Registration of sheep brain MR images for cell tracking using ferrite-composite micro-beads as markers

In the recent molecular imaging studies of the magnetic resonance imaging field, in-vivo cell tracking is becoming an issue for the observation of cell therapy and disease behavior. In order to perform cell tracking, high resolution images and long-term studies are required, because those images make better performance than low resolution images in the recognition of cells and cells are traced at least two weeks. Image registration is an essential image processing technique for long-term imaging. In this study, we proposed the image registration technique using ferrite-composite micro- beads which could be used as substitutes for the cells labeling MR contrast agent such as superparamagnetic iron oxide (SPIO) nanoparticles. Registration of sheep brain images tagging micro-beads was performed with the sufficient accuracy for cell tracking.

Transcatheter embolization of a pseudoaneurysm of the inferior epigastric artery with N-butyl cyanoacrylate

A 41-year-old man presented with alcoholic liver cirrhosis with ascites and clotting abnormality. After therapeutic paracentesis, haemoperitoneum ensued without colour Doppler ultrasound or CT evidence of pseudoaneurysm or haematoma at the site of paracentesis. However, an angiogram of the inferior epigastric artery revealed an obvious small pseudoaneurysm arising from its small muscular branch, and this pseudoaneurysm was successfully treated by transcatheter embolization with N-butyl cyanoacrylate. Transcatheter embolization with N-butyl cyanoacrylate is useful treatment for pseudoaneurysms arising from the small muscular branch of the inferior epigastric artery, which cannot be catheterized superselectively close to the pseudoaneurysm.

Document retrieval using fuzzy-valued concept networks

This paper presents a new method for document retrieval using fuzzy-valued concept networks, where the relevant degrees between the concepts in a fuzzy-valued concept network are represented by arbitrary shapes of fuzzy numbers. There are two kinds of relevant relationships between any two concepts in a fuzzy-valued concept network, i.e., fuzzy positive association and fuzzy negative association. The relevant matrices and the relationship matrices are used to model the fuzzy-valued concept network. The elements in a relevant matrix represent the relevant degrees between concepts. The elements in a relationship matrix represent the relevant relationships between concepts. Furthermore, ne also allow users' queries to be represented by arbitrary shapes of fuzzy numbers and to use fuzzy positive association relationship and fuzzy negative association relationship for formulating their queries for increasing the flexibility of fuzzy information retrieval systems. We also present an information retrieval method in the Internet environment based on the network-type fuzzy-valued concept network architecture.

Suppression and recovery of the hypothalamic function after high-dose corticosteroid treatment in preterm infants

BACKGROUND

High-dose systemic dexamethasone is effective in facilitating extubation of ventilated infants with bronchopulmonary dysplasia. Although the suppression and recovery of pituitary-adrenal response had been assessed after corticosteroid treatment in very low birth weight infants, its effect on hypothalamic function has not been longitudinally monitored.

AIMS

This study was designed to assess the longitudinal hypothalamic response before, during and 4 weeks after a 3-week dose-tapering course of systemic dexamethasone treatment.

PATIENTS AND METHODS

Twenty very low birth weight infants had blood collected for corticotropin-releasing hormone, ACTH and cortisol measurements immediately before starting dexamethasone (week 0), after receiving the maximum dose of treatment (week 1), at the end of the 3-week course (week 3) and 4 weeks after stopping corticosteroids (week 7).

RESULTS

All circulating hormone concentrations were significantly suppressed during the treatment period at week 1 and week 3 compared with pretreatment concentrations at week 0 (p < 0.001). The recovery of pituitary function started early soon after week 1, whereas that of hypothalamus and adrenal functions started after the end of the dexamethasone course. Plasma ACTH concentration at week 7 had returned to the pretreatment level, but plasma corticotropin-releasing hormone (p < 0.05) and serum cortisol (p < 0.001) concentrations remained significantly suppressed. Partial recovery of hypothalamic and adrenal function was observed at week 7 (62 vs. 36% of their pretreatment levels, respectively).

CONCLUSION

Our findings suggest that the hypothalamic function is suppressed during systemic corticosteroid treatment but partial recovery occurs 4 weeks after stopping therapy. Even in preterm infants, the hypothalamic-pituitary-adrenal axis behaves in a similar manner as in adult subjects and the pituitary function recovers earlier than that of hypothalamus and adrenals.

MicroRNA expression signature of human sarcomas

MicroRNAs (miRNAs) are approximately 22 nucleotide-long noncoding RNAs involved in several biological processes including development, differentiation and proliferation. Recent studies suggest that knowledge of miRNA expression patterns in cancer may have substantial value for diagnostic and prognostic determinations as well as for eventual therapeutic intervention. We performed comprehensive analysis of miRNA expression profiles of 27 sarcomas, 5 normal smooth muscle and 2 normal skeletal muscle tissues using microarray technology and/or small RNA cloning approaches. The miRNA expression profiles are distinct among the tumor types as demonstrated by an unsupervised hierarchical clustering, and unique miRNA expression signatures were identified in each tumor class. Remarkably, the miRNA expression patterns suggested that two of the sarcomas had been misdiagnosed and this was confirmed by reevaluation of the tumors using histopathologic and molecular analyses. Using the cloning approach, we also identified 31 novel miRNAs or other small RNA effectors in the sarcomas and normal skeletal muscle tissues examined. Our data show that different histological types of sarcoma have distinct miRNA expression patterns, reflecting the apparent lineage and differentiation status of the tumors. The identification of unique miRNA signatures in each tumor type may indicate their role in tumorigenesis and may aid in diagnosis of soft tissue sarcomas.

Data acquisition system for an advanced x-ray imaging crystal spectrometer using a segmented position-sensitive detector

A versatile time-to-digital converter based data acquisition system for a segmented position-sensitive detector has been developed. This data acquisition system was successfully demonstrated to a two-segment position-sensitive detector. The data acquisition system will be developed further to support multisegmented position-sensitive detector to improve the photon count rate capability of the advanced x-ray imaging crystal spectrometer system.

Biosynthesis of antibiotic prodiginines in the marine bacterium Hahella chejuensis KCTC 2396

AIMS

Hahella chejuensis KCTC 2396 produces red pigments, showing antibacterial and algicidal activities. The main red-coloured metabolite of the pigments was identified as antibiotic prodigiosin. With the expectation that the red pigments are a mixture of a series of close relatives, the aim of the present study is to detect new antibiotic prodigiosin analogues and to analyse the biosynthetic pattern for prodiginines in KCTC 2396.

METHODS AND RESULTS

Except prodigiosin, the other constituents in the red pigments were confirmed as well-known dipyrrolyldipyrromethene prodigiosin, norprodigiosin, and undecylprodiginine. Additionally, four new prodigiosin analogues, each of which was distinguished from prodigiosin (C(5)), according to differences in alkyl chain length (C(3)-C(7)), were detected in small quantities by liquid chromatography mass spectrometry/mass spectrometry spectroscopy. Owing to the presence of a cytotoxic methoxy group, it is expected that all the new prodigiosin analogues are bioactive.

