Brain magnetic resonance imaging abnormalities in neuromyelitis optica

OBJECTIVE

Brain abnormalities in neuromyelitis optica (NMO) attracted much attention. Our study was to identify the brain magnetic resonance imaging (MRI) abnormalities in Chinese NMO patients.

METHODS

Patients who fulfilled the latest diagnostic criteria of NMO proposed by Wingerchuk et al. [Neurology 66 (2006) 1485] and whose brain MRI did not meet the multiple sclerosis (MS) criteria of McDonald et al. [Ann Neurol 50 (2001) 121] were selected to perform MRI scanning of the brain, spinal cord and optic nerves.

RESULTS

Twenty-eight of 33 patients (84.8%) had abnormal MRI findings. Twenty-two patients (66.7%) presented with well-defined brain parenchymal lesions and the other six patients (18.2%) with macroscopic symmetrical diffuse hyperintensities in deep white matter. Fifteen of 22 patients had more than one lesion (> or =2 lesions) and the other seven patients had single lesion. In the supratentorium, most lesions were punctate or small round dot and non-specific in juxtacortical, subcortical and deep white matter regions, a few were patchy atypical confluent lesions. Brainstem was easily involved (14/33, 42.4%) especially in medulla (7/33, 21.2%).

CONCLUSIONS

This study demonstrates the characteristics of brain MRI abnormalities in Chinese NMO patients, which are helpful to the revision of diagnostic criteria for NMO.

Mode of action of abatacept in rheumatoid arthritis patients having failed tumour necrosis factor blockade: a histological, gene expression and dynamic magnetic resonance imaging pilot study

Objectives:

Abatacept is the only agent currently approved to treat rheumatoid arthritis (RA) that targets the co-stimulatory signal required for full T-cell activation. No studies have been conducted on its effect on the synovium, the primary site of pathology. The aim of this study was to determine the synovial effect of abatacept in patients with RA and an inadequate response to tumour necrosis factor alpha (TNFα) blocking therapy.

Methods:

This first mechanistic study incorporated both dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and arthroscopy-acquired synovial biopsies before and 16 weeks after therapy, providing tissue for immunohistochemistry and quantitative real-time PCR analyses.

Results:

Sixteen patients (13 women) were studied; all had previously failed TNFα-blocking therapy. Fifteen patients completed the study. Synovial biopsies showed a small reduction in cellular content, which was significant only for B cells. The quantitative PCR showed a reduction in expression for most inflammatory genes (Wald statistic of p<0.01 indicating a significant treatment effect), with particular reduction in IFNγ of −52% (95% CI −73 to −15, p<0.05); this correlated well with MRI improvements. In addition, favourable changes in the osteoprotegerin and receptor activator of nuclear factor kappa B levels were noted. DCE–MRI showed a reduction of 15–40% in MRI parameters.

Conclusion:

These results indicate that abatacept reduces the inflammatory status of the synovium without disrupting cellular homeostasis. The reductions in gene expression influence bone positively and suggest a basis for the recently demonstrated radiological improvements that have been seen with abatacept treatment in patients with RA.

Immune responses and enhanced disease resistance in Chinese drum, Miichthys miiuy (Basilewsky), after oral administration of live or dead cells of Clostridium butyrium CB2

Clostridium butyrium CB2 isolated from chickens was tested as a potential fish probiotic in the Chinese drum, Miichthys miiuy. Fish were fed live (CB), dead CB2 (D-CB) cells (10(8) cells g(-1)) or spent culture supernatant (SCS), for 30 days and challenged with Vibrio anguillarum or Aeromonas hydrophila. Survival was higher in both the CB and the CB-D fed groups, but the SCS group was not significantly different from the control. After feeding live or dead CB2 cells, there was increase in phagocytic activity of the head kidney macrophages, the lysozyme activity of serum and gut mucosa and immunoglobulin (Ig) level. The SCS group showed no obvious change in immune parameters. The results suggest that live or dead Clostridium butyrium CB2 has an immunomodulatory effect on fish.

