Immediate and late clinical and angiographic outcomes after GFX coronary stenting: is high-pressure balloon dilatation necessary?

BACKGROUND

The GFX stent is a balloon-expandable stent made of sinusoidal element of stainless steel. The adjunct high-pressure balloon dilatations were usually recommended in routine stenting procedure.

HYPOTHESIS

The aim of this study was to evaluate the immediate and long-term clinical and angiographic outcomes and to investigate the necessity of high-pressure balloon dilatation during GFX stenting.

METHODS

In all, 172 consecutive patients underwent single 12 or 18 mm GFX stent implantation in 188 native coronary lesions. Two types of stenting technique were used: (1) stent size of a final stent-to-artery ratio of 1:1 (inflation pressure > 10 atm, high-pressure group), and (2) stent size of 0.5 mm bigger than reference vessel (inflation pressure < or = 10 atm, low-pressure group). The adjunct high-pressure balloon dilatations were performed only in cases of suboptimal results.

RESULTS

The adjunct high-pressure balloon dilatation was required in 11 of 83 lesions (13%) in the high-pressure group and in 7 of 105 lesions (7%) in the low-pressure group (p = 0.203). Procedural success rate was 100%. There were no significant differences of in-hospital and long-term clinical events between the two groups. The overall angiographic restenosis rate was 17.7%; 18.4% in the high-pressure group and 17.1% in the low-pressure group (p = 0.991).

CONCLUSIONS

The GFX stent is a safe and effective device with a high procedural success rate and favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials may be needed to compare stenting techniques in GFX stent implantation.

Measurement of the Decay B_(s);(0)-->D_(s);(-)pi;(+) and Evidence for B_(s);(0)-->D_(s);(-/+)K;(+/-) in e;(+)e;(-) Annihilation at sqrt[s] approximately 10.87 GeV

We have studied B_(s);(0)-->D_(s);(-)pi;(+) and B_(s);(0)-->D_(s);(-/+)K;(+/-) decays using 23.6 fb;(-1) of data collected at the Upsilon(5S) resonance with the Belle detector at the KEKB e;(+)e;(-) collider. This highly pure B_(s);(0)-->D_(s);(-)pi;(+) sample is used to measure the branching fraction, B(B_(s);(0)-->D_(s);(-)pi;(+))=[3.67_(-0.33);(+0.35)(stat)-0.42+0.43(syst)+/-0.49(f_(s))]x10;(-3) (f_(s)=N_(B_(s);((*))B[over ]_(s);((*)))/N_(bb[over ])) and the fractions of B_(s);(0) event types at the Upsilon(5S) energy, in particular N_(B_(s);(*)B[over ]_(s);(*))/N_(B_(s);((*))B[over ]_(s);((*)))=(90.1_(-4.0);(+3.8)+/-0.2)%. We also determine the masses M(B_(s);(0))=(5364.4+/-1.3+/-0.7) MeV/c;(2) and M(B_(s);(*))=(5416.4+/-0.4+/-0.5) MeV/c;(2). In addition, we observe B_(s);(0)-->D_(s);(-/+)K;(+/-) decays with a significance of 3.5sigma and measure B(B_(s);(0)-->D_(s);(-/+)K;(+/-))=[2.4_(-1.0);(+1.2)(stat)+/-0.3(syst)+/-0.3(f_(s))]x10;(-4).

Measurement of the time-dependent CP asymmetries in B0-->K(S)(0)rho(0)gamma decays

We report the first measurement of time-dependent CP asymmetry in B(0)-->K(S)(0)rho(0)gamma decays based on 657 x 10(6) BB pairs collected with the Belle detector at the KEKB asymmetric-energy collider. We measure the CP-violating parameter S_{K_{S};{0}rho;{0}gamma}=0.11+/-0.33(stat)-0.09+0.05(syst) from a signal of 212+/-17 events. We also obtain the effective direct CP-violating parameter A{eff}=0.05+/-0.18(stat)+/-0.06(syst) for mK(S)0pi+pi- <1.8 GeV/c(2) and 0.6 GeV/c(2)<m pi+pi- <0.9 GeV/c2.

Evidence for neutral B meson decays to omegaK*0

We present the results of a study of the charmless vector-vector decay B0-->omegaK*0 with 657 x 10(6) BB pairs collected with the Belle detector at the KEKB e+e- collider. We measure the branching fraction to be B(B0-->omegaK*0) = [1.8+/-0.7(stat)+/-0.3(syst)]x 10(-6) with 3.0sigma significance. We also perform a helicity analysis of the omega and K*0 vector mesons, and obtain the longitudinal polarization fraction fL(B0-->omegaK*0) = 0.56+/-0.29(stat) -0.08(+0.18)(syst). Finally, we measure a large nonresonant branching fraction B[B0-->omegaK+pi(-);M Kpi in(0.755,1.250) GeV/c2] = [5.1+/-0.7(stat)+/-0.7(syst)]x 10(-6) with a significance of 9.5sigma.

A collective scattering system for measuring electron gyroscale fluctuations on the National Spherical Torus Experiment

A collective scattering system has been installed on the National Spherical Torus Experiment (NSTX) to measure electron gyroscale fluctuations in NSTX plasmas. The system measures fluctuations with k( perpendicular)rho(e) less, similar0.6 and k( perpendicular) less, similar20 cm(-1). Up to five distinct wavenumbers are measured simultaneously, and the large toroidal curvature of NSTX plasmas provides enhanced spatial localization. Steerable optics can position the scattering volume throughout the plasma from the magnetic axis to the outboard edge. Initial measurements indicate rich turbulent dynamics on the electron gyroscale. The system will be a valuable tool for investigating the connection between electron temperature gradient turbulence and electron thermal transport in NSTX plasmas.