CONCLUSIONS

Four characterized prodiginines, including prodigiosin and four new prodigiosin analogues are produced in different ratio in KCTC 2396. All of the prodiginines possess a common linear tripyrrolyl structure and a cytotoxic methoxy group.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study shows for the first time that KCTC 2396 is able to produce antibiotic prodigiosin, undecylprodiginine and new prodigiosin analogues in a mixture of pigments. It is also shown that KCTC 2396 possesses a novel system for the simultaneous production of multiple prodiginines in a single micro-organism.

Effects of the surface pH on interfacial interactions of collagen-elastin matrix

This study is aimed to elucidate the effects of surface pH of bioprosthetic heart valve (BHV) on their binding property to calcium and protein. It is hypothesized that the binding affinities of the BHV for calcium and protein are surface pH dependent. To test this hypothesis, collagen-elastin matrix (CEM) made of varying ratios of collagen and elastin were used as calcifiable matrices to simulate the calcium binding process of BHV. The calcium binding profiles of CEM, whose surface pHs were adjusted at 3.4, 5.0 or 7.4, were examined by either incubating CEM in the buffer solutions containing various calcium concentrations or implanting CEM in the rat subcutaneous model. The amounts of calcium and protein bound to CEM decreased as the surface pH of CEM decreased. The calcium level in the CEM (pH 7.4) was 2.32+/-0.8 as compared with 1.23+/-0.35 (microg/mg) in CEM (pH 3.4). The equilibrium dissociation constant (Kd) was in a reciprocal relationship with the surface pH. This study demonstrated that the affinity of CEM for calcium is surface pH dependent and provided basic information about the role of surface properties in BHV calcification.

Portable microscopic cell counter for the determination of residual leucocytes in blood components

BACKGROUND AND OBJECTIVES

The accurate determination of residual white blood cell (WBC) in blood components is of considerable clinical importance, and a variety of methods have been devised for the counting of low levels of residual WBC. In this study, we evaluated the performance of microscopic cell counter with microchannel plastic chip (C-reader) with regard to its ability to quantify WBC in WBC-reduced red cell concentrates.

MATERIALS AND METHODS

In order to quantify residual WBC with the microscopic cell counter, WBC-reduced red cell concentrate was stained using propidium iodide. Three studies were performed: linearity, precision and correlation compared to those of manual Nageotte chamber counting and automatic flow cytometric methods.

RESULTS

Dilution experiments, conducted over a range of 0.7-712 WBC/microl, showed a linearity of r(2) > 0.999, with coefficient of variation values of < or = 15.6% and accuracy of 93.8% over all tested ranges. In comparison with the Nageotte chamber counting and flow cytometric methods, the correlation coefficients were r(2) > 0.995. The detection limit of this method was 0.24 WBC/microl. Total analysis time per sample was approximately 5 min.

CONCLUSION

The microscopic cell counter for residual WBC counting was determined to be efficient at the level of currently defined standards, with acceptable precision and accuracy. This method may prove useful for the quality assurance and control of WBC-depleted blood products.

Effects of temperature on the mechanical properties of single stranded DNA

We present the first measurements of the temperature dependent extension of single stranded DNA. At forces between 2 and 10 pN the extension increases with temperature. This increase in extension is consistent with the disruption of hairpins, and a simple theory that includes hairpin formation shows good agreement with the data at these low forces. In contrast, at forces above 10 pN and temperatures higher than 40 degrees C, the extension decreases rapidly with temperature in a manner not consistent with predictions.

Electronic and optical properties of finite carbon nanotubes in an electric field

The effects, caused by the geometric structure and an electric field (E), on the electronic and optical properties of quasi-zero-dimensional finite carbon nanotubes are explored by employing the tight-binding model coupled with curvature effects. Electronic properties (state energies, symmetry of electronic states, energy spacing and state degeneracy) are significantly affected by the magnitude and the direction of the electric field and the geometric structure (radius, length and chirality). The electric field, by lowering the symmetry of finite carbon nanotubes, modifies the electronic properties. Thus, the optical excitation spectra, excited by electric polarization parallel to the nanotube axis, exhibit rich delta-function-like peaks, which reveal the characteristics of the electronic properties. Therefore it follows that geometric structure and E influence the low-energy absorption spectra, i.e. the change of frequency of the first peak, the alternation of the peak height and the production of the new peaks. There are more absorption peaks when E is oriented closer to the cross-section plane. Moreover, the very complicated optical absorption spectra are characteristic for the individual chiral carbon nanotube due to its specific geometric structure. Above all, the predicted absorption spectra and the associated electronic properties could be verified by optical measurements.

Determination of optimal timing window for pulmonary artery MDCT angiography

OBJECTIVE

The purpose of our study was to determine the optimal timing window for pulmonary artery MDCT angiography.

SUBJECTS AND METHODS

We prospectively studied 150 patients. Routine chest CT scans were acquired using 1.3 mL/kg of contrast medium (370 mg I/mL) that was injected at a fixed injection duration of 30 seconds, followed by a 10-second saline chase. To measure early contrast enhancement, sequential monitoring scans were obtained every 2 seconds over a fixed level of the main pulmonary artery 5 seconds after the start of the injection. Then helical diagnostic scans were obtained at three different predetermined scanning delays (group A, 25 seconds; group B, 35 seconds; and group C, 45 seconds after the start of the injection). Time-enhancement curves; time to reach 100 H, 200 H, and peak enhancement; and enhancement duration greater than 200 H of the pulmonary artery were measured from the monitoring scan. Contrast enhancements of the pulmonary artery and descending aorta and vascular artifacts were assessed from the diagnostic scan.

RESULTS

Times to reach 100 H and 200 H at the pulmonary artery were mean 11 +/- 2.5 (SD) seconds and 16 +/- 3.0 seconds, respectively. Pulmonary artery enhancement duration of greater than 200 H was 25 +/- 2.7 seconds (only obtained in group C). Mean time to peak enhancement (335 +/- 62 H) at the pulmonary artery was 37 seconds. Mean enhancement measured on the diagnostic scan was 294 +/- 43 H, group A; 208 +/- 48 H, group B; and 157 +/- 15 H, group C for the pulmonary artery, and 240 +/- 42 H, group A; 277 +/- 49 H, group B; and 172 +/- 29 H, group C for the aorta (p < 0.01). Artifacts were noted in the superior vena cava (group A, 96.7%; group B, 18.3%; and group C, 0%) and in the subclavian vein (group A, 93.5%; group B, 38.7%; and group C, 0%), (p < 0.05).

CONCLUSION

With our study protocol of a 30-second injection and 10-second saline flush, the optimal temporal window to achieve pulmonary artery enhancement greater than 200 H was from 16 seconds to 41 seconds after the start of the injection.

