MEDtube Tribune - Medical news on-line http://medtube.net/tribune Medical news on-line Thu, 13 Jun 2013 14:47:49 +0000 en-EN hourly 1 http://wordpress.org/?v=3.5.1 Long QT syndrom causes dead births http://medtube.net/tribune/long-qt-syndrom-causes-dead-births/ http://medtube.net/tribune/long-qt-syndrom-causes-dead-births/#comments Thu, 13 Jun 2013 14:45:54 +0000 yezryy http://medtube.net/tribune/?p=1962 According to the latest study of Mayo Clinic scientists from Rochester a long QT syndrome may be responsible for 5% of all intrauteris deaths.

A long QT syndrome is a rare cardiac disorder characterized by prolongation of the QT interval on electrocardiograms causing sudden death caused by specific ventricular tachyarrythmia torsade de pointes transforming to ventricular fibrillation.

A long QT syndrome (LQTS) can be acquired or congenital. Acquired long QT syndrome is caused by such factors as electrolyte disorder (low level of potassium, magnesium or calcium), ischemia of heart muscle, drugs’ influence (amiodarone, quinidine, propafenone) and toxic substances. Congenital long QT syndrome is very rare (1/2000). In recent years there have been discovered a few gene mutations which contribute to occurrence of long QT syndrome. In case of unexplained deaths it enables intentional search for genetic material disorder.

Michael Ackerman of Mayo Clinic and his team together with the researchers from Italy examined for the first time in the world the cause of babies’ morbidity who died after 14th week of pregnancy in the uterus or were stillborn. The study was done on a group of 91 children whose death cause remained undiagnosed by pathologists.

Scientists found mutations of three babies in two most known genes KCNQ1 and KCNH2 responsible for creation of LQTS. Defects of these genes lead to disorder in functioning of proteins constructing potassium channels on the heart muscle surface. The following five intrauteris deaths showed SCN5A gene mutation. This gene codes protein which constitutes part of sodium channel. Its incorrect functioning may also cause heart arythmia.

The study shows that 8 out of 91 children (8,8%) had LQTS. Ackerman far-sightedly assumes that in fact about 5% of babies died in the uterus due to sudden heart death caused by LQTS. The percentage of children who died due to inborn LQTS could be in fact higher. Ackerman examined only three most common gene mutations (KCNQ1, KCNH2, SCN5A) which does not exclude the existence of the others.

The above research shows the need for intentional estimation of mutation of genes responsible for long QT occurrence in any case of an unexplained death.



Written by: Anna Szajerska, Karolina Gasińska

Source:
1.http://www.aerzteblatt.de/nachrichten/54004/Long-QT-Syndrom-als-Ursache-von-Totgeburten
2.http://www.aerzteblatt.de/nachrichten/54234/QT-Verlaengerungen-haeufig-Zeichen-eines-nahenden-Todes
3.http://www.news-medical.net/news/20091106/Long-QT-syndrome-study-reveals-importance-of-genetic-testings-role-in-diagnosing-disease.aspx
4.http://www.kardioserwis.pl/page.php/1/0/show/386/zesp%C3%B3%C5%82_wyd%C5%82u%C5%BConego_QT.html
5.http://www.ncbi.nlm.nih.gov/pubmed/12442276


Would You like to know more? Watch on MEDtube.net: Normal Newborn Circulation

]]> http://medtube.net/tribune/fragile-x-chromosome-syndrom-new-therapy-for-patients/feed/ 0 Breakthrough in Parkinson’s disease treatment- gene therapy http://medtube.net/tribune/breakthrough-in-parkinsons-disease-treatment-gene-therapy/ http://medtube.net/tribune/breakthrough-in-parkinsons-disease-treatment-gene-therapy/#comments Wed, 05 Jun 2013 20:30:54 +0000 yezryy http://medtube.net/tribune/?p=1956 American scientists succeeded in developing gene therapy owing to which Parkinson’s disease symptoms recede. The new method reduces movement disorders such as bradykinesia, muscle stiffness and tremor at rest as proved by research published in “Lancet Neurology”.

Parkinson’s disease develops as a result of neurons degeneration in substantia nigra where the dopamine responsible for i.a. movement, coordination and muscle tension is produced. Its deficiency leads to movement disorders observed during the disease. What is more, apart from dopamine level decrease, the concentration of gamma-Aminobutyric acid (GABA), which inhibits neurons activity, is lowered. This fact was used by the scientists during the gene therapy development in Parkinson’s disease treatment.

The experiment was led by professor Peter LeWitt from Fenstein Institute for Medical Research in Manhasset, New York. It was randomized study with double blank test. 45 patients of 30-75 years old with previously diagnosed Parkinson’s disease (minimum 5 years before the research) took part in it. 22 patients were subjected to the gene therapy and 23 received placebo. Placebo consisted of simulated surgery during which neurosurgeons made a small cut in the patient’s skull and injected physiological saline.

During proper gene therapy, numerous copies of therapeutic gene encoding glutamic acid decarboxylase (GAD) were introduced into subthalamic nuclei of both brain hemispheres through catheter. The enzyme is responsible for GABA synthesis. Introduction of the gene enables increased production of this neurotransmitter. 3,5 billion of viruses, which were injected once, were used as the carrier of genetic information. The viruses were previously deprived of replication ability in human organism.

The results of the treatment turned out to be very satisfying. In almost half of the patients subjected to the gene therapy distinct diminish of movement disorders was observed. In the control group the percentage was 14%. Improvement of motor function was visible in about a month after the treatment and sustained unchanged for the 6 months of observation as stated by participant – doctor Michael Kaplitt from Weill Cornell Medical College in New York. The degree of improvement was evaluated according to special scale of movement ability. Its total was 23% after the use of gene therapy and 12,7% in the control group.

As is proved by the scientists in work published in “Lancet Neurology”, innovative treatment method is also safe. Until now, there were no reports of serious side effects. In some of the patients only minor headaches and vomiting were observed.

The gene therapy developed by American scientists is a breakthrough in Parkinson’s disease treatment. It is a chance for the improvement of the quality of life in case of resistance to drugs or in especially severe disease course.

Written by: Karolina Gasińska, Anna Szajerska

Source:
1. Kastory B. Zabić Parkinsona. Czy terapie genowe to szaleńczy eksperyment? Wprost. 35/2003 (1083).
2. Kordower JH, Bjorklund A. Trophic factor gene therapy for Parkinson’s disease. Mov Disord. 2013 Jan;28(1):96-109.
3. Morga J. Terapia genowa działa u pacjentów z chorobą Parkinsona. PAP. Pobrano z sieci WWW: http://www.naukawpolsce.pap.pl/aktualnosci/news,380642,terapia-genowa-dziala-u-pacjentow-z-choroba-parkinsona.html.
4. Moskal W. Genem w parkinsona. Pobrano z sieci WWW: http://wyborcza.pl/1,75476,9295521,Genem_w_parkinsona.html.
5. Muramatsu S. Gene therapy for Parkinson’s disease. Rinsho Shinkeigaku. 2012;52(11):896-8.
6. Nagabhushan Kalburgi S, et al. Recent gene therapy advancements for neurological diseases. Discov Med. 2013 Feb;15(81):111-9.
7. Wettergren EE, et al. Novel disease-specific promoters for use in gene therapy for Parkinson’s disease. Neurosci Lett. 2012 Nov 14;530(1):29-34.
8. Worth PF. How to treat Parkinson’s disease in 2013. Clin Med. 2013 Feb;13(1):93-6.

Would You like to know more? Watch on MEDtube.net: Parkinson’s Disease – Laryngeal Tremors

]]> http://medtube.net/tribune/breakthrough-in-parkinsons-disease-treatment-gene-therapy/feed/ 0 Dental anaesthesia may cause the absence of wisdom teeth http://medtube.net/tribune/dental-anaesthesia-may-cause-the-absence-of-wisdom-teeth/ http://medtube.net/tribune/dental-anaesthesia-may-cause-the-absence-of-wisdom-teeth/#comments Fri, 31 May 2013 20:52:03 +0000 yezryy http://medtube.net/tribune/?p=1949 Pain relief during procedures is a key element of a proper dental care. It is not surprising that local anesthesia plays an important role also in the youngest patients. The analysis conducted by researchers at Tufts University School of Dental Medicine inspires to think about using a procedure of inferior alveolar nerve block for a different purpose…

Inferior alveolar nerve block is one of the most commonly performed anaesthetic blocks in children. Bearing in mind the differences in the anatomy of the mandibular foramen between children and adults, the needle, depending on the age of the patient, is pricked below the occlusal surface of the jaw teeth, or on the height of the occlusal surface of the last lower permanent molar. Intratissue administration of the anesthetic in the area causes numbness of the lower teeth, lower lip, tip of the tongue and floor of the mouth on the side of the injection-therefore a large area using a relatively small amount of liquid. This type of anesthesia is used without restrictions-also in children aged 2 to 4 years.

The germs of wisdom teeth are easily exposed to trauma due to their late development (usually at the age of about six). The eruption starts when the patient is about 17-21 years of age and often alone leads to unpleasant complications. These teeth are very vulnerable to decay, due to their location and complex anatomy which makes them more problematic in terms of hygiene. In nine out of ten cases it displays a difficult eruption or even teeth impaction. As a result, the third molar often leads to pain, halitosis, and infection. In about 35% of the population the third molar germ is not developed and is considered useless by many dentists – as a consequence quite often prophylactically removed.

Researchers at Tufts University conducted an epidemiological study involving a group of randomly selected 439 children of 7 years and older. The findings were published The Journal of the American Dental Association in April 2013. The aim of this study was to determine the correlation between the inferior alveolar nerve anesthesia and the lack of third molar germs in the mandible. Patients were divided into two groups: a control group consisting of children who have never received inferior alveolar nerve anesthesia (376 cases), and a group in which the patients had received this type of anesthesia at least once (63 cases). After analysing the available pantomographic x-rays, statistics have been made. It turned out that in the control group 1.9% of cases presented the lack of third molar germs, whereas in the test group – 7.9%. It was decided that such a clear correlation cannot be accidental. 4.35-times higher occurrence of absent germs in the group of patients who used dental anesthesia at a young age inspires to further research. Third molars germs are located under a thin layer of soft tissue and are not larger than the diameter of the needle used to inject anesthesia, which can likely be the cause of damage in the course of anaesthesia. Have the dentists inadvertently inhibited the development of third molars in children for nearly 100 years? Discovery must be supported by further intensive research on a larger group of patients. Perhaps the destruction of wisdom teeth buds using minimally invasive procedures such as injections will become a routine procedure in children, thus eliminating the problems caused by the late extraction – money, time, and treatment complications. The intriguing discovery awaits further research.



Written by: Maria Bilińska




Source:
1. Swee J, Silvestri AR, Finkelman MD, Rich AP, Alexander SA, Loo CY. 2013. Inferior Alveolar Nerve Block and Third-Molar Agenesis: A Retrospective Clinical Study. The Journal of the American Dental Association, 144(4), 389-395. 
2. http://www.fmdental.pl/uploads/20110111150724.pdf

Would You like to know more? Watch on MEDtube.net: Inferior Alveolar Nerve Block – First Video Attempt

]]> http://medtube.net/tribune/dental-anaesthesia-may-cause-the-absence-of-wisdom-teeth/feed/ 0 Lower blood pressure without drugs? – It is possible! http://medtube.net/tribune/lower-blood-pressure-without-drugs-it-is-possible/ http://medtube.net/tribune/lower-blood-pressure-without-drugs-it-is-possible/#comments Tue, 28 May 2013 13:07:08 +0000 yezryy http://medtube.net/tribune/?p=1947 According to the recent study carried out by researchers from Queen Mary, University of London, published in the American Heart Association journal Hypertension, a cup of beetroot juice a day can help lower blood pressure in patients with hypertension.

The scientists examined the impact of consumed nitrate on blood pressure in rats and then confirmed their findings in a small group of patients with high blood pressure.

The study involved 15 volunteers (8 women and 7 men) who had systollic blood pressure between 140 to 159 millimeters of mercury (mmHg). The participants did not have other medical problems and did not take any medication for their hypertension. The participants drank 250 ml of beetroot juice and over the following 24 hours had their blood pressure observed. The beetroot juice contained about 0.2 g of nitrate, which is about the same amount of nitrate as two beetroots or a bowl of lettuce.

Participants’ systollic blood pressure decreased by 12 mmHg. The greatest decrease was observed between 3 and 6 hours after drinking the juice and it was visible for 24 hours. According to Amrita Ahluwalia, Ph.D., lead author of the study and a professor of vascular pharmacology at The Barts and The London Medical School in London, also diastolic blood pressure was significantly lowered.

Vegetables take in nitrate essential to their growth through their roots in the soil where the compound is naturally found. After delivering to the body in the nutrition nitrate is reduced to nitric oxide which potentially widens blood vessels and thus lowers blood pressure. It is interesting that the previous study showed that increased consume of beetroot juice has no impact on blood pressure in people with its normal value.

It has been proved that beetroot juice had the same outcome as medicine for hypertension. In order to launch a new medication on the market it is necessary to prove its effectiveness and safety in long term studies involving hundreds or even thousands of patients, while Amrita Ahluwalia based her research on only 15 patients. Therefore it is necessary to confirm the effects of beetroot juice on lowering blood pressure over the long term.

Hypertension is the most common reason of cardiovascular complications such as heart attack or stroke. Therefore it is considered to be the major cause of death in the developed countries. According to Ahluwalia increasing the intake of vegetables with a high dietary nitrate content, such as beetroots, lettuce, cabbage or fennel may improve cardiovascular health.



Written by: Anna Szajerska, Karolina Gasińska

Source:

http://www.medicalnewstoday.com/articles/259113.php

http://www.aerzteblatt.de/nachrichten/54061/Rote-Beete-senkt-Blutdruck?s=beete

http://www.kardiolo.pl/nadcisnienie.htm

http://www.stat.gov.pl/cps/rde/xbcr/gus/stan_zdrowia_2004.pdf

Would You like to know more? Watch on MEDtube.net: Malignant hypertension

]]> http://medtube.net/tribune/lower-blood-pressure-without-drugs-it-is-possible/feed/ 0 Psychocardiology – diagnostic problems in cardiology http://medtube.net/tribune/psychocardiology-diagnostic-problems-in-cardiology/ http://medtube.net/tribune/psychocardiology-diagnostic-problems-in-cardiology/#comments Sat, 25 May 2013 15:37:38 +0000 yezryy http://medtube.net/tribune/?p=1942 Psychocardiology is a field of psychosomatic. Psychosomatic is a discipline which investigates the influence of psychological factors and environment on human health and physiology. It is a interdisciplinary branch which connects scientist knowledge from psychiatry and general medicine. One of its subcategory is psychocardiology. It is especially important since cardiovascular diseases are the most common civilization-related diseases and number one cause of death worldwide (WHO 2008).(1) Among the important risk factors of the cardio-vascular diseases are psychosocial aspects.

Psychocardiology is dealing with a role of the factors other than somatic in etiology, course of the disease and the treatment. Especially often comes to psychosomatic stroke-like attacks and such a patient can be a problem for many doctors. The symptoms can be unequivocal for heart attack but laboratory findings don’t confirm that diagnosis (troponin, ECG twice in a period of 6-8 h). When the patient doesn’t respond to the standard treatment course it is the time that a doctor has to decide to include drugs more characteristic for psychiatric therapy which slightly influence the circulatory system but they contribute significantly to the improvement of the patient’s condition. It may be said that the treatment of the patient with psychosomatic disease is more difficult because it demands more engagement from the doctor as well as from the patient and it is more than administering drugs and monitoring the patient’s state.(2)Such people need a special psychological support, they have to be patient and very engaged in the therapy which is more like a psychological-psychiatric treatment than cardiologic therapy.

