Respiratory syncytial virus (RSV) was the agent that was most com

Respiratory syncytial virus (RSV) was the agent that was most commonly found (3.8% specific hospitalization

rate). Children receiving adequate RSV prophylaxis (90.5%) had a 58.2% (95% confidence interval: 37.6-78.3) reduction in RSV hospitalization. Risk factors for admission included malnourishment, infant age, male gender, chromosome alterations, wheezing, inadequate RSV prophylaxis fulfillment, and siblings <11 years of age. Pediatric intensive care unit care was required in click here 21.8% of the admissions and 9 patients (0.34%) died.

Conclusions: Hospital admission rate and severity of ARI remain as important issues in hemodynamically significant congenital heart disease patients. The strict fulfillment of prophylactic recommendations against RSV is the only protective factor that can be modulated to decrease the ARI hospital admission rate.”
“Introduction: Different types of grafts have been described in urethral reconstruction (UR), with penile skin graft (PSG) and buccal mucosa graft (BMG) as the most frequently used ones. It still remains unclear whether one graft is superior in terms of success when compared to the other. Material and Methods: A systematic review of the

literature was performed searching the MEDLINE database with the following Ferrostatin-1 chemical structure search strategy: ‘urethroplasty’ AND ‘penile skin’/'urethroplasty’ AND ‘buccal mucosa’. 266 and 144 records were retrieved for urethroplasty with PSG and BMG,

respectively. These records were reviewed to identify papers where PSG and BMG were used in UR and where individualized data on success were available within the same series. Results: 18 papers were found eligible for further analysis. In total, 428 and 483 patients were respectively treated with CDK inhibitor PSG or BMG. If available, follow-up duration was 64.1 versus 42.1 months (p < 0.0001) and stricture length 6.2 versus 4.6 cm (p < 0.0001) for PSG and BMG, respectively. Success of UR with PSG was 81.8 versus 85.9% with BMG (p = 0.01). Conclusions: Success of UR using BMG is significantly better compared to PSG. Results might be seriously biased by a longer follow-up duration and stricture length for PSG compared to BMG. Copyright (c) 2012 S. Karger AG, Basel”
“The stabilization effect, an increase of the reverse transition temperature T(C) with ferroelectric aging time, was recently found in acceptor doped ferroelectrics. Such an effect has found a microscopic explanation in the symmetry-conforming principle of point defects, which also accounts for a similar stabilization effect in ferroelastic/martensite materials. However, such a microscopic model is difficult to use to make a quantitative/semiquantitative evaluation of the aging process. In the present work, we propose a single-domain thermodynamic model that provides a semiquantitative fit to the experimentally observed stabilization kinetics.

Pine tannin foams without formaldehyde showed lower mechanical st

Pine tannin foams without formaldehyde showed lower mechanical strength and more elastic behaviour. (C) 2012 Elsevier B.V. All rights reserved.”
“Background and Purpose: Lithotripsy is an established method to fragment kidney stones that can be performed without general anesthesia in the outpatient setting. Discomfort and/or noise,

however, may deter some patients. It has been demonstrated that audiovisual distraction (AV) can reduce sedoanalgesic requirements and improve patient satisfaction in nonurologic settings, but to our knowledge, this has not been investigated Milciclib purchase with lithotripsy. This randomized controlled trial was designed to test the hypothesis that AV distraction can reduce perceived pain during lithotripsy.

Patients and Methods: All patients in the study received identical analgesia before a complete session of lithotripsy on a fixed-site Storz Modulith SLX F2 lithotripter. Patients were randomized to two groups: One group (n = 61) received AV distraction via a wall-mounted 32 ” (82 cm) television with wireless headphones; the other group (n = 57) received no AV distraction. The mean intensity of treatment was comparable in both groups. Patients used a visual analogue scale (0-10) to record independent pain and distress scores and a nonverbal pain score was documented by the radiographer during the procedure (0-4).

Results: In the group that received AV distraction,

all measures of pain perception were statistically lower. The patient-reported pain score was reduced from a mean of 6.1 to 2.4 (P < 0.0001), and the distress score was reduced from a click here mean of 4.4 to 1.0 (P = 0.0001). The mean nonverbal score recorded by the radiographer was reduced from 1.5 to 0.5 (< 0.0001).

