Yang W, Chen X, Cohen DS
… +4 more, Rosin ER, Toga AW, Thompson PM, Huang X
Int J Clin Exp Med
· 2017 Dec · PMID 29445429
Alzheimer's disease (AD) is a progressive, and often fatal, brain disease that causes neurodegeneration, resulting in memory loss as well as other cognitive and behavioral problems. Here, we propose a novel multimodal me...Alzheimer's disease (AD) is a progressive, and often fatal, brain disease that causes neurodegeneration, resulting in memory loss as well as other cognitive and behavioral problems. Here, we propose a novel multimodal method combining independent components from MRI measures and clinical assessments to distinguish Alzheimer's patients or mild cognitive impairment (MCI) subjects from healthy elderly controls. 70 AD subjects (mean age: 77.15 ± 6.2 years), 98 MCI subjects (mean age: 76.91 ± 5.7 years), and 150 HC subjects (mean age: 75.69 ± 3.8 years) were analyzed. Our method includes the following steps: pre-processing, estimating the number of independent components from the MR image data, extracting effective voxels for classification, and classification using a support vector machine (SVM)-based classifier. As a result, with regards to classifying AD from healthy controls, we achieved a classification accuracy of 97.7%, sensitivity of 99.2%, and specificity of 96.7%; for differentiating MCI from healthy controls, we achieved a classification accuracy of 87.8%, a sensitivity of 86.0%, and a specificity of 89.6; these results are better than those obtained with clinical measurements alone (accuracy of 79.5%, sensitivity of 74.0%, and specificity of 85.1%). We found that (1) both AD patients and MCI subjects showed brain tissue loss, but the volumes of gray matter loss in MCI subjects was far less, supporting the notion that MCI is a prodromal stage of AD; and (2) combining gray matter features from MRI and three commonly used measures of mental status, cognitive function improved classification accuracy, sensitivity, and specificity compared with classification using only independent components or clinical measurements.
Jensen BC, Bultman SJ, Holley D
… +5 more, Tang W, de Ridder G, Pizzo S, Bowles D, Willis MS
Int J Clin Exp Med
· 2017 · PMID 28794819
The cellular environment of the mammalian heart constantly is challenged with environmental and intrinsic pathological insults, which affect the proper folding of proteins in heart failure. The effects of damaged or misf...The cellular environment of the mammalian heart constantly is challenged with environmental and intrinsic pathological insults, which affect the proper folding of proteins in heart failure. The effects of damaged or misfolded proteins on the cell can be profound and result in a process termed "proteotoxicity". While proteotoxicity is best known for its role in mediating the pathogenesis of neurodegenerative diseases such as Alzheimer's disease, its role in human heart failure also has been recognized. The UPR involves three branches, including PERK, ATF6, and IRE1. In the presence of a misfolded protein, the GRP78 molecular chaperone that normally interacts with the receptors PERK, ATF6, and IRE-1 in the endoplasmic reticulum detaches to attempt to stabilize the protein. Mouse models of cardiac hypertrophy, ischemia, and heart failure demonstrate increases in activity of all three branches after removing GRP78 from these internal receptors. Recent studies have linked elevated PERK and CHOP in vitro with regulation of ion channels linked with human systolic heart failure. With this in mind, we specifically investigated ventricular myocardium from 10 patients with a history of conduction system defects or arrhythmias for expression of UPR and autophagy genes compared to myocardium from non-failing controls. We identified elevated , and mRNA, along with XBP-1-regulated mRNA, indicative of activation of the UPR in human heart failure with arrhythmias.
