Comparative study of functional and aesthetically outcomes of reverse digital artery and reverse dorsal homodigital island flaps for fingertip repair

This retrospective study was designed to compare functional and cosmetic outcomes of the reverse digital artery island flap and reverse dorsal homodigital island flap in fingertip repair. A total of 23 patients were followed for 24 to 30 months. The reverse digital artery island flap was used in 12 patients, and reverse dorsal homodigital island flap in another 11 patients. Flap sensibility was assessed using the Semmes-Weinstein monofilament test and static 2-point discrimination test. Patient satisfaction, active motion of the finger joints, complications and cold intolerance were evaluated. The static 2-point discrimination and Michigan Hand Outcomes Questionnaire (appearance) of the fingers treated with a reverse digital artery flap were significantly better than those with a reverse dorsal homodigital flap. The static 2-point discrimination of the skin-grafted donor sides after dorsal homodigital flap were poorer than that in the contralateral finger. No significant differences were found between the two flaps for pressure or touch sensibility, active ranges of digital motion, complications and cold intolerance.

LEVEL OF EVIDENCE

III.

Anti-CII antibody as a novel indicator to assess disease activity in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that affects a variety of organ systems. Anti-dsDNA Abs and complement factors have been used as indicators of lupus activity for more than 50 years. A novel indicator of activation in SLE is reported in this paper. Anti-collagen type II (CII) Ab was obviously elevated in patients with SLE compared to those patients with ankylosing spondylitis (AS) and healthy controls (HCs). Anti-CII-Ab-positive patients with SLE showed significantly higher levels of serum IgG and higher titers of ANA but lower levels of C3 and C4 than controls. A positive correlation was demonstrated between anti-CII Ab and serum IgG in SLE patients (r = 0.50, p < 0.0001). The negative correlations of anti-CII Ab with C3 and C4 were observed in SLE patients (r = -0.36, p = 0.0013; r = -0.37, p = 0.0006, respectively). The reduced anti-CII Ab level was accompanied by decreased level of serum IgG and increased levels of C3 and C4 after regular treatment. Therefore, anti-CII Ab could be a novel indicator for monitoring activity of SLE.

Dental Abnormalities Caused by Novel Compound Heterozygous CTSK Mutations

Cathepsin K (CTSK) is an important protease responsible for degrading type I collagen, osteopontin, and other bone matrix proteins. The mutations in the CTSK gene can cause pycnodysostosis (OMIM 265800), a rare autosomal recessive bone dysplasia. Patients with pycnodysostosis have been reported to present specific dental abnormalities; however, whether these dental abnormalities are related to dysfunctional CTSK has never been reported. Here we investigated the histologic changes of cementum and alveolar bone in a pycnodysostosis patient, caused by novel compound heterozygous mutations in the CTSK gene (c.87 G>A p.W29X and c.848 A>G p.Y283C). The most impressive manifestations in tooth were extensive periradicular high-density clumps with unclear periodontal space by orthopantomography examination and micro-computed tomography scanning analysis. Hematoxylin/eosin and toluidine blue staining and atomic force microscopy analysis showed that the cementum became significantly thickened, softened, and full of cementocytes. The disorganized bone structure was the main character of alveolar bone. The p.W29X mutation may represent the loss-of-function allele with an earlier termination codon in the precursor CTSK polypeptide. Residue Y283 is highly conserved among papain-like cysteine proteases. Three-dimensional structure modeling analysis found that the loss of the hydroxybenzene residue in the Y283C mutation would interrupt the hydrogen network and possibly affect the self-cleavage of the CTSK enzyme. Furthermore, p.Y283C mutation did not affect the mRNA and protein levels of overexpressed CTSK in COS-7 system but did reduce CTSK enzyme activity. In conclusion, the histologic and ultrastructural changes of cementum and alveolar bone might be affected by CTSK mutation via reduction of its enzyme activity (clinical trial registration: ChiCTR-TNC-10000876).

Changes and clinical significance of peripheral blood helper T lymphocyte and natural killer (NK) cells in unexplained recurrent spontaneous abortion (URSA) patients after abortion and successful pregnancy

OBJECTIVE

This study aims to investigate the number changes and the clinical significance of the peripheral blood T lymphocyte subsets and NK (natural killer) cells in unexplained recurrent spontaneous abortion (URSA) patients before and after abortion, as well as after successful pregnancy.

