Cytokines and angiogenic factors in metastatic renal cell cancer: Association of pretreatment serum levels with survival

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Background: To correlate serum cytokine and angiogenic factor (CAF) levels and overall survival (OS) in metastatic renal cell cancer (mRCC) treated with interferon-alpha (IFN-α). Methods: Serum CAF levels were measured in 103 patients treated on a randomized trial with IFN-α 0.5 million units (MU) twice daily or 5 MU daily. Concentrations of 17 analytes including vascular endothelial growth factor (VEGFA) and several cytokines were determined by multiplex bead immunoassays or ELISA (basic fibroblast growth factor). We used proportional hazards models to evaluate the effect of CAF levels and clinical factors on OS. Results: Pretreatment serum interleukin (IL)-5, IL-12p40, VEGFA, and IL-6 levels, and Memorial Sloan-Kettering Cancer Center risk grouping were independently correlated with OS, with hazard ratios of 2.33, 2.00, 2.07, 1.82 and 0.39, respectively (concordance index = 0.69 for the combined model versus 0.60 for the CAF model versus 0.52 for the clinical model). Based on an index derived from these five risk factors (RF), patients with 0–2 RF had a median OS time of 32 months, versus 9 months for patients with 3–5 RF (p < 0.0001). Conclusions: Serum CAF profiling contributes to prognostic evaluation in mRCC and helps to identify a subset of patients with 20% 5-year OS.

No significant financial relationships to disclose.

The patterns of care studies for operable breast cancer in China

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Background: To present the results of clinical practices for operable breast cancer (BC) in the developed areas of China during the past decade. Methods: Four academic levels of radiotherapy (RT) departments, located in the Southeast coast of China, were selected. A pattern of care study, about women with operated BC and post-operative RT during 1999 and 2006, was conducted. The recruited samples were evaluated for their medical files completeness at first. For qualified documentations, data collected included patient characteristics, clinical and pathologic features, and treatment course received. Frequencies and corresponding percentages were calculated and analyzed for comparisons between 1999 and 2006. Results: 97 in 1999 and 271 in 2006 were identified as qualified files. Patient's diagnosis median age were 48 (1996) and 46 (2006) years. The clinical staging with I, II, and III (UICC 1997) were in 11%, 69%, 13% of 1999 patients and 15%, 74%, 7% of the 2006. The pathological characteristics were clearly defined in 78% (1999) and 84% (2006), but hormonal receptors and Her2neu were performed in 59% and 0% in the 1999 vs. 73% (p < 0.05) and 1% in 2006 survey. As type and extent of surgery and RT, the percentage of conservative treatment was increased from 4% in 1999 to 12% in 2006 (p< 0.05), postmastectomy RT was done for all the others. The time interval from operation to initiation of RT were longer in 2006, the mean was delayed from 23.8 to 43.4 days. The axillary operation pattern including lymph node dissection, level I/II dissection, and sentinel lymph node biopsy (SLNB), were documented in 61%, 24%, and 8% of patients in 2006. For patients of 1999, no SLNB was performed and 16% with level I/II operation (p< 0.05). Systemic chemotherapy (CT) and/or hormonal therapy were used in 74% (1999) and 98% (2006) of patients respectively (p< 0.05). Anthracyclines and paclitaxel-based CT regimens use significantly increased between 1999 and 2006 (31% vs. 52% and 12% vs. 36%). Conclusions: The practice patterns established in this study provide a baseline data. The present results demonstrate a low level of compliance with Western guidelines of clinical practices with current BC standards and continued improvement in many categories. Establishment and widespread use of international guidelines in China are desirable.

No significant financial relationships to disclose.

Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: review of 21 consecutive cases

BACKGROUND AND PURPOSE

Anterior communicating artery (AcomA) aneurysm is the most frequent form of aneurysm. Stent placement is particularly difficult and of limited use for AcomA aneurysms. We report our experience with stent-assisted embolization for wide-neck AcomA aneurysms in 21 patients. Particular attention is given to the morphologic characteristics and strategy of stent deployment.

MATERIALS AND METHODS

Between January 2005 and February 2008, stent-assisted coiling was performed in 21 patients with wide-neck AcomA aneurysms. Patient demographics, aneurysm morphology, procedures, and clinical and angiographic outcomes were retrospectively reviewed.