Conclusions: AV distraction significantly lowered patients’ reported pain and distress scores. This correlated with the nonverbal scores reported by the radiographer. We conclude that AV distraction is a simple method of improving acceptance Vorinostat molecular weight of lithotripsy and optimizing

treatment.”
“BACKGROUND: Primary B-cell lymphomas of the cervix are rare entities and can present with hydronephrosis.

CASE: An 82-year-old woman with a history of chronic kidney disease presented with fever, altered mental status, and abdominal pain with bilateral hydronephrosis. Despite stent placement and antibiotic therapy, the patient’s condition worsened. Pelvic examination and biopsies were then performed, and a B-cell lymphoma of the cervix causing hydronephrosis was diagnosed. The patient’s family declined further treatment, and the patient died 2 weeks later.

CONCLUSION: Gynecologic examination and suspicion for pelvic malignancies are essential in the evaluation of patients presenting with hydronephrosis. Although squamous cell carcinoma is the most common type of malignancy associated with this presentation, malignancies of other cell lines, including lymphoma, should be considered. (Obstet Gynecol 2011; 117: 444-6) DOI: 10.1097/AOG.

In this study, batch experiments were carried out to verify this

In this study, batch experiments were carried out to verify this effect using synthetic solutions.

RESULTS: Addition of seed crystals could increase the rate of MAP crystallization and significantly shorten the reaction crystallization time, especially for solutions with a

lower supersaturation ratio (Omega). Crystallization time of MAP with and without seed addition can be expressed by two different formulas, in which the crystallization with feed addition followed an exponential function, and the secondary formula fitted a two-order power function. When 0.422 g L(-1) of seed crystals was added the equilibration time for crystallization calculated by the formula was reduced by 75min for low Staurosporine inhibitor supersaturation ratio solution and 26min for medium supersaturation ratio solution.

CONCLUSION: To increase the MAP reaction rate and to shorten induction

and equilibration times, seed crystal addition should be practiced (C) 2011 Society of Chemical Industry”
“Although Proteus mirabilis is a common human pathogen, bacteremia caused by the organism, especially strains producing extended-spectrum beta-lactamase (ESBL), has rarely been investigated. We examined 64 cases of P. mirabilis bacteremia identified in the Minami Ibaraki Area, Japan, between 2001 and 2010 and compared the characteristics of cases with ESBL-producing and ESBL-non-producing strains (13 and 51 cases, respectively). All ESBL-producing strains with the gene encoding the CTX-M-2-group were genetically nonidentical. Isolation of ESBL-producing strains was significantly associated with onset in

a hospital (p = 0.030), receiving hemodialysis find more (p = 0.0050), and previous antibiotic use within 1 month (p = 0.036; especially penicillin and/or cephalosporin (p = 0.010) and fluoroquinolone (p = 0.0069)). Isolation was also associated with inappropriate antibiotic therapy on the 1st and 4th days (p = 0.011 and 0.032, respectively) but not with mortality on the 30th day. These findings indicate that, for P. mirabilis bacteremia, isolation of ESBL-producing strains causes delay of initiating appropriate antimicrobial therapy but may not be associated with mortality.”
“A 68-year-old man developed a local recurrence with Buparlisib cell line multiple cutaneous and subcutaneous nodules three months after excision of a primary malignant melanoma of the temple. Despite extensive surgery and adjuvant irradiation, another local recurrence occurred. Following further local progression during dacarbazine chemotherapy, topical treatment with imiquimod was begun and the chemotherapy was changed to fotemustine. During this treatment further local progression occurred and two months later regional lymph node and distant metastasis were detected. The patient died from his tumor disease eighteen months after the first diagnosis of malignant melanoma.”
“BACKGROUND: Owing to the rapid depletion of petroleum fuel, the production of butanol through biological routes has attracted increasing attention.

Fifty matched control participants were examined

Resu

Fifty matched control participants were examined.

Results. The prevalence of TMJ symptoms was significantly higher in patients compared with control participants at inception (44% vs 20%, P = .0055) and remained significantly higher throughout the study period. The prevalence of disk displacement did not differ significantly between groups either

at inception (63% vs 53%) or at 15-year follow-up (63% vs 55%).

