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Search Results: 1 - 10 of 787 matches for " Fredrik Romi "
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Thymoma in Myasthenia Gravis: From Diagnosis to Treatment
Fredrik Romi
Autoimmune Diseases , 2011, DOI: 10.4061/2011/474512
Abstract: One half of cortical thymoma patients develop myasthenia gravis (MG), while 15% of MG patients have thymomas. MG is a neuromuscular junction disease caused in 85% of the cases by acetylcholine receptor (AChR) antibodies. Titin and ryanodine receptor (RyR) antibodies are found in 95% of thymoma MG and 50% of late-onset MG (MG onset ≥50 years), are associated with severe disease, and may predict thymoma MG outcome. Nonlimb symptom profile at MG onset with bulbar, ocular, neck, and respiratory symptoms should raise the suspicion about the presence of thymoma in MG. The presence of titin and RyR antibodies in an MG patient younger than 60 years strongly suggests a thymoma, while their absence at any age strongly excludes thymoma. Thymoma should be removed surgically. Prethymectomy plasmapheresis/iv-IgG should be considered before thymectomy. The pharmacological treatment does not differ from nonthymoma MG, except for tacrolimus which is an option in difficult thymoma and nonthymoma MG cases with RyR antibodies. 1. Thymoma in Myasthenia Gravis Thymomas in myasthenia gravis (MG) are neoplasms derived from thymic epithelial cells, and are usually of the cortical subtype (WHO type B) [1]. 50% of thymoma patients develop MG (hereafter referred to as thymoma MG in this paper) [2, 3]. Cortical thymomas usually have some morphological similarities with thymic cortex; they share the capacity to propagate the maturation of immature naive CD4 T cells and export mature naive T cells into the periphery. Thymomas lacking this ability do not induce MG [4]. Thymomas with histological similarities to medullary thymic tissue or thymomas lacking developing T cells are seldom associated with MG [4]. Other thymoma characteristics that can cause reduced self-tolerance include defective epithelial expression of the autoimmune regulator (AIRE) gene and/or of major histocompatibility complex class II molecules, absence of myoid cells, failure to generate FOXP3(+) regulatory T cells, and genetic polymorphisms affecting T-cell signalling [5]. Histologically, thymomas are epithelial neoplastic cells surrounded by maturing T cells. The epithelial cells are capable of expressing epitopes cross-reactive with skeletal muscle proteins, such as acetylcholine receptor (AChR), titin, and ryanodine receptor (RyR) [6, 7]. The muscle-like epitopes are presented to T cells together with costimulatory molecules [7]. Autoreactive T cells specific for AChR and titin are found both in thymomas and in thymoma MG patients’ sera [8]. Thymoma epithelial cells present AChR peptides to T-cell lines in
Matrix Metalloproteinase-3 in Myasthenia Gravis Compared to Other Neurological Disorders and Healthy Controls
Steven P. Luckman,Nils Erik Gilhus,Fredrik Romi
Autoimmune Diseases , 2011, DOI: 10.4061/2011/151258
Abstract: MMP-3 is capable of degrading a variety of proteins, including agrin, which plays a critical role in neuromuscular signaling by controlling acetylcholine receptor clustering. High MMP-3 levels in a proportion of myasthenia gravis (MG) patients have been reported. A pathogenic role of MMP-3 in other neurological disorders has been suggested but not proven. We have therefore examined the levels of MMP-3 in 124 MG patients and compared them to 59 multiple sclerosis (MS) patients, 74 epilepsy patients, 33 acute stroke patients, and 90 healthy controls. 15.3% of the patients in the MG group were MMP-3-positive (defined as higher than cutoff value 48?ng/mL) with very high mean MMP-3 concentration (79.9?ng/mL), whereas the proportion of MMP-3 positive patients in the MS (3.4%), epilepsy (6.7%), stroke (0%), and the control group (4.4%) was significantly lower. Mean MMP-3 concentration in the total MG group (25.5?ng/mL) was significantly higher than in the MS (16.6?ng/mL) and stroke (11.7?ng/mL) groups, but did not differ significantly from the epilepsy (19.4?ng/mL) and the control group (23.4?ng/mL). MMP-3 may have a specific pathogenic effect in MG in addition to being associated with autoimmune diseases in general. 1. Introduction Matrix metalloproteinase-3 (MMP-3) is a matrix enzyme capable of breaking down various extracellular components, including collagens (types III, IV, V, IX, and XI), matrix proteins, and proteoglycans. MMP-3 can also activate other MMPs such as MMP-9 [1, 2]. Agrin is a substrate for the endopeptidase MMP-3, stromelysin1 [3]. MMP-3 null mice have alterations to their neuromuscular junctions, including increased acetylcholine receptor (AChR) staining at the endplate and an increased number of junctional folds. An increased concentration of agrin occurs at the neuromuscular junction of such mice [4]. These observations indicate that MMP-3 is involved in controlling the structure of the neuromuscular junction via regulation of agrin levels. Myasthenia gravis (MG) is an autoimmune disorder which causes skeletal muscle weakness. Antibodies targeting the AChR are present in 85% of patients with generalized MG (GMG) and in about 50% of patients with ocular MG (OMG) [5, 6]. MG with AChR antibodies is known as seropositive MG (SPMG). Thymoma is present in approximately 15% of MG patients [7]. Antibodies to AChR impair neuromuscular transmission by complement-mediated postsynaptic membrane damage, direct blockade of ligand-receptor interaction, and/or by an increased degradation of AChR [5, 8]. MG without detectable antibodies to the AChR is
