De novo appearance of primitive neuroectodermal tumor in a patient with systemic lupus erythematosus and moyamoya disease

Primitive neuroectodermal tumor is a rare brain tumor composed of undifferentiated or poorly differentiated neuroepithelial cells with a high malignant potential that usually occurs in children, and which is only occasionally encountered in adults. A 19-year-old female with systemic lupus erythematosus presented with right hemiparesis and a headache of 10 days duration. Brain magnetic resonance imaging showed a large solid mass with necrotic portions in the left frontoparietal lobe. Primitive neuroectodermal tumor was confirmed by a neuronavigator-guided brain biopsy. This is the first case report of primitive neuroectodermal tumor associated with systemic lupus erythematosus and moyamoya disease. This case demonstrates that brain tumors, such as primitive neuroectodermal tumor, should be included in the differential diagnosis of neurological manifestations in children and adolescent patients with systemic lupus erythematosus.

In-vitro study on haemodiluted blood flow in a sinusoidal microstenosis

In-vitro experiments were carried out to investigate the haemodynamic and haemorheological behaviours of haemodiluted blood flow through a microstenosis using a micro-particle image velocimetry (PIV) technique. The micro-PIV system employed in this study consisted of a two-head neodymium:yttrium-aluminium-garnet (Nd:YAG) laser, a cooled charge-coupled device camera, and a delay generator. To simulate blood flow in a stenosed vascular vessel, a polydimethylsiloxane (PDMS) microchannel with a sinusoidal throat of 80 per cent severity was employed. The width and depth of the microchannel were 100 microm and 50 microm, respectively. To compare the flow characteristics in the microstenosis, the same experiments were repeated in a straight microchannel under the same flow conditions. Using a syringe pump, human blood with 5 per cent haematocrit was supplied into the microstenosis channel. The flow characteristics and transport of blood cells through the microstenosis were investigated with various flowrates. The mean velocity fields were nearly symmetric with respect to the channel centreline. In the contraction section, the oncoming blood flow was accelerated rapidly, and the maximum velocity at the throat was almost 4.99 times faster than that of the straight microchannel without stenosis. In the diffusion section, the blood cells show rolling, deformation, twisting, and tumbling motion due to the flow-choking characteristics at the stenotic region. The results from this study will provide useful basic data for comparison with those obtained by clinical researchers.

Efficacy and safety of 1064-nm Q-switched Nd:YAG laser with low fluence for keloids and hypertrophic scars

BACKGROUND

Several treatment modalities using laser devices have been used for the treatment of keloids and hypertrophic scars with various therapeutic outcomes.

OBJECTIVE

The purpose of this study was to describe the efficacy and safety of 1064-nm Q-switched (QS) Nd:YAG laser with low fluence on keloids and hypertrophic scars.

METHODS

Keloids and hypertrophic scars located at 21 anatomic sites in 12 Korean patients (10 men and 2 women; mean age 23.8 years, range 21-33) were treated using 1064-nm QS Nd:YAG laser with low fluence at 1-2 week intervals. Treatment settings were 1.8-2.2 J/cm(2), 7-mm spot size and 5-6 passes with appropriate overlapping.

RESULTS

Follow-up data collected 3 months after the final treatment revealed decreases in the mean score for the following lesion characteristics: pigmentation from 1.8 to 1.2; vascularity from 1.4 to 1.0; pliability from 3.0 to 2.0 and height from 2.3 to 1.8. The modified Vancouver General Hospital Burn Scar Assessment score decreased from 8.6 to 5.9 (P < 0.0001). Observed side-effects were a mild prickling sensation during treatment, and mild post-treatment erythema, both of which resolved within few hours.

CONCLUSION

Our results demonstrate that QS Nd:YAG laser with low fluence may be used for the treatment of keloids and hypertrophic scars.

The Cut-Off Rate of Skin Temperature Change to Confirm Successful Lumbar Sympathetic Block

The purpose of this study was to find the best cut-off value for the rate of change in temperature of the plantar surface of the foot for predicting the success of lumbar sympathetic block (LSB). A total of 185 LSBs were performed on 82 patients via a posterolateral approach under fluoroscopic guidance. Successful LSB was considered to have occurred when changes in the ipsilateral temperature between preblock and post-block were ≥ 2 °C. A receiver operating characteristic (ROC) curve for the minimum rate of temperature change was constructed as a predictor of the onset of a successful LSB. The area under the ROC curve was 0.971 at the rate of 0.4°C/min with a sensitivity of 89.5% and a specificity of 91.8%. Achieving a rate of temperature change of 0.4°C/min within approximately 5 min of the injection of local anaesthetic could be used as an indicator of the onset of successful LSB.

Comparison of cortical bone thickness and root proximity at maxillary and mandibular interradicular sites for orthodontic mini-implant placement

OBJECTIVES

To compare maxillary and mandibular cortical bone thickness and rootic proximity for optimal mini-implant placement.

SETTING AND SAMPLE POPULATION

CT images from 14 men and 14 women were used to evaluate buccal interradicular cortical bone thickness and root proximity from mesial of the central incisor to the 2nd molar. Cortical bone thickness was measured at 0 degrees , 15 degrees , 30 degrees , and 45 degrees angles relative to the root surface using three-dimensional images.

RESULTS

For the cortical bone thickness, there was no statistically significant difference between the maxilla and the mandible in the anterior area; however, there was a significant difference in the posterior area. Cortical bone in the maxilla, mesial and distal to canine interradicular sites, was thickest while thickness in the mandible exhibited a gradual anterior to posterior increase. Cortical bone thickness in the maxilla increased as both level and angle increased, while the cortical bone thickness in the mandible was greatest at 4 mm from the alveolar crest. Root proximity mesial and distal to 2nd premolar interradicular sites was greatest.

