3D reconstructions of spinal segmental arteries using CT angiography: applications in minimally invasive spinal procedures

BACKGROUND AND PURPOSE

Injury to spinal segmental arteries may potentially occur during spinal surgery, particularly during anterior or minimally invasive approaches. Use of a noninvasive radiologic tool to evaluate these arteries before surgery may reduce this risk.

MATERIAL AND METHODS

We performed spinal CT angiography and reconstructed 3D images of segmental arteries in 41 patients. We classified the pathways and locations of the segmental arteries into 4 zones (A, B, C, and D) according to pedicle and vertebral endplates. We designated segmental arteries from T8 to L1 as "high-level segmental arteries" and those from L2 to L4, as "low-level segmental arteries." We compared the distribution of segmental arteries between these 2 groups. We also investigated anatomic variations of segmental arteries and the rate of occurrence of the artery of Adamkiewicz.

RESULTS

In all patients, 3D reconstruction images from spinal CT angiography clearly showed the pathways of segmental arteries on the vertebral bodies. Most of the segmental arteries passed the middle portion of the vertebral body (zones B and C). However, 51 of 738 segmental arteries (6.9%) had uncommon pathways (zones A and D), and segmental arteries from L2 to L4 had a higher incidence of uncommon pathways than higher level vertebrae (P < .05). We also observed 2 types of segmental artery anatomic variation, agenesis and dual supply.

CONCLUSIONS

We suggest that spinal CT angiography can help to precisely visualize the spinal segmental arteries and surrounding bony structures and can aid clinicians in deciding on optimal approaches for spinal surgery.

Radioisotope synoviorthesis with Holmium-166-chitosan complex in haemophilic arthropathy

Radiosynoviorthesis is a safe and easy method for synovectomy in haemophilic arthropathy. Various agents have been used in radiosynoviorthesis, especially newly developed agent Holmium-166-chitosan complex has good clinical outcome. This study analysed clinical results and radiologic evaluation of radioisotope synoviorthesis using Holmium-166-chitosan complex in haemophilic arthropathy. From March 2001 to December 2003, 58 radiosynoviorthesis were performed in 53 haemophiliacs. The average age at procedure was 13.8 years. The Arnold and Hilgartner stage of the patients was from I to IV. Holmium-166-chitosan complex was injected in 31 ankle joints, 19 elbow joints and 8 knee joints. Average follow-up was 33 months since primary procedure. The range of motion of each joint, frequency of intra-articular bleeding and factor dose used were analysed for clinical assessment. There was no significant improvement of range of motion in affected joints. After procedure, the average frequency of bleeding of the elbow joint has decreased from 3.76 to 0.47 times per month, the knee joint from 5.87 to 1.12 times per month, and the ankle joint from 3.62 to 0.73 times per month respectively (P < 0.05). After treatment, the average coagulation factor dose injected was significantly decreased to 779.3 units per month from 2814.8 units per month before treatment (P < 0.001). Radioisotope synoviorthesis with Holmium-166-chitosan complex in haemophilic arthropathy is a very safe and simple procedure with the expectation of a satisfactory outcome without serious complication. It has excellent bleeding control effect on target joint and the need for substitution of coagulation factor concentrate can be reduced.

Nerve growth factor and expression of its receptors in patients with diabetic neuropathy

AIMS

Low serum nerve growth factor (NGF) levels have been reported in patients with diabetic peripheral neuropathy (DPN), but the role of NGF in the development of neuropathy is unclear. Thus, we investigated the associations of serum NGF level and NGF receptor activity with the presence and severity of DPN.

METHODS

One hundred and thirty-six patients with Type 2 diabetes were included in this cross-sectional study. Serum NGF levels were measured by ELISA. Expressions of NGF receptors (TrkA and p75(NTR)) were measured by immunohistochemical staining. The presence and severity of DPN were assessed by neuropathy disability score (NDS) and by corneal nerve fibre length (cNFL) and nerve branch density (cNBD) using in vivo confocal microscopy.

RESULTS

Patients with DPN had higher serum NGF levels (56-451 pg/ml) than patients without DPN (4-54 pg/ml). However, in DPN patients, serum NGF was negatively associated with neuropathy severity (mild 222 +/- 64 pg/ml; moderate 114 +/- 17 pg/ml; severe 89 +/- 20 pg/ml). This negative association was consistent in all severity indices (NDS, P < 0.001; cNFL, P < 0.001; cNBD P = 0.010) even after adjustment for age, sex, diabetes duration, insulin use, fasting glucose and glycated haemoglobin. Although NGF receptor activities had significantly (P < 0.05) negative associations with the presence and severity of neuropathy, these associations were not significant when adjusted for other factors.

