Aliskiren reduces vascular pathology in diabetic retinopathy and oxygen-induced retinopathy in the transgenic (mRen-2)27 rat

AIM/HYPOTHESIS

We examined whether the renin inhibitor, aliskiren, provides similar or greater protection than ACE inhibition from non-proliferative diabetic retinopathy and from the proliferative neoangiogenesis of oxygen-induced retinopathy.

METHODS

Transgenic (mRen-2)27 rats, which overexpress mouse renin and angiotensin in extra-renal tissues, were studied. For diabetic studies, non-diabetic, diabetic (streptozotocin, 55 mg/kg), diabetic + aliskiren (10 mg kg(-1) day(-1), pump), or diabetic + lisinopril (10 mg kg(-1) day(-1), drinking water) rats were evaluated over 16 weeks. For oxygen-induced retinopathy studies, rats were exposed to 80% oxygen (22 h/day) from postnatal days 0 to 11, and then room air from postnatal days 12 to 18. Aliskiren (10 or 30 mg kg(-1) day(-1), pump) or lisinopril (10 mg kg(-1) day(-1), drinking water) was administered during retinopathy development between postnatal days 12 and 18.

RESULTS

Systolic BP in diabetic (mRen-2)27 rats was reduced with 10 mg kg(-1) day(-1) aliskiren, but only lisinopril normalised systolic blood pressure. In diabetic (mRen-2)27 rats, 10 mg kg(-1) day(-1) aliskiren and lisinopril reduced retinal acellular capillaries and leucostasis to non-diabetic levels. In oxygen-induced retinopathy, neoangiogenesis and retinal inflammation (leucostasis, ED-1 immunolabelling) were partially reduced by 10 mg kg(-1) day(-1) aliskiren and normalised by 30 mg kg(-1) day(-1) aliskiren, whereas lisinopril normalised neoangiogenesis and reduced leucostasis and ED-1 immunolabelling. Aliskiren and lisinopril normalised retinal vascular endothelial growth factor expression; however, only aliskiren reduced intercellular adhesion molecule-1 to control levels.

CONCLUSIONS/INTERPRETATION

Aliskiren provided similar or greater retinal protection than ACE inhibition and may be a potential treatment for diabetic retinopathy.

Treatment of scaphoid non-union with 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularised graft

INTRODUCTION

The purpose of this paper is to share the outcome of cases of scaphoid non-union treated with 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularised graft at our institution, as well as to identify the possible factors for the failure of the procedure.

METHODS

This was a retrospective review of 13 cases of scaphoid fracture non-union treated with 1,2 ICSRA vascularised bone grafting from October 2000 to March 2003. A clinical and radiological review was conducted. Linear regression was performed in order to identify the factors associated with a negative outcome.

RESULTS

Out of the 13 patients with scaphoid non-union, ten (77 percent) had avascular necrosis of the proximal pole. The patients were followed up for a mean duration of 13 (range 3-28) months. Ten out of the 13 (77 percent) patients achieved union.

CONCLUSION

Our results are comparable to those reported by other studies and indicate that avascular necrosis was associated with failure to achieve union.

Nerve-sparing radical prostatectomy: current concepts in a robotic era

Recovery of potency sufficient for penetrative intercourse at a year after surgery varies widely. Much of the progress achieved in the past two decades in improving potency outcomes after radical prostatectomy has resulted from an improved appreciation of the anatomic basis of the nerves responsible for erection. Recent studies suggest alternative and more complex course of nerves than previously described. Better appreciation of the variable and often invisible anatomical course of the cavernosal nerves continues to engender innovations in surgical technique to optimize their preservation. Exciting frontiers of research that include efforts in stem cell neural regeneration, development of specific fluorophores and biomarkers, and performing radical prostatectomy under hypothermic conditions may provide much-needed breakthroughs to improving potency outcomes following radical prostatectomy in this current age of improved life expectancy and heightened patient expectations.

Trauma history and risk of the irritable bowel syndrome in women veterans

BACKGROUND

Over 1.8 million women in the U.S. are veterans of the armed services. They are at increased risk of occupational traumas, including military sexual trauma.

AIM

To evaluate the association between major traumas and irritable bowel syndrome among women veterans accessing Veteran Affairs (VA) healthcare.

METHODS

We administered questionnaires to assess trauma history as well as IBS, post-traumatic stress disorder (PTSD) and depression symptoms to 337 women veterans seen for primary care at VA Women's Clinic between 2006 and 2007. Logistic regression was used to evaluate the association between individual traumas and IBS risk after adjustment for age, ethnicity, PTSD and depression.

