Spontaneous isolated inferior mesenteric artery dissection

This report presents a case of a spontaneous isolated inferior mesenteric artery (IMA) dissection. To the best of our knowledge, it is the first report in the literature. A fifty-eight-year-old female who suffered from acute left lower abdominal pain was admitted. CT scan and digital subtraction angiography indicated dilation in the proximal part of the IMA and occlusion in its distal part. Signs of peri-artery exudation also seen in the CT scan. Laparotomy confirmed the diagnosis of IMA dissection and secondary thrombosis in its branches. After thrombectomy and intimal flap resection, the artery was successfully reconstructed with an autogenous vein patch. Isolated IMA dissection should be considered as one of the differentiation for patients with acute abdomen. Dilation, occlusion of the artery, and signs of peri-artery edema were important clues to suspect the IMA dissection. High resolution spiral CT, which may sometimes reveal the signs such as double lumen and intimal flap, helped to establish the diagnosis of such lesion.

Repeat Endovascular Exclusion For Distal Tear After Treatment Of Primary Aortic Dissection By Endovascular Exclusion

An obese, hypertensive, 70-year-old man was found to have an extensive chronic Stanford type B aortic dissection. The dissection was treated by placement of a stent graft. One year later, he developed a small protrusion of the intimal flap at the distal end of the stent graft that gradually enlarged, until 4 years after the procedure, it had become disrupted, and angiography showed contrast medium entering the false lumen. A second stent graft was successfully placed, and imaging 2 years later indicated no recurrence of the tear, endoleak, or malperfusion of the aortic arch vessels.

Endovascular aortic repair of infrarenal abdominal aortic dissection

We present two cases of infrarenal abdominal aortic dissection (IAAD) that were treated by endovascular aortic repair (EVAR). The EVAR procedure was successful, although one patient developed a proximal Type I endoleak several months after the procedure; both patients remain symptom-free more than 24 months after surgery. A literature search revealed that EVAR has been performed in only 14 cases of IAAD. Based on these 14 cases, we believe EVAR is feasible and effective for the treatment of IAAD. Moreover, this treatment strategy represents a reasonable alternative to open surgery, especially in cases of complicated juxtarenal abdominal aortic dissection.

Endovascular Aortic Repair of Infrarenal Abdominal Aortic Dissection

We present two cases of infrarenal abdominal aortic dissection (IAAD) that were treated by endovascular aortic repair (EVAR). The EVAR procedure was successful, although one patient developed a proximal Type I endoleak several months after the procedure; both patients remain symptom-free more than 24 months after surgery. A literature search revealed that EVAR has been performed in only 14 cases of IAAD. Based on these 14 cases, we believe EVAR is feasible and effective for the treatment of IAAD. Moreover, this treatment strategy represents a reasonable alternative to open surgery, especially in cases of complicated juxtarenal abdominal aortic dissection.

Preliminary report on a sonographic method to determine the location of the intimal breach in Stanford type B aortic dissection

Using a defined angle T, which can be measured noninvasively using Doppler ultrasound, we aim to determine the location of the intimal breach in Stanford type B aortic dissection (AD) and estimate the risk of AD using that measurement. Our subjects included 86 healthy volunteers, 60 hypertensive patients, and 42 patients with Stanford type B AD. We used dual functional color Doppler ultrasound to locate the central point of the high-speed flow zone within the descending aorta, and then calculated the angle T, using the law of cosines. In addition, we measured the degree of distortion within the descending aorta using Line BD, defined as the distance from the lateral edge of the left subclavian artery (LSA) to the center of the breach in the intima in AD. The value of T was approximately 24° ± 3° and was constant across all 3 groups. In addition, the increase in BD distance corresponded to increased distortion in the descending aorta between the LSA and the region of aortic artery ligament (RAALE). We found that when the preoperative BD was less than 2.6 cm, the aortic arch could be straightened, using a stent-graft, to approximate the normal aorta. When the preoperative BD is less than 2.6 cm, the aortic arch can be corrected using a stent. In addition, since the T angle is constant, we speculate that it can be used to predict the risk of intimal breach and estimate its location using digital subtraction angiography (DSA) to guide surgery.

A proteomic study of the aortic media in human thoracic aortic dissection: implication for oxidative stress

OBJECTIVE

The aortic media lesion is a key pathologic feature in thoracic aortic dissection. To identify key proteins in aortic media lesions that may contribute to its pathogenesis, we performed proteomic studies to find differentially expressed proteins in the media from diseased and normal thoracic aorta.

