Utility of proton MR spectroscopy for differentiating typical and atypical primary central nervous system lymphomas from tumefactive demyelinating lesions

BACKGROUND AND PURPOSE

It may be challenging to differentiate primary CNS lymphomas, especially primary CNS lymphomas with atypical MR features, from tumefactive demyelinating lesions by the use of conventional MR. This study aimed to investigate the usefulness of (1)H-MR spectroscopy for making this discrimination.

MATERIALS AND METHODS

Forty-four patients with primary CNS lymphomas and 21 with tumefactive demyelinating lesions were enrolled. Single-voxel (TE = 144 ms) (1)H-MR spectroscopy scans with the use of the point-resolved spectroscopy sequence were retrospectively analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and/or lactate peak was visually categorized into 5 grades on the basis of comparison with the height of the Cr peak. The (1)H-MR spectroscopy findings were compared in all of the primary CNS lymphomas and the tumefactive demyelinating lesions and in the subgroup of atypical primary CNS lymphomas and tumefactive demyelinating lesions. The thresholds and added value of (1)H-MR spectroscopy to conventional MR were calculated by use of receiver operating characteristic curves.

RESULTS

Discrepancies between all of the primary CNS lymphomas and tumefactive demyelinating lesions were found in the Cho/Cr ratio (P = .000), Cho/NAA ratio (P = .000), and the lipid and/or lactate peak grade (P = .000). Lymphoma rather than tumefactive demyelinating lesions was suggested when the Cho/Cr ratio was >2.58, the Cho/NAA ratio was >1.73, and a high lipid and/or lactate peak grade (grade >3) was seen. Higher Cho/Cr ratios, Cho/NAA ratios, and lipid and/or lactate peak grades were found in atypical primary CNS lymphomas when compared with those of tumefactive demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was improved from 0.827 to 0.870 when Cho/NAA ratio was added in the uncertain cases.

CONCLUSIONS

(1)H-MR spectroscopy may be useful for differentiating primary CNS lymphomas from tumefactive demyelinating lesions. Cho/NAA ratio could provide added value to conventional MR imaging.

The evaluation of dentinal tubule occlusion by desensitizing agents: a real-time measurement of dentinal fluid flow rate and scanning electron microscopy

The aims of this study were to examine changes in dentinal fluid flow (DFF) during the application of a desensitizing agent and to compare the permeability reduction levels among different types of desensitizing agents. A cervical cavity was prepared for the exposure of cervical dentin on an extracted human premolar connected to a subnanoliter fluid flow measuring device under 20 cm of water pressure. The cavity was acid-etched with 32% phosphoric acid to make dentin highly permeable. The different types of desensitizing agents that were applied on the cavity were Seal&Protect as the light-curing adhesive type, SuperSeal and BisBlock as oxalate types, Gluma Desensitizer as the protein-precipitation type, and Bi-Fluoride 12 as the fluoride type. DFF was measured from the time before the application of the desensitizing agent throughout the application procedure to five minutes after the application. The characteristics of dentinal tubule occlusion of each desensitizing agent were examined by scanning electron microscopy. The DFF rate after each desensitizing agent application was significantly reduced when compared to the initial DFF rate before application for all of the desensitizing agents (p<0.05). Seal&Protect showed a greater reduction in the DFF rate when compared to Gluma Desensitizer and Bi-Fluoride 12 (p<0.05). SuperSeal and BisBlock exhibited a greater reduction in DFF rate when compared to Bi-Fluoride 12 (p<0.05). The dentin hypersensitivity treatment effects of the employed desensitizing agents in this study were confirmed through real-time measurements of DFF changes. The light-curing adhesive and oxalate types showed greater reduction in the DFF rate than did the protein-precipitation and fluoride types.