RESULTS

Irritable bowel syndrome prevalence was 33.5%. The most frequently reported trauma was sexual assault (38.9%). Seventeen of eighteen traumas were associated with increased IBS risk after adjusting for age, ethnicity, PTSD and depression, with six statistically significant [range of adjusted odds ratios (OR) between 1.85 (95% CI, 1.08-3.16) and 2.6 (95% CI, 1.28-3.67)]. Depression and PTSD were significantly more common in IBS cases than controls, but neither substantially explained the association between trauma and increased IBS risk.

CONCLUSIONS

Women veterans report high frequency of physical and sexual traumas. A lifetime history of a broad range of traumas is independently associated with an elevated risk of the irritable bowel syndrome.

Irritable bowel syndrome symptoms and health related quality of life in female veterans

BACKGROUND

The status and determinants of health-related quality of life (HRQOL) in female veterans with and without irritable bowel syndrome (IBS) are unknown.

AIM

To compare HRQOL in female veterans with and without IBS symptoms and examine the contribution of post-traumatic stress disorder, depression and anxiety to HRQOL.

METHODS

A cross-sectional study of 339 female veterans. Self-report questionnaires were used to evaluate IBS symptoms, post-traumatic stress disorder, depression, anxiety and HRQOL.

RESULTS

Symptoms consistent with IBS were present in 33.5% of participants. Female veterans with IBS symptoms had significant reductions in physical component score and 5 of 8 Health Related Quality of Life subscales and on 7 of 8 Irritable Bowel Syndrome Quality Of Life subscales than female veterans without IBS symptoms. Compared with the US general female population, female veterans had significantly lower Health Related Quality of Life physical component score and mental component scores (MCS) irrespective of IBS symptom status. Differences in the MCS score were most explained by depression, while those in the physical component score were most explained by anxiety.

CONCLUSIONS

Irritable bowel syndrome symptoms in female veterans are associated with considerable reduction in HRQOL. However, female veterans, regardless of IBS symptom status, have lower HRQOL compared with the general US female population.

Ear size as a predictor of chronological age

It is generally observed that older people have bigger ears and noses. Cartilage is known to alter in structure with age. We conducted a cross sectional study to verify the trend between age and the size of two cartilaginous structures, ear and nose. A total of 100 young individuals were compared to older individuals with respect to their ear and nose sizes. We found that the greatest correlation coefficient of age was with ear circumference, and the linear regression equation being: Ear circumference = 88.1 + (0.51 x subject's age). Except for the ear tragus, which correlated insignificantly with age, anatomical variables of the ear had higher correlation with age than anatomical variables of the nose. This study supports the view that as people age, their ears get larger, particularly the ear circumference, which increases on average 0.51 mm per year. This enlargement is likely associated with aging changes of collagen. The knowledge from this study allows us to calculate the age of an individual based on ear size: Subject's age = 1.96 x (Ear circumference in millimeters - 88.1).

Vision-Related Quality of Life and Emotional Impact in Children with Strabismus: A Prospective Study

The potential impact of the surgical correction of strabismus on vision-related quality of life (VRQOL) and the symptoms of anxiety and depression in children with strabismus remain unclear. The present study included 60 children with strabismus: 30 with heterophoria and 30 with heterotropia. A healthy age-and gender-matched control group ( n = 60) was also recruited. The psychological instruments that were used were the short-form 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and the Hospital Anxiety and Depression Scale (HADS). The results demonstrated that eight of the 12 NEI-VFQ-25 subscales were significantly impaired in children with strabismus compared with matched controls. Compared with pre-operative values, significant improvements were noted after surgery in the NEI-VFQ-25 summary score, and the anxiety and depression scores. This study demonstrated that the NEI-VFQ-25 instrument can be used in strabismus children and that surgical interventions can improve VRQOL, anxiety and depression in strabismus patients.

A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China

BACKGROUND

The prevalence of sensitization in patients with asthma and rhinitis in mainland China remains unclear.

OBJECTIVE

Our aim was to estimate the prevalence of allergy in patients with respiratory allergic diseases such as asthma and/or rhinitis attending respiratory clinics within mainland China. The study also investigated regional and annual differences in the prevalence and pattern of sensitization among the patients in China.

METHOD

A cross-sectional survey was performed in 6304 patients suffering from asthma and/or rhinitis in 17 cities from 4 regions of China. Patients completed a standardized questionnaire asking for the presence of respiratory and allergic symptoms. They also underwent skin prick tests with 13 common aeroallergens.

