Does 6% hydroxyethyl starch 130/0.4 impact differently on blood glucose than 4% gelatin in patients receiving open heart surgery?

Objectives: To investigate whether starch-based colloid may impact differently on blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery.

Methods: 70 adult patients scheduled for elective first-time cardiac surgery were enrolled and randomized into two groups. The circuits were primed with either 6% HES 130/0.4 or 4% gelatin. The peak glucose level, incidence of hyperglycemia, glucose variation and glucose level at different time points during operation were compared between the two groups. A p-value ≤ 0.05 was accepted as significant.

Results: The peak glucose (150±30mg/dl vs 142±27, p=0.236) and glucose variation demonstrated by standard deviation (26±12mg/dl vs 23±11mg/dl, p=0.202) were comparable between the two groups. Repeated measurement ANOVA revealed that the main effect for artificial colloid was not significant (p=0.349).

Conclusions: With the data available, we could not prove that starch-based colloid (HES130) had a different impact on intra-operative blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery.

Domain-based assays of individual antibody concentrations in an oligoclonal combination targeting a single protein

Quantitation of individual monoclonal antibodies (mAbs) within a combined antibody drug product is required for preclinical and clinical drug development, including pharmacokinetic (PK), toxicology, stability, and biochemical characterization studies of such drugs. We have developed an antitoxin, XOMA 3AB, consisting of three recombinant mAbs that potently neutralize the known subtypes of type A botulinum neurotoxin (BoNT/A). The three mAbs bind nonoverlapping BoNT/A epitopes with high affinity. XOMA 3AB is being developed as a treatment for botulism resulting from BoNT/A. To develop antibody-specific assays, we cloned, expressed, and purified BoNT/A domains from Escherichia coli. Each mAb bound only to its specific domain with affinity comparable to the binding to holotoxin. mAb-specific domains were used to develop an enzyme-linked immunosorbent assay (ELISA) for characterization of the integrity and binding activity of the three mAbs in the drug product. An electrochemiluminescence bridging assay that is robust to interference from components in serum was also developed, and we demonstrate that it can be used for PK assays. This type of antigen engineering to generate mAb-specific domains is a general method allowing quantitation and characterization of individual mAbs in a mAb cocktail that binds the same protein and is superior to anti-idiotype approaches.

Fiber Confocal Back-Scattering Micro-Spectral Analysis for Single Cell

A fiber confocal back scattering micro-spectrometer (FCBS) was established, which combined fiber confocal microscopy with light scattering spectroscopy (LSS) for early diagnosis of the cancer cell at cellular level. An adherent monolayer human normal gastric epithelium line GES-1 and a carcinoma cell line NCI-N87 as well as a normal liver cell line L02 and a high-metastatic-potential hepatocellular carcinoma cell line HCC-LM3 were measured respectively. The spectral results showed that micro-back-scattering intensity from GES-1 cell and L02 cell possessed interesting oscillations in contrast to NCI-N87 and HCC-LM3 cells. There was significant difference between the spectra of the normal and the cancer cells (p < 0.001). This demonstrates that the FCBS system here is able to distinguish dysplastic cells from normal cells at cellular level.

Staphylococcal enterotoxin B compromises the immune tolerant status in the airway mucosa

BACKGROUND

The breakdown of immune tolerance plays a critical role in allergic disorders; the mechanism of breaching immune tolerance remains largely unknown.

OBJECTIVE

The present study aimed to investigate the role of Staphylococcal enterotoxin B (SEB) in the interference of the immune tolerance in the nasal mucosa.

METHODS

The immune tolerant components, tolerogenic dendritic cells (TolDC) and regulatory T cells (Treg), were assessed in the surgically removed nasal mucosa from patients with allergic rhinitis (AR) or non-AR chronic rhinitis. The contents of SEB and integrin alphavbeta6 (avb6) in the nasal epithelium were assessed using enzyme-linked immunoassay. The ability of avb6 on TolDC induction and the effect of SEB on suppression of avb6 in nasal epithelial cells were observed in cell culture.

RESULTS

Compared with that in the non-AR nasal mucosa, the frequencies of TolDCs/Tregs were lower, the contents of SEB were higher and the contents of avb6 were lower in the AR nasal mucosa. Avb6 had the ability to induce the development of TolDCs in vitro; the latter had the ability to induce Treg development. The expression of avb6 was detected in nasal epithelial cells in culture that could be suppressed by SEB.

