Very Early Treatment for Infantile-Onset Pompe Disease Contributes to Better Outcomes

OBJECTIVE

To evaluate whether very early treatment in our patients would result in better clinical outcomes and to compare these data with other infantile-onset Pompe disease (IOPD) cohort studies.

METHODS

In this nationwide program, 669,797 newborns were screened for Pompe disease. We diagnosed IOPD in 14 of these newborns, and all were treated and followed in our hospital.

RESULTS

After 2010, the mean age at first enzyme-replacement therapy (ERT) was 11.92 days. Our patients had better biological, physical, and developmental outcomes and lower anti-rh acid α-glucosidase antibodies after 2 years of treatment, even compared with one group that began ERT just 10 days later than our cohort. No patient had a hearing disorder or abnormal vision. The mean age for independent walking was 11.6 ± 1.3 months, the same age as normal children.

CONCLUSIONS

ERT for patients with IOPD should be initiated as early as possible before irreversible damage occurs. Our results indicate that early identification of patients with IOPD allows for the very early initiation of ERT. Starting ERT even a few days earlier may lead to better patient outcomes.

TGF-β1 polymorphisms and familial aggregation of liver cancer in Guangxi, China

The goal of present study was to investigate the relationship between polymorphisms of TGF-β1 and familial aggregation of liver cancer in Guangxi Zhuang, Han, and Yao populations. We conducted a population-based case-control family study of liver cancer in Guanxi, China. A total of 214 individuals from 37 case families were surveyed for polymorphisms in TGF-β1. We genotyped six functional TGF-β1 polymorphisms: rs1800469, rs2241715, rs2241716, rs11466345, rs8105161, and rs747857. Levels of TGF-β1, hepatitis B surface antigen, and anti-hepatitis C virus in all serum samples were detected using the enzyme-linked immunoassay method, and presence of hepatitis B virus (HBV) DNA was determined using polymerase chain reaction amplification. A standardized questionnaire was used to collect information from subjects, including alcohol consumption, smoking, eating, and water drinking habits. The results were compared with those from 214 control individuals. The results showed that the TGF-β1 genotypes rs1800469, rs2241715, rs2241715, and rs8105161 were more frequent in patients than in controls. The risk factors for familial aggregation of liver cancer in Guangxi were determined, from high to low, to be: drinking sugared beverages > alcohol consumption > HBV DNA-positive > rs1800469 TT homozygous genotype > rs2241715 TT homozygous genotype. The results suggested that TGF-β1 rs1800469 TT and rs2241715 TT homozygote genotypes represent the genetic factors underlying familial clustering of liver cancer in Guangxi, and that drinking water use, alcohol consumption, and testing positive for HBV DNA are the main environmental factors contributing to familial aggregation of liver cancer in Guangxi.

The use of transcallosal-interforniceal approach for microsurgical removal of the third ventricle tumors

AIM

The third ventricle is located deep in the brain and is adjacent to important neurovascular structures. This makes tumor resection in this region difficult and causes more postoperative complications than surgeries in other regions of the brain. The objective of this study was to investigate the feasibility and clinical effects of transcallosal-interforniceal approach for microsurgical removal of the third ventricle tumors.

METHODS

After preoperative evaluation, 23 patients with the third ventricle tumors were microsurgically operated using the transcallosal-interforniceal approach.

RESULTS

Of these 23 patients, 12 (52.2%) underwent total excision, 9 (39.1%) had subtotal resection, and the remaining 2 (8.7%) underwent partial excision. After surgery, the following complications were observed: diabetes insipidus (11 patients), hemorrhages of the upper digestive tract (2 patients), central fever (1 patient), and memory impairment (1 patient). No mortality in the perioperative period was reported.

CONCLUSION

The surgical procedure using the transcallosal-interforniceal approach is direct and provides good surgical field exposure and fewer post operational compilations. This approach should be considered as the method of choice for surgical removal of the third ventricle tumors.