Information Reach and Range Impact on Interorganizational Systems Platforms  [PDF]
Ismail M. Romi
Intelligent Information Management (IIM) , 2014, DOI: 10.4236/iim.2014.61001

Organizations tend to use information systems (IS) applications that require data to be exchanged between different parties, while data exchange is restricted with information reach and range, which determines the organizations’ IT platform. To determine the best platform, a comparison between electronic data interchange (EDI) and web services was conducted depending on certain criteria, and then we match the results with the information reach and range. The main findings show that the web services platform can take place when the range of information access is required by anyone and anywhere regardless of IT base. EDI can take place when the range of information access doesn’t exceed the organizations’ boundaries. But when the range of information access exceeds the organizations’ boundaries, still between certain partners, web services or EDI can take place, and thus the organization can select them from those platforms depending on other criteria such as security, and cost.

Myasthenia Gravis: A Review of Available Treatment Approaches
Nils Erik Gilhus,Jone F. Owe,Jana Midelfart Hoff,Fredrik Romi,Geir Olve Skeie,Johan A. Aarli
Autoimmune Diseases , 2011, DOI: 10.4061/2011/847393
Abstract: Patients with autoimmune myasthenia gravis (MG) should be further classified before initiating therapy, as treatment response varies for ocular versus generalised, early onset versus late onset, and acetylcholine receptor antibody positive versus MuSK antibody positive disease. Most patients need immunosuppression in addition to symptomatic therapy. Prednisolone and azathioprine represent first choice drugs, whereas several second choice options are recommended and should be considered. Thymectomy should be undertaken in MG with thymoma and in generalised, early-onset MG. For MG crises and other acute exacerbations, intravenous immunoglobulin (IvIg) and plasma exchange are equally effective and safe treatments. Children and females in child bearing age need special attention regarding potential side effects of immunosuppressive therapy. MG pathogenesis is known in detail, but the immune therapy is still surprisingly unspecific, without a pin-pointed attack on the defined disease-inducing antigen-antibody reaction being available. 1. Introduction Myasthenia gravis (MG) has a prevalence of 150 per million, with nearly one million MG patients worldwide. The yearly incidence is 10–15 per million per year [1]. Before any treatment was available the prognosis was severe, with an expected 50% 10-years’ mortality. With modern treatment facilities such as immunotherapy, thymectomy, and intensive care facilities available, population-based studies show that MG and non-MG individuals have the same life expectancy [2], but still often with reduced physical abilities, reduced quality of life, and risk of complications. There are three key aspects of MG which define the therapeutic opportunities. (i)MG is a well-defined autoimmune disease and thus responds to immunoactive treatment. (ii)MG is caused by impaired acetylcholine receptor (AChR) stimulation in the postsynaptic skeletal muscle membrane and thus responds to an increase in AChR activity.(iii)MG has muscle weakness as the only symptom, and consequently should respond to measures that increase muscle function and counteract muscle weakness. MG treatment is firmly established as the domain of neurologists. Neurologists should be in charge even if the target organ is skeletal muscle, disease mechanisms are systemic, thymus is a target organ for diagnostic, therapeutic and scientific approach, hypoventilation is a life-threatening symptom, and diplopia often the most troublesome symptom. Ten percent of MG patients have another autoimmune disorder in addition, further supporting the need for complementary medical
Arthropod borne diseases in Italy: from a neglected matter to an emerging health problem
Annali dell'Istituto Superiore di Sanità , 2010, DOI: 10.4415/ANN_10_04_12
Abstract: in medical entomology, "arthropod borne diseases", or "vector borne diseases" (vbd) are intended as a group of human and animal infections caused by different pathogen organisms (protozoa, helminthes, bacteria and viruses) transmitted by the bite of a bloodsucking insect or arachnid. it is commonly known that the infectious diseases transmitted by arthropods are mainly affecting tropical and subtropical countries, nevertheless some of them were or are still common also in the northern hemisphere, where they are usually maintained under control. vbd still represent some of the most important public health problems in the endemic areas but are becoming source of concern for developed countries too. since the last decades of the past century, a number of vbd has been spreading geographically, being recorded for the first time in areas outside their original range. this phenomenon is strictly related to the peculiar epidemiological characteristics of these diseases, that are considered the most susceptible to climatic, environmental and socioeconomic changes. this article is a short overview of the vbd endemic and emerging in italy. the possibility that some exotic vectors and/or pathogens could be introduced and become established in italy is also discussed.