RESULTS

Among the 6304 patients, 4545 (72.1%) had at least one positive skin prick reaction. The overall prevalence of positive skin prick responses was 59.0% for Dermatophagoides farinae, 57.6% for Dermatophagoides pteronyssinus, 40.7% for Blomia tropicalis, 16.1% for American cockroach, 14.0% for dog, 11.5% for Blatella germanica, 11.3% for Artemisia vulgaris, 10.3% for cat, 6.5% for Ambrosia artemisifolia, 6.3% for mixed mould I, 4.4% for mixed mould IV, 3.5% for mixed grass pollen and 2.2% for mixed tree pollen. Sensitizations to common allergens varied widely between geographical areas and demonstrated unique pattern in patients by stratification with age groups, with asthma and/or rhinitis. Severity of rhinitis and asthma was significantly correlated with skin index of reactivity to Artemisia vulgaris, Ambrosia artemisifolia and to D. pteronyssinus, D. farinae and Blomia tropicalis respectively (P < 0.001). Positive reactivity to the tested allergens and concomitant reactivity to multiple allergens including to house dust mites and Blomia tropicalis was markedly increased in patients with both asthma and rhinitis.

CONCLUSION

House dust mites were the most prevalent allergens in patients with asthma and/or rhinitis in China. There were significant differences in patterns of sensitizations in patients from different geographical areas, age groups as well as asthma and/or rhinitis.

Cervical spine motion during flexible bronchoscopy compared with the Lo-Pro GlideScope

BACKGROUND

The most appropriate device for tracheal intubation in patients with potential cervical spine injury remains controversial. We hypothesized that the Lo-Pro GlideScope (LP-G) videolaryngoscope would not cause significantly greater cervical spine movement than fibreoptic bronchoscopy even in the non-immobilized spine.

METHODS

Twenty-eight healthy adults requiring intubation for radiographic procedures were randomized to either the LP-G or the flexible bronchoscope (FB) devices. Continuous fluoroscopy was used to assess cervical spine movement during tracheal intubation. The point of maximum movement was compared with baseline for change in angulation between Occiput (Occ)-C1, Occ-C2, Occ-C4, Occ-C5, C1-2, C2-4, and C4-5. Measurements were made by two independent observers. The change in angulation was also measured for tongue pull and jaw thrust, manoeuvres for enlarging the pharyngeal space, before FB intubation.

RESULTS

LP-G resulted in greater cervical extension compared with FB for every angle calculated, statistically significant between Occ-C1 (P<0.05), Occ-C2 (P<0.05), and Occ-C4 (P<0.01). Tongue pull resulted in significantly less cervical spine motion than FB intubation at Occ-C1, Occ-C2, Occ-C4, and Occ-C5 (P<0.05). When jaw thrust was added to tongue pull, there was a tendency for greater movement than FB intubation at Occ-C1, Occ-C2, and Occ-C3. This was statistically significant at Occ-C1 and Occ-C3 (P<0.05) for one of the two observers.

CONCLUSIONS

During intubation under general anaesthesia, LP-G resulted in greater cervical movement than FB when no cervical immobilization was used in adults without cervical disease. Airway manoeuvres performed before FB, especially jaw thrust, also resulted in cervical spine movement.

Irritable bowel syndrome and dyspepsia among women veterans: prevalence and association with psychological distress

BACKGROUND

The burden of functional GI disorders and their associations with psychological distress in women veterans is unclear.

AIM

To examine 1-year prevalence of irritable bowel syndrome (IBS) and dyspepsia symptoms and their associations with anxiety, depression and post-traumatic stress disorder (PTSD) among women veterans receiving primary care at a Veteran Affairs Medical Center Women's Clinic.

METHODS

Irritable bowel syndrome, dyspepsia and psychological distress were assessed using the validated self-administered Bowel Disorder Questionnaire, the Beck Depression and Anxiety Inventories, as well as the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder Questionnaire.

RESULTS

We enrolled 248 women (84% participation rate). Ninety-three (38%) reported IBS and 51 (21%) dyspepsia symptoms. Women with IBS and dyspepsia reported higher mean scores of anxiety (IBS: 24 vs. 12, P < 0.0005 and dyspepsia: 26 vs. 12, P < 0.0005), depression (IBS: 22 vs. 11, P = 0.0005 and dyspepsia: 23 vs. 11, P < 0.0005) and PTSD (IBS: 87 vs. 69, P < 0.001 and dyspepsia: 86 vs. 69, P < 0.0005). Age- and ethnicity-adjusted logistic regression analyses showed a 3- to 46-fold increase in odds of IBS and dyspepsia among women with anxiety, depression or PTSD.

