A Study of Agastachis Herba on Ovalbumin-induced Asthma in the Mouse

Agastachis Herba is one of the well-known medicinal herbs in Korean traditional medicine. This study was taken up to examine the beneficial effects of Agastachis Herba on a mice model of asthma. BALB/c mice were sensitized and challenged with ovalbumin to produce a murine model of asthma. Methanol extracts of Agastachis Herba were orally administered to the ovalbumin-induced asthmatic mice. The effects of methanol extract of Agastachis Herba on airway hyper responsiveness, immune cell distributions in bronchoalveolar lavage fluid, ovalbumin-specific immunoglobulin E in serum, and histopathological changes were evaluated. Mice treated with the methanol extract of Agastachis Herba showed reduction of airway hyper responsiveness as well as inhibited immune cell infiltration in bronchoalveolar region. Also ovalbumin-specific immunoglobulin E levels in bronchoalveolar lavage fluid significantly decreased in extract treated mice. Histopathological findings showed significant beneficial changes in inflammatory cell infiltration.

A randomised, double-blind, placebo-controlled multi-centre phase III trial of XELIRI/FOLFIRI plus simvastatin for patients with metastatic colorectal cancer

Background:

The purpose of this randomised phase III trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3methyglutaryl coenzyme A reductase inhibitor, to XELIRI/FOLFIRI chemotherapy regimens confers a clinical benefit to patients with previously treated metastatic colorectal cancer.

Methods:

We undertook a double-blind, placebo-controlled phase III trial of 269 patients previously treated for metastatic colorectal cancer and enrolled in 5 centres in South Korea. Patients were randomly assigned (1 : 1) to one of the following groups: FOLFIRI/XELIRI plus simvastatin (40 mg) or FOLFIRI/XELIRI plus placebo. The FOLFIRI regimen consisted of irinotecan at 180 mg m⁻² as a 90-min infusion, leucovorin at 200 mg m⁻² as a 2-h infusion, and a bolus injection of 5-FU 400 mg m⁻² followed by a 46-h continuous infusion of 5-FU at 2400 mg m⁻². The XELIRI regimen consisted of irinotecan at 250 mg m⁻² as a 90-min infusion with capecitabine 1000 mg m⁻² twice daily for 14 days. The primary end point was progression-free survival (PFS). Secondary end points included response rate, duration of response, overall survival (OS), time to progression, and toxicity.

Results:

Between April 2010 and July 2013, 269 patients were enrolled and assigned to treatment groups (134 simvastatin, 135 placebo). The median PFS was 5.9 months (95% CI, 4.5–7.3) in the XELIRI/FOLFIRI plus simvastatin group and 7.0 months (95% CI, 5.4–8.6) in the XELIRI/FOLFIRI plus placebo group (P=0.937). No significant difference was observed between the two groups with respect to OS (median, 15.9 months (simvastatin) vs 19.9 months (placebo), P=0.826). Grade ⩾3 nausea and anorexia were noted slightly more often in patients in the simvastatin arm compared with with the placebo arm (4.5% vs 0.7%, 3.0% vs 0%, respectively).

Conclusions:

The addition of 40 mg simvastatin to the XELIRI/FOLFIRI regimens did not improve PFS in patients with previously treated metastatic colorectal cancer nor did it increase toxicity.

Measurements of Elliptic and Triangular Flow in High-Multiplicity 3He+Au Collisions at √(s(NN))=200 GeV

We present the first measurement of elliptic (v(2)) and triangular (v(3)) flow in high-multiplicity (3)He+Au collisions at √(s(NN))=200  GeV. Two-particle correlations, where the particles have a large separation in pseudorapidity, are compared in (3)He+Au and in p+p collisions and indicate that collective effects dominate the second and third Fourier components for the correlations observed in the (3)He+Au system. The collective behavior is quantified in terms of elliptic v(2) and triangular v(3) anisotropy coefficients measured with respect to their corresponding event planes. The v(2) values are comparable to those previously measured in d+Au collisions at the same nucleon-nucleon center-of-mass energy. Comparisons with various theoretical predictions are made, including to models where the hot spots created by the impact of the three (3)He nucleons on the Au nucleus expand hydrodynamically to generate the triangular flow. The agreement of these models with data may indicate the formation of low-viscosity quark-gluon plasma even in these small collision systems.

