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Initial Episode (initial + episode)
Selected AbstractsAn early lesion in hepatic carcinogenesis: Loss of heterozygosity in human cirrhotic livers and dysplastic nodules at the 1p36-p34 regionHEPATOLOGY, Issue 6 2001Min Sun Loss of heterozygosity (LOH) of chromosome 1 has been suggested, by karyotyping, to be an initial episode in human hepatocarcinogenesis. However, this alteration has not yet been investigated in cirrhotic nodules (CNs) or dysplastic nodules (DNs). In an initial study from explanted or resected cirrhotic livers, LOH in 1p36-p32 was examined in 31 hepatocellular carcinomas (HCCs), 25 low-grade dysplastic nodules (LGDNs), and 24 high-grade dysplastic nodules (HGDNs). In HCCs, LOH was detected most frequently at loci D1S2843 (1p36.1) (28.6%), D1S513 (1p34.3) (29.2%), and MYCL1 (1p34.1) (28.6%). In HGDN and LGDN, LOH incidences at D1S513 were 11.1% and 13.6%, respectively. To further refine those results and to determine sequential relationships among CN, DN, and HCC, LOH was next studied in an additional 53 HCCs, 56 HGDNs, 30 LGDNs, and 215 CNs from 11 explanted human cirrhotic livers, including 30 "nodule-in-nodule" lesions. Seven markers between D1S2843 (1p36.12) and MYCL1 (1p34.1), and 1 each at D1S484 (1q24.1), IGF2R-3 (6q26), and TP53 (17p13.1) were used. LOH at D1S2843 and D1S513 was detected in HCCs (20.4% and 23.5%, respectively), HGDNs (7.7% and 18.5%), LGDNs (13.6% and 6.9%), and CNs surrounding either HCCs or DNs (7.4% and 8.3%). These results demonstrate that LOH at D1S2843 and D1S513 are early events in human liver carcinogenesis. Data from CN surrounding either HCCs or DN, and also nodule-in-nodule lesions, provide evidence supporting a CN,DN,HCC progression. Different deletion patterns from multiple HCCs and DNs suggest independent origins for carcinogenesis in the same individual. [source] The impact of radio feedback from active galactic nuclei in cosmological simulations: formation of disc galaxiesMONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, Issue 1 2008Takashi Okamoto ABSTRACT In this paper, we present a new implementation of feedback due to active galactic nuclei (AGN) in cosmological simulations of galaxy formation. We assume that a fraction of jet energy, which is generated by an AGN, is transferred to the surrounding gas as thermal energy. Combining a theoretical model of mass accretion on to black holes with a multiphase description of star-forming gas, we self-consistently follow evolution of both galaxies and their central black holes. The novelty in our model is that we consider two distinct accretion modes: standard radiatively efficient thin accretion discs and radiatively inefficient accretion flows which we will generically refer to as RIAFs; motivated by theoretical models for jet production in accretion discs, we assume that only the RIAF is responsible for the AGN feedback. The focus of this paper is to investigate the interplay between galaxies and their central black holes during the formation of a disc galaxy. We find that, after an initial episode of bursting star formation, the accretion rate on to the central black hole drops so that the accretion disc switches to a RIAF structure. At this point, the feedback from the AGN becomes efficient and slightly suppresses star formation in the galactic disc and almost completely halts star formation in the bulge. This suppression of the star formation regulates mass accretion on to the black hole and associated AGN feedback. As a result, the nucleus becomes a stochastically fuelled low-luminosity AGN (Seyfert galaxy) with recurrent short-lived episodes of activity after the star bursts. During the ,on' events, the AGN produces reasonably powerful jets (radio-loud state) and is less luminous than the host galaxy, while in the ,off' phase, the nucleus is inactive and ,radio quiet'. Our model predicts several properties of the low-luminosity AGN including the bolometric luminosity, jet powers, the effect on kpc scale of the radio jet and the AGN lifetime, which are in broad agreement with observations of Seyfert galaxies and their radio activity. We also find that the ratios between the central black hole mass and the mass of the host spheroid at z= 0 are ,10,3 regardless of the strength of either supernova feedback or AGN feedback because the radiation drag model directly relates the