Effective combination of microfiltration and intermittent ozonation for high permeation flux and VFAs recovery from coagulated raw sludge

This research was conducted to investigate the effect of intermittent ozonation on permeation flux recovery and production for soluble organic materials in a membrane-coupled anaerobic VFAs fermenter (MCAVF) system. Flux recovery ratio exceeded 80% with 22.2 gO3 l-1 of ozone injection and then showed nearly 95% with 43 gO3 l-1 in batch experiment. Under the same ozone concentration, extending contact time was more effective than increasing bubbling dose rate for flux recovery. In continuous-flow operation, the value of average permeation flux was 0.69 m3 m-2 d-1 during without ozonation period, while average permeation flux for 70 days with intermittent ozone bubbling was 1.17 m3 m-2 d-1 that corresponds to 1.7 times that with no ozonation period. Moreover, in spite of intermittent ozone bubbling for 70 days, significant inhibition was not observed for volatile fatty acids (VFAs) producing bacteria and VFAs production. It was found that the average value of [permeates total organic carbon (TOC) concentration: Influent TOC concentration] with ozonation period was about 1.5 times higher than that of no ozonation period. Consequently, it is believed that a membrane-coupled anaerobic VFAs fermenter (MCAVF) process combined with intermittent ozonation is suitable to overcome the flux decline of membrane and simultaneously is useful to the recovery of soluble organic materials from coagulated raw sludge.

Effect of hydraulic loading rate on acidogenesis in a membrane-coupled anaerobic VFAs fermenter

A membrane-coupled anaerobic VFAs fermenter (MCAVF) was operated with five different hydraulic loading rates (3, 2, 1, 0.5 and 0.25 day-1) to evaluate its influence on acid phase VFAs production from coagulated raw sludge. Results show that C2 to C5 volatile fatty acids were formed as predominant compounds. At constant solids retention time (SRT) of 10 days, VFAs production ratio moderately increased over the range of hydraulic loading rate (HLR) of 3 day-1 to 2 day-1, but significantly decreased at other HLR conditions. First order hydrolysis rate constant decreased with a decrease in HLR. The relatively high degradation percentages of carbohydrate and protein were observed, ranging from 25 to 47%, 27 to 47%, respectively. However, lipid and fiber component were degraded at much lower ratio than the previous other two organic materials. On the other hand, despite some variation in the minor acids in five HLR cases, VFAs speciation appeared to be independent of HLR. The results obtained emphasize that; at least in the range investigated, the optimal HLR for VFAs production and recovery from coagulated raw sludge is in the range of 2 day-1 and 1 day-1.

Cloning and characterization of thermostable endoglucanase (Cel8Y) from the hyperthermophilic Aquifex aeolicus VF5

Aquifex aeolicus is the hyperthermophilic bacterium known, with growth-temperature maxima near 95 degrees C. The cel8Y gene, encoding a thermostable endoglucanase (Cel8Y) from Aquifex aeolicus VF5, was cloned into a vector for expression and expressed in Escherichia coli XL1-Blue. A clone of 1.7 kb fragment containing endoglucanase activity, designated pKYCY100, was sequenced and found to contain an ORF of 978 bp encoding a protein of 325 amino acid residues, with a calculated molecular mass of 38,831 Da. This endoglucanase was designated cel8Y gene. The endoglucanase has an 18-amino-acid signal peptide but not cellulose-binding domain. The endoglucanase of A. aeolicus VF5 had significant amino acid sequence similarities with endoglucanases from glycosyl hydrolase family 8. The predicted amino acid sequence of the Cel8Y protein was similar to that of CMCase of Cellulomonas uda, BcsC of Escherichia coli, CelY of Erwinia chrysanthemi, and CMCase of Acetobacter xylinum. The molecular mass of Cel8Y was calculated to be 36,750 Da, which is consistent with the value obtained from result of CMC-SDS-PAGE of the purified enzyme. Cel8Y was thermostable, exhibiting maximal activity at 80 degrees C and pH optima of 7.0 and with half-lives of 2 h at 100 degrees C, 4 h at 90 degrees C.

