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<title>International Journal of Medical Sciences</title> 
<link>http://www.medsci.org</link> 
<description>International Journal of Medical Sciences RSS feed -- Volume 7</description> 
<language>en-us</language> 
<pubDate>Fri, 12 Mar 2010 04:00:00 GMT</pubDate>
<lastBuildDate>Fri, 12 Mar 2010 04:00:00 GMT</lastBuildDate> 

<item>
<link>http://www.medsci.org/v07p0062.htm</link> 
<title>Autonomic Dysfunction Presenting as Postural Orthostatic Tachycardia Syndrome in Patients with Multiple Sclerosis</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0062.htm</guid> 
<description><![CDATA[ <p><b>Background</b>: Autonomic dysfunction is common in patients suffering from multiple sclerosis (MS) and orthostatic dizziness occurs in almost 50% of these patients. However, there have been no reports on postural orthostatic tachycardia syndrome (POTS) in patients suffering from MS.</p> <p><b>Methods:</b> The patients were included for analysis in this study if they had POTS with either a prior history of MS or having developed MS while being followed for POTS. Postural orthostatic tachycardia (POTS) is defined as symptoms of orthostatic intolerance(&#62;6months) accompanied by a heart rate increase of at least 30 beats/min (or a rate that exceeds 120 beats/min) that occurs in the first 10 minutes of upright posture or head up tilt test (HUTT) occurring in the absence of other chronic debilitating disorders. We identified nine patients with POTS who were suffering from MS as well. Each of these patients had been referred from various other centers for second opinions.</p> <p><b>Results:</b> The mean age at the time of diagnosis of POTS was 49&#177;9 years and eight of the 9 patients were women. Five patients (55%) had hyperlipidemia, 3 (33%) migraine and 2 (22%) patients had coronary artery disease and diabetes each. Fatigue and palpitations (on assuming upright posture) were the most common finding in our patients (9/9). All patients also had orthostatic dizziness. Syncope was seen in 5/9(55%) of patients. Four patients (44%), who did not have clear syncope, were having episodes of near syncope. The presence of POTS in our study population resulted in substantial limitation of daily activities. Following recognition and treatment of POTS, 6/9(66%), patients were able to resume daily activities of living. Their symptoms (especially fatigue and orthostatic intolerance) improved. The frequency and severity of syncope also improved. Three (33%) patients failed to show a good response to treatment.</p> <p><b>Conclusion:</b> Patients suffering from MS may manifest autonomic dysfunction by developing POTS. Early recognition and proper management may help improve the symptoms of POTS.</p> ]]></description>  
<dc:creator>Khalil Kanjwal, Beverly Karabin, Yousuf Kanjwal, Blair P Grubb</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>2</prism:number> 
  <prism:startingPage>62</prism:startingPage> 
  <prism:endingPage>67</prism:endingPage> 
  <prism:publicationDate>2010-3-11</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0055.htm</link> 
<title>Association between regulated upon activation, normal T cells expressed and secreted (RANTES) -28C/G polymorphism and asthma risk - A Meta-Analysis</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0055.htm</guid> 
<description><![CDATA[ <p>Regulated upon activation, normal T-cell expressed and secreted (<i>RANTES</i>) is one of the most extensively studied C-C chemokines in allergic inflammation. A growing body of evidence suggests that many cell types present in asthmatic airways have the capacity to generate<i> RANTES</i>, which directly supported the potential role of <i>RANTES</i> in asthma. A number of studies have evaluated the functional polymorphism -28C/G in the <i>RANTES</i> promoter region, which had been found to affect the transcription of the <i>RANTES</i> gene, in relation to asthma susceptibility. However, the results remain conflicting rather than conclusive. This meta-analysis on 1894 asthma cases and 1766 controls for -28C/G from 9 published case-control studies showed that the variant allele -28G was associated with significantly increased risk of asthma (GG+CG vs CC: OR=1.24, 95%CI=1.08-1.41) without any between-study heterogeneity.</p> <p>In the stratified analysis by asthma type, age and ethnicity, we found that the increased asthma risk associated with -28G/C polymorphism was more evident in children (OR=1.24, 95%CI=1.06-1.45), Asian group (OR=1.27, 95%CI=1.04-1.56) and African group (OR=1.72, 95%CI=1.07-2.78). These results suggest that <i>RANTES</i> -28G/C polymorphism may contribute to asthma development, especially in children and in Asian population. Additional well-designed large studies were required for the validation of this association.</p> ]]></description>  
<dc:creator>Qiaoqiao Fang, Furu Wang, Deyu Zhao</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>55</prism:startingPage> 
  <prism:endingPage>61</prism:endingPage> 
