Disability in atypical parkinsonian syndromes is more dependent on memory dysfunction than motor symptoms

BACKGROUND

There is a gap in the systematic description and investigation of functional disability in corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). Additionally, the relations between disability, apraxia, cognitive and behavioural changes are not well understood in atypical parkinsonian syndromes.

METHODS

Fifty patients were included in this study (CBS = 18; PSP = 11), including a subgroup of primary progressive aphasia-nonfluent variant (PPA-nfv = 21) who were used as a control group given the clinic-pathological overlap. Functional disability (basic and instrumental activities of daily living), general cognition and behavioural changes were evaluated at baseline, with a subgroup of patients being reassessed after 16 months.

RESULTS

The corticobasal syndrome group had the most marked disability in basic activities in comparison to progressive supranuclear palsy and primary progressive aphasia-nonfluent variant. Longitudinal decline was marked for all three groups. In a linear regression examining factors behind functional disability in CBS and PSP, memory dysfunction emerged as the main factor (48.5%), followed by apraxia (14.9%) and atypical parkinsonian symptoms (9.6%).

CONCLUSIONS

Memory dysfunction is the most important factor in functional disability in CBS and PSP, which has to be taken into consideration in disease management, prognosis and planning of services to fully address patients' and families' needs.

Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study

Ginseng is beneficial for many aspects of human physiology, including sexual function. In this study, we have evaluated the efficacy and safety of an extract of ginseng berry, which has a ginsenoside profile distinct from other parts of the plant, on sexual function in men with erectile dysfunction. In all, 119 men with mild-to-moderate ED participated in a multicenter, randomized, double-blind, parallel, placebo-controlled clinical study. They were administered 4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Efficacy was assessed with the International Index of Erectile Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We observed that the total and each of the individual domain scores of IIEF-15 increased from 40.95 ± 7.05 to 46.19 ± 12.69 significantly in the SKGB by the 8th week (P<0.05). The erectile function domain of IIEF changed slightly from 17.17 ± 2.57 to 18.59 ± 5.99 in the SKGB group by the 8th week (P<0.05). In addition, PEDT scores significantly improved from 9.14 ± 4.57 to 7.97 ± 4.4 and 7.53 ± 4.26 in the SKGB group after 4 and 8 weeks of treatment (P<0.05). Safety markers including hormone and lipid in the blood were assessed at the end of the 4th and 8th week and they remained unchanged. Oral administration of the SKGB extract improved all domains of sexual function. It can be used as an alternative medicine to improve sexual life in men with sexual dysfunction.

Activities of daily living in progressive non-fluent aphasia, logopenic progressive aphasia and Alzheimer's disease

BACKGROUND/AIMS

This study examined functional changes in progressive non-fluent aphasia (PNFA) and logopenic progressive aphasia (LPA) and Alzheimer's disease (AD) and the association between function, cognition and behaviour.

METHODS

59 patients were assessed with the Disability Assessment of Dementia (DAD), Addenbrooke's Cognitive Examination Revised (ACE-R) and the Cambridge Behavioural Inventory Revised (CBI-R).

RESULTS

No differences between groups in basic and instrumental activities of daily living (ADLs), and total ACE-R scores were found; there were correlations between total DAD and ACE-R scores for PNFA and LPA. Over 12 months, PNFA showed the marked decline of basic ADLs, whereas all three groups showed marked decline of instrumental ADLs.

CONCLUSION

PNFA, LPA and AD appear functionally similar when matched for disease duration. The rate of decline of ADLs depends, however, on disease diagnosis.

Thermally evaporated SiO thin films as a versatile interlayer for plasma-based OLED passivation

Silicon monoxide (SiO) thin films were introduced as an efficient interlayer for achieving plasma-based organic light-emitting diode (OLED) surface passivation. The SiO thin films could be consecutively formed via thermal evaporation, without breaking the vacuum, after deposition of the OLED cathode. The plasma resistivity and UV-blocking characteristics of the SiO interlayer protected the OLED devices against electrical and optical degradation during the plasma-enhanced atomic layer deposition (PEALD) and plasma-enhanced chemical vapor deposition (PECVD) passivation processes. In addition, the nonconformal deposition and hydroxyl group-rich surface characteristics of the SiO thin films yielded enhanced surface pinhole coverage and a higher initial film density in the subsequently deposited PEALD-based Al2O3 barrier film. As a result, the OLEDs with a SiO/Al2O3 bilayer passivation layer displayed a remarkably increased device shelf life compared to devices prepared using Al2O3-only passivation. A MOCON test showed that the water vapor transmission rate (WVTR) of the SiO/Al2O3 bilayer film was 0.0033 g/(m(2) day), 2.3 times lower than the rate of a single Al2O3 barrier film. The results of our study demonstrated the multipurpose role of a SiO interlayer in plasma-based OLED passivation. The layer acted as a damage-free protective layer for the underlying OLED devices and an assistant layer to improve the upper barrier film performance.

