The effect of bi-level positive airway pressure mechanical ventilation on gas exchange during general anaesthesia

BACKGROUND

Atelectasis may occur and ventilation-perfusion mismatch may increase during general anaesthesia with neuromuscular paralysis and mechanical ventilation, though preservation of some intermittent muscle contraction might mitigate this process. There is still no ideal manoeuvre to minimize such mismatch or atelectasis. Bi-level positive airway pressure (BiPAP) ventilation adjusts to extra breaths and improves gas exchange during recovery of diaphragm function after neuromuscular paralysis. We hypothesize that BiPAP ventilation may limit the development of pulmonary shunt and may improve ventilation-perfusion mismatch when compared with standard IPPV, with or without PEEP when neuromuscular paralysis has been used during surgery.

METHODS

Twenty ventilated patients either on BiPAP or IPPV with or without PEEP were studied randomly using the multiple inert gas elimination technique (MIGET) at 60 and 120 min after rocuronium at induction and after 60 min. Non-invasive cardiac output (NICO) monitoring and plasma concentrations of rocuronium were measured. We compared the data of MIGET, gas exchange, haemodynamic variables and pulmonary mechanics measurements between the different ventilatory modes.

RESULTS

Intrapulmonary shunt (blood flow to V(A)/Q < 0.005) did not increase at 60 min of anaesthesia in any of the different ventilation modes compared with the shunt value before anaesthesia. Log standard deviation of perfusion increased in IPPV, with and without PEEP groups, compared with the baseline (P< 0.05) but did not increase in the BiPAP group. BiPAP ventilation generated a higher level of Pa(O2)than IPPV with or without PEEP (P<0.05).

CONCLUSION

BiPAP ventilation was beneficial in decreasing ventilation-perfusion mismatch and improving oxygenation when compared with conventional IPPV (with or without PEEP).

MCM7 amplification and overexpression are associated with prostate cancer progression

The genomic DNA profiles of prostate cancers with aggressive features were compared to the profiles of matched normal DNA to identify genes that are selectively amplified in the cancer cells. One of the identified genes, MCM7, which is a component of the DNA replication licensing complex, has been studied extensively both at the DNA and protein levels in human prostate tissues. Approximately half of the prostate cancer specimens studied showed MCM7 gene amplification, and 60% of the aggressive prostate cancer specimens had increased MCM7 protein expression. Amplification or overexpression of MCM7 was significantly associated with relapse, local invasion and a worse tumor grade. Constitutive expression of MCM7 in a human prostate cancer cell line, DU145, resulted in markedly increased DNA synthesis and cell proliferation compared to vector-only controls, and an increased cell invasion in vitro. Indeed, MCM7 overexpression produced primary tumors 12 times larger than vector-only controls and resulted in a rapid demise of mice bearing those tumors. These studies implicate MCM7, and the DNA replication licensing gene family, in prostate cancer progression, growth and invasion.

Chromate sorption and reduction kinetics onto an aminated biosorbent

A novel biosorbent was prepared by chemically grafting of polyethylenimine (PEI) onto the fungal biomass of Penicillium chrysogenum through a two-step reaction. The modified biosorbent is favorable for the removal of anionic Cr(VI) species from aqueous solution due to the protonation of amine groups on the biomass surface. The sorption capacity for Cr(VI) increased by 7.2-fold after surface modification. Sorption kinetics results show that the pseudo-second-order kinetic model described the experimental data well. During the sorption process, X-ray photoelectron spectroscopy (XPS) was used to analyze the chromium species on the biosorbent surface and the results indicate that part of the Cr(VI) ions were reduced to Cr(III) ions which can be chelated with the amine groups on the biomass surface. The reduced Cr(III) ions formed some aggregates on the surface at higher solution pHs.

Charge-transfer excitations in the model superconductor HgBa(2)CuO(4+delta)

We report a Cu -edge resonant inelastic x-ray scattering (RIXS) study of charge-transfer excitations in the 2-8 eV range in the structurally simple compound HgBa(2)CuO(4+delta) at optimal doping (T(c)=96.5 K). The spectra exhibit a significant dependence on the incident photon energy which we carefully utilize to resolve a multiplet of weakly dispersive (<0.5 eV) electron-hole excitations, including a mode at 2 eV. The observation of this 2 eV excitation suggests the existence of a remnant charge-transfer gap deep in the superconducting phase. Quite generally, our results, which include additional data for the Mott insulator La(2)CuO(4), demonstrate the importance of exploring the incident photon-energy dependence of the RIXS cross section.

