S100 protein family and its application in clinical practice

Hippokratia 2008; 12 (4): 198-204

F. Sedaghat, A. Notopoulos

Abstract

The members of the S100 protein family are multifunctional proteins with a regulatory role in a variety of cellular processes. They exert their actions usually through calcium binding, although Zn2+ and Cu2+ have also been shown to regulate their biological activity. The most studied member, protein S100?, exhibits neurotrophic (at physiologic concentration) or neurotoxic (at higher concentration) activity and its immunohistochemical expression or serum levels have been determined in various clinical disorders. S100B has been well documented as a marker of astrocytic activation mediating its effects via interaction with receptor for advanced glycation end products (RAGE). We herein provide a wide range of information concerning their clinical application in traumatic brain injuries, Alzheimer disease, subarachnoid haemorrhage and other neurologic disorders, malignant melanoma and several other neoplasms (as S100B has been shown to down-regulate p53), as well as inflammatory diseases. Also its use on predicting neurologic outcome after resuscitation for cardiac arrest or in intrauterine growth retardation newborns is discussed.

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Pain and osteolysis of the thoracic spine - A case of a rare monostotic fibrous dysplasia manifestation

Hippokratia 2008; 12 (4): 254-256

A. Hatzitolios, CH. Savopoulos, G. Karagianopoulou, E. Psomas, CH. Sideri, A. Lefkopoulos, V. Assantis, I. Bischiniotis

Abstract

We describe a case of a young farmer from Central Macedonia, Greece suffering of a mild back pain more than one year. His medical history included hypercholesterolaemia (IIa type) and two episodes of spontaneous pneumothorax of unknown origin two and three years ago respectively. A full imaging survey revealed a single osteolytic lesion at the seventh thoracic vertebra. A CT guided needle biopsy was performed. Diagnosis based on clinical, imaging and histological findings was monostotic fibrous dysplasia of the thoracic spine. We discuss the clinical features and treatment of this non neoplastic condition which may simulate bone osteolytic tumor. Furthermore a possible correlation of concomitant conditions existing in our patient such as the metabolic disorder of hypercholesterolaemia and especially the history of spontaneous pneumothorax episodes with fibrous dysplasia within the spectrum of connective tissue disorder is discussed.

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Kisspeptins: a multifunctional peptide system with a role in reproduction, cancer and the cardiovascular system

E. Votsi, D. Roussos, I. Katsikis, A. Karkanaki, M. Kita, D. Panidis

Abstract

This retracts the article: Votsi E, Roussos D, Katsikis I, Karkanaki A, Kita M, Panidis D. Kisspeptins: a multifunctional peptide system with a role in reproduction, cancer and the cardiovascular system. Hippokratia 2008;12: 205-210. The Editorial Board of Hippokratia journal regrets to inform its readership that plagiarism was documented in the above named paper. A letter dated 17.12.08 was received from Prof D. Panidis, corresponding author of the above article. In his letter Prof Panidis is asking for the retraction of the article because as he states ?the title as well as some paragraphs of the text have been copied verbatim from an earlier review article with the same title in The British Journal of Pharmacology, 2007; 151: 1143-1153?. In addition to his letter, all authors have signed a statement agreeing to the retraction of this article, which is on file at Hippokratia Journal.

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Current devices of respiratory physiotherapy

Hippokratia 2008; 12 (4):211-220

A. Hristara-Papadopoulou, J. Tsanakas, G. Diomou, O. Papadopoulou

Abstract

In recent years patients with respiratory diseases use various devices, which help the removal of mucus from the airways and the improvement of pulmonary function. The aim of the present study is to determine the effectiveness of the current devices of respiratory physiotherapy, as it comes from the review of literature. The current devices of physiotherapy for patients with respiratory diseases, are presented as an alternative therapy method or a supplemental therapy and they can motivate patients to apply therapy by themselves. These devices seem to increase patients’ compliance to daily treatment, because they present many benefits, as independent application, full control of therapy and easy use.These devices are the Positive Expiratory Pressure, the High Frequency Chest Wall Oscillation, the Oral High Frequency Oscillation, the Intrapulmonary Percussive Ventilation, the Incentive Spirometry the Flutter and the Acapella and the Cornet. Current devices seem to be effective in terms of mucus expectoration and pulmonary function improvement, as it is shown by published studies. The choice of the suitable device for each patient is a challenge for the physiotherapist in order to achieve better compliance in daily treatment. More controlled studies are needed due to the fact that the number of published studies is limited.