Ultrasonographic findings of pylorogastric intussusceptions in two dogs

A Yorkshire terrier (case 1) and a Miniature Schnauzer (case 2) were diagnosed with pylorogastric intussusceptions (PGIs). Both cases showed acute vomiting and had previous histories of laparotomy. In case 1, the invaginated pyloric wall was thickened unevenly containing multiple hypoechoic areas and had indistinct wall layering on ultrasonography. PGI with diffuse gastric edema and necrosis was confirmed on laparotomy. The dog recovered completely after gastrectomy and a Y-U plasty. Case 2 had uniformly thickened walls of invaginated gastric pylorus with the distinct wall layering. PGI was reduced spontaneously the next day.

High-performance low-voltage organic field-effect transistors prepared on electro-polished aluminum wires

We report the preparation of high-performance low-voltage pentacene-based organic field-effect transistors (OFETs) fabricated on a metallic fiber (Al wire) substrate. The surface roughness of the wire was significantly reduced after 10 min of electro-polishing. A 120 nm thick Al(2)O(3) gate dielectric layer was deposited on the anodized wire, followed by octadecyltrichlorosilane (ODTS) treatment. The ODTS-modified Al(2)O(3) gate dielectrics formed around the Al wire showed a high capacitance of 50.1 nF cm(-2) and hydrophobic surface characteristics. The resulting OFETs exhibited hysteresis-free operation with a high mobility of 0.345 cm(2) V(-1) s(-1) within a low operating voltage range of -5 V, and maintained their high performance at an applied tensile strain of bending radius ~2.2.

Phase III study of gemcitabine/oxaliplatin (GEMOX) with or without erlotinib in unresectable, metastatic biliary tract carcinoma

LBA4032

Background: Currently, there is no standard regimen for palliative chemotherapy in metastatic, unresectable biliary tract cancer (BTC). A phase II trial of erlotinib monotherapy showed a promising anti-tumor activity in BTC with tolerable toxicity. Additionally, gemcitabine + erlotinib demonstrated superior efficacy when compared to gemcitabine alone in pancreatic cancer. Hence, we conducted a phase III trial to compare between GEMOX vs GEMOX+erlotinib (Tarceva [T]) (GEMOX/T) as first-line chemotherapy in unresectable, metastatic BTC. Methods: Eligible patients were as follows: histologically confirmed adenocarcinoma of biliary tract (CCC), ampulla of vater (AOV) or gall bladder (GB); unresectable or metastatic; ECOG performance status of 0~2; adequate marrow, hepatic, renal and cardiac functions; no prior chemotherapy. The primary endpoint was progression free survival (PFS). The study regimen was gemcitabine 1,000mg/m2, oxaliplatin 100mg/m2, erlotinib 100mg qd daily q 2 weeks. Results: From February 2009 to August 2010, 268 pts were randomized, 133 patients to GEMOX arm and 135 patients to GEMOX/T arm. Patient characteristics: median age 61 yrs (range 30-82); male (63.4%); CCC (n=180, 67.2%), GB (n=82, 30.6%), and AOV (n=6, 2.2%). With a median follow-up of 13.9 months (range, 6.7 – 25.0), median PFS was 5.8 months (95% CI, 4.6 - 7.0) in GEMOX/T arm and 4.2 months (95% CI, 2.7 - 5.7) in GEMOX arm (P=0.080). In subgroup analysis (CCC, n=180), however, median PFS was significantly longer in GEMOX/T arm (5.9 months) when compared with GEMOX arm (3.0 months, P=0.049). The overall response rate was significantly higher in the GEMOX/T arm when compared with GEMOX arm. There was no significant difference in overall survival between the two arms (GEMOX/T: 9.5 months, 95% CI, 7.6 – 11.4; GEMOX: 9.5 months, 95% CI, 7.5 – 11.5; P=0.611). The EGFR mutation testing results in correlation to responsiveness to erlotinib will be presented at the meeting. Conclusions: This phase III represents the first multicenter, randomized trial to compare GEMOX vs GEMOX/T in unresectable, metastatic BTC. Although PFS was not prolonged in GEMOX/T, there was a significant benefit in terms of PFS in GEMOX/T arm for CCC patients.

