Mechanical bowel preparation for elective colorectal surgery: updated systematic review and meta-analysis

PURPOSE

Mechanical bowel preparation (MBP) for elective colorectal surgery has been practiced as a clinical routine for many decades. However, earlier randomized clinical trials (RCTs) and meta-analyses suggest that MBP should be abandoned before colorectal surgery because of the futility in reducing postoperative complications and motility. The new published results from three RCTs comparing MBP with no MBP in colorectal surgery in 2010 make the updating of systemic review and meta-analysis necessary. The aim of this study was to estimate efficacy of MBP in prevention of postoperative complications for elective colorectal surgery.

METHOD

A literature search was performed mainly in electronic database including Cochrane Library, EMBASE, and MEDLINE. The inclusion criteria were randomized clinical trials comparing MBP with no MBP before colorectal surgery. Septic complications, reoperation, and death were recorded as primary and secondary outcomes. The meta-analysis was conducted according to the QUOROM statement.

RESULTS

Fourteen RCTs were included in our analysis with a total number of 5,373 patients: 2,682 with MBP and 2,691 without. Comparing with no MBP for elective colorectal surgery, our study showed that MBP had not reduce any postoperative complications when concerning anastomotic leak [odds ratio (OR) 95% confidence interval (CI), 1.08 (0.82-1.43); P = 0.56]; overall SSI [OR 95% CI, 1.26 (0.94-1.68); P = 0.12]; extra-abdominal septic complications [OR 95% CI, 0.98 (0.81-1.18); P = 0.81]; wound infections [OR 95% CI, 1.21 (1.00-1.46); P = 0.05]; reoperation or second intervention rate [OR 95% CI, 1.11 (0.86-1.45); P = 0.42]; and death [OR 95% CI, 0.97(0.63-1.48); P = 0.88].

CONCLUSION

No evidence was noted supporting the use of MBP in patients undergoing elective colorectal surgery. MBP should be omitted in routine clinical practice.

Effect of Aeromonas hydrophila on reductive dechlorination of DDTs by zero-valent iron

This study presents a reductive transformation method that combines zerovalent iron (ZVI) and Aeromonas hydrophila HS01 with iron oxide reduction property to degrade DDT (1,1-trichloro-2,2-bis(4-chlorophenyl)ethane) under anoxic conditions. The results suggest that HS01 has weak capability in terms of reducing DDT to DDD (1,1-dichloro-2,2-bis(p-chlorophenyl)ethane) and nearly failed to reduce DDD or its transformed intermediates. The coexistence of ZVI and HS01 results in a slight enhancement of DDT degradation compared with the ZVI system alone. The reduction of intermediates by ZVI, however, can be obviously accelerated in the presence of HS01, and the addition of anthraquinone-2,6-disulfonic disodium salt (AQDS) can accelerate the transformation rates further, especially for intermediate reduction. The analysis of the amount and electrochemical properties of Fe(III)/Fe(II) indicates that the presence of HS01 with or without AQDS is beneficial to the reduction of Fe(III) to Fe(II), resulting in the removal of passivating ferric precipitates on the ZVI surface. A mechanism and pathway that clarify the roles of ZVI, HS01, and AQDS in the ZVI + HS01 + AQDS system for DDT transformation are proposed. The quick removal of surface ferric precipitates is thought to be the reason for the enhancement of the transformation of DDT and its intermediates.

Human papilloma virus screening by hybrid capture II in Chinese women of Jiangsu Province

OBJECTIVE

To survey Human Papilloma Virus (HPV) infection in Chinese Women of Jiangsu Province and discuss the relationship between HPV and the biology of cervical cancer.

METHODS

Two thousand, one hundred and fifty-three sexually active women (including 66 cases of cervical cancer) were selected for high-risk human papilloma virus DNA test with Hybrid Capture II (HCII).

RESULTS

The overall HPV prevalence was 32.6% (701/2153) with higher positive rates in cervical carcinoma and Cervical Interstitial Neoplasia (CIN) [93.9% and 54.6%] respectively. For women aged 40-59 years, the overall high-risk HPV prevalence was higher than those of other age groups. Compared with CIN I, the positivity rate and viral load of HPV DNA in CIN III is much higher (80.2% vs. 29.9%, 11.89 vs. 0.53). Ninety-four per cent (64/66) of patients with Cervical cancer were detected to be HPV positive. There was no significant difference in HPV DNA among each clinical stage and pathologic grade. But the positive rates and the value of HPV DNA were higher in the patients with cervical interstitial incursion. Eighty per cent of patients (20/25) could become negative within six months after operation.

CONCLUSIONS

High-risk HPV DNA test is effective in screening for cervical diseases. HCII is an effective method to detect HPV DNA.