CONCLUSION

Based on our results, cortical bone thickness depends on the interradicular site rather than sex or individual differences.

Synergy of TLR2 and H1R on Cox-2 Activation in Pulpal Cells

Although pulp fibroblasts are a major cell type in dental pulp, their roles in microbial recognition and pulpal inflammation are not well-understood. Considering the pivotal role of Toll-like receptors (TLRs) in the recognition of micro-organisms, we hypothesized that TLRs on pulp fibroblasts may induce inflammatory signals in dental pulp. In human pulp fibroblasts, TLR2, 3, 4, and 5 were constitutively expressed. Stimulation of TLR2 and 3 induced the expression of pro-inflammatory genes such as CXCL10, CCL5, and/or Cox-2 in pulp fibroblasts. Interestingly, histamine synergistically activated TLR2-mediated Cox-2 expression and PGE(2) production. The synergistic effect of histamine is mediated by histamine receptor-1 (H1R). Studies on the intra-cellular signaling pathways revealed that p38 activation is required for the synergistic activation of Cox-2 by TLR2 and histamine. Analysis of these data suggests that TLR2 on pulp fibroblasts, in concert with H1R, can induce an inflammatory response during microbial infection in dental pulp.

Role of purinergic receptor in alpha fodrin degradation in Par C5 cells

Autoantibodies specific for alpha-fodrin fragments are found in the tissues of persons afflicted with Sjögren's syndrome (SS). However, the mechanism for alpha-fodrin degradation remains elusive. The following experiments utilized Par C5 cells to examine the role of P2X7 receptor (P2X7R) in apoptosis, particularly in the cleavage and release of alpha-fodrin, an apparent SS autoantigen. Five mM ATP stimulation induced apoptotic cell death with a sustained Ca2+ influx, which was mimicked in HEK cells transfected with P2X7R. ATP also induced cleavage of alpha-fodrin mediated by caspase-3 and calpain, releasing alpha-fodrin fragments through membrane blebs. However, both apoptotic cell death and alpha-fodrin cleavage were inhibited in the presence of 300 microM oxidized-ATP (ox-ATP), an irreversible blocker of P2X7R, or in Ca(2+)-free solution. We concluded that P2X7R plays an important role in apoptosis and alpha-fodrin degradation in salivary epithelial cells, providing an important clue elucidating the presence of alpha-fodrin fragments in SS tissues.

Celecoxib induces hepatic stellate cell apoptosis through inhibition of Akt activation and suppresses hepatic fibrosis in rats

BACKGROUND AND AIMS

Activated hepatic stellate cells (HSCs) but not quiescent HSCs express cyclo-oxygenase-2 (COX-2), suggesting that the COX-2/prostanoid pathway has an active role in hepatic fibrogenesis. However, the role of COX-2 inhibitors in hepatic fibrogenesis remains controversial. The aim of this study was to investigate the antifibrotic effects of celecoxib, a selective COX-2 inhibitor.

METHODS

The effects of various COX inhibitors-that is, ibuprofen, celecoxib, NS-398 and DFU, were investigated in activated human HSCs. Then, the antifibrotic effect of celecoxib was evaluated in hepatic fibrosis developed by bile duct ligation (BDL) or peritoneal thioacetamide (TAA) injection in rats.

RESULTS

Celecoxib, NS-398 and DFU inhibited platelet-derived growth facor (PDGF)-induced HSC proliferation; however, only celecoxib (> or =50 microM) induced HSC apoptosis. All COX inhibitors completely inhibited prostaglandin E(2) (PGE(2)) and PGI(2) production in HSCs. Separately, PGE(2) and PGI(2) induced cell proliferation and extracellular signal-regulated kinase (ERK) activation in HSCs. All COX inhibitors attenuated ERK activation, but only celecoxib significantly inhibited Akt activation in HSCs. Celecoxib-induced apoptosis was significantly attenuated in HSCs infected with adenovirus containing a constitutive active form of Akt (Ad5myrAkt). Celecoxib had no significant effect on PPARgamma (peroxisome proliferator-activated receptor gamma) expression in HSCs. Celecoxib inhibited type I collagen mRNA and protein production in HSCs. Oral administration of celecoxib (20 mg/kg/day) significantly decreased hepatic collagen deposition and alpha-SMA (alpha-smooth muscle actin) expression in BDL- and TAA-treated rats. Celecoxib treatment significantly decreased mRNA expression of COX-2, alpha-SMA, transforming growth factor beta1 (TGFbeta1) and collagen alpha1(I) in both models.

CONCLUSIONS

Celecoxib shows a proapoptotic effect on HSCs through Akt inactivation and shows antifibrogenic effects in BDL- and TAA-treated rats, suggesting celecoxib as a novel antifibrotic agent of hepatic fibrosis.

Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai-Burmese border

OBJECTIVES

Ultrasound examination of the fetus is a powerful tool for assessing gestational age and detecting obstetric problems but is rarely available in developing countries. The aim of this study was to assess the intraobserver and interobserver agreement of fetal biometry by locally trained health workers in a refugee camp on the Thai-Burmese border.

METHODS

One expatriate doctor and four local health workers participated in the study, which included examinations performed on every fifth pregnant woman with a singleton pregnancy between 16 and 40 weeks' gestation, and who had undergone an early dating ultrasound scan, attending the antenatal clinic in Maela refugee camp. At each examination, two examiners independently measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), with one of the examiners obtaining duplicate measurements of each parameter. Intraobserver measurement error was assessed using the intraclass correlation coefficient (ICC) and interobserver error was assessed by the Bland and Altman 95% limits of agreement method.