Distinct clinical and metabolic deficits in PCA and AD are not related to amyloid distribution

BACKGROUND/OBJECTIVE

Patients with posterior cortical atrophy (PCA) often have Alzheimer disease (AD) at autopsy, yet are cognitively and anatomically distinct from patients with clinical AD. We sought to compare the distribution of β-amyloid and glucose metabolism in PCA and AD in vivo using Pittsburgh compound B (PiB) and FDG-PET.

METHODS

Patients with PCA (n = 12, age 57.5 ± 7.4, Mini-Mental State Examination [MMSE] 22.2 ± 5.1), AD (n = 14, age 58.8 ± 9.6, MMSE 23.8 ± 6.7), and cognitively normal controls (NC, n = 30, age 73.6 ± 6.4) underwent PiB and FDG-PET. Group differences in PiB distribution volume ratios (DVR, cerebellar reference) and FDG uptake (pons-averaged) were assessed on a voxel-wise basis and by comparing binding in regions of interest (ROIs).

RESULTS

Compared to NC, both patients with AD and patients with PCA showed diffuse PiB uptake throughout frontal, temporoparietal, and occipital cortex (p < 0.0001). There were no regional differences in PiB binding between PCA and AD even after correcting for atrophy. FDG patterns in PCA and AD were distinct: while both groups showed hypometabolism compared to NC in temporoparietal cortex and precuneus/posterior cingulate, patients with PCA further showed hypometabolism in inferior occipitotemporal cortex compared to both NC and patients with AD (p < 0.05). Patients with AD did not show areas of relative hypometabolism compared to PCA.

CONCLUSIONS

Fibrillar amyloid deposition in PCA is diffuse and similar to AD, while glucose hypometabolism extends more posteriorly into occipital cortex. Further studies are needed to determine the mechanisms of selective network degeneration in focal variants of AD.

Effect of filler geometry on coefficient of thermal expansion in carbon nanofiber reinforced epoxy composites

This study involves the investigation of the geometry effect of nano-fillers on thermally induced dimensional stability of epoxy composites by experimentally evaluating the linear coefficient of thermal expansion (CTE). Carbon nanofibers (CNF) were chosen as the filler in epoxy matrix to investigate the effect of an aspect ratio on the CTE of the nanocomposites at three different volume fractions of 0.5, 1, and 2% of the nano-filler. The composites were fabricated using a mechanical mixing method. The CTE values were evaluated by measuring thermal strains of the composites and also compared with a micromechanics model. It was observed that the composites with short CNF (average L/d = 10) show better thermal stability than one of the composites with long CNF (average L/d = 70), and the thermal stability of the composites was proportional to the volume fraction of the filler in each composite. In addition, the CTE of mutliwalled carbon nanotubes (MWNT) reinforced epoxy composites was evaluated and compared with the CTE of the CNF reinforced composites. Interestingly, the MWNT reinforced composites show the greatest thermal stability with an 11.5% reduction in the CTE over the pure epoxy. The experimental data was compared with micromechanics model.

Photopatternable poly(4-styrene sulfonic acid)-wrapped MWNT thin-film source/drain electrodes for use in organic field-effect transistors

We describe the cross-linking of poly(4-styrene-sulfonic acid) (PSS) by exposure to ultraviolet (UV) light (λ = 255 nm) under a vacuum. Fourier transform infrared (FT-IR) spectroscopy and X-ray photoelectron spectroscopy (XPS) showed that the photo-crosslinking of PSS resulted from coupling between radicals that were generated in the polymer chains by UV excitation. The photo-cross-linkable characteristics of PSS were employed to fabricate solution-processable, photopatternable, and conductive PSS-wrapped multiwalled carbon nanotube (MWNT) composite thin films by wrapping MWNTs with PSS in water. During photo-cross-linking, the work function of the PSS-wrapped MWNTs decreased from 4.83 to 4.53 eV following cleavage of a significant number of sulfonic acid groups. Despite the decreased work function of the PSS-wrapped MWNTs, the photopatterned PSS-wrapped MWNTs produced good source/drain electrodes for OFETs, yielding a mobility (0.134 ± 0.056 cm²/(V s)) for the TIPS-PEN field-effect transistors fabricated using PSS-wrapped MWNTs as source/drain electrodes that was higher than the mobility of gold-based transistors (0.011 ± 0.004 cm²/(V s)).