Thyroid arterial embolization to treat Graves' disease

PURPOSE

To prospectively investigate the effect of thyroid arterial embolization on hyperthyroid Graves' disease in selected patients.

MATERIAL AND METHODS

Twenty-eight patients with hyperthyroidism caused by Graves' disease were enrolled to undergo thyroid arterial embolization and followed up for 12-22 months. Twenty-two patients had three thyroid arteries embolized and six patients two arteries. Serum thyroid hormone, thyroid-stimulating hormone (TSH), and autoimmune function were tested before and after embolization in all patients.

RESULTS

Of 28 patients, 22 (78.6%) became euthyroid, five improved (17.8%), and one had temporary improvement followed by recurrence (3.6%). No serious complications occurred. Compared with the pre-embolization values, serum concentrations of thyroid hormone increased temporarily on day 3 post-embolization, dropped substantially after 1 and 2 months, and returned to nearly normal at 6 and 12 months post-embolization. TSH dropped on day 3, increased after 1 and 2 months, and returned to normal after 6 and 12 months. Thyroid antibodies TGAb and TMAb declined on day 3 to normal range, rose after 1 month, dropped to normal again after 2 months, and were slightly increased at 6 and 12 months follow-up.

CONCLUSION

Thyroid arterial embolization may be an effective approach for patients with hyperthyroidism caused by Graves' disease.

Confirmation of four nitroimidazoles in porcine liver by liquid chromatography–tandem mass spectrometry

A sensitive and reliable multiresidue method is described for analysis of ronidazole, metronidazole, dimetridazole and the common metabolite of ronidazole and dimetridazole, 2-hydroxymethyl-1-methyl-5-nitroimidazole in swine liver. The sample preparation procedure was based on liquid-liquid extraction and mixed mode cation exchange/reverse phase solid-phase extraction. The compounds of interest were determined by reverse phase gradient liquid chromatography separation and tandem mass spectrometry (MS/MS) in the multiple reaction monitoring (MRM) mode. The limits of confirmation were 0.1-0.5 microg kg(-1) for the analytes.

FDG-PET study of the bilateral subthalamic nucleus stimulation effects on the regional cerebral metabolism in advanced Parkinson disease

The aim of the study was to evaluate the changes in regional cerebral metabolic rate of glucose (rCMRGlu) induced by bilateral subthalamic nucleurs (STN) stimulation in advanced Parkinson's disease (PD). 18F-Fluorodeoxyglucose (FDG) PET data obtained before and one month after stimulation were analyzed with statistical parametric mapping (SPM). As a result of clinically effective bilateral STN stimulation, rCMRGlu increased in lateral globus pallidus (GP), upper brain stem, dorsolateral prefrontal cortex (DLPFC) and posterior parietal-occipital cortex, and decreased in the orbital frontal cortex and parahippocampus gyrus (p < 0.001). We conclude that the alleviation of clinical symptoms in advanced PD by bilateral STN stimulation may be the result of activation of both ascending and descending pathways from STN and of restoration of the impaired higher-order cortex functions.

Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy

BACKGROUND

Recent evidence found probiotics could inhibit Helicobacter pylori colonization from both in vitro and in vivo studies.

AIM

To systematically evaluate whether adding probiotics to anti-H. pylori regimens could improve eradication rates and reduce side effects during anti-H. pylori treatment.

METHODS

Eligible articles were identified by searches of electronic databases. We included all randomized trials comparing probiotics supplementation to placebo or no treatment during anti-H. pylori regimens. Statistical analysis was performed with Review Manager 4.2.8. Subanalysis/Sensitivity analysis was also performed.

RESULTS

We identified 14 randomized trials (n = 1671). Pooled H. pylori eradication rates were 83.6% (95% CI = 80.5-86.7%) and 74.8% (95% CI = 71.1-78.5%) for patients with or without probiotics by intention-to-treat analysis, respectively, the odds ratio (OR) was 1.84 (95% CI = 1.34-2.54); the occurrence of total side effects were 24.7% (95% CI = 20.0-29.4%) and 38.5% (95% CI = 33.0-44.1%) for groups with or without probiotics, especially for diarrhoea, the summary OR was 0.44 (95% CI = 0.30-0.66).