METHODS

Ascending aortic segments were obtained from patients with thoracic aortic dissection (n = 8) and age-matched normal donors (n = 6). The differentially expressed proteins of their media tissues were analyzed by 2-dimensional electrophoresis and mass spectrometry, and verified by Western blotting. Oxidative stress was measured by functional assays in a larger sample size (15 patients and 10 controls).

RESULTS

Image analysis of the protein profiles from 2-dimensional gels revealed 126 differentially expressed proteins, of which 26 were identified by mass spectrometry. Among them, extracellular superoxide dismutase, an enzyme involved in oxidative stress, was selected for further studies. Western blotting showed that extracellular superoxide dismutase expression was more than 50% lower in patient samples than in controls (P < .001). Superoxide dismutase activity was consistently decreased (P < .001) and lipid peroxidation was increased (P = .019) in patient media homogenates compared with that in controls.

CONCLUSION

Our results indicate that protein expression profiles in the aortic media from thoracic aortic dissection differ significantly from that of controls, which may provide important insights into the disease mechanisms. This study also suggests that increased oxidative stress may play an important role in the disease.

Endoaortic stent grafting of a giant infected hepatic-celiac pseudoaneurysm

A 72-year-old man was admitted because of progressive right upper-abdominal distension and pain as well as concurrent remittent fever for 5 months. He had undergone a radical gastrectomy and catheter intubation in the common hepatic artery for chemotherapy 12 months before admission. The diagnosis of giant infected hepatic-celiac artery pseudoaneurysm was established. Coils embolotherapy was given in another hospital, but it failed. After admission, a computed tomographic aortogram showed a mass 10.3 x 8.5 x 8.1 cm in size in the right upper abdomen that originated from the common hepatic artery and the celiac artery. A celiac-super mesenteric artery (SMA) double catheter simultaneous digital subtraction angiography (DSA) further revealed that the entrance of the aneurysm opened directly from the abdominal aorta, the distance between the orifice of SMA and celiac axis was only 0.5 cm, and the diameter of the celiac trunk had been aneurysmally enlarged to 2.0 cm. A blood culture was positive for Bacillus pyocyaneus. After detailed discussion and preparation, a stent-graft complex was negotiated through the left femoral artery and deployed successfully into the abdominal aorta to seal the orifice of celiac trunk under the dynamic supervision of DSA. Completion angiography revealed that the hepatic-celiac pseudoaneurysm was completely excluded from aortic flow by the endoluminal stent-graft complex, while the SMA and renal arteries remained perfectly patent. The patient recovered uneventfully and was discharged without any residual symptoms. At a 5-year follow-up, the patient remained asymptomatic and was leading a normal life.

Sutureless anastomoses of small and medium sized vessels by medical adhesive

PURPOSE

Using an animal model we have assessed sutureless anastomoses.

METHODS

The two cut ends of the rabbit common carotid artery were sutured by three stitches with a 120 degrees interval circumferentially, then two optional threads were pulled horizontally and 0.1 ml adhesive was smeared on the attached surface of the two ends. The three stitches were removed after completion of anastomosis. The burst pressure of the anastomosis was measured and compared with that of a traditional sutured artery.

RESULTS

The glued anastomosis was associated with: a shorter completion time (8.25+/-6.34 min vs. 20.67+/-14.24 min, P<0.01), less bleeding (3.17+/-9.04 ml vs. 11.04+/-16.28 ml, P<0.01), and equivalent patency (93.8 vs. 87.5%, P>0.05). The sutureless anastomosis was associated with less intimal thickening (decreased by 31.4, 24.5, 23.9 and 31.9%, P<0.01 compared with the traditional suture group at 1, 2, 4 and 12 weeks, respectively).

CONCLUSION

Glued anastomoses provides an effective, simple and feasible way for anastomosing small or medium caliber vessels. This technique may reduce intimal injury.

Characterization of the tissue-specific expression of the s100P gene which encodes an EF-hand Ca2+-binding protein

S100 proteins are a calcium-binding protein family containing two EF-hand domains exclusively expressed in vertebrates and play roles in many cellular activities. Human S100P gene was first cloned as a 439 bp cDNA in placenta and it was found to be associated with human prostate cancer. Here we describe the cloning of the 1297 bp full-length cDNA, and the characterization of the tissue-specific expression of the human S100P gene. It is abundantly expressed in many tissues including placenta by Northern blot and RT-PCR analysis, unlike the expression pattern of other S100 family genes.

