Retinitis pigmentosa: evaluation of the vestibular system with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test

OBJECTIVE: Retinitis pigmentosa (RP) represents a group of inherited disorders in which abnormalities of the photoreceptors lead to progressive visual loss. Night blindness, peripheral visual field loss, and eventual total blindness represent typical visual damage of such disease. No study has previously evaluated the presence of a "latent" vestibular deficit in patients with RP. STUDY DESIGN: Prospective study with caloric test, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and video head impulse test (v-HIT). SETTING: Tertiary referral center. PATIENTS: 16 patients suffering from RP. INTERVENTION: Evaluation of vestibular dysfunction with caloric test, C-VEMPs, O-VEMPs, and the measurement of the vestibular-ocular reflex (VOR) using the v-HIT. RESULTS: Only five patients with RP showed normal values in all the vestibular tests performed. Three patients had an evident deficit at the caloric test, whereas eight (50%) of them had a normal caloric test but a pathological response in at least one of the other vestibular tests performed. No patient of the study showed a bilateral otolith or ampullary dysfunction. CONCLUSION: Our patients with RP unexpectedly showed pathological responses in at least one of the vestibular tests performed. Nowadays, in patients affected by RP, a vestibular diagnostic protocol must include VEMPs and v-HIT to confirm the vestibular damage and to identify selective damage of the vestibular nerve

Occlusion of retinal capillaries caused by glial cell proliferation in chronic ocular inflammation

The inner blood-retinal barrier is a gliovascular unit in which glial cells surround capillary endothelial cells and regulate retinal capillaries by paracrine interactions. During chronic ocular inflammation, microvascular complications can give rise to vascular proliferative lesions, which compromise visual acuity. This pathologic remodelling caused by proliferating Müller cells determines occlusion of retinal capillaries. The aim of the present study was to identify qualitative and quantitative alterations in the retinal capillaries in patients with post-traumatic chronic ocular inflammation or post-thrombotic vascular glaucoma. Moreover, we investigated the potential role of vascular endothelial growth factor (VEGF) and pro-inflammatory cytokines in retinal inflammation. Our electron microscopy findings demonstrated that during chronic ocular inflammation, thickening of the basement membrane, loss of pericytes and endothelial cells and proliferation of Müller cells occur with irreversible occlusion of retinal capillaries. Angiogenesis takes place as part of a regenerative reaction that results in fibrosis. We believe that VEGF and pro-inflammatory cytokines may be potential therapeutic targets in the treatment of this disease although further studies are required to confirm these findings

Upper Limb Structural Anatomic Mechanisms of Protection (SAMPs)

Introduction Nature has provided living bodies with extraordinarily effective reparative mechanisms. Furthermore, the biological processes involved in anatomical structures are built-up to protect life against external injuries. A series of these protective systems in the upper limb are herein described. Material and Methods From 2009 to 2017, 864 fresh frozen cadaveric upper limbs were dissected from the axilla to the fingers during the Italian Hand Society surgical anatomy dissection course. Results Arrangement of anatomical structures in the upper limb is able to protect major life supporting organs. Conclusions External injuries affecting the upper limb may cause damage to many important structures resulting in severe functional impairments. The layout of the structures and the relationship between them are organized to preserve arteries integrity first, more than muscles and nerves. This means, in our opinion, that these structures are organized to preserve life even if this has functional cost

Misdiagnosed Chronic Pelvic Pain: Pudendal Neuralgia Responding to a Novel Use of Palmitoylethanolamide: Table 1

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Microstructural, Mechanical and Wear Behavior of HVOF and Cold-Sprayed High-Entropy Alloys (HEAs) Coatings

HEAs powders, unlike standard alloys which contain one or two base elements, are new alloys that contain multiple elements in the same quantity. These materials have outstanding physical and mechanical properties and for this reason, are of great interest in the material science community for their application in advanced industrial sectors. In this investigation, cold spray (CS) and high-velocity oxy fuel (HVOF) processes were used to deposit Cantor alloy (FeCoCrNiMn) coatings. Starting feedstock powders were thoroughly characterized in terms of size, shape, phase and elastic modulus. For CS process, the coating deposition efficiency and porosity could be optimized by varying gas pressure, gas temperature and stand-off distance. In the case of HVOF process, stand-off distance influenced the thickness of the coatings. Besides, on the optimized CS and HVOF coatings, corrosion tests in 3.5% NaCl solution, as well as rubber wheel, ball on disk and jet erosion tests were carried out to evaluate their wear behavior. Also, to benchmark the corrosion and wear behavior of optimized coatings, the results were compared to 316L and C-Steel bulks. The tribological study shows that Cantor alloy coatings deposited via CS and HVOF are promising to protect parts and components in a harsh environment

Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

Background: Little is known on practice patterns of endoscopists for the management of Barrett’s esophagus (BE) over the last decade. Aims: Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE. Methods: All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey. The questionnaire included questions on demographic and professional characteristics, and on diagnosis and management strategies for BE. Results: Of the 883 SIED members, 259 (31.1%) completed the questionnaire. Of these, 73% were males, 42.9% had > 50 years of age and 68.7% practiced in community hospitals. The majority (82.9%) of participants stated to use the Prague classification; however 34.5% did not use the top of gastric folds to identify the gastro-esophageal junction (GEJ); only 51.4% used advanced endoscopy imaging routinely. Almost all respondents practiced endoscopic surveillance for non-dysplastic BE, but 43.7% performed eradication in selected cases and 30% practiced surveillance every 1–2 years. The majority of endoscopists managed low-grade dysplasia with surveillance (79.1%) and high-grade dysplasia with ablation (77.1%). Attending a training course on BE in the previous 5 years was significantly associated with the use of the Prague classification (OR 4.8, 95% CI 1.9–12.1), the top of gastric folds as landmark for the GEJ (OR 2.45, 95% CI 1.27–4.74) and advanced imaging endoscopic techniques (OR 3.33, 95% CI 1.53–7.29). Conclusions: Practice patterns for management of BE among endoscopists are variable. Attending training courses on BE improves adherence to guideline

Cadmium ions and cadmium sulphide particles in γ-titanium dihydrogen phosphate. Synthesis, thermal behaviour and X-ray characterization

AbstractLayered compounds with CdS particles supported on the ion-exchanger, γ-titanium dihydrogen phosphate, were prepared by the stepwise reaction of the ion-exchanger and cadmium solution, followed by reaction with H2S gas. The CdS content on the ion-exchanger is dependent on the timeframe of the H2S gas flow. The materials obtained were layered, as shown by the X-ray measurements that exhibit both precursor and CdS diffraction peaks. The thermal treatment of the material obtained gives evidence of its stability (≤ 320°C) before the CdS decomposition, which occurs in a single step

Adult human biliary tree stem cells differentiate to β-pancreatic islet cells by treatment with a recombinant human Pdx1 peptide

Generation of β-pancreatic cells represents a major goal in research. The aim of this study was to explore a protein-based strategy to induce differentiation of human biliary tree stem cells (hBTSCs) towards β-pancreatic cells. A plasmid containing the sequence of the human pancreatic and duodenal homeobox 1 (PDX1) has been expressed in E. coli. Epithelial-Cell-Adhesion-Molecule positive hBTSCs or mature human hepatocyte cell line, HepG2, were grown in medium to which Pdx1 peptide was added. Differentiation toward pancreatic islet cells were evaluated by the expression of the β-cell transcription factors, Pdx1 and musculoapo-neurotic fibrosarcoma oncogene homolog A, and of the pancreatic hormones, insulin, glucagon, and somatostatin, investigated by real time polymerase chain reaction, western blot, light microscopy and immunofluorescence. C-peptide secretion in response to high glucose was also measured. Results indicated how purified Pdx1 protein corresponding to the primary structure of the human Pdx1 by mass spectroscopy was efficiently produced in bacteria, and transduced into hBTSCs. Pdx1 exposure triggered the expression of both intermediate and mature stage β-cell differentiation markers only in hBTSCs but not in HepG2 cell line. Furthermore, hBTSCs exposed to Pdx1 showed up-regulation of insulin, glucagon and somatostatin genes and formation of 3-dimensional islet-like structures intensely positive for insulin and glucagon. Finally, Pdx1-induced islet-like structures exhibited glucose-regulated C-peptide secretion. In conclusion, the human Pdx1 is highly effective in triggering hBTSC differentiation toward functional β-pancreatic cells

Asymptotic Scaling of the Diffusion Coefficient of Fluctuating "Pulled" Fronts

We present a (heuristic) theoretical derivation for the scaling of the diffusion coefficient $D_f$ for fluctuating ``pulled'' fronts. In agreement with earlier numerical simulations, we find that as $N\to\infty$, $D_f$ approaches zero as $1/\ln^3N$, where $N$ is the average number of particles per correlation volume in the stable phase of the front. This behaviour of $D_f$ stems from the shape fluctuations at the very tip of the front, and is independent of the microscopic model.Comment: Some minor algebra corrected, to appear in Rapid Comm., Phys. Rev.

Alterações eletrofisiológicas na doença de Oguchi

Descrever as alterações eletrofuncionais em um caso raríssimo da Doença de Oguchi. Paciente do sexo feminino, italiana de 17 anos de idade se queixava de cegueira noturna. A resposta escotópica de bastonetes, do ERG era não registrável. A resposta escotópica ao estímulo branco forte demonstrava uma diminuição de amplitude da onda B. As respostas ao flicker de 30Hz e ao EOG eram dentro dos limites da normalidade. Era presente o fenômeno de Mizuo-Nakamura. Os exames eletrofuncionais são muito importantes no diagnóstico de certeza da doença de Oguchi. É nítida, no presente caso, a discordância entre EOG e ERG. Considerando a função dos bastonetes, as respostas normais do EOG contrastam com a ausência de respostas dos bastonetes em condições escotópicas no ERG. Mais estudos são necessários para entender o complexo mecanismo eletrofuncional dessa doença e melhor definir a origem dos componentes sensíveis à luz do EOG