353 research outputs found

    Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome

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    Background: Platelet-leukocyte gel (PLG) is being used during various surgical procedures in an attempt to enhance the healing process. We studied the effects of PLG on postoperative recovery of patients undergoing open subacromial decompression (OSD). Methods: PLG was produced from platelet-leukocyte-rich plasma (P-LRP), prepared from a unit of whole blood. Forty patients were included in the study. Self-assessed evaluations, using the American Shoulder and Elbow Surgeons scoring system of activities of daily living (ADL), joint instability, pain levels, pain medications, and clinical evaluations for range of motion were conducted. Results: Platelet and leukocyte counts were significantly increased in the P-LRP compared to baseline counts. Treated patients demonstrated decreased visual analog scales for pain and used significantly less pain medication, had an improved range of motion during passive forward elevation, external rotation, external rotation with arm at 90 degrees abduction, internal rotation, and cross body adduction compared to control patients (p < 0.001). No differences in the instability score were observed between the groups. Furthermore, treated patients performed more ADL (p < 0.05). Conclusion: In the PLG-treated group, recovery was faster and patients returned earlier to daily activities and also took less pain medication than control subjects

    A Bayesian Approach to Risk Management in a World of High-Frequency Data

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    A Realised Volatility GARCH model using high-frequency data is developed within a Bayesian framework for the purpose of forecasting Value at Risk and Conditional Value at Risk. A Skewed Student-t return distribution is combined with a Student-t distribution in the measurement equation in a GARCH framework. Realised Volatility GARCH models show a marked improvement compared to ordinary GARCH. A Skewed Student-t Realised DCC copula model using Realised Volatility GARCH marginal functions is developed within a Bayesian framework for the purpose of forecasting portfolio tail risk. The use of copulas is implemented so that the marginal distributions can be separated from the dependence structure to produce tail forecasts. This is compared to using traditional GARCH-copula models, and GARCH on an aggregated portfolio. Copula models implementing a Realised Volatility GARCH framework show an improvement over traditional GARCH models. A Bayesian detection of regime changes utilizing high-frequency data is developed, once again for the purpose of forecasting portfolio tail risk. The use of high-frequency data improves the accuracy of regime change detection compared to daily data. Monte Carlo sampling schemes are employed for the estimation of these models

    Protein kinase B (AKT) upregulation and Thy-1-α<sub>v</sub>β<sub>3</sub> integrin-induced phosphorylation of Connexin43 by activated AKT in astrogliosis.

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    In response to brain injury or inflammation, astrocytes undergo hypertrophy, proliferate, and migrate to the damaged zone. These changes, collectively known as "astrogliosis", initially protect the brain; however, astrogliosis can also cause neuronal dysfunction. Additionally, these astrocytes undergo intracellular changes involving alterations in the expression and localization of many proteins, including α &lt;sub&gt;v&lt;/sub&gt; β &lt;sub&gt;3&lt;/sub&gt; integrin. Our previous reports indicate that Thy-1, a neuronal glycoprotein, binds to this integrin inducing Connexin43 (Cx43) hemichannel (HC) opening, ATP release, and astrocyte migration. Despite such insight, important links and molecular events leading to astrogliosis remain to be defined. Using bioinformatics approaches, we analyzed different Gene Expression Omnibus datasets to identify changes occurring in reactive astrocytes as compared to astrocytes from the normal mouse brain. In silico analysis was validated by both qRT-PCR and immunoblotting using reactive astrocyte cultures from the normal rat brain treated with TNF and from the brain of a hSOD1 &lt;sup&gt;G93A&lt;/sup&gt; transgenic mouse model. We evaluated the phosphorylation of Cx43 serine residue 373 (S373) by AKT and ATP release as a functional assay for HC opening. In vivo experiments were also performed with an AKT inhibitor (AKTi). The bioinformatics analysis revealed that genes of the PI3K/AKT signaling pathway were among the most significantly altered in reactive astrocytes. mRNA and protein levels of PI3K, AKT, as well as Cx43, were elevated in reactive astrocytes from normal rats and from hSOD1 &lt;sup&gt;G93A&lt;/sup&gt; transgenic mice, as compared to controls. In vitro, reactive astrocytes stimulated with Thy-1 responded by activating AKT, which phosphorylated S373Cx43. Increased pS373Cx43 augmented the release of ATP to the extracellular medium and AKTi inhibited these Thy-1-induced responses. Furthermore, in an in vivo model of inflammation (brain damage), AKTi decreased the levels of astrocyte reactivity markers and S373Cx43 phosphorylation. Here, we identify changes in the PI3K/AKT molecular signaling network and show how they participate in astrogliosis by regulating the HC protein Cx43. Moreover, because HC opening and ATP release are important in astrocyte reactivity, the phosphorylation of Cx43 by AKT and the associated increase in ATP release identify a potential therapeutic window of opportunity to limit the adverse effects of astrogliosis

    Нейросекреторная активность супраоптического ядра переднего гипоталамуса кроликов под действием транскутанной электростимуляции зрительного анализатора

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    На 8 кролях породи Метелик вивчали вплив непрямої черезшкірної електростимуляції зорового аналізатора на нейросекреторну активність магноцелюлярних клітин супраоптичного ядра переднього гіпоталамусу. На мікропрепаратах інтактних тварин переважали нейрони II морфофункціонального типу, що перебувають у стадії синтезу нейросекрету. Показано, що за дії электростимуляції спостерігається перерозподіл головних морфо-функціональних типів нейронів. Відзначено збільшення змісту клітин I й III типів, відповідно у стадіях спокою після виведення секрету й накопичення, що вказує на активацію процесів звільнення нейросекрету і його акумуляції. Виразність реакції нервової тканини однакова при силі стимулюючого струму 100 мкА й 300 мкА.The influence of indirect through-skin electrostimulation (different doses) of the optical analyser on neurosecretory activity of anterior hypothalamus magnocellular nucleus was stading during chronic experiment. The stady was carried out on rabbits. Five morphological types of neurons was exposed in the supraoptical nucleus of control animal groop: I type- phase of rest after neurosecrets leading, II- phase of synthesis, III- phase of accumulation, IV - leading phase, V - phase of degerneration, but neurons of II types was prevalenced (51%). The indirect electrostimulation of the optical analyser provokes quantitative changes of keeping same neurons types. The number of I and III types neurons increases (on 20% and 7%) . The kind of changes is indicative of electrostimulation activation influense on neurosecrets leading and accumulation. Expression of nervous tissue reaction was identical under different doses (100 mkA and 300 mkA) of afferent electrostimulation

    Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

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    BACKGROUND: Cerebral palsy (CP) may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG) could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. METHODS: We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS), Gross Motor Function Measure (GMFM) and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS) for spasticity, pain and ease of care. RESULTS: A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. CONCLUSION: RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial
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