RESULTS

Successful deployment of the stent in the targeted artery was achieved in all patients. Nineteen Neuroform 2 or Neuroform 3 stents and 2 LEO stents were used. The distal segment of the stent was positioned in the ipsilateral A2 in 12 patients, in the contralateral A2 across the AcomA in 5 patients, and into the aneurysm sac in 4 patients. Complete occlusion was achieved in 18 patients; near-complete occlusion, in 2 patients; and partial occlusion, in 1 patient. Intraoperative perforation of the aneurysm developed in 1 patient, which was secured by subsequent coiling. Angiographic follow-up in 12 patients for 6.9 months showed 1 recanalization and no in-stent stenosis.

CONCLUSIONS

Our preliminary results suggest that stent-assisted embolization for wide-neck AcomA aneurysms is technically feasible and safe. Further follow-up is needed for long-term efficacy of stent placement.

The firing activity of pyramidal neurons in medial prefrontal cortex and their response to 5-hydroxytryptamine-1A receptor stimulation in a rat model of Parkinson's disease

The changes in the firing rate and firing pattern of pyramidal neurons in medial prefrontal cortex (mPFC) and the effects of selective 5-hydroxytryptamine-(1A) (5-HT(1A)) receptor agonist (R)-(+)-8-hydroxy-2-(dipropylamino)tetralin hydrobromide (8-OH-DPAT) and antagonist N-(2-(4-(2-methoxyphenyl)-1-piperazinyl)ethyl)-N-2-pyridylcyclohexane carboxamide maleate salt (WAY-100635) on the firing activity of the neurons were studied in sham-lesioned rats and rats with 6-hydroxydopamine lesions of the substantia nigra pars compacta (SNc). The lesion of the SNc increased the firing rate of pyramidal neurons significantly compared to sham-lesioned rats, and the firing pattern of these neurons also changed significantly towards a more burst-firing. The systemic administration of 8-OH-DPAT at doses in the range of 0.5-128 microg/kg showed an excitatory-inhibitory effect on the firing rate of pyramidal neurons in mPFC of sham-lesioned rats. At lower doses, 0.5-32 microg/kg, it evoked excitation of the neurons, and at a high dose, i.e. 128 microg/kg, inhibited the activity of the neurons. In contrast to sham-lesioned rats, 8-OH-DPAT, at the same doses, showed no excitatory effect in the lesioned rats although the inhibitory phase of the effect of 8-OH-DPAT on the firing rate of pyramidal neurons in mPFC was still present. Furthermore, the local application of 8-OH-DPAT, 5 microg, in mPFC inhibited the firing rate of pyramidal neurons in sham-lesioned rats, while having no effect on firing rate in the lesioned rats. The excitatory or inhibitory effects of 8-OH-DPAT were reversed by WAY-100635, indicating that these effects are mediated by 5-HT(1A) receptor. Altogether, these results indicate that the lesion of the SNc leads to hyperactivity of pyramidal neurons in mPFC and the abnormality of response of these neurons to 5-HT(1A) receptor stimulation, suggesting that mPFC may be involved in the pathophysiology of the psychiatric disturbance of Parkinson's disease.

Neuroglobin-overexpression alters hypoxic response gene expression in primary neuron culture following oxygen glucose deprivation

