Retinal vasculitis: a diagnostic dilemma

Inflammation of the retinal vasculature, retinal vasculitis, is a poorly understood category of ocular pathology. Patients may or may not be symptomatic. Retinal vasculitis, classified as arteritis or phlebitis, can present as a sole clinical feature or can be accompanied by an anterior uveitis, vitritis, retinal hemorrhages and/or retinal ischemia, thereby making diagnosis difficult. There is evidence that most causes of vasculitis involve an autoimmune response to specific antigens. This disorder may occur in association with infectious disease, systemic inflammatory disorders, primary ocular conditions or as an idiopathic syndrome. Differential diagnosis includes eliminating these etiologies as well as non-inflammatory disorders which can mimic true retinal vasculitis. Proper identification along with timely treatment is crucial in the management of this potentially visually devastating entity. This article provides a current, general guide to the etiology and differential diagnosis of retinal vasculitis. The clinical presentation will be illustrated through four case presentations. The practitioner will also be provided with a tailored approach to management.     

Wilson's disease: a diagnostic dilemma.

A 13 year old boy presented with headache, sore throat, myalgia, and fever and subsequently developed haemolytic anaemia and acute liver failure. Wilson''s disease, a rare cause of acute liver failure, was diagnosed at necropsy. In such cases Wilson''s disease must be diagnosed at an early stage for treatment to be effective. The most reliable indications are increased urinary and hepatic copper concentrations.     

Analysis of simple GSR measures: differential diagnostic GSR signs in hypertonics, neurological patients and healthy controls

A statistical analysis of GSR measures in three groups of Ss (Hypertonics-HP, Neurological patients-NP, and Controls-CG), subjected to standard electrodermal stimulation supports the existence of a differentiated inner connection among various GSR measures in the three groups. Latency in the CG was found negatively to correlate with amplitude of the derivational curve, while in the other two groups it proved to be an independent measure. It is assumed that the temporal GSR measures reflect its dynamic properties, while amplitude is an indicator of the overall level of the sympathetic nervous system and of the magnitude of changes in the membrane potentials of sweat glands. A point is also made of certain diagnostic applications for differentiating disorders due to organic causes from functional ones, within the framework of man's psychophysiological unit.     

Glycocalyx damage biomarkers in healthy controls,abdominal surgery,and sepsis: a scoping review

Abstract

Objective

Despite wide interest in glycocalyx biomarkers, their values in healthy individuals, patients after abdominal surgery, and septic patients have been poorly understood.     

Differential expression of proteomics models of colorectal cancer, colorectal benign disease and healthy controls

Background

Colorectal cancer (CRC) is often diagnosed at a late stage with concomitant poor prognosis. The hypersensitive analytical technique of proteomics can detect molecular changes before the tumor is palpable. The surface-enhanced laser desorption/ionization-time of flight-mass spectra (SELDI-TOF-MS) is a newly-developed technique of evaluating protein separation in recent years. The protein chips have established the expression of tumor protein in the serum specimens and become the newly discovered markers for tumor diagnosis. The objective of this study was to find new markers of the diagnosis among groups of CRC, colorectal benign diseases (CBD) and healthy controls. The assay of SELDI-TOF-MS with analytical technique of protein-chip bioinformatics was used to detect the expression of protein mass peaks in the sera of patients or controls. One hundred serum samples, including 52 cases of colorectal cancer, 27 cases of colorectal benign disease, and 21 cases of healthy controls, were examined by SELDI-TOF-MS with WCX2 protein-chips.

Results

The diagnostic models (I, II and III) were setup by analyzed the data and sieved markers using Ciphergen - Protein-Chip-Software 5.1. These models were combined with 3 protein mass peaks to discriminate CRC, CBD, and healthy controls. The accuracy, the sensitivity and the particularity of cross verification of these models are all highly over 80%.

Conclusions

The SELDI-TOF-MS is a useful tool to help diagnose colorectal cancer, especially during the early stage. However, identification of the significantly differentiated proteins needs further study.     

Comparison of sialylated N‐glycopeptide levels in serum of pancreatic cancer patients,acute pancreatitis patients,and healthy controls

Serum protein glycosylation is known to be affected by pathological conditions, including cancer and inflammatory diseases. Pancreatic cancer patients would benefit from early diagnosis, as the disease is often detected in an advanced stage and has poor prognosis. Searching for changes in serum protein site‐specific glycosylation could reveal novel glycoprotein biomarkers. We used Sambucus nigra lectin affinity chromatography to enrich α‐2,6 sialylated tryptic N‐glycopeptides from albumin‐depleted sera of pancreatic cancer patients, acute pancreatitis patients, and healthy individuals, and compared their relative abundance using ultra performance LC‐MS. Relative quantitation was done using the spectrum processing software MZmine. Identification was performed on the web‐based tool GlycopeptideID, developed for in silico analysis of intact N‐glycopeptides. Seventeen high‐abundance serum proteins, mainly acute‐phase proteins, and immunoglobulins, with total 27 N‐glycosylation sites, and 62 glycoforms, were identified. Pancreatitis patient sera contained 38, and pancreatic cancer patients sera contained 13 glycoform changes with statistical significance (p < 0.05). In pancreatitis, up to tenfold changes were found in some glycoforms, and in pancreatic cancer, threefold. Analysis showed that the changes often concerned one or two, but not all, N‐glycosylation sites in a specific glycoprotein. In conclusion, the analysis shows that pancreatic cancer, and acute pancreatitis are associated with changes in concentrations of intact sialylated N‐glycopeptides derived from acute‐phase proteins, and immunoglobulins, and that changes are site specific.     