A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus

To investigate the mechanism of inhibition of silver ions on microorganisms, two strains of bacteria, namely Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus), were treated with AgNO(3) and studied using combined electron microscopy and X-ray microanalysis. Similar morphological changes occurred in both E. coli and S. aureus cells after Ag(+) treatment. The cytoplasm membrane detached from the cell wall. A remarkable electron-light region appeared in the center of the cells, which contained condensed deoxyribonucleic acid (DNA) molecules. There are many small electron-dense granules either surrounding the cell wall or depositing inside the cells. The existence of elements of silver and sulfur in the electron-dense granules and cytoplasm detected by X-ray microanalysis suggested the antibacterial mechanism of silver: DNA lost its replication ability and the protein became inactivated after Ag(+) treatment. The slighter morphological changes of S. aureus compared with E. coli recommended a defense system of S. aureus against the inhibitory effects of Ag(+) ions.

A humanized anti--4-1BB monoclonal antibody suppresses antigen-induced humoral immune response in nonhuman primates

The interaction of 4-1BB and its ligand plays an important role in the regulation of T-cell-mediated immune responses. In this study, the authors examined the effect of a humanized anti--4-1BB monoclonal antibody (H4B4) on ovalbumin-induced immune responses in baboons. Previously, a mouse monoclonal antibody, 4B4 against the human 4-1BB molecule, was generated and characterized. Based on this antibody, a humanized version of 4B4 monoclonal antibody was constructed and the resultant antibody, H4B4, showed full recovery of the binding activity of the original antibody 4B4: a 1.5-fold increase in affinity for 4-1BB. In addition, H4B4 mediated antibody-dependent cellular cytotoxicity of activated human peripheral blood T cells and CEM cells in a dose-dependent manner. Weekly administration of H4B4 at doses of 1 or 4 mg/kg could suppress immunoglobulin G production against ovalbumin. This was not a result of the overall immune suppression, because the numbers of B and T cells and the total immunoglobulin G production were not altered during treatment with H4B4. These findings suggest that treatment with H4B4 may be a valid therapeutic approach to control unwanted immune responses in persons with autoimmune diseases.

A method for determining multileaf collimator transmission and scatter for dynamic intensity modulated radiotherapy

The main purpose of this work is to demonstrate a practical means of determining the leaf transmission and scatter characteristics of a multileaf collimator (MLC) pertinent to the commissioning of dynamic intensity modulated radiotherapy, especially for the sweeping window technique. The data are necessary for the conversion of intensity distributions produced by intensity-modulated radiotherapy optimization systems into trajectories of MLC leaves for dynamic delivery. Measurements are described for two, tungsten alloy MLCs: a Mark II 80-leaf MLC on a Varian 2100C accelerator and a Millenium 120-leaf MLC on a Varian 2100EX accelerator. MLC leakage was measured by film for a series of field sizes. Measured MLC leakage was 1.68% for a 10 x 10 cm2 field for both 6 and 18 MV for the 80-leaf MLC. For the 6 MV field, the 1.68% leakage consisted of 1.48% direct transmission and 0.20% leaf scatter. Direct transmission through the 80-leaf MLC, including the rounded leaf tip, was calculated analytically taking into account the detailed leaf geometry and a Monte Carlo-generated energy spectrum of the accelerator. The integrated fluence under the leaf tip was equivalent to an inward shift of 0.06 cm of a hypothetical leaf with a flat, focused tip. Monte Carlo calculations of the dose to phantom beyond a closed 80-leaf MLC showed excellent agreement with the analytic results. The transmission depends on the density of the MLC alloy, which may differ among individual MLCs. Thus, it is important to measure the transmission of any particular MLC. Calculated doses for a series of uniform fields produced by dynamic sweeping windows of various widths agree with measurements within 2%.