  <prism:publicationDate>2010-2-10</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0048.htm</link> 
<title>Effect of dose-escalation of 5-fluorouracil on circadian variability of its pharmacokinetics in Japanese patients with Stage III/IVa esophageal squamous cell carcinoma</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0048.htm</guid> 
<description><![CDATA[ <p><b>Objective: </b>The effects of dose-escalation of 5-fluorouracil (5-FU) on the clinical outcome and pharmacokinetics of 5-FU were investigated in Japanese patients with Stage III/IVa esophageal squamous cell carcinoma.</p> <p><b>Methods:</b> Thirty-five patients with Stage III/IVa were enrolled, who were treated with a definitive 5-FU/cisplatin-based chemoradiotherapy. A course consisted of continuous infusion of 5-FU at 400 mg/m<sup>2</sup>/day (the standard dose group, N=27) or 500-550 mg/m<sup>2</sup>/day (the high dose group, N=8) for days 1-5 and 8-12, infusion of cisplatin at 40 mg/m<sup>2</sup>/day on days 1 and 8, and radiation at 2 Gy/day on days 1 to 5, 8 to 12, and 15 to 19, with a second course repeated after a 2-week interval. Plasma concentrations of 5-FU were determined by high performance liquid chromatography at 5:00 PM on days 3, 10, 38 and 45, and at 5:00 AM on days 4, 11, 39 and 46.</p> <p><b>Results and conclusions:</b> No patient with Stage IVa achieved a complete response in the standard dose group, whereas a complete response was observed at a rate of 50% in the high dose group, and this can be explained by a higher plasma concentration of 5-FU. The circadian rhythm in the concentrations found at the standard dose was not observed for a higher dose.</p> ]]></description>  
<dc:creator>Akiko Kuwahara, Motohiro Yamamori, Kohshi Nishiguchi, Tatsuya Okuno, Naoko Chayahara, Ikuya Miki, Takao Tamura, Kaori Kadoyama, Tsubasa Inokuma, Yoshiji Takemoto, Tsutomu Nakamura, Kazusaburo Kataoka, Toshiyuki Sakaeda</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>48</prism:startingPage> 
  <prism:endingPage>54</prism:endingPage> 
  <prism:publicationDate>2010-1-31</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0043.htm</link> 
<title>Growth of Microorganisms in Total Parenteral Nutrition Solutions Without Lipid</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0043.htm</guid> 
<description><![CDATA[ <p><b>Background: </b>To identify the microorganisms that can grow rapidly in total parenteral nutrition (TPN) solutions, we investigated the growth of the major causes of catheter-related blood stream infection (<i>Staphylococcus aureus</i>, <i>Serratia marcescens</i>, <i>Bacillus cereus</i>, and <i>Candida albicans</i>) in TPN solutions without lipid. <b>Methods:</b> <u>Experiment 1</u>: A commercial TPN solution without lipid containing multivitamins (pH5.6) was used. A specific number of each test microorganism was added to each 10 mL of the TPN solution and incubated at room temperature. An aliquot of test solution was sampled and inoculated to SCD agar plates at 0, 24, and 48 hrs after the addition of the microorganisms. The number of microorganisms was counted as colony forming units. <u>Experiment 2</u>: The other 2 commercial TPN solutions without lipid (pH5.5) were supplemented with multivitamins. The pH values of the solutions were adjusted to about 6.0, 6.5, or 7.0 using 0.5 mol/L NaOH. The addition of microorganisms, incubation, and counting were performed in the same manner. <b>Results: </b><u>Experiment 1</u>: <i>S. aureus</i>, <i>S. marcescens</i>, and <i>B. cereus</i> did not increase in the TPN solution without lipid containing multivitamins (pH5.6), but <i>C. albicans</i> increased rapidly. <u>Experiment 2</u>: The 3 bacterial species did not increase even at pH6.0, but increased at pH6.5 and increased rapidly at pH7.0 in both TPN solutions. <i>C. albicans</i> increased similarly at any pH. <b>Conclusion:</b> These results suggest that bacterial species cannot grow in TPN solutions without lipid due to the acidity (pH5.6 or lower), but <i>Candida</i> species can grow regardless of the acidity.</p> ]]></description>  
<dc:creator>Takashi Kuwahara, Shinya Kaneda, Kazuyuki Shimono, Yoshifumi Inoue</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>43</prism:startingPage> 
  <prism:endingPage>47</prism:endingPage> 
  <prism:publicationDate>2010-1-22</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0036.htm</link> 
<title>Weight loss, leukopenia and thrombocytopenia associated with sustained virologic response to Hepatitis C treatment</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0036.htm</guid> 
