The vital status of human buccal epithelial cells and the bacteria associated with them

OBJECTIVE

We have shown that buccal epithelial cells (BEC) from humans can contain a polymicrobial intracellular flora. Members of that flora can induce proinflammatory responses. However, our subjects all had healthy oral mucosa. This might reflect tolerance of bacterial invasion by live BEC. Alternatively, inflammation might not occur if invaded cells were mostly dead, and thus unable to mount a response. This study addressed that issue, by determining the vital status of BEC and the bacteria associated with them.

DESIGN

Initial experiments indicated that BEC were anomalously permeable to the DNA stain propidium iodide. We used that property to develop a protocol that combined the DNA stains SYTO 9 and propidium iodide (indicators of bacterial viability) with the esterase substrate calcein blue AM (an indicator of BEC viability), and Annexin V Alexa Fluor 647 conjugate (an apoptosis marker). That protocol was applied to BEC collected from 36 human subjects.

RESULTS

On average, 70% of BEC displayed calcein blue staining, with no binding of Annexin V, 25% showed signs of apoptosis, and 5% did not stain with calcein blue. The mean percent of BEC with live cell-associated bacteria was 29%. Collectively, 25% of total BEC displayed calcein blue staining and live (SYTO 9 stained) bacteria. Only 1% of total BEC were negative for calcein blue and associated with live bacteria.

CONCLUSIONS

Our findings suggest that live BEC are tolerant of bacterial invasion. This may be due to complex interactions between members of the polymicrobial flora and their host BEC.

Mirror movements in parkinsonism: evaluation of a new clinical sign

BACKGROUND

Mirror movements (MM) are not widely appreciated in parkinsonism and no report has evaluated this clinical sign in detail.

OBJECTIVES

To define the parkinsonian clinical features associated with MM in patients with early, asymmetric parkinsonism.

METHODS

Twenty seven patients with early Parkinson's disease were evaluated using a standardised videotaping protocol. MM were scored from blinded video assessment using a clinical scale that rates the amplitude, distribution, and proportion of mirroring in the less affected limb. Parkinsonian features were combined into axial and lateralised scores using related items of the Unified Parkinson's Disease Rating Scale.

RESULTS

MM were present in 24 of 27 patients. There was a significant linear correlation between the degree of asymmetry of motor deficits and MM on the less affected side. The effect of asymmetry was greater when the proportional rather than the absolute motor difference between sides was largest. Asymmetry in leg rigidity was the most important examination feature in the prediction of contralateral foot mirroring.

CONCLUSIONS

MM are a clinical feature of the unaffected or less affected side in mild asymmetric parkinsonism. Their presence may be a useful clinical finding in early parkinsonism.

Actively regulating bioengineered tissue and organ formation

OBJECTIVES

Describe current and future approaches to tissue engineering, specifically in the area of bone regeneration. These approaches will allow one to actively regulate the cellular populations participating in this process.

DESIGN

Many approaches to actively regulate cellular phenotype are under exploration, and these typically exploit known signal transduction pathways via presentation of specific receptor-binding ligands, and may also deliver mechanical information via the physical bridge formed by the receptor-ligand interactions. Cellular gene expression may also be directly modulated utilizing gene therapy approaches to control tissue regeneration.

CONCLUSIONS

Significant progress has been made to date in bone regeneration using inductive molecules and transplanted cells, and FDA approved therapies have resulted. While approaches to date have focused on delivery of single stimuli (e.g. one growth factor), future efforts will likely attempt to more closely mimic developmental processes by the delivery of multiple inputs to the cells in spatially and temporally regulated fashions.

Centrifugal force model for pedestrian dynamics

In this paper, a centrifugal force model is developed for pedestrian dynamics. The effects of both the headway and the relative velocity among pedestrians are taken into account, which can be expressed by a "centrifugal force" term in dynamic equation. The jamming probability due to the arching at exits for crowd flows is provided. A quantitative analysis of the crowd flowing out of a hall shows that the average leaving time T is a function of the exit width W in negative power. The related simulation indicates that the proposed model is able to reproduce the self-organization phenomena of lane formation for sparse flows.