Neuroglobin (Ngb) is a tissue globin specifically expressed in neurons. Our laboratory and others have shown that Ngb overexpression protects neurons against hypoxia/ischemia, but the underlying mechanisms remain poorly understood. Recent studies demonstrate that hypoxia/ischemia induces a multitude of spatially and temporally regulated responses in gene expression, and initial evidence suggested that Ngb might function in altering biological processes of gene expression. In this study, we asked how Ngb may help regulate genes responsive to hypoxia. Expression of hypoxic response genes following oxygen-glucose deprivation (OGD) was examined using mRNA arrays in neuroglobin-overexpressing transgenic (Ngb-Tg) and wild type (WT) mouse neurons. From a total of 113 genes on the microarray, mRNA expression of 65 genes was detected. Under rest condition, 14 genes were downregulated in Ngb-Tg neurons compared to WT. In WT neurons, after 4-h OGD followed by 4-h reoxygenation (O4/R4), 20 genes were significantly downregulated, and only Fos mRNA was significantly increased. However, out of the 20 downregulated genes in WT neurons, 12 of them were no longer significantly changed in Ngb-Tg neurons: Add1, Arnt2, Camk2g, Cstb, Dr1, Epas1, Gna11, Hif1a, Il6st, Khsrp, Mars and Rara. Among these 12 genes, 8 (Add1, Camk2g, Cstb, Dr1, Epas1, Gna11, Hif1a, Khsrp) were already reduced in Ngb-Tg neurons compared to WT under rest conditions. Additionally, three genes that initially showed no changes in WT neurons (Ctgf, Egfr and Pea15) were downregulated after OGD in the Ngb-Tg neurons. These findings suggest that Ngb overexpression modulates mRNA expression of multiple hypoxic response genes in the early phase after OGD/reoxygenation. Further studies on these gene networks and interactions may lead to better understanding of Ngb in signaling pathways that contribute to neuroprotection.

Clonal integration supports the expansion from terrestrial to aquatic environments of the amphibious stoloniferous herb Alternanthera philoxeroides

Effects of clonal integration on land plants have been extensively studied, but little is known about the role in amphibious plants that expand from terrestrial to aquatic conditions. We simulated expansion from terrestrial to aquatic habitats in the amphibious stoloniferous alien invasive alligator weed (Alternanthera philoxeroides) by growing basal ramets of clonal fragments in soils connected (allowing integration) or disconnected (preventing integration) to the apical ramets of the same fragments submerged in water to a depth of 0, 5, 10 or 15 cm. Clonal integration significantly increased growth and clonal reproduction of the apical ramets, but decreased both of these characteristics in basal ramets. Consequently, integration did not affect the performance of whole clonal fragments. We propose that alligator weed possesses a double-edged mechanism during population expansion: apical ramets in aquatic habitats can increase growth through connected basal parts in terrestrial habitats; however, once stolon connections with apical ramets are lost by external disturbance, the basal ramets in terrestrial habitats increase stolon and ramet production for rapid spreading. This may contribute greatly to the invasiveness of alligator weed and also make it very adaptable to habitats with heavy disturbance and/or highly heterogeneous resource supply.

Role of cGMP-dependent protein kinase in regulation of pulmonary vascular smooth muscle cell adhesion and migration: effect of hypoxia

Exposure to prolonged hypoxia can result in pulmonary vascular remodeling and pulmonary hypertension. Hypoxia induces pulmonary vascular smooth muscle cell (PVSMC) proliferation and vascular remodeling by affecting cell adhesion and migration and secretion of extracellular matrix proteins. We previously showed that acute hypoxia decreases cGMP-dependent protein kinase (PKG) activity in PVSMC and that PKG plays a role in maintaining the differentiated contractile phenotype in normoxia. In this study, we investigated the effect of hypoxia on PVSMC adhesion and migration and the role of PKG in these functions. Ovine fetal pulmonary artery SMC were incubated in normoxia (Po(2) approximately 100 Torr) or hypoxia (Po(2) approximately 30-40 Torr) or treated with the PKG inhibitor DT-3 for 24 h in normoxia. To further study the role of PKG in the modulation of adhesion and migration, PVSMC were transiently transfected with a full-length PKG1alpha [PKG-green fluorescent protein (GFP)] or a dominant-negative construct (G1alphaR-GFP). Cell adhesion to extracellular matrix proteins was determined, and integrin-mediated adhesion was assessed by alpha/beta-integrin-mediated cell adhesion array. Exposure to hypoxia (24 h) and pharmacological inhibition of PKG1 by DT-3 significantly promoted adhesion mediated by alpha(4)-, beta(1)-, and alpha(5)beta(1)-integrins to fibronectin, laminin, and tenacin and also resulted in increased cell migration. Likewise, inhibition of PKG by expression of a dominant-negative PKG1alpha construct increased cell adhesion and migration, comparable to that induced by hypoxia. Dynamic actin reorganization associated with integrin-mediated cell adhesion is partly regulated by the actin-binding protein cofilin, the (Ser3) phosphorylation of which inhibits its actin-severing activity. We found that increased PKG expression and activity is associated with decreased cofilin (Ser3) phosphorylation, implying a role for PKG in the modulation of cofilin activity and actin dynamics. Together, these findings identify cGMP/PKG1 signaling as central to the functional differences between PVSMC exposed to normoxia versus hypoxia.