Comparison of amino acid digestibility coefficients for corn, corn gluten meal, and corn distillers dried grains with solubles among 3 different bioassays

The objective of this study was to determine standardized AA digestibility of corn, corn gluten meal, and 3 distillers dried grains with solubles (DDGS) using the precision-fed cecectomized rooster assay (PFR), the standardized ileal AA broiler chicken assay (SIAAD), and a newly developed precision-fed ileal broiler chicken assay (PFC). For the PFR, cecectomized roosters were precision-fed approximately 30 g of feed sample, and excreta were collected 48 h postfeeding. For the SIAAD, 16-d-old broilers were ad libitum fed a semi-purified diet containing the feed samples as the sole source of protein from 17 to 21 d, with ileal digesta collected at 21 d. For the PFC, 22-d-old broiler chickens were precision-fed 10 g of feed and ileal digesta were collected at 4 h postfeeding. For corn, the PFC yielded significantly higher digestibilities than the SIAAD and PFR for several AA. For corn gluten meal, the PFR yielded significantly higher values than the PFC for the majority of the AA, with the SIAAD yielding intermediate values. When 3 DDGS samples were evaluated, the PFR produced higher digestibilities than the PFC for all 3 DDGS samples for most of the AA. When comparing the PFR and the SIAAD, the PFR yielded higher values than the SIAAD for one DDGS, whereas there was generally no significant difference between these 2 methods for the other 2 DDGS samples. The results of this study indicate there were differences among standardized AA digestibility values for the PFR, SIAAD, and PFC in some instances. The differences among methods were not consistent; however, the PFR yielded higher digestibility values than the PFC for 4 of the 5 ingredient samples.

Successional colonization of perennial ryegrass by rumen bacteria

This study investigated successional colonization of perennial ryegrass (PRG) by the rumen microbiota. PRG grown for 6 weeks in a greenhouse was incubated in sacco in the rumens of three Holstein × Freisian cows over a period of 24 h. PRG incubated within the rumen was subsequently harvested at various time intervals postincubation to assess colonization over time. DGGE-based dendograms revealed the presence of distinct primary (0-2 h) and secondary (4 h onwards) attached bacterial communities. Moving window analysis, band number and Shannon-Wiener diversity indices suggest that after 2 h a proportion of primary colonizing bacteria detach, to be replaced with a population of secondary colonizing bacteria between 2 and 4 h after entry of PRG into the rumen. Sequencing and classification of bands lost and gained between 2 and 4 h showed that the genus Prevotella spp. was potentially more prevalent following 4 h of incubation, and Prevotella spp. 16S rDNA-based QPCR supported this finding somewhat, as 2- to 4-h Prevotella QPCR data were greater but not significantly so. Low-temperature scanning electron microscopy showed that attached bacteria were predominantly enveloped in extracellular polymeric substances. In conclusion, colonization of fresh PRG is biphasic with primary colonization completed within 2 h and secondary colonization commencing after 4 h of attachment in this study.

SIGNIFICANCE AND IMPACT OF THE STUDY

We investigated, over a 24-h period in sacco, whether attachment of rumen microbiota to perennial ryegrass (PRG) showed successional changes in diversity. Knowledge of the bacterial species that attach to PRG over time may aid our understanding of the temporal function of the attached microbiota and ultimately permit the development of novel strategies for improving animal production to meet the future demands for meat and milk.

Effects of protein sources on concentrations of hydrogen sulphide in the rumen headspace gas of dairy cows