Role of the C-reactive protein for the diagnosis of TB among military personnel in South Korea

Clinicians are frequently faced with the task of differentiating between pulmonary tuberculosis (PTB) and pneumonia. We evaluated the role of the C-reactive protein test (CRP) for differentiating between TB and pneumonia among military personnel in South Korea. Only immunocompetent males were eligible. Forty-six patients with PTB and 67 with pneumonia were enrolled prospectively. Median CRP concentration was lower in patients with TB than in patients with non-tuberculous pneumonia (3.2 mg/dl [range 0.1-15.7 mg/dl] vs. 8.3 mg/dl [range 0.2-33.7 mg/dl], P < 0.001). The sensitivity and specificity for TB of a low CRP concentration (< 11.2 mg/dl) in serum was 93.3% and 40.9%, respectively. CRP concentration measurement might be useful for eliminating the diagnosis of TB.

An intelligent data mining model approach for adverse effects of hormone replacement therapy

OBJECTIVES

A number of controversial studies have been reported on the potential risk of breast cancer caused by hormone replacement therapy (HRT). Some studies showed a positive relationship between HRT and breast cancer onset, but other studies have not confirmed these results. To clarify the contradictory outcomes in the relationships between HRT and the onset of breast cancer, we have designed an intelligent data mining model (IDM), which is able to find proper prognostic factors for cancer onset and provides alternate measures in interpretation of outcome of clinical data through hierarchies of attributes.

METHODS

Based on the selection criteria, we selected 22 sets of random and case-control studies of the last 15 years, which identified any involvements of HRT with breast cancer. We analyzed the relationship between HRT and breast cancer using an IDM model consisting of data mining algorithms and public domain data mining tools. Prognostic factors which underline the major etiological dispositions of breast cancer were identified.

RESULTS

The variables which are closely associated with cancer onset to some degree are age 60-69, age at menopause 40-49, parity 0, age 40-49, and types of menopause oophorectomy. An implementation of IDM model on overall pooled data indicated that there is no significant relationship between breast cancer onset and HRT. It is suggested that HRT patients with specific physiological and pathological conditions related with the higher ranks of prognostic factors may have a greater chance to get breast cancer.

CONCLUSION

The results of this study may guide biomedical research directed at establishing the causal relationships between various medications and their complications, allowing an accurate assessment of efficacy and side effects of new therapeutic treatment in clinical trials without reliance on a large control population.

The role of TST in the diagnosis of latent tuberculosis infection among military personnel in South Korea

BACKGROUND

The rapid and accurate diagnosis of latent tuberculosis infection (LTBI) is crucial in military settings because military personnel live in crowded circumstances and are of an age group with a high incidence of tuberculosis (TB). We tried to elucidate whether the tuberculin skin test (TST) accurately reflects the risk of TB infection among military personnel, in a setting of intermediate TB prevalence and where bacille Calmette-Guérin (BCG) vaccination is mandatory.

METHODS

A multi-stage cluster survey was conducted among military personnel in South Korea. Participants were grouped according to their risk of TB infection: Group 1, no identifiable risk of TB; Groups 2 and 3, recent casual (Group 2) or close (Group 3) contact with smear-positive TB patients.

RESULTS

Of 1045 participants, 857 (82.0%) had been BCG-vaccinated. The odds ratio (OR) of a positive TST (10 mm cut-off) for Group 2 (n = 184) and Group 3 (n = 83) compared with Group 1 (n = 778) were 0.95 (95%CI 0.67-1.38) and 1.7 (95%CI 1.06-2.70), respectively (P value for trend 0.16).

CONCLUSIONS

The TST does not accurately reflect the risk of LTBI among young military personnel in a setting where there is intermediate TB prevalence and extensive BCG coverage.

Endothelin-1 regulates parathyroid hormone expression of human parathyroid cells

OBJECTIVE

Parathyroid cells synthesize and release endothelin-1 (ET-1). ET-1 displays an in vitro inhibitory effect on basal parathyroid hormone (PTH) secretion and also counteracts PTH hypersecretion stimulated by low calcium. Such effects are further demonstrated in vivo, independent of the changes in calcitonin. We propose that ET-1 may regulate the pathogenesis of uremic hyperparathyroidism. However, this was not directly demonstrated in human parathyroid glands.

DESIGN

Hyperplastic parathyroid glands are obtained from the surgical operation for uremic hyperparathyroidism. Cells are isolated by enzyme digestion and treated with ET-1, and are assessed for PTH mRNA expression. PTH in the plasma and the medium is measured by a newly developed method to detect the whole PTH (1-84).

PATIENTS

Uremic patients with severe secondary hyperparathyroidism and ultrasonography-proved hypertrophy of parathyroid glands received elective surgical approaches under general anesthesia. The resected glands were immediately taken to the laboratory for fresh isolation.

MEASUREMENTS

Following ET-1 treatment, PTH mRNA expression is evaluated by RT-PCR method. ET-1 is detected with radioimmunoassay kit and PTH is measured by a new commercially available Duo PTH kit.

RESULTS

ET-1 exhibited a dose-dependent inhibitory effect (from 10(-12) - 10(-7) M) on PTH mRNA expression of parathyroid cells, either in the basal or in the low-calcium-stimulated states. Release of PTH into the medium is also gradually inhibited by the increase in ET-1 concentrations.

CONCLUSIONS

Our results demonstrate that ET-1 attenuates PTH mRNA expression in freshly isolated human parathyroid cells, and PTH release is also decreased. This result is consistent with our previously reported in vitro and in vivo experiments.

Resistance to adefovir dipivoxil in lamivudine resistant chronic hepatitis B patients treated with adefovir dipivoxil

BACKGROUND

Adefovir dipivoxil (ADV) is a potent nucleotide analogue against both the wild-type and lamivudine (LMV) resistant hepatitis B virus (HBV). The cumulative incidence of ADV resistant mutations in the nucleoside/-tide treatment naive chronic hepatitis B patient (CHB) at weeks 48, 96, and 144 was 0, 0.8-3%, and approximately 5.9%, respectively.

AIMS

The aim of this study was to characterise the genotypic and phenotypic mutation profiles to ADV in 67 LMV resistant CHB patients who were treated with ADV.

METHODS

Serum HBV DNA was quantified by real time polymerase chain reaction. The ADV mutant was detected using matrix assisted laser desorption/ionisation time of flight mass spectrometry based genotyping assays, termed restriction fragment mass polymorphism (RFMP).

RESULTS

RFMP analysis revealed that a total of 11 amino acid substitutions developed in the rt domain of the HBV polymerase in nine patients. The cumulative incidence of genotypic ADV resistance at months 12 and 24 was 6.4% and 25.4%, respectively. The rtA181V, rtN236T, and rtA181T mutations were detected in five, four, and two of the 67 patients at treatment months 12-17, 3-19, and 7-20, respectively. Serial quantification of serum HBV DNA revealed that two patients with the rtA181V mutation, with or without the rtN236T mutation, and one patient with the rtA181T mutation displayed HBV DNA rebound.

