Recombinant Mycobacterium smegmatis expressing an ESAT6-CFP10 fusion protein induces anti-mycobacterial immune responses and protects against Mycobacterium tuberculosis challenge in mice

The currently used vaccine against tuberculosis, Bacille Calmette-Guérin (BCG), has variable efficacy, so new vaccine development is crucial. In this study, we evaluated a recombinant vaccine prepared from non-pathogenic Mycobacterium smegmatis (rMS) that expresses a fusion of early secreted antigenic target 6-kDa antigen (ESAT6) and culture filtrate protein 10 (CFP10). C57BL/6 mice were immunized with the rMS expressing the ESAT6-CFP10 fusion protein (rM.S-e6c10) or with BCG. The mice in the rM.S-e6c10 group had a significantly higher titre of anti-ESAT6-CFP10 antibodies than did animals in the BCG or saline groups. Spleen cells from rM.S-e6c10-immunized mice exhibited a cytotoxic response to ESAT6 and CFP10-expressed target cells, but spleen cells from animals in the other groups did not. Levels of IFN-γ and IL-2 production by purified T cells from spleens were significantly higher in rM.S-e6c10 group than in BCG group. Finally, after M. tuberculosis (MTB)-challenged mice, dramatic reduction in the numbers of MTB colony-forming units (CFUs) in the lungs was observed for the mice immunized with the rMS. The protective efficacy of rM.S-e6c10 and BCG vaccination was similar based on measures of MTB burden and lung pathology. Our data indicate that the recombinant M. smegmatis vaccine expressing the ESAT6-CFP10 fusion protein has potential in clinic application.

Novel MEMS stiffness sensor for in-vivo tissue characterization measurement

This paper presents the design, mathematical model, fabrication and testing of a novel type of in-vivo stiffness sensor. The proposed sensor can measure both tissue stiffness and contact force. The sensing concept utilizes multiple membranes with varying stiffness and is particularly designed for integration with minimally invasive surgical (MIS) tools. In order to validate the new sensing concept, MEMS capacitive sensors are fabricated using surface micromachining with each fabricated sensor having a 1mm x 1mm active sensor area. Finally, the sensors are tested by touching polymers of different elastic stiffnesses. The results are promising and confirm the capability of the sensor for measuring both force and tissue compliance.

Prediction of true metabolizable energy from chemical composition of wheat milling by-products for ducks

The present study was conducted to evaluate the effect of chemical composition of wheat by-products on the TME value to ducks and to establish the prediction models estimating TME. Seven representative samples were selected from 23 wheat by-products millings samples based on the neutral detergent fiber (NDF) content. According to the Sibbald method, male Cherry Valley ducks were chosen to assay the TME of 7 representative samples. Stepwise regression analysis was performed to establish the prediction equations of TME using CP, ether extract (EE), NDF, acid detergent fiber, crude fiber, and gross energy (GE) as independent variables. The NDF, CP, and DM of 23 samples of wheat by-product averaged to be 33.39 +/- 11.04%, 19.2 +/- 3.25%, 87.17 +/- 0.95%, respectively. The TME values of 7 representative samples averaged 12.02 MJ/kg, with much larger CV than GE (17.72 vs. 2.82%). The crude fiber, NDF, acid detergent fiber were highly but negatively correlated with TME (P < 0.01), in which the greatest correlation coefficient (r = -0.969) was observed between NDF and TME. No significant correlation of CP, EE, ash, and GE to TME was found among the 7 representative samples. The optimal equation in terms of R(2) from using a single chemical analysis was obtained in the total group: TME = -0.1564NDF + 17.4696 (R(2) = 0.94, P = 0.0003), and the TME prediction equation was improved by the addition of the EE and CP content to sequential analysis: TME = -0.17NDF + 0.98EE - 0.27CP + 19.31 (R(2) = 0.99, residual SD = 0.35, P < 0.01). The results of present study suggest that NDF could be used as an effective indicator for the prediction of the TME value of wheat by-products for ducks.

Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management

Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a frequent and often debilitating event. The lifetime incidence of this condition is estimated to be between 13% and 40%. Fortunately, the majority of cases resolve spontaneously with simple analgesia and physiotherapy. However, the condition has the potential to become chronic and intractable, with major socio-economic implications. This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica. A Medline search was performed to obtain the published literature on the sciatica, between 1966 and 2006. Hand searches of relevant journals were also performed. Epidemiological factors found to influence incidence of sciatica included increasing height, age, genetic predisposition, walking, jogging (if a previous history of sciatica), and particular physical occupations, including driving. The influence of herniated nucleus pulposus and the probable cytokine-mediated inflammatory response in lumbar and sacral nerve roots is discussed. An abnormal immune response and possible mechanical factors are also proposed as factors that may mediate pain. The ongoing issue of the role of epidural steroid injection in the treatment of this condition is also discussed, as well as potential hazards of this procedure and the direction that future research should take.

Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the Canadian Pain Society

Neuropathic pain (NeP), generated by disorders of the peripheral and central nervous system, can be particularly severe and disabling. Prevalence estimates indicate that 2% to 3% of the population in the developed world suffer from NeP, which suggests that up to one million Canadians have this disabling condition. Evidence-based guidelines for the pharmacological management of NeP are therefore urgently needed. Randomized, controlled trials, systematic reviews and existing guidelines focusing on the pharmacological management of NeP were evaluated at a consensus meeting. Medications are recommended in the guidelines if their analgesic efficacy was supported by at least one methodologically sound, randomized, controlled trial showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment are based on degree of evidence of analgesic efficacy, safety, ease of use and cost-effectiveness. Analgesic agents recommended for first-line treatments are certain antidepressants (tricyclics) and anticonvulsants (gabapentin and pregabalin). Second-line treatments recommended are serotonin noradrenaline reuptake inhibitors and topical lidocaine. Tramadol and controlled-release opioid analgesics are recommended as third-line treatments for moderate to severe pain. Recommended fourth-line treatments include cannabinoids, methadone and anticonvulsants with lesser evidence of efficacy, such as lamotrigine, topiramate and valproic acid. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes, and treatment of pediatric and central NeP.

Femtosecond spectroscopy of carrier relaxation dynamics in type II CdSe/CdTe tetrapod heteronanostructures

Branched nanocrystal heterostructures synthesized from CdSe and CdTe exhibit a type II band structure alignment that induces separation of charge upon photoexcitation and localizes carriers to different regions of the tetrahedral geometry. The dynamics of carrier relaxation examined with femtosecond pump-probe spectroscopy showed heterostructures having rise times and biexponential decays longer than those of nanorods with similar dimensions. This is attributed to weaker interactions with surface states and nonradiative relaxation channels afforded by the type II alignment.

Analgesic effects of low-dose ropivacaine for interscalene brachial plexus block for outpatient shoulder surgery-a dose-finding study

BACKGROUND AND OBJECTIVES

Interscalene brachial plexus block (ISB) with low-dose bupivacaine provides effective postoperative shoulder analgesia in outpatients. The analgesic effect of low-dose ropivacaine for ISB is unknown.

METHODS

In this double-blind study, 66 outpatients scheduled to undergo arthroscopic shoulder surgery were randomly assigned to receive an ISB with 10 mL of 0.125%, 0.25%, or 0.5% ropivacaine before surgery. Postoperative verbal pain rating score, analgesic consumption, and the extent of motor and sensory block was assessed for 120 minutes after surgery.

RESULTS

The degree of shoulder analgesia was dose dependent. Postoperative pain scores were lowest with 0.5% ropivacaine, and analgesic was not required in the hospital in 70% of the patients who received 0.25% and 0.5% ropivacaine, compared to 30% with 0.125% ropivacaine (P < .03). In the patients who required no analgesic in the hospital, the time to first oral analgesic at home was approximately 10 hours irrespective of ropivacaine concentration. Motor and sensory block distal to the elbow was detected in 25% of the patients in the 0.5% group but none in the 0.125% group.