Association of polymorphisms of the xeroderma pigmentosum complementation group F gene with increased glioma risk

We aimed to investigate the role of 4 single nucleotide polymorphisms of the xeroderma pigmentosum complementation group F (XPF) gene (rs3136038, rs1799798, rs1800067, and rs2276466) in glioma, and the roles of gene-gene interactions in the risk of developing this type of cancer. We collected samples from 225 glioma cases and 262 controls and genotyped the rs3136038, rs1799798, rs1800067, and rs2276466 polymorphisms using a 384-well plate format with the Sequenom MassARRAY platform. Individuals carrying the rs1800067 GG genotype were more likely to have an increased risk of glioma when compared with carriers of the A/A genotype in a co-dominant model, with an odds ratio (OR) [95% confidence interval (CI)] of 2.85 (1.14-7.76). However, we did not find an association with increased risk of glioma for the polymorphisms rs3136038, rs1799798, and rs2276466 in XPF. The combination genotype of the rs1800067 G allele and the rs2276466 G allele was associated with a moderate risk of glioma (OR = 1.71, 95%CI = 1.02-2.87). Our study suggests that the rs1800067 genetic variant of XPF functions in the development of glioma.

Safety and immunogenicity of an oral DNA vaccine encoding Sip of Streptococcus agalactiae from Nile tilapia Oreochromis niloticus delivered by live attenuated Salmonella typhimurium

Attenuated Salmonella typhimurium SL7207 was used as a carrier for a reconstructed DNA vaccine against Streptococcus agalactiae. A 1.02 kb DNA fragment, encoding for a portion of the surface immunogenic protein (Sip) of S. agalactiae was inserted into pVAX1. The recombinant plasmid pVAX1-sip was transfected in EPC cells to detect the transient expression by an indirect immunofluorescence assay, together with Western blot analysis. The pVAX1-sip was transformed by electroporation into SL7207. The stability of pVAX1-sip into Salmonella was over 90% after 50 generations with antibiotic selection in vitro while remained stable over 80% during 35 generations under antibiotic-free conditions. The LD50 of SL/pVAX1-sip was 1.7 × 10(11) CFU/fish by intragastric administration which indicated a quite low virulence. Tilapias were inoculated orally at 10(8) CFU/fish, the recombinant bacteria were found present in intestinal tract, spleens and livers and eventually eliminated from the tissues 4 weeks after immunization. Fish immunized at 10(7), 10(8) and 10(9) CFU/fish with different immunization times caused various levels of serum antibody and an effective protection against lethal challenge with the wild-type strain S. agalactiae. Integration studies showed that the pVAX1-sip did not integrate with tilapia chromosomes. The DNA vaccine SL/pVAX1-sip was proved to be safe and effective in protecting tilapias against S. agalactiae infection.

Submerged cultivation of mycelium with high ergothioneine content from the culinary-medicinal king oyster mushroom Pleurotus eryngii (higher Basidiomycetes) and its composition

The culinary-medicinal king oyster mushroom, Pleurotus eryngii, was used to produce mycelia with high ergothioneine content using a one-factor-at-a-time method. The optimal culture conditions for mycelia harvested at day 14 were 25°C, 10% inoculation rate, 2% glucose, 0.5% yeast extract, and no adjustment to the initial pH value. With histidine or amino acid mix added, biomasses and the ergothioneine content of mycelia were higher than those of the control. The ergothioneine content of mycelia harvested at days 16-20 were higher than that of mycelia harvested at day 14. In addition, the ergothioneine content of mycelia from the fermentor (5.84-5.76 mg/g) was much higher than that of mycelia from the shaken flask (4.93-5.04 mg/g). Mycelia with high ergothioneine content showed a profile of proximate composition similar to that of regular mycelia but lost its characteristic umami taste. Overall, mycelia high in ergothioneine could be prepared by optimal culture conditions, the addition of precursors, prolonged harvest, and aeration in the fermentor.