CONCLUSION

Emergence of the ADV mutation in LMV resistant patients who are treated with ADV appeared to present earlier and more frequently than was reported in previous studies on nucleoside/-tide treatment naive patients.

Successful outpatient treatment of renal vein thrombosis by low-molecular weight heparins in 3 patients with nephrotic syndrome

Renal vein thrombosis (RV Thromb) is a serious complication ofnephrotic syndrome. Anticoagulation is usually recommended as the treatment of choice. This study reports 3 nephrotic patients diagnosed to have RVThromb combined with thromboembolic events. Low-molecular weight heparin (LMWHep) was given subcutaneously every 12 hours following the diagnosis of RVTromb, which continued at the outpatient clinic after an average of 11 in-hospital days. The patients visited the nephrology outpatient clinic every other week and underwent magnetic resonance image (MRI) studies at 6-week intervals for follow-up of patency of the involved renal vein. LMWHep was discontinued when MRI showed this patency. The average outpatient treatment period was 74 days. There was no recurrent RVThromb in the follow-up course of 6 months after discontinuation of LMWHep. Kidney function was preserved, as indicated by image studies and serial renal function tests. LMWHep produced a more predictable anti-coagulant effect, a superior bioavailability, a longer half-life and a dose-independent effect than unfractionated heparin and coumadin. These benefits made the outpatient treatment of RVThromb possible. Our report recommends outpatient treatment of RVThromb by LMWHep because it is feasible, effective and safe.

An orally active cathepsin K inhibitor, furan-2-carboxylic acid, 1-{1-[4-fluoro-2-(2-oxo-pyrrolidin-1-yl)-phenyl]-3-oxo-piperidin-4-ylcarbamoyl}-cyclohexyl)-amide (OST-4077), inhibits osteoclast activity in vitro and bone loss in ovariectomized rats

Human cathepsin K, a cysteine proteinase of the papain family, has been recognized as a potential drug target for the treatment of osteoporosis. The predominant expression of cathepsin K in osteoclasts has rendered the enzyme into a major target for the development of novel antiresorptive drugs. Now, we report the pharmacological properties of OST-4077 [furan-2-carboxylic acid (1-{1-[4-fluoro-2-(2-oxo-pyrrolidin-1-yl)-phenyl]-3-oxo-piperidin-4-ylcarbamoyl}-cyclohexyl)-amide] as a novel selective cathepsin K inhibitor. Human and rat cathepsin K were inhibited in vitro by OST-4077 with the IC50 values of 11 and 427 nM, respectively. OST-4077 suppressed bone resorption induced by rabbit osteoclasts (IC50, 37 nM) but did not affect bone mineralization or cellular alkaline phosphatase activity in MC3T3-E1 cells. Parathyroid hormone-induced bone resorption was inhibited in a dose-dependent manner in thyroparathyroidectomized rats gavaged with a single dose of OST-4077 (ED50, 69 mg/kg). When given orally twice daily for 4 weeks to 3-month-old ovariectomized (OVX) rats, OST-4077 dose-dependently prevented bone loss, as monitored by bone densitometry, ash content, and urinary excretion of deoxypyridinoline. No change in serum osteocalcin in the OVX rats by OST-4077 suggested that bone formation might not be affected by the agent. In summary, OST-4077 selectively inhibited bone resorbing activities of osteoclasts and prevented bone loss induced by estrogen deficiency but did not affect bone formation. OST-4077, an orally active selective human cathepsin K inhibitor, may have the therapeutic potential for the treatment of diseases characterized by excessive bone loss including osteoporosis.

Recognising tuberculosis in the lower lung field: an age- and sex-matched controlled study

OBJECTIVE

Tuberculosis (TB) can sometimes present with consolidation in the lower lung field. This study was conducted to compare the manifestations of lower-lung-field TB (LLFTB) and other pulmonary TB.

DESIGN

All new culture-proven TB patients with lower-lung-field consolidation from July 2001 through December 2002 were included. Age- and sex-matched TB patients with upper lung involvement were selected as controls.

RESULTS

A total of 79 patients with LLFTB were included. Their mean age was 58.8 years; 46 were male. The clinical, radiographic and laboratory findings were similar in the LLFTB and the control groups, except that the LLFTB patients had less cavitation (P = 0.005). Patients with LLFTB were diagnosed (P = 0.051) and treated (P = 0.001) later than the control patients. The calibres of the trachea and both main bronchi were significantly smaller in the LLFTB group (P < 0.001). More patients with LLFTB developed segmental or lobar atelectasis during follow-up (P = 0.028).

CONCLUSIONS

The manifestations of LLFTB are non-specific. The lower-lung involvement, the lower incidence of cavitation and the higher probability of segmental or lobar atelectasis implied that LLFTB was primary TB. A small bronchial calibre probably contributed to its development.

Comparison of the measured phase diagrams in the force-temperature plane for the unzipping of two different natural DNA sequences

In this work, we consider the critical force required to unzip two different naturally occurring sequences of double-stranded DNA (dsDNA) at temperatures ranging from 20 degrees C to 50 degrees C, where one of the sequences has a 53% average guanine-cytosine (GC) content and the other has a 40% GC content. We demonstrate that the force required to separate the dsDNA of the 53% GC sequence into single-stranded DNA (ssDNA) is approximately 0.5 pN, or approximately 5% greater than the critical force required to unzip the 40% GC sequence at the same temperature. In the temperature range between 20 and 40 degrees C the measured critical forces correspond reasonably well to predictions based on a simple theoretical homopolymeric model, but at temperatures above 40 degrees C the measured critical forces are much smaller than the predicted forces. The correspondence between theory and experiment is not improved by using Monte Carlo simulations that consider the heteropolymeric nature of the sequences.

Growth and photosynthetic responses of two pine species (Pinus koraiensis and Pinus rigida) in a polluted industrial region in Korea

We investigated the effects of pollutants on two pine species (Pinus koraiensis and Pinus rigida) in an industrial region in Korea, using a physiological approach. The concentrations of fluorine (F) and chlorine (Cl) in the atmosphere, in precipitation and soil water at the damaged site were all significantly higher than at a control site. Moreover, the concentrations of F, Cl and Mn in pine needles were significantly higher, and essential elements and chlorophyll in needles were significantly lower at the damaged site than at the control site. The photosynthetic capacities, shoot length and survival statistics of needles of the two pines were all significantly reduced at the damaged site compared to the control site, especially P. rigida. Based on our comparison of photosynthetic responses and the concentrations of F, Cl and Mn in needles of the two pine species, P. koraiensis is more resistant to excess Mn in its needles than P. rigida.

