CpG-island methylation study of liver fluke-related cholangiocarcinoma

BACKGROUND

Genetic changes have been widely reported in association with cholangiocarcinoma (CCA), while epigenetic changes are poorly characterised. We aimed to further evaluate CpG-island hypermethylation in CCA at candidate loci, which may have potential as diagnostic or prognostic biomarkers.

METHODS

We analysed methylation of 26 CpG-islands in 102 liver fluke related-CCA and 29 adjacent normal samples using methylation-specific PCR (MSP). Methylation of interest loci was confirmed using pyrosequencing and/or combined bisulfite restriction analysis, and protein expression by immunohistochemistry.

RESULTS

A number of CpG-islands (OPCML, SFRP1, HIC1, PTEN and DcR1) showed frequency of hypermethylation in >28% of CCA, but not adjacent normal tissues. The results showed that 91% of CCA were methylated in at least one CpG-island. The OPCML was the most frequently methylated locus (72.5%) and was more frequently methylated in less differentiated CCA. Patients with methylated DcR1 had significantly longer overall survival (Median; 41.7 vs 21.7 weeks, P=0.027). Low-protein expression was found in >70% of CCA with methylation of OPCML or DcR1.

CONCLUSION

Aberrant hypermethylation of certain loci is a common event in liver fluke-related CCA and may potentially contribute to cholangiocarcinogenesis. The OPCML and DcR1 might serve as methylation biomarkers in CCA that can be readily examined by MSP.

Influence of parameters on the heterogeneous photocatalytic degradation of pesticides and phenolic contaminants in wastewater: a short review

In recent years, the application of heterogeneous photocatalytic water purification processes has gained wide attention due to its effectiveness in degrading and mineralizing the recalcitrant organic compounds as well as the possibility of utilizing the solar UV and visible-light spectrum. This paper aims to review and summarize the recent works on the titanium dioxide (TiO(2)) photocatalytic oxidation of pesticides and phenolic compounds, predominant in storm and wastewater effluents. The effects of various operating parameters on the photocatalytic degradation of pesticides and phenols are discussed. Results reported here suggest that the photocatalytic degradation of organic compounds depends on the type and composition of the photocatalyst and, light intensity, initial substrate concentration, amount of catalyst, pH of the reaction medium, ionic components in water, solvent types, oxidizing agents/electron acceptors, catalyst application mode, and calcination temperature in the water environment. A substantial amount of research has focused on the enhancement of TiO(2) photocatalysis by modification with metal, non-metal and ion doping. Recent developments in TiO(2) photocatalysis for the degradation of various pesticides and phenols are also highlighted in this review. It is evident from the literature survey that photocatalysis has good potential to remove a variety of organic pollutants. However, there is still a need to determine the practical utility of this technique on a commercial scale.

Anti-Corrosion Studies of Novel Conductive Polymer Coatings on Aluminum Alloys

We report the corrosion protection properties of a novel conductive polymer coating on aluminum alloys. The conductive polymer coating is a double strand molecular complex of polyaniline and a polyelectrolyte. The double strand polyaniline offers advantages in stability and processability over other forms of conductive polymers. The coated aluminum alloys (AA7075- T6) were evaluated for corrosion protection in an aggressive salt environment of.5N NaCl solutions using cyclic polarization and electrochemical impedance spectroscopy. Corrosion current densities were calculated for uncoated alloy samples and alloys coated with the conductive and non-conductive derivative of the double strand polymer. The conductive form of the double strand polyaniline coating shows a two order of magnitude lowering of the corrosion current over the uncoated samples and a one order magnitude lowering over the non-conductive form of the polymer coated samples. The shape of the cyclic polarization data closely resembles results of sulfuric acid anodized aluminum. This data indicates that the conductive state of the polymer is required for improved corrosion protection and an anodized type protection is occurring.