CONCLUSION

Women veterans have high prevalence of IBS and dyspepsia symptoms, both of which are highly associated with presence of depression, anxiety and PTSD.

Predictors of the scleroderma phenotype in fibroblasts from systemic sclerosis patients

BACKGROUND

Fibroblasts from skin lesions generally exhibit the scleroderma phenotype in the early stage of in vitro culture, and act as one of the most important samples to investigate systemic sclerosis. However, not all cell lines from patients show the scleroderma phenotype, and little prospective evidence can be relied on to predict the phenotype of fibroblasts from systemic sclerosis patients.

OBJECTIVE

This study aims to find the predictive factors related to fibroblast phenotypes.

METHODS

Fibroblast lines from 15 patients with systemic sclerosis were established through explant culture, with their scleroderma phenotypes being determined by real-time reverse transcription-polymerase chain reaction (RT-PCR) of procollagen transcription. Logistic regression analysis was used to analyse the clinical data of these patients. Haematoxylin-eosin staining was performed to observe histopathological differences. Expression of methylation-related factors was detected by real-time reverse transcription-polymerase chain reaction.

RESULTS

Eight of the 15 fibroblast cell lines from patients with systemic sclerosis exhibited the scleroderma phenotype. Logistic regression analysis yielded an equation (Y = -9.718 + 2.525X1) in which X1 significantly represents the Valentini Disease Activity Index. Histopathology results demonstrated that the scleroderma phenotype was positively correlated with leucocyte infiltration. Further laboratory observations showed increased expression of Dnmt1 in the positive phenotype fibroblasts and a positive correlation between elevations of Dnmt1 and the maintenance period of the scleroderma phenotype.

CONCLUSIONS

The results of this study suggest that the Valentini Disease Activity Index and expression of Dnmt1 may act as indicators of the scleroderma phenotype in fibroblasts. Additionally, these data also imply that epigenetic factors, such as Dnmt1, may be involved in the maintenance of the scleroderma phenotype. Our analyses may be beneficial to the research in systemic sclerosis.

Portal protein diversity and phage ecology

Oceanic phages are critical components of the global ecosystem, where they play a role in microbial mortality and evolution. Our understanding of phage diversity is greatly limited by the lack of useful genetic diversity measures. Previous studies, focusing on myophages that infect the marine cyanobacterium Synechococcus, have used the coliphage T4 portal-protein-encoding homologue, gene 20 (g20), as a diversity marker. These studies revealed 10 sequence clusters, 9 oceanic and 1 freshwater, where only 3 contained cultured representatives. We sequenced g20 from 38 marine myophages isolated using a diversity of Synechococcus and Prochlorococcus hosts to see if any would fall into the clusters that lacked cultured representatives. On the contrary, all fell into the three clusters that already contained sequences from cultured phages. Further, there was no obvious relationship between host of isolation, or host range, and g20 sequence similarity. We next expanded our analyses to all available g20 sequences (769 sequences), which include PCR amplicons from wild uncultured phages, non-PCR amplified sequences identified in the Global Ocean Survey (GOS) metagenomic database, as well as sequences from cultured phages, to evaluate the relationship between g20 sequence clusters and habitat features from which the phage sequences were isolated. Even in this meta-data set, very few sequences fell into the sequence clusters without cultured representatives, suggesting that the latter are very rare, or sequencing artefacts. In contrast, sequences most similar to the culture-containing clusters, the freshwater cluster and two novel clusters, were more highly represented, with one particular culture-containing cluster representing the dominant g20 genotype in the unamplified GOS sequence data. Finally, while some g20 sequences were non-randomly distributed with respect to habitat, there were always numerous exceptions to general patterns, indicating that phage portal proteins are not good predictors of a phage's host or the habitat in which a particular phage may thrive.

Expression of the Water Channel Protein Aquaporin-9 in Human Astrocytic Tumours: Correlation with Pathological Grade

This study investigated the expression of the water channel protein aquaporin-9 (AQP9) in 100 cases of human astrocytic tumour compared with normal brain tissue. AQP9 mRNA and protein were assessed using reverse transcription-polymerase chain reaction and Western blot, respectively. The expression of both AQP9 mRNA and protein in astrocytic tumours was significantly greater than in normal brain tissue and was positively correlated with pathological grade. No significant correlations were found between the level of AQP9 mRNA or protein expression and gender, age, tumour size or tumour site. This study indicates that AQP9 may play an important role in the malignant progression of brain astrocytic tumours and may, therefore, be useful as a biomarker in its diagnosis and as a new target for gene therapy. The molecular mechanisms by which AQP9 affects the proliferation and apoptosis of astrocytic tumours need to be studied further.