CONCLUSIONS

Interscalene brachial plexus block with low-dose ropivacaine, 10 mL of 0.25% and 0.5%, provides effective long-lasting shoulder analgesia in a majority of patients after arthroscopic surgery.

[Application of video laryngoscope in diagnosis and treatment of laryngeal diseases]

OBJECTIVE

To investigate the value of video laryngoscope in diagnosis of laryngeal diseases. To study the effect of video laryngoscope in treatment of laryngeal diseases.

METHOD

Pentax VNL-1530T and Olympus BF-240T video laryngoscope were used in diagnosis of 3628 cases of laryngeal diseases and in treatment of 1221 cases of laryngeal diseases.

RESULT

3628 cases were examined by video laryngoscope, and correct diagnosis was made. 768 cases of vocal cord polyp and 249 cases of vocal cord node were excised, 113 cases of foreign bodies in hypopharynx or larynx were removed. 91 cases of other laryngeal diseases were treated under video laryngoscope.

CONCLUSION

Video laryngoscope is a new excellent instrument in diagnosis and treatment of laryngeal disease.

What is the relationship between paresthesia and nerve stimulation for axillary brachial plexus block?

BACKGROUND AND OBJECTIVES

To quantify the motor threshold current of a needle following elicitation of paresthesia during axillary brachial plexus block (ABPB).

METHODS

This is a prospective, observational study of ABPB in 72 patients. Having elicited paresthesia, the minimum current required to produce a motor response was noted. The development and success of the block were subsequently followed.

RESULTS

Nineteen blocks were excluded (18 because of arterial puncture and 1 blocked needle). Of the remaining 53 blocks, 41 (77%) produced a motor response at 0.5 mA or less. The median current was 0.17 mA (range, 0.03 to 3.3 mA). The site of initial paresthesia and subsequent motor response were related in 43 (81%) of cases.

CONCLUSIONS

A needle position causing paresthesia produced a motor response at 0.5 mA or less in 77% of cases studied. This current may, therefore, be a reasonable threshold to aim for when performing an ABPB.

Determination of porphyrin carbon isotopic composition using gas chromatography-isotope ratio monitoring mass spectrometry

Carbon isotopic compositions of aetio I occurring in the form of free-base, nickel, demetallation, dihydroxysilicon(IV) and bis(tert.-butyldimethylsiloxy)silicon(IV) [(tBDMSO)2Si(IV)] have shown that it has experienced no obvious isotope fractionation during the synthesis of [(tBDMSO)2Si(IV)] porphyrin from aetio I. Here, aetio I porphyrin species such as free-base, nickel, demetallated and dihydroxysilicon were analyzed by the conventional method, namely it is combusted in sealed system, and followed by isotope ratio monitoring mass spectrometric analysis. [(tBDMSO)2Si(IV)] aetio I was assayed by gas chromatography-isotope ratio monitoring mass spectrometry (GC-IRMS). A porphyrin mixture of [(tBDMSO)2Si(IV)] aetio I and octaethylporphyrin was also prepared. Their carbon isotopic compositions measured by GC-IRMS indicate that no isotope exchange took place between the porphyrins during the synthesis of [(tBDMSO)2Si(IV)] porphyrins. This method is employed for delta13C determination of geoporphyrins from the Maoming and Jianghan oil shales.

[Detection of the asymptomatic infection by human papillomavirus in pregnant women and neonates]

OBJECTIVE

To investigate the state of human papillomavirus (HPV) infection in similar average-aged pregnant women of different gestational periods, in the puerperium and neonates.

METHODS

Polymerase chain reaction (PCR) assay was employed to detect HPV-6, 11, 16 and 18 DNA in 30 pregnant women in the first trimester, 42 in the second and 31 in the third (who were followed up to their puerperium), and 30 non-pregnant women asking for intrauterine device in our out-patient clinic were taken as controls. Average age in the four groups showed no significant difference (P > 0.05). Samples from cervical, vaginal exfoliated cells, maternal peripheral blood and nasopharyngeal secretion of the newborns were examined respectively.