Security through diversity: moving from rhetoric to practice

In response to a range of contemporary urban water challenges, there is an increasingly urgent need to change the way water is used in our cities. In Australia, the 'Security through Diversity' policy has been introduced in a number of cities to help facilitate a shift towards sustainable urban water management. This qualitative case study research investigated the interpretation and implementation of this radically different urban water policy approach across the case study cities of Perth and Melbourne. To focus the research and allow for more reliable comparative analysis across the cities, the introduction of desalination and permanent water saving rules as new initiatives in these cities were of particular interest. The research results are drawn from a synthesis of over 65 semi-structured interviews with senior urban water practitioners in the case study cities, and a content analysis of key policy and guidance documents, as well as organizational literature where available. The key finding of this research was that because of an entrenched technological paradigm, and the difficulty in breaking this pattern of lock-in, practitioners are currently interpreting and implementing Security through Diversity in a way that does not fully realise the potential of this strategy. More specifically the interview results revealed that the urban water practitioner community believed that the introduction of seawater desalination would discharge their city's responsibility for achieving Security through Diversity and that demand management initiatives, while nice, are not essential to this policy position. Interestingly, despite context evidence to the contrary, the practitioners believed supply and demand planning to be an integrated practice within their city. The paper concludes by offering some recommendations to facilitate a more comprehensive implementation of Security through Diversity and outlines areas for possible future research.

Working towards sustainable urban water management: the vulnerability blind spot

The unprecedented water scarcity in Australia coincides with the adoption of a new urban water rhetoric. The 'Security through Diversity' strategy has been adopted in a number of Australian cities as a new and innovative approach to urban water management. Although this strategy offers a more holistic approach to urban water management, in practice, the Security through Diversity strategy is largely being interpreted and implemented in a way that maintains the historical dependence on large scale, centralised water infrastructure and therefore perpetuates existing urban water vulnerabilities. This research explores the implementation of Security through Diversity as the new water scarcity response strategy in the cities of Perth and Melbourne. Through a qualitative study with over sixty-five urban water practitioners, the results reveal that the practitioners have absorbed the new Security through Diversity language whilst maintaining the existing problem and solution framework for urban water management. This can be explained in terms of an entrenched technological path dependency and cognitive lock-in that is preventing practitioners from more comprehensively engaging with the complexities of the Security through Diversity strategy, which is ultimately perpetuating the existing vulnerability of our cities. This paper suggests that greater engagement with the underlying purpose of the security though diversity strategy is a necessary first step to overcome the constraints of the traditional technological paradigm and more effectively reduce the continued vulnerability of Australian cities.

The effect of sporting events on emergency department attendance rates in a district general hospital in Northern Ireland

BACKGROUND

Previous studies have reported a conflicting relationship between the effect of live and televised sporting events on attendance rates to emergency departments (ED). The objectives of this study were to investigate the relationship of major sporting events on emergency department attendance rates and to determine the potential effects of such events on service provision.

METHODS

A retrospective analysis of ED attendances to a district general hospital (DGH) and subsequent admissions over a 24-h period following live and televised sporting activities was performed over a 5-year period. Data were compiled from the hospital's emergency record books including the number of attendances, patient demographics, clinical complaint and outcome. Review patients were excluded. Analysis of sporting events was compiled for live local, regional and national events as well as world-wide televised sporting broadcasts.

RESULTS

A total of 137,668 (80,445 men) patients attended from April 2002 to July 2007. Mean attendance rate per day was 80 patients (men = 47). Mean admission rate was 13.6 patients per day. Major sporting events during the study period included; Soccer: 4 FA Cup and 1 World Cup (WC) finals; Rugby: 47 Six Nations, 25 Six nations games involving Ireland, 1 WC final, 2 WC semi-finals, 2 WC quarter-finals and 4 WC games involving Ireland; and Gaelic Football [Gaelic Athletic Association (GAA)]: 5 All-Ireland finals, 11 semi-finals, 11 quarter-finals and 5 provincial finals. There was a significantly higher patient admission rate during the soccer FA Cup final, Rugby Six Nations and games involving Ireland and for GAA semi- and quarter-final games (p = 0.001-0.01). There was no difference identified in total attendance or non-admission rates for sporting events throughout the study period. Although there was no correlation identified between any of these sporting events and total emergency department attendances (r < 0.15, p > 0.07), multinomial logistic regression demonstrated that FA Cup final (p = 0.001), Rugby Six Nations (p = 0.019), Rugby WC games involving Ireland (p = 0.003), GAA All-Ireland semi- and quarter-finals (p = 0.016; p = 0.016) were predictors of patient admission rates.