Two Latin square design experiments investigated the relationship between hydrogen sulphide concentration in the rumen headspace gas of dairy cows and the early stages of protein degradation in the rumen. In Expt 1, three protein sources differing in rumen N (nitrogen) degradability (maize gluten feed (MGF); sunflower meal (SFM); and soyabean meal (SBM)) were used, whereas in Expt 2 four different batches of the same feed (MGF) differing in colour (CIE L*, a*, b* (CIELAB) scale) were used. After allowing the concentration of hydrogen sulphide in rumen gas to decline close to zero, a fixed amount of protein sources was offered to cows and the concentrations of hydrogen sulphide were recorded in rumen headspace gas at 30-min intervals. In Expt 1, the concentration of hydrogen sulphide showed considerable variation between protein sources, with MGF having the highest concentration followed by SFM and SBM resulting in very low concentrations. The N wash losses (zero time measurements with nylon bags) ranked the feeds in the same way, from MGF (highest; 61%) to SBM (lowest; 26%). There were marked differences in the degradation of cystine and methionine between protein sources, although the degradation of cystine was always higher than for methionine. MGF (Expt 2) led to increased concentrations of hydrogen sulphide, with peak concentrations achieved between 1 and 2 h after feeding. The concentrations of hydrogen sulphide were higher for MGF1, intermediate for MGF2 and lower for MGF3 and MGF4, agreeing with colour scale. Differences in the early stages of dietary sulphur degradation corresponded with differences in hydrogen sulphide concentrations in rumen gas. The results suggest that hydrogen sulphide concentrations in the rumen headspace gas could be useful to evaluate nutritional parameters not measured by the in sacco technique, contributing to a better understanding of the response of dairy cows to different protein supplements.

Abstract P4-03-01: Distance of breast cancer from the skin influence axillary nodal metastasis

Background: In breast cancer, axillary lymph node status is one of the most important prognostic variables and a crucial component to the staging system. Moreover, cancers underlying skin are willing to access to the lymphatics and cause lymphatic dissemination. Therefore, there seems an association between proximity of breast cancer to the skin and the incidence of axillary node positivity or local recurrence.

The aim of this study was to determine whether distance of breast cancers from the skin affects the the clinical and pathologic features including the likelihood of axillary nodal metastases, ipsilateral breast cancer recurrence, and recurrence free survival.

Methods: Between January 2003 and December 2009, data were collected prospectively regarding 1005 consecutive breast cancer patients who underwent surgical treatment. The exclusion criteria were non-invasive carcinoma (e.g. Ductal Carcinoma In Situ), prior breast surgery, previous radiotherapy or neo-adjuvant chemotherapy and previous endocrine therapy. The distance of the tumor from the skin surface was measured from the skin to the most anterior hypoechoic leading edge of the lesion.

Results: A total of 891 patients were included in the statistical analysis, 603(68%) had no axillary nodal metastasis, 288(32%) had axillary nodal metastasis. Distance of breast cancer from the skin less than 3mm induced more axillary nodal metastasis (P = 0.039). However, there was no statistical significant correlation between distance of breast cancer from the skin less than 3mm and ipsilateral breast tumor recurrence (P = 0.788) or recurrence-free survival (P = 0.353).

Conclusion: Breast cancers located closer to the skin have a higher incidence of axillary nodal metastasis. When evaluating a breast cancer patient and considering the risk of nodal metastasis the distance of the tumor from the skin should be considered.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-03-01.

Abstract P5-04-03: Epithelial-mesenchymal transition is associated with in situ to invasive transition of basal-like breast cancer

BACKGROUND: Epithelial-mesenchymal transition (EMT) is known to play an important role in breast cancer invasion and metastatic progression and to be associated with cancer stem cells and basal-like subtype. However, its role in the progression of in situ to invasive breast carcinoma is uncertain. To investigate this question, we evaluated the difference in the expression of EMT-related markers between pure ductal carcinoma in situ (DCIS) and invasive carcinomas according to molecular subtype.

METHODS: We performed immunohistochemical analyses of EMT-related markers [expression of vimentin, smooth muscle actin (SMA), osteonectin and N-cadherin, translocation of β-catenin and loss of E-cadherin] and breast cancer stem cell markers (CD44+/CD24−, ALDH1) in 320 invasive carcinomas and 179 pure DCIS of breast using tissue microarrays. We also analyzed 39 basal-like invasive cancers with adjacent DCIS component to determine the difference in the expression of EMT-related markers in the invasive and DICS component within individual cases.