Measurement of Long-Range Angular Correlation and Quadrupole Anisotropy of Pions and (Anti)Protons in Central d+Au Collisions at sqrt[s_{NN}]=200 GeV

We present azimuthal angular correlations between charged hadrons and energy deposited in calorimeter towers in central d+Au and minimum bias p+p collisions at sqrt[s_{NN}]=200 GeV. The charged hadron is measured at midrapidity |η|<0.35, and the energy is measured at large rapidity (-3.7<η<-3.1, Au-going direction). An enhanced near-side angular correlation across |Δη|>2.75 is observed in d+Au collisions. Using the event plane method applied to the Au-going energy distribution, we extract the anisotropy strength v_{2} for inclusive charged hadrons at midrapidity up to p_{T}=4.5 GeV/c. We also present the measurement of v_{2} for identified π^{±} and (anti)protons in central d+Au collisions, and observe a mass-ordering pattern similar to that seen in heavy-ion collisions. These results are compared with viscous hydrodynamic calculations and measurements from p+Pb at sqrt[s_{NN}]=5.02 TeV. The magnitude of the mass ordering in d+Au is found to be smaller than that in p+Pb collisions, which may indicate smaller radial flow in lower energy d+Au collisions.

Cold-nuclear-matter effects on heavy-quark production at forward and backward rapidity in d + Au collisions at √sNN = 200 GeV

The PHENIX experiment has measured open heavy-flavor production via semileptonic decay over the transverse momentum range 1 < p(T) < 6  GeV/c at forward and backward rapidity (1.4 < |y| < 2.0) in d+Au and p + p collisions at √sNN = 200  GeV. In central d+Au collisions, relative to the yield in p + p collisions scaled by the number of binary nucleon-nucleon collisions, a suppression is observed at forward rapidity (in the d-going direction) and an enhancement at backward rapidity (in the Au-going direction). Predictions using nuclear-modified-parton-distribution functions, even with additional nuclear-p(T) broadening, cannot simultaneously reproduce the data at both rapidity ranges, which implies that these models are incomplete and suggests the possible importance of final-state interactions in the asymmetric d + Au collision system. These results can be used to probe cold-nuclear-matter effects, which may significantly affect heavy-quark production, in addition to helping constrain the magnitude of charmonia-breakup effects in nuclear matter.

Pancreatic ductal adenocarcinoma: prevalence and diagnostic value of dark choledochal ring sign on T2-weighted MRI

AIM

To investigate the dark choledochal ring sign on T2-weighted imaging (T2WI) as an indicator for pancreatic ductal adenocarcinoma (PDAC) among periampullary carcinomas.

MATERIALS AND METHODS

Sixty patients with surgically confirmed periampullary cancers [30 PDACs, 15 distal common bile duct (CBD) cancers, 13 ampullary cancers, and two duodenal cancers] who underwent liver magnetic resonance imaging (MRI) were included in this study. Two reviewers independently evaluated unenhanced and gadoxetic acid-enhanced MRI (T1WI image set), and a combined T2WI and T1WI image set for differentiation between PDAC and other periampullary carcinomas using a rating scale, and the presence of the dark choledochal ring sign on T2WI, for all 60 tumours.

RESULTS

In PDAC, the dark choledochal ring sign on T2WI was considered positive in 23 cases by observer 1 and 24 cases by observer 2, but only in one or two CBD cancers, as determined by each observer, respectively. This resulted in sensitivities of 76.7% and 80% and specificities of 96.7% and 93.3% for observer 1 and 2, respectively, in the diagnosis of PDAC. Adding T2WI correctly led to a change of diagnosis in three and four cases of PDAC by each observer, respectively. Thus, there were significant differences between the two image sets for both observers in distinguishing between PDAC and other periampullary carcinomas (p = 0.02).