CONCLUSIONS

Our review suggests that supplementation with probiotics could be effective in increasing eradication rates of anti-H. pylori therapy, and could be considered helpful for patients with eradication failure. Furthermore, probiotics show a positive impact on H. pylori therapy-related side effects.

Morphologic analysis of normal human lumbar dorsal root ganglion by 3D MR imaging

BACKGROUND AND PURPOSE

The dorsal root ganglion (DRG) of the spinal nerve has been considered a key structure in the mechanism of low-back pain and radicular symptoms. The purpose of this study was to clarify the normal morphologic features and variations of the lumbar DRGs in a healthy population by using 3D MR imaging.

METHODS

3D fast-field echo (FFE) with water selective excitation coronal MR images of lumbar spine obtained in 115 healthy volunteers were further reconstructed into a radial stack of 15 coronal images by using maximum intensity projection technique. The DRGs from L1 through L5 were assessed for the location, signal intensity, architecture, and dimensions.

RESULTS

Most DGRs were foraminal in location. Only 5.7% of the L5 DGRs were located intraspinally. The sizes of L1, L2, and L5 DRGs in men were larger than those in women (P < .05). The dimensions of the DRGs gradually increased from L1 to L5 (P < .0001). The biganglia (2 ganglial components) frequently occurred in the L4 and L3 DRGs, whereas the singular ganglion (1 ganglial component), in the L5 and L1 DRGs.

CONCLUSION

The normal anatomy and variants of the lumbar DRG could be better demonstrated by 3D MR imaging with water selective excitation technique. The relatively larger and more proximally located DRGs in the lower lumbar region may be more susceptible to compression. An appreciation of normal anatomy and variants of DRGs radiologically is helpful for the diagnosis and proper treatment for radiculopathy.

Giant discrete steps in metal-insulator transition in perovskite manganite wires

Optical lithography is used to fabricate LPCMO wires starting from a single (La(5/8-0.3)Pr(0.3))Ca3/8MnO3 (LPCMO) film epitaxially grown on a LaAlO3(100) substrate. As the width of the wires is decreased, the resistivity of the LPCMO wires exhibits giant and ultrasharp steps upon varying temperature and magnetic field in the vicinity of the metal-insulator transition. The origin of the ultrasharp transitions is attributed to the effect of spatial confinement on the percolative transport in manganites.

TLR engagement prevents transplantation tolerance

In many experimental models, heart, pancreas and kidney allografts are accepted long-term following costimulation-targeting therapies, whereas skin, lung and intestine resist the induction of tolerance under the same regimens. We noted that a common feature of the resistant organs is their constant exposure to commensal microbes and hypothesized that these microorganisms may stimulate Toll-like receptors (TLRs), promote alloresponses and prevent tolerance induction. This hypothesis prompts the predictions that TLR engagement at the time of transplantation should avert tolerance to heart allografts in animals treated with costimulation-targeting therapies, whereas inhibition of TLR signaling should promote tolerance to skin allografts under the same conditions. Indeed, engagement of a single TLR was sufficient to prevent anti-CD154-mediated long-term cardiac allograft acceptance and correlated with abolished intragraft recruitment of CD4+/FoxP3+ regulatory T cells and the development of linked-suppression. Conversely, a lack of donor and recipient MyD88-dependent signaling led to successful skin allograft acceptance in anti-CD154-treated animals. Thus, the status of TLR signaling contributes to the resistance versus susceptibility of organs to transplantation tolerance.

Periodic ZnO nanorod arrays defined by polystyrene microsphere self-assembled monolayers

We demonstrate a low-cost and effective method to fabricate hexagonally patterned, vertically aligned ZnO nanorod arrays. Selective wet-etching is used to develop the catalyzing gold particle hexagonal pattern with the aid of a polystyrene microsphere self-assembled monolayer. The gold particles have tunable sizes independent of the polystyrene microsphere's diameter and are inherently round in shape. Each ZnO rod is grown individually from a catalyzing site via catalyst-initiated epitaxy, and the original hexagonal periodicity is well-preserved. The rods have flat ends, and the diameters of the rods can be controlled well by the amount of source materials. This method provides a promising way to create ZnO one-dimensional nanostructures for applications as two-dimensional photonic crystal, sensor arrays, nanolaser arrays, and optoelectronic devices.

