Development of a novel bioreactor for the mechanical loading of tissue-engineered heart muscle

OBJECTIVE

In this study, we describe a novel bioreactor system to deliver controlled stretch protocols to bioengineered heart muscle (BEHM) constructs. Our primary objective was to evaluate the effect of mechanical stretch on the contractile properties of three-dimensional cardiac constructs in vitro.

METHODS

BEHMs were formed by culturing primary neonatal cardiac myocytes in a fibrin gel using a method previously developed in our laboratory. A custom bioreactor system was designed using SolidWorks (Concord, MA) and structural components were manufactured using fusion deposition modeling. We utilized the bioreactor to evaluate the effect of 2-, 6-, and 24-hour stretch protocols on the stretch-induced changes in contractile function of BEHMs.

RESULTS

We were able to demonstrate compatibility of the bioreactor system with BEHMs and were able to stretch all the constructs with zero incidence of failure. We found that loading the constructs for 2, 6, and 24 hours during a 24-hour period using a stretch protocol of 1 Hz, 10% stretch did not result in any significant change in the active force, specific force, pacing characteristics, and morphological features.

CONCLUSIONS

In this study, we demonstrate compatibility of a novel bioreactor system with BEHMs and the stability of the BEHMs in response to stretch protocols.

Electro-optic narrowband multi-wavelength filter in aperiodically poled lithium niobate

We report on an iterative design scheme for and the first experimental demonstration of active narrowband multi-wavelength filters based on aperiodically poled lithium niobate crystals. A simultaneous transmission of 8 wavelengths, each with a ~0.45-nm linewidth and nearly 100% peak transmittance, was achieved in such a device. The transmission spectrum of this device can be tuned by temperature at a rate of ~0.65 nm/ degrees C.

Electro-optic Ti:PPLN waveguide as efficient optical wavelength filter and polarization mode converter

We report the first experimental demonstration of electrically controlled Solc-type optical wavelength filters and TE-TM mode converters based on Ti-diffused periodically poled lithium niobate (Ti:PPLN) waveguides. A maximum mode conversion efficiency or a peak spectral transmittance of ~99% in the telecom C-L bands was obtained from a 9-mm long, 21.5-21.8-mum multiple-grating Ti:PPLN waveguide device with a switching voltage of as low as 22 V or 0.99 Vxd(mum)/L(cm), where d is the electrode separation and L is the electrode length. The spectral range of this device can be tuned by temperature at a rate of ~0.758 nm/ degrees C.

Electro-optic periodically poled lithium niobate Bragg modulator as a laser Q-switch

We report an electro-optic Bragg modulator using a periodically poled lithium niobate (PPLN) crystal. We measured a half-wave voltage of 160 V when transmitting a 1064 nm laser through a 14.2 mm long, 780 microm thick, 20.13 microm period PPLN crystal at the Bragg angle. We also demonstrated a Q-switched Nd:YVO(4) laser using such a PPLN Bragg modulator as its Q-switch, producing 7.8 ns, 201 microJ pulses at a 10 kHz repetition rate when pumped by a 19.35 W diode laser at 808 nm.

Juxtacrine function of interleukin-15/interleukin-15 receptor system in tumour derived human B-cell lines

Interleukin-15 (IL-15) is a cytokine that induces proliferation and promotes cell survival of human T, B and NK cells. IL-15 and interleukin-2 (IL-2) exhibit a similar spectrum of immune effects and share the IL-2 receptor (IL-2R) subunits IL-2Rbeta and IL-2Rgamma(c) for signalling in haematopoietic cells. Furthermore, each cytokine has a private alpha receptor, namely IL-2Ralpha for IL-2 and IL-15Ralpha for IL-15, that functions in ligand binding. Using reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) methods, the expression and secretion of IL-15 and IL-15Ralpha in tumour-derived B-cell lines were studied. The results as presented in this study identify that IL-15 mRNA is predominantly expressed in EBV positive (EBV(+)) B-cell lines, although IL-15Ralpha is ubiquitously and constitutively expressed in all these B-cell lines. Although no detectable levels of IL-15 protein secretion were observed in any of these cell lines, we were able to detect membrane-bound expression of IL-15 protein by FACS analysis in some cell lines. These data imply that the IL-15/IL-15R system requires complex regulatory mechanisms for protein secretion. Taken together, we speculate that these results suggest a juxtacrine, intracrine function for IL-15/IL-15R.

