Non-contact high-frequency ultrasound microbeam stimulation for studying mechanotransduction in human umbilical vein endothelial cells

We describe how contactless high-frequency ultrasound microbeam stimulation (HFUMS) is capable of eliciting cytoplasmic calcium (Ca(2+)) elevation in human umbilical vein endothelial cells. The cellular mechanotransduction process, which includes cell sensing and adaptation to the mechanical micro-environment, has been studied extensively in recent years. A variety of tools for mechanical stimulation have been developed to produce cellular responses. We developed a novel tool, a highly focused ultrasound microbeam, for non-contact cell stimulation at a microscale. This tool, at 200 MHz, was applied to human umbilical vein endothelial cells to investigate its potential to elicit an elevation in cytoplasmic Ca(2+) levels. It was found that the response was dose dependent, and moreover, extracellular Ca(2+) and cytoplasmic Ca(2+) stores were involved in the Ca(2+) elevation. These results suggest that high-frequency ultrasound microbeam stimulation is potentially a novel non-contact tool for studying cellular mechanotransduction if the acoustic pressures at such high frequencies can be quantified.

Effectiveness of milrinone for cardiogenic shock due to massive pulmonary aspiration: a case report

Pulmonary aspiration of gastric contents is one of the most frightening complications during anesthesia. Although pulmonary aspiration of gastric contents in general surgical patients is not common and resulting long-term morbidity and mortality are rare, severe hypoxemia and other sequelae of pulmonary aspiration continue to be reported. We report a case of massive aspiration of gastric contents during induction of general anesthesia, resulting in cardiac arrest due to severe pulmonary hypertension and myocardial infarction. Sustained cardiac arrest and shock that did not respond the conventional resuscitation was successfully treated using milrinone. The patient was discharged without complications in 20 days.

Radiological measurement of femoral stem version using a modified Budin method

Version of the femoral stem is an important factor influencing the risk of dislocation after total hip replacement (THR) as well as the position of the acetabular component. However, there is no radiological method of measuring stem anteversion described in the literature. We propose a radiological method to measure stem version and have assessed its reliability and validity. In 36 patients who underwent THR, a hip radiograph and CT scan were taken to measure stem anteversion. The radiograph was a modified Budin view. This is taken as a posteroanterior radiograph in the sitting position with 90° hip flexion and 90° knee flexion and 30° hip abduction. The angle between the stem-neck axis and the posterior intercondylar line was measured by three independent examiners. The intra- and interobserver reliabilities of each measurement were examined. The radiological measurements were compared with the CT measurements to evaluate their validity. The mean radiological measurement was 13.36° (sd 6.46) and the mean CT measurement was 12.35° (sd 6.39) (p = 0.096). The intra- and interobserver reliabilities were excellent for both measurements. The radiological measurements correlated well with the CT measurements (p = 0.001, r = 0.877). The modified Budin method appears reliable and valid for the measurement of femoral stem anteversion.

Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block

BACKGROUND

The aim of this study was to estimate the minimum effective volume (MEV) of 1.5% mepivacaine for ultrasound-guided supraclavicular block by placing the needle near the lower trunk of brachial plexus and multiple injections.

METHODS

Thirty patients undergoing forearm and hand surgery received ultrasound-guided supraclavicular block with 1.5% mepivacaine. The initial volume of local anesthetic injected was 24 ml, and local anesthetic volume for the next patient was determined by the response of the previous patient. The next patient received a 3 ml higher volume in the case of the failure of the previous case. If the previous block was successful, the next volume was 3 ml lower. MEV was estimated by the Dixon and Massey up and down method. MEV in 95, 90, and 50% of patients (MEV95, MEV90, and MEV50) were calculated using probit transformation and logistic regression.

RESULTS

MEV95 of 1.5% mepivacaine was 17 ml (95% confidence interval [CI], 13-42 ml), MEV90 was 15 ml (95% CI, 12-34 ml), and MEV50 was 9 ml (95% CI, 4-12 ml). Twelve patients had a failed block. Three patients received general anesthesia. Nine patients could undergo surgery with sedation only. Only one patient showed hemi-diaphragmatic paresis.