Decoupling of normal CD40/interleukin-4 immunoglobulin heavy chain switch signal leads to genomic instability in SGH-MM5 and RPMI 8226 multiple myeloma cell lines

The processes mediating genomic instability and clonal evolution are obscure in multiple myeloma (MM). Acquisition of new chromosomal translocations into the switch region of the immunoglobulin heavy chain (IgH) gene (chromosome 14q32) in MM, often heralds transformation to more aggressive disease. Since the combined effects of CD40 plus interleukin-4 (IL-4) mediate IgH isotype class switch recombination (CSR), and this process involves DNA double strand break repair (DSBR), we hypothesized that CD40 and/or IL-4 activation of MM cells could induce abnormal DNA DSBR and lead to genomic instability and clonal evolution. In this study, we show that MM cell lines that are optimally triggered via CD40 and/or IL-4 demonstrate abnormal decoupling of IL-4 signal transduction from CD40. Specifically, CD40 alone was sufficient to trigger maximal growth of tumor cells. We further demonstrate that CD40 triggering induced both DNA DSBs as well as newly acquired karyotypic abnormalities in MM cell lines. Importantly, these observations were accompanied by induction of activation induced cytidine deaminase expression, but not gross apoptosis. These data support the role of abnormal CD40 signal transduction in mediating genomic instability, suggesting a role for the CD40 pathway and intermediates in myelomagenesis and clonal evolution in vivo.

[Development of a rapid subtype-screening assay for the env region of HIV-1 CRF strains in Guangxi.]

BACKGROUND

To develop a simple and rapid subtype-screening assay for the env region of the circulating recombinant form (CRF) of human immunodeficiency virus type 1 (HIV-1) in Guangxi.

METHODS

Proviral DNA from HIV-1 positive samples were extracted and subjected to the first round PCR with universal primers for the env region that can detect HIV-1 M group isolates. In the second round PCR, two pairs of subtype-specific primers that were designed to detect subtype C or B'/C and CRF01-AE respectively were added into one tube. The PCR products of different subtypes could be distinguished in agarose-gel electrophoresis. Additionally, all of these samples were sequenced and analyzed phylogenetically.

RESULTS

Phylogenetic analysis of the env region of 50 samples showed that 3 samples (6%) were infected with CRF08-BC, 43 (86%) with CRF01-AE, and 4 (8%) remained unclassifiable. Detection of the subtype-specific primer sets revealed that 3 were subtype C or B'/C (100%), 39 were CRF01-AE (90.7%), with an adequate sensitivity (91.3%) and a high specificity (100%). Non-specific bands occasionally appeared but did not interfere with interpretation of the results. The phylogenetic analysis was consistent with subtype-specific primer sets and the consistency rate was 92%. The average reproducibility was 100% for CRF08-BC samples and 93.8% for CRF01-AE samples.

CONCLUSION

A simple, rapid and low cost assay was developed for subtype-screening of CRF01-AE in Guangxi.

Association of TPH1 with suicidal behaviour and psychiatric disorders in the Chinese population