Observation of a near-threshold enhancement in the e+e- -->Lambda+_(c)Lambda-_(c) cross section using initial-state radiation

We report a measurement of the exclusive e+ e- -->Lambda+_(c)Lambda-_(c) cross section as a function of center-of-mass energy near the Lambda+_(c)Lambda-_(c) threshold. A clear peak with a significance of 8.2sigma is observed in the Lambda+_(c)Lambda-_(c) invariant mass distribution just above threshold. With an assumption of a resonance origin for the observed peak, a mass and width of M=[4634 (+8)_(-7)(stat)(+5)_(-8)(syst)] MeV/c(2) and Gamma_(tot)=[92 (+40)_(-24)(stat)(+10)_(-21)(syst)] MeV are determined. The analysis is based on a study of events with initial-state-radiation photons in a data sample collected with the Belle detector at the Upsilon(4S) resonance and nearby continuum with an integrated luminosity of 695 fb(-1) at the KEKB asymmetric-energy e+ e- collider.

Spatial resolution study and power calibration of the high-k scattering system on NSTX

NSTX high-k scattering system has been extensively utilized in studying the microturbulence and coherent waves. An absolute calibration of the scattering system was performed employing a new millimeter-wave source and calibrated attenuators. One of the key parameters essential for the calibration of the multichannel scattering system is the interaction length. This interaction length is significantly different from the conventional one due to the curvature and magnetic shear effect.

Measurement of branching fractions, isospin, and CP-violating asymmetries for exclusive b-->dgamma modes

We report new measurements of the decays B+-->rho+gamma, B0-->rho0gamma, and B0-->omegagamma using a data sample of 657x10(6) B meson pairs accumulated with the Belle detector at the KEKB e+e- collider. We measure branching fractions B(B+-->rho+gamma)=(8.7_-2.7-1.1;+2.9+0.9)x10(-7), B(B0-->rho0gamma)=(7.8_-1.6-1.0;+1.7+0.9)x10(-7), and B(B0-->omegagamma)=(4.0_-1.7;+1.9+/-1.3)x10(-7). We also report the isospin asymmetry Delta(rhogamma)=-0.48_-0.19-0.09;+0.21+0.08 and the first measurement of the direct CP-violating asymmetry ACP(B+-->rho+gamma)=-0.11+/-0.32+/-0.09, where the first and second errors are statistical and systematic, respectively.

Search for B+-->D*+pi0 decay

We report on a search for the doubly Cabibbo suppressed decay B+-->D*+pi0, based on a data sample of 657x10(6) BB pairs collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e+e- collider. We find no significant signal and set an upper limit of B(B+-->D*+pi0)<3.6x10(-6) at the 90% confidence level. This limit can be used to constrain the ratio between suppressed and favored B-->D*pi decay amplitudes, r<0.051, at the 90% confidence level.

Evaluating airborne sound insulation in terms of speech intelligibility

This paper reports on an evaluation of ratings of the sound insulation of simulated walls in terms of the intelligibility of speech transmitted through the walls. Subjects listened to speech modified to simulate transmission through 20 different walls with a wide range of sound insulation ratings, with constant ambient noise. The subjects' mean speech intelligibility scores were compared with various physical measures to test the success of the measures as sound insulation ratings. The standard Sound Transmission Class (STC) and Weighted Sound Reduction Index ratings were only moderately successful predictors of intelligibility scores, and eliminating the 8 dB rule from STC led to very modest improvements. Various previously established speech intelligibility measures (e.g., Articulation Index or Speech Intelligibility Index) and measures derived from them, such as the Articulation Class, were all relatively strongly related to speech intelligibility scores. In general, measures that involved arithmetic averages or summations of decibel values over frequency bands important for speech were most strongly related to intelligibility scores. The two most accurate predictors of the intelligibility of transmitted speech were an arithmetic average transmission loss over the frequencies from 200 to 2.5 kHz and the addition of a new spectrum weighting term to R(w) that included frequencies from 400 to 2.5 kHz.

A 37-year-old spinal cord-injured female patient, transplanted of multipotent stem cells from human UC blood, with improved sensory perception and mobility, both functionally and morphologically: a case study

HLA-matched UC blood-derived multipotent stem cells were directly transplanted into the injured spinal cord site of a 37-year-old female patient suffering from spinal cord injury (SPI). In this case, human cord blood (UCB)-derived multipotent stem cells improved sensory perception and movement in the SPI patient's hips and thighs within 41 days of cell transplantation. CT and MRI results also showed regeneration of the spinal cord at the injured site and some of the cauda equina below it. Therefore, it is suggested that UCB multipotent stem cell transplantation could be a good treatment method for SPI patients.

The impact of post-thaw colony-forming units-granulocyte/macrophage on engraftment following unrelated cord blood transplantation in pediatric recipients

We retrospectively reviewed the engraftment kinetics following unrelated cord blood transplantation (CBT) in association with the post-thaw colony-forming units-granulocyte/macrophage (CFU-GM) number along with the numbers of total nucleated cells (TNC), CD34(+) cells and CD3(+) cells. A total of 71 cord blood units prepared for 53 patients (double-unit CBT in 18 patients) were evaluated. Either the number of infused CFU-GM or CD34(+) cells was significantly lower in patients who failed to achieve engraftment (P=0.028 and 0.005, respectively). Post-thaw CFU-GM, TNC and CD34(+) cells correlated with the speed of neutrophil engraftment (P=0.004, 0.037 and 0.004, respectively), whereas only CFU-GM showed a significant correlation with platelet engraftment (r=-0.385, P=0.024). In double-unit transplants, the number of CFU-GM was the only significant factor predicting engraftment of the predominating unit (P=0.006). We conclude that the post-thaw CFU-GM number is a reliable predictor of rapid engraftment after CBT as well as of the predominating unit in double-unit transplants. Thus, it would be important to perform post-thaw CFU-GM assay on cryopreserved aliquots from several candidate cord blood units in advance before CBT to avoid selecting the unit that might possess a low clonogenic potential.

