A practical approach to diseases affecting dentate nuclei.

A wide variety of diseases affect the dentate nuclei. When faced with the radiological demonstration of signal changes in the dentate nuclei, radiologists and clinical neurologists have to sieve through the many possibilities, which they do not encounter on a regular basis. This task can be challenging, and therefore, developing a clinical, radiological, and laboratory approach is important. Information on the topic is scattered and the subject has not yet been reviewed. In this review, a combined clinicoradiological approach is presented. The signal changes in T1, T2, fluid-attenuated inversion recovery (FLAIR), diffusion, susceptibility weighted, and gadolinium-enhanced images can give specific or highly suggestive patterns, which are illustrated. The role of computed tomography (CT) in the diagnostic process is discussed. Specific radiological patterns do not exist in a significant proportion of patients where the clinical and laboratory analysis becomes important. In this review, we group the clinical constellations to narrow down the differential diagnosis and highlight the diagnostic clinical signs, such as tendon xanthomas and Kayser-Fleischer rings. As will be seen, a number of these conditions are potentially reversible, and hence, their early diagnosis is desirable. Finally, key diagnostic tests and available therapies are outlined. The practical approach thus begins with the radiologist and winds its way through the clinician, towards carefully selected diagnostic tests defining the therapy options.

Use of insulin glargine during pregnancy: A review.

BACKGOUND AND AIMS: Hyperglycemia during pregnancy is increasing globally. Insulin therapy is considered the standard of care for its optimum management. Insulin glargine, in spite of widespread use in non-pregnant adults, lacks randomized controlled trial evidence as safe basal insulin during pregnancy. Aim of this review is to discuss major available evidences and recommendations on the use of insulin glargine during pregnancy. METHODS: Evidences related to use of insulin glargine during pregnancy, including animal studies, placental transfer studies, case reports as well as observational studies were retrieved using PUBMED & Google scholar. Recommendations regarding use of insulin glargine during pregnancy by international and Indian organizations were reviewed. RESULTS: Trans-placental transfer studies show that insulin glargine does not cross placenta when used at therapeutic concentrations. Although there are no randomized controlled trials on insulin glargine in pregnancy, it's use during pregnancy is not associated with any adverse maternal or neonatal outcomes as shown in many case reports and observational studies (both prospective and retrospective). It's use during pregnancy is hence considered safe by many organizations across the globe. CONCLUSIONS: Insulin glargine can be continued safely during pregnancy in women who are already taking it prior to pregnancy and have achieved good glycemic control with it. However we require preferably randomized controlled trials or large prospective observational studies to establish it as first line or preferred basal insulin for management of hyperglycemia during pregnancy.

Estimation of dynamically evolving ellipsoids with applications to medical imaging.

The estimation of dynamically evolving ellipsoids from noisy lower-dimensional projections is examined. In particular, this work describes a model-based approach using geometric reconstruction and recursive estimation techniques to obtain a dynamic estimate of left-ventricular ejection fraction from a gated set of planar myocardial perfusion images. The proposed approach differs from current ejection fraction estimation techniques both in the imaging modality used and in the subsequent processing which yields a dynamic ejection fraction estimate. For this work, the left ventricle is modeled as a dynamically evolving three-dimensional (3-D) ellipsoid. The left-ventricular outline observed in the myocardial perfusion images is then modeled as a dynamic, two-dimensional (2-D) ellipsoid, obtained as the projection of the former 3-D ellipsoid. This data is processed in two ways: first, as a 3-D dynamic ellipsoid reconstruction problem; second, each view is considered as a 2-D dynamic ellipse estimation problem and then the 3-D ejection fraction is obtained by combining the effective 2-D ejection fractions of each view. The approximating ellipsoids are reconstructed using a Rauch-Tung-Striebel smoothing filter, which produces an ejection fraction estimate that is more robust to noise since it is based on the entire data set; in contrast, traditional ejection fraction estimates are based only on true frames of data. Further, numerical studies of the sensitivity of this approach to unknown dynamics and projection geometry are presented, providing a rational basis for specifying system parameters. This investigation includes estimation of ejection fraction from both simulated and real data.

Leaching of pesticides in tea brew.

A cup of tea that cheers can also be an important route of human exposure to pesticide residues. It is important to evaluate the percent transfer of pesticide residue from dried (made) tea to tea infusion, as tea is subjected to an infusion process prior to human consumption. To investigate the pesticide translocation, 13 pesticides commonly used on tea were studied by subjection of fortified teas to infusion. Analytes of interest were quantified by gas-liquid chromatography with nitrogen-phosphorus and electron capture detectors. Interestingly, water solubility of pesticides did not necessarily indicate a shift of residues toward their preferential accumulation in infusion. The pesticides with larger partition coefficient (K(ow)) values remained nonextractable in infusing water. Further, boiling for longer periods (extended brewing time) resulted in higher transfer of pesticides to tea brew.