Neck injury is critical to elastase-induced aneurysm model

We modified the elastase-induced aneurysm model by use of a simple surgical technique in rabbits. A temporary arcuated aneurysm clip was placed at the origin of the right common carotid artery (RCCA), ascertaining the inner edge of the clip blade on the juncture of the RCCA and right subclavian artery (RSCA), and the elastase-induced aneurysm procedure was undertaken. We found elastase and location of the temporary arcuated aneurysm clip are critical to the success of this aneurysm model.

MicroRNA expression pattern in different stages of nonalcoholic fatty liver disease

BACKGROUND/AIMS

To explore the unique microRNA expression pattern of nonalcoholic fatty liver disease in a rat model, and search for targets of certain dysregulated microRNAs.

METHODS

Microarray and stem-loop RT-PCR were utilized to detect dysregulated microRNAs in a rat model. Significance Analysis of Microarray, Prediction Analysis of Microarray and clustering analysis were implemented to calculate significantly aberrantly expressed microRNAs. TargetScan, miRanda and PicTar were jointly used to predict targets of microRNAs.

RESULTS

Confirmed by Significance Analysis of Microarray and predicted by Prediction Analysis of Microarray, portfolios of 27 and 21 microRNAs were selected as an accurate molecular signature in distinguishing steatosis and steatohepatitis from normal rat liver. Besides, a panel of microRNA-target pairs that may be involved in lipid and glucose metabolism and inflammation process was delineated.

CONCLUSION

This is by far the first report on the dysregulated microRNAs expression pattern in nonalcoholic fatty liver disease. The successful differentiation of steatosis and steatohepatitis from normal liver hints to the potential of using lists of dysregulated microRNAs for diagnosis, though many problems need to be solved. Besides, these data will guide further studies of the contribution of microRNAs to the pathogenesis of nonalcoholic fatty liver disease while disease-specific microRNAs might become potential targets for therapeutic intervention.

MicroRNA expression pattern in different stages of nonalcoholic fatty liver disease

BACKGROUND/AIMS

To explore the unique microRNA expression pattern of nonalcoholic fatty liver disease in a rat model, and search for targets of certain dysregulated microRNAs.

METHODS

Microarray and stem-loop RT-PCR were utilized to detect dysregulated microRNAs in a rat model. Significance Analysis of Microarray, Prediction Analysis of Microarray and clustering analysis were implemented to calculate significantly aberrantly expressed microRNAs. TargetScan, miRanda and PicTar were jointly used to predict targets of microRNAs.

RESULTS

Confirmed by Significance Analysis of Microarray and predicted by Prediction Analysis of Microarray, portfolios of 27 and 21 microRNAs were selected as an accurate molecular signature in distinguishing steatosis and steatohepatitis from normal rat liver. Besides, a panel of microRNA-target pairs that may be involved in lipid and glucose metabolism and inflammation process was delineated.

CONCLUSION

This is by far the first report on the dysregulated microRNAs expression pattern in nonalcoholic fatty liver disease. The successful differentiation of steatosis and steatohepatitis from normal liver hints to the potential of using lists of dysregulated microRNAs for diagnosis, though many problems need to be solved. Besides, these data will guide further studies of the contribution of microRNAs to the pathogenesis of nonalcoholic fatty liver disease while disease-specific microRNAs might become potential targets for therapeutic intervention.

Rap1b is critical for glycoprotein VI-mediated but not ADP receptor-mediated alpha2beta1 activation

BACKGROUND

The platelet alpha2beta1 integrin functions as both an adhesion and signaling receptor upon exposure to collagen. Recent studies have indicated that alpha2beta1 function can be activated via inside-out signaling, similar to the prototypical platelet integrin alphaIIbbeta3. However, signaling molecules that regulate alpha2beta1 activation in platelets are not well defined. A strong candidate molecule is the small GTPase Rap1b, the dominant platelet isoform of Rap1, which regulates alphaIIbbeta3 activation.

OBJECTIVES

We hypothesized that Rap1b positively regulates alpha2beta1 during agonist-induced platelet activation.