CONCLUSION

The presence of the dark choledochal ring sign on axial T2WI could be a complementary imaging feature indicative of PDAC to differentiate PDAC from other periampullary carcinomas at MRI.

The effects of fasting in Muslim patients taking warfarin

BACKGROUND

Anticoagulation with warfarin is influenced by dietary changes but the effect of fasting on warfarin therapy is unknown.

OBJECTIVES

To study changes in international normalized ratio (INR) and the percentage of time within therapeutic range (%TTR) before, during and after the Muslim fasting month (Ramadan) in stable warfarinised Muslim patients.

METHODS/PATIENTS

In this prospective study, weekly INR readings were taken at home visits from participating patients during three study periods: before, during and after Ramadan. Readings were blinded to patients and their primary physicians except for when pre-set study endpoints were reached.

RESULTS

Among 32 participating patients, mean INR increased by 0.23 (P = 0.006) during Ramadan from the pre-Ramadan month and decreased by 0.28 (P < 0.001) after Ramadan. There was no significant difference (P = 1.000) in mean INR between the non-Ramadan months. %TTR declined from 80.99% before Ramadan to 69.56% during Ramadan (P = 0.453). The first out-of-range INR was seen around 12.1 days (95% CI, 9.0-15.1) after the start of fasting and returned to range at about 10.8 days (95% CI, 7.9-13.7) after Ramadan. Time above range increased from 10.80% pre-Ramadan to 29.87% during Ramadan (P = 0.027), while time below range increased from 0.57% during Ramadan to 15.49% post-Ramadan (P = 0.006). No bleeding or thrombotic events were recorded.

CONCLUSIONS

Fasting significantly increases the mean INR of medically stable patients taking warfarin and the likelihood of having an INR above therapeutic targets. For patients maintained at the higher end of INR target ranges or at increased risk of bleeding, closer monitoring or dosage adjustment may be necessary during fasting.

Antimicrobial effects of Caulerpa sertularioides extract on foodborne diarrhea-caused bacteria

AIM

Caulerpa (C.) sertularioides has many therapeutic uses in the practice of traditional medicine in Malaysia. Crude methanolic, diethyl ether extract, ethyl acetate extract and butanolic extract from C. sertularioides were subjected to antimicrobial screening including the three Gram-positive and three Gram-negative diarrhea-caused bacteria.

MATERIALS AND METHODS

The antimicrobial activities were studied by using disc diffusion method and broth dilution method. The effect of the extract on the growth profile of the bacteria was examined via time-kill assay. In addition to the bactericidal effects study, microscopic observations using Scanning electron microscopy (SEM) was done to determine the major alterations in the microstructure of Bacillus (B.) subtilis.

RESULTS

Ethyl acetate extract demonstrated antibacterial activity towards all the tested bacteria and produced inhibition zone ranging from ≤ 9 mm - ≥ 15 mm. However, all the tested bacteria were resistant to the butanolic extract treatment. B. subtilis growth curve in the presence of the crude methanol extract at MIC showed bacteriostatic. The main abnormalities found from these microscopic observations were morphology alteration of the bacteria cells after exposure to the methanol extract.

CONCLUSIONS

Data from this study revealed that C. sertularioides may be potential antimicrobial agents against foodborne Gram-positive and Gram-negative bacteria particularly cause diarrhea, and also food spoilage microorganisms.

Circulating tumour cells and circulating free nucleic acid as prognostic and predictive biomarkers in colorectal cancer

The detection of circulating tumour cells or circulating free tumour nucleic acids can potentially guide treatment and inform prognosis in colorectal cancer using minimally invasive "liquid biopsies". Current literature supports the notion that high circulating tumour cell counts or presence of tumour nucleic acid correlate with inferior clinical outcomes for patients, but they are not yet part of routine clinical care. Future research evolves around the examination of the molecular phenotype of circulating tumour cells. The key unanswered areas include differentiating between circulating tumour cell presence and their proliferative capacity and dormancy, identifying tumour heterogeneity and understanding the epithelial-mesenchymal transition.