Unusual renal cell carcinomas: a pictorial essay

Renal cell carcinoma (RCC) is the most common solid renal neoplasm. Clear cell (conventional) carcinoma is the most common pathologic subtype of RCC. Usually RCC is a hypervascular, solid, solitary mass with contour bulging. However, RCC can manifest different features according to the pathologic tumor subtypes. Preoperative diagnosis of cyst-associated RCC is very difficult, especially in cases of RCC originating in a cyst. Multiple or bilateral presentation of RCC occurs in fewer than 5% of cases. In addition, RCCs may demonstrate unusual findings such as infiltrative growth mimicking transitional cell carcinoma, fatty component mimicking angiomyolipoma, severe perinephric infiltration, and extensive calcifications mimicking inflammation or other tumor. RCCs can be associated with hereditary diseases such as von Hippel-Lindau disease. Familiarity with these radiologic features of unusual RCCs can help ensure correct diagnosis and proper management.

Improved treatment results for childhood acute myeloid leukemia in Taiwan

To improve treatment results for children with de novo acute myeloid leukemia (AML), we introduced a novel protocol, Taiwan Pediatric Oncology Group-AML-97A, for AML other than acute promyelocytic leukemia (APL), for which modified conventional protocols were used. From January 1, 1997, to December 31, 2002, 141 children younger than 17 years old with de novo AML were enrolled. In total, 117 patients with non-APL AML were treated with induction therapy of idarubicin and cytarabine (Ara-C), postremission therapy with high-dose Ara-C - containing regimens for four monthly courses, and moderate-dose therapy with idarubicin and Ara-C for four monthly courses. The first 19 patients with APL were treated with all-trans retinoic acid, idarubicin and Ara-C, with the remaining five patients receiving all-trans retinoic acid and idarubicin, followed by maintenance therapy for 2 years. Stem cell transplantation was performed in 29 patients in first remission with a similar outcome as chemotherapy alone. The remission rate in the AML-97A study was 90%, the 5-year survival 51 +/- 5.3% (s.e.) and the 5-year event-free survival 50 +/- 4.8%; for APL, these were 100%, 86 +/- 7.0, and 75 +/- 9.8%. For the whole group, the 5-year survival was 57 +/- 4.7% and the 5-year event-free survival 54 +/- 4.4%. The AML-97A regimen was well tolerated.

Dihydroartemisinin enhances radiosensitivity of human glioma cells in vitro

PURPOSE

The antimalarial agent, artemisinin, also confers cancer-specific cytotoxic effects by reacting with ferrous iron atoms to form free radicals. Here, we investigated the radiosensitizing effects of dihydroartemisinin on glioma cells and assessed some possible mechanisms for these effects.

MATERIALS AND METHODS

U373MG glioma cells treated with various concentrations of dihydroartemisinin plus radiation, and efficiency of radiosensitization was assessed by clonogenic survival assay. Expression and activity of antioxidant enzymes, glutathione-S-transferase (GST) were quantified by western blot and enzymatic activity analyses, respectively.

RESULTS

Dihydroartemisinin showed higher cytotoxicity in the glioma cell lines than in the liver, breast or cervical cancer cell lines. In clonogenic survival assays, treatment with dihydroartemisinin alone dose-dependently reduced the number of U373MG colonies, while treatment with dihydroartemisinin plus gamma-irradiation showed far lower clonal survival than cultures treated with radiation or dihydroartemisinin alone. The radiosensitizing effect of dihydroartemisinin was blocked significantly by the free radical scavengers, NAC and TIRON, indicating association with dihydroartemisinin-induced ROS generation. In addition, the radiation-induced expression of endogenous GST was suppressed by treatment with dihydroartemisinin. The radiosensitizing effect of dihydroartemisinin was also markedly enhanced by the addition of holotransferrin

CONCLUSION

Taken together, our results strongly suggest that dihydroartemisinin triggers production of ROS and inhibits GST activity, leading to effective and therapeutically relevant radiosensitization of human glioma cells.

Coenzyme q10 confers cardiovascular protection against acute mevinphos intoxication by ameliorating bioenergetic failure and hypoxia in the rostral ventrolateral medulla of the rat

Coenzyme Q10 (CoQ10, ubiquinone) is a highly mobile electron carrier in the mitochondrial respiratory chain that also acts as an antioxidant. We evaluated the cardiovascular protective efficacy of CoQ10 at the rostral ventrolateral medulla (RVLM), a medullary site where sympathetic vasomotor tone originates and where the organophosphate poison mevinphos (Mev) acts to elicit cardiovascular intoxication. Experiments were carried out in adult male Sprague-Dawley rats that were maintained under propofol anesthesia. Microinjection bilaterally of Mev (10 nmol) into the RVLM induced progressive hypotension and minor bradycardia, alongside significant depression of the activity of NADH cytochrome c reductase (enzyme marker for Complexes I and III) or cytochrome c oxidase (enzyme marker for Complex IV) in the mitochondrial respiratory chain, reduction in ATP concentration, or tissue hypoxia in the RVLM. On the other hand, the activity of succinate cytochrome c reductase (enzyme marker for Complexes II and III) remained unaltered. The Mev-induced hypotension, bioenergetic failure, or hypoxia was significantly reversed when CoQ10 (4 microg) was coadministered bilaterally into the RVLM with the organophosphate poison. We conclude that CoQ10 confers cardiovascular protection against acute Mev intoxication by acting on the RVLM, whose neuronal activity is intimately related to the "life-and-death" process. We also showed that amelioration of the selective dysfunction of respiratory enzyme Complexes I and IV in the mitochondrial respiratory chain, the reduced ATP level, and the induced tissue hypoxia in the RVLM are among some of the underlying mechanisms for the elicited protection.

Tacrolimus decreases the expression of eotaxin, CCR3, RANTES and interleukin-5 in atopic dermatitis

BACKGROUND

There is a lack of studies on the effect of tacrolimus on eosinophils and related molecules including eotaxin, CCR3, RANTES and interleukin (IL)-5.

OBJECTIVES

To investigate the effects of tacrolimus on in vivo eosinophil counts and on the related molecules eotaxin, CCR3, RANTES and IL-5 in patients with atopic dermatitis (AD).

METHODS

Lesional skin specimens and sera were obtained from 15 patients with AD and from 15 normal controls. For 8 weeks, the patients with AD applied 0.03% tacrolimus ointment to all affected areas twice daily. Blood sampling and skin biopsies were then repeated. We evaluated serum eotaxin and IL-5 levels, and tissue eotaxin, CCR3, RANTES and IL-5 levels. Additionally, tissue levels of eotaxin and CCR3 mRNA were measured.

RESULTS

After treatment with topical tacrolimus twice daily for 8 weeks, significant decreases were found in serum IL-5 levels, immunoreactive cell counts of eotaxin, IL-5, CCR3 and RANTES in AD skin, and tissue eosinophil counts. However, the change in the serum eosinophil count was not statistically significant, and mRNA levels of eotaxin and CCR3 were not decreased significantly after treatment.

CONCLUSIONS

Topical tacrolimus reduces the number of eosinophils in tissue and suppresses the expression of eotaxin, CCR3, RANTES and IL-5 related to proliferation, recruitment, activation and survival of eosinophils.

Sibutramine improves insulin sensitivity without alteration of serum adiponectin in obese subjects with Type 2 diabetes

AIM

To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin levels in obese patients with Type 2 diabetes.

