Lymphatic sparing versus lymphatic non-sparing laparoscopic varicocelectomy in children and adolescents: a systematic review and meta-analysis

OBJECTIVE

The aim of this study was to explore the true efficacy and potential advantages of lymphatic sparing laparoscopic varicocelectomy (LSV) over lymphatic non-sparing laparoscopic varicocelectomy (LNSV) in children and adolescents.

METHODS

A search was made for studies published up until 31 August 2010 using the terms "lymphatic sparing varicocelectomy", "laparoscopy", "adolescent" and "children" in the Medline, Embase, Ovid, Web of Science, and Cochrane databases. Randomized controlled trials (RCTs) and observational clinical studies (OCSs) comparing LSV and LNSV were included. A systematic review and meta-analysis was performed using odds ratios (ORs) for dichotomous variables.

RESULTS

Out of 127 studies, 2 RCTs and 4 OCSs were eligible for inclusion, comprising 489 cases of LSV and 307 cases of LNSV. The hydrocele rates after LSV were significantly lower than after LNSV (OR = 0.19; 95% confidence interval [CI] = 0.10 to 0.36; p < 0.00001). However, no significant difference was observed between LSV and LNSV with regard to recurrence (OR = 0.65; 95% CI = 0.32-1.33; p = 0.24) or catch-up growth (OR = 2.14; 95% CI =0.97-4.72; p = 0.06).

CONCLUSION

LSV is valuable in reducing the incidence of postoperative hydrocele, with similar recurrence and catch-up growth rates as LNSV. A series of RCTs are warranted to explore the efficacy of LSV in the management of varicocele in children and adolescents.

Estimation of inhibitory quotient using a comparative equilibrium dialysis assay for prediction of viral response to hepatitis C virus inhibitors

The relationship of inhibitory quotient (IQ) with the virologic response to specific inhibitors of human hepatitis C virus (HCV) and the best method to correct for serum protein binding in calculating IQ have not been addressed. A common method is to determine a fold shift by comparing the EC(50) values determined in cell culture in the absence and presence of human serum (fold shift in EC(50) ), but this method has a number of disadvantages. In the present study, the fold shifts in drug concentrations between 100% human plasma (HP) and cell culture medium (CCM) were directly measured using a modified comparative equilibrium dialysis (CED) assay for three HCV protease inhibitors (PIs) and for a novel HCV inhibitor GS-9132. The fold shift values in drug concentration between the HP and CCM (CED ratio) were ∼1 for SCH-503034, VX-950 and GS-9132 and 13 for BILN-2061. These values were ∼3-10-fold lower than the fold shift values calculated from the EC(50) assay for all inhibitors except BILN-2061. Using the CED values, a consistent pharmacokinetic and pharmacodynamic relationship was observed for the four HCV inhibitors analysed. Specifically, an approximate 1 log(10) reduction in HCV RNA was achieved with an IQ close to 1, while 2-3 and greater log(10) reductions in HCV RNA were achieved with IQ values of 3-5 and greater, respectively. Thus, use of CED to define IQ provides a predictive and quantitative approach for the assessment of the in vivo potency of HCV PIs and GS-9132. This method provides a framework for the evaluation of other classes of drugs that are bound by serum proteins but require the presence of serum for in vitro evaluation.

Stability of lyophilized human platelets loaded with small molecule carbohydrates

Long-term preservation of platelets is a great challenge for blood transfusion centers, due to the required narrow storage temperature arange (22 ± 2 degree C). Short shelf life and potential bacterial growth often lead to the shortage of high-quality platelets. Freeze-dried preservation is thus believed to be a potential solution for long-term platelet storage without losing the hemostasis function. Here we report a new platelet preservation method, which uses small molecule carbohydrates to extend storage time and to maintain platelet function. The activities of lyophilized platelets that were stabilized with small molecule carbohydrate (e.g., cell viability, mean platelet volume, activation characteristics, and aggregation kinetics) were maintained after storage of 30, 60, and 90 days at room temperature, 4 degree C, and -20 degree C. The recovery of freeze-dried platelets was 87 percent in comparison to fresh platelets. The mean platelet volume of rehydrated platelets increased (from 6.8 fl to 8.0 fl). About 40 percent of rehydrated platelets was in the early-activated stage (PCA-1 positive) and 30 percent was in the terminal-activated stage (CD62P positive). The cell viability was about 60 percent as measured with CMFDA vital probes. The aggregation rate of rehydrated platelets after 90-day storage was similar to fresh platelets stored at 22 degree C ± 2 degree C.

