Leiomyosarcoma of ovarian vein compression as a cause of hydronephrosis

We present a case of leiomyosarcoma of the right ovarian vein with MRI findings. The patient was a 52-year-old woman who had suffered from right flank pain for one week. Abdominal ultrasound and excretory urography revealed hydronephrosis of the right kidney. Ureteroscopy showed external compression at the right upper third of the ureter. CT and MRI of the abdomen revealed a retroperitoneal mass with compression of the right ureter. The retroperitoneal mass proved on histology to be a leiomyosarcoma arising from the right ovarian vein.

Monitoring and assessing variation of sewage quality and microbial functional groups in a trunk sewer line

In this study, the variation of sewage quality was investigated and the active fraction of different microbial functional groups in biofilm was quantified in a 5.6-km trunk sewer line. The sewage quality including suspended solids, biochemical oxygen demand, total chemical oxygen demand (COD), total nitrogen, total Kjeldahl nitrogen, ammonia nitrogen, nitrite nitrogen, and nitrate nitrogen were measured and compared with the values in literatures. The results indicated that since the wastewater treatment plant was not operated at its full capacity, the concentrations of different compounds were lower compared with the values in literatures. The values of heterotrophic growth rate constant lay between 5.6 and 8.6 day(-1). Its average value was 7.7 day(-1). The values of heterotrophic lysis rate constant lay between 0.2 and 0.4 day(-1). The active heterotrophic biomass in biofilm varied from 240 to 800 mg COD m(-2) and average value was 497 mg COD m(-2). The biofilm mass varied from 880 to 1,080 mg m(-2). The percentage of heterotroph to biofilm mass fall within the range of 24.0-90.9% and average value was 52.9%. In the oxygen uptake rate batch tests, the biomass, growth rate constant, and lysis rate constant of autotroph could not be determined because the fraction of autotroph in biofilm was relatively few. It revealed that the degradation of organic matters, nitrification, and denitrification occurred in the trunk sewer line. But the results indicate that the condition seem favorable for nitrification.

Effects of capsaicin-containing red pepper sauce suspension on esophageal secondary peristalsis in humans

BACKGROUND

Capsaicin-sensitive afferents have been implicated in the modulation of gastrointestinal sensorimotor functions. Secondary peristalsis is important for the clearance of retained refluxate or material from the esophagus. The aim of this study was to evaluate the effects of capsaicin-containing red pepper sauce suspension on esophageal secondary peristalsis in healthy adults.

METHODS

After a baseline recording of esophageal motility, secondary peristalsis was generated by slow and rapid mid-esophageal injections of air in 10 healthy subjects. Two separate sessions with saline and capsaicin-containing red pepper sauce were randomly performed to test their effects on esophageal secondary peristalsis.

KEY RESULTS

Infusion of capsaicin significantly increased pressure wave amplitude during rapid (P = 0.002) and slow air infusions (P = 0.01). After capsaicin, the threshold volume to generate secondary peristalsis was significantly decreased during rapid (P < 0.05) and slow air infusions (P = 0.02). Infusion of saline did not affect any parameters of secondary peristalsis during rapid or slow air infusion. The administration of capsaicin was accompanied by the occurrence of heartburn in all subjects.

CONCLUSIONS & INFERENCES

The acute administration of capsaicin-containing red pepper sauce suspension enhances sensitivity to distension-induced secondary peristalsis and facilitates secondary peristaltic contractility. These data suggest the involvement of capsaicin-sensitive afferents in the modulation of esophageal distension-induced secondary peristalsis in humans.

Disease progression in non-erosive reflux disease (NERD): impact of initial esophageal acid exposure

We investigated the 5-year clinical course in a cohort of patients with typical reflux symptoms and negative endoscopy. Prospective follow-up was conducted in patients with non-erosive reflux disease (NERD) for at least 5 years after initial evaluation with esophageal pH monitoring and upper gastrointestinal endoscopy. Within the last year of follow-up, reflux symptoms occurred in 27 of the 30 patients (90%). Twenty-five of twenty-seven symptomatic patients (93%) were on acid suppression therapy. The majority of our patients (70%) remained unchanged regarding their endoscopic status over 5 years. Progression to erosive esophagitis occurred in four patients with Los Angeles (LA) A (13%), three patients with LA B (10%), and two patients with LA C (7%). The presence of pathological acid exposure did not alter the presence of reflux symptoms over 5 years. Disease progression to erosive esophagitis occurred more frequently in patients with pathological acid exposure than those without pathological acid exposure (P= 0.025). Most NERD patients have symptoms and require acid suppression therapy 5 years after their initial diagnosis. Initial pathological acid exposure does not influence the use of acid suppression; however, it does influence the progression of NERD within 5 years of follow-up.

