Prenatal echocardiographic differential diagnosis of fetal cardiac tumors

OBJECTIVES

To present data on echocardiographic findings of fetal cardiac tumors and discuss their differential diagnoses.

METHODS

We retrospectively reviewed 14 cases of fetal echogenic cardiac mass diagnosed between 1990 and 2003; 12 were confirmed to be cardiac tumors and two were false-positive diagnoses. The echocardiographic characteristics examined included number, size, location and associated complications.

RESULTS

Eight fetuses had a single tumor and four fetuses had multiple tumors. The left ventricle was most often affected. Parents of eight fetuses opted for termination of pregnancy, one fetus died in utero and three affected fetuses survived. Histopathological examination revealed cardiac rhabdomyoma in six fetuses, fibroma in two, teratoma in two, lipoma in one and hemangioma in one. The pitfalls associated with prenatal echocardiographic diagnosis of cardiac tumors include: they may be too small to be visualized, intracardiac echogenic foci may mimic tumors, and echogenicity resulting from extracardiac structures or neoplasms near the heart may falsely appear as tumors.

CONCLUSION

Fetal cardiac tumors can be detected by echocardiography. However, differential diagnosis is important as this will affect prognosis and subsequent management.

Design, Synthesis, and Evaluation of Metabolism-Based Analogues of Haloperidol Incapable of Forming MPP+-like Species

The long-term, irreversible, Parkinsonism-like side effects of haloperidol have been speculated to involve several mechanisms. More recently, it has been speculated that the metabolic transformation to MPP+-like species may contribute to the Parkinsonism-like side effects. Because BCPP+ and its reduced analogue have been shown to possess the potential to destroy dopamine receptors in the nigrostriatum, we have designed new analogues of haloperidol lacking the structural features necessary to form neurotoxic quaternary species but retaining their dopamine-binding capacity. The most potent agent at the D2 receptor, the homopiperidine analogue 11, was found to be equipotent to haloperidol. It was also of interest to identify analogues with DA binding profiles similar to that of clozapine at the dopamine receptor subtypes. Evaluation of the proposed agents shows that the ratio of D2 to D4 (2) binding of clozapine was mimicked by 7 [K(i)(D2) = 33, K(i)(D3) = 200, K(i)(D4) = 11 nM; K(i)(D2)/K(i)(D4) = 3] and 9 [K(i)(D2) = 44, K(i)(D3) = 170, K(i)(D4) = 24 nM; K(i)(D2)/K(i)(D4) = 2]. A preliminary in-vivo testing of compound 7 shows that its behavioral profile is similar to that of clozapine. This profile suggests that there is a need for further evaluation of these two synthetic agents and their enantiomers for efficacy and lack of catalepsy in animal models.

[Establishment and identification of the monoepitopic monoclonal antibody of Plasmodium falciparum]

AIM

To prepare a monoepitopic monclonal antibody of Plasmoduim falciparum.

METHODS

According to the theory of protein structure, a peptide with 6-9 residues representting the antigenicity of the original histidine-rich protein II (HRP-II) of P. falciparum was synthesized and used to immunize BALB/c mice after purity identification by capillary electrophoresis.

RESULTS

Four hybridoma cell lines targeting a suitable peptide from pf HRP-II were obtained by using spleen embedment method and hybridoma technology.

CONCLUSION

It is the first report to prepare a monoepitopic monoclonal antibody against original protein by selecting a suitable peptide from the primary sequence of protein.

Extraperitoneal laparoscopic inguinal hernia repairs

Totally extraperitoneal herniorrhaphy (TEP) is a highly technical procedure with a long learning curve for surgeons. It demands extra skills and may be frustrating, even to the experienced laparoscopic surgeon. The main eriticisms have been the higher costs, the need for general anesthesia, and the prolonged operating room time. When properly performed, TEP provides satisfaction to all involved, namely the patient, the surgeon and the third party payer. The initial concerns of safety, efficacy and efficiency are no longer valid issues as TEP has proved to be safe in numerous randomized trials. We find that there is increasing patient demand for this procedure.