Preparation of culinary-medicinal king oyster mushroom Pleurotus eryngii-fermented products with high ergothioneine content and their taste quality

Pleurotus eryngii (DC. : Fr.) Ouel. was used in solid-state fermentation to develop novel mushroom products with a high amount of ergothioneine. The correlation coefficients between ergothioneine content and biomass were 0.8878 and 0.9206 for fermented adlay and buckwheat, respectively. Using optimal conditions, Pleurotus-fermented adlay and buckwheat (PFA and PFB) with the ergothioneine contents of 795.5 and 786.1 mg/ kg, respectively, were prepared. However, mycelia contained the highest ergothioneine content of 1514.6 mg/kg. As a result of SSF by P. eryngii, PFA and PFB contained more taste components than adlay and buckwheat, as evidenced by higher contents of total sugars and polyols, total free amino acids and monosodium glutamate-like components, and total and flavor 5'-nucleotides. In addition, PFB and buckwheat showed comparable equivalent umami concentration (EUC) values, whereas PFA showed a higher EUC value than adlay. Overall, Pleurotus-fermented products with a high amount of ergothioneine will be a novel functional food.

Ultra long SiCN nanowires and SiCN/SiO2 nanocables: synthesis, characterization, and electrical property

SiCN nanowires are synthesized by pyrolysis of hexamethyldisilazane (HMDSN) using ferrocene as a catalyst precursor at 1200 degrees C in a flowing argon atmosphere on the surface of mullite substrate, polycrystalline alumina wafer and quartz tube. In oxygen-contained argon atmosphere, SiCN/SiO2 nanocables are synthesized. The as-synthesized products are characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy and high-resolution electron microscopy equipped with energy dispersive X-ray spectroscopy. The lengths of the nanowires and nanocables are in the millimeter range. The diameter of the SiCN nanowires grown on mullite substrate and alumina wafer ranges from about 10-70 nm, while that of the nanowires grown on quartz tube surface is in the range of around 7-10 nm. The diameters of the SiCN/SiO2 nanocables are relatively large. A vapor-liquid-solid growth mechanism of the nanostructures is proposed. The electrical resistivity of a single SiCN/SiO2 nanocable is reported for the first time.

Alteration in the voltage dependence of NMDA receptor channels in rat dorsal horn neurones following peripheral inflammation

1. It has been proposed that the activation of NMDA receptors and upregulation of protein kinase C (PKC) underlie the exaggerated and persistent pain experienced in the inflammatory state. However, there is no direct evidence to show that inflammation alters the function of NMDA receptors. 2. We examined the voltage-dependent properties of NMDA receptor channels in rat dorsal horn neurones that receive sensory inputs from an inflamed hindpaw. 3. Peripheral inflammation was induced by injections of complete Freund's adjuvant (CFA). Membrane currents were measured using the perforated patch-clamp technique. 4. After CFA treatment, the current-voltage relationship of NMDA receptor channels was shifted in the hyperpolarized direction. This resulted in enhanced NMDA responses at negative potentials. 5. The change was mediated by PKC because the voltage shift was blocked by the selective PKC inhibitors chelerythrine and bisindolylmaleimide I. 6. Furthermore, the Mg(2+) blockade of NMDA receptors was reduced. This reduction could account for the shift in the voltage dependence of NMDA receptor channels. 7. These results indicate that NMDA receptor channel characteristics in the dorsal horn are altered by inflammation, and that the changes observed could contribute to the hyperalgesia and allodynia associated with tissue injury.

[Studies on bioconversion conditions and stereoselectivity of Arthrobacter K1108 hydantoinase]

The bioconversion conditions of hydantoinase of Arthrobacter K1108 were studied. It was shown that the optimum temperature of the enzyme is 55 degrees C, and the optimum pH is 7.0. The enzyme can be activated by Co2+ and Fe2+, while inhibited by Ca2+. The optimal substrate of the hydantoinase is 5-benzylhydantoin, while 5-phenylhydantoin and 5-indolylmethylhydantoin cannot effectively digested, showing a high specificity on the substrates. An investigation on the hydantoinase stereoselectivity mechanism showed that the N-carbamoylamino acid hydrolase is stereoselective but the hydantoin hydrolase is not.

Protection from experimental endotoxemia by a recombinant adeno-associated virus encoding interleukin 10

BACKGROUND

Interleukin 10 (IL-10) is a homodimeric cytokine that shows considerable clinical promise. Adeno-associated virus (AAV) vectors appear increasingly useful for in vivo gene-transfer applications.