Enhanced reductive dechlorination of DDT in an anaerobic system of dissimilatory iron-reducing bacteria and iron oxide

The transformation of DDT was studied in an anaerobic system of dissimilatory iron-reducing bacteria (Shewanella decolorationis S12) and iron oxide (alpha-FeOOH). The results showed that S. decolorationis could reduce DDT into DDD, and DDT transformation rate was accelerated by the presence of alpha-FeOOH. DDD was observed as the primary transformation product, which was demonstrated to be transformed in the abiotic system of Fe(2+)+alpha-FeOOH and the system of DIRB+alpha-FeOOH. The intermediates of DDMS and DBP were detected after 9 months, likely suggesting that reductive dechlorination was the main dechlorination pathway of DDT in the iron-reducing system. The enhanced reductive dechlorination of DDT was mainly due to biogenic Fe(II) sorbed on the surface of alpha-FeOOH, which can serve as a mediator for the transformation of DDT. This study demonstrated the important role of DIRB and iron oxide on DDT and DDD transformation under anaerobic iron-reducing environments.

Lentivirus-mediated expression of MxA in chicken spermatogonial stem cells

The aim of this study was to construct a lentivirus vector that carries the human myxovirus-resistant A (MxA) anti-virus gene for efficiently infecting rooster spermatogonial stem cells (SSCs). A lentiviral vector carrying the enhanced green fluorescent protein (EGFP) and MxA fusion gene (EGFP-MxA) was constructed using TOPO technology in this study. Enhanced green fluorescent protein-MxA was inserted in the right orientation as determined by restriction enzyme digest. No gene recombination in the vector occurred. After infecting 293FT cells, EGFP-MxA fusion protein was expressed as granular green fluorescence characteristic of EGFP-MxA expression, suggesting that the TOPO expression vector was properly constructed and the fusion protein expressed correctly. The EGFP-MxA recombinant lentivirus was packaged by cotransfecting 293FT cells with EGFP-MxA and the packaging plasmids. We also purified SSCs from testicle tissues from 25-day-old roosters for infection with the EGFP-MxA recombinant virus. After infecting rooster SSCs with the recombinant virus for 72 h, EGFP-MxA expression was detected by EGFP expression. Enhanced green fluorescent protein-MxA expression in SSCs was further confirmed at the transcription level by RT-PCR and at the protein level by immunocytochemistry. Staining with Hoechst 33342 showed that infected SSCs differed from the sertoli cells. Similar to stem cells, SSCs were positive for alkaline phosphoric acid enzyme and for stage-specific embryonic antigen-1 stem cell factor. The results demonstrated that the recombinant virus made in our study can infect rooster SSCs efficiently to express the anti-virus protein MxA, establishing the basis of transferring MxA into SSCs to obtain virus-resistant, genetically-modified roosters.

Phosphatidylserine exposure and procoagulant activity in acute promyelocytic leukemia

BACKGROUND

Acute promyelocytic leukemia (APL) frequently causes disseminated intravascular coagulation that can worsen with cytotoxic chemotherapy but improve with the therapeutic differentiating agents, all trans retinoic acid (ATRA) and arsenic trioxide (As(2)O(3)). APL cells display tissue factor but the relationship of tissue factor and other procoagulant activity to phosphatidylserine (PS) exposure is largely unknown.

METHODS

Lactadherin, a milk protein with stereospecific binding to phosphatidyl-L-serine, was used as a probe for PS exposure on an immortalized APL cell line (NB4) and on the cells of eight patients with APL. PS exposure was evaluated with flow cytometry, confocal microscopy, coagulation assays, and purified prothrombinase and factor (F) Xase assays.

RESULTS

Plasma procoagulant activity of NB4 and APL cells increased approximately 15-fold after exposure to etoposide or daunorubicin and decreased 80% after treatment with ATRA or As(2)O(3). Procoagulant activity corresponded to exposed PS on viable APL cells. PS exposure decreased after treatment with ATRA or As(2)O(3) and increased after treatment with daunorubicin or etoposide. Excess lactadherin inhibited 80-85% of intrinsic FXase, FVIIa-tissue factor and prothrombinase activities on both NB4 cells and APL cells. Confocal microscopy identified membrane patches that stained with lactadherin, but not annexin V, demonstrating focal, low-level PS exposure.

CONCLUSIONS

PS is exposed on viable APL cells and is necessary for approximately 80% of procoagulant activity.

Tanshinone IIA pretreatment protects myocardium against ischaemia/reperfusion injury through the phosphatidylinositol 3-kinase/Akt-dependent pathway in diabetic rats

AIM

Diabetes Mellitus (DM) is widely acknowledged to increase the risk of cardiovascular death, which warrants the use of aggressive primary prevention strategies. The aim of the present study was to investigate the pretreatment effects of tanshinone IIA (TSN), a traditional Chinese medicine, on myocardial infarct size, apoptosis, inflammation and cardiac functional recovery in diabetic rats subjected to myocardial ischaemia/reperfusion (I/R).

