Adherence Improvement in Glaucoma Patients: Effects of Educational Intervention Using an Eye Drop Chart

Purpose@#To evaluate the effects of an educational intervention using an eye drop chart and supplementary education on glaucoma patients’ adherence. @*Methods@#In this multicenter prospective study, medically treated glaucoma patients were educated on the administration of eye drops using an eye drop chart. At the time of recruitment, all of the patients completed a questionnaire on demographic characteristics and adherence. Three months after the initial educational intervention, the patients were randomly divided into two groups: an education group and a control group. The education group received supplementary education. Immediately thereafter and at 6 months, all of the patients completed the questionnaire on adherence again. Changes in instillation behavior, the relationship between the adherence score and demographic characteristics, and factors contributing to an improvement in adherence and intraocular pressure were then analyzed. @*Results@#The adherence scores were significantly higher in patients with fewer medications, a higher annual income and higher educational level, and an urban residence (p = 0.038, p = 0.033, p = 0.041 and p = 0.047, respectively). Education on the administration of eye drops and use of the eye drop chart improved adherence scores from 23.05 ± 3.52 to 21.30 ± 3.95 (p = 0.021) and significantly reduced the average intraocular pressure from 14.3 ± 2.9 to 12.4 ± 3.1 mmHg (p < 0.001). Working indoors (odds ratio [OR] = 5.47, p = 0.032) and supplementary education at 3 months (OR = 4.53, p = 0.030) were also correlated with improved adherence. @*Conclusions@#An eye drop chart is an effective tool for improving adherence and intraocular pressure control in glaucoma patients. Improvement in adherence was especially notable in patients whose work predominantly involved indoor activity. The effectiveness of the eye drop chart was improved by supplementary education.

Effect and Safety of Travoprost 0.003% in Open Angle Glaucoma

Purpose@#To determine whether travoprost 0.003% has a similar intraocular pressure (IOP) reduction effect to that of travoprost 0.004% while reducing side effects. @*Methods@#This was a prospective study from January 2018 to December 2018 that included 102 patients diagnosed with open angle glaucoma who switched from travoprost 0.004% to travoprost 0.003%. We investigated the changes in IOP, conjunctival hyperemia, corneal erosion, and eyelid pigmentation before and at 3 months after switching to travoprost 0.003%. Additionally, a questionnaire survey of these patients was conducted to determine possible side effects, including hyperemia, stinging, pruritus, irritation, blurred vision, dryness, and foreign body sensation. @*Results@#IOP readings before and after switching to travoprost 0.003% were 12.95 ± 4.25 and 12.94 ± 3.89 mmHg, respectively, showing no significant change (p = 0.974). No changes were observed in corneal erosion or eyelid pigmentation; however, conjunctival hyperemia was reduced significantly from 1.60 ± 0.88 to 1.36 ± 0.84 (p = 0.001). No significant changes in hyperemia, stinging, pruritus, irritation, or foreign body sensation were reported; however, a significant improvement was noted for blurred vision and dryness (p = 0.008, p = 0.007, respectively). @*Conclusions@#We were able to show the effectiveness and safety of travoprost 0.003% as being as effective as travoprost 0.004% in reducing IOP and injections while improving blurred vision and dryness.

Effect and Safety of Travoprost 0.003% in Open Angle Glaucoma

Purpose@#To determine whether travoprost 0.003% has a similar intraocular pressure (IOP) reduction effect to that of travoprost 0.004% while reducing side effects. @*Methods@#This was a prospective study from January 2018 to December 2018 that included 102 patients diagnosed with open angle glaucoma who switched from travoprost 0.004% to travoprost 0.003%. We investigated the changes in IOP, conjunctival hyperemia, corneal erosion, and eyelid pigmentation before and at 3 months after switching to travoprost 0.003%. Additionally, a questionnaire survey of these patients was conducted to determine possible side effects, including hyperemia, stinging, pruritus, irritation, blurred vision, dryness, and foreign body sensation. @*Results@#IOP readings before and after switching to travoprost 0.003% were 12.95 ± 4.25 and 12.94 ± 3.89 mmHg, respectively, showing no significant change (p = 0.974). No changes were observed in corneal erosion or eyelid pigmentation; however, conjunctival hyperemia was reduced significantly from 1.60 ± 0.88 to 1.36 ± 0.84 (p = 0.001). No significant changes in hyperemia, stinging, pruritus, irritation, or foreign body sensation were reported; however, a significant improvement was noted for blurred vision and dryness (p = 0.008, p = 0.007, respectively). @*Conclusions@#We were able to show the effectiveness and safety of travoprost 0.003% as being as effective as travoprost 0.004% in reducing IOP and injections while improving blurred vision and dryness.

