Performance of sequential organ failure assessment, logistic organ dysfunction and multiple organ dysfunction score in severe sepsis within Chinese intensive care units

This study assessed the performance of Sequential Organ Failure Assessment, Logistic Organ Dysfunction Score and Multiple Organ Dysfunction Score in outcome prediction in severe sepsis. A total of 528 consecutive patients with a diagnosis of severe sepsis were enrolled from two surgical intensive care units of university hospitals in China. Clinical and laboratory data of patients were collected and admission and maximum values of each scoring system were calculated. Areas under the receiver operating characteristic curve, which were used to assess discrimination, were 0.80, 0.83 and 0.74 for admission Sequential Organ Failure Assessment, Logistic Organ Dysfunction Score and Multiple Organ Dysfunction Score respectively, and 0.91, 0.93 and 0.86 for corresponding maximum values respectively. Calibration assessed by the Hosmer-Lemeshow statistic was better with admission (chi2 = 18.2) and maximum Logistic Organ Dysfunction Score (chi2 = 19.6) than with admission (chi2 = 98.1) and maximum Multiple Organ Dysfunction Score (chi2 = 30.9). Brier Scores, indicating the overall performance of the scores, were 0.18, 0.17 and 0.22 for admission Sequential Organ Failure Assessment, Logistic Organ Dysfunction Score and Multiple Organ Dysfunction Score respectively, and 0.12, 0.10 and 0.15 for their maximum counterparts respectively. This study found good performance of both admission Sequential Organ Failure Assessment and Logistic Organ Dysfunction Score in severe sepsis, and a slightly weaker performance of admission Multiple Organ Dysfunction Score. Since poor calibration was observed in Logistic Organ Dysfunction Score and Multiple Organ Dysfunction Score, we suggest further study of customisation of these scores in critical illness with severe sepsis.

Multiple sequence variations in SLC5A1 gene are associated with glucose-galactose malabsorption in a large cohort of Old Order Amish

Glucose-galactose malabsorption (GGM) is an autosomal recessive disease with life-threatening newborn diarrhea caused by mutations in the Na(+) /glucose cotransporter gene SLC5A1. Because of its rarity, the clinical course of the disease has not been well studied. Here, we report 33 patients with GGM from a large Old Order Amish pedigree and the associated mutations in SLC5A1 gene. Clinically, all affected individuals presented with classic watery diarrhea and dehydration. The increased bowel sounds, distended abdomen, vigorous nursing regardless of their illness, and irritability and apathy were also noted as part of the initial presentation. Patients underwent a dramatic turnaround with an immediate cease of the diarrhea and a quick rehydration if they were correctly diagnosed and adequately managed, followed by a normal growth and development pattern afterwards; whereas a prolonged clinical course would follow if the disease was not recognized. Sequence analysis of the 15 protein-coding exons and the corresponding exon-intron boundaries of SLC5A1 gene revealed four homozygous missense mutations, c.152A>G (p.N51S), c.1231G>A (p.A411T), c.1673G>A (p.R558H), and c.1845C>G (p.H615Q), that co-segregate with the GGM phenotype in all of the affected individuals. These findings suggest that founder effect of the SLC5A1 mutations associated with the disease in Amish and a population specific genetic testing is in need to pursue an early diagnosis which is critical for a favorable outcome.

Recoverable Photodegradation of Light-Emitting Polymers

The photodegradation of light-emitting polymers was studied by measuring the decay of the photoluminescence with exposure time to He-Cd laser beam at room temperature. It was found that the photoluminescence intensity decreases very fast initially, and then tends to saturate on the order of several tens of minutes. More interestingly, it was found that the degradation induced by laser beam can be self-healed. By stopping the exposure of the sample to the laser beam, the photoluminescence intensity recovers gradually without any treatment.