Evidence for neurotrophic factors associating with TRPV1 gene expression in the inflamed human esophagus

BACKGROUND

Transient receptor potential vanilloid-1 (TRPV1) receptor has been implicated in the mechanism of acid induced inflammation in gastro-esophageal reflux disease (GERD). It has been demonstrated that the increase in nerve growth factor (NGF) and glial derived neurotrophic factor (GDNF) was associated with the increased expression of TRPV1. We aimed to determine whether expression of TRPV1 was increased in severe inflamed human esophagus, and to test the hypothesis whether the expression of TRPV1 was mediated by neurotrophic factors such as NGF and GDNF.

METHODS

We compared biopsies taken from the distal esophagus of 15 patients with erosive GERD, 16 asymptomatic patients (AP), and 10 healthy controls. We assessed the biopsies with reverse transcription polymerase chain reaction (RT-PCR) and real-time quantitative polymerase chain reaction (qPCR) for TRPV1, NGF, and GDNF. Immunohistochemical analysis of TRPV1 protein expression was also determined.

KEY RESULTS

Transient receptor potential vanilloid-1 mRNA level and its protein expression were significantly greater in patients with erosive esophagitis than AP (P < 0.001) and healthy controls (P < 0.001). Nerve growth factor and GDNF gene levels in the esophageal mucosa were also significantly increased in patients with erosive esophagitis compared with AP and healthy controls (all P < 0.001). Transient receptor potential vanilloid-1 mRNA correlated well with NGF (r = 0.61, P < 0.001) and GDNF (r = 0.58, P < 0.001).

CONCLUSIONS & INFERENCES

These results support the association of NGF and GDNF in the up-regulation of TRPV1 receptors in patients with erosive esophagitis.

Ferroelectric BaTiO3 thin films on Ti substrate fabricated using pulsed-laser deposition

We report on the fabrication of ferroelectric BaTiO3 thin films on titanium substrates using pulsed laser deposition and their microstructures and properties. Electron microscopy studies reveal that BaTiO3 films are composed of crystalline assemblage of nanopillars with average cross sections from 100 nm to 200 nm. The BaTiO3 films have good interface structures and strong adhesion with respect to Ti substrates by forming a rutile TiO2 intermediate layer with a gradient microstructure. The room temperature ferroelectric polarization measurements show that the as-deposited BTO films possess nearly the same spontaneous polarization as the bulk BTO ceramics indicating formation of ferroelectric domains in the films. Successful fabrication of such ferroelectric films on Ti has significant importance for the development of new applications such as structural health monitoring spanning from aerospace to civil infrastructure. The work can be extended to integrate other ferroelectric oxide films with various promising properties to monitor the structural health of materials.

Two-dimensional metallic tungsten nanowire network fabricated by electron-beam-induced deposition

One-dimensional tungsten nanowires and two-dimensional tungsten nanowire networks were fabricated on a tungsten substrate by using electron-beam-induced deposition (EBID) without precursor injection. The as-prepared tungsten nanostructures were studied using a combination of energy-dispersive x-ray spectroscopy and selected area electron diffraction. It was revealed that the tungsten nanostructures were composed of pure metallic tungsten. The WO(3) oxide formed in the chemical preparation of tungsten foils was probably the source of tungsten for the fabrication of tungsten nanostructures by EBID.

Application of low-volume zero-balanced ultrafiltration and its effect on blood propofol concentration: a randomized controlled trial

AIM

The aim of this study was to evaluate the effectiveness of low-volume zero-balanced ultrafiltration during cardiopulmonary bypass in heart valve replacement surgery.