Light-enhanced electro-optic spectral tuning in annealed proton-exchanged periodically poled lithium niobate channel waveguides

We report the observation of light-enhanced electro-optic spectral tuning in annealed proton-exchanged, asymmetric domain-duty-cycle periodically poled lithium niobate (PPLN) channel waveguides for second-harmonic generation. The spectral tuning rate was increased rapidly from 0.07 nm/(kV/mm) to a saturated value of 0.32 nm/(kV/mm) in a 30%/70% domain-duty-cycle PPLN waveguide when the fundamental pump power near 1534 nm was increased from 0.6 to 46 mW. The second-harmonic laser power at 767 nm was identified to be the source enhancing the spectral tuning.

A comparison of sexual satisfaction and post-natal depression in the UK and Taiwan

AIM

To compare the sexual expression and sexual satisfaction of women in the UK and Taiwan before and after childbirth, to determine if there is an association between self reported sexual satisfaction and postnatal depression (PND) and the main sources of sexual information for women during this period.

METHOD

A comparative survey of postnatal women in the UK and Taiwan using a selfadministered questionnaire, a semi structured interview and the Edinburgh Postnatal Depression Scale (EPDS) to investigate sexual satisfaction, sexual expression and main sources of information as well the prevalence of postnatal depression.

RESULTS

Seventy per cent of the UK women and 89% of the Taiwanese women were generally satisfied with their sex life during the postnatal period although in both countries women thought that sexual expression was not as important to themselves as to their partner. There were differences in ranking criteria for physical and emotional sexual satisfaction in the two countries. Eighty-three per cent of UK women had sufficient information about sex during the postnatal period compared to 60% of Taiwanese women. There was no significant difference in the prevalence of PND (18% UK, 19% Taiwan p < 0.01 ANOVA) but significant negative associations (correlation coefficient) between 'sexual self-confidence' and PND in the UK (p < 0.01) and Taiwan (p < 0.05). UK Women with an unsatisfactory sex life (p < 0.05), insufficient sexual information (p < 0.05) and sexual worries after birth (p < 0.05) were more likely to have symptoms of PND. There was a strong association between a poor relationship with her partner and PND (p < 0.001).

CONCLUSIONS

These associations may be either a consequence of or a contributing factor to PND. The observed differences between the two countries may be attributed to cross cultural factors and differences in health care systems although further investigation is required.

Low-energy electronic properties of the AB-stacked few-layer graphites

In the presence of a perpendicular electric field, the low-energy electronic properties of the AB-stacked N-layer graphites with layer number N = 2, 3, and 4, respectively, are examined through the tight-binding model. The interlayer interactions, the number of layers, and the field strength are closely related to them. The interlayer interactions can significantly change the energy dispersions and produce new band-edge states. Bi-layer and four-layer graphites are two-dimensional semimetals due to a tiny overlap between the valence and conduction bands, while tri-layer graphite is a narrow-gap semiconductor. The electric field affects the low-energy electronic properties: the production of oscillating bands, the cause of subband (anti)crossing, the change in subband spacing, and the increase in band-edge states. Most importantly, the aforementioned effects are revealed completely in the density of states, e.g. the generation of special structures, the shift in peak position, the change in peak height, and the alteration of the band gap.

Single-longitudinal-mode, tunable dual-wavelength,CW Nd:YVO(4) laser

We report a single-longitudinal-mode CW diode-pumped Nd:YVO(4) laser emitting at both 1064 and 1342 nm with 10% optical efficiency at 20-W pump power. The measured spectral widths at 1064 and 1342 nm were less than 450 MHz and 400 MHz, respectively. The two emission wavelengths can be independently tuned over the lasing bandwidths of the dual-wavelength laser.