Antidiabetic effects of duodenojejunal bypass in an experimental model of diabetes induced by a high-fat diet

Background

Obese patients with type II diabetes who undergo bariatric surgery revert to normal blood glucose and insulin levels, and develop a dramatic increase in insulin sensitivity. However, the mechanisms involved are unknown. This study characterized pancreatic islet and duodenojejunal enteroendocrine cells in normal mice and those with diabetes induced by a high-fat diet (HFD) following duodenojejunal bypass (DJB).

Methods

C57BL/6J mice, fed for 8 weeks either a normal diet (n = 10) or a HFD (n = 10) resulting in a hyperglycaemic state, underwent DJB (connection of the distal end of the jejunum to the distal stomach and direction of biliopancreatic secretions to the distal jejunum). Metabolic and immunohistological analyses were carried out on the pancreas and gastrointestinal tract.

Results

A significant decrease in fasting blood glucose was observed in normal-DJB and HFD-DJB mice 1 week after the operation, with improved glucose tolerance at 4 weeks. There were no changes in pancreatic β-cell mass, but an increase in the ratio of α-cell to β-cell mass was observed in the DJB groups. Furthermore, the number of cells expressing Pdx-1, glucagon-like peptide 1, pancreatic polypeptide and synaptophysin was increased in the bypassed duodenum and/or gastrojejunum of the DJB groups.

Conclusion

Both normal and obese diabetic mice that underwent DJB displayed improved glucose tolerance and a reduction in fasting blood glucose, which mimicked findings in obese diabetic patients following bariatric surgery. The present data suggest that an increase in specific enteroendocrine cell populations may play a critical role in normalizing glucose homeostasis.

Positive and negative control of Ucp1 gene transcription and the role of β-adrenergic signaling networks

Adrenergic receptor signaling in adipocytes controls not only the hydrolysis of triglycerides as fuel for other organs but is also a driver of brown adipocyte thermogenesis and energy consumption. As the appearance of these mitochondria-rich, thermogenically active cells in 'white' adipocyte depots is correlated with resistance to overnutrition and glucose intolerance, the molecular basis of their genesis and metabolic activity needs to be understood. β-adrenergic receptors regulate the enzymatic machinery for lipolysis and fuel utilization. They also coordinately stimulate the transcription of genes that support the specific functions of white and brown adipocytes. They accomplish this through the activation of a network of signaling pathways that include cAMP-dependent protein kinase and members of the mitogen-activated protein kinase family. In brown adipocytes, these kinases control the transcription of nuclear factors such as peroxisome proliferator-activated receptor-γ coactivator-1s, as well as other molecules discovered to respond to adrenergic signals, to increase mitochondrial biogenesis and uncoupling protein-1 (UCP1) expression. However, it is also important to understand the mechanisms that may actively repress these energy-wasting processes. Toward that end, we provide evidence for an important role for the nuclear receptor LXRα as a cAMP- and oxysterol-dependent transcriptional repressor of the Ucp1 gene. Adipocytes from LXRα-null mice have increased expression of most 'markers' of brown adipocytes, increased mitochondrial mass and uncoupled respiration. These studies reveal potential new targets and directions for controlling the relative levels of white versus brown adipocytes as a means of metabolic fuel utilization in the struggle against obesity and related metabolic diseases.

Association between HLA-B*27 polymorphisms and ankylosing spondylitis in Han populations: a meta-analysis

OBJECTIVES

The aim of this study was to determine whether the HLA-B*27 polymorphisms confer susceptibility to ankylosing spondylitis (AS) in Han populations by conducting a meta-analysis.

METHODS

Publications addressing the association between the HLA-B*27 polymorphisms and susceptibility to AS in Han populations were selected from the MEDLINE, EMBASE and CBMdisc databases. Data was extracted from the studies by 2 independent reviewers. The meta-analyses were performed by Review Manager Version 5.0.24 and STATA Version 9.2 software. From these data, the odds ratio (OR) with 95% confidence interval (95%CI) was calculated.