METHODS

A recombinant AAV type 2 vector encoding human IL-10 (rAAVhIL10) was constructed by using an adenoviral-free, three-plasmid co-transfection. Cytokine production was measured by using an enzyme-linked immunosorbent assay. Endotoxic shock was induced by lipopolysaccharide (LPS) injection.

RESULTS

As media from rAAVhIL10-infected COS cells caused a dose-dependent blockade of IL-12 secretion from spleen cells of IL-10 knockout (KO) mice challenged with Brucella abortus, it was clear that vector-derived hIL-10 was biologically active in vitro. Intravenous or intramuscular administration of relatively modest levels of rAAVhIL10 (10(10) genomes) to IL-10 KO mice resulted in hIL-10 secretion into the bloodstream, which, at 8 weeks, gave median serum levels of 0.9 and 0.45 pg/ml, respectively. Acute endotoxic shock led to a 33% mortality rate, and severe morbidity, in control IL-10 KO mice, whereas no mortality and little morbidity were seen in IL-10 KO mice given rAAVhIL10 7 weeks earlier.

CONCLUSIONS

The findings demonstrate that a modest dose of rAAVhIL10 administered in vivo provides long-term protection against LPS-induced endotoxic shock in a murine model. Thus, this vector may be useful for clinical applications requiring sustained IL-10 expression, for example in the treatment of several autoimmune diseases.

IL-12 induction by a TH1-inducing adjuvant in vivo: dendritic cell subsets and regulation by IL-10

IL-12 induction is critical for immune responses against many viruses and intracellular bacterial pathogens. Recent studies suggest that IL-12-secreting dendritic cells (DC) are potent Th1-inducing APC. However, controversy exists concerning the function of DC subsets. Murine studies have suggested that CD8(+) DC preferentially induce Th1 responses, whereas CD8(-) DC induce Th2 development; in this model, different DC subsets prime different responses. Alternatively, the propensity of DC subsets to prime a Th1 response could depend upon the type of initial stimulus. We used a prototypic Th1-inducing adjuvant, heat-killed Brucella abortus (HKBA) to assess stimulation of DC subsets, relationship between Ag burden and IL-12 production, and down-regulation of DC subset IL-12 production by IL-10. In this study, we show that DC were sole producers of IL-12, although most HKBA uptake was by splenic macrophages and granulocytes. More CD8(-) than CD8(+) DC produced IL-12 after HKBA challenge, whereas only CD8(+) DC produced IL-12 after injection of another Th1-promoting microbial substance, soluble Toxoplasma gondii Ags. Studies in IL-10-deficient mice revealed that IL-10 down-regulates frequency and duration of IL-12 production by both DC subsets. In the absence of IL-10, IL-12 expression is enabled in CD11c(low) cells, but not in macrophages or granulocytes. These findings support the concept of DC as the major IL-12 producers in spleens, but challenge the notion that CD8(+) and CD8(-) DC are destined to selectively induce Th1 or Th2 responses, respectively. Thus, the nature of the stimulating substance is important in determining which DC subsets are activated to produce IL-12.

High prevalence of TT virus-related DNA (90%) and diverse viral genotypes in Norwegian blood donors

Early estimates of the prevalence of TTV viremia in healthy adults of developed countries were in the order of 1--10 %, while similar estimates in Third World countries were considerably higher. Using three different PCRs, TTV-related DNA was detected in serum from 180 out of the 201 Norwegian blood donors tested, indicating that these viruses are almost universally present in adults. Sequence analysis revealed heterogeneity similar to what is found world-wide. The data suggest that the previous discrepancy in prevalences might be related to a lower serum concentration of virus in developed countries. The high prevalence adds evidence to the benign nature of the virus.

Immunity and protection against Brucella abortus

Brucella abortus is an intracellular pathogen that causes disease in cattle and in humans. The response against B. abortus involves the whole gamut of the immune system, from innate to adaptive immunity resulting from stimulation of antigen-presenting cells, NK cells, CD4(+) and CD8(+) T cells, and B cells.

[The design of a practical instant ECG pocket recorder]

The Holter is no doubt very useful in clinic to help doctor to capture and understand the seizure from the ECG. But the device is not convenient to be use at home and is still very expensive now. This paper introduces a practical instant ECG recorder which a patient can take with at any time. It's cheap and easy of use.