Modelling periodic oscillation of biological systems with multiple timescale networks

In this paper, we aim to develop a new methodology to model and design periodic oscillators of biological networks, in particular gene regulatory networks with multiple genes, proteins and time delays, by using multiple timescale networks (MTN). Fast reactions constitute a positive feedback-loop network (PFN), while slow reactions consist of a cyclic feedback-loop network (CFN), in MTN. Multiple timescales are exploited to simplify models according to singular perturbation theory. We show that a MTN has no stable equilibrium but stable periodic orbits when certain conditions are satisfied. Specifically, we first prove the basic properties of MTNs with only one PFN, and then generalise the result to MTNs with multiple PFNs. Finally, we design a biologically plausible gene regulatory network by the cI and Lac genes, to demonstrate the theoretical results. Since there is less restriction on the network structure of a MTN, it can be expected to apply to a wide variety of areas on the modelling, analysing and designing of biological systems.

Genome-wide identification of NBS genes in japonica rice reveals significant expansion of divergent non-TIR NBS-LRR genes

A complete set of candidate disease resistance ( R) genes encoding nucleotide-binding sites (NBSs) was identified in the genome sequence of japonica rice ( Oryza sativaL. var. Nipponbare). These putative R genes were characterized with respect to structural diversity, phylogenetic relationships and chromosomal distribution, and compared with those in Arabidopsis thaliana. We found 535 NBS-coding sequences, including 480 non-TIR (Toll/IL-1 receptor) NBS-LRR (Leucine Rich Repeat) genes. TIR NBS-LRR genes, which are common in A. thaliana, have not been identified in the rice genome. The number of non-TIR NBS-LRR genes in rice is 8.7 times higher than that in A. thaliana, and they account for about 1% of all of predicted ORFs in the rice genome. Some 76% of the NBS genes were located in 44 gene clusters or in 57 tandem arrays, and 16 apparent gene duplications were detected in these regions. Phylogenetic analyses based both NBS and N-terminal regions classified the genes into about 200 groups, but no deep clades were detected, in contrast to the two distinct clusters found in A. thaliana. The structural and genetic diversity that exists among NBS-LRR proteins in rice is remarkable, and suggests that diversifying selection has played an important role in the evolution of R genes in this agronomically important species. (Supplemental material is available online at http://gattaca.nju.edu.cn.)

[Involvement of heparanase in human abdominal aortic aneurysm]

OBJECTIVE

To determine whether heparanase might participate the formation of abdominal aortic aneurysms (AAA) and explore a novel pathogenesis for it.

METHODS

Total RNA was extracted from 20 tissue samples of human infrarenal abdominal aortic aneurysm (AAA) and 5 samples of normal aorta (NA), all resected in operation, and 5 samples of primary hepatocellular carcinoma. Northern blot was used to evaluate the expression of heparanase. Immunohistochemistry and computer-assisted image analysis were used to assess the expression of heparanase and its substrate heparan sulfate proteoglycan protein (HSGP) and microvessel hyperplasia.

RESULTS

Semi-quantitative analysis showed that the expression of heparanase in AAA was significantly higher than that in normal abdominal aorta (P < 0.01), but equivalent to that in primary hepatocellular carcinoma (P > 0.05). However, the expression of HSPG was lowered in AAA and was significantly negatively correlated with the expression of heparanase and microvessel density. Both of heparanase and HSPG were mainly located in adventitia and intima of AAA walls.

CONCLUSION

Heparanase participates in the structure damage and remodeling of abdominal aorta at matrix level, which contributes to AAA formation.

Studies on the development of DNA vaccine against Cysticercus cellulosae infection and its efficacy

DNA vaccine against Cysticercus cellulosae infection was developed and its efficacy was tested. A pair of primers specific to antigen B gene of C. cellulosae was designed which amplified the gene successfully with RT-PCR. The gene was ligated to PV93 vector, and the recombinant of antigen B gene and PV93 was transformed to JM83 cells. The transformed JM83 cells were cultured in a large scale and the plasmid purified. Based on the recombinant plasmid. a DNA vaccine was developed and used to vaccinate two groups of experimental pigs. In each group, there was a routine vaccine, an enhanced vaccine and a control group. Groups 1 and 2 were challenged at 4 months and at 14 days post vaccination respectively with eggs of Taenia solium. The antibody response was also tested with ELISA. The results suggested that all animals vaccinated AgB gene DNA vaccine, no matter by routine or enhanced vaccine, their antibodies reached maximum peak 23 days post vaccination and decreased gradually. When the animals were challenged 4 months after vaccination, they had strong immunity and the parasites decrease rates were 91.2% and 93.1% respectively. When pigs vaccinated with AgB gene DNA vaccine were challenged 14 days post vaccination with 18,000 eggs/pig. The animals showed strong immunity and the parasite decrease rates were 99.5% and 84.9% respectively. However at that time, the antibodies did not reach the peak. While in the control group, the number of C. cellulosae was as many as 2,500. It was concluded that the pigs vaccinated with DNA vaccine had strong immunity against infection of eggs of T. solium.