star formation activity in the Galactic Centre and the mass accretion rate on to the central black hole. [source] Recurrent idiopathic thrombocytopenic purpura in childhoodPEDIATRIC BLOOD & CANCER, Issue 2 2008Maria Vranou MD Abstract Background Idiopathic thrombocytopenic purpura (ITP) is a common haematological disease during childhood, that usually has a benign course; however, literature on the recurrent form of the disease (rITP) is limited. Procedure rITP was characterized by intermittent episodes of thrombocytopenia (TP) followed by periods of recovery, unrelated to therapeutic intervention. We retrospectively reviewed features of patients with rITP, diagnosed and systematically followed up at our center, during the period 1975,2004. Results Forty-eight of 795 children with ITP (6.0 %) presented with rITP. The majority of patients (68.8%) had only one recurrence, whereas only one patient had four. A time interval between two episodes longer than 3 months (up to 96) was identified in 2/3 of episodes and <3 months in 1/3. The initial episode and the first recurrence mostly shared features of acute ITP; however, 22.9% of the episodes appeared with a chronic self-limited course. Bleeding manifestations were rare (18.6% of episodes) and mild, and they tended to occur in severely thrombocytopenic patients, mainly at the onset of the initial episode; intracranial hemorrhage (ICH) occurred in a toddler with short duration thrombocytopenia. Intravenous , globulin (IVIG) or corticosteroids were administered in 24.5% of episodes. None of the patients needed splenectomy. Conclusion: rITP is a rare, mild, self-limited type of ITP, although ICH may occur in a profoundly TP child. Recurrence may occur close or far apart to a previous isolated TP episode. The duration of episodes varies considerably from patient to patient and from episode to episode in the same patient. The pathogenesis of rITP still remains unclear. Pediatr Blood Cancer 2008;51:261,264. © 2008 Wiley-Liss, Inc. [source] Ocular toxoplasmosis recurrences: a single center case reportACTA OPHTHALMOLOGICA, Issue 2009U SERRA Purpose To describe recurrence patterns in a cohort of patients with aqueous humor proven ocular toxoplasmosis, followed during 3 years, at a single referral center. Methods Retrospective, observational, non comparative case series including 43 patients who suffered from an active episode of toxoplasmic retinochoroiditis during 2005, confirmed by aqueous humour polymerase chain reaction (PCR) positivity and assisted at the Ophthalmology Department of the Pitié-Salpêtrière Hospital in Paris, France. Clinical files were analyzed in terms of signs of intraocular inflammation, number, size and location of retinochoroidal active lesions and scars, presence of ocular complications related to toxoplasmic retinochoroiditis, angiographic and visual field findings and therapeutic management. Results 20 males and 23 females (mean age 37 year-old) were followed after an episode of toxoplasmic retinochoroiditis confirmed by analysis of ocular fluids. Five of them were immunocompromised and twelve have already experienced at least a previous episode of active toxoplasmic retinochoroiditis. Recurrences occurred in 13 patients (28%) with a mean age of 48 years. These episodes were noted during the first year of follow-up, between 12 and 24 months and between 24 and 36 months in 4, 5 and 3 patients respectively. Conclusion Recurrences seem to be more frequent if they occur during the first year after the initial episode of retinochoroiditis, especially in older patients. Prospective studies are needed in order to confirm these preliminary data. [source] Bone mineral density in hyperthyroidismCLINICAL ENDOCRINOLOGY, Issue 4 2004Helen Karga Summary objective, To investigate whether previous hyperthyroidism is a cause of permanent secondary osteoporosis. design and patients, In this cross-sectional study, 164 women with untreated or previously treated overt and symptomatic hyperthyroidism were examined 0,31 years after the initial episode of hyperthyroidism and its treatment, and were compared with a control group of 79 age-matched women without previous history of hyperthyroidism. Subjects with current or previous metabolic bone disease, any antiresorptive treatment for osteoporosis or treatments and habits known to affect bone metabolism were excluded. measurements, The age of the first