Combination pharmacological cardioversion of permanent atrial fibrillation in post-prosthetic mitral valve replacement outpatients: a novel approach for the treatment of atrial fibrillation

This study explored the efficacy and safety of combination pharmacological cardioversion of permanent atrial fibrillation in outpatients following prosthetic mitral valve replacement. The study group comprised 99 outpatients who were randomly divided into two groups. In group 1 (n = 50), only ventricular heart rate was controlled. In group 2 (n = 49), combination pharmacological cardioversion therapy with low-dose oral amiodarone (2 mg/kg), captopril (0.25 mg/kg) and simvastatin (0.3 mg/kg) was administered daily. During 12 months of serial pharmacological treatment, the cardioversion rate was 6% for group 1 and 39% for group 2; the likelihood of cardioversion differed significantly between the two groups. In group 2, one patient developed severe pruritus that necessitated withdrawal from the study and six patients ceased captopril treatment after contracting a persistent cough. In summary, combination pharmacological cardioversion was found to be effective and safe in outpatients who had undergone prosthetic mitral valve replacement.

Dislocation-source shutdown and the plastic behavior of single-crystal micropillars

Dislocation dynamics simulations have been used to study the stress-strain response of single-crystal micropillars containing initial dislocation networks generated via a relaxation procedure intended to approximate real thermal annealing processes. We find that, when such networks are loaded, they exhibit periods of plastic deformation, caused by the operation of single junction-stabilized spiral sources, followed by intervals of purely elastic straining when the sources shut down. The results provide insight into the mechanisms responsible for the experimentally observed staircase stress-strain behavior.

A Study of the Regulating Gene of femA from Methicillin-resistant Staphylococcus aureus Clinical Isolates

The regulating gene of femA was studied in methicillin-resistant Staphylococcus aureus (MRSA). High-level MRSA, low-level MRSA and methicillin-sensitive S. aureus (MSSA) were identified by agar diffusion. β-Lactamases were detected by nitrocephin and the presence of the mecA gene was determined by polymerase chain reaction (PCR). Only isolates that were both β-lactamase-negative and mecA-positive were used. The femA gene and its 250 base pair (bp) upstream sequence were amplified by PCR and expression was determined by real-time fluorescent quantitative PCR. The 250 bp upstream sequence was labelled by BrightStar€ Psoralen–Biotin and detected by electrophoretic mobility shift assay (EMSA). Expression levels of femA in MSSA, low-level MRSA and high-level MRSA were 3.53 × 10−3%–29.91%, 5.54 × 10−3%–3.1 × 102% and 13.88–5.50 × 104%, respectively. EMSA detected a signal shift in 57 high-level MRSA isolates but not in four low-level MRSA and four MSSA strains. Expression of femA in high-level MRSA (non-β-lactamase-producing) was higher than in low-level MRSA and MSSA. The femA regulating gene probably lies in the 250 bp upstream sequence in MRSA and high-level expression is essential for high-level methicillin resistance.

Internet use and risk behaviours: an online survey of visitors to three gay websites in China

OBJECTIVES

To describe the risk behaviours of visitors to gay websites and to explore the role of the internet in the HIV transmission among the Chinese men who have sex with men (MSM).

METHODS

Between May and August 2006, visitors of three Chinese gay websites were invited to complete an online questionnaire about the use of the internet and risk sexual behaviours.

RESULTS

The median age of the online sample was 25 years old (range 18 to 64). Over three-quarters (77.6%) had an education of college or higher. Less than 44% of the online sample reported little or no risk for HIV transmission. These men had either had no anal intercourse (28.0%) or had always used a condom for anal intercourse (15.8%). Although only about half of the participants reported that their main purpose of visiting the gay websites was to look for sexual partners, most participants (86.1%) had used the internet to seek partners. Compared with men seeking sexual partners only on the internet, men seeking partners both in traditional gay venues and on the internet were older, less likely to be students and more likely to have unprotected anal intercourse, more than six sexual partners in the past 6 months and commercial sex behaviours.