Maintenance treatment with budesonide 6 mg versus 9 mg once daily in patients with Crohn's disease in remission

BACKGROUND

In previous trials, budesonide 6 mg/day was able to prolong the time to relapse in patients with quiescent Crohn's disease and budesonide 9 mg/day was effective in active disease with limited side effects. The aim of this study was to compare the effectiveness of budesonide 9 mg vs 6 mg once daily on the maintenance of remission and occurrence of adverse events.

METHODS

Double-blind, randomised trial in patients with Crohn's disease in remission. Patients were randomised to receive 6 mg/day or 9 mg/day of budesonide (Budenofalk) without concomitant treatment for Crohn's disease. Endpoints were the time to relapse and relapse rates after one year.

RESULTS

Seventy-six patients were randomised to 6 mg/day and 81 patients to 9 mg/day. Survival analysis showed no differences in the time to relapse. One-year relapse rates were not significantly different (6 mg group 24%; 9 mg group 19%). Any adverse event was reported in 61 and 68% of patients in the 6 mg and 9 mg groups, respectively; none of the 12 serious adverse events were drug related.

CONCLUSION

The one-year relapse rates were low and not significantly different between the group of patients treated with budesonide 6 mg vs 9 mg/day. Also, time to relapse and the number of adverse events were similar in both treatment groups.

Regulation of adiponectin in adipocytes upon exposure to HIV-1

OBJECTIVES

Adipose dysregulation, dyslipidemia, and insulin resistance are hallmarks of HIV-related lipodystrophy. The precise mechanisms behind these disturbances are unknown. In HIV-infected patients, we previously demonstrated a strong relationship between lipodystrophy and levels of adiponectin, an adipose peptide implicated in regulation of glucose and lipid metabolisms. In this study we investigated the effect of HIV on adipocytes, to determine whether HIV can directly infect adipocytes and/or alter the regulation and secretion of the adipocyte-derived hormone adiponectin.

METHODS

Human subcutaneous preadipocytes and adipocytes were exposed to HIV-1 under various conditions. Adiponectin was measured in supernatants and cell lysates.

RESULTS

Although adipocytes expressed CD4, the major HIV receptor, they could not be infected in vitro. However, exposure to HIV dramatically increased the secretion of adiponectin from human adipocytes, in the absence of infection. This was exacerbated with sustained exposure to HIV in a transwell assay. Further, human peripheral mononuclear cells also produced adiponectin, but this was largely dependent upon T-cell activation.

CONCLUSIONS

We propose that the stimulation of adiponectin production by HIV can perturb adiponectin regulation, leading to substantially decreased levels upon viral suppression by antiretroviral therapy. These data suggest a potential molecular mechanism of adiponectin regulation in HIV-infected patients.

Expression of CD30 (Ber-H2) in nasopharyngeal carcinoma, undifferentiated type and lymphoepithelioma-like carcinoma. A comparison study with anaplastic large cell lymphoma

AIMS

Undifferentiated nasopharyngeal non-keratinizing carcinoma (UNPC), formerly known as lymphoepithelioma, frequently metastasizes at an early stage to regional lymph nodes and, thus, may be difficult to distinguish from Hodgkin's lymphoma (HL) or anaplastic large cell lymphoma (ALCL). CD30 expression is a useful diagnostic stain in both HL and ALCL, but its expression in UNPC deserves clarification. The aim of this study was to evaluate CD30 expression in UNPC and lymphoepithelioma-like carcinoma (LELC) from other anatomic locations and compare it with ALCL and squamous cell carcinoma (SCC).

METHODS AND RESULTS

CD30 immunoreactivity was examined in 38 cases of primary or metastatic UNPC, six cases of LELC, 10 cases of SCC and seven cases of ALCL. CD30 immunoreactivity was observed in four of 38 (10.5%) cases of UNPC. CD30 staining was absent in all cases of LELC (0/6) and SCC (0/10). All cases of ALCL (7/7) were strongly positive for CD30.

CONCLUSIONS

The majority of cases of UNPC are immunohistochemically negative for CD30; however, a small subset of cases expresses CD30 antigen. These findings provide additional evidence that CD30 expression is not restricted to neoplasms of lymphoid origin. This should be taken into consideration when interpreting CD30 immunohistology and the possibility of UNPC.

