Expression of nucleostemin gene in primary osteoarthritis.

INTRODUCTION: The identification of genes associated with osteoarthritis can help reveal underlying biological mechanisms that may lead to development of new therapeutic targets or biomarkers for early detection and risk stratification. Nucleostemin (GNL3) is a nucleolar GTPase initially identified in the nucleolus of rat neural stem cells. The current study was conducted to determine the expression of nucleostemin gene in the synovium and synovial fluid of patients with primary osteoarthritis and to correlate its expression to the different clinicopathological factors of the disease. PATIENTS AND METHODS: It included 31 patients with primary knee osteoarthritis and 25 osteoarthritis free patients served as a control group. Synovial tissue and synovial fluid samples were obtained directly from each patient for real time PCR of GNL3. RESULTS: Relative expression of GNL3 in synovial tissue and fluid samples was significantly higher in the osteoarthritic group as compared to the non-osteoarthritic group. GNL3 relative expression in both samples showed a significant difference among different BMI categories and among different radiographic grades of osteoarthritis. A high significant correlation was found between GNL3 relative expression levels in synovial tissue samples and those of synovial fluid samples with concordance of 85.7%. CONCLUSION: Nucleostemin could serve as a powerful prognostic marker for clinical use in osteoarthritis and its usefulness needs to be standardized and validated in a large-scale prospective multicentric study.

Differential hemodynamic response to repetitive transcranial magnetic stimulation in acute stroke patients with cortical versus subcortical infarcts.

OBJECTIVE: To assess the cerebral vasomotor response to ipsilesional repetitive transcranial magnetic stimulation (rTMS) on transcranial Doppler (TCD) in patients with recent ischemic stroke without carotid occlusive disease, and to compare this response in patients with cortical and subcortical infarcts. METHODS: Consecutive patients with first-ever anterior circulation acute ischemic stroke (<3 days) and no extra- or intracranial arterial stenosis were prospectively recruited. Patients were divided into 2 groups: cortical infarct (CI, n = 15) and subcortical infarct (SI, n = 16). TCD cerebral blood flow velocity (CBFV) and pulsatility index were measured before and after 10-Hz suprathreshold rTMS over the dorsolateral prefrontal cortex. RESULTS: ANOVA showed a greater percentage increase in middle cerebral artery (MCA) CBFV in the SI group than in the CI group following rTMS (p = 0.01). The percentage change in CBFV was significantly correlated between both MCAs in SI patients but not in CI patients (r = 0.8, p < 0.001 vs. r = 0.05, p = 0.9, respectively). CONCLUSIONS: 10-Hz rTMS induces significant bilateral hemodynamic changes in patients with acute ischemic stroke, which appear to be less prominent and less synchronous in patients with cortical infarcts. These findings may allow optimization of the use of TMS in acute stroke.