Su X, Tang Q, Fang D
… +9 more, Xiong G, Singla N, He Q, Zhang L, Liu P, Fan Y, Hao H, Li X, Zhou L
Int J Clin Exp Med
· 2016 Sep · PMID 32351666
The oncological outcomes of upper tract urothelial carcinoma (UTUC) and bladder cancer (BC) in patients treated with radical surgeries remains controversial. A retrospective analysis of the clinicopathologicla data of 22...The oncological outcomes of upper tract urothelial carcinoma (UTUC) and bladder cancer (BC) in patients treated with radical surgeries remains controversial. A retrospective analysis of the clinicopathologicla data of 228 consecutive UTUC patients and 174 BC patients treated with radical surgeries from 2000 to 2012 at a high-volume center in China was conducted. Kaplan-Meier method and Cox regression were used to compare overall survival (OS) and cancer-specific survival (CSS) and to find prognostic factors. In this cohort of patients, BC were associated with male sex (P<0.001), multifocality (P<0.001), positive lymph node (P=0.002), no hydronephrosis (P<0.001) and open surgical approach (P<0.001). UTUC have statistically significant better 5-year CSS rate (61.0% vs. 49.8%, P=0.008) and OS rate (58.3% vs. 37.4%, P<0.001) than BC. Bladder tumor location (UTCU vs. BC: hazard ratio (HR)=0.703 and HR=0.462) and positive lymph node status (HR=1.919 and HR=1.667) were independent risk factors of cancer-specific death and overall mortality, respectively. Our data suggest that locally invasive urothelial carcinomas (UC) behave differently in the upper and lower urinary tracts. UTUC has a better prognosis than BC when stage and grade are considered simultaneously and lymph node involvement has significant influences on clinical outcomes of urothelial carcinoma.
Niu Y, Zhang W, Mao S
… +6 more, Gao Y, Wang J, Li J, Wang L, Guan Z, Shen Z
Int J Clin Exp Med
· 2015 · PMID 26885244
OBJECTIVE: To explore the feasibility of the Chinese version of Kidney Transplant Questionnaire (KTQ) by evaluating the health-related quality of life (HRQoL) in Chinese recipients of living donor kidney transplantation....OBJECTIVE: To explore the feasibility of the Chinese version of Kidney Transplant Questionnaire (KTQ) by evaluating the health-related quality of life (HRQoL) in Chinese recipients of living donor kidney transplantation. METHODS: The English version of KTQ was translated into Chinese and underwent cultural adaptation to obtain the Chinese version of KTQ. HRQoL of 136 Chinese recipients of living donor kidney transplantation that met the inclusion criteria were evaluated to assess the validity and reliability of the questionnaire. RESULTS: One hundred and thirty-six recipients (98 males and 38 females) of living donor kidney transplantation were included. The mean age of the recipients was 43.91 years. For each dimension of the questionnaire, the Cronbach's alpha coefficient was 0.7-0.9, test-retest reliability coefficient ≥0.7, goodness of fit index (GFI) >0.9, and comparative fitness index (CFI) >0.9. CONCLUSION: The validity and reliability of the Chinese version of KTQ is similar to the English version, suggesting that the Chinese version of KTQ could be applied as a disease-specific questionnaire to evaluate the HRQoL of the recipients of living donor kidney transplantation in China.
Malkan UY, Gunes G, Eliacik E
… +11 more, Haznedaroglu IC, Etgul S, Aslan T, Yayar O, Aydin S, Demiroglu H, Ozcebe OI, Sayinalp N, Goker H, Aksu S, Buyukasik Y
Int J Clin Exp Med
· 2015 · PMID 26885243
There are some improvements in management of acute myeloid leukemia (AML). However, induction-induced deaths still remain as a major problem. The aim of this study is to assess clinical parameters affecting early death i...There are some improvements in management of acute myeloid leukemia (AML). However, induction-induced deaths still remain as a major problem. The aim of this study is to assess clinical parameters affecting early death in patients with AML. 199 AML patients, who were treated with intensive, non-intensive or supportive treatment between 2002 and 2014 in Hacettepe Hematology Department, were analyzed retrospectively. In our study early death rate for elderly was found to be lower than previous reports whereas it was similar for those who were under age of 60. Better ECOG performance (ECOG performance score 0 and 1) and non-intensive treatment associated with lower early death rates, however APL-type disease associated with higher early death rates. ECOG performance score at diagnosis was found to be the most related independent factor with higher rate of early death in 15 days after treatment (P<0.001). Therefore we decided to understand the factors which were related with ECOG. WBC count at diagnosis was found to be the only related parameter with ECOG performance score. Leucocyte count at diagnosis appears like to have an indirect effect on early death in AML patients. It maybe suggested that in recent years there is an improvement in early death rates of elderly AML patients. The currently reported findings require prospective validation and would encourage the incorporation of other next generation genomics for the prediction of early death and overall risk status of AML.