Digital rectal examination as a prostate cancer-screening method in a country with a low incidence of prostate cancer

The objective of this study was to evaluate the value of using digital rectal examination (DRE) for prostate cancer diagnosis in an Asian population. Patients with serum prostate-specific antigen (PSA) levels ranging from 2.5 to 19.9 ng/ml underwent transrectal ultrasonography-guided prostate biopsies. Patients were divided into two groups: the normal DRE group (n=721) and the abnormal DRE group (n=192). The cancer detection rate was higher in the abnormal DRE group (47.4%) than in the normal DRE group (23.0%) (P<0.001). However, the detection rates in these two groups were not significantly different in men 45-59 years old as well as in men with low PSA levels (2.5-3.9 ng/ml). In all subjects, the areas under the receiver operating characteristic curves for positive biopsies were 60.0% (95% confidence interval (CI), 55.7-64.3%, P<0.001). However, in the subgroup analysis, the predictive power of the DRE was not significant in men 45-59 years old. In addition, DREs of patients with low PSA levels had no discriminative ability. The pathological features of the prostate biopsies were not significantly different between the two groups in subjects 45-59 years old and in subjects with PSA levels from 2.5 to 3.9 ng/ml. Our data indicate that DREs increase the probability of cancer detection. However, our findings also raise the question, 'Are DREs really useful for cancer detection in younger men and men with low PSA levels in the Asian population?'

Effect of heating on the suppression of tearing modes in tokamaks

The suppression of (neoclassical) tearing modes is of great importance for the success of future fusion reactors like ITER. Electron cyclotron waves can suppress islands, both by driving noninductive current in the island region and by heating the island, causing a perturbation to the Ohmic plasma current. This Letter reports on experiments on the TEXTOR tokamak, investigating the effect of heating, which is usually neglected. The unique set of tools available on TEXTOR, notably the dynamic ergodic divertor to create islands with a fully known driving term, and the electron cyclotron emission imaging diagnostic to provide detailed 2D electron temperature information, enables a detailed study of the suppression process and a comparison with theory.

Measurement of the asymmetry in the decay Omega+-->LamdaKappa+-->rhopi+Kappa+

The asymmetry in the rho angular distribution in the sequential decay Omega+-->LamdaKappa+-->rhopi+Kappa+. has been measured to be alphaOmegaalphaLamda=[+1.16+/-0.18(stat)+/-0.17(syst)]x10(-2) using 1.89x10(6) unpolarized Omega+ decays recorded by the HyperCP (E871) experiment at Fermilab. Using the known value of alphaLamda, and assuming that alphaLamda=-alphaLamda, alphaOmega=[-1.81+/-0.28(stat)+/-0.26(syst)]x10(-2). A comparison between this measurement of alphaOmegaalphaLamda and recent measurements of alphaOmegaalphaLamda made by HyperCP shows no evidence of a violation of CP symmetry.

Observation of high-field-side crash and heat transfer during sawtooth oscillation in magnetically confined plasmas

High resolution (temporal and spatial), two-dimensional images of electron temperature fluctuations during sawtooth oscillations were employed to study the crash process and heat transfer in magnetically confined toroidal plasmas. The combination of kink and local pressure driven instabilities leads to a small poloidally localized puncture in the magnetic surface at both the low and the high field sides of the poloidal plane. This observation closely resembles the "fingering event" of the ballooning mode model with the high- mode only predicted at the low field side.

Comparison study of 2D images of temperature fluctuations during sawtooth oscillation with theoretical models

High temporal and spatial resolution two-dimensional (2D) images of electron temperature fluctuations were employed to study the sawtooth oscillation in the Toroidal Experiment for Technically Oriented Research tokamak plasmas. The 2D images are directly compared with the expected 2D patterns of the plasma pressure (or electron temperature) from various theoretical models. The observed experimental 2D images are only partially in agreement with the expected patterns from each model: The image of the initial reconnection process is similar to that of the ballooning mode model. The intermediate and final stages of the reconnection process resemble those of the full reconnection model. The time evolution of the images of the hot spot or island is partially consistent to those from the full reconnection model but is not consistent with those from the quasi-interchange model.

Search for the lepton-number-violating decay Xi(-)-->pmu(-)mu(-)

A sensitive search for the lepton-number-violating decay Xi(-)-->pmu(-)mu(-) has been performed using a sample of approximately 10(9) Xi(-) hyperons produced in 800 GeV/c p-Cu collisions. We obtain B(Xi(-)-->pmu(-)mu(-))<4.0x10(-8) at 90% confidence, improving on the best previous limit by 4 orders of magnitude.

Search for DeltaS = 2 nonleptonic hyperon decays

A sensitive search for the rare decays Omega(-)--> Lambdapi(-) and Xi(0)--> ppi(-) has been performed using data from the 1997 run of the HyperCP (Fermilab E871) experiment. Limits on other such processes do not exclude the possibility of observable rates for |DeltaS| = 2 nonleptonic hyperon decays, provided the decays occur through parity-odd operators. We obtain the branching-fraction limits B(Omega(-)-->Lambdapi(-)) < 2.9 x 10(-6) and B(Xi(0)--> ppi(-)) < 8.2 x 10(-6), both at 90% confidence level.

Impact of IL-1 receptor antagonist gene polymorphism on schizophrenia and bipolar disorder

OBJECTIVES

Variable levels of cytokines were observed in patients with schizophrenia and bipolar disorder, and an especially high level of interleukin-1 (IL-1) was detected in schizophrenia patients. It is known that IL-1 receptor antagonist (IL-1RA) binds to IL-1 receptors and inhibits the receptor binding of IL-1alpha and IL-1beta.