A pilot study of fatty acid metabolism in oral squamous cell carcinoma

This study was undertaken to determine the characteristics of fatty acid synthesis in squamous carcinoma cells and to assess the possibility of exploiting this synthesis pathway in anticancer therapy. Incorporation of [(3)H]acetate into total lipids of the TCA-83 squamous carcinoma cell line and normal gingival fibroblasts was measured. The effects of cerulenin, a specific, potent, noncompetitive inhibitor of fatty acid synthase (FAS), on growth of TCA-83 cells and normal gingival fibroblasts was determined by the MTT method, and the effect of cerulenin on apoptosis was determined by electrophoresis of cellular DNA. Incorporation of [(3)H]acetate into total lipids was significantly higher in TCA-83 cells (68 +/- 12.7 cpm per 2 x 10(5) cells) than in normal gingival fibroblasts (13 +/- 4.2 cpm per 2 x 10(5) cells; P = 0.011). Cerulenin inhibited TCA-83 cell growth in a dose-dependent manner, even at 2.5 microg/ml, a concentration at which normal gingival fibroblasts were not inhibited. After exposure to cerulenin, TCA-83 cells showed typical apoptotic DNA ladders. These results indicate that cerulenin exerts selective cytotoxic effects on squamous carcinoma cells and can induce their apoptosis. These findings suggest that targeting of fatty acid synthesis may be useful in the treatment of squamous cell carcinomas.

Characterization and functional study of five novel monoclonal antibodies against human OX40L highlight reverse signalling: enhancement of IgG production of B cells and promotion of maturation of DCs

OX40 ligand (OX40L), a molecule originally identified as human gp34, is an important co-stimulatory molecule during immune response. In this study, we report on five functional mouse anti-human OX40L monoclonal antibodies named as 9H10, 4C12, 8D10, 4H4 and 1G1, characterized by means of flow cytometry, Western blot and competition assay. These monoclonal antibodies bound to distinct OX40L epitopes on activated B cells and dendritic cells (DCs) and two of them could suppress the proliferation of T lymphocytes co-stimulated by mature DCs. Furthermore, we demonstrated that our monoclonal antibodies, such as 9H10 and 4C12, could trigger OX40L reverse signal that enhanced IgG production of B cells and promoted maturation of DCs as evidenced by the upexpression of CD80, CD86, CD83 and CXCR4 and monoclonal antibody 9H10 could also promote anti-CD40 monoclonal-antibody-stimulated DCs in order to induce T cells to secrete more interleukin-2 and interferon-gamma, which suggested that OX40L signals could strengthen the effect of CD40 signals on promoting Th1 differentiation.

A universal scaling relation in high-temperature superconductors

Since the discovery of superconductivity at elevated temperatures in the copper oxide materials there has been a considerable effort to find universal trends and correlations amongst physical quantities, as a clue to the origin of the superconductivity. One of the earliest patterns that emerged was the linear scaling of the superfluid density (rho(s)) with the superconducting transition temperature (T(c)), which marks the onset of phase coherence. This is referred to as the Uemura relation, and it works reasonably well for the underdoped materials. It does not, however, describe optimally doped (where T(c) is a maximum) or overdoped materials. Similarly, an attempt to scale the superfluid density with the d.c. conductivity (sigma(dc)) was only partially successful. Here we report a simple scaling relation (rho(s) proportional, variant sigma(dc)T(c), with sigma(dc) measured at approximately T(c)) that holds for all tested high-T(c) materials. It holds regardless of doping level, nature of dopant (electrons versus holes), crystal structure and type of disorder, and direction (parallel or perpendicular to the copper-oxygen planes).