<description><![CDATA[ <p><b>OBJECTIVE: </b>To identify apparent adverse effects of treatment of chronic hepatitis C and their relationship to sustained virologic response (SVR).</p> <p><b>METHODS:</b> A retrospective study was conducted of all Hepatitis C virus (HCV)-infected patients treated with pegylated interferon and ribavirin in an academic ambulatory infectious disease practice. Clinical and laboratory characteristics were compared between patients with SVR and without SVR.</p> <p><b>RESULTS:</b> Fifty-four patients completed therapy with the overall SVR rate of 76%. SVR was associated with genotype non-1 (<i>P</i>=0.01), weight loss more than 5 kilograms (<i>P</i>=0.04), end of treatment leukopenia (<i>P=</i>0.02) and thrombocytopenia (<i>P=</i>0.05). In multivariate analysis, SVR was significant associated with HCV genotype non-1 (Adjusted Odd Ratio [AOR] 15.22; CI 1.55 to 149.72; <i>P</i>=0.02), weight loss more than 5 kilograms, (AOR 5.74; CI 1.24 to 26.32; <i>P</i>=0.04), and end of treatment white blood cell count level less than 3 X 10<sup>3</sup> cells/&#181;l (AOR 9.09; CI 1.59 to 52.63;<i> P</i>=0.02). Thrombocytopenia was not significant after adjustment. Other factors including age, gender, ethnicity, injection drug use, viral load, anemia, alanine transaminase level, and liver histology did not reach statistical significance.</p> <p><b>CONCLUSION:</b> Besides non-1 genotype, SVR was found to be independently associated with weight loss during therapy, and leukopenia at the end of HCV treatment. These correlations suggest continuation of therapy despite adverse effects, may be of benefit.</p> ]]></description>  
<dc:creator>Nuntra Suwantarat, Alan D. Tice, Thana Khawcharoenporn, Dominic C. Chow</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>36</prism:startingPage> 
  <prism:endingPage>42</prism:endingPage> 
  <prism:publicationDate>2010-1-22</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0029.htm</link> 
<title>Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: Report of twelve cases and discussion of mechanism of action</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0029.htm</guid> 
<description><![CDATA[ <p>Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT) device (EPRT Technologies-USA, Simi Valley, CA) in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes) of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30-100%). The patients either reduced their medication or completely stopped after the course of treatment. No side effects were reported. The mechanism of action was discussed.</p> ]]></description>  
<dc:creator>Bok Y. Lee, Noori AL-Waili, Dean Stubbs, Keith Wendell, Glenn Butler, Thia AL-Waili, Ali AL-Waili</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>29</prism:startingPage> 
  <prism:endingPage>35</prism:endingPage> 
  <prism:publicationDate>2009-12-6</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0019.htm</link> 
<title>The Diels-Alder-Reaction with inverse-Electron-Demand, a very efficient versatile Click-Reaction Concept for proper Ligation of variable molecular Partners</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0019.htm</guid> 
<description><![CDATA[ <p>The ligation of active pharmaceutical ingredients (API) for working with image processing systems in diagnostics (MRT) attracts increasing notice and scientific interest. The Diels-Alder ligation Reaction with inverse electron demand (DAR<sub>inv</sub>) turns out to be an appropriate candidate. The DAR<sub>inv</sub> is characterized by a specific distribution of electrons of the diene and the corresponding dienophile counterpart. Whereas the reactants in the classical Diels-Alder Reaction feature electron-rich diene and electron-poor dienophile compounds, the DAR<sub>inv</sub> exhibits exactly the opposite distribution of electrons. Substituents with pushing electrones increase and, with pulling electrons reduce the electron density of the dienes as used in the DAR<sub>inv</sub>.</p> <p>We report here that the DAR<sub>inv</sub> is an efficient route for coupling of multifunctional molecules like active peptides, re-formulated drugs or small molecules like the alkyalting agent temozolomide (TMZ). This is an example of our contribution to the &#34;Click chemistry&#34; technology. In this case TMZ is ligated by DAR<sub>inv</sub> as a cargo to transporter molecules facilitating the passage across the cell membranes into cells and subsequently into subcellular components like the cell nucleus by using address molecules. With such constructs we achieved high local concentrations at the desired target site of pharmacological action. The DAR<sub>inv</sub> ligation was carried out using the combination of several technologies, namely: the organic chemistry and the solid phase peptide synthesis which can produce 'tailored' solutions for questions not solely restricted to the medical diagnostics or therapy, but also result in functionalizations of various surfaces qualified amongst others also for array development.</p> <p>We like to acquaint you with the DAR<sub>inv</sub> and we like to exemplify that all ligation products were generated after a rapid and complete reaction in organic solutions at room temperature, in high purity, but also, hurdles and difficulties on the way to the TMZ-BioShuttle conjugate should be mentioned.</p> <p>With this report we would like to stimulate scientists working with the focus on &#34;Click chemistry&#34; to intensify research with this expanding DAR<sub>inv </sub>able to open the door for new solutions inconceivable so far.</p> ]]></description>  