Identification of differentially transcribed genes in human lymphoblastoid cells irradiated with 0.5 Gy of gamma-ray and the involvement of low dose radiation inducible CHD6 gene in cell proliferation and radiosensitivity

PURPOSE

To identify candidate genes specifically involved in response to low-dose irradiation in human lymphoblastoid cells; to better clarify the role of the human chromodomain helicase DNA binding protein 6 gene (CHD6), one of these genes, in cell proliferation and radiosensitivity.

MATERIALS AND METHODS

DNA microarray technology was used to analyse global transcriptional profile in human lymphoblastoid AHH-1 cells at 4 h after exposure to 0.5 Gy of gamma-ray. Gene expression changes were confirmed by semi-quantitative reverse transcription--polymerase chain reaction (RT-PCR) and Northern blot. RNA interfering technology was employed to knock-down the CHD6 gene in A549 cells. Colony-forming ability was used to analyse radiosensitivity.

RESULTS

The microarray assay revealed a set of 0.5 Gy-responsive genes, including 30 up-regulated genes and 45 down-regulated genes. The up-regulated genes include a number of genes involved in: signal transduction pathways, e.g., STAT3, CAMKK2, SIRT1, CREM, MAPK3K7IP2 and GPR56; transcription or DNA-binding, e.g., CHD6, CRSP3, SNURF, SH2 domain binding protein 1 and MIZF. Some of the down-regulated genes are involved in: cytoskeleton and cell movement (WASF2, LCP1, MSN, NIPSNAP1, KIF2C); DNA replication and repair (MCM2, MCM3, MCM7 and XRCC-4). Radiation-increased expression of CHD6 was also found in A549 cells and HeLa cells. The sustained CHD6 induction was restricted to relatively low doses (0.2 Gy or 0.5 Gy), no change occurring after 4 Gy irradiation. Silencing of CHD6 mediated by siRNA increased the growth rate of A549 cells by 40 approximately 60%. Most importantly, silencing CHD6 led to an increased radioresistance of A459 cells to radiation doses up to 2 Gy, but barely affected the sensitivity of cells at 4 and 8 Gy.

CONCLUSION

This study has identified a set of genes responsive to 0.5 Gy of gamma-rays. CDH6 gene can be specifically up-regulated by low dose irradiation, and its inducible expression could be involved in a low dose hypersensitive response.

Enhanced terahertz-wave parametric generation and oscillation in lithium niobate waveguides at terahertz frequencies

We observed parametric-generation efficiency of 1.61% from 1064 to 1071 nm and at 162 microm in a 0.5 mm thick, 45 mm long z-cut congruent lithium niobate waveguide with a pump energy of 2.2 mJ and a pump pulse width of 5.8 ns. We also measured an ultralow-threshold intensity of 70 MW/cm2 for a 1064 nm pumped parametric oscillator resonating at 1071 nm and emitting at 162 microm with a 1 mm thick, 45 mm long lithium niobate waveguide.

Scoring system for empyema thoracis and help in management

OBJECTIVE

To evaluate the implications of a newly defined severity scoring of empyema in children for the prediction of surgical management and to compare the length of hospitalization as an outcome measure of patients treated using medical therapy, salvage video-assisted thoracoscopic surgery (VATS) vs early elective VATS.

METHODS

A retrospective chart review of parapneumonic empyema of patients below 18 years of age admitted to a tertiary children's hospital in northern Taiwan from April 1993 to December 2002 was performed. Patients were categorized into a medical group who received antibiotic therapy, needle aspirations with/without tube thoracostomy; a salvage VATS group when the patients required surgery for the relief of persistent fever > 38 degrees C, chest pains or dyspneic respirations despite initial medical therapy; an early VATS group when the patients received elective surgery early after admission. The demographic data, clinical features, laboratory findings, and duration of hospitalization were compared using a severity score of empyema (SSE).

