Showing papers by "Medical University of Varna published in 2010"

Electrocution-related mortality: a review of 351 deaths by low-voltage electrical current.

Abstract: BACKGROUND: We describe herein the characteristics of lethal injuries caused by low-voltage electrical current (electrocution), the most frequent injury caused by electrical current. METHODS: Nine hundred forty-five cases over a period of 41 years (1965-2006) were reviewed, of which, 351 electrocution cases were identified. The descriptive statistical analyses were carried out with the application of SPSS 11.0 software. RESULTS: Electrocution accounted for 37.14% of all studied electricity-caused injuries. The average age of the victims was 35.25 years. The average age of male victims was 36.19 years and of female victims was 32.55 years. The distribution by gender showed a significant prevalence of the male sex (74.07%). Among the circumstances leading to electrocution, household accidents (78.06%) prevailed over occupational accidents (13.39%). Suicides were significantly rarer (7.41%). 66.10% of all electrocution cases occurred during the summer period from June through September. CONCLUSION: Household accidents prevail among the circumstances under which electrocution occurs, with an insignificant difference in the male/female proportion in this group. The majority of electrocutions occurred during the summer period (June-September). The results obtained in this research can help in the development of a differentiated strategy for the prevention of electrocution, while taking into consideration gender, age and season of the year. Language: en

Adipose-derived stem cells as a remedy

Abstract: Adipobiology of stem cells is reaching enthusiastic proportions in today's regenerative medicine. Current interest in the adipose-derived stem cells (ADSC) stems from their multilineage differentiation potential, and ease of derivation in larger quantities using less invasive methods, compared with other stem cell types. The possible benefits of ADSC-based therapy may be mediated by both cell proliferation/differentiation and paracrine secretion. Adipose tissue's secretome includes adipokines (growth factors, cytokines, chemokines, neuropeptides, hypothalamic hormones/releasing factors), steroid hormones, free fatty acids, prostaglandins, and endocannabinoids. The present review, focusing on adipose tissue secretory activity, also highlights the possible implication of ADSC in the therapy of various disorders, particularly neurodegenerative diseases, myocardial infarction and stroke as well as gut, liver and skin diseases. Adipobiology 2010; 2: 51-56.

The effects of melatonin on burn-induced inflammatory responses and coagulation disorders in rats.

Abstract: The aim of this study was to investigate the effects of melatonin on burn-induced inflammatory responses and coagulation disorders in a rat model. Under ether anesthesia, shaved dorsa of rats were exposed to 90 degrees C for 10 s to induce burn injury. Melatonin (10 mg/kg) was administered immediately and after 12 h. Standard coagulation tests (prothrombin activity [PA] and activated partial thromboplastin time [aPTT]), platelet number and morphology; proinflammatory markers (C-reactive protein [CRP] and fibrinogen) and lipid peroxidation marker (malondialdehyde [MDA]) levels were assayed. Thermal injury increased the levels of MDA (by 76%, P < 0.0001), CRP (by 33%, P < 0.0001), fibrinogen (4.5-fold, P < 0.0001) and PA (by 37%; P < 0.01). Changes in aPTT and platelet numbers were nonsignificant. Melatonin diminished the elevated CRP and fibrinogen levels, normalized MDA levels, platelet morphology and decreased PA. A positive association of MDA with fibrinogen and MDA with PA were noted after melatonin treatment. To conclude, melatonin as an antioxidant and anti-inflammatory agent exerted a suppressive effect on burn-induced disorders in blood coagulation and might be useful in the prevention of disseminated intravascular microthrombosis.

Bone marrow-derived stromal cells can express neuronal markers by DHA/GPR40 signaling.