Angiotensin II type-1 receptor antagonist, CS-866, reduces blood pressure without affecting glucose/insulin metabolism in cholesterol-fed rabbits

CS-866 is an angiotensin II type-1 receptor antagonist, the effects of which on systolic blood pressure (BP) and glucose/insulin metabolism are investigated under hyperlipidaemic conditions produced by cholesterol feeding. Thirty-two female Japanese White rabbits (two months old) were assigned randomly into a CS-866-treated group (n = 17) fed a food admixture that contained 0.03% CS-866 and 0.2% cholesterol, or into a control group (n = 15) fed a food admixture containing 0.2% cholesterol only. Systolic BP was measured by an ear-cuff method. Glucose and insulin metabolism was characterised quantitatively from the results of an intravenous glucose tolerance test by a minimal model technique reported previously. After six months treatment, systolic BP in the CS-866-treated group was lower than in the control group (105 +/- 14 mmHg versus 115 +/- 18 mmHg; P <0.05), as assessed by analysis of variance and the Wilcoxon rank-sum test. No significant differences were seen in plasma aldosterone concentration, plasma renin activity, or angiotensin-converting enzyme activity between the groups. Administration of CS-866 for six months did not affect either glucose tolerance or insulin sensitivity. Other model parameters such as basal (steady-state) insulin and glucose concentration, first- and second-phase post-hepatic insulin delivery to glucose, and insulin clearance rate constant were unaffected. In conclusion, CS-866 treatment reduced systolic BP without affecting glucose/insulin metabolism under hyperlipidaemic conditions produced by cholesterol feeding.

[Location of the pre-excitation part in Wolff-Parkinson-White syndrome by Doppler tissue imaging]

OBJECTIVE

To evaluate the feasibility of newly developed Doppler tissue imaging (DTI) for locating the early contraction sites in Wolff-Parkinson-White (WPW) syndrome.

METHODS

The time-sequential changes in ventricular wall motion of thirty-three patients suffering from WPW syndrome were examined by DTI. The pre-excitation site was represented as a red region appearing on the myocardium right after the delta wave of the electrocardiogram and confirmed by electrophysiology.

RESULT

Of 21 patients with left-sided accessory pathways, the early contractive sites were correctly identified by DTI in 18 patients, while the sites were determined by DTI in 8 of 12 patients with right-sided accessory pathways. There was no significant difference between the two groups (P > 0.05).

CONCLUSION

The DTI system is helpful to localize the accessory pathways and evaluate the results after radiofrequency ablation.

The associations among thoracic aortic atherosclerosis, coronary atherosclerosis and the function of high density lipoprotein

We sought to determine the associations among thoracic aortic atherosclerosis, coronary atherosclerosis and the function of high density lipoprotein (HDL) in a case-control study. The function of HDL can be assessed by the fractional esterification rate of cholesterol in low density lipoprotein (LDL)- and very low density lipoprotein (VLDL)-depleted plasma (FER(HDL)), which reflects a balance of cholesterol uptake by HDL and cholesterol ester (CE) transport in the reverse cholesterol transport (RCT) system in humans. Cases (n=51, age: 64.3+/-8.0 years) and controls (n=51, age: 58.7+/-13.1 years) were defined as subjects with/without angiographically proven coronary artery disease (CAD), respectively and examined for thoracic aortic atherosclerosis (TAA) by transesophageal echocardiography. The severity of TAA was determined by the ratio of average sclerotic areas (ASA) and average sclerotic lengths (ASL). The cases had significantly (P<0.05) higher values of ASA (0.22+/-0.18 vs. 0.10+/-0.11), ASL (0.82+/-0.56 vs. 0.48+/-0.45), ASA/ASL ratio (0.23+/-0.08 vs. 0.17+/-0.09) and FER(HDL) (10.3+/-3.8 vs. 8.3+/-3.5% per hour) and lower HDL-C and apolipoprotein A-I levels than the controls. A receiver operating characteristic (ROC) curve analysis showed that ASA/ASL and FER(HDL) had moderate discriminating ability for CAD and the diagnostic accuracy of ASA/ASL was better than that of FER(HDL) (area under ROC curve: 0.703 and 0.656, respectively). Multivariate logistic regression analysis indicated that ASA/ASL and FER(HDL) were independent indicators for CAD [odds ratio (95% CI): 7.5 (2.4-27), P<0.01 and 4.0 (1.2-15), P<0.05] after adjusting for age, gender and other conventional risk factors, and that a high FER(HDL) value greatly increased the relative risk of CAD associated with a high ASA/ASL. The function of HDL, as assessed by FER(HDL), enhances the ability of TAA to predict CAD.