CONCLUSIONS AND CLINICAL RELEVANCE

The components of immune tolerance machinery, TolDCs and Tregs were suppressed in the AR nasal mucosa. The increases in SEB and decreases in avb6 in nasal epithelium are associated with the compromises of immune tolerance in the nasal mucosa. SEB has the ability to suppress the expression of avb6 in nasal epithelial cells.

Heritable alteration in DNA methylation induced by nitrogen-deficiency stress accompanies enhanced tolerance by progenies to the stress in rice (Oryza sativa L.)

Cytosine methylation is responsive to various biotic- and abiotic-stresses, which may produce heritable epialleles. Nitrogen (N)-deficiency is an abiotic stress being repeatedly experienced by plants. To address possible epigenetic consequences of N-deficiency-stress, we investigated the stability of cytosine methylation in rice (Oryza sativa L.) subsequent to a chronic (a whole-generation) N-deficiency at two levels, moderate (20mg/L) and severe (10mg/L), under hydroponic culture. MSAP analysis revealed that locus-specific methylation alteration occurred in leaf-tissue of the stressed plants (S(0)) experiencing either level of N-deficiency, which was validated by gel-blotting. Analysis on three non-stressed self-fed progenies (S(1), S(2) and S(3)) by gel-blotting indicated that ca. 50% of the altered methylation patterns in somatic cells (leaf) of the stressed S(0) plants were recaptured in S(1), which were then stably inherited to S(2) and S(3). Bisulfite sequencing of two variant MSAP loci with homology to low-copy retrotransposons on one stressed plant (S(0)) and its non-stressed progenies (S(1) and S(2)) showed that whereas one locus exhibited limited and non-heritable CHH methylation alteration, the other locus manifested dramatic heritable hypermethylation at nearly all cytosine sites within the assayed region. Intriguingly, when two groups of S(2) plants descended from the same N-deficiency-stressed S(0) plant were re-subjected to the stress, the group inheriting the modified methylation patterns showed enhanced tolerance to the N-deficiency-stress compared with the group bearing the original patterns. Our results thus demonstrate heritability of an acquired adaptive trait in rice, which was accompanied by epigenetic inheritance of modified cytosine methylation patterns, implicating an epigenetic basis underlying the inheritance of an acquired trait in plants.

Effects of fumigants on microbial diversity and persistence of E. coli O15:H7 in contrasting soil microcosms

Persistence of E. coli O157 in the environment is a serious public health concern. However, little is known about the persistence of this pathogen after exposure to chemical compounds like fumigants in the environment. In this study, the persistence behavior of pathogenic E. coli O157:H7 was investigated after fumigation with methyl bromide (MeBr; CH(3)Br) and methyl iodide (MeI, iodomethane; CH(3)I) in soil microcosms under laboratory conditions. Our goal was to assess changes in soil microbial community structure and persistence of E. coli O157:H7 in microcosm soils after fumigation. PCR was used to amplify 16S rRNA genes from total bacterial community composition, and the products were subjected to denaturing gradient gel electrophoresis (DGGE). Microbial diversity as determined by DGGE was significantly higher in clay soil than sandy soil. Real-time PCR and plate counts were used to quantify the survival of E. coli O157:H7 in the two soils after fumigation with MeBr and MeI. The survival of the pathogen was higher in the non fumigated controls than the fumigated treatments when determined using plate counts. These results were confirmed by real time PCR analysis targeting the stx1, stx2, and the eae genes. E. coli O157:H7 survived for about 35 days when determined using the plate count method but continued to be detected at about the detection limit of 10(2) by real time PCR for more than 86 days. Our results showed that there was a fast inactivation of the pathogen during the first 35 days. After this period, a small proportion of the pathogen continued to survive in the soil microcosms. Subsequent enrichment of soil samples and immunomagnetic separation revealed the continuous presence of viable cells after 86 days of incubation. The data presented contribute to a better understanding of the behavior of E. coli O157:H7 in soil, and showed the need for more investigation of the role of dormant cells in soil that may be a source for recontamination of the environment.

