

Sarcoidosis and autoimmune disorders. A case report and review of the literature

Sarcoidosis is a multisystem disease of unknown etiology characterized by clusters of non-necrotizing granulomas and distortion of surrounding tissue. Although some patients are asymptomatic, sarcoidosis can cause a wide range of signs and symptoms often mimicking autoimmune rheumatologic disorders. Combined sarcoidosis and autoimmune disorders is uncommon as a result of either an University Hospital database analysis and literature review. However, given the high prevalence of autoimmunity in the general population, clinicians should be alerted to correctly diagnose and manage patients suspected to have both sarcoidosis and autoimmune disorders

Optimization of broaching tool design /

Broaching is a commonly used machining operation in manufacturing of variety of internal or external complex features. High quality surfaces can be generated with high productivity if proper conditions are used. The main disadvantage of broaching is that it is not possible to change any of the cutting parameters but the cutting speed during production. That is because all machining parameters, except cutting speed, are built into broaching tools which makes tool design the most important aspect of broaching. In this thesis, a procedure for the optimization of broaching tools is presented. First, the mechanics of the broaching process and general properties of the broach tools are explained. Important design parameters and the effects of them on the broaching process are demonstrated. Most broaching tools have several tool segments with different profiles. One of the critical factors in the design of these tools is the assignment of segment profiles which determine the relative amounts of material removal rate in each section. Several alternatives are tried for optimization of section geometries and their effects are demonstrated by simulations. The objective function of the optimization problem and the constraints due to machine, tool and part limitations are presented. A heuristic optimization algorithm is developed, and demonstrated by examples. It is also shown that by using the algorithm developed the production time can be reduced due to shortened tool length. The simulation program developed is also explained and demonstrated

Cadmium uptake and antioxidative enzymes in durum wheat cultivars in response to increasing Cd application

Effects of increasing cadmium (Cd) application rates on shoot and root growth, uptake and accumulation of Cd, and activity of antioxidative defense enzymes were studied in two durum wheat (Triticum durum) cultivars (cvs. Balcah-2000 and Balcah-85) differing in Cd tolerance. These durum wheat cultivars have been selected from a screening study including 10 bread and 6 durum wheat cultivars. The selected cultivars were grown in nutrient solution under controlled environmental conditions and subjected to increasing Cd concentrations (e.g., 0, 0.5, 2, 10, and 30 uM Cd). Genotypic variation in tolerance to increasing Cd stress was observed based on the development of necrotic patches on the base of the oldest leaves and reduction in dry matter production. Based on these parameters Balcah-85 was ranked as the Cd-tolerant and Balcah-2000 the Cd-sensitive genotype. The results of the root uptake and accumulation of Cd in root and shoot showed that the distinct genotypic difference in tolerance to Cd toxicity between two durum wheat cultivars was very closely related to the differential partitioning of Cd between roots and shoots. Both cultivars responded in a very similar way in total uptake of Cd by roots, but differed greatly in root accumulation and root-to-shoot transport of Cd. Compared to Balcah-2000, Balcah-85 had higher capacity to retain Cd in roots and reduce Cd transport into shoots. Consequently, in Balcah-2000 the shoot concentration and content of Cd were nearly 2-fold higher than that of Balcah-85, indicating a possible detoxification mechanism existing in Balcah 85 to retain of Cd in roots and prevent photosynthetic tissues from Cd toxicity. Genotypic variation was also studied in terms of antioxidative enzymes including ascorbate peroxidase (AP), glutathione reductase (GR), superoxide dismutase (SOD) and catalase (CAT). The results obtained did not show any consistent relationship between Cd tolerance and activities of the antioxidative enzymes. At the highest level of Cd applications there was a clear decrease in 02-(superoxide)-generating NADPH oxidase activity in both cultivars, possibly due to inactivation of the enzyme by binding of Cd to NADPH. The results obtained in the study clearly demonstrated that differential tolerance to Cd toxicity between durum wheat cultivars is related very closely to detoxification mechanism of the absorbed Cd in roots (e.g. binding to cell wall and/or compartmentalization in vacuole)

Experimentally induced puromycine aminonucleoside nephrosis (PAN) in rats: evaluation of angiogenic protein platelet-derived endothelial cell growth factor (PD-ECGF) expression in glomeruli