Unfortunately, there are problems like where the patients with psychosomatic cardiovascular diseases should be treated. A cooperation between cardiologists (who have contact with the patients in emergency cases, should diagnose them properly and assign the patients to special group), psychologists, psychiatrists and psychosomatic specialists (if such specialists are in the country) is needed. The opinion about the patient should be holistic, focus precisely on a given patient, the course of the disease and possibilities of treatment.(3)

The European guidelines help to detect psychosocial risk factors by asking the patient a few questions about social position, education level, social relationships, stress at home and at work, depression and enmity. Especially bad – promising are low socioeconomic position which contributes to unhealthy lifestyle, depression, poor social support and stress at work. This factors are connected with increased activity of the sympathetic-adrenal system (increased heart action and reactivity of blood pressure, increased blood viscosity), activation of pituitary-adrenal system (disturbance of daily cortisol and serotonin secretion), disturbance in concentration of fibrinogen, CRP, PAI-1, predisposition for abdominal obesity and its complications.

As we can see, psychosocial risk factors may lead to activation of mechanisms responsible for somatic dysfunction of cardiovascular system. That is why it is hard to assign patients only into psychosomatic disorders group. Even if many risk factors were diagnosed and if there were psychosomatic coronary pain episodes, it is necessary to eliminate a heart attack. Proper psychological support is also important in typical somatic cardiovascular problems (state after cardiac surgeries and procedures or heart infarcts). It leads to improvement of the patients’ psychological condition, prevents recurrence of the disease and improves chances of the treatment success. That is why it is important to pay attention to psychocardiologic aspects and take care of the patient holistically. It is easier if there are appropriate specialists.

Written by: Magdalena Chorążka




Source:
1. http://who.int/mediacentre/factsheets/fs310/en/
2. Sobczak M., Kasprzak J., Drygas W. Psychokardiologia – wprowadzenie do nowej dziedziny naukowej. Kardiologia Polska 2011; 69,8: 838-843
3. Christoph Herrmann-Lingen et All. Interdisziplinäre Kursfortbildung Psychokardiologische Grundversorgung. Psychother Psych Med 2011; 61(11): 489-490

Would You like to know more? Watch on MEDtube.net: Myocardial Infarction

]]> http://medtube.net/tribune/psychocardiology-diagnostic-problems-in-cardiology/feed/ 0 Increased risk of bladder cancer due to Schistosoma haematobium http://medtube.net/tribune/increased-risk-of-bladder-cancer-due-to-schistosoma-haematobium/ http://medtube.net/tribune/increased-risk-of-bladder-cancer-due-to-schistosoma-haematobium/#comments Sun, 19 May 2013 22:11:28 +0000 yezryy http://medtube.net/tribune/?p=1940 Research conducted by International Agency for Research on Cancer show that persistent Schistosoma haematobium infection predisposes to the development of bladder cancer, especially bladder squamous cell cancer. According to World Health Organisation, over 200 million people in 76 countries suffer from schistosomiasis.

Schistosoma haematobium is a parasitic fluke which burrow into human skin during contact with contaminated water and enter blood vessels which are just under the skin. Then it transforms into migratory larval form – schistosomula, which through blood reaches lungs, left heart, systemic circulation and the liver. Then in the liver the larval form reaches maturity and becomes mature worm. Bilharzia feed on red blood cells. Mature form may live even over a dozen years. The area of S. haematobium occurrence include North Africa, Middle East, India and Australia. Flukes were included to 1st group of carcinogens by WHO’s International Agency for Research on Cancer.

The analysis of clinical cases indicates that people with S. haematobium infection are more likely to develop bladder cancer in comparison with people not infected by the parasite. What is more, the process begins in them when they are at younger age. The research was conducted in Alexandria, Egypt. 190 patients with bladder cancer and 187 patients who were admitted to hospital due to nonneoplastic causes took part in it. Research group encompassed 86 clinical cases with schistosomiasis while the control one – 69. As the data published in British Journal of Cancer show, 16% of bladder cancer cases in Egyptian population were caused by S. haematobium.

In vitro research conducted on regular urothelial cells have shown that stimulation with S. haematobium antigens causes accelerated and uncontrolled cell splitting. Additionally, they become less sensitive to signals triggering apoptosis and show atypical ability to migration. They are also able to invade adjacent tissues and form a tumour.

According to IARC experts the speed of neoplastic transformations depends on severity of the infection. That, in turn, is determined by the number of S. haematobium eggs in the bladder. What is more, the more time passed since the flukes infection, the higher is the risk of the neoplasm development.

Eggs laid in the bladder cause intensive inflammatory reaction. Secreting the oxygen derived free radicals is the result of it. Oxidative stress is considered as the mechanism which underlies carcinogenesis. It causes the damage to cells’ lipid layer and consequently it disturbs internal calcium homeostasis and damages the DNA, what leads to genetic mutations. What is more, the production of carcinogenic factors such as N-nitrosamine and polycyclic aromatic hydrocarbons is stimulated. As a result, the development of the tumour begins.

In extracts obtained from S. haematobium and in blood serum of infected people oestrogen molecules were identified. Most of them are catechol estrogens. They are created due to hydroxylation of steroid aromatic A ring. Genotoxicity of oestrogen metabolites stems from oxidation of catechol estrogens to quinones and formation of reactive oxygen forms, which reacts with the DNA. In this way the carcinogenesis begins.

Understanding of molecular mechanisms, according to which S. haematobium stimulates bladder cancer development may help in designing new methods of this neoplasm treatment and even its prevention.

Written by: Karolina Gasińska, Anna Szajerska

Source:
1. Alibek K et al. The role of infectious agents in urogenital cancers. Infect Agent Cancer. 2012 Dec 3;7(1):35. [Epub ahead of print]
2. Botelho MC et al. Schistosoma haematobium and bladder cancer: what lies beneath?Virulence. 2010 Mar-Apr;1(2):84-7. doi: 10.4161/viru.1.2.10487.
3. Botelho MC et al. Targeting molecular signaling pathways of Schistosoma haemotobium infection in bladder cancer. Virulence. 2011 Jul-Aug;2(4):267-79. Epub 2011 Jul 1.
4. Botelho MC et al. Tumour-like phenotypes in urothelial cells after exposure to antigens from eggs of Schistosoma haematobium: an oestrogen-DNA adducts mediated pathway? Int J Parasitol. 2013 Jan;43(1):17-26. doi: 10.1016/j.ijpara.2012.10.023. Epub 2012 Dec 20.
5. Ma N et al. Nitrative DNA damage and Oct3/4 expression in urinary bladder cancer with Schistosoma haematobium infection. Biochem Biophys Res Commun. 2011 Oct 22;414(2):344-9. doi: 10.1016/j.bbrc.2011.09.073. Epub 2011 Sep 17.
6. Nair SS et al. The metastasis-associated protein-1 gene encodes a host permissive factor for schistosomiasis, a leading global cause of inflammation and cancer. Hepatology. 2011 Jul;54(1):285-95. doi: 10.1002/hep.24354. Epub 2011 Jun 8.
7. Zaghloul MS, Gouda I. Schistosomiasis and bladder cancer: similarities and differences from urothelial cancer. Expert Rev Anticancer Ther. 2012 Jun;12(6):753-63. doi: 10.1586/era.12.49.
8. Zaghloul MS. Bladder cancer and schistosomiasis. J Egypt Natl Canc Inst. 2012 Dec;24(4):151-9. doi: 10.1016/j.jnci.2012.08.002. Epub 2012 Sep 20.
9. Bedwani R, et al. Schistosomiasis and the risk of bladder cancer in Alexandria, Egypt. Br J Cancer. 1998;7(7):1186–1189.

Would You like to know more? Watch on MEDtube.net: Worm Extraction from Bile Ducts

]]> http://medtube.net/tribune/increased-risk-of-bladder-cancer-due-to-schistosoma-haematobium/feed/ 0 Lung cancer – does high soy intake increase the chance of survival? http://medtube.net/tribune/lung-cancer-does-high-soy-intake-increase-the-chance-of-survival/ http://medtube.net/tribune/lung-cancer-does-high-soy-intake-increase-the-chance-of-survival/#comments Wed, 15 May 2013 16:00:59 +0000 yezryy http://medtube.net/tribune/?p=1936 Lung cancer is the most common malignant neoplasm in the world and the most frequent cause of cancer deaths among men and second after breast cancer among women. Tobacco smoking is the most important risk factor of cancer development. Asbestos, radon gas, genetic factors, air pollution and passive smoking also play a significant role. Adenocarcinoma, localized in peripheral parts of lungs, is the most often diagnosed cancer among women and non-smokers.

On the Far East soybeans’ nutrition properties have been known for thousands of years. Soy, called the queen of plants, is the source of complete proteins, fibre, unsaturated fatty acids, B vitamins and micro- and macroelements – magnesium, calcium, phosphorus and iron. Soy influence on relieving the symptoms of menopause among women and reducing the risk of osteoporosis and atherosclerosis was clinically proved. It was also discovered that high soy intake in Asian women correlates with low incidence of breast cancer in this area.

Scientists from Shanghai carried out research in which they analyzed the influence of soy in diet on lung cancer mortality. Cohort of 74 000 women were examined and in 440 of them a lung cancer, which in overwhelming majority was not related with smoking (92% of patients were never smoking), was discovered. The average age of neoplasm detection in examined group was 66,3 years. The average time of the study duration after the diagnosis was 36 months.

Researchers appraised the soy content in the patients’ diet using Food – Frequency Questionairre (FFQ) which concerned soy milk, tofu, fried tofu, dried or pressed tofu, fresh green soybeans, dry soy beans, soy sprouts and other soy products. Average intake was 18g/day for soy and 8,8g/day for soy proteins. Intake exceeding 20g/day ensured the best outcomes.

From 440 patients with lung cancer, 318 died during the research and in 301 of them neoplasm was the cause of death. Out of 440 patients, only 301 of them received information related to the assessment of cancer severity and type of applied treatment and were qualified to researched group. Initial analyses concerning all of the patients, which consisted of lifestyle assessment, demographic factors and other non-clinical factors, indicated that higher soy intake is connected with longer survival. Outcomes were as follows – the risk of death from lung cancer in women whose soy intake was in 10th percentile was increased by 81% compared with those, whose soy intake was in the 50th percentile. Then in patients whose soy intake was in the 90th percentile the risk of death was decreased by 11% compared with medium intake patients, what turned out to be statistically relevant – p=0.004.

The authors of this study claimed that soybean can have an influence on the course of neoplasm due to the content of isflavones acting like natural selective modulators of estrogen’s receptors. Soy, while competing with endogenous estrogen for binding to its receptor, blocks it and makes it insensitive to hormone’s action. There is a lot of arguments suggesting negative influence of female sex hormones on lung cancer prognosis and survival. Connection between estrogen – progesterone therapy and increased risk of death from lung cancer was also discovered.

Research carried out in Shanghai argued that high content of soybean in diet decreases lung cancer mortality among women. It would be valuable to perform further studies to check how this correlation looks like among men and patients from other demographic regions. Received outcomes give us hope that apart from surgical treatment and pharmacotherapy, modification of sick peoples’ diet may increase their chances of survival in the future.

Written by: Anna Kozioł, Julia Rudnicka

Source:
1. Gong Yang, Xiao-Ou Shu, Hong-Lan Li, Wong-Ho Chow, Wanqing Wen, Yong-Bing Xiang, Xianglan Zhang, Hui Cai, Bu-Tian Ji, Yu-Tang Gao, Wei Zheng, Prediagnosis Soy Food Consumption and Lung Cancer Survival in Women
2. Yang WS, Va P, Wong MY, Zhang HL, Xiang YB, Soy intake is associated with lower lung cancer risk: results from a meta-analysis of epidemiologic studies
3. Nick Mulcahy, Eating Soy May Improve Lung Cancer Survival in Women
4. Seow A, Poh WT, Teh M, Eng P, Wang YT, Tan WC, Chia KS, Yu MC, Lee HP, Diet, reproductive factors and lung cancer risk among Chinese women in Singapore: evidence for a protective effect of soy in nonsmokers.
5. Wu AH, Stanczyk FZ, Seow A, Lee HP, Yu MC, Soy intake and other lifestyle determinants of serum estrogen levels among postmenopausal Chinese women in Singapore.
6. Seow A, Koh WP, Wang R, Lee HP, Yu MC, Reproductive variables, soy intake, and lung cancer risk among nonsmoking women in the Singapore Chinese Health Study
7. Wada K, Nakamura K, Tamai Y, Tsuji M, Kawachi T, Hori A, Takeyama N, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C, Soy isoflavone intake and breast cancer risk in Japan: From the Takayama study.

Would You like to know more? Watch on MEDtube.net: Lobectomy – Lung Cancer Surgery

]]> http://medtube.net/tribune/lung-cancer-does-high-soy-intake-increase-the-chance-of-survival/feed/ 0 Lung transplantation using Organ Care System http://medtube.net/tribune/lung-transplantation-using-organ-care-system/ http://medtube.net/tribune/lung-transplantation-using-organ-care-system/#comments Fri, 10 May 2013 22:08:16 +0000 yezryy http://medtube.net/tribune/?p=1926 Instead of a cooler, Gary Cunningham’s new set of lungs arrived at UPMC Presbyterian in a high-tech box on wheels. The small machine kept the donor lungs functioning and “breathing” outside the body with a constant supply of blood and nutrients. The machine, made by Massachusetts-based TransMedics, allows the lungs to remain at a normal body temperature [1, 4]. It was one of the first case of using mechanical perfusion in normothermia for lung storage before transplanting. There are similar researches in kidney and liver transplantation.

“They were still alive when they put them in me,” said Cunningham, 53, of Moundsville, W.Va., who underwent a double lung transplant May 4. “It was like new hope for me. I really have a chance here.”

UPMC surgeons who oversaw the surgery said on Wednesday that the successful use of the Organ Care System (OCS) could open the door to a larger pool of donor of lungs which can be currently storaged in hypothermia only for several hours.

Like other donor organs, lungs are typically transported in hypothermia – they are resting on ice in a cooler with no blood circulation, a process that puts them at risk of organ failure directly after transplantation. Besides, OCS may expand the window of time to as much as 18 to 24 hours. This will allow organs to be transported across greater distances [1].

The new device, which has been tested several dozen times in Europe, was first tested in the United States in December in Ronald Reagan UCLA Medical Center in Los Angeles. A European study published last year in the journal The Lancet showed good lung transplantation outcomes after preservation with the system [2].

The lungs are provided oxygen and blood and flushed with a special solution of drugs and other substances that protect them and prevent contamination. By the time they are transplanted, up to several hours after being harvested, the organ’s condition and quality might be improved, surgeons said.

“You can take a bad organ and improve it, and treat it before it goes into a human. It allows us to push the envelope and take more organs and test them.”, said dr. Jonathan D’Cunha, who performed Cunningham’s eight-hour surgery. D’Cunha said surgeons often pass up organs that are not in the best condition, with infections or trauma, and the new device might someday allow doctors to correct those deficiencies.

Lung transplant patients waiting for an organ face enormous challenges. This new preservation technology may help to improve those odds. Lungs can be safely preserved and transported with the OCS Lung, resulting in complete organ use and successful transplantation [1].