RESULTS

Fourteen studies with a total of 1900 AS cases and 831 healthy controls were retrieved. Meta-analysis results showed a positive association between B*2704 and susceptibility to AS in Han population (OR=2.20, 95%CI=1.60-3.02, p<0.00001). However, B*2705, B*2706 and B*2707 showed negative associations with susceptibility to AS in Han populations (OR=0.59, 95%CI=0.43-0.81, p=0.001; OR=0.13, 95%CI=0.05-0.37, p=0.0001; OR=0.23, 95%CI=0.11-0.46, p<0.0001; respectively). In subgroup analysis, there was a positive association between B*2704 and susceptibility to AS in the southerners of China, but not in the northerners. Negative associations between B*2705, B*2706 and susceptibility to AS were determined in the southerners of China, but also not in the northerners. Results showed obviously negative associations between B*2707 and susceptibility to AS both in the southerners and northerners of China.

CONCLUSIONS

This meta-analysis confirms that B*2704 might be a potential risk factor and B*2705, B*2706, B*2707 might be potential protective factors for AS in Han populations, especially in the southerners of China.

Study on the executive function and learning ability in first-episode schizophrenia patients

Introduction

Cognitive dysfunction was thought to be one of the core features of schizophrenia. And the executive function of the patients was paid more attention by more and more researchers and clinicians.

Objectives

To investigate the executive function and the learning ability of the patients with first-episode schizophrenia, and their relationships with psychiatric symptoms.

Methods

Fifty cases of first-episode schizophrenia patients and fifty age- and gender-matched healthy controls were tested by a computerized version of Tower of London (TOL) test. The scores of the Positive and Negative Syndrome Scale(PANSS) in the group of schizophrenia patients were over 60.

Results

The numbers of the correct answer [x1 :(14.62 ± 4.12), x2: (14.80 ± 4.70)] during the first session and the second session of the TOL test of the patients group were significantly lower than that of the control group [x1: (17.48 ± 3.79), x2:(18.68 ± 3.19)], and the reaction times [t1: (9.27 ± 4.37) seconds, t2: (9.51 ± 5.58) seconds] of the two sessions of TOL were longer than the control group [t1: (7.28 ± 2.04) seconds, t2: (6.67 ± 1.51) seconds], P < 0.01. For the control group, x2 was significantly greater than x1, and t2 shorter than t1 (P < 0.01), while for the patients group, there was no difference between the performances of the first session and the second session. The scores of TOL in the schizophrenia patients were correlated with the negative symptom score of PANSS (P < 0.05) and were not correlated with the scores of other subscales of PANSS (P > 0.05).

Conclusions

The executive function and the learning ability of schizophrenia are impaired and the cognitive dysfunction is correlated with negative symptoms.

Different anesthesia methods for laparoscopic cholecystectomy

OBJECTIVES

The aim of the study was to compare the possibility of performing laparoscopic cholecystectomy using two different anesthesia procedures (spinal anesthesia versus general anesthesia).

METHODS

The study included 68 patients with symptoms of cholelithiasis examined in the 309th Hospital of PLA from 2006 to 2009. Patients were randomly selected to undergo laparoscopic cholecystectomy with low tension pneumoperitoneum with CO(2) under general anesthesia (n=33) or spinal anesthesia (n=35). The study used propofol, fentanyl, rocuronium, sevoflurane and tracheal intubation for general anesthesia and hyperbaric 15 mg bupivacaine and 20 µg fentanyl were used to achieve a sensorial level of T(3) for spinal anesthesia. Intraoperative parameters, postoperative pain, complications, recovery, patient satisfaction and cost were compared between both groups.