Abstract: Summary The exact origin of neural stem cells in the adult neurogenesis niche remains unknown. Our previous studies, however, indicated an implication of both bone marrow cells as potential progenitors of hippocampal newborn neurons and polyunsaturated fatty acids as ligands of G protein-coupled receptor 40 (GPR40) signaling. Here, we aimed at studying whether bone marrow-derived stromal cells (BMSC) treated by docosahexaenoic acid (DHA) can express neuronal markers in vitro. We focused on implication of DHA/GPR40 signaling for the expression of neural markers in clonally-expanded BMSC from young macaque monkeys. Cell cycle analysis revealed that the DHA plus bFGF treatment induced a decrease of BMSC proliferation and increased the cells in the G0 resting phase. The transitions from nestin-positive progenitors via immature neuronal (β III-tubulinpositive) to mature neuronal (NF-M and Map2-positive) phenotypes were examined using RT-PCR, Western blot and immunocytochemistry. We detected a significant increase of GPR40 mRNA and protein expression after bFGF induction, being compared with the untreated BMSC. Addition of DHA, a representative GPR40 ligand, led to a significant down-regulation of GPR40, i.e., G protein-coupled receptor-specific internalization, with a subsequent upregulation of neuronal markers such as β III-tubulin, NF-M and Map2. These data altogether suggest that adult primate BMSC can express neuronal markers with the aid of DHA/GPR40 signaling.

Adipobiology of stem cell-based therapy: secretome insight

Abstract: Stem from the promise of stem cells therapeutic potential for a number of diseases, the regenerative medicine is reaching enthusiastic proportions nowadays. Current therapies include drug treatment, lifestyle modification, organ transplantation, RNA interference “breakthrough technology”, and stem cell-based therapy. Research on stem cells is a multiplex challenge provoking both the attention and the confusion of biologists, biotechnologists, medical specialists, and politicians. By integrating various approaches of transcriptomics, proteomics and metabolomics, current adipobiology has identified more than 100 secretory proteins that are produced by the adipose tissue. These proteins designated adipokines include growth factors, cytokines, chemokines, neuropeptides and hypothalamic hormones/releasing factors. In addition, the adipose tissue’s secretome contains steroid hormones, free fatty acids, prostaglandins, and endocannabinoinds. Moreover, adipose tissue is the source of adipose-derived stem cells (ADSC). Current interest in the ADSC stems from their multilineage differentiation potential, and ease of derivation in larger quantities using less invasive methods, compared with other stem cell types. The possible benefits of ADSC-based therapy may be mediated via cell proliferation/differentiation and/or paracrine mechanisms. The present review, focusing on adipose tissue secretory activity, also highlights the possible implication of ADSC in the therapy of various disorders, particularly neurodegenerative diseases, myocardial infarction and stroke, along with gut and liver diseases. Biomed Rev 2010; 21: 57-63.

Human body as a multicrine gland

Abstract: The present Editorial is a reflection from the article by Stephen Manning and by Sridhar Gumpeny and Lakshmi Gumpeny published in this volume of Adipobiology . Focusing to injured Homo obesus and glucose and energy homeostasis, the authors also discussed adipose- and bone-derived endocrine proteins collectively termed adipokines and osteokines, respectively. Adipobiology 2010; 2: 73-75.

Hydrogen sulfide: synthesis and function in the adipose tissue

Abstract: Apart from nitric oxide (NO) and carbon monoxide (CO), hydrogen sulfide (H 2 S) is the third gaseous mediator in mammals. H 2 S is synthesized from L-cysteine by cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), or by sequential action of alanine aminotransferase and 3-mercaptopyruvate sulfurtransferase. In the cardiovascular system, H 2 S is involved in the regulation of vascular tone and blood pressure, inhibits atherogenesis, and protects myocardium from ischemia-reperfusion injury. Recent studies indicate that H 2 S is synthesized also in the adipose tissue. Hydrogen sulfide produced in periadventitial adipose tissue (tunica adiposa) of the blood vessels induces vasodilation by activating K + channels in smooth muscle cells. On the other hand, H 2 S inhibits basal and insulin-stimulated glucose uptake in visceral adipose tissue, and may be involved in the pathogenesis of insulin resistance. H 2 S production in periadventitial adipose tissue is stimulated by vasoconstrictors and aortic banding-induced hypertension and downregulated by aging. H 2 S signaling in adipose tissue may be affected by pharmacotherapy. Lipid-soluble statins (3-hydroxy-3-methylglutarylcoenzyme A reductase inhibitors) increase H 2 S level in periadventitial adipose tissue and thus augment its anticontractile effect on the blood vessels. This effect of statins results from the depletion of ubiquinone - a component of mitochondrial respiratory chain - and the impairment of mitochondrial H 2 S oxidation. Adipobiology 2010; 2: 41-50.