CONCLUSION

The users of the gay websites are relatively young and well educated, and highly vulnerable to HIV/AIDS, given their low prevalence of consistent condom use and multiple-risk sexual behaviours. Effective intervention programmes should be implemented and strengthened in China, especially for those who seek sexual partners both on the internet and in traditional gay venues.

Vena caval filters for the prevention of pulmonary embolism

BACKGROUND

Pulmonary emboli can have potentially fatal consequences. Inferior vena caval filters are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters in current clinical use are designed to be introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile is unclear.

OBJECTIVES

To examine evidence for the effectiveness of vena caval filters in preventing pulmonary embolism (PE). Secondary outcomes were mortality, distal (to filter) thrombosis, and filter-related complications.

SEARCH STRATEGY

We searched the Cochrane Peripheral Vascular Diseases Group Specialised Register (last searched August 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2007, Issue 3, MEDLINE (1966 to August 2007), and EMBASE (1966 to August 2007). Filter manufacturers and clinicians interested in filters were contacted for information.

SELECTION CRITERIA

Controlled clinical trials (CCTs) and randomised controlled trials (RCTs) that examined the efficacy of filters in preventing PE were selected.

DATA COLLECTION AND ANALYSIS

Three authors extracted information independently. Incidence figures were extracted from survival tables. Dichotomous outcomes were analysed as hazard ratio estimates.

MAIN RESULTS

One RCT was included. The PREPIC (Prévention du Risque d'Embolie Pulmonaire par Interruption Cave) trial was an open RCT of 400 participants with documented proximal deep vein thrombosis (DVT) or PE and who received concurrent anticoagulation. Permanent caval filters prevented PE at eight years (HR 0.37, 95% CI 0.17 to 0.79, in favour of the filter). No reduction in mortality was seen, but this reflected an older study population (mean age 73 years); the majority of deaths were due to cancer or cardiovascular causes. There was an increased incidence of DVT in the filter group (HR 1.52, 95% CI 1.02 to 2.27). No details were recorded of adverse events of filters.

AUTHORS' CONCLUSIONS

Limited generalisability prevents any conclusions to be drawn from the PREPIC trial in that permanent filters were used and the study lacked statistical power to detect a reduction in PE over shorter and more clinically significant time periods. However, the PREPIC trial demonstrated that permanent caval filters were associated with an increased risk of long term lower limb DVT. There is a marked paucity of caval filter outcomes evidence when used within their currently approved indications. There is also a lack of retrievable filter trials. Further trials are needed to assess vena caval filter safety and effectiveness.

Characterising alternate splicing and tissue specific expression in the chicken from ESTs

Alternate splicing is believed to produce the greatest diversity in transcriptional complexity and function in eukaryotic species. In this study, we present an analysis of alternative splicing events that occur in the chicken, using the recently sequenced genomic sequence and over 580,000 EST sequences mapped back to the genome. A carefully controlled EST-to-genome mapping pipeline is presented, based around the EXONERATE program using the est2genome model, which also considers several quality control steps to filter out erroneous matches. The data is then used to estimate the level of alternate splicing events with respect to Ensembl predicted transcripts. The EST-genome mappings are characterised at the exon level, in order to classify individual splicing events and provide estimates of novel transcripts not currently annotated by the Ensembl genome database. This is the first large scale analysis of this kind in an avian species, and suggests that chicken displays a similar level of alternate splicing as that found in other higher vertebrates such as human and mouse, both in terms of the number of genes that undergo alternate splicing events, and the average number of transcripts produced per gene. The EST data suggests alternate splicing may occur in some 50-60% of the chicken gene set and with an average of around 2.3 transcripts per gene which undergo this process. The EST data is also used to look at gene and transcript usage in the tissues sequenced in embryonic and adult libraries. Genes which display notable biases were analysed in more detail, including twinfilin-2 and embryonic heavy chain myosin. This also highlights several as yet functionally un-annotated genes which appear to be important in embryonic tissues and also undergo alternate splicing events. The analysis also demonstrates some of the difficulties involved in using EST-based data to annotate transcriptional activity in eukaryotic genes, where a broad spectrum of tissues and a large number of sequenced transcripts are required in order to fully characterise alternate splicing and differential expression.

