Intravenous leiomyomatosis with right heart involvement-a report of 4 cases and literature review

Intravenous leiomyomatosis (IVL) is a rare benign neoplasm which originates from the smooth muscle cells and is usually confined to the pelvic venous system. Rarely, intracaval and intracardiac extension has been described. Death can occur as a result of intracardiac involvement. We reported 4 cases of IVL with right heart involvement (intracardiac leiomyomatosis, ICL). Three of them suffered recurrent sudden syncope, and the other one was totally asymptomatic. All of them were successfully treated through one-stage operation under extracorporeal circulation.

Deep vein thrombosis: related to anemophilous pollen?

The etiology of deep vein thrombosis (DVT) is still not elucidated nowadays. Based on the accordance between DVT incidence and the anemophilous pollen concentration in the air, we proposed the hypothesis that allergic reaction induced by anemophilous pollen may cause "idiopathic" DVT, and proinflammatory factors may play an important role in the thrombosis process.

The structure and roles of sterile flowers in Viburnum macrocephalum f. keteleeri (Adoxaceae)

The formation and ecological roles of sterile flowers in flowering plants are interesting issues in floral biology and evolution. Here, we investigated the morphological and anatomical characteristics of both fertile and sterile flowers of Viburnum macrocephalum f. keteleeri, a self-incompatible and insect-pollinated shrub, during different developmental stages of flowers. In addition, pollinator visitation rates and fruit set were determined in intact inflorescences and those with sterile flowers removed. The results indicate that sterile and fertile flowers were developmentally similar during early developmental stages, and that development of the flower types diverged about 15 days before flowering. In addition, pollinator visitation rates, number of pollen grains on stigmas and fruit set were significantly higher in inflorescences with sterile flowers than those without sterile flowers. The results suggest that sterile flowers of this species evolved from fertile flowers under long-term selective pressure, and play a crucial role in enhancing reproductive success through effectively attracting pollinators to the plant and thus enhancing fruit set.

WITHDRAWN: Catheter-Directed Thrombolysis for Acute Iliofemoral Deep Venous Thrombosis

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The importance of conceptual models in the reactive transport simulation of oxygen ingress in sparsely fractured crystalline rock

Redox evolution in sparsely fractured crystalline rocks is a key, and largely unresolved, issue when assessing the geochemical suitability of deep geological repositories for nuclear waste. Redox zonation created by the influx of oxygenated waters has previously been simulated using reactive transport models that have incorporated a variety of processes, resulting in predictions for the depth of oxygen penetration that may vary greatly. An assessment and direct comparison of the various underlying conceptual models are therefore needed. In this work a reactive transport model that considers multiple processes in an integrated manner is used to investigate the ingress of oxygen for both single fracture and fracture zone scenarios. It is shown that the depth of dissolved oxygen migration is greatly influenced by the a priori assumptions that are made in the conceptual models. For example, the ability of oxygen to access and react with minerals in the rock matrix may be of paramount importance for single fracture conceptual models. For fracture zone systems, the abundance and reactivity of minerals within the fractures and thin matrix slabs between the fractures appear to provide key controls on O(2) attenuation. The findings point to the need for improved understanding of the coupling between the key transport-reaction feedbacks to determine which conceptual models are most suitable and to provide guidance for which parameters should be targeted in field and laboratory investigations.

[Acute phase reaction of different macromolecule vascular grafts healing in rat muscle]

To find out which biomaterial had the best biocompatibility, we compared the acute phase reaction of common biomaterials preparing for vascular grafts with the material of polyurethane modified by silk fibroin (SF-PU(1:1)). After transplanted the materials of dacron, polyterafluoroethylene (e-PTFE), polyurethane (PU), SF-PU(1:1) in rat muscle for one week, we studied the influence of different biomaterials on the histocompatibility by using rat acute toxicity test, test of local reaction in muscle, tissue section staining, WBC and PLT count. As a result, dacron had the worst histocompatibility. The other biomaterials had slight local inflammatory reaction. The WBC and PLT was nearly the same with the blank except dacron. e-PTFE, pure PU and SF-PU(1:1) had the better histocompatibility than traditional dacron. Especially SF-PU(1:1) had the best histocompatibility. Because of the better physical properties and histocompatibility of SF-PU( 1:1), the prospect of preparing small-diameter vascular grafts with SF-PU was cheerful.

Phylogeographical analysis of an estuarine fish, Salanx ariakensis (Osmeridae: Salanginae) in the north-western Pacific

This study extended the geographic coverage of a previous study to explore population genetic structure and demographic history in the Ariake icefish Salanx ariakensis from three populations of continental coastlines and one island population in the north-western Pacific based on a partial sequence of the mitochondrial cytochrome b gene. The S. ariakensis showed high genetic diversity and strong genetic structure. Phylogenetic analysis showed a shallow gene tree with no clear phylogeographical structure. Contiguous range expansion and restricted gene flow were inferred to be main population events by nested-clade analysis. Significant genetic differentiations between populations could be attributable to negligible gene flow by coalescent analysis. High nucleotide diversity of each population was due to geographic mixing of heterogenous haplotypes during lowering sea levels of the Pleistocene. These findings indicate that cycles of geographic isolation and secondary contact happened in the Pleistocene glacial-interglacial cycles shaping genetic structure and population demography of S. ariakensis.