METHODS

In this study, the association between the variable number of tandem repeats polymorphism of the IL-1RA gene and schizophrenia (n=269) and bipolar disorder (n=83) was investigated.

RESULTS

The genotype distribution and allele frequency were significantly different between schizophrenic patients and the control group (P<0.05); however, there were no prominent differences between bipolar patients and the control group. The carriage rate for the IL1RN*2 allele was associated with higher risk of schizophrenia (odds ratio=2.24).

CONCLUSIONS

This study indicates that IL-1RA could be a candidate gene for susceptibility to schizophrenia.

Evidence for the decay sigma+ --> pmu+ mu-

We report the first evidence for the decay Sigma(+)-->pmu(+)mu(-) from data taken by the HyperCP (E871) experiment at Fermilab. Based on three observed events, the branching ratio is B(Sigma(+)-->pmu(+)mu(-))=[8.6(+6.6)(-5.4)(stat)+/-5.5(syst)]x10(-8). The narrow range of dimuon masses may indicate that the decay proceeds via a neutral intermediate state, Sigma(+)-->pP(0),P0-->mu(+)mu(-) with a P0 mass of 214.3+/-0.5 MeV/c(2) and branching ratio B(Sigma(+)-->pP(0),P0-->mu(+)mu(-))=[3.1(+2.4)(-1.9)(stat)+/-1.5(syst)]x10(-8).

Attenuation of iNOS mRNA exacerbates hypoperfusion and upregulates endothelin-1 expression in hippocampus and cortex after brain trauma

Nitric oxide (NO, a vasodilator) and endothelin-1 (ET-1, a powerful vasoconstrictor) participate in the regulation of brain's microcirculation influencing each other's expression and synthesis. Following injury to the brain, NO is derived largely from the inducible form of nitric oxide synthase (iNOS). We used Marmarou's model of traumatic brain injury (TBI) to study the cerebral blood flow and expression (mRNA) of ET-1 in rats that were pretreated with antisense iNOS oligodeoxynucleotides (ODNs). Intracerebroventricular application of iNOS ODNs resulted in reduced synthesis of iNOS as detected by Western blot analysis. The cerebral blood flow (measured by laser Doppler flowmetry), generally decreased after TBI, was further markedly reduced in the treated animals and remained at low levels up to 48 h post-TBI. The expression of ET-1 (detected by in situ hybridization in cortex and hippocampus) was increased 2-3-fold following TBI alone and this increase reached 5-6-fold in animals pretreated with antisense iNOS ODNs. The results indicate that most likely, NO, generated primarily by iNOS, suppresses ET-1 production and that a decrease of NO results in upregulation of ET-1 via transcriptional and translational mechanisms. Increased availability of ET-1 at the vascular bed and the neuropil may contribute to the altered microvascular reactivity and reduced perfusion of the brain following TBI.

Search for CP violation in charged-Xi and Lambda hyperon decays

We have compared the p and p angular distributions in 117 x 10(6) Xi- -->Lambdapi- -->ppi-pi- and 41 x 10(6) Xi+ -->Lambda pi+ -->p pi+pi+ decays using a subset of the data from the HyperCP experiment (E871) at Fermilab. We find no evidence of CP violation, with the direct-CP-violating parameter AXiLambda identical with (alphaXialphaLambda-alpha Xialpha Lambda)/(alphaXialphaLambda+alphaXialphaLambda)=[0.0+/-5.1(stat)+/-4.4(syst)] x 10(-4).

Effects of Paeonia lactiflora root extracts on the secretions of monocyte chemotactic protein-1 and -3 in human nasal fibroblasts

In the field of Oriental medicine, the root of Paeonia lactiflora (Paeoniae Radix) has been prescribed usually to treat the common cold, and it was thought to alleviate upper respiratory infection or nasal inflammation. Monocyte chemotactic proteins (MCP)-1 and MCP-3 are known as the most potent chemokines to mediate allergic inflammation. The object of the study was to investigate the effect of Paeoniae Radix on the release of the chemokines such as MCP-1 and MCP-3. To detect the secretion of MCPs, an enzyme-linked immunosorbent assay was performed for human nasal mucosal fibroblasts after stimulation with several cytokines such as tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) and interleukin-1beta (IL-1beta). The secretion of MCP-1 was increased after stimulation with TNF-alpha or IL-1beta treatment. Co-treatment of TNF-alpha and IFN-gamma, or IL-1beta and IFN-gamma increased the secretion of MCP-1 and MCP-3. Paeoniae Radix was tested with inflammatory cytokines, and the results showed that the Paeoniae Radix significantly decreased the secretion of MCP-1 and MCP-3. In our study, Paeoniae Radix may play an important role in nasal inflammation with a modulation of MCP-1 and MCP-3.

Successive double high-dose chemotherapy with peripheral blood stem cell rescue collected during a single leukapheresis round in patients with high-risk pediatric solid tumors: a pilot study in a single center

In total, 18 of 26 double high-dose chemotherapies (HDCT) in pediatric solid tumors were rescued with peripheral blood stem cells collected during a single leukapheresis round (single-harvest group, SHG). In the remaining eight HDCT, additional leukapheresis were necessary after the first HDCT (HDCT1) to rescue the second HDCT (HDCT2) (double-harvest group, DHG). Stem cell collection after HDCT1 was inefficient and delayed in patients who had received prior chemotherapy before HDCT1. The interval between HDCT1 and HDCT2 was shorter in SHG than in DHG (median 62.5 days vs 178.5 days, P-value=0.002). Hematologic recovery in HDCT2 was delayed compared to HDCT1. However, there was no difference in hematologic recovery between SHG and DHG. A high rate of treatment-related mortality (TRM) was recorded during HDCT2, but there was no evidence that the shorter interval caused a higher rate of TRM (P-value=0.454). The probability of disease-free survival at 2 years after HDCT2 in the SHG and DHG were 66.7 and 25.0%, respectively (P-value=0.031). Therefore, to administer the second HDCT earlier in double HDCT, and thus to improve the survival of patients with high-risk solid tumors, the single-harvest approach is recommended rather than the double-harvest approach.