Pancreatic acinar cell: its role in acute pancreatitis

The pancreatic acinar cell is the functional unit of the exocrine pancreas. It synthesizes, stores, and secretes digestive enzymes. Under normal physiological conditions, digestive enzymes are activated only once they have reached the duodenum. Premature activation of these enzymes within pancreatic acinar cells leads to the onset of acute pancreatitis; it is the major clinical disorder associated with pancreatic acinar cells. Although there have been major advances in our understanding of the pathogenesis of this disease in recent years, available treatment options are still limited to traditional nonspecific and palliative interventions. Novel therapeutic strategies have been suggested based on ongoing research in the physiology and pathophysiology of the disease; these include the administration of systemic antibiotics, antioxidants, cytokine antagonists, and more recently, inhibition of the renin-angiotensin system. Notwithstanding this promising development, most of these potential therapies are still in an experimental stage or clinical trial. Further investigation is needed to prove the efficacy of these novel treatment modalities.     

Minor physical anomalies in patients with schizophrenia, unaffected first-degree relatives, and healthy controls: a meta-analysis

Background

Minor physical anomalies (MPAs) have been found to be more prevalent in schizophrenia than control participants in numerous studies and may index a potential endophenotype for schizophrenia.

Aim

To quantitatively define the magnitude of the difference in total MPA scores between patients with schizophrenia and healthy controls; to determine the degree of manifestation in unaffected first-degree relatives compared to patients and controls; and to investigate the degree of sensitivity among individual MPA items.

Methods

A systematic search was conducted on the literature pertaining to MPAs in patients with schizophrenia and unaffected relatives. Effect sizes (Cohen''s d and odds ratios) and corresponding confidence intervals were combined using the Comprehensive Meta-Analysis software package.

Results

A large difference was found when examining 14 studies comprising 1207 patients with schizophrenia and 1007 healthy controls (d = 0.95, 95% CI = 0.63, 1.27). Six studies involving relatives of individuals with schizophrenia showed a medium effect size (d = 0.45, 95% CI = 0.29,0.62) between patients and relatives, but a small and non-significant effect size (d = 0.32, 95% CI = −0.08, 0.73) between relatives and controls. The majority of MPAs items showed significant odds ratios (1.26–9.86) in comparing patients and controls.

Conclusions

The findings indicate that medium effect size of MPAs have been demonstrated in patients with schizophrenia as compared to healthy controls, and to a lesser extent in unaffected relatives. These findings are consistent with the idea that MPAs may represent a putative endophenotype for schizophrenia. However, more research including first-degree family members is warranted.     

Pancreatic metastasis from gastric carcinoma: a case report

Background  

The pancreas is a rare but occasionally favored target for metastasis. Metastatic lesions in the pancreas have been described for various primary cancers, such as carcinomas of the lung, the breast, renal cell carcinoma and sarcomas.     

Serum nitric oxide metabolite levels in a general healthy population: relation to sex and age

This study aims at determining serum nitrite/nitrate (NO(x)) levels in healthy subjects within the framework of a population-based study. NO(x) concentration was measured in 3505 subjects aged >/=20 years. Subjects with diabetes, renal dysfunction, those undergoing treatment for dyslipidemia and hypertension, were excluded; also excluded were smokers, pregnant women, and subjects with cardiovascular and infectious diseases or cancer; leaving 1983 (667 men, 1316 women) asymptomatic non-smoking subjects for the analysis. NO(x) concentrations were determined in serum and compared in different age groups. Mean+/-SE of NO(x) concentration was 24.8+/-0.02 and 24.4+/-0.01 micromol/l in men and women respectively. Men aged 20-29 years had significantly higher NO(x) levels compared to corresponding women (25.1+/-0.03 vs. 22.7+/-0.02). Serum NO(x) concentration peaked at 50-59 years in both genders. Comparison between lower and upper quartiles of NO(x) levels was performed in both genders. Women with high serum NO(x) were older and had significantly higher body mass index and fasting plasma glucose. The results of this study determine the normal levels of serum NO(x) concentrations in asymptomatic non-smoker subjects; also show that serum NO(x) concentrations indicate sex and age differences in these subjects.     

Therapeutics for advanced hepatocellular carcinoma: Recent advances,current dilemma,and future directions

Hepatocellular carcinoma (HCC) is one of the most common malignancies and is a serious threat to people's health worldwide. The prognosis of advanced HCC is dim if left untreated. In the clinic, the treatment options for advanced HCC include surgery, radiotherapy, transcatheter arterial chemoembolization, and so forth. In recent years, molecular targeted therapy and immunotherapy have also made great progress, bringing new hope to patients with advanced HCC. In this study, therapeutic advances, current dilemma, and future directions of advanced HCC are reviewed, which might serve as a summary for clinicians and may stimulate future research.