RESULTS: In invasive carcinomas, vimentin, SMA and osteonectin were highly expressed in basal-like subtype. In addition, loss of E-cadherin and translocation of β-catenin were most frequently found in basal-like subtype. Furthermore, there were positive correlations between the expression of EMT-related markers and stem cell markers (CD44+/CD24- and ALDH1). However, there was no significant difference in the expression of EMT-related markers according to molecular subtype in pure DCIS. When comparing invasive carcinoma with pure DCIS, expression of EMT-related markers was significantly higher in invasive carcinoma than in pure DCIS. Subgroup analysis revealed higher expression of EMT-related markers in invasive carcinoma than in DCIS in basal-like subtype, but not in non-basal-like subtypes. Moreover, in 39 basal-like invasive cancers with adjacent DCIS, expression of mesenchymal markers was increased in invasive component compared to DCIS component.

CONCLUSIONS: Our study confirmed that EMT is an intrinsic characteristic of basal-like subtype and is associated with breast cancer with stem cell phenotype. However, increased expression of EMT-related markers in invasive carcinoma compared to pure DCIS, especially in basal-like subtype, and in the invasive component of basal-like invasive carcinoma with DCIS component also suggests a role of EMT in the transition of in situ- to invasive carcinoma in basal-like breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-04-03.

Observation of direct-photon collective flow in Au + Au collisions at √s(NN)] = 200 GeV

The second Fourier component v(2) of the azimuthal anisotropy with respect to the reaction plane is measured for direct photons at midrapidity and transverse momentum (p(T)) of 1-12 GeV/c in Au + Au collisions at √s(NN)] = 200 GeV. Previous measurements of this quantity for hadrons with p(T) < 6 GeV/c indicate that the medium behaves like a nearly perfect fluid, while for p(T) > 6 GeV/c a reduced anisotropy is interpreted in terms of a path-length dependence for parton energy loss. In this measurement with the PHENIX detector at the Relativistic Heavy Ion Collider we find that for p(T) > 4 GeV/c the anisotropy for direct photons is consistent with zero, which is as expected if the dominant source of direct photons is initial hard scattering. However, in the p(T) < 4 GeV/c region dominated by thermal photons, we find a substantial direct-photon v(2) comparable to that of hadrons, whereas model calculations for thermal photons in this kinematic region underpredict the observed v(2).

Comparative protein binding of taxotere and SID530, a new docetaxel formulation with hydroxypropyl-beta-cyclodextrin, in human plasma in vitro

The purpose of this study was to evaluate the plasma-protein binding of docetaxel in two different formulations, Taxotere and SID530, a new docetaxel formulation with hydroxypropyl-beta-cyclodextrin (HP-beta-CD), in human plasma in vitro, using equilibrium dialysis. Unbound docetaxel concentration in the human plasma was determined by LC-MS/MS analysis. SID530 showed a plasma-protein binding profile comparable to that of Taxotere in the clinically relevant concentration range of docetaxel. In both formulations, the unbound fraction of docetaxel increased in a concentration-dependent biphasic manner. The resulting data indicate that the excipient used in SID530, HP-beta-CD, generates similar effects as polysorbate 80 of Taxotere in terms of plasma-protein binding of docetaxel.

Effects of diet type and ingredient composition on rate of passage and apparent ileal amino acid digestibility in broiler chicks