Changes in cortical excitability with thalamic deep brain stimulation

BACKGROUND

Deep brain stimulation (DBS) is an effective treatment for several movement disorders. However, its mechanism of action is largely unknown. Both lesioning and DBS of the ventralis intermedius (VIM) nucleus of thalamus improve essential tremor. Although DBS was initially thought to inhibit the target neurons, recent studies suggest that DBS activates neurons.

OBJECTIVE

To test the hypothesis that thalamic DBS activates the target area in patients with essential tremor.

METHODS

Cortical excitability was assessed in seven unmedicated patients with essential tremor using unilateral stimulators implanted in the VIM of the dominant hemisphere and in 11 healthy controls using transcranial magnetic stimulation (TMS). Patients were studied during optimal DBS (ON condition), half the optimal frequency (HALF), and with DBS off (OFF) in random order. Tremor was assessed after a change in DBS setting. Electromyography was recorded from the dominant hand, and TMS was applied over the contralateral motor cortex using single and paired pulses to elicit motor evoked potentials (MEPs). MEP recruitment was determined using stimulus intensities from 100% to 150% of motor threshold.

RESULTS

Tremor scores were significantly improved with DBS ON. Analysis of variance showed a significant interaction between condition (ON, HALF, OFF, Normal) and stimulus intensity on MEP amplitude. During DBS ON MEP amplitudes were significantly higher compared with controls at high but not at low TMS intensities.

CONCLUSION

Because the ventralis intermedius (VIM) projects directly to the motor cortex, the high motor evoked potential amplitude with deep brain stimulation ON suggests that VIM DBS activates rather than inhibits the target area.

beta2-Adrenergic receptor gene variations associated with stage-2 hypertension in northern Han Chinese

The aim of this study was to investigate the association between polymorphisms in the beta(2)-adrenergic receptor gene (ADRB2) (-47C/T, Arg16/Gly, Gln27/Glu) and stage-2 hypertension in northern Han Chinese. We recruited 503 individuals with stage-2 hypertension and 504 age-, gender-, and area-matched controls from the International Collaborative Study of Cardiovascular Disease in Asia. Genotyping was performed using PCR-RFLP. Logistic regression analyses revealed that carriers of the Gly16 allele had a significantly higher odds ratio (OR) for hypertension, while carriers of the Glu27 allele had a significantly lower OR. In multivariate linear regression analyses, the Arg16/Gly and Gln27/Glu genotypes were significantly associated with systolic blood pressure level (p = 0.004 and p < 0.001, respectively). In haplotype analyses, we found the frequency of haplotypes composed of the Gly16 and Gln27 alleles was significantly higher, whereas the frequency of haplotypes composed of the Arg16 and Glu27 alleles was significantly lower, in hypertensives compared to their controls (both p = 0.001). These results indicate that the Gly16 and Gln27 alleles of the ADRB2 gene confer an increased risk for stage-2 hypertension in this northern Han Chinese population.

X-Ray Storage Luminescence of BaFCl:Eu2+ Single Crystals

Temperature behaviors of X-ray luminescence (XL), photoluminescence (PL), photostimulated luminescence, and thermoluminescence (TL) were studied in BaFCl:Eu2+ single crystals from room temperature to liquid nitrogen temperature. Six emissions at 275, 315, 365, 385, 435, and 500 nm were observed in the XL spectra and are attributed to Cl excitons, V(k)(Cl2-), the 4f65d1 (2e(g)) --> 4f7 (8S(7/2)) transition of Eu2+, and oxygen vacancies, respectively. Three emission peaks at 315, 365, and 390 nm were observed in the PL and TL measurements. These three emissions are from the transitions of 4f7(6I(7/2)) --> 4f7(8S(7/2)), 4f7(6P(7/2)) --> 4f7(8S(7/2)), and 4f65d1 (2e(g)) --> 4f7(8S(7/2)) of Eu2+, respectively. In our measurements, we observed that the emission of Eu2+ increases in intensity upon beta-irradiation and did not see any signals related to Eu3+ ions, which indicates that Eu2+ ions might not be oxidized to Eu3+ upon X-ray or beta-irradiation. Instead, the color centers, Cl excitons, and oxygen defects are created and are stable at room temperature, and they might play a key role in the storage luminescence.