METHODS

Streptozocin (STZ) induced diabetic rats (n = 80) were randomized to receive TSN, TSN plus wortmannin [a phosphatidylinositol 3-kinase (PI3K) inhibitor] or saline. They were exposed to a 30-min ischaemia by ligation of the left coronary artery except for the sham group. Haemodynamics, infarct size and myocardial apoptosis were examined 3 h after reperfusion. The effects of TSN on Akt and NF-kappaB phosphorylation and the expression of tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in cardiac tissues were examined.

RESULTS

Our results revealed that TSN administration significantly reduced myocardial infarct size (0.252 +/- 0.038 vs. 0.327 +/- 0.027, p < 0.05), improved left ventricular ejection fraction (LVEF) (0.774 +/- 0.058 vs. 0.716 +/- 0.054, p < 0.05), decreased myocardial apoptotic death (0.114 +/- 0.026 vs. 0.191 +/- 0.023, p < 0.05) compared with I/R group. Western blot analysis showed that TSN treatment enhanced Akt phosphorylation and inhibited NF-kappaB phosphorylation in cardiac tissues. Moreover, pretreatment with wortmannin abolished the beneficial effects of TSN: a reduction of infarct size, a decrease in LVEF, inhibition of myocardial apoptosis and Akt phosphorylation, enhancement of NF-kappaB phosphorylation and an increase of cytokine production including TNF-alpha and IL-6 after I/R injury in diabetic rats.

CONCLUSIONS

This study indicates that TSN pretreatment reduces infarct size and improves cardiac dysfunction after I/R injury in diabetic rats. This was accompanied with decreased cardiac apoptosis and inflammation. The possible mechanism responsible for the effects of TSN is associated with the PI3K/Akt-dependent pathway.

Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses

BACKGROUND

The nursing shortage has become an internationally important issue. Nurses' professionalism and job satisfaction have been recognized as strong factors influencing their turnover. As international interchanges in nursing education are growing between Korea and China, understanding the commonalities and differences in factors associated with job satisfaction is critical to improving nurses' job retention.

AIM

To compare the factors influencing job satisfaction among Korean and Chinese nurses.

METHOD

A cross-sectional survey was conducted. The participants were comprised of 693 nurses at three general hospitals in Jinan, People's Republic of China and 593 nurses at two general hospitals in Seoul, Korea. A questionnaire was designed to measure the nurses' professionalism and job satisfaction. Stepwise multiple regression analysis was performed to identify factors related to job satisfaction.

RESULTS

Professionalism was the common factor influencing job satisfaction in Korean and Chinese nurses. Professionalism was positively related to job satisfaction in both groups. Additional factors associated with job satisfaction were demographics and job characteristics such as age, job position and department of work, which were significant only in Korean nurses.

CONCLUSIONS

Professionalism was the most important factor influencing job satisfaction in both Korean and Chinese nurses. Enhancing nursing professionalism is recommended as a common strategy to improve nurses' job retention across different healthcare systems.

Exploratory analysis of psychiatric-related utilization and costs associated with paliperidone ER compared with other oral atypical antipsychotics using pharmacy claims from an administrative database

OBJECTIVE

To compare psychiatric-related healthcare resource utilization (inpatient facility admissions, emergency room visits and ambulatory visits) and costs (medical, pharmacy and total healthcare costs) in patients initiated on paliperidone extended release (ER), risperidone, aripiprazole, olanzapine, ziprasidone or quetiapine.

METHODS

This exploratory, retrospective administrative claims analysis database compared patients from a large US commercial health plan who were initiated on their index oral atypical antipsychotics between January 1, 2007, and June 30, 2007. Cohorts were assigned by first antipsychotic claim and propensity score-matched by age, gender, US census division, race, household income, baseline antipsychotic use, co-morbid conditions and psychiatric-related utilization. Psychiatric-related healthcare resource utilization and costs were measured for 6 months post-initiation. Descriptive analyses compared paliperidone ER with the other cohorts.

RESULTS

There were 562 patients in matched paliperidone ER (n = 95), risperidone (n = 94), aripiprazole (n = 94), olanzapine (n = 89), ziprasidone (n = 95) or quetiapine (n = 95) cohorts. The paliperidone ER cohort had fewer mean psychiatric-related ambulatory visits than the risperidone cohort (p = 0.05). The paliperidone ER cohort had significantly lower mean psychiatric-related medical costs than the olanzapine, quetiapine and ziprasidone cohorts (p < 0.05) and lower total costs than the ziprasidone and olanzapine cohorts (p = 0.02). No other outcomes were significantly different.

LIMITATIONS

Small sample sizes and short post-index observation times due to the launch of paliperidone ER in January 2007, coupled with the inherent lag time with medical claims data, limit the generalizability of the study findings.

CONCLUSION

Patients treated with paliperidone ER may have psychiatric-related utilization costs that are comparable to those of patients who initiated treatment with other oral atypical antipsychotics.

