Isolation and expansion of human natural T regulatory cells for cellular therapy.

Natural T regulatory cells (nTregs) play a key role in inducing and maintaining immunological tolerance. Cell-based therapy using purified nTregs is under consideration for several conditions, but procedures employed to date have resulted in cell populations that are contaminated with cytokine secreting effector cells. We have established a method for isolation and ex vivo expansion of human nTregs from healthy blood donors for cellular therapy aimed at preventing allograft rejection in organ transplants.

Glucocerebrosidase mutations in diffuse Lewy body disease.

Clinicogenetic and pathological studies have shown that mutations of the glucocerebrosidase gene (GBA) are a risk factor for Parkinson's disease and Lewy body disorders. In the present study, we have identified GBA mutations in 6.8% (4/59) of cases with a pathological diagnosis of diffuse Lewy body disease.

Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues.

Objective: To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD).

Data Sources And Study Selection: An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion.

Head positioning and risk of pneumocephalus, air embolism, and hemorrhage during subthalamic deep brain stimulation surgery.

Purpose: The objective of the present study was to evaluate the risk of pneumocephalus, venous air embolism (VAE), and intracranial hemorrhage in subthalamic nucleus (STN) deep brain stimulation (DBS) patients operated in the strict supine (head and body flat) position.

Methods: This was a retrospective review of clinical records and brain imaging of patients who underwent STN DBS between January 2007 and June 2009 at the University of Kansas Medical Center.

Results: A total of 61 patients underwent 114 lead implantations (53 staged bilateral and 8 unilateral).

Subthalamic nucleus deep brain stimulation changes velopharyngeal control in Parkinson's disease.

Purpose: Adequate velopharyngeal control is essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on velopharyngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of velopharyngeal control, and whether these changes were correlated with limb function and stimulation settings.

Quantitative evaluation of the effects of subthalamic stimulation on gait in Parkinson's disease patients using principal component analysis.

Background: Principal component analysis (PCA) was applied to the ground reaction force (GRF) for evaluating the deep brain stimulation of the subthalamic nucleus (DBS-STN) effects in Parkinson's disease (PD) subjects with and without medication.

Methods: Ten subjects who underwent DBS-STN were evaluated under the following four conditions: without treatment (mof-sof), with stimulation (mof-son), with medication (mon-sof), and with both treatments (mon-son). A control group of 30 subjects was also evaluated.

Utility of the NeuroTrax computerized battery for cognitive screening in Parkinson's disease: comparison with the MMSE and the MoCA.

To determine the utility of a computerized assessment in Parkinson's disease (PD), we compared the cognitive performance of 50 PD patients on the NeuroTrax computerized battery relative to the mini-mental state examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The results revealed fair agreement between impairment on the NeuroTrax and the MMSE (kappa=.291, p=.

Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease.

Adequate respiratory and laryngeal motor control are essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on respiratory and laryngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of respiratory and laryngeal control, and whether these changes were correlated with limb function and stimulation parameters.

Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease.

Background: Deep-brain stimulation is the surgical procedure of choice for patients with advanced Parkinson's disease. The globus pallidus interna and the subthalamic nucleus are accepted targets for this procedure. We compared 24-month outcomes for patients who had undergone bilateral stimulation of the globus pallidus interna (pallidal stimulation) or subthalamic nucleus (subthalamic stimulation).

Plexiform fibrohistiocytic tumor in the submandibular region: A rare diagnosis.

Plexiform fibrohistiocytic tumor (PFHT) is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988 [1]. It mainly affects children and young adults and preferentially involves the upper extremity [1, 2].We report a rare case in the submandibular region which was diagnosed on histopathology.

Immune exhaustion occurs concomitantly with immune activation and decrease in regulatory T cells in viremic chronically HIV-1-infected patients.

Background: Chronic HIV-1 infection is associated with excessive immune activation and immune exhaustion. We investigated the relationship of these 2 phenotypes and frequency of regulatory T cells (Tregs) in controlled and uncontrolled chronic HIV-1 infection.

Methods: Immune exhaustion marker PD-1, its ligand PD-L1, CD4CD25 FoxP3 Tregs, HLA-DR, and CD38 coexpression as activation markers were investigated in peripheral blood lymphocytes of 44 HIV-1-infected patients and 11 HIV-1-uninfected controls by multicolor flow cytometry.

Onset of dyskinesia with adjunct ropinirole prolonged-release or additional levodopa in early Parkinson's disease.

Levodopa-induced dyskinesia can result in significant functional disability and reduced quality of life in patients with Parkinson's disease (PD). The goal of this study was to determine if the addition of once-daily ropinirole 24-hour prolonged-release (n = 104) in PD patients not optimally controlled with levodopa after up to 3 years of therapy with less than 600 mg/d delays the onset of dyskinesia compared with increasing doses of levodopa (n = 104). During the study, 3% of the ropinirole prolonged-release group (mean dose 10 mg/d) and 17% of the levodopa group (mean additional dose 284 mg/d) developed dyskinesia (P < 0.

Use of brain MRI after deep brain stimulation hardware implantation.

The objective of this study was to examine the experience with and safety of brain 1.5 Tesla (T) magnetic resonance imaging (MRI) in deep brain stimulation (DBS) patients. This was a retrospective review of brain MRI scanning performed on DBS patients at the University of Kansas Medical Center between January 1995 and December 2007.