RESULTS

All surgical procedures were completed with the chosen method with the exception of one case, in which spinal anesthesia was converted to general anesthesia. Shoulder pain was significantly less frequent in the spinal anesthesia group (6%) compared with the general anesthesia group (24%). The level of pain at 2, 4, and 6 h after the procedure under spinal anesthesia was significantly lower than that under general anesthesia. At 12 h both groups had the same evaluation in the visual analogue scale. In the spinal anesthesia group all patients recovered 6 h after surgery, while patients in the general anesthesia group spent more time in recovery. All patients were discharged from hospital after 24 h. In the postoperative evaluation all patients were satisfied with the spinal anesthesia and would recommend this procedure, while only 78.9% of patients were very satisfied in the general anesthesia group. The cost of spinal anesthesia was significantly lower than that of general anesthesia.

CONCLUSIONS

Laparoscopic cholecystectomy with low pressure pneumoperitoneum with CO(2) can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery and lower cost than general anesthesia.

Hypoxia-excited neurons in NTS send axonal projections to Kölliker-Fuse/parabrachial complex in dorsolateral pons

Hypoxic respiratory and cardiovascular responses in mammals are mediated by peripheral chemoreceptor afferents which are relayed centrally via the solitary tract nucleus (NTS) in dorsomedial medulla to other cardiorespiratory-related brainstem regions such as ventrolateral medulla (VLM). Here, we test the hypothesis that peripheral chemoafferents could also be relayed directly to the Kölliker-Fuse/parabrachial complex in dorsolateral pons, an area traditionally thought to subserve pneumotaxic and cardiovascular regulation. Experiments were performed on adult Sprague-Dawley rats. Brainstem neurons with axons projecting to the dorsolateral pons were retrogradely labeled by microinjection with choleras toxin subunit B (CTB). Neurons involved in peripheral chemoreflex were identified by hypoxia-induced c-Fos expression. We found that double-labeled neurons (i.e. immunopositive to both CTB and c-Fos) were localized mostly in the commissural and medial subnuclei of NTS and to a lesser extent in the ventrolateral NTS subnucleus, VLM and ventrolateral pontine A5 region. Extracellular recordings from the commissural and medial NTS subnuclei revealed that some hypoxia-excited NTS neurons could be antidromically activated by electrical stimulations at the dorsolateral pons. These findings demonstrate that hypoxia-activated afferent inputs are relayed to the Kölliker-Fuse/parabrachial complex directly via the commissural and medial NTS and indirectly via the ventrolateral NTS subnucleus, VLM and A5 region. These pontine-projecting peripheral chemoafferent inputs may play an important role in the modulation of cardiorespiratory regulation by dorsolateral pons.

Deposition Of Aluminium Nitride Film By Ion Beam Enhanced Reactive Magnetron Sputtering

Aluminium nitride film has been synthesized at substrate temperatures lower than 100 °C by using ion beam enhanced reactive magnetron sputtering. The growth rate was much higher than that obtained by usual physical vapor deposition at low substrate temperatures. The stoichiometry of the film was controlled by varying the resultant current of the ion beam used and identified by X-ray diffraction analysis. The optical properties of the film were also studied.

Fast tunable coupler for superconducting qubits

A major challenge in the field of quantum computing is the construction of scalable qubit coupling architectures. Here, we demonstrate a novel tunable coupling circuit that allows superconducting qubits to be coupled over long distances. We show that the interqubit coupling strength can be arbitrarily tuned over nanosecond time scales within a sequence that mimics actual use in an algorithm. The coupler has a measured on/off ratio of 1000. The design is self-contained and physically separate from the qubits, allowing the coupler to be used as a module to connect a variety of elements such as qubits, resonators, amplifiers, and readout circuitry over distances much larger than nearest-neighbor. Such design flexibility is likely to be useful for a scalable quantum computer.