METHODS

To test whether Rap1b activates alpha2beta1 downstream of glycoprotein (GP)VI or other platelet receptors, we stimulated platelets purified from Rap1b-/- or wild-type mice with diverse agonists and measured alpha2beta1 activation using fluorescein isothiocyanate-labeled monomeric collagen. We also examined the role of Rap1b in outside-in signaling pathways by analyzing adhesion and spreading of Rap1b-/- or wild-type platelets on monomeric, immobilized collagen. Finally, we monitored the activation status of related Rap GTPases to detect changes in signaling pathways potentially associated with Rap1b-mediated events.

RESULTS

Rap1b-/- platelets displayed comparable ADP-induced or thrombin-induced alpha2beta1 activation as wild-type platelets, but reduced convulxin-dependent alpha2beta1 activation. Rap1b-/- platelets exhibited increased spreading on immobilized collagen but similar adhesion to immobilized collagen compared to wild-type platelets. Rap1b-/- platelets also showed Rap1a and Rap2 activation upon agonist stimulation, possibly revealing functional compensation among Rap family members.

CONCLUSIONS

Rap1b is required for maximal GPVI-induced but not ADP-induced activation of alpha2beta1 in murine platelets.

Molecular characterisation of outbreak-related strains of vancomycin-resistant Enterococcus faecium from an intensive care unit in Beijing, China

We investigated an outbreak of vancomycin-resistant Enterococcus faecium affecting 14 patients in a 20-bed intensive care unit (ICU) between September 2006 and August 2007 (incidence: 3.56 cases per 1000 ICU patient days). Eighteen isolates of vanA type E. faecium were analysed by pulsed field gel electrophoresis, which showed 14 types overall. Multilocus sequence typing (MLST) identified eight different sequence types (STs) (ST78, ST117, ST203, ST316, ST362, ST363, ST364 and ST365), including four new types (ST362, ST363, ST364 and ST365) and 17 strains belonged to clonal complexes CC17. Sixteen of these carried the esp gene. Eighteen Tn1546-like elements encoding vanA-type VRE were classified into three types (types I to III) and all of them contained both IS1216V and IS1542 insertions. Vancomycin resistance of 14 vanA type E. faecium isolates was transferred at a frequency of 1.3 x 10(-6) to 6.4 x 10(-5) between E. faecium strains during filter mating. Our findings indicate that conjugative dissemination of Tn1546-like elements among CC17 E. faecium occurred during the outbreak in this ICU.

Observation of two-source interference in the photoproduction reaction AuAu --> AuAurho0

In ultraperipheral relativistic heavy-ion collisions, a photon from the electromagnetic field of one nucleus can fluctuate to a quark-antiquark pair and scatter from the other nucleus, emerging as a rho{0}. The rho{0} production occurs in two well-separated (median impact parameters of 20 and 40 F for the cases considered here) nuclei, so the system forms a two-source interferometer. At low transverse momenta, the two amplitudes interfere destructively, suppressing rho{0} production. Since the rho{0} decays before the production amplitudes from the two sources can overlap, the two-pion system can only be described with an entangled nonlocal wave function, and is thus an example of the Einstein-Podolsky-Rosen paradox. We observe this suppression in 200 GeV per nucleon-pair gold-gold collisions. The interference is 87%+/-5%(stat.)+/-8%(syst.) of the expected level. This translates into a limit on decoherence due to wave function collapse or other factors of 23% at the 90% confidence level.

Force spectroscopy of hepatocytic extracellular matrix components

We present atomic force microscopy and force spectroscopy data of live hepatocytes (HEPG2/C3A liver cell line) grown in Eagle's Minimum Essential Medium, a complex solution of salts and amino acids commonly used for cell culture. Contact-mode imaging and force spectroscopy of this system allowed correlation of cell morphology and extracellular matrix (ECM) properties with substrate properties. Force spectroscopy analysis of cellular "footprints" indicated that the cells secrete large polymers (e.g., 3.5mum contour length and estimated MW 1000kDa) onto their substrate surface. Although definitive identification of the polymers has not yet been achieved, fluorescent-labeled antibody staining has specified the presence of ECM proteins such as collagen and laminin in the cellular footprints. The stretched polymers appear to be much larger than single molecules of known ECM components, such as collagen and heparan sulfate proteoglycan, thus suggesting that the cells create larger entangled, macromolecular structures from smaller components. There is strong evidence which suggests that the composition of the ECM is greatly influenced by the hydrophobicity of the substrate surface, with preferential production and/or adsorption of larger macromolecules on hydrophobic surfaces.