Cryoprotective effect of an insect antifreeze protein MpAFP 698 and its mutants from the desert beetle Microdera punctipennis

An insect antifreeze protein, MpAFP698, from the desert beetle Microdera punctipennis, shares 77% similarity with TmTHP (YL-3) from Tenebrio molitor. The predicted tertiary structure for MpAFP698 was modeled as a regular A-helix with TCT motifs arrayed to form the putative ice-binding surface. This model was validated via site-directed mutagenesis. The results suggest that the desert beetle in central Asia has evolved antifreeze proteins similar to those from North America continent. In an additional study, the recombinant MpAFP698 and its mutants were expressed in Escherichia coli strain BL21 (DE3). The thermal hysteresis activity of MpAFP698 was 1.73 degree C at 1.0 mg/ml. MpAFP698 was also tested by in vitro antifreeze activity assay to evaluate its cryoprotective effect at -20 degree C. MpAFP698 displays high cryoprotective effect on bacteria cells at freezing temperatures.

Be alert to tuberculosis-mediated glomerulonephritis: a retrospective study

Mycobacterium tuberculosis infection causing glomerulonephritis is a rare disorder. This retrospective study analyzed the clinical characteristics of patients diagnosed with tuberculosis-mediated glomerulonephritis (TB-GN) between 2002 and 2009, as well as the diagnostic tools used. These findings were then compared with those of patients with primary glomerulonephritis (P-GN). The records of all patients were reviewed. The diagnosis of TB-GN was based on renal hematuria and/or proteinuria and cure after antituberculosis therapy alone plus urine culture positive for M. tuberculosis, demonstration of typical tubercle granulomas on renal biopsy specimens, or the detection of M. tuberculosis DNA by polymerase chain reaction (PCR) on renal specimens. Forty-six patients with TB-GN and 49 patients with P-GN were included. Compared with patients in the P-GN group, most (76%) patients with TB-GN had a history of TB. Systemic symptoms were much more frequent in patients with TB-GN than local genitourinary symptoms. Serological testing showed a statistical difference between the two groups. Immunoglobulin A nephropathy was found in the majority (72%) of patients with TB-GN. M. tuberculosis DNA detection was positive in 39 (84.8%) patients, a much higher positive rate of diagnosis than that with urine culture for M. tuberculosis. The manifestation of TB-GN is atypical and nonspecific. It warrants a high index of suspicion when patients with renal hematuria and proteinuria fail to respond to standard treatments for P-GN. Clinicians should pay close attention to the medical history and results of special laboratory tests. M. tuberculosis DNA detection on renal biopsy specimens should be considered in order to confirm the diagnosis of TB-GN.

Apoptotic gene expression by human periodontal ligament cells following cyclic stretch

BACKGROUND AND OBJECTIVE

Periodontal ligament cells play an important role in maintaining homeostasis of periodontal tissue upon mechanical force loading caused by mastication or orthodontic force. Previous studies revealed force-driven periodontal ligament cell death via apoptosis, but the force-sensing genes assigned to the apoptotic pathway have not been fully characterized. The present study aimed to identify force-sensing genes implicated in the apoptotic pathway in periodontal ligament cells.

MATERIAL AND METHODS

Human periodontal ligament cells were exposed to 20% stretch strain for 6 or 24 h, and the differential expression of 84 genes implicated in the apoptotic pathway were quantified by real-time PCR array technology.

RESULTS

Ten and 11 genes showed upregulated expression after 6 and 24 h stretches, respectively, and there were two downregulated genes in response to both 6 and 24 h stretches. These genes included those encoding the tumor necrosis factor ligand family (TNFSF8), tumor necrosis factor receptor family (FAS, TNFRSF10B, TNFRSF11B, TNFRSF25 and CD27), the Bcl-2 family (BAG3, BAK1, BCL2L11 and BCLAF1), the caspase family (CASP5 and CASP7), the inhibitor of apoptosis proteins family (BIRC3, BIRC6 and NAIP), the caspase recruitment domain family (RIPK2 and PYCARD) and the death domain family (DAPK1), as well as an oncogene (BRAF).

CONCLUSION

This study identified several force-sensing genes implicated in the apoptotic pathway in periodontal ligament cells and should facilitate future studies on force-driven apoptosis by providing putative target genes.