The effect of acidified glucose nutrient solution on preservation of platelet concentrate

The preservation effect of a new platelet solution--acidified glucose nutrient solution (AGN)--was tested by adding AGN to pooled platelet rich plasma (PRP) prior to preparation of platelet concentrates (PC). Each PRP unit was prepared from a unit of whole blood and four PRP of the same blood group were pooled in 400 ml volume PVC bags. Equal aliquots of each pooled PRP were made prior to preparation of PC. AGN was added to one aliquot and nothing was added to the control aliquot. Equal volume and concentration PC were then prepared and the PC were further aliquoted for storage at 22 degrees C. After five days, the parameters of platelet count, pH, aggregability and hypotonic shock response (HSR) for PC preserved in AGN plasma were better than those of the controls preserved in normal ACD plasma. The aggregability and HSR of AGN platelet concentrates recovered to baseline after two h of incubation with fresh plasma. The results of electron microscopy show that platelets preserved in AGN have less changes in morphology. The results of our work suggest that the preservation effect of AGN on PC is similar to the effect of using second generation containers or preparation of platelets from thrombocytapheresis.

Internet addiction among Chinese adolescents: prevalence and psychological features

BACKGROUND

To investigate the prevalence of Internet addiction among Chinese adolescents and to explore the psychological features associated with Internet addiction.

METHODS

A total of 2620 high school students from four high schools in Changsha City were surveyed using Diagnostic Questionnaire for Internet Addiction (YDQ), Eysenck Personality Questionnaire (the edition for children, EPQ), Time Management Disposition Scale (TMDS) and Strengths and Difficulties Questionnaire (SDQ). The mean age of whole sample was 15.19 years (ranging from 12 years to 18 years). According to the modified YDQ criteria by Beard, 64 students who were diagnosed as Internet addiction (the mean age: 14.59 years) and 64 who were diagnosed as being normal in Internet usage (the mean age: 14.81 years) were included in a case-control study.

RESULTS

The rate of Internet use among the surveyed adolescents was 88%, among which the incidence rate of Internet addiction was 2.4%. The Internet addiction group had significantly higher scores on the EPQ subscales of neuroticism, psychoticism, and lie than the control group (P < 0.05). The Internet addiction group scored lower than the control group on the TMDS subscales of sense of control over time, sense of value of time, and sense of time efficacy (P < 0.05). Compared with the control group, the Internet addiction group had also significantly higher scores on the SDQ subscales of emotional symptoms, conduct problems, hyperactivity, total difficulties and lower scores on the subscale of prosocial behaviours (P < 0.05).

CONCLUSIONS

The present study suggests that Internet addiction is not rare among Chinese adolescents. In addition, adolescents with Internet addiction possess different psychological features when compared with those who use the Internet less frequently.

Hematopoietic stem cells prevent hair cell death after transient cochlear ischemia through paracrine effects

Transplantation of hematopoietic stem cells (HSCs) is regarded to be a potential approach for promoting repair of damaged organs. Here, we investigated the influence of hematopoietic stem cells on progressive hair cell degeneration after transient cochlear ischemia in gerbils. Transient cochlear ischemia was produced by extracranial occlusion of the bilateral vertebral arteries just before their entry into the transverse foramen of the cervical vertebra. Intrascalar injection of HSCs prevented ischemia-induced hair cell degeneration and ameliorated hearing impairment. We also showed that the protein level of glial cell line-derived neurotrophic factor (GDNF) in the organ of Corti was upregulated after cochlear ischemia and that treatment with HSCs augmented this ischemia-induced upregulation of GDNF. A tracking study revealed that HSCs injected into the cochlea were retained in the perilymphatic space of the cochlea, although they neither transdifferentiated into cochlear cell types nor fused with the injured hair cells after ischemia, suggesting that HSCs had therapeutic potential possibly through paracrine effects. Thus, we propose HSCs as a potential new therapeutic strategy for hearing loss.

Medical image security in a HIPAA mandated PACS environment

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.

Trends in PACS image storage and archive

PACS is widely used in hospitals and is considered a mission critical system for around-the-clock daily clinical operation. Scheduled or unscheduled downtime of the main PACS archive storage or server could potentially cripple the entire PACS operation. This is especially the case in a filmless hospital environment. Therefore, in a downtime event, it is most desirable for users to have only a minimal performance impact without interruption of clinical data flow or loss of data and to have available historical PACS studies. This paper summarizes some of the developments in the design and implementation of a reliable PACS that insures maximum uptime for end users while preserving the integrity of the PACS data and making it available during downtime events. It also details strategy for developing proper clinical workflow contingency procedures when a scheduled downtime event to the main archive storage and server occurs. Specifically, the design and implementation of a fault-tolerant (FT) main archive server, the development of a FT back-up archive using an application service provider (ASP) model, and the clinical experiences while upgrading a main archive server and migrating the stored PACS data to new storage media will be discussed.