Medium modification of jet fragmentation in Au+Au collisions at √[s(NN)]=200 GeV measured in direct photon-hadron correlations

The jet fragmentation function is measured with direct photon-hadron correlations in p+p and Au+Au collisions at √[s(NN)]=200 GeV. The p(T) of the photon is an excellent approximation to the initial p(T) of the jet and the ratio z(T)=p(T)(h)/p(T)(γ) is used as a proxy for the jet fragmentation function. A statistical subtraction is used to extract the direct photon-hadron yields in Au+Au collisions while a photon isolation cut is applied in p+p. I(AA), the ratio of hadron yield opposite the photon in Au+Au to that in p+p, indicates modification of the jet fragmentation function. Suppression, most likely due to energy loss in the medium, is seen at high z(T). The associated hadron yield at low z(T) is enhanced at large angles. Such a trend is expected from redistribution of the lost energy into increased production of low-momentum particles.

BMP receptor-integrin interaction mediates responses of vascular endothelial Smad1/5 and proliferation to disturbed flow

BACKGROUND

Vascular endothelial cells (ECs) are constantly exposed to blood flow-induced shear stress. Our previous study demonstrated that disturbed flow with low and oscillatory shear stress (OSS) induces bone morphogenetic protein receptor (BMPR)-specific Smad1/5 activation in ECs, but the underlying mechanisms and the in vivo functional role of Smad1/5 remain unclear.

OBJECTIVES

Here we elucidated the molecular mechanisms by which OSS activates EC Smad1/5 and its in vivo functional role.

METHODS

Lentiviral Smad5-specific short hairpin RNA (Lenti-shSmad5) was constructed and intra-arterially injected into the lumen of stenosed abdominal aorta in bromodeoxyuridine-infused rats. Co-immunoprecipitation and in situ proximity ligation assays were performed on ECs exposed to OSS (0.5 ± 4 dynes/cm(2) ) in a parallel-plate flow chamber to investigate BMPR-integrin interactions and their regulatory role in OSS-activation of EC Smad1/5.

RESULTS

Intra-arterial administration of Lenti-shSmad5 inhibited bromodeoxyuridine uptake of ECs at post-stenotic sites, where disturbed flow with OSS occurs. OSS induced sustained BMPRIB-αv β3 integrin association in ECs, which was mediated by the intracytoplasmic kinase domain of BMPRII and subsequently activated the Shc/focal adhesion kinase (FAK)/extracellular signal-regulated kinase (ERK) cascade, leading to Smad1/5 activation. This OSS-activation of Smad1/5 induced its association with and activation of runt-related transcription factor-2 (Runx2), leading to activations of mammalian target of rapamycin (mTOR) and p70S6 kinase (p70S6K), a pathway critical for EC proliferation in response to OSS.

CONCLUSIONS

Oscillatory shear stress induces synergistic interactions between specific BMPRs and integrin to activate Smad1/5 through the Shc/FAK/ERK pathway, which leads to the activation of the Runx2/mTOR/p70S6K pathway to promote EC proliferation.

Airway management using a supraglottic airway device without endotracheal intubation for positive ventilation of anaesthetized rats

Endotracheal intubation is often necessary for positive pressure ventilation of rats during open thoracic surgery. Since endotracheal intubation in rats is technically difficult and is associated with numerous complications, many techniques using various devices have been described in the scientific literature. In this study, we compared the effectiveness of airway management of a home-made supraglottic airway device (SAD), which is cheap to fabricate and easy to place with that of an endotracheal intubation tube in enflurane-anaesthetized rats. Twenty male Sprague-Dawley rats (200-300 g) were randomly assigned to two equal groups for positive pressure mechanical ventilation using either the SAD or an endotracheal intubation tube. The carotid artery of each rat was cannulated for continuous blood pressure measurements and obtaining blood samples for determination of oxygen tension, carbon dioxide tension, and blood acidity before, during and after SAD placement or endotracheal intubation. Proper placement of the SAD was confirmed by observing chest wall movements that coincided with the operation of the mechanical ventilator. No complications and adverse events were encountered in the rats in which the SAD was placed, during SAD placement and immediate removal, during their mechanical ventilation through the SAD, and one week after SAD removal. From the results of blood gas analyses, we conclude that anaesthetized rats can be successfully ventilated using an SAD for open thoracic surgery.