Deterministic entanglement of photons in two superconducting microwave resonators

Quantum entanglement, one of the defining features of quantum mechanics, has been demonstrated in a variety of nonlinear spinlike systems. Quantum entanglement in linear systems has proven significantly more challenging, as the intrinsic energy level degeneracy associated with linearity makes quantum control more difficult. Here we demonstrate the quantum entanglement of photon states in two independent linear microwave resonators, creating N-photon NOON states (entangled states |N0> + |0N>) as a benchmark demonstration. We use a superconducting quantum circuit that includes Josephson qubits to control and measure the two resonators, and we completely characterize the entangled states with bipartite Wigner tomography. These results demonstrate a significant advance in the quantum control of linear resonators in superconducting circuits.

Measurement of the parity-violating longitudinal single-spin asymmetry for W± boson production in polarized proton-proton collisions at sqrt[s] = 500 GeV

We report the first measurement of the parity-violating single-spin asymmetries for midrapidity decay positrons and electrons from W+ and W- boson production in longitudinally polarized proton-proton collisions at sqrt[s] = 500 GeV by the STAR experiment at RHIC. The measured asymmetries, A(L)(W+) = -0.27 ± 0.10(stat.) ± 0.02(syst.) ± 0.03(norm.) and A(L)(W-) = 0.14 ± 0.19(stat.) ± 0.02(syst.) ± 0.01(norm.), are consistent with theory predictions, which are large and of opposite sign. These predictions are based on polarized quark and antiquark distribution functions constrained by polarized deep-inelastic scattering measurements.

Effects of Aluminum Doping on The Phase Stability and Electrochemical Properties of LiCoO2 and LiMnO2

Aluminum is of interest as a constituent for Li battery electrodes due to its low cost and low mass, and because ab initio calculations indicate that solid solution of LiAlO2 with LiMO2 (M = transition metal) in the α-NaFeO2 structure can increase intercalation voltage [1]. In this study, we investigated the effect of Al doping on LiCoO2 and LiMnO2. Single phase LiAlyCo1-yO2 has been synthesized up to y = 0.5 by firing homogenous hydroxide precursors. A systematic increase in the open circuit voltage is observed with Al content. In LiAlyMn1-yO2, the addition of LiAlO2 stabilizes LiMnO2 in the α-NaFeO2 structure under conditions where neither endmember is stable in the structure. High reversible capacity was obtained over both a 4 V and 3 V plateau, indicating that the compound transforms to a spinel-related structure during cycling, but that the cooperative Jahn-Teller distortion is suppressed.

Optical Limiting Processes in Derivatized Fullerenes and Porphyrins/Phthalocyanines

We review our results from spectral studies of the ultrafast excited-state absorption in fullerenes and derivatized fullerenes. These results allow determination of both the spectral response of reverse saturable absorption (RSA) nonlinearities such as optical limiting (OL) in fullerenes, and the dynamical response for different morphologies. We have investigated the effects of thin film and various sol-gel glass environments on the nanosecond OL and femtosecond dynamics of derivatized fullerenes. These data provide evidence of decay pathways which compete with the intersystem crossing to a triplet from the initial singlet states. With appropriate processing, however, the OL response of derivatized-fullerene sol-gel glasses can be enhanced to approach that of the same molecule in solution, while significantly enhancing the optical damage threshold. The optical limiting of these derivatized fullerenes is compared with that of various porphyrin and phthalocyanine molecules.

Correlation between imaging features and epithelial cell proliferation in keratocystic odontogenic tumour

OBJECTIVES

this study was undertaken to investigate the relationship between radiographic appearance and epithelial cell proliferations in keratocystic odontogenic tumours (KCOTs).

METHODS

a retrospective radiographic analysis was performed on 284 cases of KCOT to gain insight into the radiographic characteristics. Expression of Ki-67 in 30 of the 284 cases was detected by the labelled streptavidin-biotin (LSAB) method and evaluated by an image analysis system.