CONCLUSIONS

MEV95 was 17 ml, MEV90 was 15 ml, and MEV50 was 9 ml. However, needle location near the lower trunk of brachial plexus and multiple injections should be performed.

Comparison of ultrasound-guided supraclavicular block according to the various volumes of local anesthetic

Background

The ultrasound guidance in regional nerve blocks has recently been introduced and gaining popularity. Ultrasound-guided supraclavicular block has many advantages including the higher success rate, faster onset time, and fewer complications. The aim of this study was to examine the clinical data according to the varied volume of local anesthetics in the ultrasound-guided supraclavicular block.

Methods

One hundred twenty patients were randomized into four groups, according to the local anesthetic volume used: Group 35 (n = 30), Group 30 (n = 30), Group 25 (n = 30), and Group 20 (n = 30). Supraclavicular blocks were performed with 1% mepivacaine 35 ml, 30 ml, 25 ml, and 20 ml, respectively. The success rate, onset time, and complications were checked and evaluated.

Results

The success rate (66.7%) was lower in Group 20 than that of Group 35 (96.7%) (P < 0.05). The average onset times of Group 35, Group 30, Group 25, and Group 20 were 14.3 ± 6.9 min, 13.6 ± 4.5 min, 16.7 ± 4.6 min, and 16.5 ± 3.7 min, respectively. There were no significant differences. Horner's syndrome was higher in Group 35 (P < 0.05).

Conclusions

In conclusion, we achieved 90% success rate with 30 ml of 1% mepivacaine. Therefore, we suggest 30 ml of local anesthetic volume for ultrasound-guided supraclavicular block.

Experience with Using Multiple Types of Visual Educational Tools during Problem-Based Learning

PURPOSE

This study describes the experience of using multiple types of visual educational tools in the setting of problem-based learning (PBL). The author intends to demonstrate their roles in diverse and efficient ways of clinical reasoning and problem solving.

METHODS

Visual educational tools were introduced in a lecture that included their various types, possible benefits, and some examples. Each group made one mechanistic case diagram per week, and each student designed one diagnostic schema or therapeutic algorithm per week, based on their learning issues. The students were also told to provide commentary, which was intended to give insights into their truthfulness. Subsequently, the author administered a questionnaire about the usefulness and weakness of visual educational tools and the difficulties with performing the work. Also, the qualities of the products were assessed by the author.

RESULTS

There were many complaints about the adequacy of the introduction of visual educational tools, also revealed by the many initial inappropriate types of products. However, the exercise presentation in the first week improved the level of understanding regarding their purposes and the method of design. In general, students agreed on the benefits of their help in providing a deep understanding of the cases and the possibility of solving clinical problems efficiently. The commentary was helpful in evaluating the truthfulness of their efforts. Students gave suggestions for increasing the percentage of their scores, considering the efforts.

CONCLUSION

Using multiple types of visual educational tools during PBL can be useful in understanding the diverse routes of clinical reasoning and clinical features.

Multimodality imaging in vivo for preclinical assessment of tumor-targeted doxorubicin nanoparticles

This study presents a new multimodal imaging approach that includes high-frequency ultrasound, fluorescence intensity, confocal, and spectral imaging to improve the preclinical evaluation of new therapeutics in vivo. Here we use this approach to assess in vivo the therapeutic efficacy of the novel chemotherapy construct, HerDox during and after treatment. HerDox is comprised of doxorubicin non-covalently assembled in a viral-like particle targeted to HER2+ tumor cells, causing tumor cell death at over 10-fold lower dose compared to the untargeted drug, while sparing the heart. Whereas our initial proof-of-principle studies on HerDox used tumor growth/shrinkage rates as a measure of therapeutic efficacy, here we show that multimodal imaging deployed during and after treatment can supplement traditional modes of tumor monitoring to further characterize the particle in tissues of treated mice. Specifically, we show here that tumor cell apoptosis elicited by HerDox can be monitored in vivo during treatment using high frequency ultrasound imaging, while in situ confocal imaging of excised tumors shows that HerDox indeed penetrated tumor tissue and can be detected at the subcellular level, including in the nucleus, via Dox fluorescence. In addition, ratiometric spectral imaging of the same tumor tissue enables quantitative discrimination of HerDox fluorescence from autofluorescence in situ. In contrast to standard approaches of preclinical assessment, this new method provides multiple/complementary information that may shorten the time required for initial evaluation of in vivo efficacy, thus potentially reducing the time and cost for translating new drug molecules into the clinic.