Public awareness of stuttering in Shanghai, China

This study reports the results of an investigation of knowledge and public awareness of stuttering among laypersons in Shanghai, China. A total number of 1968 respondents answered a questionnaire including questions about prevalence, onset, gender distribution and occurrence in different cultures, cause, treatment, intelligence and heredity of stuttering. Stuttering appears to be a disorder that most people in the Shanghai area are familiar with, and for several aspects a considerable number of respondents held views that are in line with current knowledge about stuttering. For some aspects though knowledge is limited, indicating a need for disseminating scientific information on stuttering. The results of the present study are compared with a similar Belgium study.

[Endovascular intervention versus traditional bypass for treatment of Budd-Chiari syndrome]

OBJECTIVE

To retrospectively compare combined endovascular intervension with traditional bypass operation for the treatment of Budd-Chiari syndrome (BCS).

METHODS

From July 1989 to June 2001, 49 patients undergoing surgery for BCS were studied. 32 operations were performed by traditional bypass (from superior mesenteric vein or inferior vena cava to right auricle), and 17 by combined endovascular operation.

RESULTS

The data demonstrated a high incidence of perioperative complications, longer hospital stay, and expensive cost in the former group than in the latter group (P < 0.01). The mid-term effects were significantly better in the latter than in the former (P < 0.05). Severe complications occurred in the bypass group included hepatoencephalopathy, obtinacy ascites, cardiac dysfunction, and embolization of vascular grafts.

CONCLUSIONS

Combined endovascular intervention and shunting are the treatment of choice for BCS, with different combination according to its clinical type. This approach is simple, safe, effective, and economic.

Nocistatin, a peptide reversing acute and chronic morphine tolerance

It has been reported that intracerebroventricular (i.c.v.) injection of nociception/orphanin FQ (OFQ) can antagonize morphine analgesia, whereas i.c.v. OFQ antibody can reverse morphine tolerance. Nocistatin (NST) is a recently characterized neuropeptide possessing an antagonizing effect on OFQ. Here we examine whether i.c.v. NST would result in a reversal of morphine tolerance. The results showed that: (1) i.c.v. NST at doses of 0.005, 0.05, 0.5, 5 or 50 ng per rat produced a bell-shaped dose-dependent reversal of chronic morphine tolerance, with maximum response at 0.5 ng. (2) Acute morphine tolerance could also be reversed, albeit partially, by i.c.v. NST at 0.5 ng. (3) The reversal of acute and chronic morphine tolerance by NST was completely abolished when NST (0.5 ng) was co-injected with (8 microg) OFQ. Since OFQ and NST are derived from the same preprohormone, the profile of its splicing in the CNS may play an important role in determining the effectiveness of morphine analgesia.

An evaluation of the colorimetric assays based on enzymatic reactions used in the measurement of human natural cytotoxicity

In recent years colorimetric assays based on an enzymatic reaction such as the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay have been used in an attempt to replace the conventional isotopic assay for cell-mediated cytotoxicity. To clarify the problems in the colorimetric assays for natural cytotoxicity, K562 cells were employed as target cells and peripheral mononuclear cells (PBMCs) from cancer patients were used as effector cells. No correlation was found between the 51Cr assay and the MTT assay (P>0.05) or the N-acetyl-beta-D-glycosaminidase (NAG) release assay (P>0.05) in 16 cancer patients. Labeling effector cells showed that the 51Cr release levels of such cells in 19 chemotherapy patients were significantly higher than the levels from target cells in this group (P<0.01) and from effector cells in the control group (P<0.01). There was no correlation between the positive and negative 51Cr assays (P>0.05). The sensitivity of the MTT assay was greatly decreased by washing K562 cells prior to loading MTT solution. Enzyme release occurs as a result of cell metabolism and elevated enzyme release is associated with freezing. These findings indicate that the colorimetric assays based on an enzymatic reaction are not suitable for the detection of natural cytotoxicity in all populations, and are especially not suitable for the assay of natural cytotoxicity in chemotherapy patients.