This experiment evaluated rate of passage (ROP) and apparent ileal amino acid digestibility (AIAAD) of 4 diets varying in ingredient composition fed to broilers from 14 to 22 d of age. Two hundred and 88 Ross × Ross 708 chicks (12 birds per cage; 0.45 m(2) per bird) were randomly assigned to 24 cages (6 replicate cages per treatment) at 1 d of age. Experimental diets were 1) corn-soybean meal-based (CSM) diet containing porcine meat and bone meal (MBM; 5% inclusion), 2) CSM diet containing distillers dried grains with solubles (DDGS; 5% inclusion), 3) semipurified (SP) diet containing MBM (38% inclusion), and 4) SP diet containing DDGS (76% inclusion). Diets were formulated to contain 20% CP and were adequate for vitamins and minerals. Experimental diets were provided from d 14 to 22. On d 18, a total excreta collection was conducted every hour for 12 h from 0800 to 1900 h to determine ROP, and AIAAD was determined on d 22. Time of 1% TiO(2) excretion (T1), 50% TiO(2) excretion (T50), and mean retention time (MRT) were used to express ROP. The SP-MBM diet reached T1 (P < 0.05) faster than the SP-DDGS or 2 CSM diets. However, T50 indicated a faster (P < 0.05) ROP for SP-DDGS than the 2 CSM diets, and no significant difference was observed between the 2 SP diets. The MRT of the SP-DDGS diet (5.13 h) was less (P < 0.05) than the MRT of the SP-MBM, CSM-MBM, and CSM-DDGS diets, which resulted in values of 5.48, 5.62, and 5.58 h, respectively. In general, the AIAAD values were higher (P < 0.05) for the 2 CSM diets than for SP diets. Except for His, no statistical differences were observed between the AIAAD of the 2 CSM diets. Comparing the 2 SP diets, AIAAD was usually similar or higher (P < 0.05) for SP-DDGS, except for His, Lys, and Gly, which were higher (P < 0.05) for SP-MBM. Based on T50 and MRT, SP diets containing DDGS had a faster ROP in broilers than CSM diets or SP diets containing MBM.

Comparison of amino acid digestibility coefficients for soybean meal, canola meal, fish meal, and meat and bone meal among 3 different bioassays

The objective of this study was to determine amino acid digestibility of 4 feedstuffs [soybean meal (SBM), canola meal, fish meal, and meat and bone meal (MBM)] using the precision-fed cecectomized rooster assay (PFR), the standardized ileal assay (SIAAD), and a newly developed precision-fed ileal broiler assay (PFC). For the PFR, cecectomized roosters were precision-fed approximately 30 g of feed sample, and excreta were collected 48 h postfeeding. For the SIAAD, 16-d-old broilers were fed a semipurified diet containing the feed samples as the only source of protein from 17 to 21 d, with ileal digesta collected at 21 d. For the PFC, 22-d-old broilers were precision-fed 10 g of feed sample mixed with chromic oxide, and ileal digesta were collected at 4 h postfeeding. Digestibility coefficients were standardized using a nitrogen-free diet for the SIAAD and PFC and using fasted roosters for the PFR. There were generally no consistent differences in standardized amino acid digestibility values among assays, and values were in general agreement among assays, particularly for SBM and MBM. Differences did occur among methods for amino acid digestibility in fish meal; however, these differences were not consistent among methods or amino acids. The results of the study indicated that all 3 bioassays are acceptable for determining the amino acid digestibility of SBM, canola meal, MBM, and fish meal for poultry.

Beef, chicken and lamb fatty acid analysis--a simplified direct bimethylation procedure using freeze-dried material

When fractionation of meat lipids is not required, procedures such as saponification can be used to extract total fatty acids, reducing reliance on toxic organic compounds. However, saponification of muscle fatty acids is laborious, and requires extended heating times, and a second methylation step to convert the extracted fatty acids to fatty acid methyl esters prior to gas chromatography. Therefore the development of a more rapid direct methylation procedure would be of merit. The use of freeze-dried material for analysis is common and allows for greater homogenisation of the sample. The present study investigated the potential of using freeze-dried muscle samples and a direct bimethylation to analyse total fatty acids of meat (beef, chicken and lamb) in comparison with a saponification procedure followed by bimethylation. Both methods compared favourably for all major fatty acids measured. There was a minor difference in relation to the C18:1 trans 10 isomer with a greater (P<0.05) recovery with saponification. However, numerically the difference was small and likely as a result of approaching the limits of isomer identification by single column gas chromatography. Differences (P<0.001) between species were found for all fatty acids measured with no interaction effects. The described technique offers a simplified, quick and reliable alternative to saponification to analyse total fatty acids from muscle samples.