The use of cylindrical coordinates for treatment planning parameters of an elongated 192Ir source

PURPOSE

The doses given to the intima, media, and adventitia are very crucial quantities in intravascular brachytherapy. To facilitate accurate computerized treatment planning calculations, we have determined dose distributions in away-and-along table format around an 192Ir wire source and developed pertinent dosimetric parameters in cylindrical coordinates.

METHODS AND MATERIALS

The Monte Carlo method (MCNP4C code) was used to calculate the dose distributions for the AngioRad 192Ir wire source (model SL-77HS, Interventional Therapies). The calculations were carried out for photon, beta, and electron (conversion and Auger) contributions for radial distances from 0.03 to 2.0 cm with 0.01-cm increments, and up to 2.24 cm from the source center in the longitudinal direction with 0.04-cm resolution. Dose rate values are determined in away-and-along format (cylindrical coordinates) and then converted to spherical coordinate format. Dosimetric parameters, such as the geometry factor, G(r, theta), and anisotropy function, F(r, theta), are generated in both cylindrical (R, Z, phi) and spherical (r, theta, phi) coordinates. The use of a cylindrical coordinate system for treatment planning parameters is proposed as a more suitable approach for accurate calculations.

RESULTS

The photon contribution to dose varies nearly inversely with radial distance (from the source center) along the perpendicular bisector with 0.199 x 10(-3) cGy U(-1) s(-1) (0.802 cGy Ci(-1) s(-1)) at 1 cm. The beta and electron contributions start at very high values of about 35.5 x 10(-3) cGy U(-1) s(-1) and 11.0 x 10(-3) cGy U(-1) s(-1), respectively, at 0.03 cm and fall off exponentially to negligible amount near 0.2 cm. The total dose rate at 0.2 cm is 1.428 x 10(-3) cGy U(-1) s(-1) (5.754 cGy Ci(-1) s(-1)). The radial dose function, g(R), is nearly unity between 0.2 cm and 2 cm. Due to the beta and electron dose contributions, g(R) increases steeply to 5.5 as radial distance decreases from 0.2 cm down to 0.03 cm. The F(R, Z) values are close to unity for the majority of the region of interest. In contrast, F(r, theta) experiences a steep rise as shallow angles are approached (closer to the source), related to the beta dose contributions. Accurate treatment planning calculations would be possible with linear interpolation of F(R, Z), but difficult with F(r, theta) in the spherical coordinate system and the original normalization point as recommended in the American Association of Physicists in Medicine Task Group 60 (AAPM TG-60) formalism.

CONCLUSION

The AngioRad 192Ir wire source, model SL-77HS, was completely characterized dosimetrically using Monte Carlo methods. The use of cylindrical coordinates and a modified anisotropy function normalization point for dosimetric parameters of an elongated 192Ir source is more suitable for accurate computerized treatment planning calculations in intravascular brachytherapy.

Enhancement of a two-photon absorption cross section (TPACS)--design and synthesis of a novel class of photochromic molecules with large TPACS

Two novel photochromic compounds were designed and synthesized; the two-photon absorption (TPA) cross section of both were measured with a nanosecond laser pulse; their TPACS (delta) values are around 25 x 10(-46) cm4 s photon-1 molecule-1 in acetonitrile; the molecular structure of the target compounds have a 3-methyl-1-benzothiophen-2-yl moiety, which can greatly enhance the two-photon absorption cross section.