Quantitative structure-property relationships on direct photolysis of PCDD/Fs on surfaces of fly ash

Fly ash samples containing polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were generated by combustion of polyvinyl chloride, wood, high-density polyethylene and styrene. By partial least-squares (PLS) regression, quantitative structure-property relationship (QSPR) models were developed for photolysis half-lives (t(1/2)) of PCDD/Fs adsorbed on fly ash surfaces and irradiated by UV-B of simulated sunlight. Quantum chemical descriptors computed by PM3 hamiltonian were used as predictor variables. The cross validated value for the optimal QSPR model was 0.678, indicating robustness and good predictive abilities of the model. The QSPR results showed that the stability of the PCDD/F molecules increased with the increase of chlorine atoms in the parent molecules. Increasing the energy of the highest occupied molecular orbital (E(HOMO)), the energy of the lowest unoccupied molecular orbital (E(LUMO)), E(LUMO)+E(HOMO) and E(LUMO)-E(HOMO) values of the PCDD/Fs led to decrease of log t(1/2) values. Increasing the most negative atomic charge on the oxygen atom of PCDD/Fs led to elevated log t(1/2) values. The log t(1/2) values of PCDD/Fs increased with the decrease of the largest negative atomic charge on a carbon atom.

A comparative study of the hydrolysis pathways of substituted aryl phosphoramidate versus aryl thiophosphoramidate derivatives of stavudine

A comparative study of aryl phosphoramidate and aryl thiophosphoramidate derivatives of 2',3'-didehydro-2',3'-dideoxythymidine (d4T) was performed. The study focused on the nature of the substituents and the influence of a thiophosphoramidate in the structure of these derivatives. The rate of alkaline hydrolysis of these two types of d4T derivatives indicated that replacement of oxygen with sulfur decreases the rate of hydrolysis by twofold. Additionally, the activation energy (E(a)) for the sulfur analogs is comparatively higher than that of the oxygen analogs. Notably, an intermediate was formed in the hydrolysis reaction of the sulfur analogs of d4T that was absent in the case of the oxygen analog, and the tentative structure of the intermediate was proposed based on LC/mass spectroscopy data. Using both HPLC and (31)P-NMR techniques, we identified the hydrolysis product of the phosphoramidate derivatives and were able to show in in vitro studies that porcine liver esterase can hydrolyze the methyl ester portion of the phosphoramidate derivatives. Aryl phosphoramidate derivatives of d4T were 1000-fold more active than the corresponding aryl thiophosphoramidate derivatives, indicating that the energy of activation of hydrolysis of these phosphoramidate derivatives plays a significant role in their biological potency.

Molecular structural characteristics governing biocatalytic chlorination of PAHs by chloroperoxidase from Caldariomyces fumago

Based on some fundamental quantum chemical descriptors computed by PM3 Hamiltonian, a quantitative structure-property relationship (QSPR) for specific activity of 17 polycyclic aromatic hydrocarbons (PAHs) of biocatalytic chlorination by chloroperoxidase (CPO) from Caldariomyces fumago was developed using partial least squares (PLS) regression. The model can be used to estimate biocatalytic chlorination reaction rates of PAHs. The main factors affecting specific activity of PAHs of biocatalytic chlorination by CPO from Caldariomyces fumago are absolute hardness, dipole moment, absolute electronegativity, and molecular bulkness of the PAH molecules. The biocatalytic chlorination reaction rates of PAHs with large values of absolute hardness, absolute electronegativity, and molecular bulkness tend to be slow. Increasing dipole moment of PAHs leads to increase the specific activity.

Phase association of polycyclic aromatic hydrocarbons in the Minjiang River Estuary, China