Dexamethasone Interferes with Autophagy and Affects Cell Survival in Irradiated Malignant Glioma Cells

Objective@#: Radiation is known to induce autophagy in malignant glioma cells whether it is cytocidal or cytoprotective.Dexamethasone is frequently used to reduce tumor-associated brain edema, especially during radiation therapy. The purpose of the study was to determine whether and how dexamethasone affects autophagy in irradiated malignant glioma cells and to identify possible intervening molecular pathways. @*Methods@#: We prepared p53 mutant U373 and LN229 glioma cell lines, which varied by phosphatase and tensin homolog (PTEN) mutational status and were used to make U373 stable transfected cells expressing GFP-LC3 protein. After performing cell survival assay after irradiation, the IC50 radiation dose was determined. Dexamethasone dose (10 µM) was determined from the literature and added to the glioma cells 24 hours before the irradiation. The effect of adding dexamethasone was evaluated by cell survival assay or clonogenic assay and cell cycle analysis. Measurement of autophagy was visualized by western blot of LC3-I/LC3-II and quantified by the GFP-LC3 punctuated pattern under fluorescence microscopy and acridine orange staining for acidic vesicle organelles by flow cytometry. @*Results@#: Dexamethasone increased cell survival in both U373 and LN229 cells after irradiation. It interfered with autophagy after irradiation differently depending on the PTEN mutational status : the autophagy decreased in U373 (PTEN-mutated) cells but increased in LN229 (PTEN wild-type) cells. Inhibition of protein kinase B (AKT) phosphorylation after irradiation by LY294002 reversed the dexamethasone-induced decrease of autophagy and cell death in U373 cells but provoked no effect on both autophagy and cell survival in LN229 cells. After ATG5 knockdown, radiation-induced autophagy decreased and the effect of dexamethasone also diminished in both cell lines. The diminished autophagy resulted in a partial reversal of dexamethasone protection from cell death after irradiation in U373 cells; however, no significant change was observed in surviving fraction LN229 cells. @*Conclusion@#: Dexamethasone increased cell survival in p53 mutated malignant glioma cells and increased autophagy in PTENmutant malignant glioma cell but not in PTEN-wildtype cell. The difference of autophagy response could be mediated though the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling pathway.

Cellular Senescence in Pterygium

Purpose@#To determine cellular senescence in pterygium by studying the expression of senescence-related markers. @*Methods@#Impression cytology was performed on 28 eyes of 28 patients diagnosed with pterygium or pinguecula from August2019 to January 2020. From the obtained specimen, the expression of senescence-associated beta galactosidase (SA-β-gal),p16, and interleukin (IL)-1β was examined. @*Results@#The average percentage of SA-β-gal positive cells was significantly higher for the pterygium group (67.63 ± 16.61%)compared to the control group (32.64 ± 8.98%) (p< 0.01). The fluorescent expression intensity of IL-1β was higher in the pterygiumgroup (22.53 ± 19.21) compared to the control group (11.38 ± 6.30) (p= 0.02), and the p16 fluorescence expression intensitywas also higher in the pterygium group, showing 42.79 ± 23.65, compared to the control group values (26.73 ± 18.34)(p = 0.01). @*Conclusions@#Cellular senescence specific markers, SA-β-gal, IL-1β, and p16, were expressed in pterygium, indicating a newpossible framework for the development and progression of pterygium.