Improvement of oxidative stability of conjugated linoleic acid (CLA) by microencapsulation in cyclodextrins

Oxidative stability of conjugated linoleic acid (CLA) encapsulated in alpha-, beta-, and gamma-cyclodextrins (designated CLA/CDs microencapsules) was studied by measuring the headspace-oxygen depletion in airtight serum bottles and by measuring the peroxide values (POV). The rate of oxygen depletion was reduced from 41.0 (control) to 21.5, 2.1, 1.2, and 1.1 micromol/L.h(-)(1) by CLA/alpha-CD microencapsules at 1:1, 1:2, 1:4, and 1:6 mole ratios, respectively, indicating that CLA oxidation was completely protected by a 1:4 mole ratio of CLA/alpha-CD. Such a protective effect by CLA/beta-CD or CLA/gamma-CD microencapsules was achieved at a 1:6 mole ratio, but the effect by CLA/beta-CD was slightly greater than that by CLA/gamma-CD. The protective effect of alpha-, beta-, and gamma-CDs for CLA oxidation was confirmed by their POV-reducing abilities in CLA/CDs. These results suggest that alpha-CD was the most effective for the protection of CLA oxidation by microencapsulation, followed by beta-CD and gamma-CD.

IL-6 in CSF during ventriculitis in preterm infants with posthemorrhagic hydrocephalus

Treatment of infants with posthemorrhagic hydrocephalus by diversion of CSF is frequently complicated by bacterial ventriculitis. We report the CSF values before and during bacterial ventriculitis of four very low birth weight infants with progressive posthemorrhagic ventricular dilatation. Extremely high CSF IL-6 concentrations of between 8,000 and 61,000 pg/ml were observed and compared with values reported in the literature. IL-6 seems to be a useful marker for bacterial ventriculitis in preterm infants. The role of IL-6 monitoring in the CSF of preterm infants with posthemorrhagic hydrocephalus for early diagnosis of bacterial ventriculitis prior to clinical manifestation should be clarified by further studies.

Cloning and sequencing of cel5Z gene from Erwinia chrysanthemi PY35

The phytopathogenic bacterium Erwinia chrysanthemi (Ech) secretes multiple isozymes of plant cell wall disrupting enzymes such as pectate lyase and endoglucanases. We cloned genomic DNA from Ech PY35 digested with Sau3AI and ligated into pBluescript II SK+. One of the E. coli XL1-blue clones had the ability to hydrolyze carboxymethyl cellulose and polygalacturonic acid. By subsequent subcloning from this 2.9 kb fragment, we obtained a 2.0 kb (pPY401), designated cel5Z, which had the activity of hydrolyzation of carboxymethyl cellulose. The cel5Z gene had an open reading frame (ORF) of 1,281 bp starting with an ATG start codon and followed by a TAA stop codon, encoding 426 amino acids with a signal peptide of 41 amino acids. Since the deduced amino acid sequence of this protein was very similar to that of CelE of Pseudomonas fluorescens, and had the conserved region, VIYEIYNEPL, it belonged to the glycoside hydrolase family 5 of EC 3.2.1.4. The molecular mass of Cel5Z protein from E. coli XL1-blue, as analyzed by CMC-SDS-PAGE, appeared to be 42 kDa. The optimum pH was 6, and the optimum temperature was about 40 degrees C for its enzymatic activity.

Fetal heart rate observations in the brain-damaged infant

The objective of this study was to describe the fetal heart rate patterns and underlying pathophysiologic changes in the brain-damaged fetus. Fetuses with brain damage from hypoxic ischemic encephalopathy do not manifest uniform fetal heart rate patterns. However, these fetuses do show distinct fetal heart rate patterns that permit categorization based on their admission heart rate, subsequent changes in their baseline rate; and neonatal findings. Based on the observations of infants brain damaged in utero because of hypoxic ischemic encephalopathy, the intrapartum fetal management will depend on the admission fetal heart rate pattern, and the subsequent changes in the baseline rate.