CONCLUSIONS

Serum NGF level was positively associated with the presence of DPN but negatively associated with neuropathy severity in DPN patients. The change in serum NGF might be a consequence of, rather than a contributor to, the early development of DPN.

Prenatal multivitamins containing folic acid do not decrease prevalence of depression among pregnant women

Several studies have reported an association between depression and folic acid deficiency. We investigated whether intake of prenatal multivitamins containing folic acid (MVandFA) was associated with decreased rates of depression among pregnant women. A questionnaire was given to 1,314 low-risk pregnant women. Of them, 1,277 (97.2%) women completed the questionnaire. The overall prevalence of depression was 8.1%. Of 652 participants who did not take MVandFA, 9.4% had depression, whereas 6.9% of 624 women who had MVandFA had depression (p = 0.11). In a multivariate logistic regression analysis, family history of depression (adjusted OR 3.7; 95% CI 1.9-7.3) and premenstrual syndrome (adjusted OR 3.0, 95% CI 1.8-4.8) were identified as risk factors for depression during pregnancy. In conclusion, intake of MVandFA was not associated with lower rates of depression during pregnancy whereas family history of depression and personal history of premenstrual syndrome were significant risk factors.

Carrier-mediated antiferromagnetic interlayer exchange coupling in diluted magnetic semiconductor multilayers Ga1-xMnxAs/GaAs:Be

We report the antiferromagnetic (AFM) interlayer exchange coupling between Ga0.97Mn0.03As ferromagnetic semiconductor layers separated by Be-doped GaAs spacers. Polarized neutron reflectivity reveals a characteristic splitting at the wave vector corresponding to twice the multilayer period, indicating that the coupling between the ferromagnetic layers is AFM. When the applied field is increased to above the saturation field, this AFM coupling is suppressed. This behavior is not observed when the spacers are undoped, suggesting that the observed AFM coupling is mediated by doped charge carriers.

Conservative treatment for transient osteoporosis of the hip in middle-aged women

Transient osteoporosis of the hip is a clinical entity that is being diagnosed and reported with increasing frequency. Its aetiology remains a matter of speculation, and the same remains true for its treatment. Many researchers have proposed different surgical and non-surgical treatment strategies; but the conservative approach, which takes the form of analgesics, intermittent traction, range of motion exercises, abductor strengthening exercises and restricted weight bearing, is preferred. The authors report on two patients, both women, aged 35 years and 42 years, respectively, with transient osteoporosis of the hip that were successfully treated using a conservative approach.

The hydrodynamic filter separator for removal of urban storm runoff

The majority of storm runoff pollution is trapped in particles smaller than 100 microm in diameter. Solid particles smaller than 100 microm in diameter are not easily separated by conventional types of hydrodynamic separator, and remain in suspension in overflow. To overcome this problem, a HDFS (hydrodynamic filter separator) has been developed for treatment of the microparticles in urban storm runoff. We conducted a laboratory scale study on treatable potential of microparticles using HDFS that combined HDS with perlite filter. To determine the efficiency for various operation conditions, a series of experiments was performed with different solids concentrations and surface loading rate. The operation ranges of surface loading rates were 100 to 2,800 m3/m2/day, and influent solids concentrations were varied from 800 to 1,900 mg/L. Also, the particle size distribution was monitored to investigate the effects of surface loading rates on the particle size. Results indicated that the HDFS-inside type showed greater efficiency at solids separation than the other type.

Antibacterial and antifungal activity of pinosylvin, a constituent of pine

The antibacterial and antifungal activities of pinosylvin (3,5-dihydroxy-trans-stilbene), a constituent of pine, were studied and compared with those of resveratrol (3,5,4'-trihydroxy-trans-stilbene). Pinosylvin exhibited more potent growth inhibitory activity against Candida albicans and Saccharomyces cerevisiae.

The effect of TGF-beta on the induction CD8 and NK1.1 expression in CTLL-2 cell line

BACKGROUND

The presence of CD8+ T-cells expressing NK cell associated markers (TNK cells) has been observed in several experimental models, which suggests that NK cells may belong to the T-cell lineage. We used the CTLL-2 cell line, which is NK1.1+ CD3- TCR+ CD4- CD8- cells in the presence of IL-2, to investigate whether these cells can be switched to CD8+ or CD4+ cells, like TNK cells, by the TGF-beta.