Prevalence and different characteristics of two serotypes of Streptococcus parauberis isolated from the farmed olive flounder, Paralichthys olivaceus (Temminck and Schlegel), in Korea

The prevalence of two serotypes of Streptococcus parauberis isolated from the olive flounder, Paralichthys olivaceus, was evaluated in a total of 29 isolates between 2003 and 2010 in Korea. Streptococcus parauberis isolates were divided into two serologically distinct types (serotype 1 and serotype 2), except for one strain (S1091), using an agglutination assay with rabbit antiserum, and serotype 1 was identified as the dominant type (24 of 29 isolates) in this study. To identify the characteristics of the two serotypes of S. parauberis, we conducted a biochemical test using the API 20 Strep kit, a transmission electron microscopy (TEM) assay, sequence analysis of 16S-23S rRNA intergenic spacer region (ISR) and a pathogenicity test. In TEM, both serotypes possessed polysaccharide capsule layers around the cell surface when bacterial cells were treated with a homologous serotype of rabbit antiserum. However, we were unable to discriminate serotype-specific biochemical characteristics and genetic characteristics of 16S-23S rRNA ISR between the two serotypes. In the pathogenicity test, the serotype 1 strains induced significantly higher mortality than the serotype 2 strains in olive flounder when experimentally inoculated via the intraperitoneal route.

Acceptable compression ratio of full-field digital mammography using JPEG 2000

AIM

To estimate the acceptable compression ratio of full-field digital mammography (FFDM) using the Joint Photographic Experts Group (JPEG) 2000 compression algorithm.

MATERIALS AND METHODS

Eighty cases that included images of 40 masses (20 benign, 20 malignant) and 40 microcalcifications (20 benign, 20 malignant) were collected. The images were compressed to five different lossy ratios: 20:1, 40:1, 60:1, 80:1, and 100:1, and four radiologists independently determined whether the compressed group was distinguishable from the control group. The ratio of the compressed group that was rated indistinguishable from the control group was compared for each reviewer, and the results were analysed for agreements of three or more reviewers.

RESULTS

The ability to distinguish the compressed image from the control group is given as a range across the four reviewers: 0-1.3% (0/80 to 1/80) of the 20:1, 0-2.5% (0/80 to 2/80) of the 40:1, 5-7.5% (4/80 to 6/80) of the 60:1, 10-37.5% (8/80 to 30/80) of the 80:1, and 30-87.5% (24/80 to 70/80) of the 100:1. For three compression groups (20:1, 40:1, and 60:1), three or more reviewers agreed that there was a distinguishable difference for 0/80, 0/80, and 3/80 images, respectively. Thus, the compressed images do not differ significantly from the control group (p>0.05). However, the 80:1 and 100:1 compressed images were different for 9/80 and 29/80 images, respectively, which is significantly different from the control group (p<0.05).

CONCLUSION

The lossy 60:1 compression ratio for FFDM is visually identical to the control image and, therefore, potentially acceptable for primary interpretation.

The correlation between the effects of propofol on the auditory brainstem response and the postsynaptic currents of the auditory circuit in brainstem slices in the rat

BACKGROUND

Although there have been reports showing the changes of the auditory brainstem response (ABR) waves by propofol, no detailed studies have been done at the level of brainstem auditory circuit. So, we studied the effects of propofol on the postsynaptic currents of the medial nucleus of the trapezoid body (MNTB)-lateral superior olive (LSO) synapses by using the whole cell voltage clamp technique and we compared this data with that obtained by the ABR.