Tryptophan hydroxylase (TPH), the rate limiting enzyme in serotonin biosynthesis, is one of the most important regulating factors in the serotonergic system. Recently, polymorphisms of the TPH gene have been identified as being associated with suicide, but the evidence is inconsistent. To investigate the role in suicide of one of the isoforms, TPH1, we examined the association of five single nucleotide polymorphisms (SNPs) in the promoter region and in intron 7 of the TPH1 gene based on a sample from the Chinese population of 810 subjects, of whom 329 had made no suicide attempts (NSA), 297 had made suicide attempts (SA), and 184 were healthy subjects (HS). In this study, we observed statistically significant differences between NSA and HS subjects in allele distributions on one marker, -6526A (p = 0.0329; odds ratio (OR) 1.36; 95% confidence interval (CI) 1.01 to 1.81). No significant difference in genotype distribution or allele frequencies of other polymorphisms was found between the suicide victims and the controls. The overall haplotype frequency was significantly different between cases and healthy controls (p = 0.000024 NSA v HS; p < 0.000001, SA v HS; p < 0.000001, cases v HS). We found the haplotype TCAAA of -7180/-7065/-6526/218/779 to be strongly associated with suicidal behaviour and psychiatric disorders (p = 0.00243; OR = 1.62; 95% CI 1.17 to 2.24 and p = 0.018; OR = 1.41; 95% CI 1.05 to 1.91), which suggests an association of TPH1 with suicidal behaviour and indicates that TPH1 may play a significant role in the aetiology of psychiatric disorders in the Han Chinese population.

ASPM mutations identified in patients with primary microcephaly and seizures

BACKGROUND

Human autosomal recessive primary microcephaly (MCPH) is a heterogeneous disorder with at least six genetic loci (MCPH1-6), with MCPH5, caused by ASPM mutation, being the most common. Despite the high prevalence of epilepsy in microcephaly patients, microcephaly with frequent seizures has been excluded from the ascertainment of MCPH. Here, we report a pedigree with multiple affected individuals with microcephaly and seizures.

OBJECTIVE

To identify the gene responsible for microcephaly and seizures in this pedigree.

METHODS

Clinical assessments of three patients and brain MRIs of two patients were obtained. Genome-wide linkage screen with 10 k SNP microarray, fine mapping with microsatellite markers, and mutational analysis of the genomic DNA were performed on the pedigree.

RESULTS

We found that the family was linked to the MCPH5 locus on chromosome 1q31.2-q32.1. We screened ASPM and identified a previously unreported nonsense mutation that introduced a premature stop codon in exon 18 of the ASPM gene.

CONCLUSIONS

We thus expand the clinical spectrum of ASPM mutations by showing that they can occur in patients with seizures and that the history of seizures alone should not necessarily preclude the diagnosis of primary microcephaly.

Separation, cultivation and biological characteristics of oral carcinoma-associated fibroblasts

OBJECTIVES

Carcinoma-associated fibroblasts (CAFs) have been suggested to regulate the initiation and progression of many types of solid tumors. The aim of the study was to separate, cultivate, identify oral CAFs, and to investigate their biological characteristics.

MATERIALS AND METHODS

The primary CAFs and normal fibroblasts (NFs) of the tongue were obtained by tissue culture. Then cells were dissociated by 0.25% trypsin and purified by curettage method combining with trypsinization. The cells were verified according to morphological observation and immunohistochemical staining of certain proteins. Multiple proliferation indexes and karyotype of the cells were assayed.

RESULTS

Third passage purified oral CAFs and NFs were attained successfully. The morphological characteristics of the CAFs changed significantly comparing to the NFs. The CAFs showed positive staining for vimentin, alpha-smooth muscle actin and matrix metalloproteinases-2. The proliferation and mitosis ability of the CAFs were significantly increased compared with the NFs (P < 0.05). No karyotypic abnormalities were found in the CAFs.

CONCLUSIONS

There were obvious differences in the biological characteristics between oral CAFs and NFs. The results may provide us an experimental foundation for further studies on the roles of CAFs in the initiation and progression of oral cancer.

Enhanced sensitivity of DJ-1-deficient dopaminergic neurons to energy metabolism impairment: Role of Na+/K+ ATPase