MATERIALS AND METHODS

Thirty-nine URSA patients (URSA-abortion group), among who 22 patients were followed up until the final successful parturition (URSA-pregnancy group), 31 normal-pregnancy (NP) cases and 25 normal non-pregnancy (NNP) control cases in which the peripheral blood T lymphocytes and subsets, B cells, and NK cells were assessed flow cytometry.

RESULTS

Compared with the URSA-pregnancy group and the NP group, the Th cells and NK cells of the URSA-abortion group increased (p < 0.05); compared with the NNP group, the total number of T cells decreased after the first, second, and third month of the URSA abortion (p < 0.05); Th cells decreased within one to six months of the URSA abortion (p < 0.05); proportion of NK cells was significantly higher in URSA patients (p < 0.05).

CONCLUSION

The abnormal numbers of the peripheral blood T cell subsets and NK cells were related with the occurrence of URSA.

Effect of sonication on UV disinfectability of primary effluents

In this paper, the effect of sonication on the UV disinfection kinetics of primary effluents was investigated. Wastewater samples were collected from local municipal treatment plants and were sonicated with a 20-kHz ultrasound reactor at constant power but varying sonication times. Sonicated samples were irradiated using low-pressure UV light to obtain the UV dose-response curves (DRC). Results showed that sonication improved the UV disinfection of primary effluents by (1) increasing the initial slope of DRC (i.e., k1) and (2) decreasing the tailing level of the UV dose-response curve (i.e., beta). This improvement was confirmed to be caused by the breakage of large particles (> 60 microm) that are known to protect coliforms from UV photons. It also was found that the log reduction of the tailing level of DRC was directly proportional to the log reduction of the number of large particles (> 60 microm) present in the effluent sample. Although the number of large particles was proportional to the coliform count at high UV dosage, the proportionality constant varied from 0.05 to 0.25, depending on the sample.

Segmental bone tissue engineering by seeding osteoblast precursor cells into titanium mesh-coral composite scaffolds

The size and specific shape of bone grafts are important for jaw reconstruction. In this experiment, segmental bone grafts were engineered in a predetermined shape via seeding osteoblast precursor cells into titanium mesh-coral composite scaffolds. Titanium meshes were moulded into the shape of a column with length 12 mm and diameter 8mm. The column was filled with natural coral granules and the complex acted as a cell-seeding scaffold. About 4 x 10(7) osteoblast precursor cells in 200 microl cell-culture medium were seeded into each of six scaffolds and incubated in vitro for 2 days. Then, the composites were implanted subcutaneously into the backs of nude mice and incubated in vivo. Two months after implantation, the animals were killed and new bone formed in the scaffolds was investigated by gross inspection, X-ray examination, histological observation and mechanical testing. The results showed that newly formed tissue was red and presented the gross appearance of bone, and kept the original shape of the column. Titanium mesh was situated on the surface of the bone graft. An X-ray blocking shadow was observed in and around the titanium scaffolds; most of the coral granules had been absorbed. Histological observation demonstrated a large amount of new bone formed and integrated well with titanium mesh. Mechanical testing showed that new bone improved the mechanical property of the graft significantly. In conclusion, a titanium mesh-coral composite scaffold with osteoblast precursor cells is an efficient means to engineer segmental bone, possessing the desired shape and mechanical strength.

Performance of high-rate sludge digesters fed with sonicated sludge

A major limitation of anaerobic sludge digestion is the long hydraulic retention time (HRT) required for satisfactory stabilization which results in large digester size. This study explored a possibility of operating digesters at shortened HRTs by sonication pretreatment of secondary sludges. Four identical digesters designated D1, D2, D3 and D4 were fed with untreated and sludge sonicated at densities of 0.18 W/ml, 0.33 W/ml and 0.52 W/ml, respectively. All digesters were operated at three HRTs of 8-day, 4-day and 2-day. Comparing with the control digester (D1), total solids removal efficiencies improved by 12-19%, 17-36% and 20-39% in digesters D2, D3 and D4, respectively. The volatile solids removal was also increased by 11-21%, 17-33% and 19-36% in the respective digesters. The improved solids degradation corresponded with increase in biogas production by 1.4-2.5, 1.9-3.0 and 1.6-3.1 times, respectively. Increase in methane composition by 2-17% was also noted in all digesters fed with sonicated sludge. An analysis indicated that sonication pretreatment could enhance degradation of carbon, nitrogen and sulfur substances in the digestion. The study suggested that sonication of sludge is a possible pretreatment to shorten the digester operating HRT with improvement in solids degradation, biogas production and methane content. It can be deduced that to maintain a consistent solids loading at a desire performance, sludge digester with smaller size can be designed.