The g.243A>G mutation in intron 17 of MUC4 is significantly associated with susceptibility/resistance to ETEC F4ab/ac infection in pigs

Using a porcine radiation hybrid panel, we assigned the mucin 4 (MUC4) gene to SSC13q41, which harbours the enterotoxigenic Escherichia coli (ETEC) F4ab/ac receptor locus. In addition, we identified two SNPs in intron 17 of MUC4 (DQ124298:g.243A>G and DQ124298:g.334A>G) in the parental population of a White Duroc x Erhualian cross. Association analysis showed that the MUC4 g.243A>G mutation was strongly associated with ETEC F4ab/ac, and especially with F4ac adhesion phenotypes in the White Duroc x Erhualian resource population, indicating that this polymorphism was in a significant linkage disequlibrium with the ETEC F4ab/ac receptor locus. Because of different linkage disequlibrium values between the ETEC F4ab and F4ac adhesion phenotypes and the MUC4 g.243A>G mutation, we argue that the inheritance of F4ab and F4ac receptors might be under the control of two closely linked loci.

Characterization of polymorphisms of transferrin receptor and their association with susceptibility to ETEC F4ab/ac in pigs

Diarrhoea caused by enterotoxigenic Escherichia coli (ETEC) expressing F4 (F4ab, F4ac and F4ad) fimbriae is a significant cause of mortality and morbidity in newborn and weaned pigs. The locus controlling susceptibility towards ETEC F4ab/ac has been mapped to SSC13q41, in which TFRC (transferrin receptor) was localized and considered as a positional candidate gene for ETEC F4ab/ac receptor. In this study, we determined susceptibility/resistance to ETEC F4ab/ac in a total of 755 F2 animals from a White Duroc x Erhualian intercross using a microscopic enterocyte adhesion assay. We identified two TFRC polymorphisms (SNPs 591 A>G and 632 A>G) in a single exon after comparative sequencing analysis of 2371-bp amplicons containing the complete coding region of TFRC using RNA of eight full-sib F2 animals with susceptible and resistant phenotypes. The intron sequences flanking the two exon polymorphisms were obtained, revealing an intron polymorphism (SNP 291 C>T). We genotyped the 19 founder animals of the White Duroc x Erhualian intercross for the identified polymorphisms, showing that only the 291 C>T polymorphism is a highly informative marker. We further genotyped all 59 F1 and 755 F2 animals for the 291 C>T polymorphism, and the association of this polymorphism with susceptibility/resistance to ETEC F4ab/ac in these F2 animals was evaluated by the transmission disequilibrium test. The result showed that the 291 C>T polymorphism is not a causal mutation, however, has a significant linkage disequilibrium with the ETEC F4ab/ac, especially F4ac receptor locus.

Vena caval filters for the prevention of pulmonary embolism

BACKGROUND

Pulmonary emboli can have potentially fatal consequences. Inferior vena caval filters are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters in current clinical use are designed to be introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile is unclear.

OBJECTIVES

To examine evidence for the effectiveness of vena caval filters in preventing pulmonary embolism (PE). Secondary outcomes were mortality, distal (to filter) thrombosis, and filter-related complications.

SEARCH STRATEGY

Searches were conducted in the Cochrane Peripheral Vascular Diseases Group Specialised Register (last searched May 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2007), MEDLINE (1966 to May 2007), and EMBASE (1966 to May 2007). Filter manufacturers and clinicians interested in filters were contacted for information.