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Factors of cardiovascular risk in patients with type 2 diabetes and incipient nephropathy

Hippokratia 2008; 12 (4): 221-224

E. Nelaj, M. Gjata, I. Lilaj, G. Burazeri, E. Sadiku, L. Collaku, O. Bare, M. Tase

Abstract

Background: Microalbuminuria was originally established as a predictor of renal failure and an independent risk factor for cardiovascular disease in patients with diabetes mellitus as well as in general population. The aim of our study is to assess the relationship between microalbuminuria and the other risk factors in diabetics and their prevalence.Methods: Sixty five patients, 22 men and 43 women with mean age 58.6 �10.09, with type 2 diabetes, were hospitalized in the Department of Internal Medicine in the University Hospital Center “Mother Teresa” in Tirana, Albania, between March 2007 and February 2008. These patients with a mean duration of diabetes 6.09�5.41 were divided in two groups: with (Group A: 24 patients) and without (Group B: 41 patients) microalbuminuria and each group was evaluated for left ventricular mass index (LVMI), body mass index (BMI), glycosylated hemoglobin (HbA1C), lipid profile and intima media thickness (IMT). Results: The prevalence of microalbuminuria in our study was 32.3%. The prevalence of microalbuminuria in males was 37.5 and in females 62.5%. The microalbuminuric patients were older ( 59.71�9.87 vs 57.07�10.32) and had a longer duration of diabetes (7.74�5.74 vs 4.45�5.08) compared with normoalbuminuric patients.(p=0.01). The Group A had significantly higher LVMI compared with Group B ( p= 0.02). The prevalence of obesity (BMI >30kg/m2) in our sample was 44.6%. In Group A the mean BMI (30.13�4.98) was significantly higher compared with Group B (28.00�3.72, p=0.04). Diabetic retinopathy was more frequent in Group A compared with Group B ( 33.3% vs 14.6%, p=0.05). The mean value of IMT was higher in Group A compared with Group B (1.28�0.35 vs 1.09�0.28, p=0.03)Conclusion: In patients with type 2 diabetes and microalbuminuria LVMI, IMT, BMI, duration of diabetes was significantly higher compared with patients with type 2 diabetes and normoalbuminuria.

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The effect of intra-abdominal hypertension alone or combined intra-abdominal hypertension-endotoxemia in cerebral oxygenation in a porcine model

Hippokratia 2008; 12 (4): 225-229

K. Karakoulas, V. Grosomanidis, E. Amaniti, D. Kouvelas, C. Skourtis, D. Vasilakos

Abstract

Background: Abdominal compartment syndrome (ACS) has been recognized as an entity, affecting cardiovascular, pulmonary, and cerebral function, while it is often complicated with sepsis. Goal of the study was the evaluation of brain oxygenation during ACS alone and in combination with endotoxinemia.Materials and Methods: Sixteen pigs, undergone intra-abdominal hypertension, were allocated to receive intravenous administration of either saline or endotoxin. Pigs were evaluated regarding brain tissue oxygenation (PbrO2), systemic oxygenation (PaO2) and regional cerebral blood flow (rCBF).Results: Statistical analysis revealed significant reduction of PbrO2 over time for sepsis group, after endotoxin administration.Regarding differences between groups, sepsis group experienced lower PbrO2 values, compared to saline group, only after endotoxin administration.. Both groups experienced reduction in arterial oxygenation, with greater pertubations seen after sepsis induction. Regarding rCBF, septic pigs showed greater flow values, while ACS alone did n?t influence rCBF. ACS has no deleterious effects in cerebral oxygenation and flow, provided systemic oxygenation and CPP are maintained above normal value.Conclusions: Combined sepsis-ACS lead to perturbations in cerebral oxygenation, in conjunction with greater rCBF values. The latter could be ascribed to abnormalities in oxygen extraction.