RESULTS

A total of 4188 ultrasound measurements (12 per woman) were obtained in 349 pregnancies at a median gestational age of 27 (range, 16-40) weeks in 2008. The ICC for BPD, HC, AC and FL was greater than 0.99 for all four trainees and the doctor (range, 0.996-0.998). For gestational ages between 18 and 24 weeks, interobserver 95% limits of agreement corresponding to differences in estimated gestational age of less than +/- 1 week were calculated for BPD, HC, AC and FL. Measurements by local health workers showed high levels of agreement with those of the expatriate doctor.

CONCLUSIONS

Locally trained health workers working in a well organized unit with ongoing quality control can obtain accurate fetal biometry measurements for gestational age estimation. This experience suggests that training of local health workers in developing countries is possible and could allow effective use of obstetric ultrasound imaging.

An outbreak of highly pathogenic avian influenza at a public animal exhibit in seoul, Korea, during 2008

This study describes the first recorded outbreak of HPAI in the city of Seoul, in captive birds held in an exhibition for public viewing at a local district office. The index cases were two pheasants, which had been introduced into the exhibit on 24 April, 4 days prior to death, from a store in a local market in Gyeonggi-do. Ducks and chickens from an HPAI outbreak farm, subsequently confirmed on 4 May, had also been held in this store. This outbreak highlights the potential role of local markets in AIV transmission. This outbreak led to considerable public health concern in Korea, however, no human cases were reported. The non-commercial poultry sector needs to be considered in national plans for preparedness and response.

A simple, effective and cheap device for the safe irrigation of open traumatic wounds

This study reports the use of an overturned plastic gallipot from a sterile wound dressing pack as a splashguard during the irrigation of traumatic wounds with a device consisting of a 20 ml syringe and a 21F gauge hypodermic needle. This simple, effective and cheap device can be constructed from items readily available within the emergency department or operating theatre and minimises exposure to biologically hazardous material during wound irrigation.

Acne-photodynamic therapy with intra-lesional injection of 5-aminolevulinic acid

Photodynamic therapy (PDT) is a treatment option for acne patients who fail to respond to conventional therapy. Although potent, we experience side effects such as erythema, exfoliation and dyspigmentation. In attempt to specify treatment and shorten the incubation time, we injected 5-aminolevulinic acid (ALA) to the individual lesion. The results of intralesional injection ILI-PDT and conventional PDT are compared in this study.

Lupus-associated pancreatitis complicated by pancreatic pseudocyst and central nervous system vasculitis

Pancreatitis is an uncommon manifestation of systemic lupus erythematosus (SLE), but this can occasionally cause major complications. We report in this article, a case of 33-year-old female patient who developed lupus-associated pancreatitis that was subsequently complicated by pancreatic pseudocyst and central nervous system (CNS) vasculitis. Abdominal computed tomography (CT) showed an oedematous swelling of the pancreas and a pseudocyst measuring 4 x 3 cm2. Brain magnetic resonance imaging (MRI) showed multiple high-signal intensity lesions in both cerebral hemispheres. The pseudocyst did not completely resolve with high-dose steroid therapy, and it was later complicated by infection and rupture. After a surgical drainage for the complicated pseudocyst, her clinical symptoms and signs were markedly improved. This case shows the importance of performing early drainage rather than conservative treatment for a pancreatic pseudocyst in a patient with lupus-associated pancreatitis.

Cordycepin inhibits IL-1beta-induced MMP-1 and MMP-3 expression in rheumatoid arthritis synovial fibroblasts

OBJECTIVE

MMP is a key enzyme in the degradation of extracellular matrices, and its expression plays important roles in inflammatory diseases. Cordycepin (3'-deoxyadenosine), a bioactive compound of Cordyceps militaris, has been shown to exhibit many pharmacological activities, such as anti-cancer, anti-inflammatory and anti-infection activities. In this study, we aimed at the inhibitory effect of cordycepin on IL-1beta-induced MMP-1 and MMP-3 expression as well as the molecular basis using RA synovial fibroblasts (RASFs).

METHODS

RASFs were isolated from synovial tissue obtained from 12 patients with RA and cultured in monolayer. Expression of MMP-1 and MMP-3 was evaluated using western blotting and real-time PCR. Chemokines were analysed by ELISA. The phosphorylation of mitogen-activated protein kinase was measured by western blotting. Electrophoretic mobility shift assay was performed to evaluate binding activities of DNA to nuclear factor-kappaB (NF-kappaB) and activator protein-1 (AP-1).

RESULTS

Cordycepin inhibited IL-1beta-induced MMP-1 and MMP-3 expressions in RASFs in a dose-dependent manner. Among various chemokines [such as monocyte chemoattractant protein-1 (MCP-1), GRO-alpha, regulated upon activation, normal T-cell expressed and presumably secreted (RANTES) and epithelial neutrophil activating peptide 78 (ENA-78)], cordycepin specifically blocked IL-1beta-induced ENA-78 production in RASF. Moreover, cordycepin significantly inhibited IL-1beta-induced p38/JNK and AP-1 activation, but not extracellular signal-regulated kinase (ERK) and NF-kappaB activation.

CONCLUSIONS

Cordycepin is a potent inhibitor of IL-1beta-induced chemokine production and MMP expression and strongly blocks the p38/JNK/AP-1 signalling pathway in RASFs.