Written by: Sunnidaley Mafa

Source:
1.http://www.healthline.com/health-news/tech-nations-first-breathing-lung-transplant-at-ucla-032313
2.http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961344-0/abstract
3.http://transplants.ucla.edu/body.cfm?id=219
4.http://triblive.com/news/adminpage/3652252-74/transplant-upmc-device#axzz2Nt8KEVUT

Would You like to know more? Watch on MEDtube.net: Thoracoscopic lung surgery

]]> http://medtube.net/tribune/lung-transplantation-using-organ-care-system/feed/ 0 Frontotemporal dementia with motor neuron disease – a clinical case study http://medtube.net/tribune/frontotemporal-dementia-with-motor-neuron-disease-a-clinical-case-study/ http://medtube.net/tribune/frontotemporal-dementia-with-motor-neuron-disease-a-clinical-case-study/#comments Tue, 07 May 2013 21:08:38 +0000 yezryy http://medtube.net/tribune/?p=1923 On the website of the University of California there is a description of a rare disease with a non-specific clinical course. A 51-year-old lawyer, previously healthy, starts to spend the financial resources of his company to pornographic material. It turns out that he does it in order to hide his sexual activity from his wife. In these circumstances it is not difficult to accuse the man of unethical behavior. But this case refers to the example of a rare nervous system disorder manifestation.

His female colleagues begin to complain about patient’s direct comments about their appearance and suggestive glances. Lawyer no longer deals with their customers. He prefers sorting documents on the desk, reading magazines and developing pornographic collection. Finally, he is asked to resign from his post. However, this does not motivate the former employee to change his behavior and to find another job.

The patient’s family complains about his coldness and indifference to them. He still watches TV and stuffs himself with potato crisps. Also table manners, such as not using cutlery and stuffing his mouth with food, leave a lot to be desired.

Among the observed abnormalities the important information was a history of motor neuron disease in the patient’s father and cousin. Neurological examination detected fasciculation (tremor), a slight degree of atrophy and weakness of the arms and legs. Neuropsychological examination revealed deficits in attention and complex executive functions while having quite good memory and visual-spatial functions. Frontoinsular atrophy on both sides can be seen at images of MRI.

Within 9 months after diagnosis the patient died of aspiration pneumonia. Speech and swallowing disorders increasingly aggravated. In the last stage of his life he spent a lot of time weeding his backyard garden.

On the basis of clinical and neuropathological examination, the diagnosis of frontotemporal dementia with motor neuron disease was established.

Briefly summarizing the case, it is worth paying attention to the rapidly progressing nature of the disease and its beginning in a relatively young patient. Although average survival time of the patients with frontotemporal dementia is several years, the occurrence of damage to the motor neuron symptoms reduces the duration of this extremely rare condition. Both, dementia and motor neuron damage may occur separately, although there are cases of common manifestations of these disorders in the form of the analyzed neurological syndrome.

The main symptoms of frontotemporal dementia are changes in behavior (desinhibition, excessive sexual arousal), executive dysfunction (problems with performing conferred job), attention dysfunction (strange interests, excessive eating, watching TV, pointless weeding of the garden) and language dysfunction (lack of fluent speech, problems with naming things) with a relatively well-preserved memory and visuospatial functions.

Additionally, motor neuron damage component is characterized by progressing disability due to weakness and loss of muscle tissue (including problems with speech and swallowing, and even breathing in the end-stage of the disease) and finally paralysis.

The results of the neuropathological examination confirm the diagnosis on the basis of the characteristic changes in the microscopic image. There is no effective treatment.

Written by: Kamil Chorążka

Source:
1. www.memory.ucsf.edu/ftd/medical/cases/case1
2. Rowland L.P., Pedley T.A. Merritt’s Neurology 2010; Lippincott Williams & Wilkins.


Would You like to know more? Watch on MEDtube.net: Endoscopy And Biopsy Of Brain With Neuropanacea

]]> http://medtube.net/tribune/frontotemporal-dementia-with-motor-neuron-disease-a-clinical-case-study/feed/ 0 Hibiscus-derived gossypin fights melanoma http://medtube.net/tribune/hibiscus-derived-gossypin-fights-melanoma/ http://medtube.net/tribune/hibiscus-derived-gossypin-fights-melanoma/#comments Sat, 04 May 2013 18:10:01 +0000 yezryy http://medtube.net/tribune/?p=1920 The end of March and the beginning of April brought the discovery (1) of Texas scientists to light. The researchers tested a little known substance – gossypin – for its action against skin cancer cells. This naturally-occurring flavone was found to inhibit in vitro human melanoma proliferation. Scientists have also observed a unique mechanism that may be responsible for this effect. Furthermore, gossypin therapy, carried out on mice model, reduced the size of melanoma tumors and increased the survival rates. And this is not the only secret property that this flower-derived flavone has.

According to the American Cancer Society (2) melanoma accounts for only approximately 5% of skin cancers, but is responsible for 3 times as many deaths as nonmelanoma skin cancers. What is alarming is that every year the incidence of melanoma increases by 5-7%. Thus in comparison to other malignancies, melanoma incidence is the fastest increasing, right after lung cancer in women. What makes the disease more dreadful is that melanoma is generally the tumor of young patients. For example it is the most common malignant neoplasm in women aged 25-29.

As far as treatment is concerned, surgery is the standard in early stage cutaneous melanoma. A wide local excision with sentinel lymph node biopsy or elective dissection should be performed. Stage IV, or in other words, metastatic melanoma is far more troublesome. Currently it is associated with a 5-year survival rate of around 10%. At present there are no systemic therapeutic regimens that offer significant prolongation of survival without high risk of toxicities. Unfortunately the treatment of patients with advanced-staged melanoma has not improved considerably in recent years.

The need for new approaches to melanoma therapy has led scientist to search for help in natural resources. About 10 years ago it was observed that gossypin exhibits free radical scavenging, antitumor and anticarcinogenic activities (3). The question of how exactly gossypin works has not been answered yet. The following studies (4) have shown that hibiscus-derived flavone inhibits nuclear factor-kappaB (NF-kappaB), which is a transcription factor for genes associated with inflammation, carcinogenesis, hyperproliferation, invasion and angiogenesis. Gossypin hampered NF-kappaB activation induced by inflammatory stimuli and carcinogens, as well as constitutive NF-kappaB in tumor cells.

In the discussed study gossypin was tested on human melanoma cell lines that carry mutations of two kinases. BRAFV600E kinase mutation is said to be present in 70% cases of melanoma in humans. Gossypin inhibited their activities in vitro, possibly through direct binding of flavone with these kinases. This extraordinary activity was confirmed by molecular docking studies. Furthermore, hibiscus-derived compound significantly stunted melanoma growth in a three-dimensional skin culture resembling human skin. Gossypin treatment for 10 days human melanoma cells transplanted to mice reduced tumor volume by inducing the apoptosis.

Other studies show that gossypin may amaze us with its variety of properties. In one protocol it exhibited antidiabetic properties running neck and neck with standard drug gliclazide (5). Other results (6) indicate that gossypin is hypocholesterolemic through the increase in the expression of LDL receptors. Gossypin may also have antiallergic (7) properties as it reduced the histamine release and consequently pruritus in rats. Its anti-inflammatory (8), analgesic (9) and anxiolytic (10) properties could surely find clinical application. Gossypin might also be helpful for patients suffering from Alzheimer’s disease because it reduces the beta-amyloid neurotoxicity (11).

As we see, gossypin is a herbal agent which, surprisingly, seems to be a solution for many ailments of today’s world. On the first look, this flavon may be an extraordinary panaceum, but when we think deeper we might find that most of the plagues of current time result from the inappropriate lifestyle including diet. Scientist try to extract various substances from plants and test them for desirable properties but isn’t it easier to eat lots of fruits and vegetables instead of swallowing pills containing some of their compounds? This is the question that modern society will have to answer one day.



Written by: Natalia Neumann




Source:
1.Gossypin as a Novel Selective Dual Inhibitor of v-raf Murine Sarcoma Viral Oncogene Homolog B1 and Cyclin-Dependent Kinase 4 for Melanoma. Shylesh Bhaskaran, Kalarikkal V. Dileep, Sathyaseelan S. Deepa et al. Molecular Cancer Therapeutics April 2013 12:361-372, first published online 29 Mar 2013; DOI: 10.1158/1535-7163.MCT-12-0965;
2.ACS Cancer Facts & Figures 2009http://www.cancer.org/downloads/STT/500809web.pdf
3.J Exp Clin Cancer Res. 2003 Dec;22(4):581-9.Free radical scavenging, antitumor and anticarcinogenic activity of gossypin. Babu BH, Jayram HN, Nair MG et al.
4.Blood. 2007 Jun 15;109(12):5112-21. Epub 2007 Mar 1.Gossypin, a pentahydroxy glucosyl flavone, inhibits the transforming growth factor beta-activated kinase-1-mediated NF-kappaB activation pathway, leading to potentiation of apoptosis, suppression of invasion, and abrogation of osteoclastogenesis. Kunnumakkara AB, Nair AS, Ahn KS et al
5.J Diabetes. 2012 Mar;4(1):41-6. doi: 10.1111/j.1753-0407.2011.00145.x. Antidiabetic activity of gossypin, a pentahydroxyflavone glucoside, in streptozotocin-induced experimental diabetes in rats. Venkatesan T, Sorimuthu Pillai S.
6.J Agric Food Chem. 2008 Dec 10;56(23):11526-32. doi: 10.1021/jf802607x. Gossypin up-regulates LDL receptor through activation of ERK pathway: a signaling mechanism for the hypocholesterolemic effect. Lu N, Li Y, Qin H et al.
7.Indian J Biochem Biophys. 2010 Apr;47(2):90-5.Evaluation of anti-allergic activity of gossypin and suramin in mast cell-mediated allergy model.Ganapaty S, Chandrashekhar VM, Narsu ML.
8.Phytother Res. 2009 Jun;23(6):878-84. doi: 10.1002/ptr.2727.Antiinflammatory and antinociceptive activities of gossypin and procumbentin–cyclooxygenase-2 (COX-2) inhibition studies. Mada SR, Metukuri MR, Burugula L et al.
9.Eur J Pharmacol. 1984 Feb 17;98(2):289-91.Gossypin-induced analgesia in mice. Viswanathan S, Sambantham PT, Reddy K et al.
10.Neurochem Res. 2009 Oct;34(10):1867-75. doi: 10.1007/s11064-009-9969-9. Epub 2009 Apr 23. The flavonoid glycosides, myricitrin, gossypin and naringin exert anxiolytic action in mice. Fernandez SP, Nguyen M, Yow TT et al.
11.Arch Pharm Res. 2004 Apr;27(4):454-9.Gossypin protects primary cultured rat cortical cells from oxidative stress- and beta-amyloid-induced toxicity.Yoon I, Lee KH, Cho J.

Would You like to know more? Watch on MEDtube.net: Melanoma in situ

]]> http://medtube.net/tribune/hibiscus-derived-gossypin-fights-melanoma/feed/ 0 Radiation-induced oral mucositis – a new hope for effective treatment http://medtube.net/tribune/radiation-induced-oral-mucositis-a-new-hope-for-effective-treatment/ http://medtube.net/tribune/radiation-induced-oral-mucositis-a-new-hope-for-effective-treatment/#comments Wed, 01 May 2013 11:08:39 +0000 yezryy http://medtube.net/tribune/?p=1917 Melatonin gel, Smad7 protein, or perhaps some other method? Oral mucositis caused by radio and chemotherapy may be ultimately defeated soon. Scientists from Granada and Colorado, after many years of research suggest drugs that are likely to improve the quality of life and revolutionize anti side effects treatment of patients undergoing cancer therapy.

Inflammation of the oral mucosa is a common complication of radiotherapy of the head and neck region. Cancer therapy is aimed at rapidly dividing cells – the target being neoplastic cells. Of course it does not mean, however, that other tissues undergoing intensive growth and regeneration will not be damaged. The mucosa of the oral cavity is a tissue of a relatively fast renewal (complete replacement of cells is estimated at 5-8 days), controlled by growth factors, especially EGF and TGFα secreted locally and present in the saliva. The destruction of the salivary glands and impaired cell renewal are altogether the cause of stomatitis, which is characterized by redness, swelling and ulcerations. Pain, occurring during food and fluid intake or even speaking dramatically reduces the quality of life, often leading to patients’ psychological crisis. After the radiotherapy mucosa becomes more susceptible to injuries also due to the associated damage of the salivary glands. Non-healing ulcers facilitate the penetration of microorganisms into the blood, sometimes leading to a dangerous bacteremia. Inflammation is developed in four stages, wherein the third and fourth stage severe symptoms lead to the inability of food intake. The inflammation starts typically 2 weeks after the radiotherapy implementation may continue for as long as 8 weeks.

Until now, patients suffering from stomatitis could only lean on laser therapy, cryotherapy, antiseptics, analgesics and anti-inflammatory drugs, cytoprotectants (for example, allopurinol, glutamine, vitamin E), agents affecting the mucosal cell proliferation (e.g. Tretinoin) or hematopoietic growth factors (GM-CSF, G-CSF). None of the treatments has been approved by the FDA yet, leaving the patients with no hope of improving their quality of life during radiotherapy.

With such an overwhelming amount of the negative side effects of head and neck region radiotherapy it does not come as a surprise that the scientists are doing their best to find a way to defeat the problem. In February researchers from the University of Granada, after nearly twenty years of hard work patented a melatonin gel which according to the team can fight stomatitis completely. This new drug applied topically protects mitochondria against damage, while diminishing the inflammation.

Meanwhile researchers from Colorado offered another potentially effective method to battle mucositis: Smad7 protein. Produced by genetically modified rodents, this protein significantly increased resistance to mucositis after radiotherapy. Applied topically contributed to faster healing of existing ulcers. Moreover, the regeneration of the mucosa was followed by normal cells but not cancer cells, as often was the case in the use of growth factors while treating ulcers. This discovery gives hope to create a drug for topical application which will effectively prevent and treat inflammation of oral mucosa caused by radiation therapy.



Written by: Maria Bilińska




Source:
1.http://canal.ugr.es/health-science-and-technology/item/62983
2.Gangwen Han, Li Bian, Fulun Li, Ana Cotrim, Donna Wang, Jianbo Lu, Yu Deng, Gregory Bird, Anastasia Sowers, James B Mitchell, J Silvio Gutkind, Rui Zhao, David Raben, Peter ten Dijke, Yosef Refaeli, Qinghong Zhang, Xiao-Jing Wang. Preventive and therapeutic effects of Smad7 on radiation-induced oral mucositis. Nature Medicine, 2013; DOI: 10.1038/nm.3118
3.http://www.mouthsmadegood.com/PL-PL/nurse-resources/about-oral-mucositis-patient.pdf
4.http://www.nutrabem.ind.br/mucosite.pdf

Would You like to know more? Watch on MEDtube.net: Post-Radiation Colitis

]]> http://medtube.net/tribune/radiation-induced-oral-mucositis-a-new-hope-for-effective-treatment/feed/ 0 Endoscopic transplant of islet cells – a success of Polish surgeons http://medtube.net/tribune/endoscopic-transplant-of-islet-cells-a-success-of-polish-surgeons/ http://medtube.net/tribune/endoscopic-transplant-of-islet-cells-a-success-of-polish-surgeons/#comments Sat, 27 Apr 2013 20:34:54 +0000 yezryy http://medtube.net/tribune/?p=1907 What was only a dream for diabetics a few months ago became a fact today. A team from Institute and Clinic of General and Transplant Surgery of Baby Jesus Clinical Hospital in Warsaw had conducted revolutionary surgery of autogenous transplantation of islet cells under stomach’s mucosa(1).

Diabetes is a metabolic disease which slowly but significantly affects every organ of the body. Retinopathy, nephropathy or diabetes neuropathy are only capstones of long-lasting process of cells functioning disorder. There are many causes of diabetes: autoimmune, chronic pancreatitis, injuries, tumours or pancreatectomy. Because of the fact that not many patients are able to control progression of the disease and organs failure, improvements in diabetes therapy are significant.