A comparison of ultrasound treatment on primary and secondary sludges

Ultrasound treatment of primary and secondary sludges was conducted to improve the qualities of sludges for the anaerobic digestion. The impacts of different sonication times, sonication densities and solids concentrations on ultrasonication efficiency were examined. The experimental results indicated that the significant reduction in particle size and increase in soluble organics could be achieved, implying that ultrasonication could offer a feasible treatment method to efficiently disintegrate sludge. The greater decrease in particle size and increase in soluble organics of sludge indicated that the secondary sludge has a more remarkable improvement after sonication over the primary sludge. With respects to the extent of disintegration and energy consumption, higher sonication density performed more effectively in terms of specific energy. There exists an optimal solids concentration range for both the sludges for optimum sonication. Within the optimal solids concentration range, efficient sonication can be effected and sludge would be disintegrated efficiently. The ultrasound would be attenuated by scattering and absorption if the solids concentration exceeds the optimal range. It appeared from the study that the mechanical shear forces caused by ultrasonic cavitation could be a key factor for sludge disintegration and collapse of cavitation bubbles could significantly alter the sludge characteristics.

Injectable bone

Temperature-dependent polymerising polyethylene oxide hydrogel was used as a vehicle to deliver bone marrow mesenchymal cells by injection in six nude mice, four mice acting as controls, to study generation of new bone in the cell-hydrogel complex. Mesenchymal cells were harvested by in vitro cell culture, and cells were seeded into polyethylene oxide solution. The density of the suspension was adjusted to 5 x 10(7)ml(-1). The hydrogel was obtained by adjusting the temperature to over 6 degrees C. Aliquots of 0.5 ml of the cell-hydrogel complexes were injected subcutaneously into the backs of the six experimental mice, and 0.5 ml of hydrogel alone was injected into the four controls. Generation of new bone was studied by gross inspection, radiographs, and histological examination. Two months after injection hard nodes had formed subcutaneously in all six mice, whereas in the control group the hydrogel had been absorbed completely and only soft tissue was present at the site of injection. A shadow could be seen on the radiographs of all cell-seeded mice. On histological examination of the nodes there was trabecular bone and some areas of neocartilage. This method of generating new bone might be of potential clinical use.

The therapeutic effect of Ginkgo biloba extract in SHR rats and its possible mechanisms based on cerebral microvascular flow and vasomotion

This paper aimed to investigate the therapeutic effect of an extract of Ginkgo biloba leaves (EGb 761) on hypertension and its possible mechanisms in the view of cerebral microcirculation. Twenty normotensive rats and 24 SHR rats were used. Surgical preparation was made to produce a cranial window for observation of the capillary network on the cerebral cortex. The intravital videomicroscopy equipped with digital image processing system and laser Doppler flowmeter were used for this study. The arterial blood pressure, red cell velocity (V), microvacular diameter (D), number of open capillaries (OCN), circulating endothelial cells (CEC) in blood, relative blood flow (Flow) and frequency (Fc), amplitude (AMP) of vasomotion were measured. The obtained data were compared between EGb-treated rats that received per os 100 mg/kg/d for 9 days and placebo control rats. Untreated SHR rats showed very severe dysfunction in the microcirculation with high blood pressure (213 +/- 16.7 mmHg). The blood pressure decreased significantly to 153 +/- 20 mmHg in EGb-treated SHRs group, compared with those of untreated rats (p < 0.01). Both normotensive and hypertensive rats increased the blood flow velocity and LDF flow after EGb-treatment. The vasomotion property, the CEC and OCN changed greatly in EGb-treated SHR rats, but no significant difference was observed in normotensive rats. It was suggested that EGb 761 had therapeutic effect on SHR rats by increasing blood perfusion, regulating vasomotion function, opening efficiently capillaries and releasing the peripheral resistance. The injured vascular endothelium of SHR rats was also partly reversed by EGb-treatment. It was concluded that EGb 761 could be used to regulate hypertension and to protect the cerebral microcirculatory function.