DJ-1 gene mutations lead to an inherited form of early-onset parkinsonism. The function of DJ-1 is unclear, though a neuroprotective role has been postulated. Electrophysiological recordings were made of striatal and dopaminergic nigral neurons both of wild-type (WT) and DJ-1-knockout (DJ-1(-/-)) mice. We assessed the responses of dopaminergic cells to combined oxygen and glucose deprivation (OGD), and to the mitochondrial toxin rotenone. OGD induced a membrane hyperpolarization in nigral neurons from WT mice. Similarly, rotenone hyperpolarized neurons and then a depolarization occurred. In DJ-1(-/-) mice, the OGD-induced hyperpolarization was significantly enhanced. Moreover, rotenone caused a shorter hyperpolarization followed by an irreversible depolarization. To evaluate the involvement of Na+/K+ ATPase, we tested ouabain, a Na+/K+ ATPase inhibitor, on two distinct neuronal subtypes. Compared to WT mice, in dopaminergic neurons from DJ-1(-/-) mice, ouabain induced rapid and irreversible membrane potential changes. Notably, this effect was observed at concentrations that were unable to produce membrane potential shifts on striatal spiny neurons, both from WT and DJ-1(-/-) mice. These findings suggest that DJ-1 loss-of-function enhances vulnerability to energy metabolism alterations, and that nigral neurons are particularly sensitive to Na+/K+ ATPase impairment.

Novel external sensor array for capsule endoscopy

Capsule endoscopy (CE) requires placement of an eight-lead sensor array over the abdomen that receives image and localization data transmitted from the capsule. The current process of applying this array to the skin has several disadvantages: firstly, it is time-consuming; secondly, it can be cumbersome for the patient; and thirdly, it is often difficult to place the leads consistently. A new external sensor array system designed to improve this process was tested. It was hypothesized that the new method would be able to receive the transmitted data adequately during CE. The new method and device were tested on an in-patient who had two sets of sensor arrays, batteries, and data recorders placed on her simultaneously. One set was placed in the standard fashion, which served as the control, while the other set was placed using the novel external method. The data provided by the two recorders were compared and the patient's preferences were noted. The quality of the CE images provided by the two methods was identical, but the CE localization tracings were different, presumably due to movement of the gown and leads during the recording period. No signal interference was noted. The patient preferred the external device. A prepositioned external sensor array is capable of transmitting CE data without any loss in image quality, but the localization tracing differs due to movement of the external array. This new method will require testing with a larger sample size in an outpatient setting to allow full assessment of the clinical value of the new approach.

Suppression of ocular neovascularization with siRNA targeting VEGF receptor 1

In this study, we used small interfering RNA (siRNA) directed against vascular endothelial growth factor receptor 1 (vegfr1) mRNA to investigate the role of VEGFR1 in ocular neovascularization (NV). After evaluating many siRNAs, Sirna-027 was identified; it cleaved vegfr1 mRNA at the predicted site and reduced its levels in cultured endothelial cells and in mouse models of retinal and choroidal neovascularization (CNV). Compared to injection of an inverted control sequence, quantitative reverse transcriptase-PCR demonstrated statistically significant reductions of 57 and 40% in vegfr1 mRNA after intravitreous or periocular injection of Sirna-027, respectively. Staining showed uptake of 5-bromodeoxyuridine-labeled Sirna-027 in retinal cells that lasted between 3 and 5 days after intravitreous injection and was still present 5 days after periocular injection. In a CNV model, intravitreous or periocular injections of Sirna-027 resulted in significant reductions in the area of NV ranging from 45 to 66%. In mice with ischemic retinopathy, intravitreous injection of 1.0 mug of Sirna-027 reduced retinal NV by 32% compared to fellow eyes treated with 1.0 mug of inverted control siRNA. These data suggest that VEGFR1 plays an important role in the development of retinal and CNV and that targeting vegfr1 mRNA with siRNA has therapeutic potential.

New Enzyme-based Process Direction to Prevent Wool Shrinking without Substantial Tensile Strength Loss

In this paper a new enzymatic process direction is described for obtaining machine washable wool with acceptable quality. In general, application of protease enzyme technology in wool processing results in considerable loss of tensile strength by diffusion of the enzyme into the interior of wool fibers. To overcome this disadvantage enzymatic activity has been more targeted to the outer surface of the scales by improving the susceptibility of the outer surface scale protein for proteolytic degradation. This has been realized by a pretreatment of wool with hydrogen peroxide at alkaline pH in the presence of high concentrations of salt.