Solid and papillary epithelial neoplasm of the pancreas with peritoneal metastasis and its recurrence: a case report

Solid and papillary epithelial neoplasm of the pancreas is a low-grade malignant tumor, generally occurring as a slowly growing upper abdominal mass in a young female. With complete excision, the prognosis is good. Malignant behavior with metastasis does occur, but the incidence is very low. We report a young woman who had this neoplasm in the pancreatic tail with peritoneal seeding and its recurrence.

4G/5G polymorphism of the plasminogen activator inhibitor-1 gene and insertion/deletion polymorphism of the tissue-type plasminogen activator gene in atherothrombotic stroke

BACKGROUND AND PURPOSE

Decreased fibrinolytic capacity due to increased plasminogen activator inhibitor-1 (PAI-1) activity and decreased tissue-type plasminogen activator (t-PA) activity has been associated with hypertension or atherothrombotic disorders. The aims of this study were to observe associations of the genetic polymorphism for PAI-1 and t-PA with hypertension and atherothrombotic stroke, and to elucidate whether impaired fibrinolytic activity in atherothrombotic stroke was related to atherothrombosis per se or to other risk factors such as hypertension.

METHODS

Patients with atherothrombotic stroke (n = 60), hypertension (n = 100), and control subjects (n = 100) were enrolled. We genotyped all subjects for 4G/5G polymorphism in the promoter region of the PAI-1 gene and the Alu-repeat insertion/deletion (I/D) polymorphism in intron h of the t-PA gene by polymerase chain reaction and endonuclease digestion.

RESULTS

The frequency of the 4G/4G genotype of PAI-1 was significantly higher in the atherothrombotic stroke patients than the control subjects (41.7 versus 21%; p = 0.005), but not in the hypertensive subjects. There was a significant association between 4G/4G genotype of PAI-1 and atherothrombotic stroke (adjusted odds ratio = 3.11, 95% confidence interval 1.18-8.15), adjusting for age, sex, total cholesterol, low-density lipoprotein, triglyceride, and body mass index. However, the number of the I/I genotype of t-PA in the atherothrombotic stroke or hypertensive patients was virtually identical to the control subjects.

CONCLUSION

Our results suggest that the 4G/4G genotype of the PAI-1 gene is significantly associated with an increased risk of atherothrombotic stroke. This finding also supports that impaired fibrinolytic activity in atherothrombotic stroke is related to atherothrombosis per se, but not to hypertension, one of the most important risk factors of atherothrombotic stroke.

Respiratory syncytial virus infection induces matrix metalloproteinase-9 expression in epithelial cells

Increased gelatinolytic activity was observed in respiratory syncytial virus (RSV)-infected HEp-2 cells by using zymography. The anti-matrix metalloproteinase-9 (MMP-9) antibody specifically reduced the gelatinolytic activity suggesting that the increased gelatinolytic activity was due to the MMP-9. It was also supported by the results from immunofluorescent staining, treatment of MMP inhibitors, and RSV infection of the cell clones that were transfected with plasmids to express more MMP-9 and tissue type inhibitor of metalloproteinase-1 (TIMP-1). The gelatinolytic activity of extracellular MMP-9 in RSV-infected HEp-2 cells increased 1.5 +/- 0.2 fold compared with the control (p < 0.01). Cell surface MMP-9 expression was also clearly detected by immunofluorescent staining. Treatment with 1,10-phenanthroline (0.05 mM), ethylenediamine-tetraacetate (EDTA) (1.5 mM), and penta-O-galloyl-beta-D-glucose (PGG) (3.3 microM) inhibited RSV multiplication as well as syncytia formation. Furthermore, the average syncytia size increased when the cells expressing more MMP-9 were infected by RSV. In contrast, syncytia formation was inhibited in the cells manipulated to express TIMP-1. Thus, this study concludes that although RSV infection induces MMP-9, which can enhance the syncytia formation leading to RSV multiplication and spread it can be inhibited by MMP inhibitors.

Observation of the decay K- --> pi(-)mu(+)mu(-) and measurements of the branching ratios for K+/- --> pi(+/-)mu(+)mu(-)

Using data collected with the HyperCP (E871) spectrometer during the 1997 fixed-target run at Fermilab, we report the first observation of the decay K--->pi(-)mu(+)mu(-) and new measurements of the branching ratios for K+/--->pi(+/-)mu(+)mu(-). By combining the branching ratios for the decays K+-->pi(+)mu(+)mu(-) and K--->pi(-)mu(+)mu(-), we measure Gamma(K+/--->pi(+/-)mu(+)mu(-))/Gamma(K+/--->all) = (9.8+/-1.0+/-0.5)x10(-8). The CP asymmetry between the rates of the two decay modes is [Gamma(K+-->pi(+)mu(+)mu(-))-Gamma(K--->pi(-)mu(+)mu(-))]/[Gamma(K+-->pi(+)mu(+)mu(-))+Gamma(K--->pi(-)mu(+)mu(-))] = -0.02+/-0.11+/-0.04.