[Serum apolipoprotein A I, B100 and E levels and apolipoprotein E polymorphism in patients with Alzheimer's disease and multiple infarction dementia in Chinese population]

OBJECTIVE

To investigate the relationship of serum apolipoprotein (apo) A I, B100 and E levels and apo E polymorphism to Alzheimer's disease (AD) and multiple infarction dementia (MID) in Chinese population.

METHODS

The apoE phenotypes were assayed by isoelectric focusing and immunoblotting, and apolipoproteins were determined by radial immunodiffusion assay in 75 patients with AD, 36 patients with MID and 60 control subjects.

RESULTS

The frequency of apo E4 allele (epsilon 4) was significantly higher and the frequency of epsilon 2 allele was lower in AD group, compared with those in the control group (0.2333 vs 0.0666, 0.0467 vs 0.0833, P < 0.05). The frequency of epsilon 4 allele in MID group was also higher than that in the control group (0.2083 vs 0.0666, P < 0.05). The fasting serum apoA 1 and E levels in AD and MID groups were remarkably lower than those in the control group (P < 0.001 and P < 0.05).

CONCLUSION

Apo E4 allele epsilon 4 was associated with AD and MID. ApoE4 might be a risk factor for AD and MID, and apo E2 might be a protective factor for AD. The serum apo A I and apoE levels were significantly decreased in patients with Alzheimer's disease and multiple infarction dementia.

Dopamine D2 receptor inhibition of adenylyl cyclase is abolished by acute ethanol but restored after chronic ethanol exposure (tolerance)

Dopamine D2 (D2) receptors seem to mediate reinforcing responses to addicting drugs. A stably transfected NG108-15 cell line expressing the long form of the rat brain D2 receptor (D2L) was used to determine how ethanol modifies D2 receptor coupling to adenylyl cyclase. Activation of D2L receptors by the D2 receptor-specific agonist R-(-)-2,10,11-trihydroxy-N-propylnorapomorphine hydrobromide (NPA) inhibits both basal and receptor-stimulated cAMP production in these cells. Ethanol added acutely prevents D2L receptor inhibition of cAMP production. After chronic exposure to ethanol, however, D2L receptor coupling to adenylyl cyclase becomes tolerant to rechallenge with ethanol, i.e., ethanol no longer inhibits D2L receptor coupling and NPA inhibition of cAMP production is restored. Acute ethanol does not change NPA binding to D2 receptor in cell membranes but abolishes guanosine-5'-O-(3-thio)triphosphate induction of a lower-affinity state; chronic ethanol is without effect. The protein kinase A (PKA) inhibitor adenosine 3',5' cyclic monophosphorothioate, Rp-isomer, prevents acute ethanol inhibition of D2L receptor coupling. In contrast, the PKA activator adenosine 3',5' cyclic monophosphorothioate, Sp-isomer, reverses chronic ethanol-induced tolerance of D2L receptor coupling, restoring coupling to an ethanol-sensitive state. These results suggest that D2L receptor coupling to adenylyl cyclase via G(i) develops tolerance to ethanol inhibition, which appears to be influenced by PKA activity.

Thermoluminescent dosimetry of the Symmetra 125I model I25.S06 interstitial brachytherapy seed

As the efficacy of brachytherapy prostate treatment is becoming realized, new models of 125I seeds are being introduced. In this article we present thermoluminescent dosimetry (TLD) in a solid water phantom for a new design of 125I seed (UroMed/Bebig Symmetra, Model I25.S06). TLD cubes, LiF TLD-100, from Bicron (Solon, OH) with dimension 1 x 1 x 1 mm3 were irradiated at various distances from the seed at angles ranging from 0 degrees to 90 degrees in 10 degrees increments. The TLD detectors were calibrated by irradiation in a 60Co teletherapy beam. Monte Carlo simulation was used to account for TLD energy dependence and the deviation of solid water composition (as determined by chemical analysis of a sample) from liquid water. Dose rates per unit air kerma strength were determined based on calibrations traceable to the 1999 NIST standard (corrected for NIST measurement errors made in 1999) for the Symmetra seed. Dose data is presented in TG-43 format as a function of distance and angle. Values for lambda, F(r, theta), g(r), and the anisotropy constant are obtained for use in radiation treatment planning (RTP) software. The dose rate constant was determined to be 1.033+/-6.4% cGy h(-1) U(-1), which is comparable to model 6702 and higher than model 6711. We find the relative dose distributions of the Symmetra seed are similar to model 6702, and less anisotropic than model 6711. After accounting for deviation of measured solid water composition from the manufacturer's specification, good agreement between TLD results and Monte-Carlo-aided values was found.