Histamine H4 receptor: a novel target for inflammation therapy.

Histamine, a low molecular weight amine has been extensively studied for its various pharmacological profiles. Until recently histamine was thought to act on three receptors - H1, H2 and H3. Merely a decade back, sequencing of human genome has revealed a new histamine receptor - H4 receptor. This 390 amino acid sequenced receptor has around 38% homology with histamine H3 receptor besides; the pharmacological profile of the protein is quite different from other histamine receptors. H4 receptor is mainly expressed in mast cells and leukocytes and involves various physiological functions related to inflammation and allergy. Potent selective H4 receptor agonists and antagonists have been synthesized and in vivo studies have indicated their action on H4 receptor. In this review, structure, expression, homology sequence of H4 receptor among the different species has been documented. Further, structure activity relationship (SAR) of H4 ligands on the basis of their nucleus has been discussed in depth. In addition, anti-inflammatory effects of H4 receptor antagonists, with special emphasis to JNJ7777120, a selective H4 receptor antagonist have been focused exhaustively.

[Karl Marx and the Malthusian theory of population]. / Karl Marx und die Malthusianische Bevolkerungstheorie.

PIP: An analysis of the works of Karl Marx is presented in order to demonstrate the importance of the population factor. The author contends that population growth is a critical factor in Marx's theory of the progressive impoverishment of the working class. However, because of his reluctance to acknowledge the value of the Malthusian contribution, Marx focused his analysis of the labor force under capitalism on the demand for workers and neglected the supply side, which is determined by the growth of population. The author concludes that Marxist theory would have benefited from greater consideration of Malthusian theory.^ieng

Incorporating spatial variation in density enhances the stability of simple population dynamics models.

Simple discrete time models of population growth admit a wide variety of dynamic behaviors, including population cycles and chaos. Yet studies of natural and laboratory populations typically reveal their dynamics to be relatively stable. Many explanations for the apparent rarity of unstable or chaotic behavior in real populations have been developed, including the possible stabilizing roles of migration, refugia, abrupt density-dependence, and genetic variation in sensitivity to density. We develop a theoretical framework for incorporating random spatial variation in density into simple models of population growth, and apply this approach to two commonly used models in ecology: the Ricker and Hassell maps. We show that the incorporation of spatial density variation into both these models has a strong stabilizing influence on their dynamic behavior, and leads to their exhibiting stable point equilibria or stable limit cycles over a relatively much larger range of parameter values. We suggest that one reason why chaotic population dynamics are less common than the simple models indicate is, these models typically neglect the potentially stabilizing role of spatial variation in density.

The solution of an integral equation with its application to human joints.

The fundamental fluid transport mechanisms in a cavity of a joint and the deformation of the bearing surfaces are important for the understanding of the bio-mechanical process involved in the physiology of normal and pathological synovial joints. We present here a study of elasto-rheodynamic lubrication of a self-acting dynamically loaded bearing which employs a porous, elastic material (articular cartilage) and a visco-elastic non-linear lubricant (synovial fluid). The tangible solution of the model is, finally, subjected to the resolution of a non-linear integral equation. Important conclusion is drawn from the results obtained for bearing characteristics which show the self-adjusting nature of human joints.

Small stature and insulin-like growth factors: prolonged treatment of mini-poodles with recombinant human insulin-like growth factor I.

The short stature of mini-poodles is associated with low serum levels of IGF-I. Standard poodles are taller and have considerably higher serum levels of IGF-I. Low IGF-I serum levels may be a symptom or the cause of small stature. We, therefore, undertook a study in which serum IGF-I levels of mini-poodles were elevated over a prolonged period of time by a constant infusion of rhIGF-I and the growth rate of the mini-poodles was followed. We infused four mini-poodles from day 91 to day 221 of age with 6 mg/day of recombinant human insulin-like growth factor I (rhIGF-I). Serum levels of IGF-I rose from about 160 to about 500 micrograms/l. Blood glucose remained within normal limits. Stimulation tests with clonidine and with GHRH revealed suppression of endogenous GH secretion during the IGF-I infusion. Serum levels of IGF-II and of creatinine were lower in the IGF-I-infused animals. Radial length and body weight did not increase to a greater extent in the IGF-I infused dogs than in controls. However, 'adapted body mass index' (aBMI = gram body weight/(mm radial length)2) decreased in each of the IGF-I infused animals, whereas it increased in each of the control dogs (p less than 0.05). We conclude that long-term infusion of IGF-I does not stimulate growth in young mini-poodles, but may change body composition.