Early diagnosis of Parkinson's disease: recommendations from diagnostic clinical guidelines.

Therapeutic options for Parkinson's disease (PD) are currently limited to symptomatic agents. Levodopa is the most efficacious treatment; however, higher doses and long-term use are associated with adverse effects such as motor fluctuations and dyskinesia. Early treatment of PD with other agents such as dopamine agonists and monoamine oxidase type B inhibitors can provide symptomatic benefit and delay initiation of levodopa therapy.

Ciprofloxacin: review on developments in synthetic, analytical, and medicinal aspects.

In the current practices of anti-infective therapy, ciprofloxacin is a very popular fluoroquinolone having a broad spectrum of activity and diverse therapeutic prospects. The reasons for its wide use include multiresistant pathogens susceptible only to ciprofloxacin. The available clinical evidence suggests the potentially enhanced efficacy of this drug in the treatment of various community acquired and nosocomial infections, e.

Mitochondrial respiration and respiration-associated proteins in cell lines created through Parkinson's subject mitochondrial transfer.

Parkinson's disease (PD) is associated with perturbed mitochondrial function. Studies of cytoplasmic hybrid (cybrid) cell lines containing mitochondria from PD subjects suggest complex I dysfunction in particular is a relatively upstream biochemical defect. To evaluate potential downstream consequences of PD mitochondrial dysfunction, we used a cybrid approach to model PD mitochondrial dysfunction; our cybrid cell lines were generated via transfer of PD or control subject platelet mitochondria to mtDNA-depleted NT2 cells.

Evaluation of psychodynamic psychotherapy in a community mental health center.

This study describes an evaluation of the effectiveness of psychodynamic psychotherapy provided in an outpatient community mental health clinic. The study used a single group pretest-posttest design involving 78 clients. Clinical outcomes included overall psychosocial functioning and quality of life, level of subjective distress, interpersonal functioning and role functioning, measured by the Outcome Questionnaire (Lambert, Hansen, Umpress, Lunnen Okilshi, & Burlingame, 2000).

Assessment of the effects of subthalamic stimulation in Parkinson disease patients by artificial neural network.

This study aims at using a probabilistic neural network (PNN) for discriminating between normal and Parkinson disease (PD) subjects using as input the principal components (PCs) derived from vertical component of the ground reaction force (vGRF). The trained PNN was further used for evaluating the effects of deep brain stimulation of the subthalamic nucleus (STN DBS) on PD, with and without medication. A sample of 45 subjects (30 normal and 15 PD subjects who underwent STN DBS) was evaluated by gait analysis.

Comparison among probabilistic neural network, support vector machine and logistic regression for evaluating the effect of subthalamic stimulation in Parkinson disease on ground reaction force during gait.

Deep brain stimulation of the subthalamic nucleus (DBS-STN) is an approved treatment for advanced Parkinson disease (PD) patients; however, there is a need to further evaluate its effect on gait. This study compares logistic regression (LR), probabilistic neural network (PNN) and support vector machine (SVM) classifiers for discriminating between normal and PD subjects in assessing the effects of DBS-STN on ground reaction force (GRF) with and without medication. Gait analysis of 45 subjects (30 normal and 15 PD subjects who underwent bilateral DBS-STN) was performed.

Treatments for progressing Parkinson's disease: a clinical case scenario study.

Objective: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts.

Methods: The opinions of 9 experts in movement disorders on the appropriateness of 9 common pharmacological treatments for 33 hypothetical patient profiles were compared to those of 14 general neurologists. Before rating the case scenarios, all participants received a document integrating European and US guidelines for the treatment of patients with advanced PD.

Orally disintegrating selegiline in Parkinson patients with dopamine agonist-related adverse effects.

Objective: To determine whether adding orally disintegrating selegiline (ODS) while decreasing dopamine agonist (DA) dosages would reduce DA-related adverse effects (AEs) of excessive daytime sleepiness (EDS), pedal edema, hallucinations, and impulse control disorders (ICDs) without compromising efficacy in Parkinson disease (PD) patients.

Methods: This was a 12-week open-label study of 60 PD patients with motor fluctuations and DA-related AEs of EDS, pedal edema, hallucinations, and ICDs. Orally disintegrating selegiline was initiated at 1.

An open-label conversion study of pramipexole to ropinirole prolonged release in Parkinson's disease.

Ropinirole prolonged release (PR) is a once daily oral dopamine agonist approved for the treatment of Parkinson's disease (PD). The goal of this 4 week, open-label study was to determine the most effective conversion ratio with the fewest adverse effects (AEs) when switching from pramipexole to ropinirole PR. Sixty patients with PD taking pramipexole were converted overnight to ropinirole PR at ratios of 1:3, 1:4, or 1:5 such that 20 consecutive subjects were enrolled in each group.

Early biomechanical markers of postural instability in Parkinson's disease.

Current clinical assessments do not adequately detect the onset of postural instability in the early stages of Parkinson's disease (PD). The aim of this study was to identify biomechanical variables that are sensitive to the effects of early Parkinson's disease on the ability to recovery from a balance disturbance. Ten adults diagnosed with idiopathic PD and no clinically detectable postural instability, and ten healthy age-range matched controls (HC) completed the study.