RESULTS

the radiographic presentation of KCOT was divided into four types: unilocular, multilocular, multiple and naevoid basal cell carcinoma syndrome (NBCCS). The expression of Ki-67 in NBCCS was significantly different from the solitary and multiple KCOTs (P = 0.018, 0.002). In multilocular KCOTs it was also significantly different from the unilocular and syndrome-associated lesions (P = 0.000). In contrast, no significant differences were observed between the solitary and multiple lesions (P = 0.220).

CONCLUSIONS

a high correlation exists in KCOT between its biological behaviour and imaging features. The solitary KCOT seems less biologically aggressive and it should be classified as a cyst rather than a tumour. This means that more than half of KCOTs manifest themselves as ordinary cysts.

Use of gene expression analysis of periampullary carcinomas to identify biliary-like and intestinal-like subgroups of ampullary and duodenal carcinomas

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Background: Though adenocarcinomas of the ampulla of Vater are classified as biliary cancers, the epithelium of origin and treatment approach for these rare tumors remains controversial. We compared the gene expression profiles of ampullary carcinomas with that of known periampullary carcinomas.

Methods: We analyzed 32 fresh-frozen resected untreated periampullary carcinomas (8 pancreatic, 2 extrahepatic biliary, 8 non-ampullary duodenal, and 14 ampullary) with verified histology and >70% tumor tissue using the Affymetrix U133 Plus 2.0 genome array. Hierarchical clustering of all samples based upon pancreatic and duodenal differentially expressed genes and unsupervised hierarchical clustering was done. Ampullary and duodenal samples were analyzed for histologic subtype (pancreaticobiliary, intestinal, mixed), MSI by PCR, CDX-2 by IHC and KRAS and PI3K mutations by mass spectroscopy-based sequencing (Sequenom).

Results: We identified 3 subgroups: pancreatic (8 pancreatic, 1 duodenal), biliary-like (4 duodenal, 7 ampullary, 2 biliary) and intestinal-like (3 duodenal, 7 ampullary). The intestinal-like subgroup had a significantly improved RFS (p=0.03) and OS (p =0.04) compared to the biliary-like subgroup, after stratification by grade and stage. Unsupervised clustering of only ampullary and duodenal samples identified very similar good prognostic (4 duodenal, 5 ampullary) and bad prognostic groups (3 duodenal, 9 ampullary) with 3-year RFS 75% vs. 31%, p =0.05 and 3-year OS 100% vs. 27%, p =0.01. These 2 groups showed no statistically significant differences in adenoma (56% vs 25%), poor differentiation (11% vs 42%), T4 (33% vs 25%), N1 (67% vs 100%), MSI-high (22% vs 0%), KRAS mutations (33% vs 17%), or PI3K mutations (0% vs 17%). CDX-2 expression (100% vs 50%, p=.04) and intestinal histologic subtype (100% vs 0%, p <0.01) were more common in the good prognostic group.

Conclusions: Gene expression analysis classifies ampullary carcinomas with duodenal carcinomas and identifies a good prognosis intestinal-like group and a poor prognosis biliary-like group. These findings have therapeutic implications.

[Table: see text]

High Frequency Loss Mechanism in Polymers Filled with Dielectric Modifiers

We analyzed the high frequency dielectric relaxation mechanism in high-k composite materials using film substrates made of low loss organic resin filled with ferroelectric ceramics and with single wall carbon nanotubes (SWNT). We performed broadband permittivity measurements of high-k film substrates at frequencies of 100 Hz to about 10 GHz. In order to analyze the effect of the dielectric thickness, dielectric constant, loss and conductive loss on the impedance characteristics, we used a High Frequency Structure Simulator to perform a full wave numerical analysis of several power planes. Small angle neutron scattering (SANS) was used to probe the dispersion of SWNTs in polymer matrices. It was found that organic-ceramic composites exhibit an intrinsic high frequency relaxation behavior that gives rise to frequency dependent dielectric loss. The highest frequency relaxation process dominates the overall loss characteristic. In the case of polymers modified with SWNTs, we observed that 2% mass fraction of p-doped semi-conducting SWNTs increases the dielectric constant by 3 orders of magnitude, in apparent violation of the mixing-rule. The hybrid material appears to have preferential coupling within the dispersed phase. The experimental data and numerical simulation indicate that these materials can play a significant role as embedded passive devices with functional characteristics superior to that of discrete components.