A solution to the problem may be pancreas transplant which is 4th most commonly conducted transplant in the world just after kidney, liver and heart. The obvious threats of this treatment may be intra abdominal abscesses, clots and long-lasting immunosuppressant treatment.

Another method used in chronic pancreatitis treatment so far was resection of the organ with isolation of Langerhans’ islets and intrahepatic transplant through portal vein. It allowed about 30% of the patients to be completely non-insulin-dependent and in remaining group the symptoms of insulin-dependency had not occurred for almost 2 years(2). Drawbacks of the method are thrombi, haemorrhages and topical inflammatory reaction destroying beta cells(5). After pancreas injuries the islets may be transplanted even to the region of forearm especially if the tail of pancreas, which is the most abundant in insulin producing cells, is destroyed (3).

In cases of allotransplant the difficulty is to gather few donors who are tissue compatible – in order to acquire complete non-insulin-dependency, 8-9 thousand of allogenic cells per 1 kilogram of body weight are necessary. The very isolation of the islets reduced their number by half. All of this and high risk of transplant rejection lead to initial situation which is insulin therapy (4).

The team from Institute and Clinic of General and Transplant Surgery of Baby Jesus Clinical Hospital in Warsaw has conducted groundbreaking surgery by removing pancreas of the patient suffering from chronic pancreatitis. Then they isolated islet cells, prepared them properly for transplantation and conducted the transplant of the cells under stomach’s mucosa using endoscopy. Because of the fact that it was autogenous transplant, the patient would not require using immunosuppressant drugs. This method is very promising, especially among the patients who previously underwent pancreas transplant, are in bad general condition or there are any anesthesiological contraindications. Additionally, comparing to the whole organ transplantation, the risk seems to be lower (1).

The method of the team from Institute and Clinic of General and Transplant Surgery of Baby Jesus Clinical Hospital in Warsaw is insomuch innovative that research on guinea pigs proved minimal damage of the islet cells in stomach’s submucosis layer. Furthermore, the islets placement is specific what, if in doubt about functioning, allows to examine them using endoscopic USG or even biopsy. On the other hand, research showed higher risk of hypoglycaemia in guinea pigs with lower body weight (5).

The success of Polish transplantology group sounds very promising, especially because of the fact that it was done for the first time in the world. Hopefully it would be a breakthrough for many patients.

Written by: Edyta Sawicka-Glazer, Grzegorz Glazer

Source:
1.http://www.naukawpolsce.pap.pl/aktualnosci/news,394727,pierwszy-na-swiecie-endoskopowy-przeszczep-wysp-trzustkowych.html
2.Bellin MD, R Sutherland DE, Robertson RP.: Pancreatectomy and autologous islet transplantation for painful chronic pancreatitis: indications and outcomes. Hosp Pract (1995). 2012 Aug;40(3):80-7.
3.http://www.serena.unina.it/index.php/jop/article/view/634/919
4.http://www.mojacukrzyca.pl/articles.php?article_id=122
5.http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2009.02815.x/full

Would you like to know more? Watch on MEDtube.net: Hyalinized islets – Histopathology of pancreas

]]> http://medtube.net/tribune/endoscopic-transplant-of-islet-cells-a-success-of-polish-surgeons/feed/ 0 Glybera – a drug that will replace a defective gene http://medtube.net/tribune/glybera-a-drug-that-will-replace-a-defective-gene/ http://medtube.net/tribune/glybera-a-drug-that-will-replace-a-defective-gene/#comments Tue, 23 Apr 2013 08:40:54 +0000 yezryy http://medtube.net/tribune/?p=1899 Glybera is the first drug authorized in Europe which is based on gene therapy. It is also known as the most expensive drug in the world – a therapy with the use of it is expected to cost about 1.2 million euros. The drug helps people suffering from familial lipoprotein lipase deficiency (LPLD) which a rare disease of lipid metabolism. In 2012 the European Commission authorized the drug and it will be available in 27 countries of the European Union in a few months (in the second half of 2013).

The familial lipoprotein lipase deficiency (LPLD) is also known under the name of hyperlipoproteinemia type I or a familial hyperchylomicronemia. LPLD is a rare and inherited disease that affects about 1-2 persons per million. Familial hyperchylomicronemia is caused by a defective gene encoding a lipoprotein lipase. Fats cannot be metabolized, thus they accumulate in the form of chylomicrons. Symptoms of the disease include: hepatomegaly, xanthomas, high level of triglycerides in the blood, jaundice and recurrent pancreatitis [1,2].

The disease is diagnosed by examining the level of cholesterol and triglycerides in the blood, performing genetic tests, and (sometimes) by examining the activity of lipoprotein lipase in the blood. Until now, the only treatment was to follow a diet (eating no more than 20 mg of fat per day). [2]

How can we help people suffering from LPLD? A hope is a new drug that will appear at the market soon. Glybera is a drug for a gene therapy which introduces a functional lipoprotein lipase (LPL) gene into the cells of the body. The vector which transfer genes is a virus AAV (called adeno-associated virus). It does not cause infection and cannot replicate in the cells. Instead, it is characterized by a high affinity to the muscle cells in which the lipoprotein lipase is produced [3,4,5].

The drug was tested on a group of 27 patients with severe family lipoprotein lipase deficiency. In each case the drug was well tolerated, lipid levels after meals decreased, and the number of recurrent pancreatitis was reduced (which is associated with fewer hospitalizations and fewer visits to the ICU) [5].

Glybera can be administered to adult patients with a diagnosis of familial lipoprotein lipase deficiency suffering from severe or repeated pancreatitis despite a fat-restricted diet. The diagnosis must be confirmed by a genetic test. Before and after subjecting the patients to the gene therapy, they should receive an immunosuppressant treatment. The drug is administered once, in the form of multiple injections in the thighs and lower leg muscles of both legs. Glybera works for a long time – the level of chylomicrons remained decreased not only for 24, but also 52 weeks after administration. [4,5]

Glybera is the most expensive drug in the world thus far. The cost of the treatment per patient is over 1.2 million euro. Discussions with individual countries about the price and payment are ongoing (it is proposed to spread the payment into instalments for five years -250 thousand euro annually). In 2012 the drug was approved by the European Medicines Agency (EMA). Works on the admission of Glybera for sale in the United States, Canada and other countries are ongoing. The drug will be available in Europe in a few months, in the second half of 2013. [6]



Written by: Magdalena Mroczek

Source:
1.Dugdale, III, David C.; Zieve, David, eds. (May 29, 2011), “Familial lipoprotein lipase deficiency”, A.D.A.M. Medical Encyclopedia (National Center for Biotechnology Information), retrieved October 15, 2012
2.https://www.rareconnect.org/en/community/lipoprotein-lipase-deficiency
3.http://www.echodnia.eu/apps/pbcs.dll/article?AID=/20121107/STYLZYCIA01/121109270
4.http://www.ema.europa.eu/docs/pl_PL/document_library/EPAR__Product_Information/human/002145/WC500135472.pdf
5.http://www.uniqure.com/products/glybera/
6.http://www.oil.org.pl/xml/nil/gazeta/numery/n2013/n201301/n20130114

Would You like to know more? Watch one MEDtube.net: Acute Pancreatitis

]]> http://medtube.net/tribune/glybera-a-drug-that-will-replace-a-defective-gene/feed/ 0 Alcohol and suicide – relation encoded in genes? http://medtube.net/tribune/alcohol-and-suicide-relation-encoded-in-genes/ http://medtube.net/tribune/alcohol-and-suicide-relation-encoded-in-genes/#comments Sat, 20 Apr 2013 21:42:15 +0000 yezryy http://medtube.net/tribune/?p=1894 Polish scientists from Medical Genetics Institute of Warsaw Medical University discovered that tendencies to certain reactions to alcohol are genetically conditioned and may lead to an increase in probability of suicidal attempts.

Statistical data confirm that the most of suicides are committed under the influence of alcohol. Many papers confirming a thesis that the sequence of numerous genes is responsible for the tendencies to suicidal behaviour can be found in the literature. According to the scientists from WMU, those two factors can have a common reference point in 7th chromosome of AUTS2 gene encoding protein which undergoes gene expression in developing brain and amygdaloidal.

It is proven that various variants of this gene are responsible for autism, mental retardation, epilepsy, dyslexia, and also alcoholism occurrence. The aim of the researchers was to state whether there is any variant of this gene which increases the predispositions to suicidal behaviours.

625 bodies of suicide from WMU Medical Jurisprudence Institute were examined. 300 of them drank alcohol shortly before the suicide. Control group were 3861 people emerged as randomised group of Polish society from the programme of WOBASZ (National Health Survey in Poland). The analysis considered the amount and type of used alcohol. From both, the control and research groups (out of blood samples stored after death) blood samples for EDTA were collected and according to Miller’s salting method the DNA was isolated. Then, using Real-Time PCR with TaqMan probes, variants of gene AUTS2 were sought.

Obtained results has shown that overrepresentation of gene ATUS2 variant with alleles A was present in those who committed suicide. The same gene variant was found in the DNA of control group who drank less alcohol than the others. The results turned to be statistically vital in dominant and co-dominant system of the gene occurrence.

The scientists from WMU highlight that their discovery has no determinant character – having discovered gene variant does not mean that the person whose DNA contains it has to commit suicide after using alcohol. It only describes the direction of pathomechanism interpretation of such phenomenon. The person with the gene AUTS2 with A allele may react to the alcohol in a way inducing depressive moods, which in turn may induce suicidal behaviours.

It would be valuable to conduct further analysis of particular genes responsible for depressive behaviours, suicidal attempts and committed suicides in order to know mechanisms which govern them precisely and in the future maybe to predict such events in people who are genetically burdened and to apply effective prevention.



Written by: Julia Rudnicka, Anna Kozioł, Jerzy Bednarski

Source:
1. Mann JJ, Arango VA, Avenevoli S, Brent DA, Champagne FA, et al. (2009) Candidate endophenotypes for genetic studies of suicidal behavior. Biol Psychiatry 65: 556–563.
2. Pedersen NL, Fiske A (2010) Genetic influences on suicide and nonfatal suicidal behavior: twin study findings. Eur Psychiatry 25: 264–267.
3. Voracek M, Loibl LM (2007) Genetics of suicide: a systematic review of twin studies. Wien Klin Wochenschr 119: 463–475.
4. Brent DA, Mann JJ (2005) Family genetic studies, suicide, and suicidal behavior. Am J Med Genet C Semin Med Genet 133C: 13–24.
5. Tidemalm D, Runeson B, Waern M, Frisell T, Carlstrom E, et al. (2011) Familial clustering of suicide risk: a total population study of 11.4 million individuals. Psychol Med 1–8.
6. Kim S, Choi KH, Baykiz AF, Gershenfeld HK (2007) Suicide candidate genes associated with bipolar disorder and schizophrenia: an exploratory gene expression profiling analysis of post-mortem prefrontal cortex. BMC Genomics 8: 413.

Would You like to know more? Watch on MEDtube.net: Alcoholic Liver Disease

]]> http://medtube.net/tribune/alcohol-and-suicide-relation-encoded-in-genes/feed/ 0 Face transplant for the first time in Poland http://medtube.net/tribune/face-transplant-for-the-first-time-in-poland/ http://medtube.net/tribune/face-transplant-for-the-first-time-in-poland/#comments Sun, 14 Apr 2013 21:27:38 +0000 yezryy http://medtube.net/tribune/?p=1890 A group of Silesian Surgeons from the Cancer Centre of Maria Skłodowska-Curie Institute in Gliwice announced that they are ready to perform first facial allograft transplantation in Poland and Middle-East Europe. A team of Professor Adam Maciejewski is still searching for the best match of donor and recipient. Similar surgeries have already been performed in USA, Spain, Germany, France and Belgium.

Professor Adam Maciejewski, who is a member of the American Society of Reconstructive and Microvascular Surgery, made a lot of achievements i.a. he carried out the first half laryngeal reconstruction in a patient with thyroid cancer in Europe. Now, owing to the allotted finds from the Health Ministry, obtained Poltransplant’s consent and bioethical commission he will make facial allograft transplantation.

The first partial facial transplant was conducted in 2005 in France. The patient was 38-years-old woman with facial injury caused by a dog bite. She received ‘new’ nose, mouth and chin. Since then 18 patients have received transplants with promising results. The second one took place in China in 2006 and it was also partial face transplant. Unfortunately, the patient died two years later – he stopped taking immune – suppressant drugs and was neglected by socio-psychological care. On this example we can see how important are criteria for choosing right recipient and then the psychological and social support.

In December 2008 a team led by Professor Maria Siemonow conducted 4th facial transplant in the world. The patient was 46-years-old woman who was shot. During the surgery 80% of face was transplanted and the operation was successful. First total face transplantation was performed in 2010 in Barcelona. The patient- Spanish farmer injured in a shooting accident was unable to breathe or eat by his own. He received a transplant of facial muscles, skin, lips, jaw, teeth, palate and cheekbones.

Transplantology, which in the beginning was controversial and dangerous, became a rescue when all other methods failed. We are transplanting hearts, livers, kidneys and other vital organs in our bodies. Aristotle said that ‘man is by nature a social animal’ and it’s our face which plays the most important role in our lives as well as in society. People with severe facial disfigurement experience severe psychological problems. Their facial expression is usually diminished, affects normal communication, express emotions and leads to isolation, depression, anxiety. In facial transplantations the goal is to give back to the patient his normal appearance and also movement, functioning and sensation of their face.

Complexity of the qualification process for the transplant is based on proper choice of donor and recipient. Criteria are: age, gender, skin phonotype, immunological criteria (group or Rh), allergy assessment by panel of reactive antibodies, negative cross-matching, health condition and psychical condition of the recipient. Eligibility recipients are people in good health and physiological condition to be able to withstand procedure and post-operative powerful immunosuppressive treatment for the rest of their life.

Candidate for face transplantation should be aware of risks and benefits, screened by multidisciplinary team of specialists. The risk of rejection is high. A lifelong regimen of immunosuppressive therapy is necessary, even if it increases risks of kidney damage, develop cancer and life threatening infections. Another major factor is psychological effect – both on the recipient and on the donor’s family. Nevertheless facial appearance of the recipient would be shaped by underlying skeleton and facial volume, making resemblance to the donor unlikely.

Face transplantation presents big challenge- surgical, immunologic and ethical. This alternative should be available for people with serious facial disfigurement who have exhausted all conventional reconstructive surgeries. As a result, they will have a chance to function normally in the society.

Written by: Aneta Piotrowska


Source:
1.http://www.przeszczeptwarzy.pl/
2.www.naukawpolsce.pap.pl
3.Siemionow M., Sonmez E., Klimczak A. Technical and immunological aspects of face transplantation. Pol. Prz. Chir. 2009: 81 (1) s.101-112
4.Siemionow M., Hivelin M. Face transplantation: clinical application of the concept. Pol. Prz. Chir. 2008: 80 (10) s.1041-1053
5.Siemionow M. Is it ethical to consider human face transplantation? Nowiny Lek. 2006: 75 (3) s.279-280

Would You like to know more about plastic surgery? Watch on MEDtube.net: Fornix Reconstruction With Amniotic Membrane

]]> http://medtube.net/tribune/face-transplant-for-the-first-time-in-poland/feed/ 0 Fear and forgetting – triggering and inhibiting phobias are governed by independent neuronal paths http://medtube.net/tribune/fear-and-forgetting-triggering-and-inhibiting-phobias-are-governed-by-independent-neuronal-paths/ http://medtube.net/tribune/fear-and-forgetting-triggering-and-inhibiting-phobias-are-governed-by-independent-neuronal-paths/#comments Wed, 10 Apr 2013 16:02:01 +0000 yezryy http://medtube.net/tribune/?p=1885 Polish scientists from the Nencki Institute of Experimental Biology of the Polish Academy of Science and The International Institute of Molecular and Cell Biology (IIMCB) in Warsaw under the guidance of dr. Ewelina Knapska, Ph.D. Jacek Jaworski and professor Leszek Kaczmarek confirmed common speculations that two independent of each other neuronal pathways are responsible for triggering and inhibiting phobias. It is manifested in difficulties of phobias treatment because creating competing engrams is responsible for quenching fear.