Biodiversity as a source of anticancer drugs

Natural Products have been the most significant source of drugs and drug leads in history. Their dominant role in cancer chemotherapeutics is clear with about 74% of anticancer compounds being either natural products, or natural product-derived. The biodiversity of the world provides a resource of unlimited structural diversity for bioprospecting by international drug discovery programs such as the ICBGs and NCDDGs, the latter focusing exclusively on anticancer compounds. However, many sources of natural products remain largely untapped. Technology is gradually overcoming the traditional difficulties encountered in natural products research by improving access to biodiverse resources, and ensuring the compatibility of samples with high throughput procedures. However, the acquisition of predictive biodiversity remains challenging. Plant and organism species may be selected on the basis of potentially useful phytochemical composition by consulting ethnopharmacological, chemosystematic, and ecological information. On the conservation/political front, the Convention on Biological Diversity (CBD) is allaying the anxiety surrounding the notion of biopiracy, which has defeated many attempts to discover and develop new natural products for human benefit. As it becomes increasingly evident and important, the CBD fosters cooperation and adaptation to new regulations and collaborative research agreements with source countries. Even as the past inadequacies of combinatorial chemistry are being analyzed, the intrinsic value of natural products as a source of drug leads is being increasingly appreciated. Their rich structural and stereochemical characteristics make them valuable as templates for exploring novel molecular diversity with the aim of synthesizing lead generation libraries with greater biological relevance. This will ensure an ample supply of starting materials for screening against the multitude of potentially "druggable" targets uncovered by genomics technologies. Far from being mutually exclusive, biodiversity and genomics should be the driving force of drug discovery in the 21st century.

Computed tomography angiography for the detection and characterization of intra-cranial aneurysms: Current status

Multidetector computed tomography angiography (MD-CTA) of the intra-cranial vessels is now a routine examination, and is becoming fully integrated into the imaging and treatment algorithm of patients presenting with acute subarachnoid haemorrhage in many centres in the UK and Europe. The development and current status of CTA for cerebral aneurysms, and the strengths and limitations of this technique are herein reviewed.

Computed tomography pseudofractures of the mid face and skull base

Thin-section multislice CT delineates numerous normal skull-base and mid-facial bony discontinuities. These represent sutures, fissures and neurovascular foramina or channels, and should be differentiated from fractures. This pictorial review describes and illustrates the characteristic location and multiplanar CT appearances of these structures. Their clinical significance in terms of pathological processes and surgical planning are discussed.

Caesarean scar pregnancy: a diagnosis to consider carefully in patients with risk factors

INTRODUCTION

Caesarean scar pregnancy is rare. A high index of suspicion is necessary to make the right diagnosis early.

CLINICAL PICTURE

Two women, each with a history of 1 previous caesarean delivery, were initially diagnosed with spontaneous abortion in progress when ultrasonography scan revealed the gestational sac to be in the lower uterine cavity. Subsequent ultrasound scans showed that the gestational sac was actually in the anterior uterine wall at the level of the uterine isthmus.

TREATMENT

Both women were managed successfully with intrasac methotrexate injection.

OUTCOME

We report 2 cases of caesarean scar pregnancies mistaken for spontaneous abortions by experienced ultrasonographers.

CONCLUSION

This highlights the difficulty in differentiating between these 2 diagnoses and the importance of having a high index of suspicion in women with risk factors.

The flight experiment ANITA--a high performance air analyser for manned space cabins

Analysing Interferometer for Ambient Air (ANITA) is a flight experiment as precursor for a permanent continuous trace gas monitoring system on the International Space Station (ISS). For over 10 years, under various ESA contracts the flight experiment was defined, designed, breadboarded and set up. For the safety of the crew, ANITA can detect and quantify quasi on-line and simultaneously 32 trace gases with ppm or sub-ppm detection limits. The self-standing measurement system is based on Fourier Transform Infrared Spectrometer (FTIR) technology. The system represents a versatile air monitor allowing for the first time the detection and monitoring of trace gas dynamics of a spacecraft atmosphere. It is envisaged to accommodate ANITA in a Destiny (US LAB) Express Rack on the ISS. The transportation to the ISS is planned with the first ATV 'Jules Verne'. The options are either the Space Shuttle or the Automated Transfer Vehicle.

Carpal tunnel syndrome due to gouty infiltration of the lumbrical muscles and flexor tendons

A case of gout first presenting as carpal tunnel syndrome due to intratendinous and lumbrical muscle involvement with tophi is reported. Surgical decompression with excision of tophi and diseased muscle produced symptomatic relief.