[CaSRB9, a novel Candida albicans gene, plays a role in morphogenesis of Saccharomyces cerevisiae]

Candida albicans is the most frequently isolated fungal pathogen in humans. Many factors are involved in its morphological transition. Flo8 plays an important role in morphogenesis of Saccharomyces cerevisiae. In this work, a C.albicans genomic DNA library was introduced into an S.cerevisiae flo8/flo8 mutant to screen genes which could complement its invasive growth defect. In this screening, a novel gene was isolated and designated CaSRB9 (Candida albicans SRB9 gene). The CaSRB9 gene had an ORF of 4 998 bp, encoding a putative protein of 1 665 amino acids. The CaSrb9 shared highest similarity in amino acids (38%) with Srb9 of S.cerevisiae. Ectopic expression of the CaSRB9 gene in diploid S. cerevisiae suppressed defect in filamentous growth of some mutants in filamentation MAPK pathway (ste7/ste7, ste 12 / ste 12, and tec 1 / tec 1) and flo 8 / flo 8 mutant under nitrogen starvation conditions. In haploid S. cerevisiae, ectopic expressed CaSrb9 complemented the invasive growth defect of flo8 mutant but failed to complement the invasive growth defects of the mutants in filamentation MAPK pathway.

Computer automated approach to the extraction of epiphyseal regions in hand radiographs

Epiphyseal region is the most sensitive region to developmental changes of the skeletal system. Extraction of this area is the very first step in any computerized image analysis. In this report a fully automated analysis of a hand radiograph resulting in extraction of distal and middle regions of the II, III, and IV phalanx is presented. The processing is performed in 3 stages. First, the trend of background is removed from radiograph to obtain a binary hand mask. At this stage a labeling procedure is necessary to eliminate artifacts (markers). Then, II, III, and IV phalanges are identified in the binary image, and the phalangeal axes are drawn. Finally, the intensity profile along each phalangeal axis is analyzed, and, on its basis, distal and middle regions are located. The presented procedure is designed as a part of currently developed system for automatic bone age assessment; however, it also can be as a preprocessing step in other diseases the diagnoses of which may require a computer assistance.

Nuclear aggregation of huntingtin is not prevented by deletion of chaperone Hsp104

Polyglutamine expansion causes the disease proteins to aggregate, resulting in stable insoluble aggregates in the nucleus. The in vitro aggregation and cellular toxicity of polyglutamine proteins are reduced by chaperone heat shock proteins (Hsp). In polyglutamine disease animal models, however, polyglutamine inclusions remain in the nucleus despite the suppression of neurodegeneration by Hsp. Studies using yeast genetic approach revealed that the balance of Hsp is important for regulating protein aggregation in the cytoplasm of yeast cells. Here we report that N-terminal fragments of huntingtin with an expanded polyglutamine tract form aggregates only in the cytoplasm of yeast cells and, when tagged with nuclear localization sequences (NLS), are able to aggregate in the nucleus. Deletion of the Hsp104 gene prevents the aggregation of huntingtin in the cytoplasm but is unable to eliminate the aggregation of NLS-tagged huntingtin in the nucleus. The inhibitory effect of Hsp104 deletion on the cytoplasmic aggregation of huntingtin only occurs in viable yeast cells, as aggregates can be formed in Hsp104 deletion cells that have been frozen for 72 h. Fresh cytosolic extracts of the Hsp104 deletion strain inhibit the aggregation of huntingtin in vitro, suggesting that the deletion of Hsp104 may alter the activities of other cytoplasmic factors to inhibit polyglutamine aggregation in the cytoplasm. We propose that the regulatory effects of chaperones may mainly be restricted to the cytoplasm and have much less influence on polyglutamine-containing aggregates in the nucleus.

[Studies on mimotopes of hepatitis C virus E1 protein]

OBJECTIVE

To study the B-cell epitope of E1 protein of hepatitis C virus.

METHODS

By induction of IPTG, the E.coli M15 strains harboring the pQE30-HCVe118 expressed truncated C-terminal HCV E1 protein (Pte1). The proteins were purified with preparative electrophoreses system, which captured anti-E1 IgG in HCV (+) sera. By applying the antibodies as selective molecular 12 mers random peptide libraries were panned, and positive clones were obtained by ELISA. Amino acid sequences of display peptide were compared with that of HCV E1 protein.

RESULTS

The purified HCV E1 proteins could react specifically with partly anti-HCV sera by ELISA. Among 10 phage display peptides, 6, 6, 2 were the most homologous to HCV E1 protein at position 320-336aa, 251-263aa, 225-248, respectively.

CONCLUSIONS

There exist multiple B-cell epitopes in HCV E1 protein. At least one preponderant epitope is mapped at residues 320-336 of HCV E1 protein.

Computer-assisted bone age assessment: image preprocessing and epiphyseal/metaphyseal ROI extraction

Clinical assessment of skeletal maturity is based on a visual comparison of a left-hand wrist radiograph with atlas patterns. Using a new digital hand atlas an image analysis methodology is being developed. To assist radiologists in bone age estimation. The analysis starts with a preprocessing function yielding epiphyseal/metaphyseal regions of interest (EMROIs). Then, these regions are subjected to a feature extraction function. Accuracy has been measured independently at three stages of the image analysis: detection of phalangeal tip, extraction of the EMROIs, and location of diameters and lower edge of the EMROIs. Extracted features describe the stage of skeletal development more objectively than visual comparison.