Brain structures responsible for these processes are evolutionarily very old. This assumption allows to study them in primitive animals, including rats, what was used in this experiment. For the exact localisation of functionally involved neurons to be possible, appropriate modification of rat’s genome was conducted. Owing to this, in changed animals fluorescent protein which persisted for a few hours was secreted in active synapses. The procedure of the experiment guaranteed that it would be present only in neurons responsible for transmitting fear reaction.

In order to do that an influence of various factors which caused fear and phobias was used in animals according to compiled procedure. Afterwards, the rats were slain and their brains were subjected to microscopic analysis focusing on amygdaloid body and paths connecting it with hippocampus and cortical cortex.

As it is known amygdalae processes emotions. The lack of amygdalae’s activity has connection with the lack of fear sense and gentleness. Additional symptoms are i.a. excessive sexual activity and epilepsy. In turn, prefrontal cortex and hippocampus analyse where and when similar stress situation occurred. It is proven that a damage of hippocampus is relevant to learning problems what correlates with belief that this structure account for memory perpetuation and long-term memory creation. Interestingly, hippocampus may be damaged even under the influence of high stress. Glucocorticoids may have similar influence on it.

That is why described structures interested Polish scientists who demonstrated the existence of two cells populations functioning independently in the area of amygdalae’s lateral nuclei. It turned out that different paths connecting studied structures with reoccurrence of fear reactions were activated than those when the reaction was suppressed. Other paths are responsible for fear transmission and another for e.g. petrifaction. In this context attenuation of phobias is connected not only with decline of mnemic trace. Then, according to the scientists, occurs the dominance of new stimuli deadening fear in different areas of amygdalae.

The results give new not only researching, but also therapeutic possibilities and can influence the development of new psychological methods. If anatomy and functional histology of the brain are known precisely, it would be possible to treat a specific pathway pharmacologically what will prevent the side effects.



Written by: Jakub Patryn, Michał Czerwiec, Jerzy Bednarski

Source:
1.Functional anatomy of neural circuits regulating
fear and extinction. Ewelina Knapskaa,1, Matylda Maciasb,c, Marta Mikosza, Aleksandra Nowaka, Dorota Owczarekb, Marcin Wawrzyniakb, Marcelina Pieprzykc, Iwona A. Cymermanc, Tomasz Werkaa, Morgan Shengd,2, Stephen Marene, Jacek Jaworskic,1, and Leszek Kaczmarekb,
2.Functional internal complexity of amygdala: Focus on gene activity mapping after behavioral training and drugs of abuse. Physiol Rev 87:1113–1173.Knapska E, Radwanska K, Werka T, Kaczmarek L (2007)
3. Naukowcy wiedzą, gdzie się kryją fobie”, PAP- Nauka w Polsce
4. Contextual and temporal modulation of extinction: Behavioral and biological mechanisms.” Biol Psychiatry 60: 352–360. Bouton ME, Westbrook RF, Corcoran KA, Maren S (2006)
5.Chronic glucocorticoids increase hippocampal vulnerability to neurotoxicity under conditionsthat produce CA3 dendritic retraction but fail to impair spatial recognition memory.
Conrad CD, McLaughlin KJ, Harman JS, Foltz C, Wieczorek L, Lightner E, Wright RL. J Neurosci. 2007 Aug 1;27(31):8278-85.
6. Pearce JM. Amygdala. „European neurology”. 5 (59), s. 283, styczeń 2008.

Would you like to know more? Watch on Medtube.net: Endoscopy – brain

]]> http://medtube.net/tribune/fear-and-forgetting-triggering-and-inhibiting-phobias-are-governed-by-independent-neuronal-paths/feed/ 0 Da Vinci Robot http://medtube.net/tribune/da-vinci-robot/ http://medtube.net/tribune/da-vinci-robot/#comments Sun, 07 Apr 2013 16:02:30 +0000 yezryy http://medtube.net/tribune/?p=1883 Robotic surgery can be considered as a “step forward” in laparoscopic surgery. Surgeon does not stand behind the operating table, but controls the intervention using a special console. The image is seen three-dimensionally, what facilitates the view of the surgical field and improves precision. The Da Vinci robots are used widely in surgeries of prostate, kidney, colon, bladder, in the cancer of head and neck, the uterus and appendages, and in tumors of the chest.

The Da Vinci system consists of a console, which is usually located in the same room as the patient, and four robotic arms. One of the arms is an endoscopic camera with two lenses, which allows to obtain a stereoscopic image. Other three arms are surgical instruments e.g. scalpels, scissors or cautery tools. The surgeon controls the course of an intervention by watching it through a pair of binoculars, he can also maneuver the two pedals and two manual controllers. Surgeon’s movements are transformed into more precise movements of the robot using the a special scale. Thus shaking of the operator’s hands can be eliminated [1].

An operation with the utilization of the da Vinci robot is easier for the surgeon than traditional laparoscopy, because the doctor can operate while sitting, as well as watch the operative field in the 3 D, life-size, 10 times magnification. The da Vinci robot allows to see those areas, to which insight with traditional surgery is difficult to obtain (operations of prostate, uterus and appendages, rectum, excision of tumors of the skull base). The operator’s eyes are in one line with the instruments and to change the position of surgical instruments a surgeon needs only to use his hands [1,4].

Operation with the utilization of the Da Vinci robot is easier for the surgeon than traditional laparoscopy, because the doctor can operate while sitting, as well as watch the operative field in the 3D, life-size, 10 times magnification. The da Vinci robot allows to see those areas, to which insight with traditional surgery is difficult to obtain (operations of prostate, uterus and appendages, rectum, excision of tumors of the skull base). The operator’s eyes are in one line with the instruments and to change the position of surgical instruments a surgeon needs only to use his hands [1,4].

The da Vinci technology brings many benefits to the patient: reduces bleeding, amount of stitches and the scar is smaller (due to the smaller cut). With the help of the robot the patient can be operated through small holes (size of 0.5-2cm). All this allows to discharge patient from the hospital faster, and reduces duration of recovery. The risk of infection is minimal[4,7].

The da Vinci robots are frequently used to perform prostatectomy and hysterectomy. The device can also be useful in vascular and cardiac surgery as well as in surgery of the digestive tract. In experimental oncology, the possibility of using a robot to resect the liver and pancreatic cancer is being investigated [6].

In 2012, more than 200,000 robotic surgeries around the world were performed. In all countries operate more than 2,000 such devices (in January 2013) [6]. Most of the Da Vinci robots are located in the United States, in Italy there are 54, in Germany 48 in the Czech Republic and Romania 9.



Autor: Magdalena Mroczek

Źródło:
1.http://www.intuitivesurgical.com/
2.http://www.wssk.wroc.pl/index.php?option=com_content&task=view&id=267
3.http://www.se.pl/wydarzenia/kraj/wroclaw-robot-da-vinci-pomog-przeszczepic-nerke_299988.html
4.http://www.chirurgiarobotowa.pl
5.http://www.gazetawroclawska.pl/artykul/427763,robot-da-vinci-niewykorzystany-cud,2,id,t,sa.html
6.http://en.wikipedia.org/wiki/Da_Vinci_Surgical_System
7.http://davincisurgery.pl

Would You like to know more? Watch on MEDtube.net: Robotic prostatectomy in HD – DaVinci Surgery – part 1

]]> http://medtube.net/tribune/da-vinci-robot/feed/ 0 Shift work and cancer risk http://medtube.net/tribune/shift-work-and-cancer-risk/ http://medtube.net/tribune/shift-work-and-cancer-risk/#comments Wed, 03 Apr 2013 07:57:11 +0000 yezryy http://medtube.net/tribune/?p=1880 Recently, it is a lot of talk about the impact of shift work on higher risk of malignant tumours. About 15-20% of the population of the European Union works in shifts [6]. Desynchronization of internal clock causes increased risk of breast, endometrial or colon cancer. Is it a fact that women are particularly vulnerable to the side effects of shift work?

Work at night certainly disturbs the 24- hour rhythm of sleep and wakefulness. Studies have shown that long-term circadian rhythms disorder causes damage to the front of the hypothalamus, which includes nucleus suprachasmaticus. The damage of optic nerve, which is also in this area, affects the pineal gland and the amount of melatonin secreted. This hormone acts chronobiologically-darkness increases its secretion and even the minimum amount of light causes its inhibition. Why melatonin is so important? Not only it works as immunomodulator and behaves as an antioxidant, but also has an effect on the secretion of endocrine hormones associated with circadian rhythm, gets involved in the process of sexual maturation and reproduction, and gives an additive effect on antitumor activity of IL-2 [1]. All these beneficial effects have the peak around 1.00-2.00 at night [2]. Melatonin level decreases in the absence of sleep at night and does not reach its growth even when the patient is asleep during the day [13]. It has been proven that higher risk of cancer occurs not only in the absence of sleep, but also in its deprivation (morning and evening) – the number and activity of NK cells increases then and this reduces the protective effects of the immune system [3].

In the German population (GENICA trial) it was demonstrated that long-term shift work caused slightly higher risk of breast cancer [2]. On the other hand, the Tokumaru and co. study, followed in a group of flight attendants [3], proved a greater probability of breast cancer. However, in this group of patients the observation might have been disturbed by so called lag (fatigue, reduced intellectual reactivity, drowsiness) and cosmic radiation which was higher than in statistical woman’s life. Similar results of the increased incidence of breast cancer was registered in professional groups of nurses [12] and women working in the Danish army[15]. It was also shown that women already diagnosed with breast cancer should not perform their occupation at night due to the suppression of melatonin which in low concentration causes the tumour progression [6].

Because of the fact that the amount of melatonin decreases significantly in perimenopausal period, higher correlation with the incidence of breast and endometrial cancer is observed[1]. Obesity and diabetes, which often coexist with endometrial cancer, also cause the reduction of melatonin level which decreases estrogen level and rises level of progesterone [1]. Women working more than 20 years in the shift showed up to 47% higher risk of endometrial cancer [7]. Even though this work period coincides with the onset of menopause, their colleagues never working night shifts had much lower risk [7]. WREN and WRENSYR trials confirmed the greater incidence of endometrial cancer, especially in female patients spending more than 50% of the work time at night shifts [8].

2 trials: the Nurses’ Health Study (NHS) and the Nurses’ Health Study II (NHSII) tried to identify the incidence and risk of epithelial ovarian cancer. There was no relationship between duration of shift work and the risk of ovarian mutagenesis in each study group [5]. But the latest research of scientists from the Hutchinson Cancer Research Center have shown that such a risk exists and is significantly higher in women with rotational work. Even if they work only 2 – 3 years, the risk is 24% higher in the case of advanced cancer and 49% higher in the early stage of cancer. They also proved that the minority of cases in the group suffering from the tumour were so called owls, perhaps better adapting to the shifts [11].

Melatonin is produced not only in the pineal gland, but also in the skin. Nurses’ Health Study gave us a look at the incidence of skin cancer in night shift workers which turned out to appear 14% less often in and even 44% less often in patients with melanoma [4].

What’s worth noticing, the Swedish men working at night have shown no increased risk of prostate cancer. On the other hand, in population of Japanese or Canadians the higher risk was statistically significant [14] what also indicate the variability not only between individuals, but also race. Interestingly, night workers are also more prone to non- Hodgkin lymphomas – it particularly refers to men [9].

In connection with such a strong correlation of the decrease in the level of melatonin in cancer incidence, can exogenous melatonin supplementation be an antidote or even prevention [1]? The answer will be probably brought by trials. In response to such disturbing reports regarding the risk of cancer in night shift workers, the scientists have developed general prevention program. It includes training for effective sleep, hygiene and relaxation techniques [10]. Women certainly will wait impatiently hoping for further reports on the proven methods of preventing cancer.

Written by: Edyta Sawicka- Glazer, Grzegorz Glazer

Source:
1. Bartosz Bilski: Czy praca zmianowa i nocna jest czynnikiem ryzyka choroby nowotworowej? Medycyna Pracy, 2005;56(2):175 — 178
2. Beate Pesch, Volker Harth, Sylvia Rabstein, Christian Baisch, Markus Schiffermann, Dirk Pallapies, Nadine Bonberg, Evelyn Heinze, Anne Spickenheuer, Christina Justenhoven, Hiltrud Brauch, Ute Hamann, Yon Ko, Kurt Straif, Thomas Brüning, Pesch B, Harth V, Rabstein S, Baisch C, Schiffermann M, Pallapies D, Bonberg N, Heinze E, Spickenheuer A, Justenhoven C, Brauch H, Hamann U, Ko Y, Straif K, Brüning T: Night work and breast cancer – results from the German GENICA study. Scand J Work Environ Health 2010;36(2):163–179
3. Giovanni Costa, Erhard Haus, Richard Stevens,Costa G, Haus E, Stevens R.: Shift work and cancer – considerations on rationale, mechanisms, and epidemiology. Scand J Work Environ Health. 2010;36(2):163–179.
4. Eva S. Schernhammer, Pedram Razavi, Tricia Y. Li, Abrar A. Qureshi, Jiali Han.: Rotating Night Shifts and Risk of Skin Cancer in the Nurses’ Health Study.Oxford University Press.
5. Elizabeth M. Poole1, Eva S. Schernhammer, and Shelley S. Tworoger: Rotating Night Shift Work and Risk of Ovarian Cancer. Cancer Epidemiol Biomarkers Prev 2011;20:934-938.
6. Jens Peter Bonde, Johnni Hansen, Henrik A Kolstad, Sigurd, Mikkelsen, Jørgen H Olsen, David E Blask, Mikko Härmä, Helge Kjuus, Harry J de Koning, Jørn Olsen, Morten Møller, Eva S Schernhammer, Richard G Stevens, Thorbjörn Åkerstedt: Work at night and breast cancer – report on evidence-based options for preventive actions. Scand J Work Environ Health. 2012;38(4):380–390.
7. Akila N. Viswanathan, Susan E. Hankinson, and Eva S. Schernhammer: Night Shift Work and the Risk of Endometrial Cancer. Cancer Res 2007;67:10618-10622.
8. Jennifer L. Marino1,2, Victoria L. Holt1,2, Chu Chen1,2, and Scott Davis1,2: Shift work, hCLOCK T3111C polymorphism, and endometriosis risk. Epidemiology. 2008; 19(3): 477–484.
9. Tuuli A. Lahti, Timo Partonen, Pentti Kyyr€onen, Timo Kauppinen and Eero Pukkala: Night-time work predisposes to non-Hodgkin lymphoma.Int. J. Cancer: 123, 2148–2151
10. Kneginja Richter & Jens Acker & Nikola Kamcev & Stojan Bajraktarov & Anja Piehl & Guenter Niklewski: Recommendations for the prevention of breast cancer in shift workers.EPMA Journal (2011) 2:351–356
11. Parveen Bhatti,Kara L Cushing-Haugen, Kristine G Wicklund, Jennifer A Doherty, Mary Anne Rossing: Nightshift work and risk of ovarian cancer. Occup Environ Med 2013;70:231-237.
12. Brudnowska J, Pepłońska B.: Night shift work and cancer risk: a literature review.Med Pr. 2011;62(3):323-38.
13. Davis S, Mirick DK, Chen C, Stanczyk FZ. Night shift work and hormone levels in women. Cancer Epidemiol Biomarkers Prev. 2012 Apr;21(4):609-18.
14. Lara G. Sigurdardottir, Unnur A. Valdimarsdottir, Katja Fall, Jennifer R. Rider, Steven W. Lockley, Eva S. Schernhammer, and Lorelei A. Mucci: Circadian Disruption, Sleep Loss and Prostate Cancer Risk: A Systematic Review of Epidemiological Studies. Cancer Epidemiol Biomarkers Prev
15. Hansen J, Lassen CF: Nested case-control study of night shift work and breast cancer risk among women in the Danish military. Occup Environ Med. 2012;69(8):551-6.