Effects of oral epigallocatechin gallate supplementation on the minimal erythema dose and UV-induced skin damage

BACKGROUND/AIMS

Excessive exposure to UV radiation causes acute adverse effects like sunburn and photosensitivity reactions and is involved in the induction and development of skin cancer. It has been reported that antioxidants have photoprotective effects against solar UV radiation. We investigated the effect of oral epigallocatechin gallate (EGCG), a powerful antioxidant in green tea, on the minimal erythema dose (MED) and UV-induced skin damage.

METHOD

Female HWY/Slc hairless rats were fed the normal diet supplemented with 1,500 ppm EGCG for 8 weeks; then, the MED was determined and visual scores and transepidermal water loss were assessed to evaluate the severity of UV-induced skin damage.

RESULTS

At week 8 of the study, the use of dietary EGCG significantly increased MED. UV-radiation-induced sunburn severity and alterations in epidermal barrier function were also attenuated by the supplementation of EGCG.

CONCLUSION

Regular intake of EGCG strengthens the skin's tolerance by increasing MED and thus prevents UV-induced perturbation of epidermal barrier function and skin damage. These results suggest that EGCG is a potent candidate for systemic photoprotection.

Microwave absorption measurements using a broad-band meanderline approach

We describe a technique that permits broad-band, field-dependent ferromagnetic and electron paramagnetic resonance absorption measurements that is applicable to thin films and patterned micro-/nanostructured arrays and is based on a wire-wound meanderline approach. Techniques to prepare meanderlines and perform microwave measurements are described along with some demonstrations involving an electron paramagnetic resonance calibration/test material, 2,2-diphenyl-1-picryl-hydrazyl, and a ferromagnetic cobalt thin film.

Low seroprevalence of HIV and syphilis in pregnant women in refugee camps on the Thai-Burma border

SUMMARY

Refugee and migrant populations are considered to be at high risk from sexually transmitted infection (STI) and HIV. Cross-sectional surveys for syphilis and HIV were conducted in antenatal clinics (ANCs) on the Thai-Burmese border. In Mae La refugee camp, the seroprevalence of HIV and syphilis were 0.2% (one of 500) (95% CI 0-1.1) and 0% (0 of 404) (95% CI 0-0.9) in 1997; and 0.4% (two of 500) (95% CI 0.1-1.4) and 0.4% (three of 741) (95% CI 0.1-1.2) in 2005, respectively; syphilis seroprevalence in migrant women in 2005 was 0 (0 of 234) (95% CI 0-1.6). The seroprevalence was lower than that reported from surrounding ANCs for Thai or Burmese women. Focus group discussions with HIV-negative and -positive pregnant refugee women established that aspects of Karen culture and isolation (geographical and political) had a significant protective role from HIV and STI. This survey has resulted in programmatic changes in services to pregnant women in this area.

The gep oncogenes, Galpha(12) and Galpha(13), upregulate the transforming growth factor-beta1 gene

Transforming growth factor-beta1 (TGFbeta1) plays a role in neoplastic transformation and transdifferentiation. Galpha(12) and Galpha(13), referred to as the gep oncogenes, stimulate mitogenic pathways. Nonetheless, no information is available regarding their roles in the regulation of the TGFbeta1 gene and the molecules linking them to gene transcription. Knockdown or knockout experiments using murine embryonic fibroblasts and hepatic stellate cells indicated that a Galpha(12) and Galpha(13) deficiency reduced constitutive, auto-stimulatory or thrombin-inducible TGFbeta1 gene expression. In contrast, transfection of activated mutants of Galpha(12) and Galpha(13) enabled the knockout cells to promote TGFbeta1 induction. A promoter deletion analysis suggested that activating protein 1 (AP-1) plays a role in TGFbeta1 gene transactivation, which was corroborated by the observation that a deficiency of the G-proteins decreased the AP-1 activity, whereas their activation enhanced it. Moreover, mutation of the AP-1-binding site abrogated the ability of Galpha(12) and Galpha(13) to induce the TGFbeta1 gene. Transfection of a dominant-negative mutant of Rho or Rac, but not Cdc42, prevented gene transactivation and decreased AP-1 activity downstream of Galpha(12) and Galpha(13). In summary, Galpha(12) and Galpha(13) regulate the expression of the TGFbeta1 gene through an increase in Rho/Rac-dependent AP-1 activity, implying that the G-protein-coupled receptor (GPCR)-Galpha(12) pathway is involved in the TGFbeta1-mediated transdifferentiation process.

The effect of pneumoperitoneum and Trendelenburg position on acute cerebral blood flow-carbon dioxide reactivity under sevoflurane anaesthesia

This study compared cerebral blood flow-carbon dioxide (CBF-CO2) reactivities in the supine and modest Trendelenburg position under pnemoperitoneum during sevoflurane anaesthesia. After induction of anaesthesia in 25 patients, mechanical ventilation was adjusted to increase Paco2 from 4.7 (T1) to 6.0 kPa (T2) in the supine position, and the change in jugular bulb oxygen saturation was measured as an index of CBF. Then, after establishment of pneumoperitoneum and 30 degrees Trendelenburg position, the CO(2) step and measurement of CBF were repeated. The CBF-CO2 reactivity was 7.5 (3.3) %xkPa(-1) (% change in jugular bulb oxygen saturation per unit change in Paco2) in the supine position and 6.8 (2.3) %xkPa(-1) in the 30 degrees Trendelenburg-pneumoperitoneum condition (p = 0.086). We conclude that CBF-CO2 reactivity is unchanged by the modest Trendelenburg position under pneumoperitoneum during sevoflurane anaesthesia.