METHODS

This was a randomized, double-blind, controlled study carried out in the operating room. Forty patients of ASA grade II-III, elected to undergo heart valve replacement surgery, were enrolled. All patients were randomly assigned to either a low-volume (35 mL/kg) zero-balanced ultrafiltration group (N.=20) or to a control group (N.=20). Blood propofol concentrations and entropy index were measured using cardiopulmonary bypass. Concentrations of plasma tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-10 (IL-10), and cardiac troponin I were measured before and after the end of cardiopulmonary bypass and corrected according to hematocrit.

RESULTS

Blood levels of cardiac troponin I, TNF-alpha, IL-6, and IL-10 after surgery were all significantly lower in the ultrafiltration group than in the control group (P<0.05) after the end of bypass. Blood propofol concentrations decreased significantly in both groups during cardiopulmonary bypass and remained significantly lower in the ultrafiltration group than the control group. However, there was no significant difference between the two groups in the entropy index (P=0.5583).

CONCLUSION

Low-volume zero-balanced ultrafiltration performed during cardiopulmonary bypass surgery significantly decreased post-bypass levels of the cytokines, TNF-alpha, IL-6, IL-10, and postoperative cardiac troponin I. Blood propofol concentration was also decreased; however, the depth of anesthesia was not affected significantly.

Evidence for oesophageal visceral hypersensitivity and aberrant symptom referral in patients with globus

We tested the hypotheses that globus patients demonstrate oesophageal visceral hypersensitivity and aberrant viscerosomatic referral of oesophageal stimuli. Oesophageal visceral perception was assessed by oesophageal balloon distension and electrical stimulation in nine patients with globus and compared with 11 healthy controls. Oesophageal perception and pain thresholds were determined. Subjects recorded the area of thoracic viscerosomatic referral on a body map in response to each stimulus. All the patients reported their first sensation at balloon volumes between 2 and 6 mL whereas controls reported their first sensation at volumes between 3 and 14 mL (P = 0.03). All the patients reported pain at balloon volumes between 5 and 12 mL whereas controls experienced pain at volumes between 8 and 20 mL (P = 0.001). In response to electrical stimulation to the oesophagus patients and controls demonstrated comparable sensory thresholds. In response to oesophageal balloon distension seven of nine patients, but no controls, referred the sensation to the region at or above the suprasternal notch (P = 0.001). Similarly, significant differences in viscerosomatic referral pattern were observed in response to oesophageal electrical stimulation (P = 0.03). Patients with globus demonstrate oesophageal visceral hypersensitivity to mechanical distension. The differential responses to stretch and electrical stimuli may indicate that the hypersensitivity is a peripheral, rather than central, phenomenon. The aberrant referral of oesophageal sensations in response to both mechanical and electrical stimulation supports the hypothesis that referral of symptoms to the neck might be a central phenomenon.

Detection of urine and blood clenbuterol following short-term oral administration in the horse

BACKGROUND AND AIM

The pharmacokinetics of clenbuterol in equine urine and blood was investigated.

MATERIAL AND METHODS

Urine and blood samples were collected following 3-day multiple oral administrations. The samples were examined using enzyme-linked immunosorbent assay and further confirmed by solid phase extraction and capillary electrophoresis.

RESULTS

Urinary clenbuterol was detectable until day 14 after the last dose. The urinary excretion of clenbuterol was characterized by a biphasic pattern. The half-lives of the bi-exponential elimination (t(1/2alpha) and t(1/2beta)) for urinary clenbuterol were about 12.1 and 48 hours. After a single oral administration (4 microg/kg) of clenbuterol, the half-life of serum clenbuterol was approximately 11.4 hours.

Silver nanowires with a monoclinic structure fabricated by a thermal evaporation method

Silver nanowires with a monoclinic structure (mono-Ag NWs) were fabricated by a thermal evaporation method for the first time. The crystal lattice parameters of the mono-Ag NWs were calculated using the UnitCell program. They are as follows: a = 0.303 nm, b = 1.140 nm, c = 0.292 nm, and beta = 118.5 degrees. In situ annealing experiments revealed that the as-prepared mono-Ag NWs transited to fcc-Ag NWs during annealing at approximately 1173 K for 60 s.