A study of the process and kinetics of electrochemical deposition and the hydrothermal synthesis of hydroxyapatite coatings

Hydroxyapatite (HAp) coatings were prepared using electrochemical deposition and post-hydrothermal synthesis. The composition and morphology of coatings at each processing step was studied through the application of scanning electron microscopy (SEM), X-ray diffraction (XRD) and infra-red spectroscopy (IR). The mechanism and kinetics of hydrothermal synthesis were considered in particular, and the influence of the temperature and time on the HAp formation rate was also investigated. The results show that the electrochemical deposition coatings are composed of CaHPO42H2O crystals which are converted into needle-like HAp crystals after post-hydrothermal treatment. The HAp content of the coatings increases with the treatment temperature and time. The synthesis rate also increases with the pH value of the water. The formation of HAp coatings is considered to be a combination of several reactions. An Arrhenius relationship was found between the HAp formation rate and the temperature, and an apparent activation energy of 94.4 KJ/mol was obtained by calculation.

Effects of four methods of sperm preparation on motion characteristics and nitric oxide concentration in laboratory-prepared oligospermia

BACKGROUND

To compare four different spermatozoa preparation methods in semen samples with respect to recovery rate, percent motility, path and progressive velocity, and nitric oxide (NO) production before and after centrifugation.

METHODS

Each of 36 semen specimens was diluted to 1 x 10(6)/ml and divided into four 1-ml aliquots for sperm processing using four methods: swim-up, two (Percoll II) and three (Percoll III) layer Percoll (Pharmacia Biotech AB, Uppsala, Sweden) gradients and albumin columns. The motile sperm recovery rate, percent motility and motion parameters were measured for each semen specimen (n = 36) before and after processing using the four methods. NO was measured with the use of a chemiluminescence method before and after centrifugation (n = 17).

RESULTS

The sperm recovery rate was higher using both Percoll gradients than with the other two methods (Percoll II, 68 +/- 20.5%, Percoll III, 75.3 +/- 22.2% vs swim-up, 25.8 +/- 9.9% and albumin, 33.1 +/- 20.7%). The results were similar for total motile cells (Percoll II, 3.55 +/- 1.72 x 10(6)/ml, Percoll III, 4.25 +/- 1.29 x 10(6)/ml vs swim-up, 1.19 +/- 0.71 x 10(6)/ml and albumin, 1.89 +/- 1.36 x 10(6)/ml). Both Percoll methods and the albumin method produced a statistically significant improvement over the swim-up method in motility. The albumin column method resulted in the least path and progressive velocities (51.3 +/- 15.4 microns/s and 46.2 +/- 16.5 microns/s, respectively). NO produced during sperm processing did not differ significantly among the four processing methods (swim-up, 4,531 +/- 1,626 nM, Percoll II, 5,119 +/- 3,969 nM, Percoll III, 6,060 +/- 5,512 nM, albumin 4,838 +/- 2,462 nM).

CONCLUSIONS

Our data suggest that Percoll methods are superior to swim-up and albumin columns for sperm preparation, yielding good sperm recovery, motility and motion characteristics. The trend toward lower NO levels among samples prepared using albumin columns did not reach statistical significance.

Anterolateral thigh vastus lateralis myocutaneous flap for vulvar reconstruction after radical vulvectomy: a preliminary experience

BACKGROUND

There are many myocutaneous flap methods which have been reported for the immediate reconstruction of large vulvar defects created by deforming radical cancer surgery in the female perineum except for the anterolateral thigh vastus lateralis myocutaneous flap. The present report describes our preliminary experience with the use of this flap in a patient who underwent radical vulvectomy for locally advanced squamous cell carcinoma of the vulva.

CASE

A 75-year-old woman underwent radical vulvectomy with bilateral inguinal lymphadenectomy due to right vulvar squamous cell carcinoma. The large vulvar defect was immediately reconstructed by using anterolateral thigh vastus lateralis myocutaneous flap. The postoperative course was uneventful. In addition to the expected primary healing, the neovulva had a relatively normal appearance with satisfactory sensation and function and the donor defect was found to be minimal both functionally and aesthetically.