Persistent organic pollutants such as polycyclic aromatic hydrocarbons (PAHs) are of great concern due to their persistence, bioaccumulation and toxic effects. In this work the levels of 16 priority PAHs were determined in water, pore water, sediment, soil and vegetable samples from Minjiang River Estuary, China. Total PAH concentrations varied from 9.9 to 474 microg/l in water, 82.1 to 239 microg/l in pore water, 112 to 877 ng/g dry wt. in surficial sediments, 128 to 465 ng/g dry wt. in soil and 8600 to 111,000 ng/g dry wt. in Chinese vegetables. Overall, the mean concentrations of PAHs were present in higher levels in pore water than that in surface water, due possibly to higher concentrations of dissolved organic carbon or colloids with which the hydrophobic pollutants were strongly associated. Such a concentration gradient implies a potential flux of pollutants from sediment pore water to overlying water. Contamination was dominated by high molecular mass PAH compounds in all samples, indicating combustion-derived sources (for example, pyrolysis at high temperature). The levels of PAHs in water and vegetable were relatively high in comparison to other studies, although PAHs in sediment and soil were comparable to those found in many other similar environments. The ratios of selected PAHs indicated again that PAHs in Minjiang River Estuary were mainly derived from incomplete combustion of fossil fuel.

Sequencing and characterization of the full-length gene encoding the single-stranded DNA binding protein of a novel Chelonian herpesvirus

Through 4 consecutive genomic walks employing a recently modified inverse polymerase chain reaction technique, a 4,054-bp DNA fragment of a newfound green turtle herpesvirus (GTHV) was obtained from tumor tissues of a green turtle with fibropapillomas. This newly identified viral DNA fragment contains two non-overlapping open reading frames (ORF) oriented in the 3' to 5' direction. The first ORF is 59% G+C rich and contains the full-length genomic sequence of the DNA binding protein (DBP) gene (3,585 bp) encoding a protein of 1,195 amino acid residues in length. The second ORF encodes a partial peptide of the UL28 gene. Phylogenetic analysis of the GTHV DBP gene confirmed and substantiated that this novel Chelonian herpesvirus is closely related to the subfamily Alphaherpesvirinae. Examination of the translated amino acid sequence further supports this categorization since GTHV DBP comprises a highly conserved zinc finger motif (CXLCX4RX2C) and a putative DNA binding domain, and exhibits high sequence homology to other alphaherpesviruses. Cloning and sequencing the genome of this putative herpesvirus will facilitate current understanding of its role in causing GTFP and the development of molecular- and immuno-based methods for the diagnosis and prevention of this devastating disease of green turtles.

Fate and assessment of persistent organic pollutants in water and sediment from Minjiang River Estuary, Southeast China

Persistent organochlorine compounds were analyzed in surface water, porewater and surficial sediment samples from Minjiang River Estuary, which is the first large river in Fujian Province, Southeast of China. The total concentrations of 18 organochlorine pesticides were 214.4-1819, 4541-13,699 ng/l, 28.79-52.07 ng/g in surface water, porewater and sediments (dry weight) respectively, and those of 21 polychlorinated biphenyls (PCBs) in the three phases were: 203.9-2473, 3192-10,855 ng/l, 15.14-57.93 ng/g respectively. The results showed that the concentrations of these selected organochlorine pesticides and PCBs in porewater were higher than those in surface water. It may be due to the fact that these organic hydrophobic pollutants tend to stay in the sediments, and then re-suspend from the sedimentary phase to the upper water. We have analyzed the distribution characteristics of individual organochlorine pesticide components and PCBs, and found that alpha-HCH, DDE, Heptachlor, Endosulfan II, Methoxychlor were the most common organochlorine pesticides contaminants. Considering the groups of HCHs (HCHs=alpha-HCH+beta-HCH+gamma-HCH+delta-HCH) and DDTs (DDTs=DDT+DDD+DDE), the predominance of beta-HCH, DDE in all water, porewater and sediment samples was clearly observed. This observation suggested that beta-HCH was resistant to biodegradation and the DDTs had been transformed to its metabolites, DDE and DDD, of which DDE that was more un-degradable. The PCB congeners containing 3-6 chlorines had the great preponderance in the three phase. These results were compared with those present in other estuaries and harbors. A risk assessment was evaluated for the persistent organic pollutants in the Minjiang River Estuary.

Sequential pathological and immunologic analysis of percutaneous microwave coagulation therapy of hepatocellular carcinoma

PURPOSE

To evaluate sequential pathologic and immunologic changes and their prognostic significance after percutaneous microwave coagulation therapy (PMCT) of hepatocellular carcinoma (HCC).