METHODS

This study is a randomized, double-blind, placebo-controlled parallel comparison study of sibutramine 15 mg/day and placebo. Forty-eight eligible obese patients with Type 2 diabetes (age between 30 and 75 years with body mass index > or = 27 kg/m(2)) were randomly assigned to receive either placebo (n = 24) or sibutramine (15 mg/day) (n = 24) for 6 months. Fifteen subjects in each group underwent meal tests and modified insulin suppression tests before and after 6 months' treatment.

RESULTS

After 6 months of sibutramine treatment statistically significant changes from baseline were observed for body weight (85.4 +/- 2.5 vs. 82.9 +/- 2.4 kg, P < 0.005) and body mass index (32.0 +/- 0.7 vs. 31.4 +/- 0.6 kg/m(2), P < 0.05) without a significant alteration of waist-hip ratio (W/H), blood pressure, heart rate, glycaemic parameters or lipid profiles. The steady-state plasma glucose (SSPG) level during the modified insulin suppression test was significantly reduced in the sibutramine group (17.33 +/- 2.92 vs. 14.29 +/- 4.19 mmol/l, P < 0.05) despite similar steady-state plasma insulin (SSPI) concentrations. In addition, serum adiponectin and C-reactive protein (CRP) levels remained unchanged, although modest weight reduction was achieved after sibutramine treatment. There were also no significant correlations between changes in serum adiponectin and reduction of SSPG or body weight. Daily ambient plasma insulin and glucose concentrations in response to a test meal were not significantly different in subjects receiving sibutramine treatment.

CONCLUSIONS

We conclude that treatment with sibutramine 15 mg once daily effectively reduces weight and enhances insulin sensitivity without alteration of serum adiponectin levels in obese patients with Type 2 diabetes.

Smad4 expression in gastric adenoma and adenocarcinoma: frequent loss of expression in diffuse type of gastric adenocarcinoma

Smads are signal transducers for the members of the TGF-beta superfamily. Of these Smads, Smad4 is essential for TGF-beta signaling. The purpose of this study was to elucidate Smad4 expression and localization in 65 gastric adenomas, 49 intestinal-type and 39 diffuse type of gastric adenocarcinomas (including 12 cases of fresh frozen tissue) using Real-time RT-PCR and immunohistochemistry. Real-time RT-PCR showed that intestinal type gastric adenocarcinomas have higher Smad4 mRNA expression than diffuse type gastric adenocarcinomas. Immunohistochemical stain for Smad4 revealed that expression of Smad4 was significantly lower in diffuse-type gastric adenocarcinoma than intestinal-type gastric adenocarcinomas. Also, higher Smad4 protein expression in intestinal type gastric adenocarcinomas than overall gastric adenoma was noted. The rate of reduced Smad4 expression was higher in advanced gastric cancer than early gastric cancer. These results suggest that Smad4 might play different roles in human gastric carcinogenesis, especially between intestinal type and diffuse type of gastric adenocarcinoma.

Low-molecular-weight heparin successfully treating a nephrotic patient complicated by renal and ovarian vein thrombosis and pulmonary embolism

Thromboembolic complications, frequently associated with idiopathic membranous glomerulonephritis, are frequent and serious problems associated with nephrotic syndrome. However, ovarian vein thrombosis associated with nephrotic syndrome has never been reported. This study describes the case of a 35-year-old woman with idiopathic membranous glomerulonephritis who developed left renal vein thrombosis with ovarian vein thrombosis and pulmonary embolism. The thromboembolic complications were successfully treated with low-molecular-weight heparin. Low-molecular-weight heparin thus appears safe and effective for treating thromboembolism in nephrotic patients.

Effects of yeast (Saccharomyces cerevisiae) cell components on growth performance, meat quality, and ileal mucosa development of broiler chicks

An experiment was conducted with 240, 1-d-old, male broilers to investigate the effects of Saccharomyces cerevisiae (SC) cell components on the growth performance, meat quality, and ileal mucosa development. There were 4 dietary treatments, each consisting of 6 replicates. Whole yeast (WY), SC extract (YE), and SC cell wall (CW) were added at 0.5, 0.3, and 0.3%, respectively, to the control starter and finisher diets. From 0 to 3 wk of age, a lower feed/gain ratio (P < or = 0.05) was observed with CW, whereas the WY-fed birds at 4 to 5 wk of age showed a lower feed/gain ratio compared with the control. From 0 to 5 wk of age, WY and CW gave higher BW gains than did the control. The shear force of raw drumstick decreased in the WY treatment relative to the control, and YE and CW treatments were intermediate. The shear forces in cooked breast and drumstick in treatments WY and YE decreased when compared with the control. The amount of 2-thiobarbituric acid-reactive substances (TBARS) in the breast meats of WY, YE, and CW were lower than the control at 10 d of incubation. In raw drumstick meats, TBARS values were lower in treatments WY and YE than that of the control at 6 and 10 d of incubation. At 10 d of incubation, skins from YE and CW treatments had lower TBARS values than did the control. Villus height was greater in WY and CW compared with those in control and YE. No differences were found in crypt depth among the 4 treatments. The villus height/ crypt depth ratios in WY and CW were greater than those of the control and YE. It could be concluded that dietary yeast components, such as WY or CW supplementation improved growth performance. Meat tenderness could be improved by the WY or YE. Both YE and CW had oxidation-reducing effects. Yeast cell wall may improve ileal villus development.

Analysis of Allograft Biopsy Specimens in Renal Transplants With Proteinuria: Is Proteinuria a Culprit of Graft Loss?

It has been proposed that proteinuria occurring after renal transplantation may be not only a marker but also a culprit of allograft dysfunction. We retrospectively analyzed the data from 55 patients who underwent transplant renal biopsy for proteinuria and/or azotemia occurring beyond 1 year after transplantation. Proteinuria was considered as significant when > or = 30 mg/dL, and the results of transplant biopsy were categorized according to the Banff 97 classification. Logistic regression was used to estimate odds ratios (OR) for graft loss associated with proteinuria and transplant pathology. The patients were followed for 86.0 +/- 32.8 months after transplantation, and transplant biopsy was performed at 54.1 +/- 31.0 months. Proteinuria at 1 year after transplantation noted in 29.1% of patients was not significantly associated with graft loss (OR = 1.94, 95% CI from 0.59 to 6.41). In addition, proteinuria at the time of transplant biopsy was not significantly associated with graft loss. Chronic allograft nephropathy was the most frequent transplant pathology. Only glomerulonephritis was significantly associated with proteinuria at the time of the transplant biopsy. On the other hand, graft loss was significantly associated with the presence of proteinuria both at 1 year after transplant biopsy and at the final follow-up. These results suggest that posttransplantation proteinuria is an important marker of graft dysfunction, but is not predictive of graft loss in biopsy-proven cases. Appropriate management guided by the results of a transplant biopsy may improve the outcome.

