Efficacy of early immunomodulator therapy on the outcomes of Crohn’s disease

BACKGROUND: The natural course of Crohn’s disease (CD), with continuing relapses and remissions, leads to irreversible intestinal damage. Early adoption of immunomodulator therapy has been proposed in order to address this; however, it is still uncertain whether early immunomodulator therapy could affect the natural course of the disease in real practice. We evaluated the efficacy of such therapy on the prognosis of newly diagnosed patients with CD. METHODS: This retrospective study included 168 patients who were newly diagnosed with CD and who started treatment at Severance Hospital, Seoul, Korea between January 2006 and March 2013. The short- and long-term outcomes were compared between patients treated with early immunomodulator therapy and those treated with conventional therapy. RESULTS: A Kaplan-Meier analysis identified that administration of immunomodulators within 6 months after diagnosis of CD was superior to conventional therapy in terms of clinical remission and corticosteroid-free remission rates (P=0.043 and P=0.035). However, P=0.827). Patients with a baseline elevated CRP level were more likely to relapse (P<0.005). Drug-related adverse events were more frequent in the early immunomodulator therapy group than in the conventional therapy group P=0.029). CONCLUSIONS: Early immunomodulator therapy was more effective than conventional therapy in inducing remission, but not in preventing relapse. Baseline high CRP level was a significant indicator of relapse

Cerebellar Hypoperfusion during Transient Global Amnesia: An MRI and Oculographic Study

Background and Purpose Transient global amnesia (TGA) is characterized by sudden anterograde and retrograde amnesia lasting for LIP to 24 hours. Diffusion-weighted magnetic resonance imaging (DWI) in cases of TGA and ischemia demonstrates a high frequency of high signal intensities restricted to the hippocampus, and this has been proposed as an etiology of TGA. The aims of this study were to characterize the DWI and single-photon-emission computed tomography (SPECT) findings during the acute and recovered phases of TGA and to correlate the findings with oculomotor abnormalities. Methods Five consecutive patients with a clinical diagnosis of TGA underwent DWI and SPECT of the brain within 24 hours after symptom onset and again 3 days later. Eye movements were also recorded using three-dimensional video-oculography. Results In all patients, DWI disclosed small punctuate (1-3 mm), high-signal lesions in the lateral portion of the hippocampus. The initial SPECT also revealed hypoperfusion in the cerebellar vermis, which had recovered by the follow-up examination. Three patients showed saccadic hypermetria or impaired smooth pursuit only during the acute phase. Conclusions Our patients with TGA showed cerebellar vermian hypoperfusion in addition to ischemic insults to the lateral hippocampus. The oculomotor abnormalities observed in our patients support the Occurrence of cerebellar dysfunction during the TGA attack. J Clin Neurol 2009;5:74-80This study was supported by a grant of the Korean Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (no. A050079).Yang Y, 2008, J CLIN NEUROL, V4, P59Sander K, 2005, LANCET NEUROL, V4, P437Lampl Y, 2004, ACTA NEUROL SCAND, V110, P75Tong DC, 2004, NEUROLOGY, V62, P2154Takeuchi R, 2004, EUR J NUCL MED MOL I, V31, P578, DOI 10.1007/s00259-003-1406-8Teicher MH, 2003, NEUROSCI BIOBEHAV R, V27, P33, DOI 10.1016/S0149-7634(03)00007-1Anderson CM, 2002, PSYCHONEUROENDOCRINO, V27, P231Asada T, 2000, PSYCHIAT CLIN NEUROS, V54, P691Pantoni L, 2000, ACTA NEUROL SCAND, V102, P275Jovin TG, 2000, J NEUROIMAGING, V10, P238Warren JD, 2000, J CLIN NEUROSCI, V7, P57Levitt JJ, 1999, AM J PSYCHIAT, V156, P1105Loeber RT, 1999, SCHIZOPHR RES, V37, P81Giedd JN, 1999, PROG NEURO-PSYCHOPH, V23, P571SCHMAHMANN JD, 1999, MOVEMENT DISORDERSBerquin PC, 1998, NEUROLOGY, V50, P1087Schmidtke K, 1998, J NUCL MED, V39, P155Ghelarducci B, 1997, ARCH ITAL BIOL, V135, P369HODGES JR, 1994, J NEUROL NEUROSUR PS, V57, P605HODGES JR, 1990, J NEUROL NEUROSUR PS, V53, P834HODGES JR, 1990, BRAIN, V113, P639HEATH RG, 1976, J NEUROL NEUROSUR PS, V39, P1037

Two different types of malignant fibrous histiocytomas from pet dogs

We describe 2 cases of malignant fibrous histiocytomas (MFHs) that spontaneously developed in young pet dogs. To classify these tumors, we applied a panel of antibodies (vimentin, desmin, α-SMA, and ED1) and Azan staining for collagen. The MFHs were most consistent with osteoclast-like giant and inflammatory cell types. The first case had positive staining for ED1 and vimentin, and given the osteoclast-like giant cells, calcification sites accompanying peripheral giant cell infiltrates. The latter case, the inflammatory cell type, exhibited a storiform-pleomorphic variant of neoplastic cells, including an ossifying matrix. MFHs are among the most highly aggressive tumors occurring in soft tissue sarcomas in elderly dogs; however, MFHs have been poorly studied from a diagnostic point of view. Herein, we describe the histologic and immunohistologic features of MFHs in detail, thus classifying the subtypes of these tumors

Acute Idiopathic Hemorrhagic Pericarditis with Cardiac Tamponade as the Initial Presentation of Acquired Immune Deficiency Syndrome