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Detection of T cells secreting type 1 and type 2 cytokines in the peripheral blood of patients with oral lichen planus

Hippokratia 2008; 12 (4): 230-235

F. Kalogerakou, E. Albanidou-Farmaki, A K. Markopoulos A K., D Z Antoniades

Abstract

Objective: The purpose of this study was to detect and enumerate T cells secreting type 1 and 2 cytokines in the peripheral blood of patients with oral lichen planus (OLP)and in healthy controls.Subjects and Methods:The study group consisted of 80 OLP patients and 80 healthy individuals. Cytokine secreting T cells were detected using ELISPOT assay.Results: There was a statistically significant decrease (p0.05). Also there was no significant difference in the numbers of IFN-?, IL-12, IL-2 and TNF-a secreting cells between reticular and erosive forms of OLP (p>0.05). As regards type 2 cytokines, the number of IL-5 and IL-10 secreting cells was significantly decreased in OLP patients compared to the healthy control group (p0.05). Similarly, no statistical difference was observed in the number of IL-4 secreting cells between OLP patients and controls (p>0.05). No significant difference was also found in the numbers of IL-4, IL-5, IL-10 and IL-6 secreting cells between reticular and erosive OLP group.Conclusion: These data suggest decreased type 1 and type 2 cytokine production (except IL-4) in OLP patients.

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Biopsy of subcutaneus fatty tissue for diagnosis of systemic amyloidosis

Hippokratia 2008; 12 (4): 236-239

B. Bogov, M. Lubomirova, B. Kiperova

Abstract

Background: The diagnosis of systemic amyloidosis is determined through histological material from biopsy of different parenchymal organs, which have high diagnostic and informative value, but hide a high risk of bleeding because of the accumulation of amyloid in the vessels’ wall. The main methods are kidney, liver, gastro-intestinal tract biopsy and aspiration of subcutaneous fatty tissue. The sensitivity of trans-dermal core kidney biopsy (KB) is close to 100%.The rectal biopsy is positive in 73% of cases, the biopsy of bone marrow in bout 50% and the one of gingival mucosa in 40-46 % of cases. The biopsy of subcutaneous fatty tissue (BSFT) is a new, highly sensitive method with sensitivity 73% and specificity 90%, so that it can be used as a screening test in patients without any clinical symptom or organ dysfunction.Patients and Methods: One hundred fifteen patients, 59 male and 56 female with an average age 49.7�15.93 years were included in the study divided in two groups. The first group consisted of patients with kidney biopsy proved amyloidosis compared to biopsy findings from other parenchymal organs. The second group consisted of patients suspected having amyloidosis who underwent biopsies from various tissues or organs except kidney biopsy because there was contraindication. Results: One hundred fifteen biopsies of subcutaneous fatty tissue (SFT) were performed for the diagnosis of systemic amyloidosis. In order to compare the data from the BSFT to the other known and practiced till the moment methods BSFT was performed in 54 patients with proved amyloidosis by KB. In 51/54 the positive result for amyloid was confirmed. A comparison of the data in a sample of 20 patients, 11 female and 9 male, in 18/20 patients the result from BSFT is positive (90%). In coloring with Congo red are typed with KMnO4 19/54 patients, 12 female and 7 male, with average age 48.12 (SD �13.21). In 14/19 the amyloidosis was typed as AА (74.2%) and 5/19 non - АА, probably AL (25.8%).To reveal the meaning of so called screening-biopsy of subcutaneous fatty tissue for excluding accompanying amyloidosis in patients with significant proteinuria and/or uremia, dysglobulinemia, laboratory constellations for nephritic syndrome in immune nephropathies and chronic infections (Chronic Obstructive Lung Disease, purulent infections) with contraindications for kidney biopsy 61 screening BSFT were performed, accumulation of amyloid was defined in 37. In all of the patients the result was verified also by biopsies of rectal, gingival and stomach mucosa.Conclusion: The purposeful searching and proving of amyloid in subcutaneous fatty tissue of the abdominal wall is a new, highly sensitive method. The receiving of richer material from SFT in the method “biopsy” in stead of “aspiration”,makes it more reliable for proving amyloid in the case that it exists. The method is enough informative for proving not only amyloidosis AL, but also for amyloidosis АА, in treating with KMnO4.The biopsy of SFT in combination with biopsies from other mucosa can prove the accumulation of amyloid in contraindications for performing KB.