Characterization of Erwinia chrysanthemi PY35 cel and pel gene existing in tandem and rapid identification of their gene products

Genomic DNA of the phytopathogenic Erwinia chrysanthemi PY35 was partially digested with Sau3AI, ligated into the BamHI site of pBluescript II SK+, and introduced into E. coli. One clone that was able to hydrolyse carboxymethylcellulose and polygalacturonic acid was selected. A 2.9 kb fragment containing the pelL1 gene (pPY300) and cel5Z gene (pPY401) in tandem was subcloned and sequenced. The pelL1 and cel5Z genes had open reading frames of 1,278 bp and 1,281 bp encoding 425 and 426 amino acid residues with calculated molecular weights of 45,649 Da and 46,473 Da, respectively. pelL1 and cel5Z carried a typical prokaryotic signal peptide of 24 and 41 amino acid residues, respectively. The apparent molecular masses of the proteins when expressed in E. coli cells were approximately 43 kDa (PelL1) and 42 kDa (Cel5Z) as assessed by PGA-SDS-PAGE and CMC-SDS-PAGE.

Mini-detachable snare ligation for the treatment of esophageal varices

BACKGROUND

We manufactured and studied the usefulness of a newly designed mini-detachable snare in the treatment of esophageal varices. The use of a multiple rubber band ligator, although generally effective and well tolerated, has certain limitations, including high cost, reduced visual field, and inadvertent band release.

METHODS

We performed a prospective randomized controlled trial of the use of mini-detachable snare ligation vs. multiple band ligation in patients with recent or active esophageal variceal bleeding. The outcomes assessed were immediate hemostasis and rates of recurrent bleeding, eradication, and recurrence.

RESULTS

From March 1997 to October 1998, 103 patients were entered into this trial; 46 underwent mini-detachable snare ligations and 57 multiple band ligations. Among patients with active bleeding, hemostasis was achieved in 6 of 7 (86%) in the mini-detachable snare ligation group and 11 of 13 (85%) in multiple band ligation group. Recurrent bleeding after initial treatment occurred in 2 of 46 (5.5%) in the mini-detachable snare ligation group and 3 of 57 (5.3%) in the multiple band ligation group. Esophageal varices were eradicated or reduced to grade I in 4.8 +/- 2.1 and 4.5 +/- 1.9 sessions in the mini-detachable snare ligation group and multiple band ligation group, respectively. The recurrence rate was 5 of 46 (11%) and 6 of 57 (11%) in the mini-detachable snare ligation group and multiple band ligation group during a follow-up period of 6 and 16 months, respectively. No serious complication occurred in either group.

CONCLUSION

The mini-detachable snare is a new device that provides safe and effective treatment for esophageal varices that is comparable to multiple band ligation.

Left ventricular muscle mass regression after aortic valve replacement

Implanting a valve that will reduce left ventricular mass is critical in aortic stenosis. Regression of left ventricular hypertrophy in 46 aortic valve replacement (AVR) patients receiving a St. Jude Medical (SJM) valve was assessed by serial electrocardiographic and echocardiographic studies during the preoperative, immediate, and late postoperative periods. The patients were divided into three groups according to valve size; 19 mm group (n=9), 21 mm group (n=20), and 23+mm group (n=17). There was no surgical mortality. The NYHA functional class improved from an average of 2.2+/-0.8 preoperatively to 1.3+/-0.5 post-operatively. Left ventricular muscle mass index (LVMI) regression failed to reach statistical significance in the 19 mm group, whereas in the other two groups a steady decrease in the LVMI occurred with follow up. ECG findings were less remarkable showing insignificant differences in voltage among the three groups (p=0.000). In conclusion, the current data suggest that the 19 mm SJM valve may not result in satisfactory left ventricular muscle mass regression despite adequate function, even in small patients. Therefore, additional procedures to accommodate a larger valve may be warranted in the aortic annulus smaller than 21 mm.

