Thereafter, changes in CD11b and tumor necrosis factor alpha (TNF

Thereafter, changes in CD11b and tumor necrosis factor alpha (TNF-alpha) immunoreactivity in microglia were evaluated in the SNc. MPTPp progressively increased CD11b immunoreactivity, conferring to microglia a highly activated morphology. Moreover, TNF-alpha levels were increased (457.38% over vehicle) after MPTPp. Rosiglitazone administration counteracted the increase in CD11b immunoreactivity caused by MPTPp. Moreover, rosiglitazone reverted TNF-alpha

expression to control levels. Nigrostriatal degeneration was assessed by high pressure liquid chromatography (HPLC) BMS202 measurement of striatal dopamine, and counting of TH-positive neurons in the SNc. MPTPp treatment caused a severe decline of striatal dopamine and a partial degenera- tion of the SNc. Rosiglitazone arrested the degenerative process in both areas. Results suggest that PPAR-gamma expression in microglia and TNF-alpha production by these cells are crucial changes by which rosiglitazone exerts neuroprotection in PD. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Purpose: Surgical management of children with myelomeningocele addresses 2 aspects of the disease, neurogenic this website bladder and neurogenic bowel. Results of total continence reconstruction using an artificial urinary sphincter and Malone antegrade

continence enema are presented.

Materials and Methods: We performed a retrospective chart review of patients who underwent simultaneous artificial urinary sphincter placement and a Malone antegrade continence enema procedure. From 1997 to 2007 a total of 21 patients with myelomeningocele underwent total continence reconstruction using the artificial urinary sphincter. Mean patient age was 10.4 years (range 6 to 22) and mean followup was 4.7 years (range 0.66 to 11.7). Artificial urinary sphincter cuff was placed around the bladder neck. A Malone antegrade continence enema was performed using Lck appendix in 19 patients and cecal based flaps in 2. Two patients underwent concomitant augmentation cystoplasty. Six patients had concomitant Mitrofanoff

vesicostomy using split appendix in 4 and Monti tube in 2.

Results: Immediate postoperative complications were observed in 5 patients, including prolonged ileus (2), urinary tract infection (2) and superficial wound dehiscence (1). Seventeen patients (81%) achieved complete urinary continence and 5 were voiding with sphincter cycling. Improvement in urinary continence with dry intervals greater than 3 hours was reported in 2 patients. There were 19 patients (90%) who reported fecal continence, with 2 reporting soiling 1 to 2 times a week. Malone antegrade continence enema stoma stenosis occurred in 3 patients and 2 required revisions. Sixteen patients (76%) achieved complete continence of stool and urine. During followup 2 artificial urinary sphincters were explanted and 8 patients (38%) underwent bladder augmentation.

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