Visual attention deficits contribute to impaired facial emotion recognition in boys with attention-deficit/hyperactivity disorder

The purpose of the present study was to examine whether attention deficits contribute to dysfunctional facial emotion recognition in boys with ADHD. The first hypothesis was that ADHD patients would commit more errors in facial emotion recognition than the control group. The second hypothesis was that attention deficits, which were measured by a computerized continuous performance test (CPT), would be responsible for the errors in facial emotion recognition in boys with ADHD. A revised emotional recognition test (ERT) was used to assess the subjects' ability to recognize emotions. The ADHD diagnostic system (ADS), a computerized continuous performance test (CPT), was used to evaluate attention performance. Subjects with ADHD showed significantly lower scores of contextual understanding than the controls (t=-2.569, df=67, P=0.012). Among age, IQ, and ADS scores, only the score of omission errors on the ADS accounted significantly for the score of contextual understanding in ADHD (effect size 3.4%, P<0.05). Attention deficits in boys with ADHD seemed to account for their difficulty in recognizing facial expressions of emotion. Effective treatment for attention deficits is expected to have a beneficial effect on facial emotion recognition in boys with ADHD.

The rate of Salmonella spp. infection in zoo animals at Seoul Grand Park, Korea

Salmonellosis is an important zoonotic disease that affects both people and animals. The incidence of reptile-associated salmonellosis has increased in Western countries due to the increasing popularity of reptiles as pets. In Korea, where reptiles are not popular as pets, many zoos offer programs in which people have contact with animals, including reptiles. So, we determined the rate of Salmonella spp. infection in animals by taking anal swabs from 294 animals at Seoul Grand Park. Salmonella spp. were isolated from 14 of 46 reptiles (30.4%), 1 of 15 birds (6.7%) and 2 of 233 mammals (0.9%). These findings indicate that vigilance is required for determining the presence of zoonotic pathogen infections in zoo animals and contamination of animal facilities to prevent human infection with zoonotic diseases from zoo facilities and animal exhibitions. In addition, prevention of human infection requires proper education about personal hygiene.

Calcium-alginate coated, whey protein-based microspheres: preparation, some properties and opportunities

An 'all aqueous' encapsulation process followed by a heat treatment was used to prepare calcium-alginate-coated, whey protein-based, water insoluble microspheres containing micronized calcium carbonate as a model core. Results obtained with this process were compared to those obtained with a similar process in which chemical cross-linking was utilized. At an initial core load of 25 or 50% (w/w), core retention ranged from 84.2-95.12% and was not significantly affected by the initial core load or by the cross-linking method. Regardless of the cross-linking method, protein retention during the process was high and ranged from 78.2-87.5%. Outer topography of the microspheres was not influenced by the cross-linking method, however, at a given composition, the inner structure of heat treated microspheres differed from that obtained with chemically-cross-linked microspheres. Swelling properties of denovo microspheres were affected by pH. Results indicated that the micronized calcium carbonate could be used as a porogenic core. Removal of the core, by an acid treatment, allowed preparing microporous delivery devices. In addition to offer opportunities for encapsulation and delivery of crystalline core, the investigated process can provide means to prepare 'ghost' microporous delivery systems that can, in potential, be loaded, following their preparation, with sensitive core materials at conditions that favour the stability and functionality of this core.

Phase I study of capecitabine in combination with cisplatin and irinotecan in patients with advanced solid malignancies

PURPOSE

This phase I trial assessed the safety and the maximum tolerated dose of capecitabine given for 10 days prior to a combination of cisplatin and irinotecan in patients with advanced solid malignancies. It also evaluated the changes in cisplatin DNA adducts induced by capecitabine.

PATIENTS AND METHODS

Patients with refractory solid tumors who had not failed 5-fluorouracil (5-FU) analogs or topoisomerase I inhibitors were eligible. All cohorts of patients first received a 28-day cycle of cisplatin and irinotecan. Both drugs were given at a dose of 50 mg/m(2) intravenously on day 1, followed by irinotecan on days 8 and 15 at the same dose. The first cycle served as an internal control. Starting from the second cycle, patients received increasing doses per cohort of capecitabine from day 1 to 10 of each cycle, followed by cisplatin on day 11 and irinotecan on days 11, 18 and 25, both at same doses as the first cycle. Cycles were repeated every 38 days. The starting dose of capecitabine was 500 mg/m(2)/day which was escalated by 250 mg/m(2)/day in the subsequent cohort of patients to reach the maximum tolerated dose (MTD). Later, additional patients were treated at the MTD of capecitabine to further evaluate the safety, pharmacodynamics, and tumor response. Patients blood was tested for cisplatin-DNA adducts to determine the impact of capecitabine on cisplatin-based therapy.

RESULTS

Fifteen patients received at least 2 cycles of treatment. At 1,250 mg/m(2), two DLT of prolonged neutropenia of grade > or =3 were observed. The MTD for capecitabine was thus determined to be 1000 mg/m(2)/day. Fatigue and diarrhea of grade 1 or 2 were the most frequent toxicities at this dose level. No significant hematologic toxicity was observed at the MTD. Two complete and three partial remissions were observed. Four of the responders had received a platinum agent and/or 5-FU in the past.

CONCLUSIONS

A sequential treatment with capecitabine followed by cisplatin and irinotecan is well tolerated and demonstrates clinical activity in patients with advanced solid malignancies. The influence of capecitabine, if any, on the efficacy of the cisplatin-irinotecan combination is not related to a variation in cisplatin-DNA adducts.