METHODS

Eighty-nine nodules in 82 consecutive patients were studied. The 89 nodules were divided into two groups: a treatment group, with 82 primary nodules (average dimension was 3.4 +/- 1.2 cm) in 82 patients, and a control group, of seven nodules (average dimension was 1.4 +/- 0.6 cm) in seven patients. The criteria for a nodule's inclusion in the control group was that the nodule was one of two nodules in the same patient and that the two nodules were located in different liver lobes. This guarantees that while one nodule is treated by PMCT, the distant one will not be directly affected by the microwave thermal field. The control group nodules were treated after the study was completed. Specimens were taken with ultrasound-guided liver biopsy from the treated nodule and the control nodule, pre- and post-PMCT. Infiltration by T-lymphocytes, B-lymphocytes, NK cells and macrophages in the tumour tissue were observed immunohistochemically using a panel of monoclonal antibodies against CD3, CD45RO, CD20, CD56 and CD68. The extent of immune cell infiltration was compared both before and after PMCT, as well as between the treated and control nodules. The relationship between the prognosis and the extent of immunocyte infiltration was analysed.

RESULTS

The patients were followed for 2-26 months (mean 14.6 +/- 6.3) post-treatment. The recurrence rates at 1 and 2 years were 20.4% and 28.1% within the liver in treatment group, respectively. The survival rates at 1 and 2 years were 92.5% and 75.3% for the treatment group. T-cells, NK cells and macrophages increased significantly in both treated and untreated nodules after PMCT, albeit less markedly within untreated nodules when compared to the treated ones. There is a statistically significant correlation between survival outcome and the extent of immunocyte infiltration.

CONCLUSIONS

For inoperable HCC patients, PMCT is one of the treatment choices shown to be effective. Apart from its tissue coagulation effect, an increased systemic immune response directed against the tumour may also play an important role in improved survival.

Dissolved insecticides and polychlorinated biphenyls in the Pearl River Estuary and South China Sea

Persistent organic pollutants (POPs) such as organochlorine (OCl) insecticides and polychlorinated biphenyls (PCB), together with the new generation of organophosphorus (OP) insecticides, are of global concern, due to their widespread occurrence, persistence, bioaccumulation and hormone disruption potential. This paper represents an attempt to study the source and transportation of such pollutants in estuarine and coastal environments as an integrated ecosystem, by determining the levels of 18 OCl insecticides, 21 PCB congeners, and 17 OP insecticides in the Pearl River Estuary and South China Sea. The total concentrations varied from 126-1198 ng l(-1) for OCl insecticides, 33.38-1064 ng l(-1) for PCB congeners, and 4.44-6356 ng l(-1) for OP insecticides in the Pearl River Estuary. In comparison, their levels in the South China Sea were significantly lower, varying from 57.09-202 ng l(-1) for OCl insecticides, 21.72-144 ng l(-1) for PCBs, and 1.27-122 ng l(-1) for OP insecticides, respectively. The predominance of beta-HCH in HCHs, and DDE in DDTs in all water samples was clearly observed, suggesting beta-HCH and DDE's resistance to further degradation. The PCBs were dominated by those with 3-6 chlorines. The distribution characteristic of OP insecticides shows that five compounds (methamidophos, dimethoate, malathion, dichlorvos and omethoate) accounted for 56% and 72% of the total OP insecticide concentration. The relationship between pollutant concentrations and salinity in the estuary showed that they were all removed during the mixing process, therefore behaving non-conservatively.

Three-dimensional computer modeling of the human upper respiratory tract

Computer simulations of airflow and particle-transport phenomena within the human respiratory system have important applications to aerosol therapy (e.g., the targeted delivery of inhaled drugs) and inhalation toxicology (e.g., the risk assessment of air pollutants). A detailed description of airway morphology is necessary for these simulations to accurately reflect conditions in vivo. Therefore, a three-dimensional (3D) physiologically realistic computer model of the human upper-respiratory tract (URT) has been developed. The URT morphological model consists of the extrathoracic (ET) region (nasal, oral, pharyngeal, and laryngeal passages) and upper airways (trachea and main bronchi) of the lung. The computer representation evolved from a silicone rubber impression of a medical school teaching model of the human head and throat. A mold of this ET system was sliced into 2-mm serial sections, scanned, and digitized. Numerical grids, for use in future computational fluid dynamics (CFD) simulations, were generated for each slice using commercially available software (CFX-F3D), AEA Technology, Harwell, UK. The meshed sections were subsequently aligned and connected to be consistent with the anatomical model. Finally, a 3D curvilinear grid and a multiblock method were employed to generate the complete computational mesh defined by the cross-sections. The computer reconstruction of the trachea and main bronchi was based on data from the literature (cited herein). The final unified 3D computer model may have significant applications to aerosol medicine and inhalation toxicology, and serve as a cornerstone for computer simulations of air flow and particle-transport processes in the human respiratory system.