Stoma formation for fecal diversion: a plea for the laparoscopic approach

BACKGROUND

The aim of this study was to assess the results of laparoscopic stoma creation for fecal diversion, specifically focussing on feasibility, safety, and efficacy, as well as indications and techniques.

METHODS

Within a 10-year-period, all patients requiring laparoscopic stoma creation were evaluated prospectively. Patients' profiles and indications, procedures and results of operation, conversion, morbidity, mortality and short-term complications (stoma-related, laparoscopy-associated) were analyzed.

RESULTS

A total of 80 patients (39 males, 41 females) with a mean age of 55.5 years (range, 17-91) underwent laparoscopic stoma creation. Most common indications were unresectable advanced colorectal cancer (n=20), pelvic malignant cancer (e. g. ovarian, cervix and prostate cancer, n=16), and perianal Crohn's disease with complex fistulas (n=16). Only in one female patient with pelvic malignant disease was the procedure converted to laparotomy due to obesity (conversion rate, 1.3%). 79 patients underwent laparoscopic stoma creation (completion rate, 98.7%) including loop ileostomy (n=30), loop sigmoid colostomy (n=40) and end sigmoid colostomy (n=9). Postoperative complications were documented in 9 patients (overall morbidity rate, 11.4%), including 4 minor complications treated conservatively (2 cases of prolonged atonia and 1 case each of pneumonia and urinary tract infection) and 5 major complications requiring reoperation (reoperation rate, 6.3%): one parastomal abscess (drainage), one stoma retraction following rod dislocation (laparoscopic stoma recreation), small bowel obstruction in two patients (small bowel resection), one port-site hernia (fascial closure), and hemorrhage (managed by re-laparoscopy). Mean operation time was 74 min (range, 30-245 min). Mean blood loss volume was 80 ml (range, 30-400 ml). Patients were discharged from hospital after a mean of 10.3 days (range, 3-47). Within a 1-year follow-up, no further stoma complications were documented.

CONCLUSIONS

The advantages of laparoscopic stoma creation are low morbidity and reoperation rates, and no procedure-related mortality; our results suggest that laparoscopic stoma creation for fecal diversion is safe, feasible and effective. Therefore, at our institution, laparoscopic stoma creation is the method of choice for fecal diversion.

Cholinesterase inhibition and acetylcholine accumulation following intracerebral administration of paraoxon in rats

We evaluated the inhibition of striatal cholinesterase activity following intracerebral administration of paraoxon assaying activity either in tissue homogenates ex vivo or by substrate hydrolysis in situ. Artificial cerebrospinal fluid (aCSF) or paraoxon in aCSF was infused unilaterally (0.5 microl/min for 2 h) and ipsilateral and contralateral striata were harvested for ChE assay ex vivo. High paraoxon concentrations were needed to inhibit ipsilateral striatal cholinesterase activity (no inhibition at <0.1 mM; 27% at 0.1 mM; 79% at 1 mM paraoxon). With 3 mM paraoxon infusion, substantial ChE inhibition was also noted in contralateral striatum. ChE histochemistry generally confirmed these concentration- and side-dependent effects. Microdialysates collected for up to 4 h after paraoxon infusion inhibited ChE activity when added to striatal homogenate, suggesting prolonged efflux of paraoxon. Since paraoxon efflux could complicate acetylcholine analysis, we evaluated the effects of paraoxon (0, 0.03, 0.1, 1, 10 or 100 microM, 1.5 microl/min for 45 min) administered by reverse dialysis through a microdialysis probe. ChE activity was then monitored in situ by perfusing the colorimetric substrate acetylthiocholine through the same probe and measuring product (thiocholine) in dialysates. Concentration-dependent inhibition was noted but reached a plateau of about 70% at 1 microM and higher concentrations. Striatal acetylcholine was below the detection limit at all times with 0.1 microM paraoxon but was transiently elevated (0.5-1.5 h) with 10 microM paraoxon. In vivo paraoxon (0.4 mg/kg, sc) in adult rats elicited about 90% striatal ChE inhibition measured ex vivo, but only about 10% inhibition measured in situ. Histochemical analyses revealed intense AChE and glial fibrillary acidic protein staining near the cannula track, suggesting proliferation of inflammatory cells/glia. The findings suggest that ex vivo and in situ cholinesterase assays can provide very different views into enzyme-inhibitor interactions. Furthermore, the proliferation/migration of cells containing high amounts of cholinesterase just adjacent to a dialysis probe could affect the recovery and thus detection of extracellular acetylcholine in microdialysis studies.