[Profile of telomerase and telomerase RNA expression in nasopharyngeal carcinogenesis of rats induced by N, N'dinitrosopiperazine (DNP)]

OBJECTIVE

To investigate the profile of telomerase and telomerase RNA expression in nasopharyngeal carcinogenesis (NPC) induced by N, N'dinitrosopiperazine (DNP) and examined histolofically.

METHODS

Nasopharyngeal carcinomas of rats were induced by DNP and examined histologically. PCR-ELISA and nested RT-PCR were used to assay telomerase and telomerase RNA expression at different stages in the nasopharyngeal tissues of rats.

RESULTS

During the carcinogenesis process, telomerase activity increased along with the formation of a nasopharyngeal carcinoma. Telomerase expression was positively related with nasopharyngeal carcinogenesis. Telomerase RNA expression was present and did not change during the NPC process. Expression of telomease RNA was earlier than telomerase activation. Telomerase activation and telomerase RNA expressin were also detected in the pre-cancerous nasopharyngeal lesions.

CONCLUSION

Telomerase activation may participate in the onset and progression of NPC, and is an early step in NPC.

In vivo gene expression profile analysis of metallothionein in renal cell carcinoma

The antiapoptotic and mitogenic responses of metallothionein (MT) have been well documented in vitro. While MT protein overexpression, frequently encountered in a number of human primary tumors, has been shown to be correlated with disease progression, little information is available on the in vivo isoform expression of MT. In this study we have demonstrated the occurrence of MT proteins and further defined their differential expression profile in human primary renal cell carcinoma (RCC). Pooled normal human kidney RNA and paired biopsy specimens (tumor and control) obtained from 11 patients diagnosed with RCC with tumor grade ranging from 1-3 and a pathological staging of T2-T3 (N0M0) were used for the study. Samples were analyzed for the presence of MT protein using immunohistochemical (IHC) analysis and for MT isoform-specific mRNA expression by reverse transcriptase polymerase chain reaction. Metallothionein protein assumed both cytoplasmic and nuclear staining in cancer cells and was detected in eight of 11 samples (72%) with polyclonal antibodies. The immunoreactivity of MT protein, but not its cellular localization, in RCC specimens suggests a relationship between and advanced disease. While alterations in the basal level of expression of MT-1E, MT-1F and MT-1X genes remained unchanged, significant up-regulation of MT-2A and down-regulation of MT-1A and MT-1G transcripts was observed in RCC tissue specimens when compared with controls. Intriguingly, the paired RCC biopsy specimens had lower MT-1H transcripts than pooled normal human controls. We here provide the first report of the differential expression of MT isoforms in human RCC and that this data further support the role of MT-2A in tumorigenesis.

[Mitogenesis of platelet-derived growth factors to human osteoblasts modulated by basic fibroblast growth factor]

OBJECTIVES

To investigate the mechanism by which basic fibroblast growth factor modulates the mitogenesis of platelet-derived growth factor to human osteoblasts.

METHODS

The osteoblasts isolated from human fetal calvaria were incubated with PDGF-AB (100 ng/ml) or bFGF(10 ng/ml) combined with PDGF-AB (100 ng/ml); the growth curve was plotted. The(3)H-TdR incorporation of the osteoblasts was measured after the cells were incubated with different combination of bFGF and PDGF-AA or PDGF-BB. After incubated with bFGF (10 ng/ml) for 24 hours, the number of PDGFR-alpha and PDGFR-beta on the membrane of the osteoblasts was detected by fluoroimmunoassay.

RESULTS

Four days after PDGF-AB added into the medium, the population of the osteoblasts was larger than that of the control (P < 0.05). The number of the osteoblasts incubated with PDGF-AB (12.1 x 10(4)) was 1.8 times as large as the control (6.8 x 10(4)) in the 10th day (P < 0.05), and that of the osteoblasts incubated with both bFGF and PDGF-AB increased more quickly than the cells only incubated with PDGF-AB. The incorporation of (3)H-TdR into the osteoblasts cultured with bFGF combined with PDGF-AA (533.6 +/- 13.1) was more than that cultured only with PDGF-AA (435.4 +/- 14.8, P < 0.01), so was the incorporation of (3)H-TdR of those cells cultured with bFGF and then PDGF-AA (633.8 +/- 51.5). bFGF up-regulated PDGFR-alpha and down-regulated PDGFR-beta on the surface of the human osteoblasts.

CONCLUSION

bFGF elevates the mitogenesis of PDGF-AA or -AB to human osteoblasts by up-regulating PDGFR-alpha.