Search

Odeh M, Sabo E, Srugo I, Oliven A. Serum levels of tumor necrosis factor-α correlate with severity of hepatic encephalopathy due to chronic liver failure. Liver International 2004: DOI: 10.1111/j.1478-3231.2004.0894.x. © Blackwell Munksgaard 2004 Several studies have shown that serum levels of tumor necrosis factor-α (TNF) are significantly elevated in patients with acute and chronic liver diseases, where these elevations are independent of the etiology of the underlying disease. Serum levels of TNF are significantly higher in patients with cirrhosis than in those without cirrhosis, reaching the highest levels in decompensated cirrhosis. It has also been shown that plasma levels of TNF correlate with the severity of hepatic encephalopathy (HE) in fulminant hepatic failure. However, still there are no published data regarding the relationship between blood levels of TNF and the presence or severity of HE in patients with chronic liver failure. The aim of this study is to determine the relationship between serum levels of TNF and clinical grades of HE in patients with liver cirrhosis. Using a commercially available high-sensitivity enzyme-linked immunosorbent assay kit, serum levels of TNF were measured in 74 patients with liver cirrhosis in various clinical grades of HE (grades 0–4). The mean±SEM values of serum levels of TNF at presentation in patients with grade 0 of HE ( n=23), grade 1 ( n=12), grade 2 ( n=14), grade 3 ( n=16), and grade 4 ( n=9) were 4.50±0.46, 9.10±1.0, 12.98±1.22, 21.51±2.63, and 58.26±19.7 pg/ml, respectively. A significant positive correlation was found between serum levels of TNF and the severity of HE ( P<0.0001). Serum levels of TNF correlate positively with the severity of HE in patients with chronic liver failure. [ABSTRACT FROM AUTHOR]

This study compares the anti-emetic effect of acupuncture with that of ondansetron and a placebo. Ninety children undergoing dental treatment under general anaesthesia were randomly allocated to one of the three equal groups, to receive acupuncture needle insertion, intravenous ondansetron 0.15 mg x kg(-1) or a placebo. Parental satisfaction scores and the incidence of emetic episodes were recorded. A significant difference was found in the number of patients who vomited and the total number of the emetic episodes when comparing the two treatment groups with the placebo group (p < 0.0001). A significant difference was also found between the treatment groups and the placebo group with respect to parental satisfaction score (p < 0.03). We conclude that traditional Chinese acupuncture is a valid non-pharmacological alternative anti-emetic treatment that can be recommended as a prophylactic technique in children undergoing dental surgery under general anaesthesia. [ABSTRACT FROM AUTHOR]

Aims: Periventricular white matter injury in premature infants occurs following hypoxia/ischaemia and systemic infection, and results in hypomyelination, as well as neuromotor and cognitive deficits later in life. Inflammatory infiltrates are seen within human cerebral white matter from periventricular leucomalacia (PVL) cases. Methods: In this study, we examine the time course of CD-68+ microglial cell responses relative to cell death within white matter following hypoxia/ischaemia in a rat model of PVL. We also tested the efficacy of the minocycline, an agent that suppresses microglial activation, in this model when administered as a post-insult treatment. Results: We show that preoligodendrocyte injury in the post-natal day 6 begins within 24 h and continues for 48–96 h after hypoxia/ischaemia, and that microglial responses occur primarily over the first 96 h following hypoxia/ischaemia. Minocycline treatment over this 96 h time window following the insult resulted in significant protection against white matter injury, and this effect was concomitant with a reduction in CD-68+ microglial cell numbers. Conclusions: These results suggest that anti-inflammatory treatments may represent a useful strategy in the treatment of PVL, where clinical conditions would favour a post-insult treatment strategy. [ABSTRACT FROM AUTHOR]

This study compares the anti-emetic effect of acupuncture with that of ondansetron and a placebo. Ninety children undergoing dental treatment under general anaesthesia were randomly allocated to one of the three equal groups, to receive acupuncture needle insertion, intravenous ondansetron 0.15 mg.kg-1 or a placebo. Parental satisfaction scores and the incidence of emetic episodes were recorded. A significant difference was found in the number of patients who vomited and the total number of the emetic episodes when comparing the two treatment groups with the placebo group (p < 0.0001). A significant difference was also found between the treatment groups and the placebo group with respect to parental satisfaction score (p < 0.03). We conclude that traditional Chinese acupuncture is a valid non-pharmacological alternative anti-emetic treatment that can be recommended as a prophylactic technique in children undergoing dental surgery under general anaesthesia. [ABSTRACT FROM AUTHOR]

Matrix metalloproteinase (MMP)-9 is produced by many inflammatory cells such as macrophages, neutrophils, mast cells, eosinophils and T lymphocytes. Activated T cells are capable, through cell–cell contact, of inducing MMP-9 expression in human mast cells.To investigate the activation status of peripheral CD4+ T cells and the level of MMP-9 in the plasma of patients with chronic urticaria (CU), and whether MMP-9 levels are in association with CU severity.Study subjects included 29 patients with CU and 30 healthy control subjects. At the time of assessment, patients were divided into subgroups according to urticarial severity. Plasma levels of total MMP-9 (free pro-MMP-9 and free MMP-9) were determined by ELISA. CD4+ lymphocytes were positively selected with magnetic microbeads. After 48 h of activation, CD4+ T cells were assayed for both nuclear factor-kappaB (NF-κB) expression and proliferation.Plasma levels of MMP-9 were found to be significantly higher in 29 CU patients compared with 18 healthy controls (186±174 vs. 31±21 ng/mL,P<0.0001). We also found a significant correlation between MMP-9 levels and urticarial severity (r=0.92,P<0.001). In addition, CD4+ T cells from CU patients expressed higher levels of NF-κB than CD4+ T cells from healthy controls (82±30 vs. 69±20 optical density,P=0.007). Finally, as compared with seven healthy individuals, DNA synthesis in CD4+ T cells from seven CU patients was found to be significantly elevated (1000±240 vs. 751±166 counts per minute,P=0.01).Increased levels of MMP-9 are found in CU patients, and particularly among those with severe disease. We also demonstrated that CD4+ T cells from such patients are highly activated. [ABSTRACT FROM AUTHOR]