Would You like to know more? Watch on MEdtube.net: Cancer – treatment

]]> http://medtube.net/tribune/shift-work-and-cancer-risk/feed/ 0 Bioteeth instead of implants? Biotechnological miracle of natural teeth replacement http://medtube.net/tribune/bioteeth-instead-of-implants-bitechnological-miracle-of-natural-teeth-replacement/ http://medtube.net/tribune/bioteeth-instead-of-implants-bitechnological-miracle-of-natural-teeth-replacement/#comments Sun, 31 Mar 2013 18:04:06 +0000 yezryy http://medtube.net/tribune/?p=1873 Crocodile teeth grow continuously throughout the animal’s life. When a bad tooth falls out, a new one grows immediately in its place. This phenomenon has inspired scientists to look for a new breed of human laboratory-grown teeth. So far, the success could already be claimed by a number of research groups over the globe. The results of the experiments however did not give a hope for the use of this phenomenal approach in the dental clinics in a large-scale. King’s College in London, however, has set an important milestone on the way to the true immortality of our smile.

Dental implants despite their many advantages, are still not a completely perfect solution for replacing the missing teeth. The whole treatment is long and expensive. Numerous local and general health contradictions contribute to the rejection of this type of a treatment for a wide range of patients. Insufficient quantity or a questionable quality of the bone complicates the implant treatment by adding extra surgeries and postpones the final outcome. Problematic “pink aesthetics” in the anterior region as a result of advancing gum recession, graying of gums due to the visibility of titanium under the translucent soft tissue, alveolar loss in the area of the missing teeth, and a progressive resorption of the bone surrounding the implants – all these drawbacks are not entirely unacceptable, but they provoke the search for even better solutions. Until now, it was claimed that there is no better treatment to get a full dental arch than implantoprosthetic treatment. With a high sucess rate, it allows the suregons to add the missing teeth by the use of implants -the most functionally comparable to the natural teeth artificial structures. Implantologists praise the treatment of this type, however, is there anything that could be better than natural teeth?

The answer is: no. Researchers from King’s College in London have found a way to restore our own natural teeth roots, without having to worry about the aesthetics of the gums, as in the case of implants. Producing “bio-teeth” using stem cells in the laboratory is not a novelty. So far the stem cells have been harvested from the embrionic teeth -such as the third molars that are not fully developed untill the age of 17 to 25. Obtaining the cells starts being problematic after the permanent teeth had fully grown. The failure of the stem cell harvest in older individuals has cast a shadow upon this phenomenal discovery, and the treatement appeared not to be applicable in daily practice. A team of researchers under the supervision of Professor Paul Sharpe has found out that epithelial cells taken from the gingiva of adult patients, combined with mesenchymal cells of laboratory mice, after the implantation into the rodet’s bodies, can produce natural teeth. Hybrid teeth formed in this process include both the enamel and the dentin as well as the entire structure of the root. Studies have shown that epithelial cells derived from adult human gingiva are able to respond to signals provided by the stem cells of mice, in a manner that allows proper developement and organisation of the crown and root cells, giving a hope for an extensive use of this discovery in the future . The next step in the research of teeth breeding is to identify the culture of mesenchymal stem cells in the adult human body, which will be able to induce the formation of human teeth in the laboratory. So far only embryonic mesenchymal cells are capable of such an induction, but researchers do not lose their enthusiasm and hope for a quick and positive progression of the research.



Written by: Maria Bilińska




Source:
1. http://www.implantoprotetyka.net.pl/
2. The research was funded by the UK National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, UK.
Adult Human Gingival Epithelial Cells as a Source for Whole-tooth Bioengineering Journal of Dental Research 2013, Kings College London

Would You like to know more? Watch on MEDtube.net: How to prepare alveolar bone for implantation after tooth extraction

]]> http://medtube.net/tribune/bioteeth-instead-of-implants-bitechnological-miracle-of-natural-teeth-replacement/feed/ 0 Implantation of first cyberarm http://medtube.net/tribune/implantation-of-first-cyberarm/ http://medtube.net/tribune/implantation-of-first-cyberarm/#comments Sun, 24 Mar 2013 12:17:32 +0000 yezryy http://medtube.net/tribune/?p=1862 For the first time an implantation of muscle and nerve controlled arm prosthesis was conducted at Sahlgrenska University Hospital in Gothenburg (Sweden). The arm prosthesis is attached permanently using electrodes and nerves of an amputee. The result is that the control of an advanced robotic prosthetic improved and similar to the pattern of movement of a human arm.

There have been two major issues on the advancement of robotic prostheses: 1) how to firmly attach an artificial limb to the human body; 2) how to intuitively and efficiently control the prosthesis in order to be truly useful and regain lost functionality.

A surgical team led by Dr Rickard Brånemark created the solution by combining a bone anchored prosthesis with implanted electrodes. A titanium screw, so-called osseointegrated implant, is used to anchor the prosthesis directly to the stump, which provides many advantages over a traditionally used socket prosthesis.

Osseointegration is a direct connection between a living bone and the surface of the implant. The oxygen content in the bone tissue creates a layer of titanium dioxide on the surface of a specially prepared implant so that a new bone tissue can be deposited on that layer.

In existing prostheses, amputees use only visual or auditory feedback. This means, for example, that you have to look at or hear the motors in the prosthesis in order to estimate the grip force applied to a cup if you want to move it around. With the new method, patients receive feedback as the electrodes stimulate the neural pathways to the patient’s brain, in the same way as the physiological system. This means that the patient can control his or her prosthesis in a more natural and intuitive way. This has not been possible previously.

By using implanted electrodes, rather than electrodes positioned on the skin, more signals can be retrieved and therefore more movement control is possible. It is also possible to provide the patient with feeling through neural stimulation.

The first patient to be treated with this technology was a prior robotic hand user who had reported major difficulties in operating that device in cold and hot environments and interference from shoulder muscles. These issues have now disappeared thanks to the new system, and the patient has reported that almost no effort is required to generate control signals. Moreover, tests have shown that more movements may be performed in a coordinated way, and that several movements can be performed simultaneously.

“The next step will be to test electrical stimulation of nerves to see if the patient can sense environmental stimuli, that is, get an artificial sensation. The ultimate goal is to make a more natural way to replace a lost limb, to improve the quality of life for people with amputations” says Rickard Brånemark.

The new arm protesis allows complete degree of motion for the patient, fewer skin related problems and a more natural feeling that the prosthesis is part of the body. Overall, it brings better quality of life to people who are amputees. “We believe that implanted electrodes, together with a long-term stable human-machine interface provided by the osseointegrated implant, is a breakthrough that will pave the way for a new era in limb replacement” says Rickard Brånemark.The new arm protesis allows complete degree of motion for the patient, fewer skin related problems and a more natural feeling that the prosthesis is part of the body. Overall, it brings better quality of life to people who are amputees. “We believe that implanted electrodes, together with a long-term stable human-machine interface provided by the osseointegrated implant, is a breakthrough that will pave the way for a new era in limb replacement” says Rickard Brånemark.



Written by: Sunnidaley Mafa MD

Source:
1. http://www.chalmers.se/en/news/Pages/World-premiere-of-muscle-and-nerve-controlled-arm-prosthesis.aspx
2. http://giznet.pl/pierwsza-cyberreka-gotowa-do-wszczepienia/
3. http://www.oandp.com/articles/NEWS_2013-02-22_01.asp

Would you like to know more? Watch on MEdtube.net: Prosthesis Of Scapula Radical Removal Due To Sarcoma Of The Ewing – Part 1

]]> http://medtube.net/tribune/implantation-of-first-cyberarm/feed/ 0 What could be left in children’s psychic after neoplasm? http://medtube.net/tribune/what-could-be-left-in-childrens-psychic-after-neoplasm/ http://medtube.net/tribune/what-could-be-left-in-childrens-psychic-after-neoplasm/#comments Mon, 18 Mar 2013 21:17:54 +0000 yezryy http://medtube.net/tribune/?p=1856 The oncologically affected children are only 1 % of the whole oncologic patients. Comforting is the fact that up to 80% of the young patients may recover from neoplasm(1), however, it is widely known that the disease will influence their lives. It is worth remembering because these adults will need a slightly different internal medicine care and especially psychological support due to the fact that so serious event in their life leaves not only physical, but also mental trace. The even better development of medicine and oncologic therapy is the reason why more and more medicine practitioners will meet such patients in their work.

The oncologic treatment is very intensive and has a lot of side effects which can be divided into early and late. According to the report of National Cancer Policy Board from 2003,(2) 2/3 of the young patients are affected by the late side effects of therapy, and in 25% of them they can be very intensive or life-threatening. Depending on applied treatment schema, ailments of all human systems may appear.

A child who had experienced long hospital treatment and painful and persistent therapy may have psychological problems. In the 80s it was observed, that oncologic patients are more prone to mental problems,(4) however, there were observations which gave totally opposite results. (5) Because of such serious experiences a lot of patients are more vulnerable to syndrome similar to post traumatic stress disorder. Especially liable are older teenagers who are in double stress situation – the disease and growing up from the cheerful childhood to maturity. The severity of the disease and intensity of the treatment may have an influence on the subsequent behavioural disorders in some of the patients.

There are papers which prove that oncologic patients have higher predispositions to depression, anxiety disorders, and society adaptation difficulties. However, it is not unquestionable because at the same time there are authors who claim that these patients have identical susceptibility for psychical disorders as normal society, or even are more socially adapted than healthy people. All of this theories are not authoritative because if personality and behaviour are concerned, there are no fixed standards according to which it would be possible to assess every human being.(3)

The post-neoplasm patients may have problems with remembering new things and they are slightly nervous. According to one of the study 85% of the patients confirm such problems but simultaneously 94% of the same research group think that they are better people because of the neoplasm experience. (3)

One of the understandable reasons why the patients after neoplastic disease have huge problems with adaptation to society and depression is often their lower education level. It is evident that they could not attend school with their peers. The patients after brain radiation therapy may have specific problems since they often have the greatest difficulties with cognitive functions what makes harder not only education, but also everyday life.(3)

Unfortunately, not in every case the proverb “what doesn’t kill you, makes you stronger” is true. That is why on the one hand the young patients should be admired for defeating such a strong enemy but on the other, they should be watched closely all the time in order to react in time and give them appropriate help.



Written by: Magdalena Chorążka




Source:
1. http://www.wydawnictwo-apis.pl/artykuly/nowotdz.htm
2. http://www.nap.edu/openbook.php?record_id=10767&page=49
3. Wiener L, Battles H, et al. Persistent psychological distress in long-term survivors of pediatric sarcoma: the experience at a single institution. Psychooncology. 2006 October ; 15(10): 898–910.
4. Moore I, Glasser M, Ablin A. The late psychosocial consequences of childhood cancer. J Ped Nurs 1987;3:150–158
5. Gray RE, Doan BD, Shermer P, et al. Surviving childhood cancer: a descriptive approach to understanding the impact of life-threatening illness. Psycho-Oncology 1992;1:235–245.

Would You like to know more? Watch on MEDtube.net: Osteoma Radioablation

]]> http://medtube.net/tribune/what-could-be-left-in-childrens-psychic-after-neoplasm/feed/ 0 Primary cutaneous lymphomas – diagnostics and treatment http://medtube.net/tribune/primary-cutaneous-lymphomas-diagnostics-and-treatment/ http://medtube.net/tribune/primary-cutaneous-lymphomas-diagnostics-and-treatment/#comments Thu, 14 Mar 2013 20:24:00 +0000 yezryy http://medtube.net/tribune/?p=1851 Lymphomas are the malignant cancers of lymphatic system which involve mainly lymph nodes. However, they can also develop in many other organs such as the skin. By the primary cutaneous lymphomas we understand the processes, which for minimum 6 months since they have been diagnosed, are limited only to the skin. They also are not the effect of secondary generalization of systemic lymphomas. The most common diseases units are Mycosis fungoides (MF) and Sézary syndrome (SS).

Mycosis fungoides appears in about 50% of all cases of primary cutaneous lymphomas. To the symptoms of MF we can include skin lesions with a heterogeneous course hence there are three phases of this disease. In the initial period erythematosus lesions occur. The second period is an infiltrative one in which flat, inflammatory infiltrations within erythematosus lesions prevail. The last period – called knobbly – is characterized by livid tumors with a tendency to ulceration within infiltrations or in clinically unchanged skin. Another typical symptom is pruritus appearing just after the initial period and escalating with the progress of the disease. Mycosis fungoides is of persistent course and the patients are in a good general condition in early stages of the disease.

Sézary syndrome is characterized by a triad of symptoms: erythroderma, generalized lymphadenopathy and the presence of atypical lymphocyte, nuclei of which looks like a brain (Sézary cells). We can find the Sézary cells in the skin, blood and lymph nodes. In the course of SS the skin is thickened, inflamed and severe pruritus occur. Additional symptoms are alopecia, hyperkeratosis of hands and feet, onychodystrophy.

Diagnostics and treatment of primary cutaneous lymphomas is an interdisciplinary issue in which dermatologists, oncologists, hematologists and pathomorfologists should be involved. Diagnostic future is based on tumor cell phenotyping. Studies conducted in Medical University of Gdańsk showed the usefulness of testing CD26 antigen expression in differentiating late and less advanced form of mycosis fungoides, Sézary syndrome and dermatosis. Assessment of losing CD26 antigen on CD4+ and CTL+ cells is more sensitive and specific method than assessment of losing CD7 antigen on the same cells. This method, because of its high usefulness and relatively low cost of implementation, was recognized as obligatory in differential diagnosis and in assessment of severity of primary cutaneous lymphomas deriving from T cells(5). Recent studies, which were conducted by scientist at the University of London, showed the presence of PLS3 (T-plastin) expression on lymphocytes in patients witch SS. PLS3 is a protein which is normally present in epithelial cells but is not observed in hematopoietic cells. Interestingly, scientists found the connection between the acquisition of PLS3 protein to the cells and simultaneous loss of CD26 antigen(6).
In the literature there is a lot of information about new therapeutic procedures and medicaments. Recently, results of the first phase of clinical trial which involved treating people suffering from MF with two medicaments: O6-benzylguanine in combination with topical carmustine have been published. The research showed that this combination is well tolerated by the patients and shows satisfactory clinical results when carmustine treatment doses are reduced (7).

In case of treating SS a mention of extracorporeal photopheresis, which should be used as the first-choice “drug” in this disease, appeared. Photopheresis is a method in which blood is treated with photoactivatable drugs, then lymphocytes are separated from the blood and extracorporeally activated with the use of ultraviolet light (UVA). This treatment has response rate of 30%–80% and complete remission rate of 14%–25%.

Actively conducted research allows for faster diagnosis and more effective treatment. Implementation of new diagnostic possibilities in Poland is not a big problem. Unfortunately, in the case of treatment due to financial cut downs and limited availability of new medicines we have to wait for the implementation of new methods.