Effect of the cathepsin K inhibitor odanacatib on bone resorption biomarkers in healthy postmenopausal women: two double-blind, randomized, placebo-controlled phase I studies

Inhibition of cathepsin K (CatK) is a potential new treatment for osteoporosis. In two double-blind, randomized, placebo-controlled phase I studies, postmenopausal female subjects received odanacatib (ODN), an orally active, potent, and selective CatK inhibitor, once weekly for 3 weeks or once daily for 21 days. Bone turnover biomarkers, safety monitoring, and plasma ODN concentrations were assessed. These studies showed ODN to be well tolerated. Pharmacokinetic (PK) analysis revealed a long half-life (t(1/2); 66-93 h) consistent with once-weekly dosing. Pronounced reductions in C-terminal telopeptide of type I collagen (approximately 62%) and N-terminal telopeptide of type I collagen normalized to creatinine (NTx/Cr) (approximately 62%) at trough (C(168 h)) were seen following weekly administration. Robust reductions in CTx (up to 81%) and NTx/Cr (up to 81%) were seen following daily administration. ODN exhibits robust and sustained suppression of bone resorption biomarkers (CTx and NTx/Cr) at weekly doses > or = 25 mg and daily doses > or = 2.5 mg.

Pharmacokinetics of raltegravir in individuals with UGT1A1 polymorphisms

Raltegravir is a human immunodeficiency virus-1 (HIV-1) integrase strand transfer inhibitor metabolized by glucuronidation via UDP-glucuronosyltransferase 1A1 (UGT1A1). In this study, 30 subjects with a UGT1A1*28/*28 genotype (associated with decreased activity of UGT1A1) and 27 UGT1A1*1/*1 control subjects (matched by race, age, gender, and body mass index) received a single 400-mg dose of raltegravir after fasting. No serious adverse experiences were reported, and there were no discontinuations due to adverse experiences. The geometric mean ratio (GMR) (UGT1A1*28/*28 to UGT1A1*1/*1) and 90% confidence interval (CI) were 1.41 (0.96, 2.09) for raltegravir area under the concentration-time curve (AUC(0-infinity)), 1.40 (0.86, 2.28) for maximum plasma concentration (C(max)), and 1.91 (1.43, 2.55) for concentration at the 12-h time point (C(12 h)). No clinically important differences in time to maximum concentration (T(max)) or half-life were observed. Plasma concentrations of raltegravir are modestly higher in individuals with the UGT1A1*28/*28 genotype than in those with the UGT1A1*1/*1 genotype. This increase is not clinically significant, and therefore no dose adjustment of raltegravir is required for individuals with the UGT1A1*28/*28 genotype.

Establishment of an enzyme-linked immunosorbent assay system for determining soluble CD96 and its application in the measurement of sCD96 in patients with viral hepatitis B and hepatic cirrhosis

CD96, previously named T cell activation increased late expression (Tactile), is a transmembrane molecule that functions as an activated receptor on natural killer cells. It is well known that many transmembrane molecules have soluble forms, which were either shed from the cell surface or spliced at mRNA level. In many cases, the levels of soluble forms in the circulation could be used as biomarkers of lymphocyte activation in bacterial or virus infection, tumour, transplantation and autoimmune disease. To investigate whether CD96 could be released into the sera and the possible biological function of soluble hCD96 (sCD96), we generated and characterized five clones of anti-hCD96 mouse monoclonal antibodies (mAb) and developed a sandwich enzyme-linked immunosorbent assay (ELISA) system based on two anti-hCD96 mAbs with different epitope specificities. Using this ELISA system, sCD96 in serum samples from 99 healthy individuals could be detected. Furthermore, we found that the level of sCD96 in serum samples from patients with chronic viral hepatitis B or classes B and C of hepatic cirrhosis classified using the Child-Pugh score was much higher (P < 0.001 versus healthy individuals; P = 0.006 versus healthy individuals respectively) than that from healthy individuals (0.98 ng/ml). Our study demonstrates for the first time that sCD96 existed in sera, and suggests that sCD96 may be used as a serous marker for some diseases such as chronic viral hepatitis B infection or hepatic cirrhosis in classes B and C. The level of sCD96 in patients' serum may have some relationship with a chronic inflammatory reaction.

[Analysis of management on 23 cases of carotid body tumors]

OBJECTIVE

By reviewing the clinical material in 23 cases (25 tumors) of carotid body tumors, we concluded our experience in selecting the appropriate diagnostic modality and surgical therapy to facilitate surgical maneuvers and decrease the incidence of postoperative complications.