[Study on cytotoxicity to leukemia cell and enhancement of immunologic functions of jiexinkang]

Cytotoxicity to leukemia cell and enhancement of immunologic functions of jiexinkang (JXK, traditional Chinese medicine) were observed in 34 cases of leukemia in vitro. The results showed that the leukemia cytotoxicity in the group of vincristine combined with JXK was significantly higher than that in vincristine alone. It was also found among all the observed cases that 20 refractory or recurred patients resistant to vincristine showed an obvious intention of the anti-toxicity efficiency when JXK was added. Jiexinkang alone had anti-leukemia cell effect, too. We explored JXK effects on immunologic functions in mice, and found that IFNr and NK activities of normal and experimental model mice were significantly higher than those of control group(P < 0.01). The results indicate that JXK has an effect of anti-leukemia cell and may improve the cell-immunologic functions.

A New Technique for the Measurement of the Dynamic Evolution of Surface Tension

We develop a novel technique which deduces the surface tension in air of a fluid as a function of surface age, beginning at age zero. The technique utilizes pointwise measurements of perpendicular free surface profiles of a steady oscillating jet corresponding to a discretization interval on the order of 0.1 ms. We implement the technique on constant-surface-tension test fluids (100% ethanol and 15% ethanol/85% water by volume) to demonstrate the extent to which the technique can qualitatively capture that the surface tensions of these fluids are constant in time, and quantitatively produce values of these constants consistent with static measurements. We then implement the technique on jets of two agricultural surfactant mixtures, Triton X-405 and Triton X-100, and quantitatively deduce the decay of surface tension as a function of surfactant concentration.

Frataxin expression rescues mitochondrial dysfunctions in FRDA cells

Friedreich's ataxia (FRDA) is the result of mutations in the nuclear-encoded frataxin gene, which is expressed in mitochondria. Several lines of evidence have suggested that frataxin is involved in mitochondrial iron homeostasis. We have transfected the frataxin gene into lymphoblasts of FRDA compound heterozygotes (FRDA-CH) with deficient frataxin expression to produce FRDA-CH-t cells in which message and protein are rescued to near-physiological levels. FRDA-CH cells were more sensitive to oxidative stress by challenge with free iron, hydrogen peroxide and the combination, consistent with a Fenton chemical mechanism of pathophysiology, and this sensitivity was rescued to control levels in FRDA-CH-t cells. Iron challenge caused increased mitochondrial iron levels in FRDA-CH cells, and a decreased mitochondrial membrane potential (MMP), both of which were rescued in FRDA-CH-t cells. The rescue of the low MMP, and high mitochondrial iron concentration by frataxin overexpression suggests that these cellular phenotypes are relevant to the central pathophysiological process in FRDA which is aggravated by exposure to free iron. However, even at physiological iron concentrations, FRDA-CH cells had decreased MMP as well as lower activities of aconitase and ICDH (two enzymes supporting MMP), and twice the level of filtrable mitochondrial iron (but no increase in total mitochondrial iron), and the observed phenotypes were either fully or partially rescued in FRDA-CH-t cells. Free iron is known to be toxic. The observation that frataxin deficiency (either directly or indirectly) causes an increase in filtrable mitochondrial iron provides a new hypothesis for the mechanism of cell death in this disease, and could be a target for therapy.

[Determination of chloramphenicol in chloramphenicol and dexamethasone sodium phosphate ear drops by first derivative spectrometry]

Determination of chloramphenicol in the ear drops by first derivative spectrometry was studied. The detecting wavelength was 303.0 nm. The linear range was 0-65.2 micrograms.ml-1 (r = 0.9999). The average recovery was 99.84%, RSD = 0.37% (n = 8). The method is simple and accurate.

Coping with chronic pain: a comparison of two measures

Cognitive-behavioral models of chronic pain hypothesize that how a person copes with pain influences how well he or she adjusts to the pain. Several measures have been developed to assess pain coping, but no studies have yet examined whether these measures are complementary or redundant. In the current study, two pain coping measures (the Chronic Pain Coping Inventory, CPCI, and the Coping Strategies Questionnaire, CSQ) were completed by a large number (N=564) of primarily male veterans referred to a chronic pain program. Regression analyses indicated that the CPCI scales did not contribute unique variance to the prediction of depression over and above the CSQ scales. The CSQ Catastrophizing scale was the single most powerful predictor of depression, although several other CSQ scales (Coping Self-Statements, Diverting Attention, and Increasing Behavioral Activities) also contributed. Both the CPCI and the CSQ contributed unique variance to the prediction of disability, although the CPCI scales appear to be more strongly related to disability than the CSQ scales. The CPCI Guarding scale was the single most powerful predictor of disability of all the coping responses assessed in this study. Other scales predicting disability were the CPCI Seeking Social Support, the CSQ Catastrophizing, and the CSQ Increasing Behavioral Activities. While both CSQ and CPCI contribute unique but modest variance to the prediction of pain severity, the CSQ Catastrophizing scale was the single most powerful predictor of pain severity. The findings of this study are consistent with cognitive-behavioral models of pain. Future research will need to determine whether changes in coping responses (catastrophizing and guarding, in particular) merely reflect, or actually influence, adjustment to chronic pain. In the meantime, clinicians would be wise to give these coping responses particular attention in chronic pain programs.