The D allele of the angiotensin-converting enzyme gene and reperfusion-induced ventricular arrhythmias in patients with acute myocardial infarction

The renin-angiotensin system may play a pivotal role in reperfusion ventricular arrhythmias (RVA). The purpose of this study was to investigate the association between angiotensin-converting enzyme (ACE) gene polymorphism and RVA in patients with acute myocardial infarction (AMI) in a case-control study. Patients who had undergone successful coronary intervention for AMI were enrolled (n= 127, male/female: 97/30, mean age, 62.6 years). The incidence of RVA was continuously monitored by ECG at a coronary care unit. The severity of ventricular arrhythmias was evaluated in terms of the Lown's grade and patients with a high risk of ventricular arrhythmias that may cause sudden cardiac death (Lown's grade > or =2) within 5 h of coronary intervention were defined as cases (n=59), and otherwise as controls (n=68). A receiver operating characteristic curve was used to determine the discriminatory ability of continuous variables and to produce dummy variables for use in a logistic regression analysis. Cases had a significantly higher body mass index, higher maximal levels of serum creatine kinase, and a shorter time preceding coronary intervention than controls. The severity of coronary atherosclerosis was similar between the 2 groups. The frequency distribution of ACE genotypes in cases differed from that in controls (II/ID/DD: 22.0%/52.6%/25.4% vs 44.1%/41.4%/14.7%, p<0.05, by the Mantel-Haenzel chi-square test). The ACE-D allele had additive and dominant effects with regard to the occurrence of significant ventricular arrhythmias after adjusting for other risk factors. The ACE-D allele may play a pivotal role in sudden cardiac death in patients with AMI.

Ytterbium-169: a promising new radionuclide for intravascular brachytherapy

PURPOSE

To explore the feasibility of 169Yb (gamma, 93 keV) as a new radionuclide for intravascular brachytherapy (IVBT) in terms of dose distribution, penetration power, and radiation safety features as compared with 125I and 192Ir.

METHODS

The dose distributions for catheter-based sources, 169Yb, 125I, and 192Ir, in homogeneous water and in the presence of calcium and a steel stent have been determined and compared using the Monte Carlo method (MCNP4B2 code). The dose rates of the sources were evaluated from 0.02 to 100 cm.

RESULTS

In the short distance range (0.02<r<1.0 cm), the dose distributions in homogeneous water are very similar for the three radionuclides when the dose rates are normalized at 2 mm. Between 1 and 20 cm, the relative dose rates fall off similarly for 169Yb and 192Ir, whereas for 125I, it decreases much more rapidly. At a distance further away (r approximately 100 cm), the dose rate of 169Yb is about 10 times lower than that of 192Ir, indicating the cathlab radiation shielding requirement for 169Yb is substantially reduced as compared with 192Ir. Calcified plaques and stents cause a drastic dose reduction in the arterial wall for 125I, but have no effect for 192Ir gamma-rays. Only slight dose reductions were detected for 169Yb beyond a layer of 1.0-mm calcium (2-3%), and behind a steel stent strut (5%).

CONCLUSION

169Yb is a promising new radionuclide for IVBT. It has a much better penetrating power through calcified plaques and stents compared with the low-energy source 125I. It also provides easier radiation protection measures for cardiac cathlab personnel than the high-energy source 192Ir, while preserving a favorable dose distribution in tissues surrounding an arterial vessel.