Interactive effects of age, sex, and strain on apparent ileal amino acid digestibility of soybean meal and an animal by-product blend in broilers

The objectives of this study were to determine if age, sex, and strain of broilers affect the apparent ileal amino acid digestibility (AID) of soybean meal and an animal by-product blend. Chicks from 2 broiler strains, 1 commercially available and the other in the test phase, were obtained from a common hatchery, feather-sexed, and placed into floor pens. The birds received common diets while on floor pens. Birds were transferred to metabolism crates for 2 ileal digestibility trials conducted at 3 and 6 wk of age. Two semipurified diets were formulated with each of the feed ingredients providing all of the amino acids (AA) in the diets. Diets were formulated to contain 20% CP, with chromic oxide added to the diet at 0.30% as the indigestible marker. The experimental diets were fed for a 72-h period after an overnight fast to 8 replicate cages of 5 birds per cage. Upon completion of the experimental periods (i.e., d 22 and 43), birds were euthanized and ileal digesta samples were collected and pooled by pen, frozen, lyophilized, and analyzed for AA and chromium concentrations. For soybean meal, no main effects were observed for age, sex, or strain; however, significant (P ≤ 0.05) 3-way interactions were observed for several dispensable and indispensable AA. Statistical analyses of these interactions indicate the AID of soybean meal may be different for 42-d males of the test strain. For the animal by-product blend, only main effects were significant for each AA, with the exception of Ile and Tyr. Main effect of strain was observed for most of the AA, showing that the commercially available strain had higher AID than the test strain. Also, significant main effect of age indicated that the AID for animal by-product blend was higher at 42 d than at 21 d. Evaluation of these 2 ingredients showed that age, sex, and strain may affect digestibility of feedstuffs and should be considered independently or interactively, for some cases, in future investigations as sources of variation in AA digestibility.

Highly sensitive electrochemical detection of proteins using aptamer-coated gold nanoparticles and surface enzyme reactions

A novel electrochemical detection methodology is described for the femtomolar detection of proteins which utilizes both DNA aptamer-functionalized nanoparticles and a surface enzymatic reaction. Immunoglobulin E (IgE) was used as a model protein biomarker, which possesses two distinct epitopes for antibody (anti-IgE) and DNA aptamer binding. A surface sandwich assay format was utilized involving the specific adsorption of IgE onto a gold electrode surface that was pre-modified with a monolayer of aptamer-nanoparticle conjugates followed by the specific interaction of alkaline phosphatase (ALP) conjugated anti-IgE. To clearly demonstrate the signal enhancement associated with nanoparticle use, anodic current measurements of the ALP catalyzed oxidation of the enzyme substrate 4-aminophenylphosphate (APP) were also compared with electrode surfaces upon which the aptamer was directly attached. The detection of an unlabelled protein at concentrations as low as 5 fM is a significant improvement compared to conventional electrochemical-based immunoassay approaches and provides a foundation for the practical use and incorporation of nanoparticle-enhanced detection into electrochemical biosensing technologies.

Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle

BACKGROUND

The results of recent studies suggest that factors in rural environments may protect against the development of allergic diseases, but the underlying mechanisms are not well understood. The aim of this study was to investigate the prevalence of allergic diseases, to establish if this prevalence is influenced by migration from rural to urban areas and to identify environmental risk factors associated with these diseases.

METHODS

A cross-sectional study of children aged 9-12 years from a rural village, a rural town and an urban city in Korea was conducted. Demographic and disease-related information was obtained via a detailed questionnaire, and skin prick tests were performed.

RESULTS

There were significant differences in lifestyle and environmental factors between children from the rural village, the rural town and the urban children. The prevalence of allergic diseases and atopy was higher in urban children. A lower prevalence of allergic diseases and atopy was associated with farming parents, contact with farm animals during pregnancy, owning pets or a stable, breast-feeding and having older siblings. A comparison of rural village and rural town children revealed no evidence of an association of allergic diseases and atopy with farming parents, contact with farm animals during pregnancy or owning a stable. On the other hand, having older siblings and antibiotic use during infancy were significantly associated with allergic diseases and atopy in these children.

CONCLUSIONS

Protective factors associated with a farming environment and/or rural lifestyle may influence the prevalence of allergic diseases and atopy in Korean children.