METHODS

CTLL-2 cells were cultured with TGF-beta or other cytokines and activators in the presence of IL-2. In order to see the surface and intracytoplasmic antigen expression in a single-cell level, simultaneous surface CD4, CD8, TCR with NK1.1, and intracytoplasmic NK1.1 staining was performed and three-color flow cytometric analysis was performed.

RESULTS

During routine passage, less than 5% of cells were CD8a+, although 20-40% of cells expressed CD8a when treated with IL-2 + TGF-beta, whereas TPA + Calcium ionophore, IFN-gamma, and TNF-alpha cause no significant changes in the proportion of CD8+ cells. Twenty percent of CTLL-2 cells expressed NK1.1 with IL-2 treatment, and this expression was also increased up to 65%-70% with IL-2 + TNF-beta. Furthermore, most of the CD8 positive cells showed intracytoplasmic NK1.1.

CONCLUSION

Our results indicated that these would be useful models to investigate CD8 precursor potentials in populations of CD4-CD8- (double negative) cells and the relationship of NK1.1. These results also support a role for TGF-beta in T-cell differentiation and the hypothesis that T-cells and NK cells may have the same ontogeny.

Production of red pigment by submerged culture of Paecilomyces sinclairii

AIMS

From a survey of submerged culture of edible mushrooms, a high pigment-producing fungus Paecilomyces sinclairii was selected and its optimal culture conditions investigated.

METHODS AND RESULTS

The optimal culture conditions for pigment production were as follows: inoculum age, 3 d; temperature, 25 degrees C; initial pH, 6.0; carbon source, 1.5% (w/v) soluble starch; nitrogen source, 1.5% (w/v) meat peptone. Although addition of 10 mmol l(-1) CaCl2 to the culture medium slightly increased pigment production, most of the bio-elements examined had no notable or detrimental effect on pigment production.

CONCLUSIONS

Under the optimal conditions obtained in the flask culture tested, a ninefold increase in pigment production (4.4 g l(-1)) was achieved using a 5(-l) batch fermenter. Paecilomyces sinclairii secreted water-soluble red pigment into the culture medium. The pigment colour was strongly dependent on the pH of the solution: red at pH 3-4, violet at pH 5-9 and pink at pH 10-12.

SIGNIFICANCE AND IMPACT OF THE STUDY

The high concentration of pigment (4.4 g l(-1)) produced by P. sinclairii demonstrates the possibility of commercial production of pigment by this strain, considering its relatively high production yield and light stability.

Effect of agitation intensity on the exo-biopolymer production and mycelial morphology in Cordyceps militaris

AIMS

The influence of agitation intensity on Cordyceps militaris morphology and exo-biopolymer production was investigated in a 5 litre stirred vessel using a six-blade Rushton turbine impeller.

METHODS AND RESULTS

The mycelial morphology of C. militaris was characterized by means of image analysis, which included mean diameter, circularity, roughness and compactness of the pellets. The morphological parameters of the pellets grown under different stirring conditions were significantly different, which correspondingly altered exo-biopolymer production yields.

CONCLUSIONS

The compactness of the pellets was found to be the most critical parameter affecting exo-biopolymer biosynthesis; more compact pellets were formed at 150 rev min(-1) with maximum exo-biopolymer production (15 g l(-1)).

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study suggest that morphological change of pellets is a good indicator for identifying the cell activity for exo-biopolymer production.

Mycelial growth and exo-biopolymer production by submerged culture of various edible mushrooms under different media

AIMS

The effect of synthetic media on the submerged mycelial growth and exo-biopolymer production in various edible mushrooms was investigated in shake flask culture.

METHODS AND RESULTS

Among 19 mushrooms examined, the relatively high yield in mycelial biomass and exo-biopolymer production was achieved in potato malt peptone (PMP) medium. In particular, Ganoderma lucidum NO. 1 and Phellinus linteus KCTC 6190 showed favourable growth in PMP medium with exo-biopolymer concentration of 1170 and 1520 mg l(-1), respectively.

CONCLUSIONS

Enhanced exo-biopolymer production was achieved from Ganoderma lucidum NO. 1 and Phellinus linteus KCTC 6190 in a 5L batch fermentor, indicating approximately 5000 and 2410 mg l(-1), respectively.

SIGNIFICANCE AND IMPACT OF THE STUDY

The exo-biopolymer production and mycelial growth from various mushrooms were found to be strongly controlled by different complex media.