Identification of proSAAS homologs in lower vertebrates: conservation of hydrophobic helices and convertase-inhibiting sequences

The prohormone convertases (PCs) 1/3 and 2 accomplish the major proteolytic cleavage events in neuroendocrine tissues; each of these convertases has a small associated binding protein that inhibits convertase action in the secretory pathway. The proSAAS protein binds to PC1/3, whereas the 7B2 protein binds to PC2. However, both convertase-binding proteins are more widely expressed than their cognate enzymes, suggesting that they may perform other functions as well. All known mammalian proSAASs are over 85% conserved; thus, identifying functionally important segments has been impossible. Here, we report the first identification of nonmammalian proSAAS molecules, from Xenopus and zebrafish (Danio rerio). Although these two proteins show an overall amino acid sequence identity of only 29 and 30% with mouse proSAAS, two 14-16 residue hydrophobic segments (predicted to form alpha-helices) and two, nine through 11 residue sequences containing basic convertase cleavage sites are highly conserved; therefore, these sequences may be of functional importance. Confidence that these nonmammalian molecules represent authentic proSAAS is supported by the finding that both inhibit mouse PC1/3 with nanomolar inhibition constants; human furin was not inhibited. In vitro, the two proteins were cleaved by PC2 and furin to three or more peptide products. Both zebrafish and Xenopus proSAAS exhibited neural and endocrine distributions, as assessed by in situ and PCR experiments, respectively. In summary, the identification of proSAAS molecules in lower vertebrates provides clues as to functional regions within this widely expressed neuroendocrine protein.

Effects of tracheal tube orientation on the success of intubation through an intubating laryngeal mask airway: study in Mallampati class 3 or 4 patients

BACKGROUND

We evaluated the effects of conventional tracheal tube orientation on success of intubation through an intubating laryngeal mask airway (ILMA) in Mallampati class 3 or 4 patients.

METHODS

Two hundred adults, ASA I-II, Mallampati class 3 or 4, undergoing elective surgery under general anaesthesia were enrolled. All the patients were randomly allocated to either normal or reverse group based on the orientation of the tracheal tube as it was initially inserted into the ILMA. Tracheal intubation was considered successful, if proper tracheal positioning was attained within three insertion attempts. chi(2) analysis was used to compare categorical variables.

RESULTS

Tracheal intubation through the ILMA was successful in 183 of 200 patients (91.5%): 157 (78.5%) on the first attempt. Seventeen (8.5%) were intubated using direct laryngoscopy. The first-attempt success rate was higher in the reverse than in the normal group (85.0% vs 72.0%, P=0.025), although the overall success rate was similar between the reverse and the normal groups (93.0% vs 90.0%). The incidence of sore throat was comparable in the normal group and the reverse group (22.0% vs 12.0%, NS).

CONCLUSIONS

Overall, tracheal intubation was successful in 91.5% of patients through an ILMA with a conventional tracheal tube in Mallampati class 3 or 4 patients. The first-attempt success rate was higher in the reverse group compared with the normal group, but the overall success rate was similar between the reverse and the normal groups.

Indications of conical emission of charged hadrons at the BNL relativistic heavy ion collider

Three-particle azimuthal correlation measurements with a high transverse momentum trigger particle are reported for pp, d+Au, and Au+Au collisions at sqrt[s_{NN}]=200 GeV by the STAR experiment. Dijet structures are observed in pp, d+Au and peripheral Au+Au collisions. An additional structure is observed in central Au+Au data, signaling conical emission of correlated charged hadrons. The conical emission angle is found to be theta=1.37+/-0.02(stat)-0.07+0.06(syst), independent of p_{ perpendicular}.