Activation of phonological codes during eye fixations in reading

Two experiments addressed the issue of whether phonological codes are activated early in a fixation during reading using the fast-priming technique (S. C. Sereno & K. Rayner, 1992). Participants read sentences and, at the beginning of the initial fixation in a target location, a priming letter string was displayed, followed by the target word. Phonological priming was assessed by the difference in the gaze duration on the target word between when the prime was a homophone and when it was a control word equated with the homophone on orthographic similarity to the target. Both experiments demonstrated homophonic priming with prime durations of about 35 ms, but only for high-frequency word primes, indicating that lexicality was guiding the speed of the extraction of phonological codes early in a fixation. Evidence was also obtained for orthographic priming, and the data suggest that orthographic and phonological priming effects interact in a mutually facilitating manner.

Activation of phonological codes during eye fixations in reading

Two experiments addressed the issue of whether phonological codes are activated early in a fixation during reading using the fast-priming technique (S. C. Sereno & K. Rayner, 1992). Participants read sentences and, at the beginning of the initial fixation in a target location, a priming letter string was displayed, followed by the target word. Phonological priming was assessed by the difference in the gaze duration on the target word between when the prime was a homophone and when it was a control word equated with the homophone on orthographic similarity to the target. Both experiments demonstrated homophonic priming with prime durations of about 35 ms, but only for high-frequency word primes, indicating that lexicality was guiding the speed of the extraction of phonological codes early in a fixation. Evidence was also obtained for orthographic priming, and the data suggest that orthographic and phonological priming effects interact in a mutually facilitating manner.

Diversity of core promoter mutations in immune clearance phase of chronic HBV infection

BACKGROUND/AIMS

Transcription of HBV (hepatitis B virus) pre-core and pre-genomic mRNAs is controlled by core promoter. Therefore, mutations in the core promoter region might change the activity of liver diseases through an altered transcriptional level of the mRNA. The present study was carried out to determine the diversity of HBV core promoter sequences in chronic HBV carriers.

METHODS

DNA sequences in the core promoter region were determined after cloning the PCR product. Two groups of chronic HBV carriers with HBeAg, including five cases of asymptomatic carriers (ASCs, 21 clones) and eight with chronic hepatitis (CH, 50 clones) were studied.

RESULTS

Mutations in the core promoter were found in three out of the ASCs (11 clones), and in all eight cases in the CH group (48 clones). While mutations at nucleotide 1762 (A-->T) and 1764(G-->A) were not found in ASC, mutations at the same positions were found in all the cases of CH group (40 clones) (P=0.003). Diverse patterns of mutations in the core promoter were observed in each patient in the CH group.

CONCLUSIONS

Further studies are needed to determine whether the diversity of HBV core promoter mutations has clinical significance such as the seroconversion of HBeAg to anti-HBe.

Relationship between cell surface carbohydrates and intrastrain variation on opsonophagocytosis of Streptococcus pneumoniae

Streptococcus pneumoniae undergoes spontaneous phase variation between a transparent and an opaque colony phenotype, the latter being more virulent in a murine model of sepsis. Opaque pneumococci have previously been shown to express lower amounts of C polysaccharide (cell wall teichoic acid) and in this study were shown to have a higher content of capsular polysaccharide by immunoelectron microscopy. This report then examined the relationship between expression of these two cell surface carbohydrate structures and their relative contribution to the increased virulence of opaque variants. Comparison of genetically related strains showed that the differential content of capsular polysaccharide did not affect the amount of teichoic acid as measured by a capture enzyme-linked immunosorbent assay (ELISA). In contrast, when the teichoic acid structure was altered by replacing choline in the growth medium with structural analogs, the quantity of capsular polysaccharide as measured by a capture ELISA was decreased, demonstrating a linkage in the expression of the two surface carbohydrate structures. A standardized assay was used to assess the relative contribution of cell surface carbohydrates to opsonophagocytosis. The opaque variants required 1.2- to 30-fold more immune human serum to achieve 50% opsonophagocytic killing than did related transparent variants (types 6B and 9V). The opsonophagocytic titer was proportional to the quantity of capsular polysaccharide rather than teichoic acid. The major factor in binding of the opsonin, C-reactive protein (CRP), was also the amount of capsular polysaccharide rather than the teichoic acid ligand. Only for the transparent variant (type 6B), which bound more CRP, was there enhanced opsonophagocytic killing in the presence of this serum protein. Increased expression of capsular polysaccharide, therefore, appeared to be the major factor in the decreased opsonophagocytic killing of opaque pneumococci.