Transzygomatic approach to the tentorial incisura: surgical anatomy

A simple transzygomatic approach to the middle fossa centered on the inferior retraction of the temporal muscle after transection of the zygomatic arch is described. This approach allows a very low basal exposure of the middle and temporal fossa, minimizing the amount of temporal lobe retraction needed to approach intradural and extradural lesion in this location. This approach is simple, easily performed, does not require extensive skull base removal, and still offers excellent visualization of the middle fossa and of the region of the tentorial incisura.

A combined intradural presigmoid-transtransversarium-transcondylar approach to the whole clivus and anterior craniospinal region: anatomic study

Surgical exposure of the clivus is difficult because of its proximity to vital neurovascular structures. The anatomic bases of a new surgical approach to this area are discussed. A supra-auricular skin incision is extended toward the posterior border of the sternocleidomastoid muscle. The vertebral artery is exposed from C2 to the occiput unroofing the foramen transversarium of C1. The bone removal consists of a posterior temporal craniotomy, a suboccipital craniectomy, including mastoidectomy with sigmoid sinus unroofing, removal of the lateral margin of the foramen magnum, of the medial third of the occipital condyle, and retrolabyrinthine petrous drilling. Posterior retraction of the vertebral artery facilitates occipital condyle drilling. Intradural exposure of the petroclival region is achieved by L-shaped cutting of the dura with the long branch placed infratentorially anterior to the sigmoid sinus. Intradural exposure of the craniospinal/upper cervical areas is achieved by cutting of the dura medial to the distal sigmoid sinus and by longitudinal cutting of the dura anterior to the vertebral artery. This approach allows multiple ports of entry to the clivus with full control of the vertebrobasilar system, and of the dural sinuses, and is anatomically suited for controlled removal of tumors located in these areas. This approach, or segments of it, has been used successfully in the treatment of large neoplasms of the craniovertebral junction.

High prevalence of bla(CTX-M) extended-spectrum β-lactamase genes in Escherichia coli isolates from pets and emergence of CTX-M-64 in China

As a cause of community-acquired infections, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli constitute an emerging public-health concern. Few data on the molecular epidemiology of ESBL-producing E. coli isolates from pets are available in China. Detection and characterization of ESBL genes (bla(CTX-M), bla(SHV) and bla(TEM)) was conducted among 240 E. coli isolates recovered from healthy and sick pets in South China from 2007 to 2008. The clonal relatedness of ESBL-producing E. coli isolates was assessed by pulsed field gel electrophoresis. ESBL-encoding genes were identified in 97 (40.4%) of the 240 isolates and 96 (40.0%) of them harbored CTX-M. The most common CTX-M types were CTX-M-14 (n = 45) and CTX-M-55 (n = 24). The recently reported CTX-M-64 was identified in three isolates. Isolates producing CTX-M-27, -15, -65, -24, -3 and -9 were also identified. Ten isolates carried two or three CTX-M types, with the combination of CTX-M-14 and CTX-M-55 being the most frequent (n = 6). ISEcp1 was identified in the upstream region of 93 out of the 107 bla(CTX-M) genes (86.9%). The sequence of the spacer region (45 bp) between ISEcp1 and the start codon of all bla(CTX-M-55) genes (except four) was identical to that of bla(CTX-M-64). No major clonal relatedness was observed among these CTX-M producers. It is suggested that the horizontal transfer of bla(CTX-M) genes, mediated by mobile elements, contributes to their dissemination among E. coli isolates from pets. Our finding of high prevalence of ESBL in E. coli of companion animal origin illustrates the importance of molecular surveillance in tracking CTX-M-producing E. coli strains in pets.

Giant anharmonic phonon scattering in PbTe

Understanding the microscopic processes affecting the bulk thermal conductivity is crucial to develop more efficient thermoelectric materials. PbTe is currently one of the leading thermoelectric materials, largely thanks to its low thermal conductivity. However, the origin of this low thermal conductivity in a simple rocksalt structure has so far been elusive. Using a combination of inelastic neutron scattering measurements and first-principles computations of the phonons, we identify a strong anharmonic coupling between the ferroelectric transverse optic mode and the longitudinal acoustic modes in PbTe. This interaction extends over a large portion of reciprocal space, and directly affects the heat-carrying longitudinal acoustic phonons. The longitudinal acoustic-transverse optic anharmonic coupling is likely to play a central role in explaining the low thermal conductivity of PbTe. The present results provide a microscopic picture of why many good thermoelectric materials are found near a lattice instability of the ferroelectric type.