RESULTS

(1) In the first trimester, HPV-DNA was detected in the cervical, vaginal exfoliated cells of 5 cases and in the maternal peripheral blood of 7 cases. (2) In the second trimester, HPV-DNA was detected in the cervical, vaginal exfoliated cells of 12 cases and in the maternal peripheral blood of 11 cases. (3) In the third trimester, HPV-DNA was detected in the cervical, vaginal exfoliated cells of 23 cases and in the maternal peripheral blood of 18 cases. (4) In the puerperium, HPV-DNA was detected in samples of cervical, vaginal exfoliated cells of 8 cases and maternal peripheral blood of 7 cases. (5) In the control group, HPV-DNA was detected in the cervical, vaginal exfoliated cells of 8 cases and in the maternal peripheral blood of 6 cases. (6) Consecutive examinations were carried out in 31 pregnant women from the third trimester, through labor to 6 weeks of postpartum. HPV-DNA was positive in the cervical, vaginal samples of 17, 21 and 8 cases, respectively, according to the perinatal periods, and in the maternal peripheral blood of 14, 13 and 7 cases, respectively. The result through the above gestational stages was fluctuated in the cervical, vaginal samples of 6 cases and in the maternal peripheral blood of 7 cases. (7) Successive examinations in infants at time of birth, 48-72 h and 6 weeks after birth showed positive HPV-DNA in the nasopharyngeal secretion of 13, 6 cases and 1 case with respect to the examining periods. (8) The positive cases were mainly infected by HPV-16, 18.

CONCLUSIONS

(1) Infective rate of HPV is statistically significant in the third trimester, but no significant difference exists among the first trimester, the second trimester, the puerperium or the non-pregnancies. (2) Examining consecutively, the HPV positive rate is found to be decreased after delivery, the positive expression of HPV during the gestational periods exhibited fluctuation. (3) Infective rate of HPV in the neonatal nasopharyngeal specimens tends to decrease with time after delivery.

Determining minimum effective anesthetic concentration of hyperbaric bupivacaine for spinal anesthesia

We determined the minimum effective anesthetic concentration (MEAC) of bupivacaine for spinal anesthesia, defined as the median effective concentration at which a spinal anesthetic produces surgically equivalent anesthesia within 20 min of administration in 50% of human subjects. Two doses of spinal bupivacaine (7.5 mg and 10 mg) were administered to 45 volunteers (19-39 yr) in a randomized, double-blinded fashion. Hyperbaric bupivacaine solutions of 0.1% to 0.75% containing 8.25% dextrose were administered intrathecally and MEAC established by using the Dixon's up-and-down method. Complete anesthesia was defined as: 1) pinprick anesthesia at or higher than T12; 2) anesthesia to transcutaneous tetanic electric stimulation (50 Hz at 60 mA for 5 s) in the knees; and 3) complete leg paralysis, all occurring in both lower extremities within 20 min of intrathecal injection. We found that the MEAC of spinal bupivacaine was 0.43% (95% confidence interval 0.24-0.62) when 10 mg was administered. At this dose, a concentration as low as 0.1% could provide complete anesthesia, but consistent blockade was obtained only with the 0.7% solution. The 7.5-mg dose failed to provide complete anesthesia consistently, even in the presence of 0.75% (maximum). The current commercially available 0.75% concentration of hyperbaric bupivacaine seems to be clinically optimal when 10 mg is used if complete bilateral lower extremity blockade is desired.

Neurophysiology of cancer pain

BACKGROUND

Recent basic science research has greatly added to our knowledge of pain mechanisms. Application of this knowledge to cancer pain syndromes has led to new and innovative approaches to cancer pain management.

METHODS

The mechanisms involved in the three main cancer pain syndromes (somatic, visceral, and neuropathic) are reviewed, and various therapeutic options are discussed.

RESULTS

Advances in knowledge in neurophysiology, neuroanatomy, and pharmacology have allowed a greater understanding of the peripheral and central mechanisms of pain. New drugs and interventional techniques based on this knowledge have improved the control of cancer pain.

CONCLUSIONS

Understanding the neurophysiology of cancer pain promotes use of the most appropriate palliative measures for pain control.