Association between indoor air pollution measurements and respiratory health in women and children in Lao PDR

This article presents the results of a study on the association between measured air pollutants and the respiratory health of resident women and children in Lao PDR, one of the least developed countries in Southeast Asia. The study, commissioned by the World Health Organisation, included PM(10), CO and NO(2) measurements made inside 181 dwellings in nine districts within two provinces in Lao PDR over a 5-month period (12/05-04/06), and respiratory health information (via questionnaires and peak expiratory flow rate (PEFR) measurements) for all residents in the same dwellings. Adjusted odds ratios were calculated separately for each health outcome using binary logistic regression. There was a strong and consistent positive association between NO(2) and CO for almost all questionnaire-based health outcomes for both women and children. Women in dwellings with higher measured NO(2) had more than triple of the odds of almost all of the health outcomes, and higher concentrations of NO(2) and CO were significantly associated with lower PEFR. This study supports a growing literature confirming the role of indoor air pollution in the burden of respiratory disease in developing countries. The results will directly support changes in health and housing policy in Lao PDR.

PRACTICAL IMPLICATIONS

This is the first study that investigated indoor air quality and its impact within residential dwellings in Lao PDR, which is one of the poorest and least developed countries in south-east Asia, with a life-expectancy of 56 years in 2008. While there have been other studies published on indoor air quality in other developing countries, the situation in Laos is different because the majority of houses in Laos used wood stoves, and therefore, emissions from wood burning are the dominant sources of indoor air pollution. In other countries, and studies, while emission from wood burning was investigated, wood was rarely the main or the only fuel used, as the houses used in addition (or solely) dung, kerosene or coal. The study quantified, for the first time, concentrations in houses two provinces in Laos PDR and shed light on the impact of human activities and urban design on pollutant concentrations and respiratory health. This study contributes to the accumulation of evidence to provide more reliable estimates of risk and a more informed basis for decision-making by concerned governments and communities.

Pollutant concentrations within households in Lao PDR and association with housing characteristics and occupants' activities

The paper presents the results of a study conducted to investigate indoor air quality within residential dwellings in Lao PDR. Results from PM(10), CO, and NO(2) measurements inside 167 dwellings in Lao PDR over a five month period (December 2005-April 2006) are discussed as a function of household characteristics and occupant activities. Extremely high PM(10) and NO(2) concentrations (12 h mean PM(10) concentrations 1275 ± 98 μg m(-3) and 1183 ± 99 μg m(-3) in Vientiane and Bolikhamxay provinces, respectively; 12 h mean NO(2) concentrations 1210 ± 94 μg m(-3) and 561 ± 45 μg m(-3) in Vientiane and Bolikhamxay, respectively) were measured within the dwellings. Correlations, ANOVA analysis (univariate and multivariate), and linear regression results suggest a substantial contribution from cooking and smoking. The PM(10) concentrations were significantly higher in houses without a chimney compared to houses in which cooking occurred on a stove with a chimney. However, no significant differences in pollutant concentrations were observed as a function of cooking location. Furthermore, PM(10) and NO(2) concentrations were higher in houses in which smoking occurred, suggestive of a relationship between increased indoor concentrations and smoking (0.05 < p < 0.10). Resuspension of dust from soil floors was another significant source of PM(10) inside the house (634 μg m(-3), p < 0.05).

Concurrent chemoradiotherapy with cetuximab plus twice-weekly paclitaxel and cisplatin followed by esophagectomy for locally advanced esophageal squamous cell carcinoma

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Background: We investigated the efficacy and safety of adding cetuximab into twice-weekly paclitaxel/cisplatin-based concurrent chemoradiotherapy (CCRT), followed by surgery, for patients with locally advanced esophageal squamous cell carcinoma (ESCC).

