Intracavernous injection of platelet-rich plasma reverses erectile dysfunction of chronic cavernous nerve degeneration through reduction of prostate hyperplasia evidence from an aging-induced erectile dysfunction rat model.

Age-induced erectile dysfunction (ED) is a convoluted medical condition, and restoring erectile function (EF) under geriatric conditions is highly complicated. Platelet-rich plasma (PRP) treatment is an inexpensive cell-based therapeutic strategy. We have aimed to restore EF in aged-ED rats with PRP as a therapeutic tool. Male rats were grouped into aged and young according to age. The young rats were considered as normal control (NC) and treated with saline. Aged were further divided into 2 groups and treated with intracavernous (IC) PRP and saline. Treatment was scheduled at the 9th and 10th week for NC and 41th and 42th week for aged-ED rats, with EF analysis scheduled on the 12th week for NC and 44th week for aged-ED rats, respectively. Erectile response, immunofluorescence staining, and electron microscopic analyses were performed. IC PRP treatment effectively reduced prostate hyperplasia (PH). EF response indicated a significant increase in crucial EF parameters in PRP-treated aged-ED rats. Histological evidence denoted a rigid and restored development of tunica adventitia of the dorsal artery, decreased vacuolation of the dorsal penile nerve, and structural expansion of the epineurium. Masson's trichrome and immunostaining results affirmed an elevated expression of α-smooth muscle actin (α-SMA) in the corpus cavernosum (CC). Ultrastructure findings revealed that PRP effectively rejuvenated degenerating nerves, preserved endothelium and adherent junctions of corporal smooth muscle, and restored the axonal scaffolds by upregulating neurofilament-H (NF-H) expression. Finally, PRP enhanced neural stability by enhancing the axonal remyelination processes in aged-ED rats. Hence, PRP treatment was proven to restore EF in aged-ED rats, which was considered a safe, novel, cost-effective, and hassle-free strategy for EF restoration in geriatric patients.

Amyloid PET pattern with dementia and amyloid angiopathy in Taiwan familial AD with D678H APP mutation.

INTRODUCTION: The novel D678H amyloid precursor protein (APP) gene mutation has been called the "Taiwan mutation". The study aims to identify amyloid deposition patterns and clinical features associated with this mutation. METHODS: we analyzed the clinical manifestations, brain neuroimages and 18F-AV-45 positron emission tomography (PET) findings in symptomatic patients and asymptomatic subjects with the autosomal-dominant Alzheimer's disease (AD). We compared the amyloid deposition pattern among 10 patients with genetically-positive familial cognitive decline (CD), 18 patients with sporadic CD, and 19 healthy controls. RESULTS: The clinical features were the early onset of memory impairment in all 10 patients and cerebral amyloid angiopathy in 3 patients. The characteristic results of brain 18F-AV-45 PET included the highest standard uptake value ratio (SUVR) in the occipital and cerebellar cortical areas in the genetically-positive CD patients. In subgroup analysis, the familial AD patients had a decreased amyloid SUVR trend in most areas except for cerebellar cortex compared to those with familial mild cognitive impairment. CONCLUSION: Our data indicate that the familial D678H gene mutation have resulted in a more potent amyloid burden than in the patients with sporadic AD patients. The high amyloid uptake in the occipital area is characteristic of the specific Taiwan APP gene.

Generalizing the effects of chirality on block copolymer assembly.