Plasma biomarkers of depressive symptoms in older adults

The pathophysiology of negative affect states in older adults is complex, and a host of central nervous system and peripheral systemic mechanisms may play primary or contributing roles. We conducted an unbiased analysis of 146 plasma analytes in a multiplex biochemical biomarker study in relation to number of depressive symptoms endorsed by 566 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) at their baseline and 1-year assessments. Analytes that were most highly associated with depressive symptoms included hepatocyte growth factor, insulin polypeptides, pregnancy-associated plasma protein-A and vascular endothelial growth factor. Separate regression models assessed contributions of past history of psychiatric illness, antidepressant or other psychotropic medicine, apolipoprotein E genotype, body mass index, serum glucose and cerebrospinal fluid (CSF) τ and amyloid levels, and none of these values significantly attenuated the main effects of the candidate analyte levels for depressive symptoms score. Ensemble machine learning with Random Forests found good accuracy (~80%) in classifying groups with and without depressive symptoms. These data begin to identify biochemical biomarkers of depressive symptoms in older adults that may be useful in investigations of pathophysiological mechanisms of depression in aging and neurodegenerative dementias and as targets of novel treatment approaches.

Measurements of higher order flow harmonics in Au+Au collisions at √s(NN)=200 GeV

Flow coefficients ν(n) for n=2, 3, 4, characterizing the anisotropic collective flow in Au+Au collisions at √s(NN)=200 GeV, are measured relative to event planes Ψ(n), determined at large rapidity. We report ν(n) as a function of transverse momentum and collision centrality, and study the correlations among the event planes of different order n. The ν(n) are well described by hydrodynamic models which employ a Glauber Monte Carlo initial state geometry with fluctuations, providing additional constraining power on the interplay between initial conditions and the effects of viscosity as the system evolves. This new constraint can serve to improve the precision of the extracted shear viscosity to entropy density ratio η/s.

Suppression of back-to-back hadron pairs at forward rapidity in d+Au collisions at √s(NN)=200 GeV

Back-to-back hadron pair yields in d+Au and p+p collisions at √s(NN)=200 GeV were measured with the PHENIX detector at the Relativistic Heavy Ion Collider. Rapidity separated hadron pairs were detected with the trigger hadron at pseudorapidity |η|<0.35 and the associated hadron at forward rapidity (deuteron direction, 3.0<η<3.8). Pairs were also detected with both hadrons measured at forward rapidity; in this case, the yield of back-to-back hadron pairs in d+Au collisions with small impact parameters is observed to be suppressed by a factor of 10 relative to p+p collisions. The kinematics of these pairs is expected to probe partons in the Au nucleus with a low fraction x of the nucleon momenta, where the gluon densities rise sharply. The observed suppression as a function of nuclear thickness, p(T), and η points to cold nuclear matter effects arising at high parton densities.

Comparison of the Incidence of parenchymal hematoma and poor outcome in patients with carotid terminus occlusion treated with intra-arterial urokinase alone or with combined IV rtPA and intra-arterial urokinase

BACKGROUND AND PURPOSE

Patients with acute CTO generally have a poor prognosis, despite IV or IA thrombolytic treatment. The goal of this study was to analyze the results of patients with CTO who had IA urokinase treatment with or without initial IV rtPA based on a bridging protocol.

MATERIALS AND METHODS

Sixteen consecutive patients with acute ischemic stroke due to CTO who had combined IV and IA or a single IA thrombolytic treatment were enrolled. The baseline characteristics and prognosis were described. The patients who did and did not develop a PH shortly after treatment were compared.

RESULTS

The mean age was 66.4 years, and the median initial NIHSS score was 17. The median dose of IA urokinase was 320,000 U, and recanalization (TICI grade II-III) was achieved in 12 patients (75%). However, 5 patients died and 10 patients had poor prognosis with mRS 5-6 at discharge. Six patients (37.5%) with a PH had a higher NIHSS score 1 day after treatment (26.7 versus 13.6, P = .002), and they had more frequent mortality (66.7% versus 10.0%, P = .018) and worse prognosis (mRS 5-6; 100% versus 40%, P = .016) at discharge than patients without PH.