METHODS

5 rats at postnatal (P) 15 days were used for the study of the ABR. After inducing deep anesthesia using xylazine 6 mg/kg and ketamine 25 mg/kg, the ABRs were recorded before and after intraperitoneal propofol injection (10 mg/kg) and the effects of propofol on the latencies of the I, III, and V waves and the I-III and III-V interwave intervals were evaluated. Rats that were aged under P11 were used in the voltage clamp experiments. After making brainstem slices, the postsynaptic currents (PSCs) elicited by MNTB stimulation were recorded at the LSO, and the changes of the PSCs by the bath application of propofol (100 microM) were monitored.

RESULTS

We found small, but statistically significant increases in the latencies of ABR waves III and V and the interwave intervals of I-III and III-V by propofol. However, no significant changes were observed in the glycinergic or glutamatergic PSCs of the MNTB-LSO synpases by the application of propofol (100 microM).

CONCLUSIONS

Glycinergic or glutamatergic transmission of the MNTB-LSO synapses might not contribute to the propofol-induced changes of the ABR.

Students' Response to the Questionnaire about the Usefulness of Concept Maps for Problem-Based Learning and the Forms of Concept Maps

PURPOSE

Concept maps have been studied and used in diverse ways in scientific fields. This study aimed to investigate the usefulness and limitations of using concept maps during problem-based learning (PBL) in Year 3 medical students.

METHODS

After each PBL module, we gathered concept maps from each pair of students and questionnaires about the usefulness and limitations of concept maps, and analyzed them.

RESULTS

There were two types of concept maps, with some modifications. The students felt that concept maps provided overall understanding, analysis, and reorganization of problem cases. But, they also criticized shortage of disciplines related to drawing skills and rationales for each type of map. A strong need for expert maps and feedback for students resulted.

CONCLUSION

For optimal use of concept maps, we recommend that the committee implements a plan to teach drawing skills, explains rationales for each type of map, and gives feedback to students.

Central nervous system distribution of the transcription factor Phox2b in the adult rat

Phox2b is required for development of the peripheral autonomic nervous system and a subset of cranial nerves and lower brainstem nuclei. Phox2b mutations in man cause diffuse autonomic dysfunction and deficits in the automatic control of breathing. Here we study the distribution of Phox2b in the adult rat hindbrain to determine whether this protein is selectively expressed by neurons involved in respiratory and autonomic control. In the medulla oblongata, Phox2b-immunoreactive nuclei were present in the dorsal vagal complex, intermediate reticular nucleus, dorsomedial spinal trigeminal nucleus, nucleus ambiguus, catecholaminergic neurons, and retrotrapezoid nucleus (RTN). Phox2b was expressed by both central excitatory relays of the sympathetic baroreflex (nucleus of the solitary tract and C1 neurons) but not by the inhibitory relay of this reflex. Phox2b was absent from the ventral respiratory column (VRC) caudal to RTN and rare within the parabrachial nuclei. In the pons, Phox2b was confined to cholinergic efferent neurons (salivary, vestibulocochlear) and noncholinergic peritrigeminal neurons. Rostral to the pons, Phox2b was detected only in the oculomotor complex. In adult rats, Phox2b is neither a comprehensive nor a selective marker of hindbrain autonomic pathways. This marker identifies a subset of hindbrain neurons that control orofacial movements (dorsomedial spinal trigeminal nucleus, pontine peritrigeminal neurons), balance and auditory function (vestibulocochlear efferents), the eyes, and both divisions of the autonomic efferent system. Phox2b is virtually absent from the respiratory rhythm and pattern generator (VRC and dorsolateral pons) but is highly expressed by neurons involved in the chemical drive and reflex regulation of this oscillator.