SELECTION CRITERIA

Controlled clinical trials (CCTs) and randomised controlled trials (RCTs) that examined the efficacy of filters in preventing PE were selected.

DATA COLLECTION AND ANALYSIS

Three authors extracted information independently. Incidence figures were extracted from survival tables. Dichotomous outcomes were analysed as hazard ratio estimates.

MAIN RESULTS

One RCT met the inclusion criteria. The PREPIC trial was an open RCT of 400 participants with documented proximal deep vein thrombosis (DVT) or pulmonary embolism and who received concurrent anticoagulation.PREPIC demonstrated the efficacy of permanent caval filters in preventing PE at eight years (HR 0.37, 95% CI 0.17 to 0.79, in favour of the filter). No reduction in mortality was seen, but this reflected an older study population (mean age 73 years); the majority of deaths were due to cancer or cardiovascular causes. There was an increased incidence of DVT in the filter group (HR 1.52, 95% CI 1.02 to 2.27). No details were recorded of adverse events of filters. No CCTs suitable for inclusion were found.

AUTHORS' CONCLUSIONS

Limited generalisability prevents any conclusions to be drawn from PREPIC. PREPIC employed permanent filters and lacked statistical power to detect a reduction in PE over shorter and more clinically significant time periods. However, PREPIC demonstrated that permanent caval filters are associated with an increased risk of long term lower limb DVT. There is a marked paucity of evidence regarding caval filter outcomes when used within their currently approved indications. There is also a lack of retrievable filter trials. Further trials are needed to assess vena caval filter safety and effectiveness.

Myocardial Fiber Length Mapping with MR Diffusion Tensor Imaging

Diffusion tensor MRI is emerging as a rapid, nondestructive method to map myocardial fiber organization. A precise biological description of myocardial fiber performance requires knowledge of four variables: length, force, velocity and time. However, study of quantification of myocardial fiber length is lacking. The current study aims to show myocardial fiber length maps of formalin-fixed heats. Diffusion tensor MRI with medium diffusion resolution (15 directions) was performed in one isolated pig heart. Fiber length maps were investigated in multiple short-axis slices. The results provide supplementary information of myocardial fiber organization. To our knowledge, the present study is the first report of the myocardial fiber length mapping.

Prognostic significance of osteopontin in hepatitis B virus-related hepatocellular carcinoma

BACKGROUND AND AIMS

Osteopontin (OPN) is known to be associated with metastasis in many types of cancers. Since OPN is a highly phosphorylated and glycosylated protein, the modification after transcription is very important to its function. In hepatocellular carcinoma (HCC), the elevated expression of OPN at mRNA levels and its relationship with metastasis and poorer prognosis of the patients have been reported. However, the prognostic impact of OPN at protein levels on the patients with hepatitis B virus (HBV)-related HCC after hepatectomy is still limited.

PATIENTS AND METHODS

The expression of OPN was examined at protein level by using immunohistochemistry in 72 patients who underwent hepatectomy for HBV-related HCC, and its prognostic significance in disease-free and overall survival of the patients was also analyzed by log-rank test and multivariate Cox regression analyses.

RESULTS

Thirty-nine of 72 (54.17%) HBV-related HCC specimens were positive for OPN with cytoplasmic staining. OPN was highly expressed in the specimens with capsular infiltration compared to those without (P<0.05), and also was significantly related with portal vein invasion (P<0.01) and lymph node invasion (P<0.01). The mean disease-free survival (DFS) was only 13.55+/-14.77 months when the HBV-related HCC specimens highly expressed OPN compared to 36.00+/-18.68 months for those with low expression (P<0.001). The overall survival (OS) of the patients was 18.63+/-17.28 months when the HCC over-expressed OPN compared to 42.59+/-16.85 months for HCC with the low expressed OPN (P<0.001). Multivariate analysis showed that OPN over-expression was the strongest independent adverse prognostic factor for both DFS (P=0.01) and OS (P=0.014).