Electrical transport of bottom-up grown single-crystal Si(1-x)Ge(x) nanowire

In this work, we fabricated an Si(1-x)Ge(x) nanowire (NW) metal-oxide-semiconductor field-effect transistor (MOSFET) by using bottom-up grown single-crystal Si(1-x)Ge(x) NWs integrated with HfO(2) gate dielectric, TaN/Ta gate electrode and Pd Schottky source/drain electrodes, and investigated the electrical transport properties of Si(1-x)Ge(x) NWs. It is found that both undoped and phosphorus-doped Si(1-x)Ge(x) NW MOSFETs exhibit p-MOS operation while enhanced performance of higher I(on)∼100 nA and I(on)/I(off)∼10(5) are achieved from phosphorus-doped Si(1-x)Ge(x) NWs, which can be attributed to the reduction of the effective Schottky barrier height (SBH). Further improvement in gate control with a subthreshold slope of 142 mV dec(-1) was obtained by reducing HfO(2) gate dielectric thickness. A comprehensive study on SBH between the Si(1-x)Ge(x) NW channel and Pd source/drain shows that a doped Si(1-x)Ge(x) NW has a lower effective SBH due to a thinner depletion width at the junction and the gate oxide thickness has negligible effect on effective SBH.

Dependence of the distance between cut-wire-pair layers on resonance frequencies

We studied both experimentally and theoretically the influence of the distance between adjacent cut-wire-pair layers on the magnetic and the electric resonances in the microwave-frequency regime. Besides the dependence on the separation between cut-wire pairs, along the electric-field direction, the electric resonance strongly depends on the distance between cut-wire-pair layers, while the magnetic resonance is almost unchanged. This contrast can be understood by the difference in the distribution of induced-charge density and in the direction of the induced current between the electric and magnetic resonances. A simple model is proposed to simulate our experimental results and the simulation results are in good agreement with the experiment. This result provides important information in obtaining left-handed behavior when the cut-wire pairs are combined with the continuous wire.

A token-flow paradigm for verification of rule-based expert systems

This paper presents a novel approach to the verification of rule-based systems (RBSs). A graph structure, called the rule-dependency graph (RDG), is introduced to describe the dependency relationship among the rules of an RBS, in which each type of improper knowledge forms a specific topological structure. Knowledge verification is then performed by searching for such topological structures through a token-flow paradigm. An algorithm is provided, which automatically generates a minimally sufficient set of literals as test tokens in the detection procedure. The proposed scheme can be applied to rules of non-Horn clause form in both propositional and first-order logic, and restrictions imposed by other graph-based approaches can be avoided. Furthermore, explicit and potential anomalies of RBSs can be correctly found, and efficient run-time validation is made possible.

Deriving minimal conflict sets by CS-trees with mark set in diagnosis from first principles

To discriminate among all possible diagnoses using Hou's theory of measurement in diagnosis from first principles, one has to derive all minimal conflict sets from a known conflict set. However, the result derived from Hou's method depends on the order of node generation in CS-trees. We develop a derivation method with mark set to overcome this drawback of Hou's method. We also show that our method is more efficient in the sense that no redundant tests have to be done. An enhancement to our method with the aid of extra information is presented. Finally, a discussion on top-down and bottom-up derivations is given.

Constructing neural networks for multiclass-discretization based on information entropy

Cios and Liu (1992) proposed an entropy-based method to generate the architecture of neural networks for supervised two-class discretization. For multiclass discretization, the inter-relationship among classes is reduced to a set of binary relationships, and an independent two-class subnetwork is created for each binary relationship. This two-class-based method ends up with the disability of sharing hidden nodes among different classes and a low recognition rate. We keep the interrelationship among classes when training a neural network. Entropy measure is considered in a global sense, not locally in each independent subnetwork. Consequently, our method allows hidden nodes and layers to be shared among classes, and presents higher recognition rates than the two-class-based method.

A neural-fuzzy system for congestion control in ATM networks

We propose the use of a neural-fuzzy scheme for rate-based feedback congestion control in asynchronous transfer mode (ATM) networks. Available bit rate (ABR) traffic is not guaranteed quality of service (QoS) in the setup connection, and it can dynamically share the available bandwidth. Therefore, congestion can be controlled by regulating the source rate, to a certain degree, according to the current traffic flow. Traditional methods perform congestion control by monitoring the queue length. The source rate is decreased by a fixed rate when the queue length is greater than a prespecified threshold. However, it is difficult to get a suitable rate according to the degree of traffic congestion. We employ a neural-fuzzy mechanism to control the source rate. Through learning, membership values can be generated and cell loss can be predicted from the status of the queue length. Then, an explicit rate is calculated and the source rate is controlled appropriately. Simulation results have shown that our method is effective compared with traditional methods.

Dependence of the magnetic-resonance frequency on the cut-wire width of cut-wire pair medium

We investigated some magnetic metamaterials based on cut-wire pairs instead of split-ring resonators to quest for the possibility of a negative magnetic permeability. Several periodic structures of cut-wire pairs were designed and fabricated, and their transmission spectra were measured in the microwave-frequency regime. The width dependence of magnetic-resonance frequency was studied both theoretically and experimentally for the periodic structures of cut-wire pairs. It was found that, besides the length dependence, the magnetic-resonance frequency also depends significantly on the width of cut-wire pair. A simple equivalent-circuit model proposed by Zhou et al. [Opt. Lett. 31, 3620-3622 (2006)] was employed to elucidate this interesting phenomenon and to simulate the width dependence. In the simulation the magnetic and the electric energies of the cut-wire pair were directly calculated to obtain the magnetic-resonance frequency. The theoretical results are in good agreement with the experimental ones. It reveals that there is a rather easy way to manipulate the magnetic-resonance frequency of magnetic-magnetic metamaterials.