CONCLUSIONS

Patients with CTO who received IA urokinase treatment based on a bridging protocol had a poor prognosis. The development of PH might affect this outcome.

Association of hypertension with small, dense low-density lipoprotein in patients without metabolic syndrome

A higher proportion of small, dense low-density lipoprotein (sdLDL) is known to be associated with a high prevalence of cardiovascular disease in association with metabolic syndrome (MS). Hypertension (HTN) is one of the known risk factors for MS. However, whether HTN is associated with sdLDL in patients without MS is not yet clear. The lipid profiles, including low-density-lipoprotein (LDL) subfractions, of 383 consecutive subjects were evaluated. The patients without MS consisted of 198 hypertensive patients (non-MS/HTN group) and 108 normotensive subjects (non-MS/non-HTN group). The peak and mean particle diameter of LDL were measured by gradient gel electrophoresis. Plasma total cholesterol, LDL cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride (TG), HDL cholesterol/Apo A1, LDL-C/ApoB and Apo(A1, B, CII and E) levels did not differ between the non-MS/non-HTN and non-MS/HTN groups. When analyzing LDL subfraction, the absolute amount of patterns A and B was not different between the non-MS/non-HTN and non-MS/HTN groups. Compared with the non-MS/non-HTN groups, the proportion of sdLDL was higher in the non-MS/HTN group (37.7% versus 39.9%, P=0.046), but not significant after adjustment of waist circumference, serum TG, age and statin usage. The proportion of sdLDL to total LDL was higher in hypertensive subjects, even those without MS, than in normotensive subjects. However, this difference of LDL subfraction in hypertensive patients is associated with higher waist circumference, higher serum TG, older age and more statin usage. This result suggests that HTN may contribute to atherosclerosis and endothelial dysfunction with associated risk factors that influence LDL size.

Urinary chemokines CXCL9 and CXCL10 are noninvasive markers of renal allograft rejection and BK viral infection

Renal transplant recipients require periodic surveillance for immune-based complications such as rejection and infection. Noninvasive monitoring methods are preferred, particularly for children, for whom invasive testing is problematic. We performed a cross-sectional analysis of adult and pediatric transplant recipients to determine whether a urine-based chemokine assay could noninvasively identify patients with rejection among other common clinical diagnoses. Urine was collected from 110 adults and 46 children with defined clinical conditions: healthy volunteers, stable renal transplant recipients, and recipients with clinical or subclinical acute rejection (AR) or BK infection (BKI), calcineurin inhibitor (CNI) toxicity or interstitial fibrosis (IFTA). Urine was analyzed using a solid-phase bead-array assay for the interferon gamma-induced chemokines CXCL9 and CXCL10. We found that urine CXCL9 and CXCL10 were markedly elevated in adults and children experiencing either AR or BKI (p = 0.0002), but not in stable allograft recipients or recipients with CNI toxicity or IFTA. The sensitivity and specificity of these chemokine assays exceeded that of serum creatinine. Neither chemokine distinguished between AR and BKI. These data show that urine chemokine monitoring identifies patients with renal allograft inflammation. This assay may be useful for noninvasively distinguishing those allograft recipients requiring more intensive surveillance from those with benign clinical courses.

Cold nuclear matter effects on J/ψ yields as a function of rapidity and nuclear geometry in d+A collisions at sqrt[s(NN)]=200 GeV

We present measurements of J/ψ yields in d+Au collisions at sqrt[s(NN)]=200  GeV recorded by the PHENIX experiment and compare them with yields in p+p collisions at the same energy per nucleon-nucleon collision. The measurements cover a large kinematic range in J/ψ rapidity (-2.2<y<2.4) with high statistical precision and are compared with two theoretical models: one with nuclear shadowing combined with final state breakup and one with coherent gluon saturation effects. In order to remove model dependent systematic uncertainties we also compare the data to a simple geometric model. The forward rapidity data are inconsistent with nuclear modifications that are linear or exponential in the density weighted longitudinal thickness, such as those from the final state breakup of the bound state.