CONCLUSION

This study suggests that live or televised sporting events do not significantly affect ED attendances to a DGH. However, some events appeared to be predictors of patient admission rates. Although it may be beneficial to consider the effect of sporting events on service stratification during these periods, the overall effect is probably minimal and should not create a major concern for future service provision despite the implementation of the European Working Time Directive.

Dynamic formation of a hot field reversed configuration with improved confinement by supersonic merging of two colliding high-β compact toroids

A hot stable field-reversed configuration (FRC) has been produced in the C-2 experiment by colliding and merging two high-β plasmoids preformed by the dynamic version of field-reversed θ-pinch technology. The merging process exhibits the highest poloidal flux amplification obtained in a magnetic confinement system (over tenfold increase). Most of the kinetic energy is converted into thermal energy with total temperature (T{i}+T{e}) exceeding 0.5 keV. The final FRC state exhibits a record FRC lifetime with flux confinement approaching classical values. These findings should have significant implications for fusion research and the physics of magnetic reconnection.

BDA special care case mix model

Routine dental care provided in special care dentistry is complicated by patient specific factors which increase the time taken and costs of treatment. The BDA have developed and conducted a field trial of a case mix tool to measure this complexity. For each episode of care the case mix tool assesses the following on a four point scale: 'ability to communicate', 'ability to cooperate', 'medical status', 'oral risk factors', 'access to oral care' and 'legal and ethical barriers to care'. The tool is reported to be easy to use and captures sufficient detail to discriminate between types of service and special care dentistry provided. It offers potential as a simple to use and clinically relevant source of performance management and commissioning data. This paper describes the model, demonstrates how it is currently being used, and considers future developments in its use.

Peri-operative blood glucose management in general surgery - a potential element for improved diabetic patient outcomes - an observational cohort study

BACKGROUND

Hyperglycaemia impairs many of the physiological processes involved in recovery from surgery but there is limited research on the effect of optimal peri-operative glucose control in diabetic general surgery patients. The objectives of this study were to assess blood glucose management in diabetic general surgical patients and to determine if protocol deviations were associated with adverse outcomes.

METHODS

All diabetic patients undergoing elective and emergency general surgical procedures between August 2007 and July 2008 were included in the study. The hospital protocol for peri-operative blood glucose control was based on the Alberti Regimen. Data was collected regarding blood glucose measurements, adherence to protocol and complications following surgery.

RESULTS

A total of 69 adult patients (M = 44, F = 25; median age 61, range 15-93 years; T1DM = 35, T2DM = 34) were included. 38 patients underwent elective surgery (cholecystectomy, hernia repair, varicose vein surgery) and 31 underwent emergency surgical procedures (laparotomy, incision and drainage of abscess). 10.3% of capillary blood glucose readings were less than 6.1 mmol/l, 32.8% were between 6.1 and 10.0 mmol/l, 44.6% were greater than 10.0 mmol/l 12.3% of scheduled blood glucose measurements were not completed. An insulin-dextrose infusion was indicated in 30 patients, of which 14 (46.7%) were treated according to protocol. In the 16 protocol-deviation cases, insulin was generally either administered according to a sliding scale (6 patients) or not at all during their time on the ward. While an insulin-dextrose infusion was not indicated in 39 patients, 14 (35.9%) of these patients were inappropriately given insulin either as an infusion (8 patients) or according to a sliding scale (6 patients). Overall, only 39 (56.5%) patients were treated according to protocol. The overall complication rate was 29%, which included 7 out of 39 (17.9%) and 13 out of 30 (43.3%) protocol-based and protocol-deviation patients respectively (p = 0.45).

CONCLUSION

Although not statistically significant, optimal glucose homeostasis according to hospital protocol was associated with a 25.4% reduction in peri-operative complications. We recommend careful blood glucose management according to pre-defined guidelines in all diabetic patients undergoing general surgical procedures.