manifestation of the disease, the age at the measurement of bone mineral density (BMD) at the spine and femoral neck and the interval between diagnosis and treatment of hyperthyroidism and BMD measurement were recorded and the Z-scores and T-scores of BMD were analysed. results, Untreated hyperthyroidism and hyperthyroidism up to 3 years after its diagnosis and treatment were associated with decreased BMD. Three or more years after the first episode of the disease the mean Z-score at both skeletal sites was near zero and not different from the controls. The age at which hyperthyroidism was manifested for the first time had no effect on the final outcome. Women affected at a young age (13,30 years) had a more pronounced loss of BMD when examined untreated or early (< 3 years) after diagnosis, but a BMD significantly above zero if examined later (> 3 years). Older women (aged 51,70 years) showed a similar pattern, although the differences were not significant. Middle-aged subjects (31,50 years) had the smallest loss of BMD during the first 3 years. Analysis of T-scores of former hyperthyroid women aged , 51 years showed no significantly different relative risk (RR) for osteoporosis in comparison with the controls. However, the study was not powered enough to give meaningful RR results. conclusions, Overt symptomatic hyperthyroidism is associated with decreased BMD during the first 3 years after diagnosis and treatment of the disease. After this interval, former hyperthyroid women have a Z-score near zero and not different from women without a history of the disease, apparently because of recovery of the bone density lost early during the course of the disease. Symptomatic hyperthyroidism does not seem to be a cause of long-lasting osteoporosis, and the age of the patient during the first episode is irrelevant. [source] Novel ADAMTS-13 mutations in an adult with delayed onset thrombotic thrombocytopenic purpuraJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 9 2006Z. TAO Summary.,Background:,Thrombotic thrombocytopenic purpura (TTP) is associated with congenital and acquired deficiency of ADAMTS-13, a metalloprotease that cleaves von Willebrand factor (VWF) and reduces its adhesive activity. Mutations throughout the ADAMTS13 gene have been identified in congenital TTP patients, most of whom have initial episodes during infancy or in early childhood. Patients and methods:,We report the case of an adult male who was diagnosed with idiopathic thrombocytopenic purpura at age 34, and with TTP 14 years later. The patient was compound heterozygous for an 18 bp in-frame deletion (C365del) in the disintegrin domain and a point mutation of R1060W in the seventh thrombospondin domain of the ADAMTS-13 gene. Conclusions:In vitro studies found that C365del and R1060W severely impair ADAMTS-13 synthesis in transfected Hela cells, whereas the deletion mutant also failed to cleave VWF under static and flow conditions. [source] Disability and its treatment in bipolar disorder patientsBIPOLAR DISORDERS, Issue 1-2 2007Nancy Huxley Bipolar disorders (BPD) are major, life-long psychiatric illnesses found in 2,5% of the population. Prognosis for BPD was once considered relatively favorable, but contemporary findings suggest that disability and poor outcomes are prevalent, despite major therapeutic advances. Syndromal recovery from acute episodes of mania or bipolar major depression is achieved in as many as 90% of patients given modern treatments, but full symptomatic recovery is achieved slowly, and residual symptoms of fluctuating severity and functional impact are the rule. Depressive,dysthymic,dysphoric morbidity continues in more than 30% of weeks in follow-up from initial episodes as well as later in the illness-course. As few as 1/3 of BPD patients achieve full social and occupational functional recovery to their own premorbid levels. Pharmacotherapy, though the accepted first-line treatment for BPD patients, is insufficient by itself, encouraging development of adjunctive psychological treatments and rehabilitative efforts to further limit morbidity and disability. Interpersonal, cognitive,behavioral, and psychoeducational therapies all show promise for improving symptomatic and functional outcomes. Much less is known about how these and more specific rehabilitative interventions might improve vocational functioning in BPD patients. [source] | ||||||||||