Written by: Martyna Pyka

Source:
1. R. Willemze. Primary cutaneous lymphomas. Annals of Oncology, 2011; 22 (Suppl. 4): iv72-iv75.
2. A.Jankowska-Konsur, A.Batycka- Baran, J.Maj. Diagnostic and classification of Mycosis fungoides and Sezary syndrome.Dermatologia kliniczna 2008, 10(3):166-170.
3. R. Willemze. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2010 2:1 (suppl 5): v177-v180.
4. W. Kempf, C.A.Sander. Classification of cutaneous lympfomas- an update. Histopathology 2010, 56: 57-70.
5. M. Sokołowska- Wojdyło.Rola chemokin, ich receptorów i antygenu CD26 w diagnostyce ziarniniaka grzybiastego i zespołu Sezary`ego- przyczynek do patogenezy chłoniaków pierwotnych skóry.
6. Olsen EA, Rook AH, Zic J,et al . Sézary syndrome: immunopathogenesis, literature review of therapeutic options, and recommendations for therapy by the United States Cutaneous Lymphoma Consortium (USCLC). J Am Acad Dermatol 2011;64:352-404
7. Phase I clinical trial of O6-benzylguanine and topical carmustine in the treatment of cutaneous T-cell lymphoma, mycosis fungoides type.

Would You like to know more? Watch on MEDtube.net: Diffuse large B-cell lymphoma – Histopathology of pre-sacral mass

]]> http://medtube.net/tribune/primary-cutaneous-lymphomas-diagnostics-and-treatment/feed/ 0 Impaired metabolism of polyamines in Parkinson’s disease as a potential target of the modern drug therapy http://medtube.net/tribune/impaired-metabolism-of-polyamines-in-parkinsons-disease-as-a-potential-target-of-the-modern-drug-therapy/ http://medtube.net/tribune/impaired-metabolism-of-polyamines-in-parkinsons-disease-as-a-potential-target-of-the-modern-drug-therapy/#comments Mon, 11 Mar 2013 21:09:06 +0000 yezryy http://medtube.net/tribune/?p=1848 Parkinson’s disease (PD) is a disorder belonging to a large group of neurodegenerative diseases. One of the features of most of these disorders of the central nervous system (CNS) is the unknown pathogenesis. The same applies to PD. Recent studies show that abnormal polyamine biochemical changes in the CNS may cause neurotoxicity responsible for the development of PD.

PD has several characteristics that allow for establishing the probable diagnosis. These include bradykinesia (slowness of movements), rigidity, and tremor. Progressive degenerative damages in the CNS, mainly in the substantia nigra that produces dopamine, cause deterioration of the patient’s state and increase the degree of disability. Drugs currently used act only on the symptoms of the disease, but do not modify its course (1).

The potential role of abnormalities in the metabolism of polyamines (organic compounds containing amino groups) may meet expectations of more effective therapies in PD. In one of the most comprehensive works on the participation of polyamines in the pathogenesis of PD it is stated that in the brainstem of patients with PD the activity of an enzyme involved in the catabolism of polyamines SAT1 (called spermidine / spermine N1-acetyltransferase 1) is reduced. While studying yeast, Lewandowski et al. found that polyamines increase the toxicity of alpha-synuclein (protein deposits which are present in the neuropathology of PD). However, the histopathology in mice showed that inhibition of SAT1 activity resulted in worse neuropathological image with more inclusions of alpha-synuclein and the progression of the disease. In addition, an unique variant of SAT1 gene, which was absent in the control group, was discovered in patients with PD. The study of yeast, mice and the patients reveals that there is a link between the concentration of polyamines and the PD prevalence (2).

In another work, Antony et al. noted a similar relationship for the presence of polyamines and their effects on aggregation, fibrillization of alpha-synuclein and the pace of these phenomena occurrence. In an environment devoid of polyamines alpha-synuclein deposits were less abundant, almost no aggregation took place (3).

Other studies have tried to focus on quantifying the concentration of polyamines in body fluids of patients with PD. Paik et al. showed that the concentration of polyamines in the cerebrospinal fluid of patients with PD (as well as those with multisystem atrophy) was statistically higher in comparison with the control group (4). In turn, Gomes-Trolin et al. in their project have indicated that the concentration of polyamines related to red blood cells was higher in patients with PD and in patients with amyotrophic lateral sclerosis as well (5).

The results suggest that polyamines have a potential role as a PD risk factor. There are ongoing experiments which try to determine whether the drugs modifying concentration of polyamines could have some influence on the course of PD and whether they effectively cross the blood-brain barrier. If it is possible to confirm the clinical value of this therapy, patients with PD could benefit from the treatment affecting not only the symptoms, but also the cause of the disease.



Written by: Kamil Chorążka

Source:
1. Kozubski W, Liberski PP. Neurologia. Podręcznik dla studentów medycyny. Warszawa 2006. PZWL.
2. Lewandowski NM, Ju S, Verbitsky M, Ross B, Geddie ML, Rockenstein E, Adame A, Muhammad A, Vonsattel JP, Ringe D, Cote L, Lindquist S, Masliah E, Petsko GA, Marder K, Clark LN, Small SA. Polyamine pathway contributes to the pathogenesis of Parkinson disease. Proc Natl Acad Sci U S A. 2010 Sep 28;107(39):16970-5. doi: 10.1073/pnas.1011751107. Epub 2010 Sep 13.
3. Antony T, Hoyer W, Cherny D, Heim G, Jovin TM, Subramaniam V. Cellular polyamines promote the aggregation of alpha-synuclein. J Biol Chem. 2003 Jan 31;278(5):3235-40. Epub 2002 Nov 14.
4. Paik MJ, Ahn YH, Lee PH, Kang H, Park CB, Choi S, Lee G. Polyamine patterns in the cerebrospinal fluid of patients with Parkinson’s disease and multiple system atrophy. Clin Chim Acta. 2010 Oct 9;411(19-20):1532-5. doi: 10.1016/j.cca.2010.05.034. Epub 2010 Jun 1.
5. Gomes-Trolin C, Nygren I, Aquilonius SM, Askmark H. Increased red blood cell polyamines in ALS and Parkinson’s disease. Exp Neurol. 2002 Oct;177(2):515-20.

Would you like to know more? Watch on MEDtube.net: Parkinson’s Disease – Laryngeal Tremors

]]> http://medtube.net/tribune/impaired-metabolism-of-polyamines-in-parkinsons-disease-as-a-potential-target-of-the-modern-drug-therapy/feed/ 0 New ketogenic diet and epilepsy http://medtube.net/tribune/new-ketogenic-diet-and-epilepsy/ http://medtube.net/tribune/new-ketogenic-diet-and-epilepsy/#comments Mon, 04 Mar 2013 22:23:57 +0000 yezryy http://medtube.net/tribune/?p=1843 Using diet for medicinal purposes has been known since the beginnings of medicine. Due to the lack of other methods, diet was also used in epilepsy treatment. The ketogenic diet has been used for over 80 years and it is quite effective. Even though pharmacological treatment of epilepsy is widely available nowadays, not every child with epilepsy responds well enough to it. This is the reason for the growing interest in ketogenic diet (KD).

Starvation diet as a treatment has been known for centuries. It was used by Chinese, Tibetan, Persian, Babylonian, Arab, Jewish, Greek and Romanian medics. Even Hippocrates, the father of medicine, recommended fast to his patients until they see the first symptoms of health. Galen, a Roman doctor, said that restraining oneself from eating from time to time helps to cleanse the whole body. The Arab scholar, Avicenna, who was an author of the treatise which was the foundation of European medicine for many centuries, claimed that starvation diet is one of the most important therapeutic methods. This diet was also used in epilepsy treatment as there were no any other ways to treat it. Rafael Santi on his unfinished painting titled “Transfiguration” depicts the biblical scenes described in The Gospel According to Mark, when Jesus says: “It can be thrown away only by means of prayer and starvation” and he must have been talking about epilepsy. In the nineteenth century when pharmacological treatment was based on using phenobarbitals or bromides, and surgical treatment was very rare, the idea of treating epilepsy by means of diet was very popular among scientists and doctors [1].

Nowadays, a few kinds of ketogenic diet are known. The so-called “classic” ketogenic diet is the most popular. It is based on long-chain fatty acids. In the 1950s a new kind of diet was invented. It was based on medium-chain fatty acids and it produced a bigger ketosis. However, it is rarely used as it causes intestinal disorders and it is not well tolerated by patients. Ketosis became less popular in epilepsy treatment in the 1930s. Instead, the doctors started using some new forms of phenytoin therapy. These new methods became more easier to apply than a diet. Treating epilepsy by means of pharmaceuticals became the main subject of research and the only form of therapy until the 1990s. Despite the obvious success of ketogenic diet, it was rarely used. The lack of experienced doctors and nutritionists levelled its therapeutical effects significantly. It was believed that it is too rigorous, tasteless and that it complicates patients’ everyday life [1,4].

Currently, despite the huge success of pharmacotherapy of epilepsy, ketogenic diet is one of the most effective ways to treat epilepsy. The interest in the diet increased due to the possibility of treatment of drug-resistant epilepsy and the forms of epilepsy which occur in children such as West, Lennox-Gastaut and Dravet syndromes. Despite clinical data about the effectiveness of the ketogenic diet, its mechanism is not fully known. Simon Eaton, a biochemist from the Institute of Child Health, presented a number of ideas connected with the “classic” ketogenic diet. According to his ideas, the state of ketosis is responsible for equalization of amino acid disorders, changes in the nerve cells (which can reduce neural excitability and therefore work against epilepsy), regulation of the genes, and the acidification in central nervous system. In 1998 the biggest research on the ketogenic diet confirmed its effectiveness. Freeman, an author of the research, analyzed the impact of ketogenic diet on the reduction of epileptic seizures in 150 children (from 4 months-old to 16 years-old). Before the treatment the children had approximately 410 seizures a month. After 6-12 months of the diet about half of them had only 50% of the previous number of fits. In some cases, ketogenic diet contributed also to the reduction of doses or to complete resignation from the antiepileptic drugs. Nowadays, despite the huge progress in pharmacotherapy of epilepsy, the ketogenic diet is still a way of treating it [1,5].

Written by: Anna Brończyk-Puzoń

Source:
1. Chorągwiewicz T., Żarnowska I., Gąsior M. i wsp. Anticonvulsant and neuroprotective effects of the ketogenic diet. Przegląd Lekarski 2010; 67, 3, 205-2012.
2. Conklin H.W. Cause and treatment of epilepsy. Jam. Osteopatic. Assoc. 1922; 26, 11.
3. Wilder R.M. The effect of ketonemia on course of epilepsy. Mayo Clin. Proc. 1921; 2, 307.
4. Huttenlocher P.R. Wilbourn A.J. Signore J.M. Medium-chain triglicerides as a therapy for intractable childhood epilepsy. Neurology 1971; 21, 1097
5. Starbała A. Bawa H. S. The Role of the ketogenic diet in the management of epilepsy. ROCZN. PZH 2007; 58, 1-6, 139-143.

Would You like to know more? Watch on MEDtube.net: Brain signals – 3D Medical Animation

]]> http://medtube.net/tribune/new-ketogenic-diet-and-epilepsy/feed/ 0 Dental implants for people with significant bone loss and osteoporosis http://medtube.net/tribune/dental-implants-for-people-with-significant-bone-loss-and-osteoporosis/ http://medtube.net/tribune/dental-implants-for-people-with-significant-bone-loss-and-osteoporosis/#comments Thu, 28 Feb 2013 22:40:15 +0000 yezryy http://medtube.net/tribune/?p=1840 Dental implant treatment is becoming more popular around the world, often replacing traditional prosthetic treatment. Dental implant market is growing rapidly. Unfortunately, for some patients this treatment is not available due to systemic and local contraindications. With the discovery of the Universitat Jaume I scientists in Castellón comes a great oportunity for a group of patients who have been refused a dental implant treatment before.

The twenty-first century has brought us to a raised awareness of the power of a beautiful smile-patients are increasingly willing to spend larger amounts of money on aesthetics and dental health. Implantology has evolved significantly over the last 25 years -the modern methods of placing implants are less problematic, increasing competition in the market, brings the treatment prices to a more affordable level for potential patients, the success rate of implantprosthetic treatment already reached 95%. Implantology shyly enters the medical universities to become part of the mandatory program for students of dentistry and is more boldly rooted in the consciousness of society as a treatment option of choice. The treatment duration was also significantly shortened -the multi-step protocol, which takes several months is more often replaced by a one-step protocol, also an immediate load of implants is beginning to become a standard procedure. It has been found that an immediate loading does not impair the formation and mineralization of bone tissue in the direct surrounding of the implant during osseointegration. All these elements contribute to the growing success of implant-based restorations.

However wonderful and flawless dental implant therapy seems, there is a wide range of patients for whom therapy is not possible. Among the contraindications to consider before starting the treatment are systemic diseases such as cardiovascular disease and hematologic disorders, immune deficiencies, chemotherapy, diabetes, advanced osteoporosis.
Locally, one may find that the bone intended for the implant treatment is of insufficient thickness or width and the augmentation of the area is not possible. Until now, patients with this kind of a problem were excluded from the treatment as their bone was not able to accept and integrate the dental implant. Researchers at the Universitat Jaume I created a biodegradable coating for implants, designed to improve osseointegration in patients with bone deficiency.

Up to now, titanium implants needed a few months for a proper osseointegration. Thanks to the experimentally used additional layer on the implants in Spain, this period is getting shorter. The researchers used a Sol-Gel method based on the properties of alkoxides, which under the influence of water, acid or catalyst and silanes form a network of SiO 2. When using metal alkoxides with organic chains, it is possible to obtain an organic-inorganic layer, ideal for the coating of metal layers – in this case, titanium, leading to improved biocompatibility, bioactivity and tissue integration. With the help of this technology enzymes, antibodies, and proteins favorable for the integration of the implant can also be transported to the bone. Biodegradable film during its decomposition in the bone liberates silicon particles of the material and other biologically active molecules which increase bone generation. “Soldent” properties have been laboratory confirmed in vitro and during the tests on animals – the next step will be clinical trials that are likely to enable the introduction of the product to the market in two to three years.

The possibility of even more perfect integration of implants, while supporting bone formation has so far seemed to be unrealistic. The results of the tests show that in a few years time we will observe a huge breakthrough in the field of implantology. Clinical studies will undoubtedly provide valuable information soon.



Written by: Maria Bilińska




Source:
1. http://www.uji.es/ES/noticies/detall&id_a=31293315
2. http://pimaresearch.wix.com/group#!soldent/c1n5o
3. http://www.dentaleconomics.com/articles/print/volume-100/issue-12/features/trends-in-implant-dentistry.html

Would You like to know more? Watch on MEDtube.net: Reconstruction Of Bone – Intra-Bone Implant

]]> http://medtube.net/tribune/dental-implants-for-people-with-significant-bone-loss-and-osteoporosis/feed/ 0 Organs from the printer http://medtube.net/tribune/organs-from-the-printer/ http://medtube.net/tribune/organs-from-the-printer/#comments Sat, 23 Feb 2013 18:59:40 +0000 yezryy http://medtube.net/tribune/?p=1837 Modern sciences – such as medicine and technology are developing at a very fast pace. The result of this development is the emergence of ever new devices, tools and techniques. The purpose of these inventions is to support not only the work of scientists and experimenters, but also practitioners. This development is so fast that things which a few years ago seemed like a pure abstraction are common now, and in some cases even commonly used in clinical practice. One of the latest techniques are 3D bioprinters.

Bioprinters are also referred to as organ printers because of the use of 3D technology which allows to create objects solely on the basis of a model that is stored in a computer program. When choosing the appropriate material, which will serve as the ink, it is possible to print almost any object.

The first printer of this type already exists. The inventors are employees of Biomedical Invetech. The 3D printer was delivered to Ogranovo, the company which is now a pioneer in the field of bio-technology printing. The printer at this stage can “print” the arteries and cartilage, and according to the experts bypass “printed” on the bio printers can be implanted in patients in the time of five years. A little longer (about ten years) we will have to wait for other much more complex structures and organs (heart, liver, bones).