Analysis of Macular Capillary Plexuses after Cataract Surgery via Optical Coherence Tomography Angiography

Purpose@#We used optical coherence tomography angiography (OCTA) to evaluate changes in the vessel densities of macular capillary plexuses after cataract surgery. @*Methods@#We performed a retrospective chart review of 24 eyes of 24 cataract patients who underwent phacoemulsification cataract surgery from July 2018 to June 2019. The changes in vessel density (VD) in the macular superficial capillary plexus (SCP), the deep capillary plexus (DCP), inside the disc, and in the peripapillary area and foveal avascular zone (FAZ), were analyzed on OCTA images obtained preoperatively and at 1 week, and 1, 3, and 6 months, postoperatively. @*Results@#The VDs of the foveal SCP and DCP increased significantly from 15.42 ± 6.61 and 28.43 ± 7.62% preoperatively to 17.20 ± 6.21 and 30.52 ± 7.06% at 6 months postoperatively (p < 0.001, p = 0.001). The VDs of the parafoveal SCP and DCP increased significantly from 47.28 ± 5.76 and 53.06 ± 3.89% preoperatively to 50.34 ± 5.00 and 53.90 ± 4.20% at 6 months postoperatively (p = 0.002, p = 0.014). The VDs of the perifoveal SCP and DCP increased significantly from 45.20 ± 5.01 and 46.62 ± 5.89% preoperatively to 48.52 ± 4.32 and 50.96 ± 5.57% at 6 months postoperatively (p < 0.001, p = 0.002). The VDs of the area inside the disc, and of the peripapillary area and FAZ, did not change significantly (p = 0.068, 0.332, and 0.206, respectively). @*Conclusions@#After cataract surgery, the VDs of the SCP and DCP increased significantly at 1 week, and 1, 3, and 6 months, postoperatively.

Analysis of Macular Capillary Plexuses after Cataract Surgery via Optical Coherence Tomography Angiography

Purpose@#We used optical coherence tomography angiography (OCTA) to evaluate changes in the vessel densities of macular capillary plexuses after cataract surgery. @*Methods@#We performed a retrospective chart review of 24 eyes of 24 cataract patients who underwent phacoemulsification cataract surgery from July 2018 to June 2019. The changes in vessel density (VD) in the macular superficial capillary plexus (SCP), the deep capillary plexus (DCP), inside the disc, and in the peripapillary area and foveal avascular zone (FAZ), were analyzed on OCTA images obtained preoperatively and at 1 week, and 1, 3, and 6 months, postoperatively. @*Results@#The VDs of the foveal SCP and DCP increased significantly from 15.42 ± 6.61 and 28.43 ± 7.62% preoperatively to 17.20 ± 6.21 and 30.52 ± 7.06% at 6 months postoperatively (p < 0.001, p = 0.001). The VDs of the parafoveal SCP and DCP increased significantly from 47.28 ± 5.76 and 53.06 ± 3.89% preoperatively to 50.34 ± 5.00 and 53.90 ± 4.20% at 6 months postoperatively (p = 0.002, p = 0.014). The VDs of the perifoveal SCP and DCP increased significantly from 45.20 ± 5.01 and 46.62 ± 5.89% preoperatively to 48.52 ± 4.32 and 50.96 ± 5.57% at 6 months postoperatively (p < 0.001, p = 0.002). The VDs of the area inside the disc, and of the peripapillary area and FAZ, did not change significantly (p = 0.068, 0.332, and 0.206, respectively). @*Conclusions@#After cataract surgery, the VDs of the SCP and DCP increased significantly at 1 week, and 1, 3, and 6 months, postoperatively.

Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment

PURPOSE: To evaluate the efficiency of a surgical method using original breaks to drain subretinal fluid without using retinotomy and perfluorocarbon liquid for patients with rhegmatogenous retinal detachment (RRD). METHODS: A retrospective chart review comparing 41 eyes of 41 patients who received vitrectomy, and used original breaks to drain subretinal fluid without using perfluorocarbon liquid, and 40 eyes of 40 patients who received vitrectomy using perfluorocarbon liquid for simple RRD between February 2014 and December 2017 was conducted. All patients were followed for a minimum of 6 months after surgery. RESULTS: The primary anatomical success percentages were 97.6% and 97.5% for groups that did not and did use perfluorocarbon liquid, respectively. Retinal detachment recurred in one eye from both groups. The final success percentage was 100%. The preoperative mean logMAR best-corrected visual acuity (BCVA) of 0.87 ± 0.80 improved to 0.30 ± 0.30 at postoperative 6 months for the group that did not use perfluorocarbon liquid, while it improved from 0.86 ± 0.71 to 0.42 ± 0.52 for the group that did use perfluorocarbon liquid. Both groups showed significant BCVA improvement (p < 0.01). There was no significant difference in the incidence of complications caused by the use of perfluorocarbon liquid. CONCLUSIONS: Using original breaks to drain subretinal fluid without perfluorocarbon liquid in cases with RRD may be an effective and safe surgical technique for functional and anatomical recovery without serious complications.

Central Serous Chorioretinopathy with Peripapillary Retinoschisis

PURPOSE: To report a case of central serous chorioretinopathy with peripapillary retinoschisis. CASE SUMMARY: A 64-year-old male presented with abnormal color vision of the left eye, which occurred 6 months prior to his visit. At the initial visit, a funduscopic examination revealed retinal elevation with suspected serous retinal detachment around the optic disc in the left eye. Spectral domain optical coherence tomography showed subretinal fluid on the nasal side of the optic disc and retinoschisis on the temporal side of the optic disc in the left eye. Fluorescein angiography revealed multiple leakages in the left eye. Indocyanine green angiography revealed choroidal vascular hyperpermeability in both eyes. Based on these results, the patient was diagnosed with chronic central serous chorioretinopathy and was treated with argon laser photocoagulation at the leakage points. After 8 weeks of laser therapy, optical coherence tomography indicated that there was no retinoschisis or subretinal fluid in the macula, nasal, or temporal sides of the optic disc. CONCLUSIONS: Peripapillary retinoschisis due to central serous chorioretinopathy improves with argon laser photocoagulation at leakage sites.

Comparative Analysis of Protein Tyrosine Phosphatases Regulating Microglial Activation

Protein tyrosine phosphatases (PTPs) are key regulatory factors in inflammatory signaling pathways. Although PTPs have been extensively studied, little is known about their role in neuroinflammation. In the present study, we examined the expression of 6 different PTPs (PTP1B, TC-PTP, SHP2, MEG2, LYP, and RPTPβ) and their role in glial activation and neuroinflammation. All PTPs were expressed in brain and glia. The expression of PTP1B, SHP2, and LYP was enhanced in the inflamed brain. The expression of PTP1B, TC-PTP, and LYP was increased after treating microglia cells with lipopolysaccharide (LPS). To examine the role of PTPs in microglial activation and neuroinflammation, we used specific pharmacological inhibitors of PTPs. Inhibition of PTP1B, TC-PTP, SHP2, LYP, and RPTPβ suppressed nitric oxide production in LPS-treated microglial cells in a dose-dependent manner. Furthermore, intracerebroventricular injection of PTP1B, TC-PTP, SHP2, and RPTPβ inhibitors downregulated microglial activation in an LPS-induced neuroinflammation model. Our results indicate that multiple PTPs are involved in regulating microglial activation and neuroinflammation, with different expression patterns and specific functions. Thus, PTP inhibitors can be exploited for therapeutic modulation of microglial activation in neuroinflammatory diseases.