METHOD

From 2003 to 2008, 23 cases of carotid body tumors were admitted and treated in Wuhan Union Hospital. All the 23 cases were operated after determining diagnosis that was deterred by angiography and noninvasive examinations including color Doppler scan, computed tomography angiography and magnetic resonance angiography.

RESULT

There was no patient died, no cerebral infarctions, no recurrence after operation. Nervous complications occurred in 5 cases post operatively.

CONCLUSION

Preoperative angiography is a appropriate diagnostic modality for carotid body tumor, which can shows the supply arteries of the tumor and estimate the structure of the Willis Circle, so that we can judge the possibility to temporarily clamp the carotid artery during the operation to control the hemorrhage and eliminate the postoperative nervous complications.

Liver transplantation for patient with variant hepatic artery arising from right renal artery: a case report

Abnormalities of recipient or donor vascular structures are common and associated with reconstructive difficulties in liver transplantation. A patient with a variant hepatic artery arising from right renal artery underwent modified piggyback liver transplantation in our center. The donor hepatic artery was anastomosed end-to-side to the recipient's middle colic artery. Graft function has remained excellent more than 1 year postoperatively.

122 INTRACELLULAR ICE FORMATION IN VITRIFIED MOUSE MORULAE DURING WARMING

Vitrification is an ice-free cryopreservation method. However, ice can form during warming if the concentration of cryoprotectant is insufficient. For the best use of vitrified embryos, it is important to know the condition in which intracellular ice (ICI) is formed, since ICI is fatal to the cell. So, we tried to estimate the conditions in which ICI forms in vitrified embryos during warming. Compacted morulae were obtained from ICR mice. Vitrification solutions were prepared by diluting ethylene glycol (EG) with FS solution (PB1 medium containing 30% Ficoll and 0.5 M sucrose) at 10, 20, 30, 40, and 50% (EFS10, EFS20, EFS30, EFS40, and EFS50, respectively). Morulae were treated with the solutions for 30, 60, or 120 s at 25�C, loaded in a straw, and vitrified using liquid nitrogen. The sample was warmed by various methods. The survival of embryos was assessed by their ability to develop to expanded blastocysts in culture. The difference in survival was analyzed by the chi-square test. In addition, the morphology of damaged embryos was examined to estimate the type of injury. It was confirmed that 20% or more EG was necessary to prevent the formation of extracellular ice during cooling without embryos. In the rapid warming protocol (control), in which vitrified samples were directly immersed in 25�C water, high embryonic survival was obtained with EFS30 (79–88%) and EFS40 (96–99%), but not with EFS20 (12–45%) and EFS50 (0–14%). This suggests that embryos vitrified with EFS20 were injured by ICI, whereas those vitrified with EFS50 were injured by the chemical toxicity of the solution. When embryos vitrified with EFS30 and EFS40 were warmed slowly by holding the straw in air at 25�C for 120 s, the survival rate decreased significantly (44–64%), probably because the cytoplasm of the embryos that had vitrified in a state of supercooling devitrified during slow warming. To estimate the condition in which ICI forms, embryos vitrified with EFS30 and EFS40 were kept at intermediate temperatures for various times before being warmed in 25�C water. Compared with control, survival rates decreased significantly by keeping samples for 3 min at -80�C (27–65%), -60�C (16–39%), -40�C (6–26%), or -20�C (33–46%). These results suggest that ICI forms at a wide range of temperatures between -80�C and -20�C, but more likely forms at temperatures between -60�C and -40�C. When the holding time was prolonged to 1 h and 24 h, the survival decreased further (0–58% and 0–14%, respectively). This shows that ICI forms not only quickly but also slowly at an intermediate temperature. From the morphological examination, embryos that should be injured by ICI swelled at recovery in PB1 medium and collapsed in culture, whereas those that should be injured by the toxicity of solution underwent decompaction after culture. This observation reinforces our supposition that slowly warmed embryos are injured by ICI.

Extrahepatic portal vein aneurysm: Two case reports of surgical intervention

We report two cases of extrahepatic portal vein aneurysm, and both of them underwent surgical intervention. The first case had a mild pain in right upper quadrant of the abdomen; the second had no obvious symptoms. Physical examination revealed nothing abnormal. Both of them were diagnosed by magnetic resonance imaging angiography (MRA). One of the aneurysms was located at the main portal vein, the other, at the confluence of the superior mesenteric vein and the splenic vein, and these two places are exactly the most common locations of the extrahepatic portal vein aneurysm reported in the literature (30.7% each site). The first case underwent aneurysmorrhaphy and the second case, aneurysm resection with splene-ctomy. Both of them recovered soon after the operation, and the symptom of the first case was greatly alleviated. During the follow-up of half a year, no complication and adverse effect of surgical intervention was found and the color Doppler ultrasonography revealed no recurrence of the aneurysmal dilation. We suggest that surgical interv-ention can alleviate the symptom of the extrahepatic portal vein aneurysm and prevent its complications effectively and safely for low risk patients.