New galactolipids from the marine bacillariophycean microalga Nitzschia sp

Two new galactopyranosyldiacylglycerols have been isolated from the marine bacillariophycean microalga Nitzschia sp. and their structures were determined as (2S)-3-O-beta-D-galactopyranosyl-1,2-di-O-(9Z-hexadecenoyl)glycerol (1) and (2S)-3-O-beta-D-galactopyranosyl-1-O-(5Z,8Z,11Z,14Z,17Z-eicosapentaenoyl)-2-O-(9Z-hexadecenoyl)glycerol (2) by physicochemical evidence.

Diffusion-weighted magnetic resonance imaging in Wernicke's encephalopathy

OBJECTIVE

To report diffusion-weighted imaging (DWI) findings and postulate the pathogenic mechanism of Wernicke's encephalopathy (WE).

PATIENT

A 47-year-old-woman presented with altered consciousness, ophthalmoplegia, and ataxia. DWI revealed the abnormal signal changes in periaqueductal gray matter, mamillary bodies and bilateral medial thalami. Apparent diffusion coefficient (ADC) map revealed the high signal intensity lesions in bilateral medial thalami, suggestive of vasogenic edema. The abnormal signal intensity lesions disappeared on follow-up imaging with clinical improvement.

CONCLUSIONS

Vasogenic edema plays an important role in the pathogenesis of WE and can be reversed by proper management. DWI findings in the early stage of WE may provide useful information about the prognosis.

Liquid chromatographic resolution of biphenyl dimethyl dicarboxylate (DDB) and its analogues on a chiral stationary phase

Racemic biphenyl dimethyl dicarboxylate (DDB) and its analogues have been successfully resolved on a commercial HPLC chiral column, (3R,4S)-Whelk-O 1. In general, cyclic amide analogues of DDB, which were derived from pyrrolidine or piperidine, showed greater enantioselectivity and greater retention than the corresponding N,N-dialkyl amide or N-alkyl amide or ester analogues. From these results, it was concluded that the carbonyl oxygen of the DDB analogues plays an important role as a hydrogen bond acceptor, though the steric bulkiness of the amide functionality of DDB analogues may be another factor governing chiral recognition. The conformational stability of the two enantiomers of DDB and its analogues was also found to be high enough for the two enantiomers to be resolvable on (3R,4S)-Whelk-O 1.

Synergy of Bacteroides fragilis and Escherichia coli in the induction of KC gene expression in mouse peritoneal tissues

B. fragilis induces cytokine expression, which can serve as a host signal leading to inflammatory reaction and abscess formation in the peritoneal cavity. We assessed the hypothesis that enteric bacteria may alter the B. fragilis-induced expression of KC genes in mouse peritoneal tissues (MPT). After C57BL/6 mice were inoculated with abscess-forming mixture containing B. fragilis in the presence or absence of E. coli, RNA was extracted from MPT. Expression of KC mRNA was quantified using reverse-transcription polymerase chain reaction and standard RNA. KC and TNFalpha proteins were measured by enzyme-linked immunosorbent assay. KC mRNA in MPT was upregulated following inoculation of B. fragilis and this was paralleled by increased KC protein secretion. When the mice were co-infected with E. coli and B. fragilis intraperitoneally, there was a synergistic increase in the expression of KC of MPT. Co-infection with L. acidophilus and B. fragilis downregulated KC mRNA expression, but co-infection with E. faecalis and B. fragilis synergistically increased KC expression in the infected MPT. Inhibition of TNFalpha production could downregulate KC expression in mixed infected MPT. These results suggest that enteric bacteria may significantly affect the KC signal produced by the host peritoneal cavity in response to B. fragilis infection.

A case of primary adenosquamous carcinoma of the liver presented with liver abscess

Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6 x 5 x 5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.

Nuclear factor-kappa B plays a major role in the regulation of chemokine expression of HeLa cells in response to Toxoplasma gondii infection

Toxoplasma gondii infection results in an infiltration of immune cells. The mechanisms responsible for triggering inflammatory cell infiltration in T. gondii infection are not fully understood. We report that T. gondii-infected HeLa cells induced nuclear factor-kappa B (NF-kappaB) activation and increased the expression of interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) mRNA. An inhibitor of NF-kappaB activation, calpain-1 inhibitor, blocked the chemokine secretion induced by live T. gondii. Activation of the IL-8 and NF-kappaB transcriptional reporters was suppressed in cells co-transfected with IkappaB kinase beta and the IkappaBalpha super-repressor plasmids. Moreover, the addition of IL-1alpha increased NF-kappaB activation and IL-8 mRNA expression in T. gondii-infected HeLa cells. These results suggest that NF-kappaB is a central regulator of the chemokine response in T. gondii-infected human epithelial cells and that chemokine IL-8 and MCP-1 secretion might be involved in the pathogenesis of T. gondii, via the recruitment of neutrophils, monocytes, and lymphocytes.