The Modulation of Neurotrophin and Epigenetic Regulators: Implication for Astrocyte Proliferation and Neuronal Cell Apoptosis After Spinal Cord Injury

OBJECTIVE: To investigate alterations in the expression of the main regulators of neuronal survival and death related to astrocytes and neuronal cells in the brain in a mouse model of spinal cord injury (SCI). METHODS: Eight-week-old male imprinting control region mice (n=36; 30–35 g) were used in this study and randomly assigned to two groups: the naïve control group (n=18) and SCI group (n=18). The mice in both groups were randomly allocated to the following three time points: 3 days, 1 week, and 2 weeks (n=6 each). The expression levels of regulators such as brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), histone deacetylase 1 (HDAC1), and methyl-CpG-binding protein 2 (MeCP 2) in the brain were evaluated following thoracic contusive SCI. In addition, the number of neuronal cells in the motor cortex (M1 and M2 areas) and the number of astrocytes in the hippocampus were determined by immunohistochemistry. RESULTS: BDNF expression was significantly elevated at 2 weeks after injury (p=0.024). The GDNF level was significantly elevated at 3 days (p=0.042). The expression of HDAC1 was significantly elevated at 1 week (p=0.026). Following SCI, compared with the control the number of NeuN-positive cells in the M1 and M2 areas gradually and consistently decreased at 2 weeks after injury. In contrast, the number of astrocytes was significantly increased at 1 week (p=0.029). CONCLUSION: These results demonstrate that the upregulation of BDNF, GDNF and HDAC1 might play on important role in brain reorganization after SCI.

Radiation-Induced Autophagy Contributes to Cell Death and Induces Apoptosis Partly in Malignant Glioma Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Radiation-induced autophagy has been shown to play two different roles, in malignant glioma (MG) cells, cytocidal or cytoprotective. However, neither the role of radiation-induced autophagy for cell death nor the existence of autophagy-induced apoptosis, a well-known cell-death pathway after irradiation, has been verified yet. MATERIALS AND METHODS: We observed both temporal and dose-dependent response patterns of autophagy and apoptosis to radiation in MG cell lines. Additionally, we investigated the role of autophagy in apoptosis through knockdown of autophagy-related proteins. RESULTS: Autophagic activity measured by staining of acidic vesicle organelles and Western blotting of LC-3 protein increased in proportion to radiation dose from day 1 to 5 after irradiation. Apoptosis measured by annexin-V staining and Western blotting of cleaved poly(ADP-ribose) polymerase demonstrated relatively late appearance 3 days after irradiation that increased for up to 7 days. Blocking of pan-caspase (Z-VAD-FMK) did not affect apoptosis after irradiation, but silencing of Atg5 effectively reduced radiation-induced autophagy, which decreased apoptosis significantly. Inhibition of autophagy in Atg5 knockdown cells was shown to be beneficial for cell survival. Stable transfection of GFP-LC3 cells was observed after irradiation. Annexin-V was localized in cells bearing GFP-LC3 punctuated spots, indicating autophagy in immunofluorescence. Some of these punctuated GFP-LC3 bearing cells formed conglomerated spots and died in final phase. CONCLUSION: These findings suggest that autophagy appears earlier than apoptosis after irradiation and that a portion of the apoptotic population that appears later is autophagy-dependent. Thus, autophagy is a pathway to cell death after irradiation of MG cells.

Influence of the Rotational Alignment of the Femoral and Patellar Components on Patellar Tilt in Total Knee Arthroplasty

PURPOSE: The purpose of this study was to analyze the influence of rotational alignment of the femoral and patellar components on patellar tilt after total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 56 patients (76 knees) who underwent TKA using Advance Medial Pivot Knee system between May 2009 and April 2011 and were available for minimum 1-year follow-up were enrolled in this study. Whiteside's line and the transepicondylar line were used to determine the rotational alignment of the femoral component. Patella cut was aimed to be parallel to the anterior patellar cortex during surgery. Radiographic evaluation was performed using plain axial radiographs. The rotational alignment of the femoral component was measured as the angle between the anterior condylar axis and the surgical transepicondylar axis. The patellar resection angle was measured between the patellar resection axis and the anterior cortical line of the patella. Patellar tilt was evaluated to investigate the correlation with the rotation of the femoral component and patellar resection angle. RESULTS: The mean rotation of the femoral component was 0.42degrees+/-3.18degrees of internal rotation. The mean patellar resection angle was 1.82degrees+/-3.44degrees, indicating medial overresection. The mean patellar tilt was 6.12degrees+/-4.31degrees of lateral tilt. The rotational angle of the femoral component showed a negative correlation with patellar tilt in the linear regression analysis (p=0.749), but the patellar resection angle showed a positive correlation with patellar tilt (p<0.001). CONCLUSIONS: Accurate patellar resection is recommended for proper patellar tracking in TKA.