This paper presents a case of cardiac tamponade with idiopathic hemorrhagic pericarditis as the initial symptom of human immunodeficiency virus (HIV) infection. A 29-year-old male came to the emergency room with a sudden onset of dizziness. Upon arrival, he was hypotensive although not tachycardic, and his jugular venous pressure was not elevated. His chest X-rays revealed a mild cardiomegaly. Transthoracic echocardiography revealed a large amount of pericardial effusion with a diastolic collapse of the right ventricle, a dilated inferior vena cava with little change in respiration, and exaggerated respiratory variation of mitral inflow velocities, representing echocardiographic evidence of cardiac tamponade. After pericardiocentesis, his blood pressure improved to 110/70 mmHg without inotropics support. Serial 12-lead electrocardiograms during hospitalization revealed upwardly concave diffuse ST-segment elevation followed by a T-wave inversion suggestive of acute pericarditis. Pericardial fluid cytology and cultures for bacteria, mycobacteria, adenovirus, and fungus were all negative. HIV enzyme-linked immunosorbent assay (ELISA) was positive and confirmed by Western blot. The CD4 cell count was 168/mm3. Finally, the diagnosis of cardiac tamponade due to HIV-associated hemorrhagic pericarditis was made. It was concluded that HIV infection should be considered in the diagnosis of unexplained pericardial effusion or cardiac tamponade in Korea

Electrically Robust Single-Crystalline WTe2 Nanobelts for Nanoscale Electrical Interconnects

As the elements of integrated circuits are downsized to the nanoscale, the current Cu-based interconnects are facing limitations due to increased resistivity and decreased current-carrying capacity because of scaling. Here, the bottom-up synthesis of single-crystalline WTe2 nanobelts and low- and high-field electrical characterization of nanoscale interconnect test structures in various ambient conditions are reported. Unlike exfoliated flakes obtained by the top-down approach, the bottom-up growth mode of WTe2 nanobelts allows systemic characterization of the electrical properties of WTe2 single crystals as a function of channel dimensions. Using a 1D heat transport model and a power law, it is determined that the breakdown of WTe2 devices under vacuum and with AlOx capping layer follows an ideal pattern for Joule heating, far from edge scattering. High-field electrical measurements and self-heating modeling demonstrate that the WTe2 nanobelts have a breakdown current density approaching approximate to 100 MA cm(-2), remarkably higher than those of conventional metals and other transition-metal chalcogenides, and sustain the highest electrical power per channel length (approximate to 16.4 W cm(-1)) among the interconnect candidates. The results suggest superior robustness of WTe2 against high-bias sweep and its possible applicability in future nanoelectronics

Effects of Propofol on Endotoxin-Induced Acute Lung Injury in Rabbit

This study was undertaken to clarify the effects of propofol on endotoxin-induced acute lung injury. Rabbits were randomly assigned to one of four groups. Each group received intravenous infusion of saline only, saline and Escherichia coli endotoxin, propofol (1 mg/kg bolus, then 5 mg/kg/hr) and endotoxin, or propofol (4 mg/kg bolus, then 20 mg/kg/hr) and endotoxin respectively. Infusion of saline or propofol was started 0.5 hr before the infusion of saline or endotoxin, and continued for 6 hr thereafter. The lungs of rabbits were ventilated with 40% oxygen. Mean blood pressure, heart rate, arterial oxygen tension (PaO2), and peripheral blood leukocyte and platelet count were recorded. The wet/dry (W/D) weight ratio of lung and lung injury score were measured, and analysis of bronchoalveolar lavage fluid (BALF) was done. Endotoxin decreased PaO2, and peripheral blood leukocyte and platelet count. And it increased W/D ratio of lung, lung injury score and leukocyte count, percentage of PMN cells, concentration of albumin, thromboxane B2 and IL-8 in BALF. Propofol attenuated all these changes except the leukocyte count in peripheral blood. In conclusion, propofol attenuated endotoxin-induced acute lung injury in rabbits mainly by inhibiting neutrophil and IL-8 responses, which may play a central role in sepsis-related lung injury

Effect of Ga and As vacancies on electronic properties of Ga0.9375Al0.0625As

Electronic properties of Ga0.9375Al0.0625As with Ga and As monovacancies are investigated with the density functional theory. A perfect GaAlAs, which specifically produces a radiation wavelength of ???825.6 nm, has been determined in terms of size and number of atoms of substances. We have introduced eight types of vacancies depending on the distance from the Al atom to the vacancy to obtain the changes in charges, band structures, density of states, and optical conductivity. We found that the Fermi level enters into the valence band due to the formations of the Ga or As vacancies so that the vacant materials may show the characteristics of the p-type semiconductor. Interestingly, Ga-vacancy systems make direct band gaps, which are still good for the use in a semiconductor laser. But, As-vacancy systems, where the indirect gaps appear, are not feasible for the same application. It has been found that the latter phenomenon is induced by a newly formed density of state, which comes from the overlapping of hybridised 4s and 4p orbitals of Ga atoms around As vacancy.close0

Accuracy investigation of equivalent dipole arrays for near-field estimation in presence of shielding or dielectric structures

The accuracy of equivalent dipole arrays for source modeling of electromagnetic fields is affected by several factors. In the step for extracting equivalent dipole arrays for a given source, there are three factors that can affect accuracy: scanning height, source spacing, and scanning gap. In the evaluation step of reconstructed fields, there are two other factors that can also affect accuracy: evaluation height and additional structures. In this paper, simple guidelines are suggested considering the three factors in extracting equivalent dipole arrays. Also, the effects of the evaluation height on accuracy of reconstructed fields are demonstrated in the presence of shielding or dielectric structures. A feature selective validation process was utilized to evaluate similarities between actual and estimated fields