Conclusions. This prospective 15-year follow-up suggests that the development of TMJ symptoms, both immediate and delayed, is common in whiplash patients.”
“Background We analyzed the clinical response of pediatric and adolescent hereditary angioedema (HAE) patients to pdC1-INH in the International Multicenter Prospective Angioedema C1-INH

Trials (I.M.P.A.C.T.) 1 and 2. Methods Patients included in this post hoc analysis of prospectively collected data were between click here 10 and 18 yr old with type I or II HAE and a documented history of abdominal or facial attacks. Patients received a single injection of pdC1-INH concentrate (Berinert (R), CSL Behring, Marburg, Germany) 20 U/kg. Efficacy end-points were time from the administration of study drug to onset of symptom relief and time to complete relief of all symptoms. Results Seven pediatric patients were included in I.M.P.A.C.T.1 with only 1 attack Pevonedistat price analyzed per patient. Median time to onset of relief was 0.42 h and to complete resolution was 8.08 h. No patient experienced a worsening of symptoms during the 04-h GDC-0068 order assessment period. Nine patients

who experienced a total of 115 attacks were included in the analysis of I.M.P.A.C.T.2. Abdominal attacks were rated as severe more frequently than were other types of attacks. The number of attacks per patient ranged from 2 to 42, and study participation ranged from 1 to 38 months. Median times to onset of symptom relief and to complete symptom resolution were 0.49 h and 14.1 h, respectively. Of 4 treatment-emergent adverse events in both studies, only 2 were considered related to treatment. Conclusions Study results showed that outcomes with pdC1-INH treatment of HAE in pediatric patients are comparable with outcomes in adults.”
“Aim:

To establish the normal range of frontonasal angle (FNA) at 11+0 to 13+6 weeks of gestation and the feasibility of FNA measurement, evaluate the correlation of such a parameter with crown-rump length (CRL) and nuchal translucency (NT) and assess the potential of FNA in improving the performance of first trimester sonographic and biochemical screening for trisomy 21.

Methods:

We conducted a prospective study in 400 singleton uncomplicated pregnancies. FNA was obtained during maternal screening for trisomy 21. NT thickness and FNA were measured by 2D ultrasound in a midsagittal plane of the fetal profile. FNA was measured between the line along the upper surface of the frontal bone and the superior edge of the nasal profile until the echogenic tip.

Records were reviewed for postoperative gastrojejunostomy leak,

Records were reviewed for postoperative gastrojejunostomy leak,

stricture, and marginal ulcer, and these early complications were classified according to anastomosis technique. Multivariate analysis was performed to MCC950 concentration determine associations between complications and anastomosis technique.

Preoperative demographics, length of hospital stay, and postoperative follow-up did not differ between the three groups. The majority of patients underwent LSA (n = 514, 61.6%) followed by HSA (n = 180, 21.6%) and CSA (n = 140, 16.8%). Using multivariate analysis, there were no statistically significant differences in the rates of leak (LSA 1.0%, HSA 1.1%, CSA 0.0%, p = 0.480), stricture (LSA 6.0%, HSA 6.1%, CSA 4.3%, p = 0.657), or marginal ulcer (LSA 8.0%, HSA 7.7%, CSA 3.6%, p = 0.180).

The three techniques can be used safely with a low complication rate. Our data do not identify a superior VEGFR inhibitor anastomosis technique.”
“Adenolipoma refers to a variant of a lipoma with entrapped eccrine or, rarely,

apocrine units. We present 5 cases of cutaneous adenolipoma to demonstrate the spectrum of changes in the lipomatous and epithelial components. The cases include 3 lesions having a conventional lipomatous element and 1 with a spindle cell lipomatous component, each additionally featuring entrapped minimally altered eccrine units. In the remaining case, the epithelial component manifested a combination of hyperplastic and metaplastic changes (clear cell and squamous metaplasia) and unusually altered polarity of luminal cells with expression of myoepithelial cell markers on the luminal cells while focal absence of basal/myoepithelial cell in the corresponding area as evident microscopically and immunohistochemically.”
“Helichrysum has long been used medicinally, proving to be beneficial in treatment of acne, asthma, bronchitis and circulatory problems, and lymphatic system diseases. The objective of this research was to study the antioxidant and antibacterial activities and chemical composition of the compounds derived from the stems and roots of cultivated Selleck TPX-0005 H oligocephalum

using gas chromatography (GC) and gas chromatography-mass spectroscopy (GC-MS). The primary components found in the stem oil were ortho-vanillin (51.0%) and carvacrol (16.0%), and those found in the root oil were 1,8-cineole (30.6%) and isobornyl acetate (13.9%). Stem and root oils of H. oligocephalum demonstrated antibacterial activity, particularly in relation to Gram-positive bacteria. In a beta-carotene/linoleic acid bleaching assay, the root oil of H oligocephalum demonstrated an antioxidant effect. Antioxidant capacity measured with 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was 1205.0 for the stem oil and 722.8 mu g/ml for the root oil.”
“Understanding of chronic heart failure (HF) has progressed from a syndrome of disordered hemodynamics caused by alterations in the structure of the heart to one that involves intertwined molecular pathways in disarray.