Plasma total antioxidant capacity (TAC) in obese Malaysian subjects

INTRODUCTION

There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.

METHODS

Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.

RESULTS

Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.

CONCLUSION

Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.

Evolution of π(0) suppression in Au+Au collisions from √(s(NN))=39 to 200 GeV

Neutral-pion π(0) spectra were measured at midrapidity (|y|<0.35) in Au+Au collisions at √(s(NN))=39 and 62.4 GeV and compared with earlier measurements at 200 GeV in a transverse-momentum range of 1<p(T)<10 GeV/c. The high-p(T) tail is well described by a power law in all cases, and the powers decrease significantly with decreasing center-of-mass energy. The change of powers is very similar to that observed in the corresponding spectra for p+p collisions. The nuclear modification factors (R(AA)) show significant suppression, with a distinct energy, centrality, and p(T) dependence. Above p(T)=7 GeV/c, R(AA) is similar for √(s(NN))=62.4 and 200 GeV at all centralities. Perturbative-quantum-chromodynamics calculations that describe R(AA) well at 200 GeV fail to describe the 39 GeV data, raising the possibility that, for the same p(T) region, the relative importance of initial-state effects and soft processes increases at lower energies. The p(T) range where π(0) spectra in central Au+Au collisions have the same power as in p+p collisions is ≈5 and 7 GeV/c for √(s(NN))=200 and 62.4 GeV, respectively. For the √(s(NN))=39 GeV data, it is not clear whether such a region is reached, and the x(T) dependence of the x(T)-scaling power-law exponent is very different from that observed in the √(s(NN))=62 and 200 GeV data, providing further evidence that initial-state effects and soft processes mask the in-medium suppression of hard-scattered partons to higher p(T) as the collision energy decreases.

Prognostic factors for recurrence after bilateral rectus recession procedure in patients with intermittent exotropia

PURPOSE

The purpose of this study is to evaluate prognostic factors, specifically age, at the time of surgery, for recurrence after bilateral lateral rectus recession (BLR) in patients with intermittent exotropia.

METHODS

Medical records of 511 subjects who underwent BLR procedures between the ages of 3 and 10 years with more than 12 months of follow-up were retrospectively reviewed. Patients' surgical outcomes with a deviation of less than 10 prism diopters (PD) exotropia and less than 5 PD esotropia were defined as a success. Outcomes with more than 11 PD exotropia were designated as recurrences, and those with esotropia of more than 5 PD after 3 months of surgery were noted as overcorrection. Prognostic factors for recurrence were analyzed by multivariate logistic regression test.

RESULTS

Of the 511 subjects, 371 had successful surgical outcomes and 129 had recurrences, whereas 11 were found to be overcorrected. Age at surgery and immediate postoperative alignment proved to be significant factors influencing a favorable outcome by multivariate logistic regression analysis (P<0.05). However, gender, photophobia, age at onset, spherical equivalent (SE) refractive error, astigmatism, SE anisometropia, and preoperative deviation size were not significantly predictive of success (P>0.05).

CONCLUSION

In BLR procedures, increasing patient age at surgery was associated with lower recurrence rates.