Despite the disabling nature of chronic urticaria (CU), little is known about the disease's duration or the efficacy of adopting aggressive therapeutic regimens such as cyclosporine A. The aim of this study was to evaluate whether parameters such as angioedema, autologous serum test, anti-thyroid antibodies, and total IgE could predict both CU duration and severity. One hundred and thirty-nine patients suffering from CU were prospectively followed over a 5-year period for disease duration, severity and the presence of angioedema. Also investigated was the association between these clinical parameters and the subsequent detection of autologous serum test, anti-thyroid antibodies, and total IgE. CU lasted over 1 year in more than 70% of cases and in 14% it still existed after 5 years. Angioedema co-existed or appeared during the course of CU in 40% of patients and was associated with disease duration. Autologous serum test and anti-thyroid antibodies were found positive in 28 and 12% of patients, respectively, compared to none of normal individuals, P = 0.001. CU duration was associated with the presence of both autologous serum test and anti-thyroid antibodies; however, autologous serum test and not anti-thyroid antibodies was found in association with CU severity. We demonstrate for the first time that CU duration is associated with clinical parameters such as severity and angioedema, and with laboratory parameters such as autologous serum test and anti-thyroid antibodies. The ability to predict CU duration may facilitate decisions regarding the possible early initiation of cyclosporine A as a means by which to reduce disease severity and duration. [ABSTRACT FROM AUTHOR]

Aims: To find a possible correlation of Ki67 antigen and proliferating cell nuclear antigen (PCNA) with prognosis in anorectal malignant melanoma. Methods and results: Thirty patients with anorectal malignant melanoma were studied. The percentage of tumour cells stained for Ki67 and PCNA in paraffin sections was assessed. Mode of treatment (local excision or abdominoperineal resection), depth of tumour invasion, attempt at cure as defined by complete tumour excision and absence of distant metastases at presentation, tumour blood vessel invasion, and tumour necrosis, as well as Ki67 and PCNA, were all correlated with survival. By univariate analysis, PCNA, Ki67, attempt at cure, local excision (and not abdominoperineal resection), and depth of invasion were all significantly associated with longer survival. By multivariate analysis, only PCNA was significantly associated with survival, while Ki67 showed a significant positive correlation with PCNA. With a cut-off point of 40%, patients with lower Ki67 scores showed survival advantage over those with higher Ki67 scores (P =0.0004). With a cut-off point of 80%, patients with lower PCNA scores showed survival advantage over those with higher PCNA scores (P =0.0001). The staining for proliferation markers was also associated with depth of tumour invasion. Conclusions: Ki67 and PCNA immunostaining in paraffin sections may be useful for the prediction of survival in patients with anorectal malignant melanoma. Larger studies are needed to confirm our results. [ABSTRACT FROM AUTHOR]

Objective: The propagation speed of ultrasound beams changes in different media. The aim of the study was to assess the possible measurement error of fetal biometry performed in cases of a myomatous uterus. Design: Three iron phantoms of 30 mm, 50 mm and 70 mm were measured by ultrasound. Each phantom was measured by three different transducers of 3.5 MHz, 6.5 MHz and 7.5 MHz. Measurements were performed in a water bath and the intraobserver variability was assessed. Thereafter phantoms were measured with one of their edges covered by a specimen of a myomatous uterus while their other edge was covered with water. Results: Artifactual lengthening of the phantoms' size was observed in measurements performed with the uterine myoma. The measurement errors were inversely related to the length of the phantoms and became statistically significant in the phantoms of 30 mm (13.15 +/- 3.16% without the myoma vs. 17.38 +/- 4.39% with the myoma; p < 0.0001). Measurement errors were independent of the transducer type (p = 0.001, p = 0.01 and p = 0.014 for the 3.5-MHz, 6.5-MHz and 7.5-MHz transducers, respectively). Conclusions: Ultrasound measurement errors are expected while examining small fetal organs which are partially overshadowed by a myoma. [ABSTRACT FROM AUTHOR]

The incidence of inguinal hernia is higher in premature infants, particularly in low birth weight neonates. This latter group may also incur increased postoperative respiratory complications and inpatient admissions. The purpose of this study was to compare the effects of general and spinal anaesthesia on postoperative respiratory morbidity and on the length of hospital stay in high-risk infants undergoing inguinal herniorrhaphy. Forty patients, all high-risk infants who underwent unilateral or bilateral herniorrhaphies, were randomly assigned to receive general anaesthesia (n = 20) or spinal anaesthesia (n = 20). There was a significant difference in respiratory morbidity between the two groups, as well as a significant difference in the inpatient hospital stay. The present study suggests that spinal anaesthesia can be used safely for high-risk infants, preterm or formerly preterm, undergoing inguinal hernia repair. [ABSTRACT FROM AUTHOR]