Association of p53 and BCL-2 expression with Epstein-Barr virus infection in the cancers of head and neck

BACKGROUND

Reports that have both evaluated the site-specific Epstein-Barr virus (EBV) infection and compared it with the expression of the EBV-related proto-oncogenes and tumor suppressor genes in the various cancers of head and neck are scarce.

METHODS

Thirty-eight nasopharyngeal carcinoma (NPC) cases, 32 oropharyngeal or hypopharyngeal carcinoma (OPC/HPC) cases, and 93 laryngeal carcinoma (LC) cases were evaluated with in situ hybridization on EBV-encoded small RNA (EBER) and immunohistochemical assessments of the p53, bcl-2, and epidermal growth factor receptor (EGFR) by use of formalin-fixed paraffin-embedded tissue array slides.

RESULTS

The expression of viral EBERs was observed in more than two thirds (71.1%) of the NPC cases. In contrast, only 1 case of OPC and none of the HPC or LC cases exhibited EBV positivity. In the nonkeratinizing NPC, the EBV positivity was significantly associated with both frequent p53 overexpression (p =.033) and bcl-2 expression (p =.001). In the EBV-positive nonkeratinizing NPC, a correlation between p53 overexpression and the tumor infiltration lymphocyte (TIL) density was noted (p =.012).

CONCLUSIONS

A site-specific expression of viral EBER was demonstrated in the head and neck cancers, which suggests an important role for both p53 and bcl-2 in the carcinogenesis of an EBV-infected NPC. The correlation between p53 overexpression and the TIL density in the EBV-infected NPC suggests that the product of a lymphoepithelial interaction, such as A20, can induce a dysfunctional p53 protein.

Requirement of de novo protein synthesis for aminopterin-induced apoptosis in a mouse myeloma cell line

Cells synthesize nucleotides through de novo and salvage pathways that require the activities of dihydrofolate reductase (DHFR) and hypoxanthine-guanine phosphoribosyltransfease (HGPRT), respectively. Aminopterin, an inhibitor of dihydrofolate reductase, has been demonstrated to allow HGPRT(-) cells to be negatively selected. However, the pathway by which aminopterin leads to cell death remains to be clarified. In this study, we characterized features of cellular responses induced by aminopterin treatment in P3-X63-Ag8.653, a mouse HGPRT(-) myeloma cell line. Upon treatment with aminopterin, the cells readily underwent an apoptotic process, as assessed by DNA fragmentation assay and electron microscopic analysis. Aminopterin-induced apoptosis was drastically reduced by addition of actinomycin D and cycloheximide, indicating that active RNA and protein synthesis is required for the apoptotic effect of aminopterin. Interestingly, the induction of c-myc gene expression preceded the activity of DNA fragmentation in aminopterin-treated cells. Taken together, these results suggest that cells deficient in the salvage pathway of purine biosynthesis are susceptible to aminopterin-induced apoptosis that requires de novo synthesis of proapoptotic factors, including Myc oncoprotein.

Differential display analysis of gene expression altered by ras oncogene

The goal of the signal transduction pathways, such as those controlled by Ras, is in large part to ensure highly stringent regulation of the target genes in the nucleus, which are collectively responsible for the signal output, or phenotypes, of the cell. Understanding of the Ras effect ultimately requires the identification of these downstream target genes. Reverse genetic approaches would trace back the pathways by which they are regulated by Ras. While newer methods such as DNA microarray are emerging, differential display has allowed the identification of a greater number of differentially expressed genes than have been cloned by all the other methods combined, based on Medline search. Much of this success has been attributed to its simplicity (RT-PCR and DNA-sequencing gel) and versatility (compare more than two RNAs for both up- and downregulated genes). It has become obvious that finding the genes by either differential display or DNA microarray is only the first step toward the understanding of biological problems under investigation. It is hoped that finding the right genes through careful experimental designs, such as outlined here, will narrow down the number of relevant genes and increase the odds for solving the puzzles of nature, such as ras.