A comparative study of the effects of magnetic stimulation and electric stimulation on peripheral nerve injury in rat

The influence of pulsed magnetic stimulation (MS) on the sciatic nerve injury was investigated. Thirty rats were divided into three groups equally: MS group (A), electric stimulation (ES) group (B) and the control group (C). The MS and ES were applied immediately after the first 10 min of the sciatic nerve crush. Sciatic function index (SFI), toe spreading reflex (TSR), muscular weight and volume were measured after the experiment. The TSR of in the groups A and B occurred at 4th day while in the control group it occurs at 10th day. There was statistically significant difference in SFI between groups A and B (P < 0.01). The weight and volume of the gastrocnemius muscle were statistically greater in the groups A and B than in the control group (P < 0.01). The effect of MS was similar to that of ES. It was suggested that the application of MS immediately after the nerve injury might have an important clinical value as it can accelerate functional recovery and prevent or minimize muscle atrophy. The technique is easily to operate, non-invasion, painless and permits tolerance of high intensity output to be used.

Time at confluence for human RPE cells: effects on the adherens junction and in vitro wound closure

PURPOSE

To determine how time at confluence affects the properties of cultured human retinal pigment epithelium (RPE) cells, with emphasis on the adherens junction.

METHODS

Cultures were maintained at confluence without passage for intervals to several months. Adherens junction proteins (N-cadherin, E-cadherin, alpha-catenin, beta-catenin, plakoglobin, and actin) and the proliferation marker Ki-67 were localized in the cultures by fluorescence microscopy, and in vitro wound healing was compared. Adherens junctions were analyzed for protein solubility in detergent buffers and sensitivity to disruption by treatment with anti-cadherin antibodies and low calcium conditions.

RESULTS

Compared with cultures in early-confluence (2-3 days), postconfluent cultures (weeks) had more mature adherens junctions characterized by a circumferential (rather than linear) actin organization, and a zonular (rather than punctate) distribution of more detergent resistant cadherin and catenins. Postconfluent cultures also had fewer Ki-67-positive cells and a higher cell packing density. Early-confluence cells migrated into in vitro wounds as dissociated single cells, whereas postconfluent cells moved as contiguous sheets, retaining an intact junction during wound-induced cell migration and proliferation. Mature junctions were not disrupted by treatment of living cells with N-cadherin antibodies, which bound to and remained detectable at junctions for several days. Calcium withdrawal displaced N-cadherin from mature junctions and rendered it more soluble, but the dominant circumferential pattern of actin was stable. Restoration of medium calcium resulted in a rapid (hours) recovery of a nearly complete zonular pattern of insoluble N-cadherin.

CONCLUSIONS

Over long postconfluent periods, cultured RPE cells became more growth quiescent, and intercellular cadherin adhesions became more stable, exhibiting increased resistance to calcium removal and greater retention of junctional integrity during in vitro wound closure. Consideration should be given to whether the behavior of RPE cells in postconfluent cultures, where intercellular adhesions are more mature, more closely simulates RPE cells in situ than cells in early-confluence cultures, which are more commonly used for analysis.

Digital hand atlas and web-based bone age assessment: system design and implementation

Bone age assessment is a procedure frequently performed in pediatric patients to evaluate their growth disorder. A simple method commonly used in bone age assessment is atlas matching by a radiological examination of a left-hand radiograph against a small reference set of Greulich-Pyle atlas patterns of normal standards. The method however can lead to significant deviation in age assessment, due to a variety of observers with different levels of training. The Greulich-Pyle atlas developed in the 1950s based on middle upper class white populations, is also not fully applicable for children of today, especially regarding the standard development in other racial groups. In this paper, we present our system design and initial implementation of a digital hand atlas and computer-aided diagnostic (CAD) system for Web-based bone age assessment. The CAD system is built on top of existing picture archiving and communication system (PACS), as well as recent advances in Internet technology. It consists of a hand atlas database, a CAD module and a Java-based Web user interface. The digital atlas is based on a large new set of clinically normal hand images of diverse ethnic groups. A relational image database system is used to organize hand images, their extracted quantitative features and patient data. The digital atlas removes the disadvantages of the currently out-of-date Greulich-Pyle atlas and allows the bone age assessment to be computerized. The Java-based Web user interface allows users to interact with the hand image database from browsers. Users can use a Web browser to push a clinical hand image to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, are then extracted and compared with patterns from the atlas database to assess the bone age. The digital atlas method based on open system Internet technology provides an alternative to supplement or replace the traditional one for a quantitative, accurate and cost-effective assessment of bone age.