Enhancement of random lasing based on the composite consisting of nanospheres embedded in nanorods template

A simple and general approach has been developed for the enhancement of random lasing based on the composite consisting of nanospheres and nanorods array. Due to the inherent nature of high refractive index, the selected nanorods act efficiently as scattering feedback centers, which can promote the formation of closed loop paths of the emission arising from nanospheres. To illustrate our working principle, the composite consisting of Tb(OH)(3)/SiO(2) nanospheres and ZnO nanorods was chosen as an example. Quite interestingly, it is found that the random lasing behavior can be easily achieved for the composite system, while it is absent in pure Tb(OH)(3)/SiO(2) nanospheres. The strategy demonstrated here should be very useful for the future development of coherent light emission sources and many other optoelectronic devices.

In situ TEM observation of the growth and decomposition of monoclinic W(18)O(49) nanowires

The growth of monoclinic W(18)O(49) nanowires by heat treatment of a tungsten filament at approximately 873 K and the decomposition of these nanowires under 200 keV electron irradiation at approximately 1023 K have been investigated using in situ transmission electron microscopy (TEM). In situ TEM observation of the growth confirmed the vapor-solid growth mechanism of the monoclinic W(18)O(49) nanowires. In situ irradiation experiments revealed the formation of metallic bcc tungsten from monoclinic W(18)O(49) nanowires under 200 keV electron irradiation.

Inhibiting glycogen synthase kinase-3 reduces endotoxaemic acute renal failure by down-regulating inflammation and renal cell apoptosis

BACKGROUND AND PURPOSE

Excessive inflammation and apoptosis are pathological features of endotoxaemic acute renal failure. Activation of glycogen synthase kinase-3 (GSK-3) is involved in inflammation and apoptosis. We investigated the effects of inhibiting GSK-3 on lipopolysaccharide (LPS)-induced acute renal failure, nuclear factor-kappaB (NF-kappaB), inflammation and apoptosis.

EXPERIMENTAL APPROACH

The effects of inhibiting GSK-3 with inhibitors, including lithium chloride (LiCl) and 6-bromo-indirubin-3'-oxime (BIO), on LPS-treated (15 mg x kg(-1)) C3H/HeN mice (LiCl, 40 mg x kg(-1) and BIO, 2 mg x kg(-1)) and LPS-treated (1 microg x mL(-1)) renal epithelial cells (LiCl, 20 mM and BIO, 5 microM) were studied. Mouse survival was monitored and renal function was analysed by histological and serological examination. Cytokine and chemokine production, and cell apoptosis were measured by enzyme-linked immunosorbent assay and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling staining, respectively. Activation of NF-kappaB and GSK-3 was determined by immunostaining and Western blotting, respectively.

KEY RESULTS

Mice treated with GSK-3 inhibitors showed decreased mortality, renal tubular dilatation, vacuolization and sloughing, blood urea nitrogen, creatinine and renal cell apoptosis in response to endotoxaemia. Inhibiting GSK-3 reduced LPS-induced tumour necrosis factor-alpha (TNF-alpha) and CCL5/RANTES (released upon activation of normal T-cells) in vivo in mice and in vitro in murine kidney cortical collecting duct epithelial M1 cells. Inhibiting GSK-3 did not block TNF-alpha-induced cytotoxicity in rat kidney proximal tubular epithelial NRK52E or in M1 cells.

CONCLUSIONS AND IMPLICATIONS

These results suggest that GSK-3 inhibition protects against endotoxaemic acute renal failure mainly by down-regulating pro-inflammatory TNF-alpha and RANTES.

Europium adsorption on multiwall carbon nanotube/iron oxide magnetic composite in the presence of polyacrylic acid