Proteomic analysis of the molecular response of Raji cells to maslinic acid treatment

Maslinic acid, a natural pentacyclic triterpene has been shown to inhibit growth and induce apoptosis in some tumour cell lines. We studied the molecular response of Raji cells towards maslinic acid treatment. A proteomics approach was employed to identify the target proteins. Seventeen differentially expressed proteins including those involved in DNA replication, microtubule filament assembly, nucleo-cytoplasmic trafficking, cell signaling, energy metabolism and cytoskeletal organization were identified by MALDI TOF-TOF MS. The down-regulation of stathmin, Ran GTPase activating protein-1 (RanBP1), and microtubule associated protein RP/EB family member 1 (EB1) were confirmed by Western blotting. The study of the effect of maslinic acid on Raji cell cycle regulation showed that it induced a G1 cell cycle arrest. The differential proteomic changes in maslinic acid-treated Raji cells demonstrated that it also inhibited expression of dUTPase and stathmin which are known to induce early S and G2 cell cycle arrests. The mechanism of maslinic acid-induced cell cycle arrest may be mediated by inhibiting cyclin D1 expression and enhancing the levels of cell cycle-dependent kinase (CDK) inhibitor p21 protein. Maslinic acid suppressed nuclear factor-kappa B (NF-κB) activity which is known to stimulate expression of anti-apoptotic and cell cycle regulatory gene products. These results suggest that maslinic acid affects multiple signaling molecules and inhibits fundamental pathways regulating cell growth and survival in Raji cells.

Basic Cardiac Life Support: 2011 Singapore guidelines

The core skills required in resuscitation of cardiac arrest individuals is referred to as Basic Cardiac Life Support or cardiopulmonary resuscitation (CPR). Once cardiac arrest (an unresponsive patient with no breathing or only gasping motions) is recognised, chest compressions should be initiated. Healthcare workers may choose to also check for a pulse to verify cardiac arrest if they are trained. The time taken for breathing check (and pulse check) should not exceed ten seconds. Good quality chest compressions are recommended with each being delivered with arms extended, elbows locked, shoulders vertically above the patient's chest and the heel of the palm on the lower half of the sternum. The rescuer should push hard and fast, with a compression of at least 5.0 cm,100 compressions per minute for adults and allow complete chest recoil after each compression. Every 30 chest compressions should be followed promptly by two quick and short ventilations (each 400-600 ml tidal volume) delivered within six seconds. Chest compression-only CPR is recommended for dispatcher-instructed CPR or if the rescuer, for any reason, is unable or unwilling to do mouth-tomouth ventilations. CPR should only be stopped when the patient wakes up or an emergency team arrives and takes over patient care, or if an automated external defibrillator were to prompt interruption of chest compressions for analysis of heart rhythm or delivery of shock.

Relative strength of the interlayer dipole fields and the interlayer exchange coupling in nanostructured cells of synthetic ferrimagnets

Both analytical and numerical calculations are carried out to examine the relative strength of the interlayer dipole fields in comparison to that of the interlayer exchange coupling in nanostructured cells of synthetic ferrimagnets as functions of their size, shape, and thickness. The relative strength in aligning the magnetizations antiparallel increases with decreasing cell size and with increasing cell thickness, in agreement with the size and thickness dependence of the magnetostatic interactions. As the cell shape changes from rectangle to ellipse, the relative strength decreases, due to the decreased density of free poles with the shape change. The relative strength of the interlayer dipole field is found to be not small, being approximately 10% of the strongest interlayer exchange coupling observed for the CoFeB/Ru/CoFeB structure. In an elliptical cell with the dimensions of 160 nm (long axis) x 80 nm (short axis) x 2 nm (thickness), for example, the strength is 0.016 erg/cm2.

Tannase enzyme production by entrapped cells of Aspergillus niger FETL FT3 in submerged culture system

The ability of immobilized cell cultures of Aspergillus niger FETL FT3 to produce extracellular tannase was investigated. The production of enzyme was increased by entrapping the fungus in scouring mesh cubes compared to free cells. Using optimized parameters of six scouring mesh cubes and inoculum size of 1 × 10(6) spores/mL, the tannase production of 3.98 U/mL was obtained from the immobilized cells compared to free cells (2.81 U/mL). It was about 41.64% increment. The immobilized cultures exhibited significant tannase production stability of two repeated runs.