The

authors report 3 patients who encountered prominently

The

authors report 3 patients who encountered prominently rhythmic neck myoclonias with and without absences (loss of awareness). The descriptive symptoms of attacks by witnesses were head shaking or turning repeatedly instead of absences. The seizures were induced by hyperventilation in all 3 cases. Two cases had a history of previous febrile seizures. In all patients, video-electroencephalography showed a one-to-one correspondence relationship between the 2.5- to 3.5-Hz generalized spike and wave discharges and the rhythmic myoclonic jerks of the neck, which was further confirmed by sternocleidomastoideus PP2 clinical trial electromyography recording in 1 patient. Seizures had been controlled by 1 or 2 antiepileptic drugs. Neck myoclonia with absences might be classified either as 1 special subtype of typical absence or as an independent seizure type. Paying close attention to the special phenomenon will help to clarify the clinical spectrum of this seizure.”
“Purpose To critically appraise, compare and summarize the measurement SB525334 properties of self-report fatigue questionnaires validated in patients

with multiple sclerosis (MS), Parkinson’s disease (PD) or stroke.

Methods MEDLINE, EMBASE, PsycINFO, CINAHL and SPORTdiscus were searched. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of studies. A qualitative data synthesis was performed to rate the measurement properties for each questionnaire.

Results Thirty-eight studies selleck chemical out of 5,336 records met the inclusion criteria, evaluating 31 questionnaires. Moderate evidence was found for adequate internal consistency and structural validity of the Fatigue Scale for Motor and Cognitive functions (FSMC) and for adequate reliability and structural validity of the Unidimensional Fatigue Impact Scale (U-FIS) in MS.

Conclusions We recommend the FSMC and U-FIS in MS. The Functional Assessment

of Chronic Illness Therapy Fatigue subscale (FACIT-F) and Fatigue Severity Scale (FSS) show promise in PD, and the Profile of Mood States Fatigue subscale (POMS-F) for stroke. Future studies should focus on measurement error, responsiveness and interpretability. Studies should also put emphasis on providing input for the theoretical construct of fatigue, allowing the development of questionnaires that reflect generic and disease-specific symptoms of fatigue.”
“An alternative method to resonant tunneling for obtaining total transmission in semiconductor heterostructures is investigated. This nonresonant total transmission has been shown to be difficult to achieve for electrons at normal incidence. However, if the momentum of the electron is altered so that the component in the direction parallel to the material interface is nonzero, the transmission properties of the electron change, and the potential for total transmission is more promising.

(Funded by Boehringer Ingelheim; RE-MEDY and RE-SONATE ClinicalTr

(Funded by Boehringer Ingelheim; RE-MEDY and RE-SONATE ClinicalTrials.gov numbers, NCT00329238 and NCT00558259, respectively.)”
“The functional expression

of heterologous genes using standard bacterial expression hosts such as Escherichia coli is often limited, check details e.g. by incorrect folding, assembly or targeting of recombinant proteins. Consequently, alternative bacterial expression systems have to be developed to provide novel strategies for protein synthesis exceeding the repertoire of the standard expression host E. coli.

Here, we report on the construction of a novel expression system that combines the high processivity of T7 RNA polymerase with the unique physiological properties of the facultative photosynthetic bacterium Rhodobacter capsulatus. This system basically consists of a recombinant R. capsulatus T7 expression strain (R. capsulatus B10S-T7) harboring the respective polymerase gene under control of a fructose inducible promoter.

In addition, a set of different broad-host-range vectors (pRho) was constructed allowing T7 RNA polymerase dependent and independent target gene expression in R. capsulatus and other Gram-negative bacteria. The expression efficiency of the novel system was studied in R. capsulatus and 4SC-202 E. coli using the yellow fluorescent protein (YFP) as model protein. Expression levels were comparable in both expression hosts before and yielded up to 80 mg/l YFP in phototrophically grown R. capsulatus cultures. This result clearly indicates that the novel R. capsulatus-based expression system is well suited for the high-level

expression of soluble proteins. (C) 2009 Elsevier Inc. All rights reserved.”
“BACKGROUND

Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter.