Methods: Patients with operable ESCC (T3N0-1M0 or T1-3N1M0 or M1a) were treated with paclitaxel (35 mg/m2 1 h on days 1 and 4/week), cisplatin (15 mg/m2 1 h on days 2 and 5/week), cetuximab (400 mg/m2 2 h on day -5, then 250 mg/m2 2 h on day 3/week) and radiotherapy (2 Gy on days 1-5/week). When the accumulated radiation dose reached 40 Gy, the feasibility of esophagectomy was evaluated for all patients. In patients for whom esophagectomy was not feasible, CCRT was continued to a radiation dose of 60-66 Gy.

Results: Sixty-two patients with ESCC were enrolled, and the majority had T3N1M0 or M1a tumors by endoscopic ultrasonographic staging (94%). All patients received CCRT to 40 Gy. Forty-three patients underwent surgery, and 17 patients continued definitive CCRT to 60-66 Gy. Of the scheduled doses of paclitaxel, cisplatin, and cetuximab, 80%, 79%, and 99% were given, respectively. The intent-to-treat pathological complete response rate was 24% (15/62) (95% confidence interval: 13-35%). At the median follow-up of 13.3 months, the one-year progression-free and overall survivals were 76% and 63%, respectively. The most common grade 3/4 toxic effects were leukopenia (51%), neutropenia (15%), esophagitis (19%), and infection (12%). Grade 1, 2, and 3 skin rash occurred in 59%, 36%, and 2% of patients, respectively. Grade 1, 2, 3, and 4 hypomagnesemia occurred in 14%, 5%, 0%, and 5% of patients, respectively.

Conclusions: Adding cetuximab to twice-weekly paclitaxel/cisplatin-based CCRT prior to esophagectomy is an active and tolerable treatment for locally advanced ESCC.

No significant financial relationships to disclose.

CD14+ cell-derived IL-29 modulates proinflammatory cytokine production in patients with allergic airway inflammation

BACKGROUND

  Interleukin (IL)-29 is a newly described cytokine that has anti-viral activity, induces tumor cell death and regulates immune function. Whether it plays a role in immune disorders is unclear. This study aims to examine the role of IL-29 in the modulation of immune response under allergic environment.

METHODS

  A group of patients with allergic asthma or/and allergic rhinitis was recruited to this study. Serum samples were collected from the patients in both in-season and out-season; the serum levels of IL-29 were determined by enzyme-linked immunoassay. Cell types of IL-29-producing cells in upper airway mucosa were identified with immune staining and examined by immunohistochemistry and flow cytometry.

RESULTS

  High serum levels of IL-29 were detected in patients with allergic asthma in in-season, but not in out-season. The majority of IL-29(+) cells in upper airway tissue were CD14(+) cells. Exposure to specific antigens triggered the release of IL-4 from antigen-specific CD4(+) T cells; the released IL-4 activated CD14(+) cells to release IL-29; the released IL-29 further triggered the release of IL-6 and tumor necrosis factor from CD4(+) T cells.

CONCLUSIONS

  Interleukin-29 is involved in the pathogenesis of allergic inflammation via modulating immune cells' function to release proinflammatory cytokines.

465 nm laser sources by intracavity frequency doubling using a 49-edge-emitters laser bar

A compact blue laser was generated by intracavity frequency doubling based on quasi-phase-matched second-harmonic generation (SHG) in a MgO-doped periodically poled lithium niobate bulk crystal. A 49 single-transverse-mode edge-emitters laser bar with antireflective coating was used as a pump source. An optical output power of 1.2 W SHG of blue lights at 465 nm is generated at 45 A injection current, equivalent to an overall wall-plug efficiency of 1.33%.