Nucleotide sequence analyses of partial envgp46 gene of human T-lymphotropic virus type I from inhabitants of Fujian Province in Southeast China

Partial sequences from the env(gp46) gene of two human T-lymphotropic virus type I (HTLV-I) isolates (LIN and WEN) obtained from inhabitants of Fujian Province in southeast China were analyzed. A phylogenetic tree was constructed from these sequence data and those of other known HTLV-I isolates from all over the world. Comparisons of the LIN and WEN nucleotide sequences with other HTLV-I isolates showed diversity ranging from 0.73 to 7.00% for LIN and from 0.87 to 7.00% for WEN. Sequences of isolates LIN, WEN, MT-2, TSP1, and CH were most closely related, and the phylogenetic tree showed that all belong to the widespread subtype A of the cosmopolitan group. These preliminary data indicate that HTLV-I isolates from Fujian Province, China are closely related to HTLV-I strains from Japan and the Caribbean.

High levels of E-/P-cadherin: correlation with decreased apical polarity of Na/K ATPase in bovine RPE cells in situ

PURPOSE

The adherens junction protein E-cadherin induces a basolateral polarity of Na/K ATPase in most epithelial cells that express it, whereas in retinal pigment epithelium (RPE) cells, Na/K ATPase is largely apical. The purpose of this study was to determine whether the distribution of Na/K ATPase differs in RPE cells in situ, that differ in levels of junctional E-cadherin.

METHODS

Bovine RPE cells in situ were immunostained with an E-cadherin antibody (which has some cross-reactivity with the closely related epithelial cadherin P-cadherin), and RPE cells with different levels of junctional stain were identified. RPE cells with low and high E-/P-cadherin were costained in various combinations with Na/K ATPase and interacting proteins of the membrane cytoskeleton (ankyrin, fodrin, and actin) and analyzed by confocal imaging.

RESULTS

Individual RPE cells within the same monolayer differed in amount of Na/K ATPase, with a lower frequency of high expressing cells in the area centralis. High expressing Na/K ATPase cells were found among cells with both low and high E-/P-cadherin levels. In cells with low E/P-cadherin, Na/K ATPase localized to apical microvilli, whereas in high E-/P-cadherin cells, Na/K ATPase was on basolateral surfaces in addition to microvilli. Actin staining showed that microvillar domains were smaller and that lateral membrane domains were taller in high E-/P-cadherin cells. In high but not low E-/P-cadherin cells, ankyrin and fodrin levels varied among cells, with a subset of cells showing distinctly higher expression. Both ankyrin and fodrin had complex subcellular distribution patterns, although they tended to be enriched basal to rather than apical to the adherens junction. Cells with high Na/K ATPase did not necessarily have commensurately higher levels of ankyrin or fodrin. Where both Na/K ATPase and ankyrin were high, they codistributed weakly in apical microvilli but more prominently on the basal cell surface.

CONCLUSIONS

Within the same RPE monolayer, the polarity of Na/K ATPase differs among cells, with a more basal polarity found in cells with high levels of junctional E-/P-cadherin. The increased basal Na/K ATPase was due to a combination of a smaller microvillar domain, a taller lateral domain, and more basolateral staining for Na/K ATPase, perhaps because of an enrichment of a basal ankyrinfodrin membrane cytoskeleton with which Na/K ATPase is known to associate.

The molecular basis of selective permeability of connexins is complex and includes both size and charge

Although gap junction channels are still widely viewed as large, non-specific pores connecting cells, the diversity in the connexin family has led more attention to be focused on their permeability characteristics. We summarize here the current status of these investigations, both published and on-going, that reveal both charge and size selectivity between gap junction channels composed of different connexins. In particular, this review will focus on quantitative approaches that monitor the expression level of the connexins, so that it is clear that differences that are seen can be attributed to channel properties. The degree of selectivity that is observed is modest compared to other channels, but is likely to be significant for biological molecules that are labile within the cell. Of particular relevance to the in vivo function of gap junctions, recent studies are summarized that demonstrate that the connexin phenotype can control the nature of the endogenous traffic between cells, with consequent effects on biological effects of gap junctions such as tumor suppression.

Expression of E-cadherin by human retinal pigment epithelium: delayed expression in vitro

PURPOSE

To determine whether retinal pigment epithelial (RPE) cells, which reportedly express N-cadherin as their major cadherin cell adhesion protein, also express the more common epithelial cadherin, E-cadherin.

METHODS

Cadherins expressed by human RPE cells in situ were examined by western blot analysis of extracts prepared from the RPE of human adult eyes. Cadherins expressed in vitro were examined by analysis of confluent and postconfluent human RPE cultures, using the methods of reverse transcription-polymerase chain reaction (RT-PCR) and western blot analysis. Protein distribution was examined by conventional fluorescence microscopy, confocal imaging, or both. Proteins whose expression, distribution, or both correlated with E-cadherin expression in other epithelial cells were examined by similar methods in cultured RPE cells.