The effects of drinks made from simple sugars on blood pressure in healthy older people

The objective of the research was to determine the blood pressure (BP) lowering effects in older people of 50 g carbohydrate drinks with varying carbohydrate content using a randomised, cross-over study with ten (six females) healthy older subjects (mean age 72.20 (sem 1.50) years). BP, heart rate and glucometer-derived blood glucose levels were determined at baseline and following the ingestion of equal volumes (300 ml) of water and carbohydrate drinks with varying nutrient content (glucose, sucrose and fructose). A significant decline in BP over the first 60 min was seen following glucose (systolic BP (SBP) P<0.01, diastolic BP (DBP) P<0.01, mean arterial BP (MAP) P=0.03) and sucrose (SBP P<0.01, DBP P<0.01, MAP P<0.01) ingestion, although the decrease occurred earlier after glucose than sucrose ingestion (SBP 7.33 (sem 2.19) v. 21.00 (sem 4.30) min (P=0.03) and MAP 11.22 (sem 3.10) v. 17.00 (sem 3.78) min (P=0.03)). BP increased after water ingestion (SBP P=0.04, DBP P=0.18, MAP P=0.02) but did not change after fructose ingestion (SBP P=0.36, DBP P=0.81, MAP P=0.34). Post hoc analyses revealed that the BP (SBP, DBP and MAP) decrease following glucose and sucrose ingestion were similar but significantly greater than following fructose or water ingestion. Sucrose, which is used widely (table sugar), reduces BP as much as glucose. In contrast to this, fructose ingestion causes no change in BP. Further studies are required to determine if the substitution of glucose or sucrose with fructose may be beneficial in the medical management of older people with severe symptomatic postprandial hypotension.

Clinical research on monitoring CSFP through lumbar epidural pressure

OBJECTIVE

Explore the relationship between lumbar Epidural Pressure (LEDP) and CSFP through clinical studies and to determine whether LEDP can represent CSFP.

METHODS

We selected 150 cases of cerebral diseases at random for this study. A special mini transducer was implanted into the lumbar epidural space between the third and the 4th lumbar vertebra by means of a No. 18 Touhy needle for monitoring of LEDP. In the meantime, a traditional lumbar puncture was made between the 4th and the 5th lumbar vertebrae and CSFP, which was taken as the standard value, was measured using an ordinary catheter. The transducer was adjusted until the LEDP was equal to CSFP and was designated LEDP0. The LEDP0 was monitored continuously and was translated into a continuous curve. In each and every case, a lumbar puncture was repeated at 24, 48, 72 and 96 hours to obtain CSFP for comparison and to explore the relationship between LEDP0 and CSFP. While monitoring LEDP0, we observed the variation in pressure when the patient breathed, coughed, changed posture, and also if the clinical symptoms changed with intracranial hypertension.

RESULT

The values of the intracranial pressure measured by these two methods were identical.

CONCLUSION

LEDP responded to the changes of CSFP.

Haplotypic analyses of the aldosterone synthase gene CYP11B2 associated with stage-2 hypertension in northern Han Chinese