METHODS

We prospectively assessed 100 patients with gastroesophageal reflux disease before and after sphincter augmentation. The study did not include a concurrent control group. The primary outcome measure was normalization of esophageal acid exposure or a 50% or greater reduction in exposure at 1 year. Secondary outcomes were 50% or greater improvement in quality of life related to gastroesophageal reflux disease and a 50% or greater reduction in the use of proton-pump inhibitors at 1 year. For each outcome, the prespecified definition of successful treatment was achievement of the outcome in at least 60% of the patients. The 3-year results of a 5-year study are reported.

RESULTS

The primary outcome was achieved in 64% of patients (95% confidence interval [CI], 54 to 73).

)”
“A functional polymorphism in the 5′flanking region of th

)”
“A functional polymorphism in the 5′flanking region of the serotonin transporter gene (17q11.2, 5-HTTLPR) alters the transcription of the 5-HT transporter gene and seems to be associated with depression and anxiety-related personality traits in humans. This effect appears to be the most pronounced in individuals who are homozygous for the low-expressing “”S”" allele who have experienced significant critical life events

in the past. Animal studies now link this polymorphism to an increased stress reactivity of the hypothalamus-pituitary-adrenal Tideglusib mw (HPA) axis. In humans, it remains unknown whether this polymorphism by itself affects HPA axis or only in interaction with environmental factors. The aim of the present study was to investigate the role of the 5-HTTLPR polymorphism for the HPA axis LY2874455 ic50 in humans early in the development at a time when individuals were exposed to very few or no early adverse experiences so far.

We genotyped DNA for the 5-HTTLPR polymorphism including the A/G single-nucleotide polymorphism (SNP) in 126 three-day old newborns. The newborn’s stress response was stimulated by a heel prick which is a part of a routine medical procedure. The heel prick induced a significant biological

(i.e., cortisol) stress response in all newborns. Newborns with the “”S/S”" genotype showed a significantly higher endocrine response in comparison to newborns with “”L/L”" or “”S/L”" genotype.

In this sample of newborn babies, the 5-HTTLPR genotype affected the HPA stress response to painful stimulation irrespective of additional influence of pre- or perinatal environmental factors we measured. (C) 2009 PD0332991 solubility dmso Elsevier Ltd. All rights reserved.”
“A characteristic of Parkinson’s disease (PD) is the development of tremor within the 4-6 Hz range. One method used to better understand pathological tremor is to compare the responses to tremor-type actions generated intentionally in healthy adults. This study was designed to investigate the similarities and differences between voluntarily generated 4-6 Hz tremor and PD tremor in regards to their amplitude, frequency and coupling characteristics. Tremor responses

for 8 PD individuals (on- and off-medication) and 12 healthy adults were assessed under postural and resting conditions. Results showed that the voluntary and PD tremor were essentially identical with regards to the amplitude and peak frequency. However, differences between the groups were found for the variability (SD of peak frequency, proportional power) and regularity (Approximate Entropy, ApEn) of the tremor signal. Additionally, coherence analysis revealed strong inter-limb coupling during voluntary conditions while no bilateral coupling was seen for the PD persons. Overall, healthy participants were able to produce a 5 Hz tremulous motion indistinguishable to that of PD patients in terms of peak frequency and amplitude.

Published by Elsevier Inc “
“Inflammasomes are cytosolic pro

Published by Elsevier Inc.”
“Inflammasomes are cytosolic protein complexes that regulate caspase-1 activation and the secretion of interleukin-1 beta (IL-1 beta) and IL-18. Several different inflammasome complexes have been identified, but the NLRP3 inflammasome is particularly notable because of its central role in diseases of inflammation. Recent work has demonstrated an essential role for the NLRP3 inflammasome in host defense against influenza virus. We show here that two other RNA viruses, encephalomyocarditis virus

(EMCV) and vesicular stomatitis virus (VSV), activate the NLRP3 inflammasome in dendritic cells and macrophages through a mechanism requiring CRT0066101 research buy viral replication. Inflammasome activation in response to both viruses does not require MDA5 or RIG-I signaling. Despite the ability of the NLRP3 inflammasome to detect EMCV and VSV, wild-type and caspase-1-deficient mice were equally susceptible to infection with both viruses. These findings indicate that the NLRP3 inflammasome may be a common pathway for RNA virus detection,