(AC)(n) polymorphism of aldose reductase gene and diabetic microvascular complications in type 2 diabetes mellitus

Recent studies suggest that the gene encoding aldose reductase, the enzyme that converts glucose to sorbitol, may confer susceptibility to microvascular disease. The aim of this study therefore, was to investigate the relationship between the aldose reductase gene and type 2 diabetic microvascular complications such as diabetic nephropathy and retinopathy. DNA from 127 Korean patients with type 2 diabetes was typed for an (AC)(n) dinucleotide repeat polymorphic marker at the 5'-end of the aldose reductase gene using polymerase chain reaction. No significant difference in the frequency of the putative risk allele Z-2 was found in patients of nephropathy and retinopathy groups compared with the uncomplicated group (32.2, 34.1 vs. 25.1%, respectively, P>0.05). Similarly, no difference was found in the frequency of the putative protective allele Z+2 among any of the study groups. In conclusion, the results of the study in Korean type 2 diabetic patients do not support the hypothesis that polymorphism at the 5' end of the aldose reductase gene contributes to the susceptibility to diabetic microvascular complications.

Fetal surgery for congenital heart disease

Certain congenital heart defects, which present at birth as complex morphologic defects, are actually the result of a relatively simple primary lesion and the subsequent acquired development of a complex secondary lesion during gestation. Moreover, fetal heart approach during gestation can prevent simple cardiac lesions from such development. Specific structural lesions can be diagnosed before 12 weeks of gestation by transvaginal fetal echocardiography, and animal experiments have shown that direct or indirect fetal cardiac approach and fetal cardiac bypass are technically feasible. A number of fetal bypass models have resulted in long-term survivors, with for example, the delivery of normal lambs at full-term gestation. Also, successful full-term delivery has been obtained after fetal cardiac intervention. The success of fetal cardiac bypass was accomplished by the use of total spinal anesthesia and the administration of indomethacin. Moreover, a 42 % long-term survival after fetal cardiopulmonary bypass in a fetal lamb model has been reported. Maternal risk related to fetal bypass should be considered carefully alongside fetal risks and benefits. Most fetal malformations do not directly threaten maternal health, yet the procedures required to address fetal malformations can produce significant maternal risk and discomfort and subsequent pregnancies may be jeopardized. Further investigation of maternal outcome is required. Deep exploration of fetal and maternal pathophysiologic responses to intervention and comprehensive investigation is required to overcome current limitations, and should precede clinical trials as many problems remain to be solved before these techniques can be applied to human beings.

Effect of nitrite and propolis preservative on volatile basic nitrogen changes in meat products

Pig meat was treated with 0.3% ethanol extracted propolis (EEP), 0.3% water extracted propolis (WEP), 0.4% dried residue of ethanol extracted propolis (DREEP) and 0.2% potassium sorbate (PS). The samples were stored for 8 weeks at 4, 10 and 20 degrees C, respectively. Volatile basic nitrogen (VBN) tests were carried out to measure the influence of temperature after 0, 2, 4 and 8 weeks. The VBN value in 0.3% EEP pork sausages was the lowest for all treatments after 8 weeks of storage at 4 degrees C. The 0.3% EEP treatment was superior to the 0.2% PS treatment. This was due to the lower VBN of the former than that of the latter. Hence, EEP, WEP and DREEP can serve as good chemical preservatives of pork meat products and can contribute to promote human health because they are naturally produced.

Cytoprotective effect of Scutellaria baicalensis in CA1 hippocampal neurons of rats after global cerebral ischemia

Based on the use of Scutellaria baicalensis for the treatment of stroke in traditional Oriental medicine, the current study was carried out to evaluate neuroprotective effects of S. baicalensis after transient global ischemia using rat 4-vessel occlusion model. Methanol extracts from the dried roots of S. baicalensis (0.1-10 mg/kg) administered intra-peritoneally significantly protected CA1 neurons against 10 min transient forebrain ischemia as demonstrated by measuring the density of neuronal cells stained with Cresyl violet. Methanol extract of S. baicalensis inhibited microglial tumor necrosis factor-alpha (TNF-alpha) and nitric oxide production, and protected PC12 cells from hydrogen peroxide-induced toxicity in vitro.

Protective effect of glutathione in HIV-1 lytic peptide 1-induced cell death in human neuronal cells

To elucidate the pathogenic mechanisms involved in neurodegeneration in AIDS patients with cognitive deficits, we have examined the toxic effect of the lentivirus lytic peptide 1 (LLP-1) corresponding to the carboxyl terminus of HIV-1 transmembrane glycoprotein gp41 on human neuronal and glial cell lines. LLP-1 induced a significant lactate dehydrogenase (LDH, a marker of cell death) release from these cells in a concentration- and time-dependent manner, while the noncytolytic LLP-1 analog 2 had little effect. Application of LLP-1 to SH-SY5Y, a well-characterized human neuronal cell line, caused the decline of intracellular glutathione (GSH) content that appeared to occur before a significant LDH release. Furthermore, LLP-1 elicited a significant loss of mitochondrial function as measured by mitochondrial transmembrane potential (MTP). Among the reducing agents and antioxidants tested, GSH and a GSH prodrug N-acetylcysteine (NAC) provided protection against LLP-1-induced neuronal cell death, evidently by restoring the intracellular GSH levels and blocking the disruption of mitochondrial integrity. Thus, gp41-derived LLP-1 may be a potential neurotoxic agent capable of causing the intracellular GSH depletion and disturbing the mitochondrial function, possibly contributing to the neurodegenerative cascade as seen in HIV-1-associated dementia. Our data indicate that restoring both GSH concentration and mitochondrial function may hold promise as possible therapeutic strategies for slowing disease progression of dementia in AIDS patients.

Characterization of aberrant FHIT transcripts in gastric adenocarcinomas

Aberrant transcripts of FHIT (fragile histidine triad) have been reported in several types of primary tumors and cell lines, including gastric carcinoma. The role of these aberrant transcripts in tumorigenesis is not clear yet. Forty-eight aberrant-sized FHIT transcripts with various lengths and number in 35 cases of gastric adenocarcinomas were further characterized. Aberrant transcripts, with deletions and/or insertions, were frequently observed in 20 cases of tumors. Sequence analysis demonstrated that different types of aberrant transcripts used normal splice sites but skipped exons, contained the inserts with the part of intron 5 sequences, or used the FHIT cDNA sequence 179-180 as a cryptic splice acceptor site. Most of aberrant transcripts lacked exon 5 and were presumably non-functional as the translation initiation codon is located in exon 5. Additionally, other transcripts, indicative of additional splice processing, either deletions or insertions, were expressed in several tumors. Taken together, our data indicate that the FHIT gene expression is frequently altered in gastric adenocarcinomas by aberrant splicing, and suggest that different types of aberrant transcripts may result during the multi-step splice processing.