CONCLUSION

This technique can be used as an alternative method for vulvar reconstruction after radical vulvectomy. Further studies are warranted to prove the efficacy of this myocutaneous flap in reconstructing large vulvar defects.

Actions of endomorphins on synaptic transmission of Adelta-fibers in spinal cord dorsal horn neurons

The effects of endogenous mu-opioid ligands, endomorphins, on Adelta-afferent-evoked excitatory postsynaptic currents (EPSCs) were studied in substantia gelatinosa neurons in spinal cord slices. Under voltage-clamp conditions, endomorphins blocked the evoked EPSCs in a dose-dependent manner. To determine if the block resulted from changes in transmitter release from glutamatergic synaptic terminals, the opioid actions on miniature excitatory postsynaptic currents (mEPSCs) were examined. Endomorphins (1 microM) reduced the frequency but not the amplitude of mEPSCs, suggesting that endomorphins directly act on presynaptic terminals. The effects of endomorphins on the unitary (quantal) properties of the evoked EPSCs were also studied. Endomorphins reduced unitary content without significantly changing unitary amplitude. These results suggest that in addition to presynaptic actions on interneurons, endomorphins also inhibit evoked EPSCs by reducing transmitter release from Adelta-afferent terminals.

Mechanism underlying increased neuronal activity in the rat ventrolateral periaqueductal grey by a mu-opioid

1. The overall effect of the mu-opioid receptor agonist DAMGO (Tyr-D-Ala-Gly-MePhe-Gly-ol) on ventrolateral periaqueductal grey (PAG) neurons in brain slices was studied using the whole-cell patch-clamp recording technique. 2. Under current-clamp conditions, DAMGO (1 microM) increased cell firing in many PAG neurons even though the opioid induced hyperpolarization and inhibited excitatory postsynaptic potentials (EPSPs) in these cells. 3. The increase in cell activity by DAMGO was observed in both transverse and horizontal slices. The increase persisted when the membrane potential was re-depolarized to the control level. Thus, different planes of sections or the removal of Na+ channel inactivation could not account for the observation. 4. The GABA antagonist bicuculline caused cell firing, mimicking the excitatory effect of DAMGO. Unlike DAMGO, however, bicuculline depolarized PAG cells. 5. Under voltage-clamp conditions, with the same driving force, the evoked inhibitory postsynaptic currents (IPSCs) in these neurons were 2.3 times larger than the evoked excitatory postsynaptic currents (EPSCs). Furthermore, DAMGO inhibited IPSCs by 60.7% while it inhibited EPSCs by 35.3%. 6. We propose that the overall effect of an opioid depends on the dynamic balance of its excitatory and inhibitory actions. In the PAG, the blockade of the inhibitory drive of GABAergic inputs by DAMGO is large. It overcomes the DAMGO-induced hyperpolarization and inhibition of EPSCs and thus results in the excitation of these neurons.

The impact of department sub-division on hospital performance

BACKGROUND

Chang Gung Memorial Hospital is the first hospital in Taiwan to adopt the 'sub-division management'. The hospital sub-divided extensively growing departments into two or more similar sub-divisions. This study compared the relative performance before and after the implementation of "sub-division management".

METHODS

The cardiac department of Chang Gung Memorial Hospital was subdivided into Cardiac I and Cardiac II in July 1992. This study collected the managerial information of cardiac inpatients from 1991 through 1993 in Chang Gung Memorial Hospital. By exploring the effects of the "sub-division management" and other confounding factors, we tried to find out the possible impact they brought to hospital performance.

RESULTS

Considering a time trend effect, the results of regression indicate that 'sub-division' mechanism had little effect on departmental performance. However, the performance is different between Cardiac I and Cardiac II in the aspect of total expenditure per admission, average length of stay, and average number of discharge per physician. These differences might be affected by the characteristics of physicians' sub-specialties rather than the implementation of sub-division management.

CONCLUSION

The significant decrease in mortality rate of patients in the cardiology department after the implementation might suggest that the quality of care in the cardiology department increased after the introduction of sub-divisions. The long-term effects of practice behavior induced by competition within and between sub-divisions require further organizational and behavioral studies.