Myeloid differentiation factor 88 gene is involved in antiviral immunity in grass carp Ctenopharyngodon idella

A full-length MyD88 cDNA (CiMyD88) was cloned and characterized from grass carp Ctenopharyngodon idella. CiMyD88 was found to be broadly expressed and was up-regulated by grass carp reovirus (GCRV) and CiMyD88 transcripts in vitro were rapidly elevated in C. idella kidney (CIK) cells after challenge with poly(I:C). These results suggest that CiMyD88 may be involved in the antiviral immune defence in C. idella.

Occurrence of Chilli veinal mottle virus in Nicotiana tabacum in Yunnan, China

Flue-cured tobacco (Nicotiana tabacum) is an important crop in Yunnan Province, China. During a survey in July 2010, tobacco plants (N. tabacum cv. Yunyan 85) in the fields near Dali County in the northwest Yunnan Province of China had symptoms of chlorosis along leaf veins and later showed symptoms of white or brown necrosis along the veins. In 10 surveyed fields in Baizhishu Village in the city of Weishan, a commercial tobacco field (10 ha) developed virus-like disease symptoms; the incidence of affected plants ranged from 0.5 to 3%, which caused obvious economic losses. An isolate (YN75) was collected at random from five symptomatic leaves sampled from five plants. Negative staining of crude extracts of the infected leaves and subsequent electron microscopy revealed flexuous rods of 12 to 13 × 750 nm. Pinwheel-like inclusion bodies were abundant in thin sections of infected leaves. The particle size suggested a species of Potyviridae. Thus, the isolate was assayed in double antibody sandwich-ELISA (Agdia, Elkhart, IN) for the presence of Potato virus Y, Tobacco etch virus, and Tobacco vein mottling virus. All antigens gave negative results. Total RNA was extracted from leaves and tested by reverse transcription (RT)-PCR. The primer M4-T (5'-GTT TTC CCA GTC ACG ACT TTT TTT TTT TTT TT-3') was employed for cDNA synthesis described by Chen et al (1). The primer set ChiVMV-F (5'-TAG TTG YGC ATA C (C/G) C AGG AGA GAG-3')/M4 (5'-GTT TTC CCA GTC ACG AC-3') is complimentary to the region of coat protein and 3'-untranslated region of Chilli veinal mottle virus (ChiVMV), respectively. The expected 1,189-bp fragments were amplified from RNA templates and the amplicon was cloned and sequenced (GenBank Accession No. HQ218936). Comparisons of amplicons with the amino acid sequence available in the NCBI database using BLAST showed 91.4% identity with ChiVMV from India (GenBank Accession No. EF213688) and 90.7% with ChiVMV from Taiwan (Accession No. DQ854950). The virus particle size, RT-PCR results, and sequence data revealed that these tobacco plants were infected by ChiVMV. To our knowledge, this is the first report of ChiVMV infecting N. tabacum in China. Reference: (1) J. Chen et al. Arch. Virol. 146:757, 2001.

Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification

BACKGROUND

For the emerging DSM-V, it has been recommended that dimensional and categorical methods be used simultaneously in diagnostic classification; however, little is known about this combined approach for abuse and dependence.

METHOD

Using data (n=37 708) from the 2007 National Survey on Drug Use and Health (NSDUH), DSM-IV criteria for prescription opioid abuse and dependence among non-prescribed opioid users (n=3037) were examined using factor analysis (FA), latent class analysis (LCA, categorical), item response theory (IRT, dimensional), and factor mixture (hybrid) approaches.

RESULTS

A two-class factor mixture model (FMM) combining features of categorical latent classes and dimensional IRT estimates empirically fitted more parsimoniously to abuse and dependence criteria data than models from FA, LCA and IRT procedures respectively. This mixture model included a severely affected group (7%) with a comparatively moderate to high probability (0.32-0.88) of endorsing all abuse and dependence criteria items, and a less severely affected group (93%) with a low probability (0.003-0.16) of endorsing all criteria. The two empirically defined groups differed significantly in the pattern of non-prescribed opioid use, co-morbid major depression, and substance abuse treatment use.

CONCLUSIONS

A factor mixture model integrating categorical and dimensional features of classification fits better to DSM-IV criteria for prescription opioid abuse and dependence in adults than a categorical or dimensional approach. Research is needed to examine the utility of this mixture classification for substance use disorders and treatment response.