RESULTS

In addition to N-cadherin, E-cadherin (and P-cadherin) was found in adult human RPE in situ. In cultured human RPE cells, N-cadherin was ubiquitous, but E-cadherin was limited to patches of cells and was not expressed until several weeks after confluence, a time when several phenotypic variants become prominent. E-cadherin was absent from RPE cells of fusiform shape but was found in only a subset of epithelioid RPE cells. Unlike epithelial cell lines expressing E-cadherin, cultured RPE cells with E-cadherin did not show diminished coexpression of N-cadherin, increased expression of desmosomal proteins, or a preferential expression of the alphaE- (rather than alpha-N) isoform of the cadherin linker protein alpha-catenin. Na/K ATPase distributed to both apical and basolateral membranes in RPE cells with junctional E-cadherin and not preferentially to the basolateral domain as in most epithelial cells with E-cadherin.

CONCLUSIONS

RPE cells express E-cadherin, a cadherin found in most other epithelial cells, but which was believed to be absent from RPE. In RPE in vitro, E-cadherin expression is a late developmental event, occurring in late confluence in cells that already express N-cadherin. E-cadherin is an established epithelial morphoregulatory protein, but it does not induce the same properties in RPE cells as in other epithelial cells, suggesting tissue-specific differences in the potential of E-cadherin to determine an epithelial phenotype.

Progressive association of a "soluble" glycolytic enzyme with the detergent-insoluble cytoskeleton during in vitro morphogenesis of MDCK epithelial cells

In MDCK epithelial cells, cell contact at confluency initiates a protracted process of morphogenesis during which several proteins known to bind the cytoskeleton become progressively associated with the detergent-resistant cell fraction and distributed to their characteristic polarized domains. Using extraction protocols that identify this tight cytoskeletal linkage, here we show a similar but slower, time-dependent enrichment in the detergent resistant fraction of glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a highly abundant glycolytic enzyme that is traditionally considered soluble. Similar enrichment did not occur for two other glycolytic enzymes, phosphoglycerate mutase or lactate dehydrogenase. Insoluble GAPDH was not homogeneously distributed in the cytoplasm but rather displayed several discrete patterns that varied within and among MDCK cells. It also localized prominently to a few nuclei in the phenotypically heterogeneous cells of late confluency cultures. Disruptors of cytoskeletal filaments were relatively ineffective in the postconfluent epithelial monolayers, although use of disrupting agents implicated actin as the cytoplasmic filament that tethers insoluble GAPDH. Catalytic activity could be demonstrated in the insoluble fraction of GAPDH from postconfluent cultures, but only after release by mechanical disruption of insoluble extracts. Treatment of postconfluent cells with agents that deplete ATP diminished the fraction of cytoskeletally associated GAPDH, and levels of insoluble GAPDH were restored with ATP repletion, suggesting that ATP levels may regulate cytoskeletal linkage and thereby local enzyme activity. We conclude that the highly abundant and ubiquitous enzyme GAPDH becomes progressively enriched in detergent stable subcellular compartments during the process of epithelial morphogenesis. The process that produces GAPDH compartments is slow, suggesting that epithelial cells just at confluency, when they are typically analyzed, have not yet maximized the organizational state that can be attained in monolayer culture.

[Functional improvement of remnant stomach after proximal subtotal gastrectomy for cardiac cancer]

OBJECTIVE

To evaluate the function of the remnant stomach after proximal subtotal gastrectomy for cardiac cancer and to improve the life quality of post-surgical patients.

METHODS

17 patients with cardiac cancer underwent proximal subtotal gastrectomy combined with disconnection of pyloric sphincter (PSG + DPS) by finger pressing. Intraoperative pyloric manometric studies were performed in the 17 patients before and after DPS. Five subjects who underwent laparotomy for non-esophagogastric reasons was taken as controls. Total bile acids (TBA) in gastric juice was tested in the 17 patients at 5th postoperative day, and radionuclide gastric emptying was also studied from the 18th to 20st postoperative day.

RESULTS

Both pyloric resting pressure and pyloric contracting pressure were significantly decreased after DPS (P > 0.01). In comparison with normal subjects, PCP was increased before DPS (P > 0.01) and decreased after the procedure (P < 0.05). However, PRP did not show significant differences before (P > 0.05) and after (P > 0.05) DPS. There were no significant differences regarding TBA content in gastric juice in PSG + DPS group, PSG group, and normal subjects (P > 0.05). The time required for the stomach to empty half of its radioactive contents (T1/2) was longer in the patients having PSG only than those undergoing PSG + DPS (P < 0.01) and normal controls (P < 0.05). However, there were no significant differences regarding T1/2 between the patients with PSG + DPS and normal controls (P > 0.05).

CONCLUSIONS

The emptying of remnant stomach after subtotal gastrectomy for cardiac cancer is delayed because of the increase of emptying-resistance and decrease of peristalsis. PSG combined with DPS not only improves gastric emptying, but also prevents duodenogastric reflux. Consequently, postoperative life quality of the patients with cardiac cancer can be effectively improved.