[The construction and physical-mechanical characterization of polymer foams of D. L-PLA]

This study was intended to construct biogradable polymer foam used in tissue engineering. The D. L-PLA was supplied by chengdu institute of organic chemistry. Biogradable polymer membranes were prepared with a novel solvent-casting particulate-leaching technique, then, the constituent membranes with the proper order were laminated to produce three-dimensional foams with continuous pore structure and morphology. Afterwards, the physical-mechanical property of polymer foams were tested. The test results indicated that the lamination process did not change the physical-mechanical property of the polymer membranes.

Vascular osteomuscular autograft prefabrication using coral, type I collagen and recombinant human bone morphogenetic protein-2

In 20 male Sprague-Dawley rats, 10 pieces of L-shaped coral combined with type I collagen and recombinant human bone morphogenetic protein-2 (rhBMP-2) and 10 discs (diameter 5 mm) were wrapped in the gracilis muscle, and left pedicled on the femoral vessels. Untreated coral was buried in muscle at a distant control site in 4 animals. After 3 weeks, autografts were examined for the shape of new bone, vascular patency, and induction of bone. In all grafts in viable tissue, heterotopic bone was formed. The shape of the new bone was the same as that of the coral, and there was no significant inflammatory reaction. Part of the coral in the composite was absorbed. Bone was not formed in any of the control sites. Coral and type 1 collagen are effective as a carrier for BMP to prefabricate vascular osteomuscular autografts with designed shape. There is a potential clinical application for BMP to bioengineer microvascular free flaps with intrinsic skeletal muscle for maxillofacial reconstruction.

Prolonged asymptomatic dense deposit disease in Chinese. Report of 2 cases in Taiwan

Dense deposit disease (DDD) is a less common form of membranoproliferative glomerulonephritis (MPGN). The disease occurs predominantly in children and young adults and the prognosis is variable. DDD varies considerably in incidence among different populations and has not been reported in Chinese. Herein we reported 2 cases of DDD in young Chinese girls in Taiwan. Although 1 case (case 2) had mild hypertension, both patients had asymptomatic proteinuria and ran a benign course of 8 and 14 years, respectively. The histological features of case 1 resembled membranous glomerulonephritis (MGN) on hematoxylin-eosin stain, but revealed DDD on periodic acid Schiff and chromotrope-2R silver methenamine stains. Whereas case 2 showed focal MPGN on light microscopy, she had a fine granular immunofluorescence pattern resembling MGN. Characteristic intramembranous dense deposits were demonstrated by electron microscopy in the basement membranes of the glomeruli, Bowman's capsules and the renal tubules. Both patients were followed closely, and had stable normal renal function 1 year after renal biopsy.

Cocoa procyanidins and human cytokine transcription and secretion

We examined whether cocoa, in its isolated procyanidin fractions (monomer through decamer), would modulate cytokine production at the levels of transcription and protein secretion in both resting and phytohemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMC). In resting cells, interleukin (IL)-1beta and IL-4 gene expression from cocoa-treated cells varied markedly among the subjects tested. However, at the protein level, the larger fractions (pentamer through decamer) stimulated a dramatic increase in IL-1beta concentration (up to ninefold) with increasing degree of polymerization. Similarly, these larger fractions augmented IL-4 concentration by as much as 2 pg/ml, whereas the control displayed levels nearly undetectable. In the presence of PHA, gene expression also seemed to be most affected by the larger procyanidin fractions. The pentameric through decameric fractions increased IL-1 beta expression by 7-19% compared with PHA control, whereas the hexameric through decameric fractions significantly inhibited PHA-induced IL-4 transcription in the range of 71-86%. This observation at the transcription level for IL-1 beta was reflected at the protein level in PHA-stimulated PBMC. Significant reductions in mitogen-induced IL-4 production were also seen at the protein level with the hexamer, heptamer and octamer. Individual oligomeric cocoa fractions were unstimulatory for IL-2 in resting PBMC. However, when induced with PHA, the pentamer, hexamer and heptamer fractions caused a 61-73% inhibition in IL-2 gene expression. This study offers additional data for the consideration of the health benefits of dietary polyphenols from a wide variety of foods, including those benefits associated specifically with cocoa and chocolate consumption.