Stereochemical selectivity of methanandamides for the CB1 and CB2 cannabinoid receptors and their metabolic stability

Several chiral, analogues of the endogenous cannabinoid receptor ligand, arachidonylethanolamide (anandamide), methylated at the 2,1' and 2' positions using asymmetric synthesis were evaluated in order to study (a) stereoselectivity of binding to CB1 and CB2 cannabinoid receptors; and (b) metabolic stability with regard to anandamide amidase. Enantiomerically pure 2-methyl arachidonic acids were synthesized through diastereoselective methylation of the respective chiral 2-oxazolidinone enolate derivatives and CB1 and CB2 receptor affinities of the resulting chiral anandamides were evaluated using a standard receptor binding assay. Introduction of a single 2-methyl group increased affinity for CB1, led to limited enantioselectivity and only modestly improved metabolic stability. However, a high degree of enantio- and diastereoselectivity was observed for the 2,1'-dimethyl analogues. (R)-N-(1-methyl-2-hydroxyethyl)-2-(R)-methyl-arachidonamide (4) exhibited the highest CB1 receptor affinity in this series with a K(i) of 7.42 nM, an at least 10-fold improvement on anandamide (K(i)=78.2 nM). The introduction of two methyl groups at the 2-position of anandamide led to no change in affinity for CB1 but somewhat enhanced metabolic stability. Conversely, chiral headgroup methylation in the 2-gem-dimethyl series led to chiral analogues possessing a wide range of CB1 affinities. Of these the (S)-2,2,2'-trimethyl analogue (12) had the highest affinity for CB1 almost equal to that of anandamide. In agreement with our previous anandamide structure-activity relationship work, the analogues in this study showed high selectivity for the CB1 receptor over CB2. The results are evaluated in terms of stereochemical factors affecting the ligand's affinity for CB1 using receptor-essential volume mapping as an aid. Based on the results, a partial CB1 receptor site model is proposed, that bears two hydrophobic pockets capable of accommodating 1'- and 2-methyl groups

Effects of high-dose troglitaz one on insulin sensitivity and beta-cell function in Watanabe heritable hyperlipidemic rabbits

To clarify the dose-response effects of troglitazone on insulin sensitivity and beta-cell function, we examined the effects of high-dose troglitazone (100 mg/day per animal, administered as a food admixture) on glucose and insulin metabolism in hyperinsulinemic Watanabe heritable hyperlipidemic (WHHL) rabbits, and compared the results with our previous results with low-dose troglitazone (10 mg /day per animal).

MATERIALS AND METHODS

Glucose and insulin metabolism were quantitatively characterized by a minimal model technique as reported previously.

RESULTS

When troglitazone was administrated at a high dose for 6 months, it reduced hyperinsulinemia as reflected by a reduced basal (steady-state) insulin concentration lb and the insulin response to a glucose load, improved beta-cell function as reflected by decreased second-phase post-hepatic insulin delivery to glucose phi2, and reduced insulin resistance as reflected by increased insulin sensitivity to glucose disposal Si, without affecting glucose tolerance as reflected by an unchanged rate of glucose utilization Kg or insulin-independent glucose disposal Sg. The reductions in Ib and phi2 and the increases in Si in WHHL rabbits treated with a high dose of troglitazone were greater (p<0.05) than those observed in WHHL rabbits treated with a low dose of troglitazone, as assessed by a two-way repeated measures analysis of variance and the Wilcoxon-Mann-Whitney test.

CONCLUSION

In WHHL rabbits, troglitazone dose-dependently reduced hyperinsulinemia, improved beta-cell function, and increased insulin sensitivity.

The effect of adeno-associated virus mediated brain derived neurotrophic factor in an animal model of neurogenic impotence

PURPOSE

We tested the hypothesis that transfecting penile tissue with brain derived neurotrophic factor may facilitate neural recovery and erectile capability after cavernous nerve injury.

MATERIALS AND METHODS

Of the 34 Sprague-Dawley rats used 10 underwent sham operation and 24 underwent bilateral cavernous nerve freezing and intracavernous injection of adeno-associated virus-LacZ (12) or adeno-associated virus-brain derived neurotrophic factor (12). Erectile function was assessed by cavernous nerve electrostimulation at 4 and 8 weeks, and samples of penile tissue and the major pelvic ganglia were evaluated histologically.