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Environmental risk factors for iron deficiency anemia in children 12-24 months old in the area of Thessalia in Greece

Hippokratia 2008; 12 (4): 240-250

E. Tympa-Psirropoulou, C. Vagenas, O. Dafni, A. Matala, F. Skopouli

Abstract

Background and aim: Iron deficiency anemia (IDA) is a common problem all over the world, which attacks mainly pregnant women, infants and children. The aim of the study was to estimate the prevalence of IDA in children 12-24 months old in a specific area of Thessalia, located in the central part of Greece, and to identify the environmental risk factors associated with it. Patients and Methods: In the first part of this cross-sectional and case-control study, the hemoglobin (Hb) levels of 938 children were estimated by a mobile photometer analyzer. In the second part of the study, children with Hb <11 gr/dl were compared with matched random selected controls in hematological, anthropometric and environmental parameters. The estimated laboratory values were Hb, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, zinc protoporphyrin, serum iron, serum ferritin, transferring saturation, total iron binding capacity and Hb electrophoresis. Finally 75 children (34 boys, 41 girls, mean age 17.51+3.5 months), who were found with IDA, constituted the case group while 75 healthy children constituted the control group.Results: The prevalence of IDA in the region was 7.99%. At the same time, a number of children with stigma of bthalassaemia (2.13%) was discovered, something that had escaped identification. There were no differences due to the method of determination (mobile or laboratory) in the values of Hb between the two groups. Significant differences were recorded (p <0.001) in all hematological and anthropometric parameters except for head circumference.Regarding environmental factors, significant differences were found in the following parameters: ratio rooms/number of family members (p=0.01), number of family members (p=0.01), number of children in the family (p <0.001), birth rate (p<0.001), education and profession of the parents (p<0.001), source of drinking water and sewage system (p<0.001), duration of breast feeding (p<0.001), milk consumption by the child during the period of the reported research (p<0.001), child’s health status according to the mother (p<0.001), and frequency of seeking pediatric care(p=0.02).Conclusions: Although the prevalence of IDA in this area of Greece is similar to the one observed in the rest of the developed world, it still consists a public health problem. The mobile method for Hb estimation should be introduced in Greece since its reliability to detect IDA has been, once more, confirmed. The application of simple questionnaires for the detection of the environmental IDA risk factors could help in the prognosis and prevention of anemia. Further improvement of the IDA status in Greece could be achieved through the dissemination of information about iron rich foods, the amelioration of environmental conditions and the application of reliable, easy to use and cheap methods for Hb estimation.

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Alveolar soft – part sarcoma of the extremity: a case report

Hippokratia 2008; 12 (4): 251-253

V. Sidi, I. Fragandrea, E. Hatzipantelis, C. Kyriakopoulos, A. Papanikolaou, M. Bandouraki, DE. Koliouskas

Abstract

Alveolar soft- part sarcoma (ASPS) is a rare form of soft tissue sarcoma and is most often seen in adolescents and young adults. Surgical excision of the primary tumor and pulmonary metastases has resulted in prolonged survival in some patients while the benefit of adjuvant chemotherapy and/or radiotherapy has been disputed. An 11- year-old boy with ASPS which presented with a markedly vascular tumor in the left thigh, and multiple bilateral pulmonary metastases 8 months after diagnosis is described. The patient has remained disease-free for over 5 years since the initial diagnosis.

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