We explore the generality of the influence of segment chirality on the self-assembled structure of achiral-chiral diblock copolymers. Poly(cyclohexylglycolide) (PCG)-based chiral block copolymers (BCPs*), poly(benzyl methacrylate)-b-poly(d-cyclohexylglycolide) (PBnMA-PDCG) and PBnMA-b-poly(l-cyclohexyl glycolide) (PBnMA-PLCG), were synthesized for purposes of systematic comparison with polylactide (PLA)-based BCPs*, previously shown to exhibit chirality transfer from monomeric unit to the multichain domain morphology. Opposite-handed PCG helical chains in the enantiomeric BCPs* were identified by the vibrational circular dichroism (VCD) studies revealing transfer from chiral monomers to chiral intrachain conformation. We report further VCD evidence of chiral interchain interactions, consistent with some amounts of handed skew configurations of PCG segments in a melt state packing. Finally, we show by electron tomography [3D transmission electron microscope tomography (3D TEM)] that chirality at the monomeric and intrachain level ultimately manifests in the symmetry of microphase-separated, multichain morphologies: a helical phase (H*) of hexagonally, ordered, helically shaped tubular domains whose handedness agrees with the respective monomeric chirality. Critically, unlike previous PLA-based BCP*s, the lack of a competing crystalline state of the chiral PCGs allowed determination that H* is an equilibrium phase of chiral PBnMA-PCG. We compared different measures of chirality at the monomer scale for PLA and PCG, and argued, on the basis of comparison with mean-field theory results for chiral diblock copolymer melts, that the enhanced thermodynamic stability of the mesochiral H* morphology may be attributed to the relatively stronger chiral intersegment forces, ultimately tracing from the effects of a bulkier chiral side group on its main chain.

Family caregivers' sleep disturbance and its associations with multilevel stressors when caring for patients with dementia.

OBJECTIVE: We tested a stress process model of multilevel stressors on sleep disturbance for family caregivers (FCG) of persons with dementia (PWD). METHODS: For this cross-sectional study, trained research assistants collected data from a purposive sample of 180 PWD-FCG dyads at two teaching hospitals, two local hospitals, and two community long-term care service programs in northern Taiwan. PWDs' neuropsychiatric symptoms were assessed using the Chinese Neuropsychiatric Inventory (CNPI), FCGs' distress by CNPI Caregiver Distress Scale, physical fatigue by Visual Analogue for Fatigue Scale, mental fatigue by Attentional Function Index, depressive symptoms by the Center for Epidemiological Studies Depression Scale - Short Form, and sleep disturbance by the General Sleep Disturbance Scale. RESULTS: FCGs' most prevalent sleep disturbance problems were sleep quality problems (99.4%). Hierarchical regression models revealed that FCGs' sleep disturbance was predicted by their physical fatigue, their depressive symptoms, and the synergistic effect of physical fatigue and depressive symptoms in the final model, explaining 57.8% of the variance. CONCLUSIONS: This study supports the model that development of caregivers' sleep problems may depend on their depression, fatigue, and the synergistic effects of these two variables. These findings suggest that clinicians should educate FCGs about self-care and offer strategies for dealing with a cluster of symptoms when maintaining sleep hygiene.

Event-related evoked potentials in Alzheimer's disease by a tool-using gesture paradigm.

The Alzheimer's disease (AD) has a wide spectrum of symptoms, ranging from cognition dysfunction to behavior disturbances and functional impairment. The evoked cerebral potentials by specific paradigms are useful for disclosing neuropsychological activities. The evolution of AD is accompanied by progressive cognitive impairment which may result in a difficulty to recognize or comprehend gestures. In the present study, a visual tool-using gesture paradigm was employed to assess the cognitive functions of 16 probable AD patients, 17 subjects mild cognitive impairment (MCI), and 17 age-matched control subjects. Each subject was conducted by visual stimuli by a series of pictures, each displaying randomly a gesture with correctly or incorrectly using a tool. The P300 amplitude was further used as a parameter to build classifiers based on support vector machine.

Brain connectivity of patients with Alzheimer's disease by coherence and cross mutual information of electroencephalograms during photic stimulation.

Alzheimer's disease (AD) is a neurodegenerative disease, usually diagnosed by neuropsychological tests, and excluded from other cerebral diseases by brain images. An electroencephalogram (EEG) provides a means of disclosing the reduced functional couplings between brain regions that occurs with AD. In the present study, 16 probable AD patients and 15 age-matched, gender-matched normal subjects were enrolled. Spectral coherence and cross mutual information (CMI) were used to analyze EEGs during intermittent photic stimulation (PS). Ocular- and heartbeat-related source components (SCs) obtained from multi-channel EEGs by the independent component analysis were discarded, and the photic-related SCs were reduced using a comb filter. The undisturbed SCs and photic-related SCs before and after photic reduction were used to reconstruct photic-preserved EEGs and photic-reduced EEGs, from which harmonic coherences (direct photic-driving response) and rhythmic coherences and CMI (indirect photic affection) were computed, respectively. Our results indicate that the rhythmic coherences (particularly in the alpha and beta bands) and CMI variables as well as the harmonic coherences (particularly related to 3-Hz PS) were significantly lower in the probable AD than in normal subjects, whereas the variables derived from the resting EEGs were not statistically significant. This finding implied that the variables obtained during PS could be used to disclose impaired intra-brain associations in probable AD.