Drug-resistant pulmonary tuberculosis in a tertiary referral hospital in Korea

OBJECTIVES

To estimate the resistance rate and to correlate the clinical characteristics of resistant tuberculosis with the patients of pulmonary tuberculosis who were referred to the university hospital.

METHODS

We prospectively performed sensitivity tests for all patients who were diagnosed as active tuberculosis by sputum smear or sputum culture from January, 1995 to June, 1996. Patients profile, previous treatment history, patterns of drug resistance, initial chest films and other clinical findings were analysed.

RESULTS

Overall, 24(26.0%) of the 92 patients had resistance to at least one drug and 8(8.6%) had resistance to isoniazid(INH) and rifampin(RFP). Among the 66 patients without previous tuberculosis therapy, 11(16.6%) were drug-resistant and 2(3.0%) were multi-drug resistant. Among the 26 patients with previous therapy, 13(50.0%) were drug-resistant and 6(23.0%) were multi-drug resistant. For all 92, resistance to INH was most common (19.5%), followed by RFP (9.7%) and ethambutol (9.7%). Drug resistance was significantly high in previously treated patients and in cavity-positive patients. Treatment failure was also high in previously treated patients with resistant tuberculosis. In patients with primary resistance, treatment failure was not observed.

CONCLUSION

Sensitivity tests are strongly recommended in all culture positive patients with previous therapy but, in patients with primary resistance, sensitivity tests are not required. Proper combination chemotherapy should be given under careful surveillance.

Co-amplification of a novel cyclophilin-like gene (PPIE) with L-myc in small cell lung cancer cell lines

Specific genetic alterations affecting proto-oncogenes of the myc gene family are frequently detected in human lung cancer. Among 11 SCLC cell lines with L-myc gene amplification, four were found to have alteration of the RLF gene by Southern blot and RT-PCR analyses. One cell line, NCI-H378, contained aberrantly-sized L-myc-hybridizing bands by Southern and Northern blot hybridization but had no alteration of RLF. Some L-myc-hybridizing cDNAs from NCI-H378 contained a novel sequence with close homology to the cyclophilins joined to antisense L-myc exon 2 sequence. Full length cDNAs isolated from human skeletal muscle containing only the novel sequence identify open reading frames of 301 and 296 amino acids and differ in the C-terminal region by 22 and 17 amino acids. This gene, tentatively named PPIE (peptidyl-prolyl cis-trans isomerase E), has 83% amino acid identity with the central conserved region of cyclophilin A, is evolutionarily conserved by Southern blot, and exhibits differential tissue expression with highest levels found in muscle and brain. Co-amplification of PPIE was observed in seven of eleven L-myc amplified cell lines. Analysis of radiation hybrids suggests that the gene order is RLF-PPIE-L-myc on chromosome 1p and pulse-field gel electrophoresis localizes all three genes to an 800 megabase Mlu I fragment. The prognostic and functional consequences of PPIE gene amplification in SCLC can now be determined.

Serious respiratory illness associated with rhinovirus infection in a pediatric population

BACKGROUND

Rhinoviruses have long been associated with mild upper respiratory illness in both adults and children. However, the role of rhinoviruses as lower respiratory tract pathogens has not been fully characterized. Previous data suggests that rhinoviruses may cause severe lower respiratory illness in young children or infants.

OBJECTIVES

The present study describes the clinical presentations, severity of illness and outcomes for a large cohort of pediatric patients with documented rhinovirus infections.

SUBJECTS AND METHODS

A retrospective chart review was done on 93 pediatric patients from whom 101 nasopharyngeal or endotracheal specimens were positive by viral culture for a rhinovirus. All patients were hospitalized or seen in the pediatric emergency department at The Children's Hospital of Philadelphia between 1 January, 1990 and 31 May, 1996.