Özkan EA, Khosroshahi HE, Serin Hİ
… +5 more, Özdemir ZT, Kılıç M, Ekim M, Geçit UA, Domur E
Int J Clin Exp Med
· 2015 · PMID 26885242
BACKGROUND: Obesity is associated with many risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension and leads to early atherosclerosis. The aim of this study was to investigate the relation of the mean plate...BACKGROUND: Obesity is associated with many risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension and leads to early atherosclerosis. The aim of this study was to investigate the relation of the mean platelet volume (MPV) and the carotid intima media thickness (CIMT) on cardiac functions among obese children. MATERIALS AND METHODS: Sixty obese children, with body mass index percentile were >95% and forty eight healthy controls were enrolled in the study. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), thyroid function tests, hemoglobin, white blood cell, MPV and insulin resistance were evaluated. CIMT was measured by using high-resolution ultrasound and echocardiography was performed to all individuals. RESULTS: MPV and CIMT values were found significantly higher in obese children than controls. There was positive correlation between CIMT and age, body surface area (BSA), systolic and diastolic blood pressure, left ventricular meridional end-systolic wall stress (ESWSm), myocardial fiber stress (MFS), stroke volume (SV) and insulin and negative correlation with left ventricle end-systolic elastance by single beat technique (Ees(sb)) and arterial elastance (Ea). There was no correlation between LVM, cardiac risk profiles and CIMT. Multiple stepwise regression analyses revealed that ESWSm (β=0.337, P=0.049) was only independent factor on CIMT. MPV values showed negative correlation with ALT, AST, Free T4, thyroid stimulating hormone and positive correlation with age and BSA. CONCLUSION: Current study showed that obesity has an independent impact on CIMT and MPV values in children. Increased CIMT in obese children leads significant increase in ESWSm and decrease in Ea and Ees(sb).
OBJECTIVE: To determine effects of DEX versus propofol on saturation of pulse oximetry (SPO2) in children with Tetralogy of Fallot (TOF) during anesthesia. METHODS: 54 children with TOF who planned to receive corrected o...OBJECTIVE: To determine effects of DEX versus propofol on saturation of pulse oximetry (SPO2) in children with Tetralogy of Fallot (TOF) during anesthesia. METHODS: 54 children with TOF who planned to receive corrected operation were randomly assigned to two groups: group DEX and group Propofol. Indicators were compared at T0 (immediate induction of anesthesia), T1 (tracheal catheterization), T2 (skin incision), T3 (sternal exposure) and T4 (aortic catheterization). RESULTS: In group DEX, the hear rate (HR) and partial pressure difference between alveolar air and arteries [P(A-a)O2] at T1 were lower than those at T0, while systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and SPO2 at T1 were higher than those at T0, with statistically significant differences (P<0.05, respectively). In the group Propofol, SBP, DBP, MBP and SPO2 at T1 were lower than those at T0, while P(A-a)O2 at T1 was higher than that at T0, with statistically significant differences (P<0.05, respectively). There were statistically significant differences in all indicators at T1 between two groups (P<0.05, respectively). The group DEX had lower HR and P(A-a)O2, and higher SBP, DBP, MBP and SPO2 than group Propofol. There were no statistically significant differences in all indicators (except for lower HR) at other points between two groups. CONCLUSION: During induction of anesthesia, DEX was better than propofol to improve alveolar oxygenation, reduce myocardial oxygen consumption, increase arterial oxygen content and induce stable induction in patients with TOF, though they were comparable during maintenance of anesthesia.