Photoyellowing inhibition of bleached high yield pulps using novel water-soluble UV screens

To address the deficiencies of benzophenone UV screens for preventing brightness reversion in high yield mechanical papers, we synthesized a new series of such materials with enhanced water solubility and compatibility with the lignocellulosic substrate. A series of 2,4-dihydroxybenzophenones (DHB) were synthesized containing various Mannich bases at the C3 position of one of its rings. They possess the UV-screening ability of o-hydroxylbenzophenones, and they also contain tertiary nitrogen atoms that may function as radical scavengers. Aqueous solutions of the hydrochloride salt of 3-(dimethylaminomethylene)-2,4-dihydroxylbenzophenone (1), when applied on bleached chemithermomechanical pulp (CTMP) sheets, were significantly more efficient in preventing photoyellowing than the original DHB applied on the sheets from ethanol-water solutions. This confirmed our original hypothesis that increasing the compatibility of the UV screen with the lignocellulosic matrix would increase its efficiency in preventing photoyellowing. Compound 1, however, was found to be somewhat more effective than its hydrochloride salt toward preventing photoyellowing. This was attributed to the synergistic action of the free tertiary aminic center attached on the molecule with its UV-screening ability. To comprehend further the various parameters that influence the photoyellowing inhibition performance of these compounds and DHB with bleached CTMP pulp fibers, a series of handsheets were prepared at different pH. The interactions of the protonated compound 1 with pulp fibers were then evaluated by studying their kinetics of absorption and desorption to and from the fiber matrix. This part of our study found that the adsorption of protonated Mannich derivatives of DHB onto pulp is most likely governed by a cation-exchange mechanism involving the cationic amine group with the sulfonic and carboxylic acid groups located on the surface of the fibers. The pH the paper sheet was made from was also found to affect profoundly the adsorption and retention characteristics of these compounds onto the lignocellulosic matrix.

Femoral nerve block and ketorolac in patients undergoing anterior cruciate ligament reconstruction

PURPOSE

The primary objective was to evaluate the analgesic effectiveness of femoral nerve block and ketorolac following ACL reconstruction. The secondary objective was to examine their effects on recovery milestones.

METHODS

Prior to standard general anesthesia, 90 patients were randomized into three groups of preoperative treatment: 1) femoral nerve block (15 mL bupivacaine 0.5%) and 1 mL normal saline i.v. (FNB group); 2) placebo femoral nerve block (15 mL normal saline) and 30 mg (1 mL) ketorolac i.v. (KT group); 3) placebo femoral nerve block (15 mL normal saline) and 1 mL normal saline i.v. (PL group). Postoperatively, pain was assessed by visual analogue score, demand and consumption of morphine via patient-controlled analgesia pump. The times for patients to tolerate oral fluid, food, sit up, ambulate and void were also noted.

RESULTS

Morphine consumption within one hour, three hours and until POD 1 in the FNB group was lower than the PL group (7 +/- 6, 11 +/- 9, 27 +/- 23 mg vs 13 +/- 5, 20 +/- 9, 49 +/- 28 mg respectively), whereas only that within one hour in the KT group was lower than the PL group. Pain score was lower in FNB and KT groups in the first postoperative hour than in the PL group (P < 0.05). There were no differences among the three groups in the times to meet recovery milestone and discharge criteria.

CONCLUSION

Femoral nerve block provides superior analgesia than placebo for ACL reconstruction but was insufficient to facilitate early recovery.

Association of peptides with heat shock protein gp96 occurs in vivo and not after cell lysis

Immunization of mice and rats with gp96 preparations isolated from syngeneic cancers has been shown to elicit protective immunity to a number of cancers. The specific immunogenicity of gp96 preparations derives from the antigenic peptides chaperoned by the gp96 molecule and not from gp96 molecules per se. Studies reported here demonstrate that the association of peptides with gp96 occurs in vivo and is not a procedural artifact which occurs in vitro after cell lysis. This demonstration has a bearing on the proposed functional role of HSP peptide association in antigen processing and presentation by MHC I molecules.