NGF-OME: ITS METABOTROPHIC EXPRESSION Homage to Rita Levi-Montalcini

Abstract: Nowadays, in the postgenome time, many "-ome" studies have emerged including proteome, transcriptome, interactome, metabolome, adipokinome, connectome. In this vein, the catchall term NGF-ome embodies all the actions of NGF in health and disease. Accordingly, the present Festschrift, also tabula gratulatoria, is to honor and acknowledge the contributions of the distinguished neuroscientist and magistra Rita Levi-Montalcini, the Nobel Prize winner-1986 for the discoverer of NGF. Today, NGF and another neurotrophin, brain-derived neuroptrophic factor (BDNF), are well recognized to mediate multiple biological phenomena, ranging from the neurotrophic through immunotrophic and epitheliotrophic to metabotrophic effects. These latter effects are involved in the maintenance of cardiometabolic homeostasis (glucose and lipid metabolism as well as energy balance, and cardioprotection). Circulating and/or tissue levels of NGF and BDNF are altered in cardiometabolic diseases (atherosclerosis, obesity, type 2 diabetes, metabolic syndrome, and type 3 diabetes/Alzheimer's disease). A hypothesis thus emerged that a metabotrophic deficit due to the reduction of NGF/BDNF availability and/or utilization may be implicated in the pathogenesis of cariometabolic and neurodegenerative diseases. The present challenge is therefore to cultivate a metabotrophic thinking about how we can modulate NGF/BDNF secretion and signaling for the benefit of human cardiometabolic and mood health. Biomedical Reviews 2010; 21: 25-29.

Feeling the meaning: sobering thoughts at seventy

Abstract: Another title of this Foreword might be "Ju, or the differences between 100 fireflies". Anyhow, the story began "when the night has come" and I sent a message to Professor Hiroshi Yamamoto in Kanazawa asking him to write in Japanese: "Longevity is a good thing". Shortly I received two kanji, cho-ju, calligraphically expressing the meaning of longevity. Adipobiology 2010; 2: 3-4.

Polychlorinated biphenyls and organochlorine pesticides in black mussel and goby from Black Sea, Bulgaria

Abstract: Concentrations of persistent organic pollutants including polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were measured in two marine species: black mussel (Mytilus galloprovincialis) and goby (Neogobius cephalarges). Samples were collected from Lake Varna and Varna Bay in the period of 2004 - 2005 in order to evaluate the status, spatial distribution and potential sources of pollution in these areas. The mussel, one of the most widely used bioindicators of persistent organic pollutants, has been used to monitor PCBs and DDTs contamination trends in Lake Varna and Varna Bay. Black sea gobies are non-migratory species and feed mainly with benthic organisms. Average PCB concentration in mussels were found 28.7 ng/g fat. Total PCB concentrations in goby varied in the range of 21.3 and 71.5 ng/g fat. Concentration in black mussel were found 28.7 ng/g fat for total DDTs. Average DDTs concentration in goby were measured 2116 ng/g fat. The levels of PCBs and DDTs in black mussels and goby from the Lake Varna and Varna Bay were comparable with those found in other marine ecosystems.

Eosinophilic fasciitis - a diagnosis to consider. case report and review of the literature

Abstract: Eosinophilic fasciitis is a rare sclerodermatous dis order with controversial etiology and pathogenesis. Constellation of clinical features and laboratory abnormalities establishes the di agnosis: deep induration of the subcutaneous tissue, flexion joint contractures, high eosinophil count in blood and bone marrow, characteristic histologic find ings, arthralgia, myalgia, negative visceral involvement, negative Raynaud phenomenon, history of excessive physical exercise, therapeutic sensitivity to corticosteroids and characteristic MRI findings. The main stay of treatment are systemic corticosteroids and early intervention is usually effective with a benign course of the disease. Refractory cases may require immunosuppressive or alternative agents. Scripta Scientifica Medica 2010;42(1):11-15