Intervertebral foraminal ligaments of the lumbar spine: anatomy and biomechanics

The anatomical existence of the transforaminal ligaments has been studied extensively. However, there are very few studies examining how the transforaminal ligaments could be involved in the causation of nerve root compression and the low back pain syndrome. In this article, the authors review earlier studies in an attempt to find anatomical and biomechanical correspondence between the intervertebral foraminal ligaments of the lumbar spine and the low back pain syndrome.

Detection of circulating tumor cells in patients with gastrointestinal tract cancer using RT-PCR and its clinical implications

To investigate the relationship between the presence of circulating tumor cells in different stages of gastrointestinal tract cancer and the subsequent relapse or distant metastasis, circulating levels of CEA mRNA was serially examined at an interval of 10.6+/-4.5 or 13.7+/-3.0 months in gastric or colorectal cancer patients, respectively. CEA mRNA was measured by means of RT-PCR amplification as an indicator for micrometastatic malignant cells. Seven of twenty-nine respectable gastric cancer patients (24.1%) [EGC: 2/9 (22.2%), AGC IIIa: 1/5 (20.0%), AGC IIIb: 4/15 (26.6%)] were positive for CEA mRNA on the initial test and 10 of 29 patients (34.4%) [EGC: 2/ 9 (22.2%), AGC IIIa: 1/5 (20.0%), AGC IIIb: 7/15 (46.7%)] were positive on a follow-up test. Only in AGC IIIb, the positive rate for CEA mRNA increased about twice and 6 of 7 positive cases (85.7%) relapsed within 2.6+/-2.4 months after the follow-up test. In colorectal cancer, 4 of 19 patients (21.1%) [B2: 1/6 (16.7%), C2: 3/13 (23.0%)] were positive on the initial test and 10 of 19 patients (52.6%) [B2: 4/6 (66.7%), C2: 6/13 (46.2%)] were positive on a follow-up test showing an increase in positive rates during a follow-up, however, no significant correlation between CEA mRNA positivity and subsequent relapse was demonstrated. These results suggest that an early tumor cell dissemination may occur in gastrointestinal tract cancer without subsequent relapse, however, the serial regular examination of CEA mRNA level may contribute to predicting a subsequent relapse in AGC IIIb in gastric cancer.

Biomechanical properties of calvarium prosthesis

There are many materials available for the reconstruction of calvarial defects. Even though their biomaterial properties are well known, the biomechanical properties as part of the calvarium have not been investigated. In this article, calvarial implants are reviewed with their historic development into modern cranioplasty. Materials for trephined skulls are classified by their category. Individual parameters to describe their mechanical properties are collected and revealed in detail. The laboratory testing methodology for cranioplasty material is introduced to understand each parameter. At last, we discuss an engineering technique to look into the implant behavior. Since there is no standard goal for the biomechanical and biomaterial point of view for cranioplasty, this article suggests the finite element method for evaluation of the implant behavior and the degree of damage upon the impact injury.

Enhanced gene expression of renin-angiotensin system, TGF-beta1, endothelin-1 and nitric oxide synthase in right-ventricular hypertrophy

It has been suggested that various vasoactive substances and growth factors are involved in left-ventricular myocardial hypertrophy and failure. However, limited data are available on the role of humoral factors involved in right-ventricular (RV) hypertrophy. To examine implications of humoral factors involved in the development of RV hypertrophy, altered mRNA expressions of the renin-angiotensin system (RAS), transforming growth factor (TGF)- beta1, endothelin-1 and nitric oxide synthase (NOS) were investigated in monocrotaline (MCT)-induced pulmonary hypertensive rats. Male Sprague-Dawley rats were treated with MCT (60 mg x kg(-1), s.c.) to induce a selective RV hypertrophy. Three or 6 weeks later, the heart was removed to determine the tissue gene expressions in the right and left ventricles (LV) by reverse transcription-polymerase chain reaction due to the relatively low mRNA expression levels of the RAS components in the ventricle (n= 6 in each group). MCT-treated rats showed a selective RV hypertrophy at weeks 3 and 6 of MCT treatment (the ratios of RV/body weight were 1.5- and 2.2-fold higher than the controls, respectively). Levels of renin and angiotensinogen mRNAs in the hypertrophied RV were significantly increased at both weeks 3 and 6 of MCT treatment. The angiotensin-converting enzyme mRNA level also increased approximately 2-fold at week 3. In contrast, RAS component mRNAs in the LV were not significantly altered by MCT treatment, except for a 1.8-fold increase of angiotensinogen mRNA at week 3. The expression of Ang II receptors, either AT1A or AT1B, was not significantly altered by MCT treatment. Furthermore, MCT treatment significantly increased TGF- beta1 mRNA levels in the RV at weeks 3 and 6, while it did not significantly affect them in the LV. Endothelin-1 mRNA expression was significantly higher in the RV at week 3, but was normalized at week 6 of MCT treatment. The gene expression of the endothelial constitutive isoform of NOS was increased in the RV at weeks 3 and 6, but not in the LV. Elevated gene expression of local RAS, along with TGF- beta1 and endothelin-1 in the present study may contribute to the development of RV hypertrophy. On the contrary, an enhanced ecNOS expression may be a mechanism counteracting the hypertrophy.