Tacrolimus reduces staphylococcal colonization on the skin in Korean atopic dermatitis patients

It is well known that topical tacrolimus is safe and effective in the treatment of atopic dermatitis (AD) patients. Tacrolimus is primarily an immunosuppressive agent without any antistaphylococcal effects. Thus colonization of Staphylococcus aureus on the skin of patients treated with this agent might be increased. The purpose of this study was to determine the effect of tacrolimus on S. aureus colonization in patients with AD and to compare the results with clinical severity and skin barrier function. We enrolled 65 patients with moderate to severe AD. They were treated with 0.03% tacrolimus ointment twice daily for 4 weeks. Clinical severity was assessed by the eczema area and severity index (EASI). S. aureus colonization was measured by the tape method. Skin barrier function was checked by measuring transepidermal water loss (TEWL). Evaluations were performed at weeks 0 (baseline), 1, 2 and 4. The results were compared and statistical analysis was performed. S. aureus colonization was significantly decreased with tacrolimus treatment at week 1 compared with baseline. However, there were no differences among weeks 1, 2 and 4. EASI and TEWL showed a decreasing tendency in a time-dependent fashion. The correlations between data were variable.

Scale formation in NF/RO: mechanism and control

Scale formation of soluble salts is one of the major factors limiting the application of nanofiltration (NF) and reverse osmosis (RO) membranes. This article reviews the scale formation mechanisms in membrane systems, methods to retard scale formation, and a new hybrid system consisting of MF-NF/RO. Two distinct mechanisms in NF/RO fouling by scale formation including surface and bulk crystallization have been identified and investigated. The hydrodynamic operating conditions as well as module geometry determines which fouling mechanism is dominant. An increase in solute concentration at the membrane surface by concentration polarization is responsible for surface crystallization. Conventional methods for scale control only retard the rate of scale formation and their performances are unpredictable. On the other hand, using a MF-NF/RO hybrid system for continuous removal of crystal particles from the retentate stream appears to be effective at high recovery of permeate. When applying the MF-NF/RO hybrid system, substantial improvement in flux is observed in spiral wound module, whereas it is negligible in case of the tubular module. This is because the microfilter could only removes crystals formed in the retentate through the bulk crystallization that is the dominant fouling mechanism in the spiral wound module.

Removal of endocrine disruptors using homogeneous metal catalyst combined with nanofiltration membrane

Chemicals that are known or suspected of being endocrine disrupting chemicals (EDCs) have received increased attention over the past decade for their potential presence in drinking water sources. This study focuses on the development of a hybrid system that combines the advantages of nanofiltration (NF) and homogeneous catalytic oxidation, which include compactness, operational facilitation, high treatment efficiency, and selective reaction capability. Iron(lll)-tetrasulfophthalocyanine (Fe-TsPc) was employed as a homogeneous metal catalyst to degrade bisphenol-A (BPA), a representative EDC. The treatment efficiency of BPA as well as operational characteristics of the hybrid system was investigated to examine the applicability of this technique to decrease the concentration of EDCs in drinking water. Fe-TsPc homogeneous catalyst revealed a remarkable activity in degrading BPA under acidic condition. The high rejection of Fe-TsPc catalyst in the feed stream by the membrane for its large molecular weight (976 Da) and functional group (SO3(-) X4) allowed the continuous use of the catalyst for BPA oxidation reaction. The NF with Fe-TsPc/H2O2 hybrid system turned out to have higher BPA treatment efficiency comparing with the NF-only system since the hybrid system reduced BPA concentration in the feed stream by catalytic destruction of BPA as well as it mitigated concentration polarization on the surface of the membrane.

Influence of floc structure on membrane permeability in the coagulation-MF process

The relation between floc structure and membrane permeability was studied in a coagulation-MF hybrid process. The floc structure changed with operating parameters in the coagulation process and was quantified with fractal dimension (dF). The concentration ratio between suspended colloids and injected coagulant had an essential effect on dF of coagulated flocs. Larger flocs with low fractal dimension were produced for ALT (aluminum ion concentration dosed/suspended particle concentration) between 0.4 and 0.8. Flocs maintained stable characteristics at the coagulation period of over 20 minutes. Membrane permeability was improved with coagulated flocs of lower fractal dimension, which tend to have higher porosity and aggregate relatively loosely. These more porous flocs reduce specific resistance of coagulated flocs. The relation between membrane filterability and fractal dimension of flocs was explored in a submerged MF hybrid system as well as in a batch unstirred cell filtration.

Plasma ghrelin and resistin concentrations are suppressed in infants of insulin-dependent diabetic mothers

This study aimed to investigate 1) the effect of maternal diabetes mellitus on ghrelin, resistin, leptin, and insulin in term newborns; 2) the interrelationship of these metabolic hormones in the early postnatal period; and 3) the association of the hormones with anthropometric parameters at birth. A total of 120 term newborns were prospectively enrolled and categorized into three groups: 40 were infants of nondiabetic mothers (group N), 42 were infants born to mothers with gestational diabetes on low energy dietary treatment (group D), and 38 were infants born to mothers with preexisting or severe gestational diabetes who required exogenous insulin for stabilization of blood sugar during pregnancy (group I). Plasma ghrelin and resistin were significantly lower in group I than in either group N or group D infants (P < 0.048). Plasma ghrelin and subscapular skinfold thickness were significantly higher in female than in male infants [plasma ghrelin: median (interquartile range), 3.8 (3.0-4.8) vs. 3.0 (2.4-4.0) ng/ml in females and males, respectively; P = 0.003; subscapular skinfold thickness: 4.9 (4.2-5.6) vs. 4.6 (3.9-5.2) mm; P = 0.03]. In group N, plasma ghrelin was significantly, but negatively, associated with birth weight (r = -0.31; P = 0.05) and body length (r = -0.33; P = 0.04), whereas in group I, plasma ghrelin was negatively correlated with plasma resistin (r = -0.37; P = 0.02). Plasma ghrelin and resistin are suppressed in infants of insulin-dependent diabetic mothers, suggesting that the metabolic hormonal system is probably operational in fetal and early postnatal life. A low circulating ghrelin concentration may be advantageous to these infants, because a reduction in appetite may prevent excessive weight gain postnatally and counterbalances the in utero anabolic effect of hyperinsulinism in poorly controlled diabetic mothers. The suppressive effect of insulin on resistin may partially explain the excess accumulation of adipose tissue in infants of diabetic mothers by reducing the inhibitory effect of resistin on adipogenesis. Female infants have significantly higher plasma ghrelin levels than male infants, suggesting that sexual dimorphism exists in utero. This study has also shown an association between some of the metabolic hormones in specific groups of infants and thus suggests that these hormones could have interacted in utero to regulate growth and fat storage during this critical period.

Beneficial effects of fluvastatin following percutaneous coronary intervention in patients with unstable and stable angina: results from the Lescol intervention prevention study (LIPS)

AIMS

To investigate the effect on risk of major adverse cardiac events (MACE) of lipid lowering treatment with fluvastatin 80 mg/day after a first percutaneous coronary intervention in patients with stable and unstable angina.