Unilateral proptosis: a diagnostic clinical and neuroimaging challenge

Abstract: INTRODUCTION: The differential diagnosis of unilateral proptosis includes tumors, infections often related with immunological process, trauma, vascular diseases or axial myopia. CASE REPORTS: We present two patients with unilateral proptosis. A 34-yeard old caucasian man with a 3-months history of proptosis of the left eye with diplopia and normal visual acuity; initial CT scan examination showed highly suggestive finding for orbital apex tumor or glioma of the optic nerve, but a second CT scan with complementary projections was performed and a highly swollen inferior rectus muscle simulating an orbital apex tumor was visible. A diagnosis of unilateral thyroid ophthalmopathy was made. A 56-year old caucasian woman with unilateral exophthalmus and medical history of Graves’ hyperthyroidism; previously Graves’ ophthalmopathy was suggested. Fundoscopy showed myopic fundus. The CT scan revealed normal extraocular muscles without swollen. CONCLUSION: These two cases of unilateral proptosis are described because of their clinical and radiological differential diagnosis. We suggest that the accurate diagnosis of a unilateral proptosis remains a big challenge to the neuroophthalmologist, endocrinologist, immunologist, neurosurgeon and radiologist.

A case of rosacea associated with keratitis in 7 years old girl

Abstract: Rosacea is a common cutaneous disorder, that usually atacts between age 40 and 60 years. It is characterized by redness, bumps, pimples. Rosacea usually occurs on the face and rare cases is associated with mild ocular involvement in child population.

Treatment options in late Parkinson's disease: decimeter wave therapy

Abstract: Late stage Parkinson's disease (PD) is characterized by significant worsening of symptoms, motor fluctuations and decrease of effectiveness of drug therapy. Decimeter wave therapy (DWT) is one option to enlarge treatment strategy in late PD. We studied the effect of DWT in 12 patients (7 males), aged 65,83± 4,02 years, with 6,42± 1,51 years disease duration. Seven were at Hoehn-Yahr stage III and remaining 5 at stage IV. Mean UPDRS total score sum was 39,25± 1,91, and mean UPDRS part III sum was 24,67± 2,1. DMW was performed according to a standard protocol with apparatus Volna - 2, 10 consecutive procedures, once daily. Evaluation of UPDRS total and part III was performed on baseline, on days 11, 31 and 61. On day 11 all patients showed decrease in their both UPDRS total and part III. We lowered the levodopa doses of 6 patients in Hoehn-Yahr stage III with greatest decrease of UPDRS. On days 31 and 61 UPDRS total and part III were still lower. Our results demonstrate substantial effect of DWT on motor symptoms in late PD patients. All patients showed improvement, assessed by UPDRS, as the effect still lasted for 2 months after the physical therapy, even slightly diminished on day 61, compared to day 11. According to our results and patients subjective satisfaction reported, we could propose DWT become a part of the treatment strategy in late PD patients.

Ectopic pregnancy after assisted reproductive technology: a retrospective study

Abstract: In this study from 2006 to 2010,1628 IVF-ET cycles were performed in our unit. Long protocol with GnRH agonist plus recombinant FSH, short protocol with GnRH antagonist, short protocol with microdoses of GnRH agonist (flare up), natural modified cycle with GnRH antagonist and hCG were applied. The serum level of the P-hCG was measured 12 days after embryotransfer (ET). When positive, the P-hCG level was determined every 4 days until the ultrasound examination 22 days after the ET. From 1628 IVF - ET cycles, we had 10 tubal pregnancies (0,61%) and one heterotopic pregnancy (HP). Salpingectomy was performed in all patients, 7 had laparoscopy, and 3 underwent emergent laparotomy due to hemorrhagic shock. Regarding the HP patient, an ultrasound scan confirmed a viable intrauterine 8-weeks gestation and an ectopic pregnancy (EP) in the left tube with fetal heartbeat corresponding to gestational age of 7-8 weeks. Laparoscopy with left salpingectomy was performed the following day. The intrauterine pregnancy proceeded uneventfully. The patient delivered by elective Cesarean section at 39 weeks of gestation due to breech presentation. Patients undergoing IVF-ET must be informed of the risk of EP and the possibility of HP should not be ignored.