Human glutathione S-transferase P1-1 interacts with TRAF2 and regulates TRAF2-ASK1 signals

Human glutathione S-transferase P1-1 (GSTP1-1) is an ubiquitously expressed protein that plays an important role in the detoxification and xenobiotics metabolism. It has been shown that GSTP1-1 interacts with c-Jun NH(2)-terminal kinase (JNK) and suppresses its activity. Here, we report a novel function of GSTP1-1 in regulating tumor necrosis factor-alpha (TNF-alpha)-triggered signaling. The present experiments showed that GSTP1-1 physically associated with tumor necrosis factor receptor-associated factor 2 (TRAF2) in vivo and in vitro. Overexpression of GSTP1-1 inhibited TRAF2-induced activation of both JNK and p38 but not of nuclear factor-kappaB (NF-kappaB). Glutathione S-transferase P1-1 also attenuated TRAF2-enhanced apoptosis signal-regulating kinase 1 (ASK1) autophosphorylation and inhibited TRAF2-ASK1-induced cell apoptosis by suppressing the interaction of TRAF2 and ASK1. Conversely, silencing of GSTP1-1 expression through RNA interference (RNAi) resulted in increase of TNF-alpha-dependent TRAF2-ASK1 association followed by hyper-activation of ASK1 and JNK. A mutant GSTP1-1 lacking TRAF domain-binding motif exhibited a significant decline of capacity to bind TRAF2 and block TRAF2-ASK1 signaling compared with the wild type of GSTP1-1. Moreover, the glutathione-conjugating activity of GSTP1-1 was not involved in the regulation of TRAF2 signaling. These findings indicate that GSTP1-1 plays an important regulatory role in TNF-alpha-induced signaling by forming ligand-binding interactions with TRAF2, which provides a new insight for analysing the protective effects of GSTP1-1 in tumor cells.

Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting

BACKGROUND

There have been recent advances in chemotherapy-induced nausea and vomiting using 5-HT(3) inhibitors and dexamethasone. However, many still experience these symptoms, and expert panels encourage additional methods to reduce these symptoms.

OBJECTIVES

The objective was to assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients.

SEARCH STRATEGY

We searched MEDLINE, EMBASE, PsycLIT, MANTIS, Science Citation Index, CCTR (Cochrane Controlled Trials Registry), Cochrane Complementary Medicine Field Trials Register, Cochrane Pain, Palliative Care and Supportive Care Specialized Register, Cochrane Cancer Specialized Register, and conference abstracts.

SELECTION CRITERIA

Randomized trials of acupuncture-point stimulation by any method (needles, electrical stimulation, magnets, or acupressure) and assessing chemotherapy-induced nausea or vomiting, or both.

DATA COLLECTION AND ANALYSIS

Data were provided by investigators of the original trials and pooled using a fixed effect model. Relative risks were calculated on dichotomous data. Standardized mean differences were calculated for nausea severity. Weighted mean differences were calculated for number of emetic episodes.

MAIN RESULTS

Eleven trials (N = 1247) were pooled. Overall, acupuncture-point stimulation of all methods combined reduced the incidence of acute vomiting (RR = 0.82; 95% confidence interval 0.69 to 0.99; P = 0.04), but not acute or delayed nausea severity compared to control. By modality, stimulation with needles reduced proportion of acute vomiting (RR = 0.74; 95% confidence interval 0.58 to 0.94; P = 0.01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% confidence interval 0.60 to 0.97; P = 0.02), but manual acupuncture did not; delayed symptoms for acupuncture were not reported. Acupressure reduced mean acute nausea severity (SMD = -0.19; 95% confidence interval -0.37 to -0.01; P = 0.04) but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics.

AUTHORS' CONCLUSIONS

This review complements data on post-operative nausea and vomiting suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies combining electroacupuncture with state-of-the-art antiemetics and in patients with refractory symptoms are needed to determine clinical relevance. Self-administered acupressure appears to have a protective effect for acute nausea and can readily be taught to patients though studies did not involve placebo control. Noninvasive electrostimulation appears unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologic antiemetic therapy.