The printer is equipped with two print heads which job is to put the target cells in the right place and to introduce supporting material. This material can be either collagen, growth factor or a hydrogel. This printer even has the incredible precision of up to micrometers and owing to a specially developed software “printed” tissues or organs are exactly of the expected parameters.

Currently, very first experiments with 3D bioprinters are conducted. These experiments relate to both the supporting material (research by dr Anna Gutowska of Pacific Northwest National Labolatory Richland), and the use of printers (i.a. research conducted at the Wakw Forest Medical University in the United States, the study conducted by a team of prof. Barralet Jake at McGill University in Montreal, the study conducted by a team of prof. Jeremy Mao of Columbia University or research team led by prof. Atali Anthony of Wake Forest University).

Bioprinters 3D allowing for tissues and whole organs printing may soon be a breakthrough in medicine, especially in transplantation and tissue engineering. Owing to them, the most important problems in those two fields can be solved now. First of all, the ability to “print” organs and tissues can solve the problem of waiting for a transplant. Currently this time, particularly in certain cases, is very long. In addition, organ formation in such devices with the use of live cells from the recipient organism may to a very large extent minimize and even eliminate the risk of rejection of the transplanted organ. Though bioprinters may seem like a fiction, they are a real chance for hundreds or even thousands of patients.



Written by: Sandra Kryśka, Mateusz Grajek, Anna Rej


Source:
1. http://pogodawpolsce.bloog.pl/id,332542739,title,BIODRUKARKI-MOGA-WKROTCE-ZREWOLUCJONIZOWAC-IMPLANTOLOGIE,index.html?ticaid=61002f
2. http://www.inzynieria-biomedyczna.com.pl/biomaterialy/180-biodrukarki-spojrzenie-na-transplantologie.html
3. http://dolinabiotechnologiczna.pl/nowosci/biodrukarka-3d-%E2%80%94-technologia-przyszlosci-w-terazniejszosci/
4. http://odkrywcy.pl/kat,111398,title,Biodrukarki-zbuduja-nowe-organy-i-kotlety,wid,15280092,wiadomosc.html?smg4sticaid=61002f

Would You like to now more? Watch on MEDtube.net: Human Cardiovascular System, Diseases And Heart Transplantation

]]> http://medtube.net/tribune/organs-from-the-printer/feed/ 0 The frailty syndrome – there are more and more such patients http://medtube.net/tribune/the-frailty-syndrome-there-are-more-and-more-such-patients/ http://medtube.net/tribune/the-frailty-syndrome-there-are-more-and-more-such-patients/#comments Sun, 17 Feb 2013 14:00:07 +0000 yezryy http://medtube.net/tribune/?p=1832 Owing to the fact that societies are ageing, especially in industrialized countries, the number of geriatric patients to whom we should pay special attention increases. It was noticed long time ago that not the metrical but the biological age is significant to asses condition and prognosis of the patients. That’s why a scale called Clinical Frailty Scale (CFS) was developed. After describing the co-existent diseases and disability or impairment of cognitive functions, it allows for assessment of the biological age of the patient.

The frailty syndrome is associated with depletion of strength reserves not only as a result of accumulation of various diseases, stress reactions, misbalance of internal homeostasis, processes in the organism, but also environmental influence on human. The patients lose energy, physical fitness, cognitive abilities, and health.

There are various methods used to diagnose the frailty syndrome. One of the most important is to confirm 3 of 5 criteria such as: unintentional weight loss (more than 5 kg/year), coptosis, weakness (low grip strength), slowed walking speed, low physical activity. (1) Another way is to summarize different disabilities and weaknesses but it is of low clinical value. Inference on the basis of medical interview and physical examination has a huge clinical significance. Owing to the correct assessment of the frailty level there are more chances to accurately evaluate risk and choose appropriate therapy.

After observation of the patients over the age of 65 in study groups CSHA-1 and CSHA-2 (each study lasted 5 years) Canadian researchers divided the patients into 7 groups (1-7). Group 1 consisted of the fittest patients. The age, gender and level of education were also taken into account to predict the length of the patient’s life. It turned out that women and elderly people were more frequently assigned to the groups with higher risk of death. (2)

Currently there are 9 groups of elderly people according to their fitness level. (3). The first group are “very fit” patients who are active, vigorous, and they do sports regularly. Group number 2 described as “well’ are people who don’t have active disease symptoms but they are not so active and they do sport occasionally. In group 3 were the “managing well” patients who are ill but they are under medical control, their sport activity is limited to walking. Another group – 4 are the vulnerable patients and although they are independent, their afflictions limit their daily routine and they complain because of slowdown and fatigue. The 5th group is described as „mildly frail” and consists of the patients who cannot cope with housework, finances, transportation, treatment, and over time they need help in shopping, going outside, and meal preparation. Group number 6 are “moderately frail” patients who need help in every activity concerning going out and housekeeping, they may have problems with walking up the stairs, bathing, they need support in getting dressed. The “severely frail” people are group 7 and they are completely dependent on others in everything because of mental impairment or physical disability, they have high risk of death (in about 6 months). “Very severely frail” are described as group 8 and they are also completely dependent on others in upcoming end of their life. Even minor illness could be fatal for them. The last, number 9 group, are “terminally ill” patients. Their life expectancy is less than 6 months but they have no other symptoms of frail.

Also the dement people can be divided in 3 frail groups. When the patients have problems with recent memory but they are still aware who they are even when socially withdrawn it is described as mild dementia. Recent memory is very impaired in moderate dementia. However the patients can remember events from the past life very well, they need care consisting in controlling, exhorting and prompting them. The patients with severe dementia should be assisted in every activity.

The assessment of frailty level can be used in a lot of medical specializations in case of treatment of elderly patients. It is very helpful in diagnosis of the cardiological risk in the patients after STEMI and also in other medical cases. (5) The fitness seems to have an influence on improvement of frailty status. (6) Criteria of frailty severity assessment are quite clear. Owing to them the patient’s biological age and the chances of therapy success can be evaluated easily and additionally, the appropriate treatment can be applied.



Written by: Magdalena Chorążka




Source:
1. The frailty syndrome: definition and natural history, Qian-Li Xue, PhD, Clin Geriatr Med. 2011 February; 27(1): 1–15.
2. www.ncbi.nlm.nih.gov/pmc/articles/PMC1188185/
3. http://geriatricresearch.medicine.dal.ca/pdf/Clinical%20Faily%20Scale.pdf
4. hhttp://www.ptkardio.pl/Kruchosc_nowy_czynnik_prognostyczny_u_starszych_pacjentow_z_zawalem_serca_bez_uniesienia_odcinka_ST-1702ttp://
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490887/

Would you like to know more? Watch on MEDtube.net: Fracture of the Femur

]]> http://medtube.net/tribune/the-frailty-syndrome-there-are-more-and-more-such-patients/feed/ 0 MicroRNAs in cancer therapy and diagnosis http://medtube.net/tribune/micrornas-in-cancer-therapy-and-diagnosis/ http://medtube.net/tribune/micrornas-in-cancer-therapy-and-diagnosis/#comments Sun, 10 Feb 2013 21:57:25 +0000 yezryy http://medtube.net/tribune/?p=1826 MicroRNAs are proteins non-coding RNA molecules of about 20-24 nucleotides length. Their function is to control the expression of other genes during transcription or posttranscriptionally. Distinct expression of certain classes of microRNAs in various conditions were detected, including certain types of cancer. MicroRNAs class let-7 has a function in many metabolic pathways, and their goal is the inhibition of cell proliferation. They inhibit the growth of tumors. Reduction of miRNA let-7 class in some types of tumors, such as lung cancer and breast cancer, was detected. Another type of miRNAs that can be used in cancer therapy is the miR-34. The use of miRNAs in cancer diagnosis and therapy is promising but requires further study.

MiRNA class let-7 plays an important role in oncogenesis. It has a suppressor and pro-apoptotic role. Lack of let-7 is a marker of poorly differentiated tumors. Decreased expression of let-7 has been observed in many tumor types: colon, lung, pancreatic ducts, stomach, prostate cancer as well as in malignant melanoma, leukemia, and Burkitt’s lymphoma. Let-7 is hipermethylated in epithelial ovarian cancer and lung adenocarcinoma [1].

Studies are conducted using let-7 in cancer therapy. First, with the qRT-PCR the expression level of let-7 was examined in 30 patients with small cell lung cancer. The malignant cells had let-7 expression reduced by 54-70% comparing with healthy lung cells in the same patients. A hypothesis that administration of synthetic let-7 can inhibit tumorigenesis was made.

Human lung cancer cells were transplanted to mice. Let-7 inhibited tumor growth both when it was given in a single dose just prior to transplantation, as well as when it was injected into the tumor after transplantation. Administering as a control other miRNA did not have any effect. Let-7 given to healthy cells are not toxic, in contrast to traditional chemotherapy. [2]

Another tested suppressor miRNA is miR-34. It is expressed in a reduced amount in the different types of tumors. Introduction of miR-34 to cells in vitro or in vivo inhibits tumor growth. MiR-34 increases the expression of p53, which stops the cell cycle and induces apoptosis. Given the fact that over half of cancer show abnormal expression of p53, miR-34 appears to be a promising therapy.

With qRT-PCR the expression level of miR-34 in prostate cancer cells and lung cancer cells in humans was examined. In 76% of lung cancer cases and 86% of prostate cancer cases, decreased expression level of miR-34 in comparison to normal lung and prostate cells was detected.

MiR-34 was introduced into lung cancer and prostate cancer cells in vitro. This resulted in inhibition of cell growth. With the administration of other miRNAs (negative control) cells were confluent and showed signs of apoptosis.

MiR-34 was administered intravenously to mice subcutaneously implanted with human lung cancer cells. Histopathological examination demonstrated that miR-34 inhibits tumor growth. MiR-34 was also examined in a mice model of prostate cancer that metastasize to various organs, leading to death of the animals. Thus, this model can be used to test the length of survival. It has been shown that applying miR-34 improves survival in mice, as well as decreases the number of lung metastases by 75% compared to the negative control animals (treated with a different miRNA) [3].

Currently the possibilities of using miRNAs in cancer diagnostics is being investigated. MiRNAs can be used to classify poorly differentiated tumors. It is also possible to use them as a prognostic factor. MiRNAs appears also to allow to predict the response to systemic therapy (in ovarian cancer, small cell lung cancer, hepatocellular carcinoma, breast cancer). MiRNAs circulating in the blood can be also investigated to determine the origin of the tumor [4].

MiRNAs appear to be very promising, both in diagnosis and in the treatment of cancer. Their use on a larger scale, however, requires further research.



Written by: Magdalena Mroczek


Source:
1. Let-7 replacement therapy: applicability in cancer. Cancer Therapy Vol 6, 2008 Review Article Debmalya Barh Centre for Genomics and Applied Gene Technology, IIOAB, Nonakuri, Purba Medinipur, WB-721172, India
2.http://www.mirnarx.com/___Research/Pipeline_let7.aspx
3.http://www.mirnarx.com/___Research/Pipeline_miR-34.aspx
4. Diagnostic applications of cell-free and circulating tumor cell-associated miRNAs in cancer patients Bianca Mostert, Anieta M. Sieuwerts, John W.M. Martens, Stefan Sleijferhttp: //repub.eur.nl/res/pub/22635/ExpertReviews_Submittedms.pdfhttp://s.v3.tvp.pl/images/d/b/2/uid_db2a191ad27032feb4448253c26b4d1a1355852528660_width_700_play_0_pos_3_gs_0.jpg


Would You like to know more? Watch on MEDtube.net: Cancer – treatment

]]> http://medtube.net/tribune/micrornas-in-cancer-therapy-and-diagnosis/feed/ 0 Pittsburgh compound B – the opportunity for an early diagnosis of Alzheimer’s disease http://medtube.net/tribune/pittsburgh-compound-b-the-opportunity-for-an-early-diagnosis-of-alzheimers-disease/ http://medtube.net/tribune/pittsburgh-compound-b-the-opportunity-for-an-early-diagnosis-of-alzheimers-disease/#comments Thu, 07 Feb 2013 22:49:08 +0000 yezryy http://medtube.net/tribune/?p=1817 Diagnosis of Alzheimer’s disease (AD) is a very complicated clinical matter from a practical point of view – certain confirmation of this condition in patients is an autopsy of a central nervous system (CNS). However, lately it is reported that a novel marker Pittsburgh Compound B (PiB) used in positron emission tomography (PET) may diagnose AD in patients before decease (1).

It is generally known how destructively dementias (e.g. AD) affect functioning of a society. Patient is isolated and incomprehensible to healthy individuals becomes a shadow of an active man from his past. Additionally, this group of diseases is becoming more common in the human population due to the process of society ageing (2). The mentioned facts put together motivate people interested in the issue to search for more effective methods of diagnosis, treatment and prevention from dementias.

PET offers the possibility of some development in this direction, because it takes advantage of various metabolic active substrates marked with radioisotopes that bind to particular structures in our bodies and present them in a digital form after a computer modification. The most common substrate is fludeoxyglucose (FDG) due to an important role of glucose as a source of energy. Abnormal physiological processes are characterized by wrong circulation of this substance that may be interpreted on a computer after an edition of the image by the device. However, PiB used in PET (PiB-PET) gives hope for an early diagnosis in AD patients before death and offers images of specific changes of the disease on radiological scans (1-3).

PiB is a fluorescent marker that binds mainly to beta-amyloid plaques in the brain with AD. Beta-amyloid is one of the morphological features found in this illness and is a potential cause of pathology taking place in the CNS of patients with AD (1,2). Effectiveness of PiB-PET is confirmed by research comparing its results with CNS autopsies of the donors who underwent this kind of computed tomography before decease. Both the autopsies and PiB-PET presented similar abnormal outcomes for frontal lobes and other CNS areas characteristic of this type of dementia (4, 5)

Correlation of PiB-PET with the autopsies allows scientists and clinicians to state that we have a prospective radiological tool for an early diagnosis and controlling of AD progression. PiB-PET seems to be another relevant interdisciplinary medical breakthrough because it concerns a problem that becomes more easy to notice every year (6). Probably we need to wait a little bit longer for a final answer whether it will be used in a routine practice.



Written by: Kamil Chorążka

Source:
1. Klunk W.E., Engler H., Nordberg A. i wsp. Imaging brain amyloid in Alzheimer’s disease with Pittsburgh Compound-B. Ann Neurol 2004; 55: 306-19.
2. Rowland L.P., Pedley T.A. Merritt’s Neurology 2010; Lippincott Williams & Wilkins.
3. Bailey D.L., Townsend D.W., Valk P.E. i wsp. Positron Emission Tomography: Basic Sciences. Secaucus 2005; NJ: Springer-Verlag.
4. Ikonomovic M.D., Klunk W.E., Abrahamson E.E. i wsp. Post-Mortem Correlates of In-Vivo PiB-PET Amyloid Imaging in a Typical Case of Alzheimer’s Disease. Brain 2008; 131: 1630–1645.
5. Morris J.C., Roe C.M., Gran E.A. i wsp. Pittsburgh Compound B Imaging and Prediction of Progression From Cognitive Normality to Symptomatic Alzheimer Disease. Arch Neurol 2009; 66: 1469-1475. DOI:10.1001/archneurol.2009.269.
6. Sosa-Ortiz A.L., Acosta-Castillo I., Prince M.J. Epidemiology of dementias and Alzheimer’s disease. Arch Med Res 2012; 43: 600-8. DOI: 10.1016/j.arcmed.2012.11.003.


Would You like to know more? Watch on MEDtube.net: Alzheimer disease – Histopathology – Brain

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