Effect of Regular Exercise on Cardiopulmonary Fitness in Males With Spinal Cord Injury

OBJECTIVE: To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. METHODS: We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu RESULTS: Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. CONCLUSION: There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury.

Pain-Related Evoked Potential in Healthy Adults

OBJECTIVE: To investigate the normal data of pain-related evoked potentials (PREP) elicited with a concentric surface electrode among normal, healthy adults and the relationship between PREP and pain intensity. METHODS: Sixty healthy volunteers (22 men and 38 women; aged 36.4+/-10.7 years; height, 165.4+/-7.8 cm) were enrolled. Routine nerve conduction study (NCS) was done to measure PREP following electrical stimulation of hands (C7 dermatome) and feet (L5 dermatome). Negative peak (N), positive peak (P) latencies, peak to peak (NP) amplitudes, conduction velocity (CV), and verbal rating scale (VRS) score were obtained. Linear regression analysis tested for significant relevance between variables of PREP and VRS score. RESULTS: Normal NCS results were obtained in all subjects. N latency of hand PREP was 163.8 +/-40.0 ms (right) and 161.0+/-39.9 ms (left). N latency of foot PREP was 178.0+/-43.9 ms (right), 180.4+/-43.4 ms (left). NP amplitude of hands was 20.6+/-10.6 microV (right) and 21.9+/-11.6 microV (left). NP amplitude of feet was 18.8+/-8.3 microV (right) and 19.0+/-8.4 microV (left). The calculated CV was 13.2+/-4.7 m/s and VRS score was 3.8+/-1.0. A highly significant positive correlation was evident between VRS score and NP amplitude (y=0.1069x+1.781, r=0.877, n=60, p<0.0001). CONCLUSION: PREP among normal, healthy adults revealed a statistically significant correlation between PREP amplitude and VRS score.

Follow-up Testing of Interferon-Gamma Release Assays Are Useful in Ankylosing Spondylitis Patients Receiving Anti-Tumor Necrosis Factor Alpha for Latent Tuberculosis Infection

We evaluated the utility of follow-up interferon-gamma release assays (IGRAs) for the diagnosis of reactivation of latent tuberculosis infection (LTBI) or new tuberculosis in ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor alpha (anti-TNFalpha). The study participants (n=127) had a negative IGRA screening before receiving anti-TNFalpha and were evaluated by follow-up IGRA. We retrospectively examined data of the subjects according to age, gender, tuberculosis prophylaxis, concomitant medications, IGRA conversion and anti-TNFalpha, including type and treatment duration. The median duration of anti-TNFalpha was 21.5 months, and the median age was 35.3 yr. Of the 127 patients, IGRA conversion was found in 10 patients (7.9%). There was no significant variation between IGRA conversion rate and any risk factors except for age. IGRA conversion rate was not significantly different between AS and rheumatoid arthritis (P=0.12). IGRA conversion was observed in AS patients receiving anti-TNFalpha in Korea. A follow-up IGRA test can be helpful for identifying LTBI or new tuberculosis in AS patients receiving anti-TNFalpha.

Roles of Long Non-Coding RNAs on Tumorigenesis and Glioma Development

More than 98% of eukaryotic transcriptomes are composed of non-coding RNAs with no functional protein-coding capacity. Those transcripts also include tens of thousands of long non-coding RNAs (lncRNAs) which are emerging as key elements of cellular homeostasis, essentially tumorigenesis steps. However, we are only beginning to understand the nature and extent of the involvement of lncRNAs on tumorigeneis. Here, we highlight recent progresses that have identified a myriad of molecular functions on tumorigenesis for several lncRNAs including metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), prostate cancer associated non-coding RNA 1 (PRNCR1), prostate cancer gene expression marker 1 (PCGEM1), H19, and homeobox transcript antisense intergenic RNA (HOTAIR), and several new lncRNAs for glioma development. Potential therapeutic approaches for the lncRNAs in various human diseases are also discussed.