AS1842856 datasheet but its precise role in the host response may be variable.”
“Adenosine receptors are the most important biochemical targets of caffeine, a common trimethylxanthine found in food and beverages. Adenosine plays modulatory action during the development through adenosine receptors and their intracellular pathways activation. In this study, we aimed to evaluate if caffeine gave to zebrafish in the very first steps of development is able to affect its direct targets, through the adenosine receptors mRNA expression evaluation, and latter indirect targets, through evaluation of the pattern of dopamine

and cAMP-regulated phosphoprotein and brain-derived neurotrophic factor (BDNF) mRNA expression. Here, we demonstrate that zebrafish express adenosine receptor subtypes (A1,A2A1, A2A2 and A2B) since 24 h post-fertilization (hpf) and that caffeine exposure is able to affect the expression of these receptors. Caffeine exposure from 1 hpf is able to increase Al expression at 72-96 hpf and A2A1 expression at 72 hpf. No alterations occurred in A2A2 and A2B expression after caffeine treatment. DARPP-32, a phosphoprotein involved in adenosine intracellular pathway is also expressed since selleck inhibitor 24 hpf and early exposure to caffeine increased DARPP-32 expression at 168 hpf. We also evaluate the expression of BDNF as one of the targets of adenosine intracellular pathway activation. BDNF was also expressed since 24 hpf and caffeine treatment increased its expression at 48 and 72 hpf. No morphological alterations induced by caffeine treatment were registered by the check of general body features and total body length. Assessment of tactile sensibility also demonstrated no alterations by caffeine treatment. Altogether, these results suggest that caffeine is able to affect expression of its cellular targets since early phases of development in zebrafish without affect visible features.

ASPECTS mismatch correlated strongly with volumetric

mism

ASPECTS mismatch correlated strongly with volumetric

mismatch with rho = 0.763 [95% CI 0.585-0.870], p < 0.0001. Sensitivity and specificity for volumetric mismatch a parts per thousand yen20% was 83.9% [95% CI 65.5-93.5] and 100% [95% CI 65.9-100], respectively, using ASPECTS mismatch a parts per thousand yen1. Volumetric mismatch a parts per thousand yen50%, a parts per thousand yen100%, and a parts per thousand yen150% were optimally identified using ASPECTS mismatch a parts per thousand yen1, a parts per thousand yen2, and a parts per thousand yen2, respectively.

On CTP, ASPECTS mismatch showed strong correlation to volumetric mismatch. ASPECTS mismatch a parts per thousand

yen1 was the optimal cut point for volumetric EPZ004777 cell line mismatch a parts per thousand yen20%.”
“Introduction: Although recognized with increasing frequency, the pathogenesis of venous aneurysms (VA) remains poorly understood. We evaluated 8 patients with 10 VA for the presence, localization and activity of metalloproteinases (MMPs).

Methods: Tissue specimens from VA (n=8), normal saphenous vein (NSV n=7) and varicose veins (VV n=7) were compared by histology and immunohistochemistry (IHC). Histologic sections were stained with H&E, Movats pentachrome, and toluidine blue, and IHC specimens with antibodies to CD68, MMP2, MMP9, and MMP13. Protein expression and enzyme selleck activity were determined by Western immunoblotting and zymography.

Results: Three of 4 patients with popliteal VA presented with edema and leg pain and the remaining patient with deep venous thrombosis (DVT) and pulmonary embolism (PE). The 5 popliteal VA were treated by; excision and reanastomosis (n=2) lateral venorrhaphy (n=2) and spiral saphenous

vein graft (n=1). The 3 patients with 4 upper extremity VA had discomfort over a compressible mass. Two of the FRAX597 concentration VA were excised and the remaining patients aneurysm ruptured spontaneously. The mesenteric VA, an incidental finding at laparotomy was excised. Thrombus was present in 2 popliteal, 1 upper extremity and in the mesenteric aneurysm. Histologically, VA and VV were characterized by fragmentation of the elastic lamellae, loss of smooth muscle cells (SMCs) and attenuation of the venous wall when compared to NSV. Varicose veins and VA also demonstrated increased expression of MMP-2, MMP-9 and MMP-13 in endothelial cells (ECs), SMCs and adventitial microvessels compared to NSV. Both pro-MMP-2 and pro-MMP-9 were detected by zymography VA,VV and NSV but only MMP-2 activity was demonstrable.

Conclusions: The structural changes in the venous wall in addition to the increased expression of MMP-2, MMP-9 and MMP-13 in VA compared to NSV and VV suggests a possible causal role for these MMPs in their pathogenesis. (J Vasc Surg 2008;48:1278-85.