This paper examines the interaction between Eu(III) and a multiwall carbon nanotube (MWCNT)/iron oxide magnetic composite in the absence and presence of poly(acrylic acid) (PAA). PAA was used as a surrogate for natural organic matter. The effects of pH, initial Eu(III) concentration, and PAA on Eu(III) adsorption on the magnetic composite were investigated using a batch technique. Percentage adsorption of Eu(III) on the magnetic composite increased with increasing pH and decreased with initial Eu(III) concentration. PAA adsorption on the magnetic composite decreased with increasing pH and was not obviously affected bythe presence of Eu(III). The presence of PAA resulted in strong enhancement of Eu(III) adsorption below pH 4.5. However, above pH 5, an increase in soluble Eu-PAA complexes resulted in a decrease in Eu(III) adsorption on the magnetic composite. With increasing PAA concentrations, maximum adsorption of Eu(III) decreased and the adsorption "edge" shifted toward a lower pH range. Obvious difference of Eu(III)/PAA addition sequences on Eu(III) adsorption was observed above pH 4. The Freundlich model fitted Eu(III) adsorption isotherms very well in the absence and presence of PAA. These results are important for estimating and optimizing the removal of organic and inorganic pollutants by the magnetic composite.

Proximal versus distal oesophageal motility as assessed by combined impedance and manometry

BACKGROUND

Regional differences in oesophageal motility have been shown in primary peristalsis, but it is unclear whether such differences occur in secondary peristalsis. We investigated whether oesophageal motor function differs between the proximal and distal oesophagus.

METHODS

Eleven healthy subjects were studied with combined impedance and manometry. Saline and solid agar boluses of 5 ml were applied for primary peristalsis, and secondary peristalsis was stimulated by rapid mid-oesophageal injections of saline. Impedance tracings were analysed and compared for bolus presence time, bolus transit time in the proximal and distal oesophagus.

RESULTS

Most of the manometric parameters were not significantly different between the proximal and distal oesophagus. Bolus presence time was longer in the distal oesophagus for both primary peristalsis and secondary peristalsis (p<0.001). The proximal bolus transit time was shorter than the distal bolus transit time during saline and solid swallows (p<0.001). Bolus transit time and bolus presence time were shorter for primary peristalsis than secondary peristalsis induced by saline injection.

CONCLUSION

Our data demonstrated that the impedance technique can successfully detect functional differences between the proximal and distal oesophagus, and such differences were still noticeable when the oesophagus was directly stimulated by saline injection.

Single-walled carbon nanotube based pH sensors on a flexible parylene-C substrate

In this paper, we present a suspended Single-Walled Carbon Nanotube (SWNT) based pH sensor utilizing a low temperature Dielectrophoretic (DEP) assembly process on a flexible parylene-C substrate. Parylene-C, a light weight, flexible and inert material, is compatible with many microfabrication processes. Furthermore, utilizing parylene-C as a flexible substrate, one can readily create a suspended microplatform utilizing an O2 plasma etch process. Suspended nanobridges have larger exposed surface areas and may potentially have enhanced sensitivity for sensing applications. Fabricating these structures on a thin (10 microm) parylene-C substrate allows their utilization as flexible devices or in wearable sensor applications. We have successfully assembled suspended SWNT nanobridges across a spacing of 4 microm. The electrical characterization results from the assembled SWNTs yield ohmic behavior with a measured two-terminal resistance of approximately 17Komega. Furthermore, the conductometric measurements of the SWNT sensors have demonstrated that corresponding to an increase in pH value, the resistance of SWNTs has decreased due to the OH- group that attached on to the wall of the SWNTs and changed the electrical properties of the SWNTs. These novel suspended nanostructures can be used as potential candidates in nanosensor applications.

Induction of indoleamine 2,3-dioxygenase in livers following hepatectomy prolongs survival of allogeneic hepatocytes after transplantation

OBJECTIVES

Indoleamine 2,3-dioxygenase (IDO), which catalyzes the breakdown of tryptophan into kyneurenine, has immunologic significance for the induction of maternal tolerance and liver allograft tolerance by inhibiting T-cell activation. In the present study, we compared survival of syngeneic or allogeneic hepatocytes in livers with or without hepatectomy. Subsequently, we investigated gene expression and localization of IDO in the recipient liver.

METHODS

DA and Fisher 344 rats were used in the following experimental groups: group 1, DA hepatocytes transplanted into hepatectomized Fisher 344 rats; group 2, Fisher 344 hepatocytes transplanted into hepatectomized Fisher 344 rats; group 3, DA hepatocytes transplanted into nonhepatectomized Fisher 344 rats; and group 4, Fisher 344 hepatocytes transplanted into nonhepatectomized Fisher 344 rats. After transplantation, the surviving cells were evaluated on day 5. The IDO signal of the recipient liver was detected by reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry.