Frequency locking in spatially extended systems

A variant of the complex Ginzburg-Landau equation is used to investigate the frequency-locking phenomena in spatially extended systems. With appropriate parameter values, a variety of frequency-locked patterns including flats, pi fronts, labyrinths, and 2pi/3 fronts emerge. We show that in spatially extended systems, frequency locking can be enhanced or suppressed by diffusive coupling. Novel patterns such as chaotically bursting domains and target patterns are also observed during the transition to locking.

Application of finite element analysis in neurosurgery

With the rapid development of computer equipment, approximation by analytical solutions has become popular in mathematical modeling. Finite element (FE) analysis uses numerical methods to solve problems with physical phenomena, and these can be applied to various geometrically complex materials, such as brain. The FE formulation can provide such diverse domains as heat conduction, torsion of elastic material, diffusion and fluid flow, and it can view different objects of study in the neurosurgical field. In this article, the various applications of FE methods are introduced to illustrate the usefulness of the technique and the link between the external biomechanical aspect and internal phenomena in brain research.

Different cutoff values of Cyfra 21-1 for cavitary and noncavitary lung cancers

STUDY OBJECTIVES

Cell lysis and tumor necrosis release cytokeratin, a tumor marker of lung cancer, into the serum. The serum cytokeratin level can also be elevated in benign cavitary lung diseases. The purpose of this study was to evaluate whether Cyfra 21-1 can differentiate malignant lung diseases from benign diseases with cavitary lesions.

DESIGN

This study is a retrospective review of the case records of patients with lung lesions seen during a 4-year period from January 1993 to May 1996.

SETTING AND PATIENTS

Serum Cyfra 21-1 levels were measured in 306 patients with lung cancer (n = 143) or benign lung disease (n = 163). The patients were grouped according to radiologic evidence of cavitary lung lesions. Lung cancer included both non-small cell (n = 123) and small cell (n = 20) lung cancers, and the benign diseases include tuberculosis (n = 87), abscess (n = 26), pneumonia (n = 4), and others (n = 46).

MEASUREMENTS AND RESULTS

Although Cyfra 21-1 clearly differentiated cavitary lung cancer (15.0, 9.1-29.8 ng/ml, median and interquartile range, n = 39) from benign cavitary disease (P < 0.001), and noncavitary lung cancer from benign noncavitary disease (1.7, 0.9-2.6 ng/ml, n = 108, P < 0.001), it could not differentiate noncavitary lung cancer (5.0, 2.1-12.4 ng/ml, n = 104) from benign cavitary diseases (3.3, 1.4-8.3 ng/ml, n = 55, P = 0.45).

CONCLUSIONS

Serum Cyfra 21-1 is a useful tumor marker for differentiating benign from malignant lung diseases. However, different cutoff values are needed, depending on the presence of cavitary lesions. We recommend cutoff values of 30 ng/ml for cavitary lung diseases and 6 ng/ml for noncavitary lung diseases. If there are no radiologic data, a cutoff value of 15 ng/ml is recommended.

Impact simulation on pre-formed prosthesis for large cranial defect

Cranioplasty greater than 10 cm2 in size is challenging task for neurosurgeon. There are many successful trials to fill the small defect with various materials. Proper cranioplasty can provide subsequently restoration of cerebral protection, cosmetic aspect and neuronal function. However, larger defect may not provide adequate protection from the auto, industrial or sport accident even with cranioplasty. In this study, patch design using two popular materials was evaluated and compared with bone material. Then impact-releasing holes were implemented to the patch. The movement of the large patch and its effect on the underlying brain tissue upon simulated impact was evaluated by using finite element analysis.

A case of Cushing's syndrome in ACTH-secreting mediastinal paraganglioma

Paragangliomas are unusual neuroendocrine cell tumors arising from paraganglia, of which ACTH-secreting cases in the mediastinum are extremely rare. A 51-year-old woman was admitted for generalized edema and weakness which began 5 months ago. Chest X-ray and CT scan revealed a tumor mass in the anterior mediastinum. The plasma cortisol and ACTH levels were very high. Other sources secreting ACTH, except mediastinal mass, were not found. Surgical excision of mediastinal mass and left supraclavicular lymph node was performed. The postoperative microscopic finding and immunohistochemical staining revealed organoid tumor cell nests (zellballen) and S-100 protein positive sustentacular cells which are characteristics of paraganglioma. This was thus a case of Cushing's syndrome resulting from ectopic ACTH production in anterior mediastinal paraganglioma.

Asiatic acid derivatives protect cultured cortical neurons from glutamate-induced excitotoxicity

Asiatic acid, a triterpene of Centella asiatica (L.) Urban (Umbelliferae), has been patented as a treatment for dementia and an enhancer of cognition by the Hoechst Aktiengesellschaft (EP 0 383 171 A2). We modified the chemical structure of asiatic acid and obtained 36 derivatives of asiatic acid in an attempt to prepare neuroprotective compounds that were more efficacious than asiatic acid itself. The neuroprotective activities of these derivatives were evaluated using primary cultures of rat cortical neurons insulted with the neurotoxin, glutamate, as an in vitro screening system. Among the semi-synthesized derivatives, three derivatives significantly mitigated the neurotoxicity induced by glutamate in this screening system. The neuroprotective activities of these 3 derivatives appeared to be more powerful than that of asiatic acid itself. These 3 derivatives significantly attenuated decreases in the levels of glutathione, glutathione peroxidase and other enzymes, which participate in the cellular defense mechanisms blunting oxidative stress. Furthermore, they significantly reduced the overproduction of NO induced by glutamate. These results showed that these derivatives of asiatic acid exerted significant neuroprotective effects on cultured cortical cells by their potentiation of the cellular oxidative defense mechanism. Therefore, these agents may prove to be efficacious in protecting neurons from the oxidative damage caused by exposure to excess glutamate.