CONCLUSIONS

OPN over-expression was closely related to capsular infiltration, venous invasion, lymph node metastasis, and also with worse prognosis, suggesting that OPN might be deemed as a useful molecular marker for predicting the prognosis of HCC.

Minocycline increases quality and longevity of chronic neural recordings

Brain/machine interfaces could potentially be used in the treatment of a host of neurological disorders ranging from paralysis to sensory deficits. Insertion of chronic micro-electrode arrays into neural tissue initiates a host of immunological responses, which typically leads to the formation of a cellular sheath around the implant, resulting in the loss of useful signals. Minocycline has been shown to have neuroprotective and neurorestorative effects in certain neural injury and neurodegenerative disease models. This study examined the effects of minocycline administration on the quality and longevity of chronic multi-channel microwire neural implants 1 week and 1 month post-implantation in auditory cortex. The mean signal-to-noise ratio for the minocycline group stabilized at the end of week 1 and remained above 4.6 throughout the following 3 weeks. The control group signal-to-noise ratio dropped throughout the duration of the study and at the end of 4 weeks was 2.6. Furthermore, 68% of electrodes from the minocycline group showed significant stimulus-driven activity at week 4 compared to 12.5% of electrodes in the control group. There was a significant reduction in the number of activated astrocytes around the implant in minocycline subjects, as well as a reduction in total area occupied by activated astrocytes at 1 and 4 weeks.

Aluminium mobilization from acidic forest soils in Leigongshan area, Southwestern China: Laboratory and field study

Aluminium mobilization from acidic forest soils in the remote Leigongshan area in southwestern China was investigated in the field and by a laboratory batch experiment using sequential extractions with HCl solutions with pH of approximately 3.4. Experimental data showed that strongly organically bound aluminium (Alp-Alcu) decreased significantly after sequential extraction, whereas exchangeable aluminium (Alex) increased in all three horizons. In the A-horizon with higher base saturation (BS), dissolved aluminium exchanged with base cations (BCs) on soil complex, causing lower aluminium release but significant leaching of BCs. In AB- and B-horizon with lower BS, more dissolved aluminium remained in solution. Al3+ activities in both experimental soil extracts and field soil waters strongly deviated from those predicted by the gibbsite model (i.e., pAl = pKsp + 3.0 pH) despite a significant increase in Al3+ with a decrease in pH. The soil organic-bound aluminium model, using Alcu and Alp to account for differences in the size of available Al pools in the soil, gave considerably better fits to both experimental and field data. SOM-Al model, approved by using Alex instead of organically bound aluminium (i.e., Alp and Alcu), could depict the changes in Al activities most successfully. We have concluded that Alp-Alcu is the main source of aqueous aluminium, whereas Alex plays an important role in regulating aluminium solubility during soil acidification.

Quantitative urinalysis of the mercapturic acid conjugates of allyl formate using high-resolution NMR spectroscopy

As end products of xenobiotic metabolism via glutathione conjugation, mercapturic acids (MCAs) can be used as markers to indicate exposure to allylic compounds as well as the rate and efficiency of their excretion. In addition, the formation of certain MCAs indicates metabolism via the known toxin acrolein, a strong electrophile. High-resolution 1H NMR spectroscopy has been employed to quantitatively measure the presence of MCAs in the urine of Sprague-Dawley rats, collected in the 8 h following 25 and 50 mgkg(-1) i.p. doses of allyl formate (AF), a model toxin. 3-Hydroxypropylmercapturic acid (HPMA) was found to be the only 1H NMR-observable MCA excreted in the urine, exhibiting a percentage recovery of approximately 20% at the 25 mgkg(-1) dose level, and approximately 30% at the 50 mgkg(-1) dose level.