Previous history of gonococcal infection as a risk factor in patients presenting with gonorrhoea

Recidivism is common in patients infected with gonorrhoea. Identifying the factors most closely associated with recurrent gonococcal infection can help to target health promotion and disease prevention interventions. A case-control study design was used to quantify the importance of past infection as a risk marker for gonorrhoea while controlling for other demographic and behavioural factors. Data were available for 134 cases of gonorrhoea and 150 controls. A history of gonorrhoea (odds ratio [OR] 4.36 [95% CI 1.78-10.71]) was the strongest predictor of current infection. The number of partners in the last month (OR 2.19 [95% CI 1.20-4.02]) was also significantly associated with a diagnosis of gonorrhoea. Patients presenting with gonorrhoea are a specific high-risk group who require additional interventions and should be prioritized for evidence-based, enhanced and interactive counselling.

No effect of donepezil on striatal dopamine release in mild to moderate Alzheimer's disease

OBJECTIVE

Work in experimental animals suggests that an interaction with dopaminergic networks might explain some of the therapeutic effects of the cholinesterase inhibitor class of drugs. This study aimed to test whether acute (single 5 mg) or 4-8 weeks (5-10 mg) of treatment with oral donepezil would elicit measurable striatal dopamine (DA) release in patients with mild to moderate Alzheimer's disease. A second aim was to establish whether any increase in DA levels would be associated with improvements in cognitive and motor function.

METHODS

Percentage change in [(11)C]-raclopride (RAC) binding potential (BP(ND)) between baseline and treatment conditions was used to provide a measure of DA release. Repeated measures ANOVA was used to determine the effect of treatment on [(11)C]-RAC BP(ND) and neuropsychological test performance.

RESULTS

Contrary to our prediction there was no significant change in [(11)C]- RAC BP(ND) after acute or a mean of 6 weeks (range 4-12) of treatment with donepezil. Although motor speed (finger tapping) improved following 4-12 weeks of treatment with donepezil (F(1,19) = 8.7, p = 0.009), this was not associated with the degree of change in [(11)C]-RAC BP(ND).

CONCLUSIONS

Our findings provide no evidence that striatal DA levels are altered during the first 3 months of donepezil treatment. However, we cannot rule out the possibility that extrastriatal effects may be occurring.

Transgenic approaches for pre-harvest control of mycotoxin contamination in crop plants

Mycotoxins are fungal metabolites that can contaminate food and feed crops worldwide and are responsible for toxic effects in animals and humans that consume contaminated commodities. Regulatory guidelines and limits for mycotoxins have been set by the US Food and Drug Administration (FDA) and food safety agencies of other countries for both import and export of affected commodities. Mycotoxin contamination of foods and feeds can also cause serious economic hardships to producers, processors, and the consumer. Therefore, there has been a concerted effort by researchers worldwide to develop strategies for the effective control of mycotoxin contamination of crops, particularly at the pre-harvest stage. Strategies currently being utilised to combat pre-harvest mycotoxin contamination include: (1) use of non-toxigenic biocontrol strains; (2) improved agricultural practices; (3) application of agrochemicals; (4) plant breeding for resistance; and (5) genetic engineering of resistance genes into crop plants. This article highlights research on the genetic engineering of plants for resistance to invasion by mycotoxigenic fungi as well as detoxification of mycotoxins. Emphasis is placed on the most economically relevant fungi and the mycotoxins they produce. These include aflatoxins produced mainly by Aspergillus flavus and A. parasiticus, trichothecenes produced mainly by Fusarium graminearum, and to a lesser extent, fumonisins produced by F. verticillioides. Information is also presented on the use of genomics and proteomics technologies as a means of identifying genes and proteins that can be utilised in transgenic approaches to control the growth of mycotoxigenic fungi and the mycotoxins that they produce in food and feed crops.