RESULTS

In the hepatectomized groups subjected to allogeneic or syngeneic hepatocyte transplantation, the number of surviving hepatocytes was greater than in the nonhepatectomized group after transplantation. The IDO signals (RT-PCR) in the hepatectomized groups were stronger than those in the nonhepatectomized groups. Immunohistochemistry demonstrated that the IDO signal is located in liver antigen-presenting cells, such as Kupffer cells or dendritic cells, and not expressed in hepatocytes.

CONCLUSIONS

Our results demonstrated that IDO is induced in antigen-presenting cells of hepatectomized livers by which subsequently transplanted cells may be protected from rejection by inhibiting indirect or direct recognition of donor antigen and further T-cell activation.

Identification of impaired oesophageal bolus transit and clearance by secondary peristalsis in patients with non-obstructive dysphagia

Impaired secondary peristalsis has been shown in non-obstructive dysphagia (NOD). The relationship between such changes and alterations in bolus transport has not been studied. The aim of this study was to evaluate the integrity and characteristics of oesophageal bolus transit by secondary peristalsis in NOD patients with multichannel intraluminal impedance (MII). Eleven healthy volunteers and 10 consecutive patients underwent combined MII recording and manometry. Secondary peristalsis was stimulated by mid-oesophageal injections of saline. Values for bolus presence time at each of the recording sites and bolus transit time were calculated. Bolus transit was considered to be complete when impedance defined complete bolus clearance at all recording sites. Secondary peristaltic responses were triggered significantly less frequently in patients with NOD than in controls (P < 0.001). The proportion of secondary peristalsis demonstrating complete bolus transit was lower in NOD patients than in controls (P < 0.001). Oesophageal bolus transit time by secondary peristalsis was longer in NOD patients than in controls (P = 0.005), as was bolus presence time at each of the recording sites (P < 0.05). When compared with controls, NOD patients demonstrated a higher proportion of incomplete bolus transit in response to normal secondary peristalsis (P < 0.001). Abnormal bolus transit occurred more often associated with ineffective and synchronous responses than normal responses in both groups studied (P < 0.001). Multichannel intraluminal impedance identifies functional defects of oesophageal bolus clearance by secondary peristalsis in NOD patients and such defects are characterized by a longer oesophageal dwell and a prolonged clearance time.

Magnetic ground state and transition of a quantum multiferroic LiCu2O2

Based on resonant soft x-ray magnetic scattering, we report that LiCu2O2 exhibits a large interchain coupling which suppresses quantum fluctuations along spin chains, and a quasi-2D short-range magnetic order prevails at temperatures above the magnetic transition. These observations unravel the fact that the ground state of LiCu2O2 possesses long-range 2D-like incommensurate magnetic order rather than being a gapped spin liquid as expected from the nature of quantum spin-1/2 chains. In addition, the spin coupling along the c axis is found to be essential for inducing electric polarization.

Clinical correlates of dysphagia to oesophageal dysmotility: studies using combined manometry and impedance

This study aimed to elucidate the mechanism of dysphagia by determining the simultaneous relationships between subjective perception of swallow with oesophageal motility and bolus transport in patients with non-obstructive dysphagia (NOD). Combined oesophageal manometry and impedance was performed in 18 consecutive NOD patients and 14 healthy controls. Swallow was abnormal if the amplitude of distal oesophageal contractions was less than 30 mmHg or simultaneous contractions occurred. Bolus transit was abnormal if bolus exit was not found at one or more of the measuring sites. Perception of each swallow was assessed using a standardized scoring system and was enhanced if score was >1. The prevalence of complete bolus transit was lower in NOD patients compared with healthy controls (P = 0.001). Abnormal liquid bolus transit was found in 40% of patients with normal motility and 38% of patients with abnormal motility, whereas abnormal viscous bolus transit was observed in 38% of patients with normal motility and 70% of patients with abnormal motility. Agreement between enhanced perception and impedance was poor during liquid (kappa = 0.12, 95% CI: -0.003 to 0.233) and viscous swallowing (kappa = 0.12, 95% CI: -0.004 to 0.244). Agreement between enhanced perception and manometry was even poorer during liquid (kappa = -0.16, 95% CI: -0.302 to 0.022) and viscous swallowing (kappa = -0.12, 95% CI: -0.25 to 0.002). NOD patients show poor correlation between dysphagia and oesophageal motility parameters. The results suggest that, in patients with NOD, oesophageal motor dysfunction may play a limited role, if any, in the generation of dysphagia.