RESULTS

In the brain derived neurotrophic factor group mean maximal intracavernous pressure plus or minus standard deviation was significantly higher than in the LacZ group at 4 and 8 weeks (58.5 +/- 11.7 cm. water versus 28.4 +/- 5.5 and 61.3 +/- 12.5 versus 37.7 +/- 7.9, respectively). In addition, in the brain derived neurotrophic factor group reduced nicotinamide adenine dinucleotide phosphate diaphorase staining and neuronal nitric oxide synthase immunostaining revealed significantly more positive nerve fibers in the dorsal nerves and cavernous tissue than in the LacZ group at each time point and the percent of neuronal nitric oxide synthase positive neurons in the major pelvic ganglia was also significantly greater. Moreover, in the LacZ group most neurons showed a light staining pattern with irregular contours and numerous vacuoles in the cytoplasm.

CONCLUSIONS

Intracavernous injection of adeno-associated virus-brain derived neurotrophic factor may prevent the degeneration of neuronal nitric oxide synthase containing neurons in the major pelvic ganglia and facilitate the regeneration of neuronal nitric oxide synthase containing nerve fibers in penile tissue, thus, enhancing the recovery of erectile function after bilateral cavernous nerve injury.

[Study on apoE gene polymorphism in Chinese type II b hyperlipidemia]

OBJECTIVE

To study apolipoprotein(apo) E polymorphism and its relationship with plasma lipids and apolipoproteins levels in Chinese patients with type II b hyperlip oproteinemia.

METHODS

apoE genotypes were assayed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method, serum lipids were determined by enzyme method, and apolipoproteins were measured by radial immunodiffusion assay in 74 type II b hyperlipidemia patients whose fasting serum lipids levels were TG > or = 2.26 mmol/L, TC > or = 6.21 mmol/L and in 230 healthy subjects whose fasting serum lipids levels were TG < 1.82 mmol/L, TC < 6.21 mmol/L from a population of Chinese Han nationality in Chengdu area.

RESULTS

Compared with the control group, the serum TG, TC, LDLC, nHDLC, apoA II, apoB100, apoC II, apoC III, apoE levels and TG/HDLC ratio in patients with type II b hyperlipidemia were significantly increased(P < 0.001), and the serum HDLC levels and apoE/apoC III ratio were significantly decreased (P < 0.05). ApoE3/3 genotype and allele epsilon 3 frequency in type II b hyperlipidemia group and control group were both the highest. In type II b hyperlipidemia group, allele epsilon 2 frequency tended to increase and allele epsilon 4 frequency tended to decrease as compared with those in the control group (P > 0.05). In type II b hyperlipidemia group the genotype of apoE2 was associated with higher serum TG, apoC II, apoE levels and apoE/apoC III ratio when compared with the genotype of apoE3; the genotype of apoE4 was associated with higher serum TC, nHDLC and apoE levels when compared with the genotypes E3 and E2 (P < 0.001).

CONCLUSION

The alleles epsilon 2 and epsilon 4 are associated with serum TG, TC, nHDLC, apoC II and apoE levels to some extent in type II b hyperlipide in Chinese population.

Identification of a chlamydial protease-like activity factor responsible for the degradation of host transcription factors

Microbial pathogens have been selected for the capacity to evade or manipulate host responses in order to survive after infection. Chlamydia, an obligate intracellular pathogen and the causative agent for many human diseases, can escape T lymphocyte immune recognition by degrading host transcription factors required for major histocompatibility complex (MHC) antigen expression. We have now identified a chlamydial protease- or proteasome-like activity factor (CPAF) that is secreted into the host cell cytosol and that is both necessary and sufficient for the degradation of host transcription factors RFX5 and upstream stimulation factor 1 (USF-1). The CPAF gene is highly conserved among chlamydial strains, but has no significant overall homology with other known genes. Thus, CPAF represents a unique secreted protein produced by an obligate intracellular bacterial pathogen to interfere with effective host adaptive immunity.

[Study on apoE gene polymorphism in Chinese endogenous hypertriglyceridemia]

OBJECTIVE

To investigate apolipoprotein(apo) E polymorphism and its relationship with serum lipids and apolipoproteins in Chinese patients with endogenous hypertriglyceridemia(HTG).