Delayed and Prolonged Local Brain Hypothermia Combined with Decompressive Craniectomy: A Novel Therapeutic Strategy That Modulates Glial Dynamics

Hypothermia is considered a useful intervention for limiting pathophysiological changes after brain injury. Local hypothermia is a relatively safe and convenient intervention that circumvents many of the complications associated with systemic hypothermia. However, successful hypothermia treatment requires careful consideration of several factors including its practicality, feasibility, and associated risks. Here, we review the protective effects-and the cellular mechanisms that underlie them-of delayed and prolonged local hypothermia in rodent and canine brain injury models. The data show that the protective effects of therapeutic hypothermia, which mainly result from the modulation of inflammatory glial dynamics, are limited. We argue that decompressive craniectomy can be used to overcome the limitations of local brain hypothermia without causing histological abnormalities or other detrimental effects to the cooled area. Therefore, delayed and prolonged local brain hypothermia at the site of craniectomy is a promising intervention that may prove effective in the clinical setting.

Difference of Diagnostic Rates and Analytical Methods in the Test Positions of Vestibular Evoked Myogenic Potentials

OBJECTIVE: To compare the differences of diagnostic rates, of the two widely used test positions, in measuring vestibular evoked myogenic potentials (VEMP) and selecting the most appropriate analytical method for diagnostic criteria for the patients with vertigo. METHODS: Thirty-two patients with vertigo were tested in two comparative testing positions: turning the head to the opposite side of the evaluating side and bowing while in seated position, and bowing while in supine positions. Abnormalities were determined by prolonged latency of p13 or n23, shortening of the interpeak latency, and absence of VEMP formation. RESULTS: Using the three criteria above for determining abnormalities, both the seated and supine positions showed no significant differences in diagnostic rates, however, the concordance correlation of the two positions was low. When using only the prolonged latency of p13 or n23 in the two positions, diagnostic rates were not significantly different and their concordance correlation was high. On the other hand, using only the shortened interpeak latency in both positions showed no significant difference of diagnostic rates, and the degree of agreement between two positions was low. CONCLUSION: Bowing while in seated position with the head turned in the opposite direction to the area being evaluated is found to be the best VEMP test position due to the consistent level of sternocleidomastoid muscle tension and the high level of compliance. Also, among other diagnostic analysis methods, using prolonged latency of p13 or n23 as the criterion is found to be the most appropriate method of analysis for the VEMP test.

Difference of Diagnostic Rates and Analytical Methods in the Test Positions of Vestibular Evoked Myogenic Potentials

OBJECTIVE: To compare the differences of diagnostic rates, of the two widely used test positions, in measuring vestibular evoked myogenic potentials (VEMP) and selecting the most appropriate analytical method for diagnostic criteria for the patients with vertigo. METHODS: Thirty-two patients with vertigo were tested in two comparative testing positions: turning the head to the opposite side of the evaluating side and bowing while in seated position, and bowing while in supine positions. Abnormalities were determined by prolonged latency of p13 or n23, shortening of the interpeak latency, and absence of VEMP formation. RESULTS: Using the three criteria above for determining abnormalities, both the seated and supine positions showed no significant differences in diagnostic rates, however, the concordance correlation of the two positions was low. When using only the prolonged latency of p13 or n23 in the two positions, diagnostic rates were not significantly different and their concordance correlation was high. On the other hand, using only the shortened interpeak latency in both positions showed no significant difference of diagnostic rates, and the degree of agreement between two positions was low. CONCLUSION: Bowing while in seated position with the head turned in the opposite direction to the area being evaluated is found to be the best VEMP test position due to the consistent level of sternocleidomastoid muscle tension and the high level of compliance. Also, among other diagnostic analysis methods, using prolonged latency of p13 or n23 as the criterion is found to be the most appropriate method of analysis for the VEMP test.