Combined inhibition of DNA methylation and histone acetylation enhances gene re-expression and drug sensitivity in vivo

Histone deacetylation and DNA methylation have a central role in the control of gene expression in tumours, including transcriptional repression of tumour suppressor genes and genes involved in sensitivity to chemotherapy. Treatment of cisplatin-resistant cell lines with an inhibitor of DNA methyltransferases, 2-deoxy-5′azacytidine (decitabine), results in partial reversal of DNA methylation, re-expression of epigenetically silenced genes including hMLH1 and sensitisation to cisplatin both in vitro and in vivo. We have investigated whether the combination of decitabine and a clinically relevant inhibitor of histone deacetylase activity (belinostat, PXD101) can further increase the re-expression of genes epigenetically silenced by DNA methylation and enhance chemo-sensitisation in vivo at well-tolerated doses. The cisplatin-resistant human ovarian cell line A2780/cp70 has the hMLH1 gene methylated and is resistant to cisplatin both in vitro and when grown as a xenograft in mice. Treatment of A2780/cp70 with decitabine and belinostat results in a marked increase in expression of epigenetically silenced MLH1 and MAGE-A1 both in vitro and in vivo when compared with decitabine alone. The combination greatly enhanced the effects of decitabine alone on the cisplatin sensitivity of xenografts. As the dose of decitabine that can be given to patients and hence the maximum pharmacodynamic effect as a demethylating agent is limited by toxicity and eventual re-methylation of genes, we suggest that the combination of decitabine and belinostat could have a role in the efficacy of chemotherapy in tumours that have acquired drug resistance due to DNA methylation and gene silencing.

Age at intracranial aneurysm rupture among generations: Familial Intracranial Aneurysm Study

BACKGROUND

Previous studies have reported intracranial aneurysm (IA) occurring at young ages in subsequent generations. These studies did not correct for duration of follow-up. Second-generation members who would have their ruptured IA late in life may not be detected due to shorter follow-up time than the first generation. We examined families in which ruptured IA occurred in two consecutive generations for the hypothesis that the second generation (F1) was more likely to have a rupture at a younger age than the older generation (F0).

METHODS

The Familial Intracranial Aneurysm (FIA) Study is a multicenter, international study recruiting families of ruptured and unruptured IA. All available family members are interviewed. Cox proportional hazards regression models and Kaplan-Meier curves were used to examine differences by generation.

RESULTS

Although we found that the F1 generation was more likely to have an aneurysm rupture at a younger age than the F0 generation, we found that this was largely because of a lack of follow-up time in the F1 generation. The F1 generation had 50% the rupture rate of the prior generation. When analyzed by Kaplan-Meier curves, we found a tendency to have a slightly later rupture rate in the F1 generation once time to follow-up was included in the analysis model.

CONCLUSIONS

Families of ruptured intracranial aneurysm (IA) do not appear to demonstrate "anticipation." Our finding suggests that genetic epidemiology of ruptured IA should examine all types of variations such as single base-pair changes, deletions, insertions, and other variations that do not demonstrate anticipation.

Cutaneous vasoconstriction as a measure of incipient autonomic dysreflexia during penile vibratory stimulation in spinal cord injury

STUDY DESIGN

Measurement of haemodynamic responses, cutaneous blood flow and sweat release during penile vibratory stimulation (PVS) in spinal cord-injured men.

OBJECTIVE

To assess the validity of using markers of sympathetic activity (cutaneous blood flow and sweat release) as a measure of incipient autonomic dysreflexia during PVS in spinal cord-injured men.

SETTING

Prince of Wales Medical Research Institute, Australia.

SUBJECTS

Ten spinal cord-injured men with injuries ranging from C3 to T6.

METHODS

Continuous arterial pressure, intermittent auscultation, heart rate (HR), respiration, cutaneous blood flow and sweat release from both finger and toe were recorded during PVS.

RESULTS

Vibration of the penis caused immediate cutaneous vasoconstriction, but negligible sweat release, in the hands and feet of the quadriplegics and the feet of the paraplegics. Systolic blood pressure (BP) increased by up to 90 mm Hg, and a compensatory vagal bradycardia was observed in five of the six quadriplegics and two of the four paraplegic subjects.

CONCLUSION

Given that there was-in general-an inverse relationship between BP and skin blood flow, we conclude that continuous measurements of skin blood flow above and below the lesion can provide important information on the state of the sympathetic nervous system and early identification of reflexly evoked increases in sympathetic vasoconstrictor drive, below a spinal lesion. Coupled with a decrease in HR, this cutaneous vasoconstriction infers an increased BP.