A novel function for HSF1-induced mitotic exit failure and genomic instability through direct interaction between HSF1 and Cdc20

Although heat-shock factor (HSF) 1 is a known transcriptional factor of heat-shock proteins, other pathways like production of aneuploidy and increased protein stability of cyclin B1 have been proposed. In the present study, the regulatory domain of HSF1 (amino-acid sequence 212-380) was found to interact directly with the amino-acid sequence 106-171 of Cdc20. The association between HSF1 and Cdc20 inhibited the interaction between Cdc27 and Cdc20, the phosphorylation of Cdc27 and the ubiquitination activity of anaphase-promoting complex (APC). The overexpression of HSF1 inhibited mitotic exit and the degradations of cyclin B1 and securin, which resulted in production of aneuploidy and multinucleated cells, but regulatory domain-deficient HSF1 did not. Moreover, HSF1-overexpressing cells showed elevated levels of micronuclei and genomic alteration. The depletion of HSF1 from cells highly expressing HSF1 reduced nocodazole-mediated aneuploidy in cells. These findings suggest a novel function of HSF1 frequently overexpressed in cancer cells, to inhibit APC/C activity by interacting with Cdc20, and to result in aneuploidy development and genomic instability.

An MTT-based method for quantification of periodontal ligament cell viability

OBJECTIVE

Survival of periodontal ligament cells is crucial issue after tooth replantation. To understand this matter, we introduced MTT assay, which can be used as a tool for measuring the viability of periodontal ligament cells from extracted rat molars.

MATERIALS AND METHODS

The maxillary molars of 4-week-old Sprague-Dawley white female rats were used. Ten teeth of each immediate, 1 h Viaspan and 1 h dry were processed for MTT evaluation. Another 10 teeth from each group were treated in the same manner as above, but were replanted into their original socket. After 2 weeks, the animals were killed and the prevalence of resorption pits was evaluated.

RESULTS

In vivo MTT assay corresponded with the histological results of the resorption pits (P <or= 0.05). The polarizing and optical microscopic findings were consistent with the in vivo MTT assay results.

CONCLUSIONS

In vivo MTT measurements were consistent with the histologic observations and suggest that the in vivo MTT assay could be a tool for evaluating the viability of periodontal ligament cells directly from the extracted root surface. The advantages are shorter analysis time compared with animal or cell culture experiments, easy manipulation, clear quantification and immediate identification of the vital cells.

Eugenol inhibits K+ currents in trigeminal ganglion neurons

Eugenol, a natural capsaicin congener, is widely used in dentistry. Eugenol inhibits voltage-activated Na(+) and Ca(2+) channels in a transient receptor potential vanilloid 1 (TRPV1)-independent manner. We hypothesized that eugenol also inhibits voltage-gated K(+) currents, and investigated this in rat trigeminal ganglion neurons and in a heterologous system using whole-cell patch clamping. Eugenol inhibited voltage-gated K(+) currents, and the inhibitory effects of eugenol were observed in both capsaicin-sensitive and capsaicin-insensitive neurons. Pre-treatment with capsazepine, a well-known antagonist of TRPV1, failed to block the inhibitory effects of eugenol on K(+) currents, suggesting no involvement of TRPV1. Eugenol inhibited human Kv1.5 currents stably expressed in Ltk(-) cells, where TRPV1 is not endogenously expressed. We conclude that eugenol inhibits voltage-gated K(+) currents in a TRPV1-independent manner. The inhibition of voltage-gated K(+) currents is likely to contribute to the irritable action of eugenol.

ABBREVIATIONS

human Kv1.5 channel, hKv1.5; transient receptor potential vanilloid 1, TRPV1.

Ureteral obstruction caused by mucocele of the appendix: MDCT findings

Mucocele of the appendix is characterized by distension of the appendiceal lumen due to abnormal accumulation of mucoid substance. Among the known complications of appendiceal mucocele, it is known to be unusual for the appendiceal mucocele to be a cause of ureteral obstruction. Only a few reports have been published in the English literature. We describe a case of right hydronephroureterosis secondary to appendiceal mucocele diagnosed with multidetector-row CT.

Limits on interactions between weakly interacting massive particles and nucleons obtained with CsI(Tl) crystal detectors

The Korea Invisible Mass Search (KIMS) experiment presents new limits on the weakly interacting massive particle (WIMP)-nucleon cross section using data from an exposure of 3409 kg.d taken with low-background CsI(Tl) crystals at the Yangyang Underground Laboratory. The most stringent limit on the spin-dependent interaction for a pure proton case is obtained. The DAMA signal region for both spin-independent and spin-dependent interactions for the WIMP masses greater than 20 GeV/c2 is excluded by the single experiment with crystal scintillators.

Assessment of rituximab's immunomodulatory synovial effects (ARISE trial). 1: clinical and synovial biomarker results

OBJECTIVE

Treatment with the anti-CD20 monoclonal antibody (mAb) rituximab is effective in rheumatoid arthritis (RA). Marked depletion of circulating B cells, seen in almost all patients, does not correlate with efficacy. The potential synovial immunomodulatory effects of rituximab have not been fully defined.

METHODS

The ARISE trial is an open label, serial synovial biopsy (pre-treatment and 8 weeks) study of rituximab, given 1 g intravenously on days 0 and 14 without peri-infusional steroids, in active RA patients on concomitant methotrexate (MTX). Synovial tissue was analysed by immunohistochemistry with digital image analysis and gene expression by real-time PCR.