Structural and expression analyses of two vitellogenin genes in the carp, Cyprinus carpio

We cloned and sequenced two vitellogenin (vg) cDNAs of the carp, Cyprinus carpio, using a cDNA library constructed from estradiol-17 beta (E2)-treated livers. One was a novel, longer 5000 bp-long cDNA termed vg-B2 encoding 1624 amino acids in a single open reading frame. The other was a shorter cDNA (vg-B1), identical to that registered previously as carp vg cDNA in the international nucleotide sequence database. The deduced amino acid sequences of these two molecules were well-aligned with known vertebrate Vgs sharing common characteristics such as N-terminal lipovitellin I (LVI), phosvitin (PV) and C-terminal lipovitellin II (LVII). The novel Vg-B2 bore a highly conserved GL/ICG motif within the LVII region, in contrast to the shorter Vg-B1 that has a truncated C-terminal and lacks the beta-component within the LVII region including the GL/ICG motif. Both vg-B2 and vg-B1 genes were expressed in the livers of females and E2-injected males. Western blot analysis using anti-Vg and anti-vitellin (Vn) antisera demonstrated that both Vg-B2 and Vg-B1 were detected as polypeptides with an estimated molecular mass of 180 kDa and 160 kDa, respectively, in the blood of females and E2-injected males. The results suggest the potential utilization of these genes as sensitive xenoestrogenic markers.

Expression of Phox2b by brainstem neurons involved in chemosensory integration in the adult rat

Central congenital hypoventilation syndrome is caused by mutations of the gene that encodes the transcription factor Phox2b. The syndrome is characterized by a severe form of sleep apnea attributed to greatly compromised central and peripheral chemoreflexes. In this study, we analyze whether Phox2b expression in the brainstem respiratory network is preferentially associated with neurons involved in chemosensory integration in rats. At the very rostral end of the ventral respiratory column (VRC), Phox2b was present in many VGlut2 (vesicular glutamate transporter 2) mRNA-containing neurons. These neurons were functionally identified as the respiratory chemoreceptors of the retrotrapezoid nucleus (RTN). More caudally in the VRC, many fewer neurons expressed Phox2b. These cells were not part of the central respiratory pattern generator (CPG), because they were typically cholinergic visceral motor neurons or catecholaminergic neurons (presumed C1 neurons). Phox2b was not detected in serotonergic neurons, in the A5, A6, and A7 noradrenergic cell groups nor within the main cardiorespiratory centers of the dorsolateral pons. Phox2b was expressed by many solitary tract nucleus (NTS) neurons including those that relay peripheral chemoreceptor information to the RTN. These and previous observations by others suggest that Phox2b is expressed by an uninterrupted chain of neurons involved in the integration of peripheral and central chemoreception (carotid bodies, chemoreceptor afferents, chemoresponsive NTS neurons projecting to VRC, RTN chemoreceptors). The presence of Phox2b in this circuit and its apparent absence from the respiratory CPG could explain why Phox2b mutations disrupt breathing automaticity during sleep without causing major impairment of respiration during waking.

Re-circulation artefact at the carotid bulb can be differentiated from true stenosis

Re-circulation artefact developing secondary to vortex flow at the bulb of the internal carotid artery is very difficult to distinguish from true stenotic defect on two-dimensional Fourier transformed time-of-flight magnetic resonance angiography (2D-FT TOF MRA). The purpose of our study is to identify appropriate distinguishing features of re-circulation artefact. We included 45 extracranial carotid arteries collected from 25 patients who underwent both 2D-FT TOF MRA and contrast medium based angiography. Review of the 45 vessels demonstrated re-circulation artefact in 21 vessels, true stenotic defect in 8 vessels, and no filling defect in 16 vessels on 2D-FT TOF MRA. We compared the findings of re-circulation artefact and true stenotic defect in 29 vessels excluding the 16 vessels without filling defect. The following were evaluated: (1) preservation of posterior wall contour; (2) marginal character of filling defect; (3) darkness of filling defect; (4) involvement of common carotid artery by filling defect; (5) size of filling defect. In four out of the five evaluated items, statistically significant difference was present between re-circulation artefact group and true stenotic defect group (p<0.01 in all four items, chi(2) analysis). Re-circulation artefact demonstrated the preservation of the posterior wall contour (19/21), ill-defined margin (19/21), less dark defect (18/21), and no involvement of the common carotid artery (19/21). On the contrary true stenotic defect demonstrated focal loss of posterior wall contour (8/8), sharp margin (8/8), dark defect (8/8), and involvement of common carotid artery (4/8). No significant difference was noted in the size of the defect between the two groups (p>0.05). The specificity of 2D-FT TOF MRA for carotid stenosis was markedly increased after application of above signs. These distinguishing signs are very helpful in differentiating re-circulation artefact from true stenotic defect.