RESULTS

Of the 93 patients, 52 were male and 41 female. The age range was 0 days to 18 years with 25 (27%) less than 3 months, 42 (45%) between 3 and 12 months and 26 (28%) over the age of 12 months. Clinical presentations on evaluation in the emergency department or admission included 78 (84%) patients with acute respiratory illness, 13 (17%) with fever and suspected sepsis and 11 (12%) with other complaints. Reported physical findings on examination included one or more lower respiratory symptoms or signs of acute distress and fever greater than or equal to 38.1 degrees C. A total of 64 (69%) children were noted to have significant past medical histories, including 28 (44%) with prematurity or complicated neonatal courses, 11 (17%) with prior reactive airways, 8 (12%) with congenital cardiac disease and 7 (11%) with neurologic disorders. Of the patients, 29 (31%) were considered to be otherwise healthy children with no underlying dysfunctions. The mean duration of hospitalization for 69 patients admitted with respiratory illness who did not develop subsequent unrelated complications was 3.7 days. No significant bacterial or fungal pathogens were identified in 91% of the cases.

CONCLUSIONS

This study shows that rhinoviruses were associated with severe lower respiratory illness and hospitalization in a large pediatric population and that rhinovirus infection was a complicating factor in those patients with underlying or predisposing conditions.

Preliminary results of a new covered biliary metal stent for malignant biliary obstruction

BACKGROUND AND STUDY AIMS

The biliary stents in current use have a tendency to be blocked, so we designed a self-expandable metal stent covered with polyurethane to overcome the risk of tumor ingrowth of uncovered self-expandable metal stents. To evaluate the success and the effectiveness of the new membrane-covered self-expandable metal stent (covered modified Gianturco biliary stent), we studied patients with biliary obstruction caused by biliopancreatic carcinoma.

PATIENTS AND METHODS

We retrospectively evaluated 47 patients with malignant biliary obstruction to receive either a newly developed self-expandable metal stent covered with polyurethane (21 cases) or an uncovered metal stent (Strecker stent or Wallstent, 26 cases) by the endoscopic transpapillary route.

RESULTS

The success rate of stent insertion and drainage effect of stent showed no statistical difference in patients with a new membrane-covered self-expandable metal stent compared with those with an uncovered metal stent (90.4% vs. 88.5%, P > 0.05; and 100% vs. 95.6%, P > 0.05, respectively). The median patency of the stent was slightly prolonged in patients with a membrane-covered self-expandable metal stent, but there was no statistical difference between two groups (267 vs. 233 days, P > 0.05). The rate of early complication related to stent insertion showed no significant difference between the two groups. During the follow-up period, stent occlusion due to tumor ingrowth occurred in two patients (10.5%) in the membrane-covered, self-expandable stent group, compared with six patients (26.1%) in the uncovered metal stent group. The membrane-covered metal stent was removed successfully and a polyethylene stent was reinserted in one patient who had developed tumor overgrowth.

CONCLUSIONS

A new, membrane-covered, self-expandable metal stent has a tendency towards better long-term patency than the uncovered metal stent, and it can effectively prevent tumor ingrowth into the stent. Also it is possible to remove an occluded membrane-covered stent. However, a case-controlled study, including a larger patient number, and long-term follow-up are needed.

Antimicrobial effects of metal ions (Ag+, Cu2+, Zn2+) in hydroxyapatite

The antimicrobial ceramics (AC) based on hydroxyapatite (HA) were made in a wet chemical process with additions of AgNO3, Cu(NO3)2. 3H2O and Zn(NO3)2. 6H2O. The ACs were composed of metal-ion substituted hydroxyapatite and nitrate-apatite, which was identified by X-ray diffraction. The viable count and turbidity measurement was adopted to observe the antimicrobial effects of the various ACs. The aerobic Escherichia coli was used in the study. An obvious antimicrobial effect against E. coli was observed in Ag+ AC. In contrast to Ag+ AC, it was difficult to ascertain any bactericidal effect in the case of Cu2+ and Zn2+ AC. The bactericidal effect of Ag+ was observed using a dialysis tube experiment. This suggests that Ag+ dissolved out and reacted with E. coli, thus inhibiting its growth.