METHODS

apoE genotype was assayed by polymerase chain reaction- restriction fragment length polymorphism(PCR-RFLP), serum lipids were determined by enzyme method, and apolipoproteins were measured by radial immunodiffusion assay in 225 endogenous HTG patients whose fasting serum TG levels were > or = 2.26 mmol/L and in 230 healthy subjects whose fasting serum lipids levels were TG<1.82 mmol/L, TC<6.21 mmol/L from a population of Chinese Han nationality in Chengdu area.

RESULTS

Compared with the controls, the values of BMI, TG, TC, nHDLC, apoB100, CII, CIII, E and TG/HDLC in HTG patients were significantly increased and the values of HDLC, apoAI and apoE/apoCIII were significantly decreased(P<0.001). apoE3/3 genotype and allele epsilon(3) frequency in HTG group and the control group were both the highest, and allele epsilon( 2) frequency in HTG group tended to increase than that in the control group(P>0.05). Both in HTG group and control group, the genotype of apoE2 had higher serum TG and apoE levels, lower LDLC level and decreased apoE/apoCIII ratio as compared with the genotype of apoE3 or apoE4(P<0.001).

CONCLUSION

Allele epsilon(2) of apoE gene was associated with higher serum TG and apoE levels and lower serum LDLC level, and the lower ratio of apoE/apoCIII was associated with the higher serum level of TG in endogenous HTG.

[Study of blood dynamics of ophthalmic artery in patients with sudden sensorineural hearing loss using color Doppler flow imaging]

OBJECTIVE

To investigate the relationship between the pathogenesis of sudden sensorineural hearing loss (SSHL) and the disorder of blood circulation in inner ear.

METHOD

Blood dynamics of the ophthalmic artery were studied quantitatively using color doppler imaging in 34 patients with SSHL.

RESULT

Compared with 34 self-controls and 15 normal controls, 28 patients (82.4%) with SSHL had significantly lower blood flow velocities and higher resistance indices (P < 0.05), and there was no significant difference between the self-control group and the normal control group (P > 0.05).

CONCLUSION

The study suggested that the blood situations--the decreased blood flow velocities and perfusion and increased resistance of ophthalmic artery in patients with SSHL maybe play a role in the pathogenesis of SSHL.

Treatment planning dosimetric parameters for a (90)Y coil source used in intravascular brachytherapy

BACKGROUND

(90)Y coil sources have been used in animal and clinical trials for treatment of restenosis in intravascular brachytherapy (IVBT). This study aims to determine the American Association of Physicists in Medicine (AAPM) Task Group-60 (TG-60) dosimetric quantities in regions surrounding the balloon wall for use in treatment planning computer systems.

METHODS

The Monte Carlo method was used to determine the dose distribution, using MCNP4B2 code. The coil source was modeled by a hollow cylinder of 2.9 cm length centered in a balloon (2.5 mm diameter) filled with carbon dioxide (CO(2)) at 5 atm. Scoring voxels consisted of contiguous annular disk shells with 0.1 mm spacing in the radial direction and 0.2 mm spacing in the longitudinal direction. The scoring region ranges from the center of the source to 1.0 cm in the longitudinal direction, and from 0.13 to 1 cm in the radial direction. In the plane containing the source axis, the Monte Carlo-generated doses in rectilinear coordinates are converted to polar coordinates.

RESULTS

The dose rate of the source is provided in both Cartesian and polar coordinates. The dose rate constant [D(r(0),theta(0))], anisotropy function [F(r,theta)], and radial dose function [g(r)] were generated from these values and listed in tabular format. At shallow angles and longer distances from the source center, large values of the anisotropy function resulted, deviating two orders of magnitude from unity. CONCLUSIONS The doses given to the intima, media, and adventitia are very crucial quantities in IVBT. The calculated TG-60 dosimetric quantities, used commonly in conventional brachytherapy applications, provide a means for the user to determine the three-dimensional dose surrounding the balloon catheter. These parameters can be used in future treatment planning system for IVBT. We also discuss the need to develop a new formalism specific to longer sources used in IVBT.