[P15(INK4B) gene methylation in malignant hematopoietic diseases]

OBJECTIVE

To study the effect of operative region hypermethylation gene in human malignant hematopoietic tumors.

METHODS

The abnormal methylation rate of P(15)(INK4B) gene 5'CpG island in 68 cases of malignant hematopoietic tumor samples were determined by methylation specific PCR using bisulfite modified DNA.

RESULTS

The methylation rates of P(15)(INK4B) were 84%, 0, 50% and 75%, respectively, for 25 cases of acute myeloid leukemia (AML), 15 chronic myeloid leukemia (CML), 16 myelodysplastic syndrome (MDS) and 12 multiple myeloma (MM). P(15)(INK4B) gene was frequently methylated in patients with high risk MDS and early stage of MM.

CONCLUSION

Hypermethylation of P(15)(INK4B) gene is one of the main causes of its inactivation. Hypermethylation of CpG island was closely related to the development of malignant hematopoietic diseases.

Membrane sweeping in conjunction with labor induction

OBJECTIVE

To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial.

METHODS

We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum dose of oxytocin used, induction-labor interval, and mode of delivery.

RESULTS

We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E(2) and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor interval (13.6 +/- 1.4 versus 17.3 +/- 1.2 hours, P =.048), lower mean maximum dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P =.01), and increased normal delivery rates (vaginal delivery 83. 3% versus 58.2%, P =.01). Sweeping also had a favorable effect on nulliparas who received oxytocin alone (mean induction-labor interval 5.8 +/- 3.1 versus 11.2 +/- 3.6 hours, P =.04; mean maximum dose 8.8 +/- 1.3 versus 16.3 +/- 1.9 mU/min, P =.01). Those differences were limited to women with unfavorable cervices. There were no differences in any outcome measures in multiparous women.

CONCLUSION

Sweeping of the membranes during induction of labor had a beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE(2).

Embossed Bragg Gratings Based on Organically Modified Silane Waveguides in InP

Considering the large variety of applications for optical glass waveguide gratings, the effective production method of embossing for micropatterning, and the unique advantages of InP-based materials, we expect that hybridization of embossed optical glass waveguide gratings and InP substrates will inevitably lead to new applications in integrated optics. We present our preliminary results of research toward the development of solgel-derived glass waveguide gratings made by embossing on InP. Theoretically, the dependence of the stop-band FWHM and transmission contrast of the grating filter on the grating length, and the relationship between the Bragg grating's reflective wavelength and the dopant concentration in the solgel waveguide, are obtained. Experimentally, using organically modified silane, we solve the problem of mismatching of SiO(2) and InP, and successfully fabricate an embossed glass grating with a second-order Bragg reflection wavelength of 1580 nm and a FWHM of 0.7 nm fabricated upon a solgel waveguide on an InP substrate.

A cDNA located on chromosome 7q32 shows loss of expression in epithelial cell line of nasopharyngeal carcinoma

OBJECTIVE

To isolate and clone the tumor suppressor gene on chromosomal region 7q32 correlated with the carcinogenesis of human nasopharyngeal carcinoma (NPC).

METHODS

The genotypes of polymorphic microsatellite markers on 7q32 in DNA from 24 biopsies of nasopharyngeal carcinoma and matched normal blood cells were identified. The expression levels of 20 expressed sequence tags (ESTs) on 7q32 between human nasopharyngeal carcinoma epithelial 1 (HNE1) and primary cultures of normal nasopharyngeal epithelial (PNNE) cells were compared using differential RT-PCR and Northern hybridization. The quantity of AA070437 DNA and mRNA was detected by differential PCR and differential RT-PCR, respectively.

RESULTS

Loss of heterozygosity (LOH) was found in 25%-46% of NPC biopsies. AA070437 EST expression was down-regulated in HNE1 cell compared to PNNE cells. The down-regulation of AA070437 was found in 30.7% of NPC biopsies and allelic loss of AA070437 was observed in 29.1% of NPC biopsies.

CONCLUSION

Our results show that AA070437 EST is negatively related with the occurrence of human NPC and may represent a candidate tumor suppressor gene of NPC on 7q32.