METHOD AND RESULTS

This prespecified subgroup analysis of the LIPS (Lescol intervention prevention study) analysed 1658 patients with documented diagnosis; 824 had unstable angina (417 randomly assigned to fluvastatin, 407 to placebo) and 834 had stable angina (including silent ischaemia; fluvastatin, 418; placebo, 416). Median follow up was 3.9 years. There was no significant effect of anginal status on long term risk of MACE. Fluvastatin treatment reduced the risk of MACE by 28% compared with placebo (p = 0.03) among patients with unstable angina, with no difference between patients with stable and patients with unstable angina (relative risk 1.07, 95% confidence interval 0.87 to 1.30, p = 0.53). Fluvastatin reduced coronary atherosclerotic events (MACE excluding restenosis) by 36% (p = 0.006) among patients with unstable angina and 31% (p = 0.02) among patients with stable angina. Fluvastatin caused similar reductions in total cholesterol and low density lipoprotein cholesterol concentrations in both patient groups.

CONCLUSION

Treatment with fluvastatin 80 mg/day produced significant reductions in MACE and coronary atherosclerotic events after percutaneous coronary intervention in patients with average cholesterol concentrations. The beneficial effects of fluvastatin are observed in patients with unstable or stable angina alike.

Early postoperative complications in recipients of living donor liver transplantation

PURPOSE

Complications are common in the early postoperative period after living donor liver transplantation (LDLT). The aims of this analysis were to describe and identify risk factors for early postoperative complications.

METHODS

Between June 1994 and June 2003, 140 consecutive LDLT patients were divided into 3 groups: group I was small infants <9 kg (n = 30); group II, pediatric patients (n = 63); and group III, adult patients (n = 47). The complications within 3 months after operation were analyzed.

RESULTS

The mortality rate was 1.4%. Surgical complications requiring relaparotomy occurred in 7.9% of patients. Intraoperative portal vein thrombosis requiring immediate thrombectomy, which occurred in 10 patients, was significantly more frequent in the small infant group (23.1% vs 3.2% vs 2.1%; P < .01). Acute hepatic artery thrombosis that occurred in 2 patients was remedied successfully using operative rearterilization. Hepatic outflow obstruction requiring radiological interventions developed in 5 subjects. Medical complications included the following: pulmonary (14.3%), renal (19.3%), bacteremia (10.7%), cytomegalovirus infection (9.3%), and drain-related infections (20.7%). The incidence of hospital-acquired renal insufficiency was significantly higher in adult patients (3.3% vs 14.3% vs 36.2%; P < .01). There was no significant difference in the incidence of acute cellular rejection between members of the 3 groups (10.0% vs 17.5% vs 17%; P = .63).

CONCLUSIONS

Sophisticated postoperative care with multiple disciplinary involvements may achieve a low early mortality rate in LDLT. Small infants weighing <9 kg may carry a greater risk of intraoperative portal vein thrombosis. Pulmonary complications and renal function impairments were the most troublesome in pediatric and adult recipients, respectively.

Rapid in vitro adventitious shoot propagation of Scopolia parviflora through rhizome cultures for enhanced production of tropane alkaloids

A rapid micropropagation system for Scopolia parviflora Nakai (Solanaceae), a rare medicinal plant native to Korea, was established using rhizome cultures. Shoots that originated from adventitious shoots of the rhizome were multiplied when the rhizomes were cultured on half-strength B5 liquid medium supplemented with various growth regulators. Optimum shoot multiplication was observed in half-strength B5 medium containing 3% (w/v) sucrose and 5.77 microM gibberellic acid (GA(3)). Each rhizome gave rise to an average of 12 shoots. Shoot elongation and root induction from multiple shoots occurred on growth regulator-free half-strength B5 solid medium. Healthy plantlets were transferred to a peat moss:vermiculite mixture for acclimatization, which was successful. The concentrations of tropane alkaloids, hyoscyamine and scopolamine were determined in different tissues of native growing plants, in vitro-propagated plants and acclimatized plants by high-performance liquid chromatography. The analysis revealed that the levels of hyoscyamine and scopolamine were higher in in vitro-propagated plants than in the native growing plants. When the rhizome was cut into segments and transferred to optimal culture conditions for multiple shoot propagation, only 12 weeks were required to produce a mature plant. We conclude that in vitro propagation techniques through rhizome cultures provide an efficient and rapid method for shoot propagation of S. parviflora.

A new selection method for pepper transformation: callus-mediated shoot formation

We used two genes, TMV-CP and PPI1 (pepper-PMMV interaction 1 transcription factor), to transform commercially important chili pepper (Capsicum annuum) inbred lines (P915, P409) by means of Agrobacterium co-culture. Eighteen independently transformed T0 plants were obtained. The most critical point in the pepper transformation protocol was the selection of shoots growing on calli--referred to as callus-mediated shoot formation (indirect shooting)--because shoots not grown from the callus (direct shooting from the wounded surface) developed into non-transformants. Selection of the correct right callus type also proved to be an important requirement for obtaining transformed peppers. Six different types of callus developed during the selection process. Shoots regenerated from two of these types, while one type regenerated significantly more shoots than the other types, suggesting that the capacity for shoot formation is callus type-specific. Although the transformation rate was low, transformation via callus-mediated shoot formation proved to be reproducible and was confirmed by Southern and Northern blot analyses. Based on the experimental data, we have succeeded in developing a new protocol for the selection and transformation of pepper and expect that it will be used in the future for pepper transformation.

Effects of inhaled corticosteroids on systemic blood pressure in preterm infants

OBJECTIVE

To assess the effect of inhaled fluticasone propionate on (i) systemic blood pressure, and (ii) the need for volume expanders (crystalloids and colloids) and inotropes for blood pressure support in preterm, very low birth weight (VLBW) infants.

METHODS

Ventilated VLBW infants, less than 32 weeks of gestation, with respiratory distress syndrome were randomised to receive a 14-day course of either fluticasone propionate (500 microg/puff, 2 puffs every 12 h; n=27) or placebo (n=26) with a metered dose inhaler-spacer device. The response of treatment was assessed by comparing the use of volume expanders, inotropes, and the average and the lowest systolic, mean and diastolic blood pressures in 6 hourly epochs between the 2 groups.

RESULTS

There were no significant differences in the average or the lowest systolic, mean and diastolic blood pressures in 6 hourly epochs between the 2 groups. However, the total volume of crystalloids and colloids requirement was significantly greater in control than in treated infants (p=0.03). There was also a trend towards greater consumption of the total cumulative dose of dopamine in the control infants (p=0.10).

CONCLUSIONS

Fluticasone-treated infants required significantly less volume of crystalloids and colloids for blood pressure support compared with control infants. Further larger scale studies are required to determine whether inhaled corticosteroids could minimise the use of volume replacement therapy and inotropes in the treatment of hypotension in preterm infants in the early postnatal period.