Association of intrastrain phase variation in quantity of capsular polysaccharide and teichoic acid with the virulence of Streptococcus pneumoniae

The pneumococcus undergoes spontaneous phase variation between an opaque and a transparent colony form. In an animal model of systemic infection following intraperitoneal inoculation of mice, the opaque phenotype was significantly more virulent than the transparent for each of 3 strains examined. The opaque phenotype was associated with 1.2- to 5.6-fold greater amounts of capsular polysaccharide compared with the transparent using a sandwich ELISA. A similar technique comparing the amount of total teichoic acid showed that the transparent phenotype had 2.1- to 3.8-fold more immunodetectable teichoic acid. This difference was confirmed by comparing the incorporation of [3H]choline into teichoic acid. Cell fractionation revealed that variation in quantity of incorporated choline was due to differences in cell wall-associated teichoic acid. Results suggest that the pneumococcus phase varies between a virulent form with more capsular polysaccharide and less teichoic acid and an avirulent form with less capsular polysaccharide and more teichoic acid.

Loss of heterozygosity of the retinoblastoma and p53 genes in primary cervical carcinomas with human papillomavirus infection

OBJECTIVE

Paired DNA samples from 55 primary uterine cervical carcinomas and normal bloods were studied for chromosomal allelic loss (loss of heterozygosity; LOH) of the retinoblastoma (Rb) and p53 gene loci by polymerase chain reaction (PCR) or PCR-restriction fragment length polymorphism analysis. All the study samples contained at least one of the oncogenic human papillomavirus (HPV) type 16 and/or 18 sequences. And the relationships between allelic losses of these genes and conventional clinicopathological parameters were evaluated.

METHODS

In order to detect LOH of the Rb gene in cervical cancers, we analyzed four polymorphic intronic sites (intron 1, 17, 20, and 25) of the Rb gene and one additional microsatellite near the Rb locus (D13S118). For detection of the LOH in p53, three intragenic polymorphisms (exon 1, exon 4, intron 6) and one microsatellite distal to the p53 gene (D17S5) were examined.

RESULTS

By analyzing this system, we could increase the heterozygosity of the Rb and p53 loci up to 0.91 and 1, respectively. The observed allelic loss rates of the Rb and p53 loci in informative cases were 14% (7/50) and 5.5% (3/55), respectively. The patients with LOH at the D13S118 locus also had the allelic loss of the Rb gene, whereas only one of the four patients with LOH at the D17S5 locus showed a concomittant allelic loss of the p53 gene. The frequency of cervical cancer with one LOH at the Rb or p53 loci was 20% (11/55). No shifted bands were observed in the PCR-single-strand conformation polymorphism analysis of the p53 gene. The LOH of the Rb or p53 gene was not significantly associated with other parameters including clinical stage, histological type, degree of differentiation, status of HPV infection, and p53 gene mutation.

CONCLUSION

Concerning the results above, we conclude that the allelic imbalance of the Rb or p53 gene itself is not implicated as a major contributing factor in the malignant transformation or the tumor progression in HPV-positive uterine cervical cancers.

A new approach for the calculation of photon dose conversion factors in the PMMA slab phantom

A new simple method using the computer code MCNP is proposed for calculation of photon dose conversion factors in the PMMA slab phantom. Absorbed dose is calculated by multiplying fluence buildup in the PMMA slab phantom by virtual energy deposition in the ICRU tissue substance. This method does not need auxiliary calculations to determine the dose conversion factors, such as calculation of backscatter factors in the ICRU tissue cube and the PMMA slab phantoms. The discrepancies between the results of the direct method presented here and a more conventional indirect method is less than 2%, except for low energy photons (<100 keV) at large depths. As the direct method reduces the number of calculational steps, the results are more reliable than those of the indirect method.