<p>Abstract</p> <p>Background</p> <p>In experimentally induced puromycine aminonucleoside nephrosis (PAN) animal models, nephrotic syndrome with minimal change disease and focal and segmental sclerosis-like nephritis similar to that in human is demonstrated; however, the real mechanism of PAN is not yet elucidated. Platelet derived endothelial cell growth factor (PD-ECGF), an endothelial mitogen protein, is believed to take part in microvessel formation and in stimulation of angiogenesis and its expression has not been totally demonstrated in PAN rats yet. In this study, we aimed to examine PD-ECGF expression in acute and chronic PAN induced in rats and find out the association between its expression and the stages of angiogenesis in kidney.</p> <p>Methods</p> <p>For the experiment, twenty-four Male Wistar Albino rats were used and divided into four groups; control group (n = 6), pre-proteinuria group (n = 6), acute group (n = 6) and chronic group (n = 6). We compared statistically all data by One-way ANOVA Test followed by Dunn Multiple Comparison Test.</p> <p>Results</p> <p>Proteinurea levels in control and pre-proteinuria groups were not statistically different; however, it was remarkably higher in the acute nephrosis group and significantly greater in the chronic nephrosis group than control group (<it>p </it>< 0.0025). In pre-proteinuria group, the serum albumin and creatinine clearances also did not significantly differ from the control group. On the other hand, in the acute and chronic nephrosis groups, serum albumin and creatinine clearances progressively decreased (<it>p </it>< 0.05). In our immunohistochemical studies, we showed elevated PD-ECGF expression in glomeruli of acute and chronic PAN rats. Microscopic and ultrastructural appearances of the glomeruli of acute and chronic PAN showed various sequential steps of angiogenesis, macrophages and immature capillaries with primitive lumens and apoptotic endothelial cells in the increased mesangial matrix.</p> <p>Conclusions</p> <p>It is reported that acute and chronic PAN progressively increase PD-ECGF expression and following induction of angiogenesis in the affected glomeruli.</p

Real-world effectiveness of fremanezumab for the preventive treatment of migraine: Interim analysis of the pan-European, prospective, observational, phase 4 PEARL study

Chronic; Episodic; Real-world evidenceCrònica; Episòdic; Evidència del món realCrónico; Episódico; Evidencia del mundo realBackground The ongoing Pan-European Real Life (PEARL) phase 4 study is evaluating fremanezumab effectiveness and safety for the prevention of episodic and chronic migraine. This interim analysis reports primary, secondary and exploratory endpoints from when 500 participants completed at least six months of treatment. Methods Adults with episodic migraine or chronic migraine maintaining daily headache diaries were enrolled upon initiation of fremanezumab. Primary endpoint: proportion of participants with ≥50% reduction in monthly migraine days during the six-month period after fremanezumab initiation. Secondary endpoints: mean change from baseline across months 1–12 in monthly migraine days, acute migraine medication use, and headache-related disability. Exploratory endpoint: mean change in headache severity from baseline across months 1–12. Safety was assessed through adverse events reported. Results Overall, 897 participants were enrolled and 574 included in the effectiveness analyses (episodic migraine, 25.8%; chronic migraine, 74.2%). Of participants with data available, 175/313 (55.9%) achieved ≥50% monthly migraine days reduction during the six-month period post-initiation. Across months 1–12, there were sustained reductions in mean monthly migraine days, acute medication use, disability scores, and headache severity. Few adverse events were reported. Conclusion PEARL interim results support the effectiveness and safety of fremanezumab for migraine prevention in a real-world population across several European countries. Trial registration: encepp.eu: EUPAS3511

Tracheal adenoid cystic carcinoma masquerading asthma: A case report

BACKGROUND: Tracheal tumors are often misdiagnosed as asthma and are treated with inhaled steroids and bronchodilators without resolution. CASE PRESENTATION: Here, a patient with tracheal adenoid cystic carcinoma who had been previously diagnosed with difficult asthma was reported. The possibility of the presence of localized airway obstruction was raised when the flow-volume curve suggesting fixed airway obstruction, was obtained. CONCLUSION: The presenting case report emphasizes the fact that not all wheezes are asthma. It is critical to bear in mind that if a patient does not respond to appropriate anti-asthma therapy, localized obstructions should be ruled out before establishing the diagnosis of asthma