Differences in oesophageal bolus transit between patients with and without erosive reflux disease

BACKGROUND

We determined any difference in oesophageal function between reflux patients with and without erosive esophagitis by the application of concurrent manometry and impedance.

METHODS

Twenty patients with erosive esophagitis, 20 patients with non-erosive reflux disease, and 15 controls were included in this study. All subjects underwent studies with a catheter containing four impedance-measuring segments and five solid-state pressure transducers. Each subject received 10 liquid and 10 viscous boluses to be swallowed.

RESULTS

Healthy controls had greater distal oesophageal peristaltic amplitude than both patient groups (p < 0.05). Normal oesophageal peristalsis was found more frequently in healthy controls than either of the patient groups (p < 0.05). Patients with erosive esophagitis exhibited a lower percentage of complete bolus transit compared to healthy controls and non-erosive reflux disease patients (both p < 0.05). Patients with erosive esophagitis had a longer total bolus transit time compared to healthy controls and non-erosive reflux disease patients (both p < 0.05).

CONCLUSIONS

Erosive esophagitis is characterized by longer oesophageal bolus transit and fewer complete bolus transit than non-erosive reflux disease. The noted differences in oesophageal bolus transit may reflect a continuum of dysfunction secondary to increasing oesophageal mucosal damage.

The role of a nuclear protein, histone H1, on signalling pathways for the maturation of dendritic cells

We have demonstrated previously that liver allograft tolerance is associated with the immunosuppressive activity of anti-histone H1 autoreactive antibodies induced in the serum of liver transplantation. Furthermore, we and others have shown that nuclear proteins such as histone H1 and high mobility group box 1 play an important role in maturation of dendritic cells (DCs), although the precise mechanisms are still unknown. In the present study, we focus upon the significance of histone H1 on DCs in terms of the intracellular signalling pathway of DCs. Our immunostaining and immunoblot studies demonstrated that histone H1 was detected in cytoplasm and culture supernatants upon the activation of DCs. Histone H1 blockage by anti-histone H1 antibody down-regulated the intracellular activation of mitogen-activated protein kinases (MAPKs) (p38) and IkappaBalpha of DCs, and inhibited DC activity in the proliferation of CD4+ T cells. On the other hand, the addition of histone H1 without endotoxin stimulation up-regulated major histocompatibility complex class II, the CD80 and CD86 surface markers of DCs and the activation of MAPKs (p38 and extracellular-regulated kinase 1/2) and IkappaBalpha. These results suggest that the translocation of histone H1 from nuclei to cytoplasm and the release of their own histone H1 are necessary for the maturation of DCs and the activation for T lymphocytes.

Utility of esophageal impedance in identifying dysmotility in patients with erosive esophagitis

This study was intended to assess the utility of combined multiple intraluminal impedance and esophageal manometry (MII-EM) in evaluating reflux patients and in identifying those with esophageal dysmotility. Thirteen controls and 20 patients with gastroesophageal reflux disease (GERD) underwent combined MII-EM with a catheter containing four impedance-measuring segments and four solid-state pressure transducers. Each subject received 10 liquid and 10 viscous boluses to be swallowed. Distal esophageal contraction amplitude was significantly lower in GERD patients than in controls for viscous swallows (58.3 +/- 7.3 mmHg versus 82.4 +/- 4.1 mmHg, P = 0.005). Total bolus transit time was significantly slower in GERD patients than in controls for liquid swallows (P = 0.035). The percentages of complete bolus transit were significantly lower in GERD patients compared with controls (all P = 0.005). Half of GERD patients with normal EM still had abnormal bolus transit while three-quarters of those with abnormal EM had abnormal bolus transit. MII helps identify bolus transit abnormalities not detected by conventional manometry. Combined MII-EM is clinically useful for detecting esophageal dysmotility in patients with erosive esophagitis.