The objective of this study was to investigate the association of polymorphisms in the aldosterone synthase gene CYP11B2 (-344T/C, Lys173/Arg, and an intronic conversion [IC]) with stage-2 hypertension in northern Han Chinese. A total of 503 hypertensives and their age-, gender-, and area-matched controls were included in this study. The female hypertensives had significantly higher frequencies of the -344T, 173Lys, and IC-conversion alleles (p = 0.002, 0.002, and 0.014, respectively). The estimated frequency of haplotype composed of the -344T, 173Lys, and IC-conversion alleles (haplotype 4) was significantly higher in the female hypertensives compared with their controls (p = 0.007). Using a multivariate score test, we found that haplotype 4 remained associated with female hypertension after the adjustment for covariates (p = 0.003), while the haplotype 3 of T-Arg-WT showed a protective effect both in the males and in the females (p = 0.03 and 0.006, respectively). The odds ratio for haplotype phase of 4-4 was 2.60 (95% CI, 1.21-5.58) and for 3-3, 0.20 (95% CI, 0.03-0.77). These results indicate that the Lys173 and the IC-conversion allele of the CYP11B2 gene confer an increased risk for stage-2 hypertension in northern Han Chinese women.

Characteristics of patients with seasonal allergic rhinitis and concomitant asthma

BACKGROUND

Allergic rhinitis and asthma often co-exist and appear to produce a continuum of airway disease, but whether the clinical characteristics of asthma in patients with seasonal rhinitis differ from those of persistent asthma has not been examined.

OBJECTIVE

The aim of this retrospective study was to characterize the clinical features of patients with seasonal allergic rhinitis with concomitant asthma and to compare them with those in patients with persistent asthma.

METHODS

The patient populations for this study were derived from nine prospective, placebo-controlled planned clinical trials of similar design. Six studies (958 patients) enrolled patients with seasonal allergic rhinitis and concomitant asthma; three (607 patients) involved patients with persistent asthma. In all studies, patients were excluded from oral corticosteroid therapy in the preceding 3 months, and from inhaled corticosteroids in the preceding month.

RESULTS

Patients with seasonal rhinitis and asthma had a significantly (P<0.001) higher total asthma symptom score than those with persistent asthma. In particular, cough was three times more severe. The need for beta(2)-agonist as a rescue medication and the ratio of forced expiratory volume in 1 s/forced vital capacity (FVC) were similar in the two groups whereas forced expiratory fraction 25-75%/FVC was significantly (P<0.02) reduced in the persistent asthmatics. Asthma and nasal symptom severity scores were correlated in patients with seasonal rhinitis and asthma (P<0.0001).

CONCLUSIONS

Patients with seasonal allergic rhinitis and concomitant asthma appear to differ from those with persistent asthma. A prospective study should be designed to discover whether patients with seasonal rhinitis and asthma may represent a distinct nosological entity, 'allergic airway disease'.

Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery: a randomised controlled trial

Patients with breast cancer who require axillary clearance traditionally remain in hospital until their wound drains are removed. Early discharge has been shown to improve clinical outcomes, but there has been little assessment of the psychosocial and financial impact of early discharge on patients, carers and the health service. This study aimed to evaluate the effectiveness of a nurse-led model of early discharge from hospital. Main outcome measures were quality of life and carer burden. Secondary outcomes included patient satisfaction, arm morbidity, impact on community nurses, health service costs, surgical cancellations and in-patient nursing dependency. A total of 108 patients undergoing axillary clearance with mastectomy or wide local excision for breast cancer were randomised to nurse-led early discharge or conventional stay. Nurse-led early discharge had no adverse effects on quality of life or patient satisfaction, had little effect on carer burden, improved communication between primary and secondary care, reduced cancellations and was safely implemented in a mixed rural/urban setting. In total, 40% of eligible patients agreed to take part. Nonparticipants were significantly older, more likely to live alone and had lower emotional well being before surgery. This study provides further evidence of the benefits of early discharge from hospital following axillary clearance for breast cancer. However, if given the choice, most patients prefer to stay in hospital until their wound drains are removed.

Thalamic deep brain stimulation activates the cerebellothalamocortical pathway

To investigate the mechanism of action of deep brain stimulation (DBS), the authors studied the effects of thalamic DBS on the cerebellothalamocortical (CTC) pathway. With DBS turned off, excitability of the CTC pathway was reduced. Turning DBS on resulted in facilitation of the CTC pathway. Therefore, thalamic DBS appears to activate rather than inhibit the target area.