Occurrence and behaviour of organophosphorus insecticides in the River Wuchuan, southeast China

Organophosphorus (OP) insecticides are used worldwide, yet their persistence in the environment is not well understood. This paper summarises recent research on 17 OP insecticides in the River Wuchuan, an important catchment in China, by determining their concentrations in water, soil, sediment and plants by gas chromatography with flame photometric detection (GC-FPD). The concentrations of the total OP insecticides ranged from 92.77 to 229 ng l-1 in river water, 1.61 to 9.93 ng g-1 dry weight in soil, 1.24 to 7.56 ng g-1 dry weight in sediment and 75.28 to 326 ng g-1 dry weight in plants. There was a relatively high abundance of methamidophos, dichlorvos, malathion, omethoate and dimethoate in all water, soil, sediment and plant samples. On average, these five compounds collectively accounted for 64%, 71%, 71% and 54% of the total OP insecticide concentration in water, soil, sediment and plants, respectively, which was similar to the composition of OP insecticides in application formulations used in our study area and in China as a whole. The results therefore reflect the application pattern to some extent, and suggest that the sources of the OP insecticides are mainly from current usage. When compared with other areas, the levels of OP insecticides in the River Wuchuan were moderate. The animal and human risks from exposure to OP insecticides in water and plants were evaluated against relevant threshold values. The results therefore provide important information on the current contamination status of a key agricultural watershed in China, and point to the need for urgent action to control the use of some excessively applied and potentially persistent agrochemicals, such as methamidophos, omethoate and dimethoate.

[Clinical significance of Q-Tc dispersion after exercise in aged patients with old myocardial infarction]

OBJECTIVE

This study was aimed to evaluate clinical significance of Q-Tc dispersion after exercise in aged patients with old myocardial infarction.

METHOD

Sixty-four aged patients with old myocardial infarction(infarction group) were examined by treadmill exercise, dynamic electrocardiography, echocardiography, and were followed up for average of 24.12 +/- 7.7 months. 30 healthy aged persons were served as control group.

RESULTS

Compared with that (40.21 +/- 15.21 ms) before exercise, Q-Tc dispersion (59.37 +/- 20.17 ms) was increased significantly after exercise in infarction group(P < 0.01). But no significant difference was found in Q-Tc dispersion of control group before and after exercise(34.70 +/- 12.29 ms vs 38.91 +/- 13.62 ms P > 0.05). In infarction group, occurrence of abnormal contraction of left ventricular wall, aneurysms, NYHA III class and > III class of Lown's ventricular arrhythmia classification was significantly higher in Q-Tcd > 50 ms patients than that in Q-Tcd < 50 ms ones(P < 0.05). It was found that 5 patients died of cardiac sudden death in Q-Tcd > 50 ms patients and no one died of cardiac sudden death in Q-Tcd < 50 ms ones.

CONCLUSION

The Q-Tc dispersion after exercise is an important index to predict ventricular arrhythmia and cardiac death in the patients with old myocardial infarction.

[Expression of bcl-2, bax and p53 protein in the basal cell carcinoma]

The expression of bcl-2, bax and p53 protein was studied in the basal cell carcinoma with 32 patients by immunohistochemical method. The results showed that bcl-2 protein was positive in 26 patients (81.2%), bax protein was positive in 9 patients(28.1%), and p53 protein was positive in 13 patients (40.6%); there is a negative correlation between the expression of bcl-2 and bax protein(P < 0.05). These findings suggest that apoptosis is suppressed which might cause the production of basal cell carcinoma.