Correlation of early-phase 18F-florbetapir (AV-45/Amyvid) PET images to FDG images: preliminary studies.

PURPOSE: (18)F-Florbetapir (AV-45/Amyvid) is a novel positron emission tomography (PET) tracer for imaging plaque pathology in Alzheimer's disease (AD), while PET images of fluorodeoxyglucose (FDG) for cerebral glucose metabolism can provide complementary information to amyloid plaque images for diagnosis of AD. The goal of this preliminary study was to investigate the perfusion-like property of relative cerebral blood flow estimates (R(1)) and summed early-phase AV-45 images [perfusion AV-45 (pAV-45)] and optimize the early time frame for pAV-45. METHODS: Dynamic AV-45 PET scans (0-180 min) were performed in seven subjects. pAV-45, late-phase AV-45, and FDG images were spatially normalized to the Montreal Neurological Institute template aided by individual MRI images, and the corresponding standardized uptake value ratio (SUVR) was computed. The R(1) images were derived from a simplified reference tissue model. Correlations between regional and voxelwise R(1) and the corresponding FDG images were calculated. An optimization of time frames of pAV-45 was conducted in terms of correlation to FDG images. The optimal early time frame was validated in a separate cohort. RESULTS: The regional distribution in the R(1) images correlated well (R = 0.91) to that of the FDG within subjects. Consistently high correlation was noted across a long range of time frames. The maximal correlation of pAV-45 to FDG SUVR of R = 0.95 was observed at the time frame of 1-6 min, while the peak correlation of R = 0.99 happened at 0-2 min between pAV-45 and R(1). A similar result was achieved in the validation cohort. CONCLUSION: Preliminary results showed that the distribution patterns of R(1) and pAV-45 images are highly correlated with normalized FDG images, and the initial 5-min early time frame of 1-6 min is potentially useful in providing complementary FDG-like information to the amyloid plaque density by late-phase AV-45 images.

[Sleep disturbance and associated factors amongst family caregivers of dementia patients].

BACKGROUND: In Taiwan, eighty-five percent of dementia patients are cared for by family caregivers (FCGs), who have indicated insomnia to be a prevalent personal health problem. PURPOSE: The aim of this study was to explore sleep disturbance and associated factors among FCGs caring for dementia patients. METHODS: A purposive sample of 180 dementia patient dyads and their FCGs was recruited from northern Taiwan. Dementia patients neuropsychiatric symptoms were assessed using the Chinese Neuropsychological Inventory (CNPI). FCG distress, depressive symptoms, and sleep disturbance were assessed using the CNPI Caregiver Distress Scale, Center for Epidemiological Studies-Depression Scales, and Lee's General Sleep Disturbance Scale, respectively. RESULTS: Sleep disturbance was reported as interfering with the daily lives of 13.3% of FCGs. The hierarchical regression model indicated (1) relationships between patients and FCGs and (2) FCG depressive symptoms as two significant predictors of sleep disturbance in FCGs, explaining 45.8% of variance. FCG depressive symptoms represented the most significant single predictor - contributing 31% of variance. CONCLUSIONS: Sleep disturbance in FCGs is predicted by the patient-FCG relationship and FCG depressive symptoms. To better care for FCGs of dementia patients, nurses should assess patients behavioral problems, FCG distress, and FCG depressive symptoms. Nurses may also better allocate social resources based on the specific relationships between FCGs and their dementia patients. In addition, nurses should redirect FCG attention toward positive thinking in order to alleviate depressive symptoms and decrease sleep disturbance.