On an extremal problem in two Siegel domains
Romi Shamoyan
Mathematics , 2012,
Abstract: We provide sharp new estimates for distance function in a Siegel domain of first and of second type
Abstract: The research theme is the concept of business according to Islamic economics. This study aims to describe how to financing of Islamic Bank contract performance 2008 -2013 period. This research base on published data of Bank Indonesia and Financial Service Autority . The method used in this research is ratio analysis tehcnic and Coomonsize analysis technic of the quantitative approach. The result shows that: signifcant contribution of murabaha and musyaraka contract financing in Islamic Bank balance statements, significant and smoth of growth level with murabaha and musyaraka contract. The impact of this research, Islamic Bank must be focus to use of murabaha and musyaraka contract financing and salam contract,istishna contract, ijarah contract unimplemented or maybe deleted. Because its unsignificant countribution and more fluktuatif performance of growth.
Heavy Metals Accumulation in Topsoils from the Wine-growing Regions Part 2. Relationships between soil properties and extractable copper contents
Marija Romi,Davor Romi,Gabrijel Ondra?ek
Agriculturae Conspectus Scientificus (ACS) , 2004,
Abstract: The present study analyses the effects of high copper concentrations on its mobility in the soils from the wine-growing regions of the Northwestern Croatia. The aims of this study were to determine the copper distribution in vineyard soils by single extraction procedures, and to relate the total, mobile and mobilisable copper content to several chemical soil characteristics using multiple regression analysis. The total Cu concentrations were determined by an aqua regia procedure. Two other methods were used for evaluating soil available copper: DTPA extraction and calcium chloride extraction. The physical and chemical characteristics (texture, organic C, pH, CaCO3, total P, CEC) were determined as well. Both DTPA- and CaCl2-extractable copper were largely explained by the total copper contents, and they were also highly correlated to each other. It was found that the DTPA-extractable copper decreased with increasing cation exchange capacity, but concentrations of CaCl2-extractable copper mainly depend on pH.
Motion Extrapolation in the Central Fovea
Zhuanghua Shi, Romi Nijhawan
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033651
Abstract: Neural transmission latency would introduce a spatial lag when an object moves across the visual field, if the latency was not compensated. A visual predictive mechanism has been proposed, which overcomes such spatial lag by extrapolating the position of the moving object forward. However, a forward position shift is often absent if the object abruptly stops moving (motion-termination). A recent “correction-for-extrapolation” hypothesis suggests that the absence of forward shifts is caused by sensory signals representing ‘failed’ predictions. Thus far, this hypothesis has been tested only for extra-foveal retinal locations. We tested this hypothesis using two foveal scotomas: scotoma to dim light and scotoma to blue light. We found that the perceived position of a dim dot is extrapolated into the fovea during motion-termination. Next, we compared the perceived position shifts of a blue versus a green moving dot. As predicted the extrapolation at motion-termination was only found with the blue moving dot. The results provide new evidence for the correction-for-extrapolation hypothesis for the region with highest spatial acuity, the fovea.
Comparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome
Naess H, Romi F
Vascular Health and Risk Management , 2011, DOI: http://dx.doi.org/10.2147/VHRM.S22950
Abstract: mparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome Original Research (2852) Total Article Views Authors: Naess H, Romi F Published Date August 2011 Volume 2011:7 Pages 497 - 502 DOI: http://dx.doi.org/10.2147/VHRM.S22950 Halvor Naess, Fredrik Romi Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway Background: To compare the clinical characteristics, and short-term outcome of spinal cord infarction and cerebral infarction. Methods: Risk factors, concomitant diseases, neurological deficits on admission, and short-term outcome were registered among 28 patients with spinal cord infarction and 1075 patients with cerebral infarction admitted to the Department of Neurology, Haukeland University Hospital, Bergen, Norway. Multivariate analyses were performed with location of stroke (cord or brain), neurological deficits on admission, and short-term outcome (both Barthel Index [BI] 1 week after symptom onset and discharge home or to other institution) as dependent variables. Results: Multivariate analysis showed that patients with spinal cord infarction were younger, more often female, and less afflicted by hypertension and cardiac disease than patients with cerebral infarction. Functional score (BI) was lower among patients with spinal cord infarctions 1 week after onset of symptoms (P < 0.001). Odds ratio for being discharged home was 5.5 for patients with spinal cord infarction compared to cerebral infarction after adjusting for BI scored 1 week after onset (P = 0.019). Conclusion: Patients with spinal cord infarction have a risk factor profile that differs significantly from that of patients with cerebral infarction, although there are some parallels to cerebral infarction caused by atherosclerosis. Patients with spinal cord infarction were more likely to be discharged home when adjusting for early functional level on multivariate analysis.
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