Influence of comorbid depression, sociodemographic and seizure-related variables on quality of life of adults with epilepsy

Abstract: Quality of life (QOL) is recognised as an important concept to better understand the distress of living with epilepsy. As it is a multidimensional construct it can be influenced by many and different factors including sociodemografic, disease-specific and psychosocial ones. AIM AND METHOD: We assessed the influence of comorbid depressive disorder, some sociodemografic and seizure-related variables on QOL of people with epilepsy (PWE). The sample included 106 adult patients with idiopathic epilepsy (41 males and 65 females). All subjects underwent clinical psychiatric examination, including evaluation on Hamilton Depression Rating Scale (HAM-D-17) and completed Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Seizure severity was measured by Seizure Severity Questionnaire (SSQ). A questionnaire for demographic and seizure-related variables was also completed. Comorbid depressive disorder was diagnosed according to ICD-10 diagnostic criteria for affective and delusional disorders and ILAE classification for epilepsies and epileptic syndromes was used. Statistical analysis included correlation analysis, t-tests and multivariation analysis. RESULTS: Employment, education and age, seizure frequency and seizure severity were associated with QOL scores. Comorbid depressive disorder was associated with QOL scores accounting for 32% of the variance in QOLIE-31 overall score and was a strong predictor for the variance in overall QOL, emotional well-being, energy/fatigue and cognitive functioning scores. Seizure severity influenced most the variance in seizure-worry score. Seizure frequency accounted most for social functioning and medication effects scores. Gender, marital status, seizure type, age at seizure onset, duration of seizures and antiepileptic medication intake had no significant association with QOLIE-31scores in this study. CONCLUSIONS: Multiple factors determine QOL of PWE. Detection and treatment of comorbid depressive disorder, being the most frequent psychiatric comorbidity in epilepsy, is a challenge for improving the QOL these patients and future research should give priority to this issue.

Call to friendship: some passing thoughts at 70

Abstract: During these Christmas holidays, I received a greeting card from Professor Marcia Hiriart of Mexico with a message saying "May our growth factors continue to grow in a collaborative effort between our labs." Our in-house evaluation reveals that this should be the thought of Brain-and-Heart Friendship (BHF) for the year 2010. This definitely contrasts to the word of year 2009 "to unfriend" as chosen by the New Oxford American Dictionary, primarily used by Facebook. Biomedical Reviews 2010; 21: iii-iv.

Delayed surgical resections of brain metastases after gamma knife radiosurgery.

Abstract: Although brain metastases are one of the most frequently diagnosed sequelae of systemic malignancy, their optimal management still is not well defined. In that respect, the different diagnostic and therapeutic approaches of BMs patients is an issue for serious discussions. The treatment options include surgical excision, WBRT, radiosurgery, chemotherapy, immunotherapy, etc. Nowadays, the aforementioned treatment modalities are usually combined in different treatment schemes. More than one option is used for the same patient and combining these treatment modalities gives better results than when separately use them. The value of surgical excision of progressing brain metastases treated with gamma knife surgery (GKS) is not well investigated.With the present study, we aim to investigate the value of surgical excision of symptomatic brain lesions that have been previously treated with GKS.

SOS for Homo sapiens obesus

Abstract: Published on 1 December 1994 issue of Nature , the Jeffrey Friedman's discovery "gave leptin in the beginning" of the endocrine saga of adipose tissue. Onwards, studies on this tissue have enjoyed an explosive growth that conceptualized a novel field of research, adipobiology. Arguably, in the heart of adipobiology and adipopharmacology are studies focusing on the pathogenesis, prevention and therapy of cardiometabolic diseases (CMD) including atherosclerosis, hypertension, obesity, type 2 diabetes, metabolic syndrome (global cardiometabolic risk), and lipodystrophies. Adipobiology 2010; 2: 5-8.