Noncompetitive inhibition by camphor of nicotinic acetylcholine receptors

The effect of camphor, a monoterpenoid, on catecholamine secretion was investigated in bovine adrenal chromaffin cells. Camphor inhibited [3H]norepinephrine ([3H]NE) secretion induced by a nicotinic acetylcholine receptor (nAChR) agonist, 1,1-dimethyl-4-phenylpiperazinium iodide (DMPP), with a half-maximal inhibitory concentration (IC50) of 70 +/- 12 microM. In addition, camphor inhibited the rise in cytosolic calcium ([Ca2+]i) and sodium ([Na+]i) induced by DMPP with IC50 values of 88 +/- 32 and 19 +/- 2 microM, respectively, suggesting that the activity of nAChRs is also inhibited by camphor. On the other hand, binding of [3H]nicotine to nAChRs was not affected by camphor. [Ca2+]i increases induced by high K+, veratridine, and bradykinin were not affected by camphor. The data suggest that camphor specifically inhibits catecholamine secretion by blocking nAChRs without affecting agonist binding.

Can the expression of histocompatibility antigen be changed by lithium?

OBJECTIVES

This study attempted to determine whether human leukocyte antigen (HLA) type changes would be caused by lithium.

METHODS

A total of 15 patients were chosen as subjects (4 males, 11 females) and completed tests in class I. Eight of the 15 patients completed tests in class II. Their mean age was 27 +/- 7 years. For an average of 51 +/- 17 days, lithium, 600-1,200 mg/day (mean daily dose: 920 +/- 211 mg) was administered for the HLA testing and then compared with the HLA type prior to the time the drug was administered. Class I type test was performed according to the Terasaki microcytotoxicity method and class II type by the Erlich polymerase chain reaction method.

RESULTS

Of the 15 subjects, 11 had changes in HLA-A, B, C types and two of the eight subjects had changes in HLA DR type.

CONCLUSION

Lithium, in the therapeutic dose, is considered to bring about changes in HLA expressions in as short a time period as 2 months.

Methylation controls the low temperature induction of flowering in Arabidopsis

Control of the transition to flowering is critical for reproductive success of a plant. Studies in Arabidopsis have led us to suggest how this species has harnessed the environmental cue of a period of low temperature to ensure flowering occurs at an appropriate time. We propose that Arabidopsis has both vernalization-independent and vernalization-dependent pathways for the initiation of inflorescence development in the shoot apex. The vernalization-independent pathway may be concerned with the supply of carbohydrate to the shoot apex. In late flowering ecotypes which respond to vernalization the vernalization-independent pathway is blocked by the action of two dominant repressors of flowering, FRI and FLC, which interact to produce very late flowering plants which respond strongly to vernalization. We have isolated a gene which may correspond to FLC. We suggest the vernalization-dependent pathway, which may be concerned with apical GA biosynthesis, is blocked by methylation of a gene critical for flowering. This gene may correspond to that encoding kaurenoic acid hydroxylase (KAH), an enzyme catalysing a step in the GA biosynthetic pathway. Under this scheme vernalization causes unblocking of this pathway by demethylation possibly of the KAH gene and consequent biosynthesis of active GAs in the apex.