RESULTS

The mean (SD) baseline DAS28 score was 6.5 (0.4), and mean MTX dose 17.3 mg/week. Of 13 patients, 11 had failed prior tumour necrosis factor (TNF) inhibitor therapy. With treatment, all patients experienced near complete depletion of circulating B cell numbers. During the 6 months after treatment, 7/13 patients achieved an American College of Rheumatology (ACR) 20% improvement (ACR20) response, 3/13 an ACR50 response and 2/13 an ACR70 response. There was a significant decrease in synovial B cells after treatment, but only a small trend towards greater reduction among clinical responders. Among the three patients with ACR50 responses there was a significant decrease in synovial immunoglobulin synthesis.

CONCLUSIONS

These data suggest that unlike those in circulation, synovial B cells are decreased but are not eliminated by rituximab therapy. Patients with higher levels of response may have more consistent depletion of synovial B cells, and may also have an alteration in synovial B cell function, as indicated by decreases in synovial immunoglobulin synthesis. Thus, effects on synovial B cells may be necessary but not sufficient for inducing clinical efficacy. Other effects, such as on primary lymph organ B cell antigen presentation or cytokine production, may be operative.

Perpendicular antiferromagnetic ordering of Mn and exchange anisotropy in Fe/Mn multilayers

Fe/Mn is a model system in which to study exchange bias, since the antiferromagnetic (AF) Mn layers are believed to have uncompensated moments with all spins aligned in the plane and parallel to those of the Fe. We have determined the microscopic AF ordering at the interfaces using single-crystal neutron diffraction. An unexpected magnetic structure is obtained, with out-of-plane Mn moments perpendicular to those of Fe. This explains the low bias field and shows that the simple AF ordering assumed in a variety of exchange-biased systems may well have to be revised.

Single bolus of intravenous ketamine for anesthetic induction decreases oculocardiac reflex in children undergoing strabismus surgery

BACKGROUND

Oculocardiac reflex (OCR) is a major complication of pediatric strabismus surgery. The aim of the present study was to determine whether a single bolus of intravenous (i.v.) ketamine for anesthetic induction can decrease OCR in children undergoing strabismus surgery.

METHODS

One hundred and twenty healthy children undergoing strabismus surgery were allocated to three groups using double-blind randomization. Anesthesia was induced with propofol 3 mg/kg in Group P, ketamine 1 mg/kg in Group K1, or ketamine 2 mg/kg in Group K2. Anesthesia was maintained with 3% sevoflurane in 50% N(2)O/O(2) in all patients. The baseline heart rate was obtained 30 s prior to the first traction of the extraocular muscle (EOM). OCR was defined as a development of arrhythmia or a decrease of more than 20% of the baseline heart rate during EOM traction.

RESULTS

The incidence of OCR was significantly lower in the ketamine groups (4/40 and 1/40 in Group K1 and K2, respectively) compared with the propofol group (14/40).

CONCLUSION

A single bolus of i.v. ketamine 1 or 2 mg/kg for anesthetic induction results in a lower incidence of OCR than propofol when combined with sevoflurane for maintenance in children undergoing strabismus surgery.

Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy

We compared inpatient and outpatient costs alongside clinical outcomes associated with hematopoietic cell transplantation between 2000 and 2003 with high-dose regimens (HDCT, n=185) and with reduced intensity regimens (RICT, n=90) from human leukocyte antigen (HLA)-matched donors for patients with hematological malignancies. With a comparable median follow-up of 3 years, long-term clinical outcomes, including cumulative incidence of chronic graft-vs-host disease, disease-free survival and overall survival, were similar between the two groups. In the univariate analysis, median costs for the first 100 days ($104,380 vs $42,149) and 1 year ($128,253 vs $80,499) in the HDCT group were higher than those in the RICT group. Median days of hospitalization are also higher for HDCT recipients (39 vs 21), although the number of outpatient clinic visits for HDCT recipients were fewer compared to that for RICT recipients (16 vs 25) during the first year. Adjusting for patient characteristics, RICT recipients had approximately 16 fewer days of hospitalization and cost $53,030 less than HDCT recipients within the first year after transplantation. Our data suggest that substantially lower costs and fewer days of hospitalization within the first year after RICT procedures can be obtained with no compromise of long-term clinical outcomes compared to HDCT procedures.

Safety of benzyl benzoate lotion and permethrin in pregnancy: a retrospective matched cohort study

OBJECTIVE

To assess the safety of benzyl benzoate lotion (BBL) and permethrin, topical treatments for scabies, during pregnancy.

DESIGN

A retrospective controlled cohort study.

POPULATION

Refugee and migrant women attending antenatal clinics (ANC) on the Thai-Burmese border between August 1993 and April 2006.

METHODS

Women treated with either BBL (25%) or permethrin (4%) were identified from a manual search of antenatal records. Each case of scabies was matched with four scabies-free controls for gravidity, age, smoking status, malaria, period of treatment and gestational age at treatment. Conditional Poisson regression was used to estimate risk ratios for outcomes of pregnancy (proportion of abortions, congenital abnormalities, neonatal deaths, stillbirths and premature babies), mean birthweight and estimated median gestational age, for scabies and scabies-free women, independently for BBL and permethrin.

RESULTS

There were no statistically significant differences in pregnancy outcomes between women who were treated with either BBL (n = 444) compared with their matched controls (n = 1,776) or permethrin (n = 196) treated women and their matched controls (n = 784). Overall, only 10.9% (n = 66) of treatments were in the first trimester. Retreatment rates were higher with BBL 16.4%, than permethrin 9.7%, P = 0.038. Scabies was more common during cooler periods.

CONCLUSION

We found no evidence of adverse effects on pregnancy outcome due to topical 25% BBL or 4% permethrin.