<dc:creator>Manfred Wiessler, Waldemar Waldeck, Christian Kliem, Ruediger Pipkorn, Klaus Braun</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>19</prism:startingPage> 
  <prism:endingPage>28</prism:endingPage> 
  <prism:publicationDate>2009-12-5</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0015.htm</link> 
<title>Comparison between single antiplatelet therapy and combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0015.htm</guid> 
<description><![CDATA[ <p>Satisfactory results have not yet been obtained in therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome (APS). We therefore compared single antiplatelet therapy and a combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with APS.</p> <p>The subjects were 20 ischemic stroke patients with antiphospholipid antibody, 13 with primary antiphospholipid syndrome and 7 with SLE-related antiphospholipid syndrome. Diagnosis of APS was based on the 2006 Sydney criteria. Eligible patients were randomly assigned to either single antiplatelet therapy (aspirin 100 mg) or a combination of antiplatelet and anticoagulation therapy (target INR: 2.0-3.0; mean 2.4&#177;0.3) for the secondary prevention of stroke according to a double-blind protocol. There was no significant difference between the two groups in age, gender, NIH Stroke Scale on admission, mRS at discharge, or rate of hypertension, diabetes mellitus, hyperlipidemia, or cardiac disease. We obtained Kaplan-Meier survival curves for each treatment. The primary outcome was the occurrence of stroke. The mean follow-up time was 3.9&#177;2.0 years. The cumulative incidence of stroke in patients with single antiplatelet treatment was statistically significantly higher than that in patients receiving the combination of antiplatelet and anticoagulation therapy (log-rank test, p-value=0.026). The incidence of hemorrhagic complications was similar in the two groups. The recent APASS study did not show any difference in effectiveness for secondary prevention between single antiplatelet (aspirin) and single anticoagulant (warfarin) therapy. Our results indicate that combination therapy may be more effective in APS-related ischemic stroke.</p> ]]></description>  
<dc:creator>Hirohisa Okuma, Yasuhisa Kitagawa, Takashi Yasuda, Kentaro Tokuoka, Shigeharu Takagi</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>15</prism:startingPage> 
  <prism:endingPage>18</prism:endingPage> 
  <prism:publicationDate>2009-12-5</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

<item>
<link>http://www.medsci.org/v07p0001.htm</link> 
<title>Fat-Storing Multilocular Cells Expressing CCR5 Increase in the Thymus with Advancing Age: Potential Role for CCR5 Ligands on the Differentiation and Migration of Preadipocytes</title> 
<guid isPermaLink="true">http://www.medsci.org/v07p0001.htm</guid> 
<description><![CDATA[ <p>Age-associated thymic involution is characterized by decreased thymopoiesis, adipocyte deposition and changes in the expression of various thymic microenvironmental factors. In this work, we characterized the distribution of fat-storing cells within the aging thymus. We found an increase of unilocular adipocytes, ERTR7<sup>+</sup> and CCR5<sup>+ </sup>fat-storing multilocular cells in the thymic septa and parenchymal regions, thus suggesting that mesenchymal cells could be immigrating and differentiating in the aging thymus. We verified that the expression of CCR5 and its ligands, CCL3, CCL4 and CCL5, were increased in the thymus with age. Hypothesizing that the increased expression of chemokines and the CCR5 receptor may play a role in adipocyte recruitment and/or differentiation within the aging thymus, we examined the potential role for CCR5 signaling on adipocyte physiology using 3T3-L1 pre-adipocyte cell line. Increased expression of the adipocyte differentiation markers, PPAR&#947;2 and aP2 in 3T3-L1 cells was observed under treatment with CCR5 ligands. Moreover, 3T3-L1 cells demonstrated an ability to migrate<i> in vitro</i> in response to CCR5 ligands. We believe that the increased presence of fat-storing cells expressing CCR5 within the aging thymus strongly suggests that these cells may be an active component of the thymic stromal cell compartment in the physiology of thymic aging. Moreover, we found that adipocyte differentiation appear to be influenced by the proinflammatory chemokines, CCL3, CCL4 and CCL5.</p> ]]></description>  
<dc:creator>Valeria de Mello Coelho, Allyson Bunbury, Leticia B. Rangel, Banabihari Giri, Ashani Weeraratna, Patrice J. Morin, Michel Bernier, Dennis D. Taub</dc:creator>
<dc:publisher>Ivyspring International Publisher</dc:publisher> 
  <prism:volume>7</prism:volume> 
  <prism:number>1</prism:number> 
  <prism:startingPage>1</prism:startingPage> 
  <prism:endingPage>14</prism:endingPage> 
  <prism:publicationDate>2009-12-4</prism:publicationDate> 
<prism:section>Research Paper</prism:section>
</item>

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