RESULTS

Streptococcus pneumoniae was the most common infecting organism, followed by Staphylococcus aureus, Pseudomonas aeruginosa. No organisms were recovered in 39% of patients. A pleural pH < 7.1 increases the odds of requiring surgical intervention by 6 times among this cohort. Children who required decortication of empyema had a higher severity score (mean 4.8 vs 3.0, p < 0.005). The duration of hospitalization for patients having early VATS showed a shortening stay (mean 18 vs 28 days) as compared to salvage VATS.

CONCLUSION

A pleural pH < 7.1 and a newly designed clinical severity score of empyema 4 are two predictors of surgical intervention for fibrinopurulent empyema in the present study. Early elective VATS may be adopted not later than 7 days after failure of appropriate antibiotic therapy and adequate drainage of empyema to decrease the length of stay and minimize morbidity.

Interleukin-10 promoter gene polymorphisms have no clear influence on interleukin-10 protein secretion in AIDS-associated B-cell lines

Interleukin-10 (IL-10) is a pleiotropic cytokine involved in several immune responses and expressed by a variety of cell types. IL-10 interacts with at least two subunits of the IL-10 receptors (IL-10R1 and IL-10R2), which are members of the interferon receptor family, and play important roles in ligand binding and signaling. Using reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) methods, the mRNA expression and secretion patterns of IL-10 were studied. IL-10R1 and IL-10R2 mRNA expression patterns were also studied in the tumor-derived human B-cell lines. IL-10 protein is expressed and predominantly secreted by AIDS-associated B-cell lines (AABCL). However, IL-10R1 and IL-10R2 are constitutively and ubiquitously expressed in all the B-cell lines included in our study. These results suggest that B-cell IL-10 functions as an autocrine growth factor, in AABCL. Furthermore, we report that higher secretion of IL-10 observed in AABCL could be due to the specific GCC haplotype of IL-10 promoter polymorphisms, although no specific correlation was observed between IL-10 promoter polymorphisms and IL-10 protein secretion as analyzed by PCR-sequence specific primers methodology and ELISA, respectively.

Monolithic quasi-phase-matched nonlinear crystal for simultaneous laser Q switching and parametric oscillation in a Nd:YVO4 laser

We report the performance of a periodically poled lithium niobate (PPLN) crystal inside a diode-pumped Nd:YVO4 laser for simultaneous laser Q switching and optical parametric oscillation. The monolithic PPLN crystal consists of two sections, a 1-cm-long 14-microm-period electrode-coated section and a 4-cm-long 30-microm-period section, functioning as a low-voltage Pockels cell and a quasi-phase-matched parametric gain medium, respectively. At a 150-V Q-switching voltage and a 6-kHz switching rate, we measured 25-microJ pulse energy and 4-kW peak power at 1.55 microm with 9-W absorbed diode power.

Pulmonary inflammation caused by chitosan microparticles

Chitosan is a cationic biopolymer derived from chitin with potential therapeutic applications such as controlled drug delivery to mucosal-epithelial surfaces in the body. Inhaled chitosan microparticles (CM), for example, are of potential interest in pulmonary pharmacotherapy. In this context, we examine some basic reactions of lung tissue to CM. Inhaled CM (2-10 mg/kg of particles) induce dose-dependent proinflammatory effects in rat lungs; these effects are documented in increases in bronchoalveolar lavage fluid protein (BALF-P) and lactate dehydrogenase activity (BALF-LDH) and increases in lung tissue myeloperoxidase (MPO) activity and leukocyte migration. Overall, the biochemical parameters (i.e., average of BALF-P, BALF-DH, and MPO) indicate that the inflammation response is 1.8-fold greater than controls without CM; the same inflammation parameters, however, are 1.9-fold lower with CM compared with the proinflammatory effects of lipopolysaccharide (LPS). Cytological examination of BALF shows a large infiltration of polymorphonuclear neutrophils to lung tissue: more than a sixfold increase in this population of inflammatory cells, after inhalation of CM relative to air inhalation controls. Thus, the results indicate that inhaled CM can have significant proinflammatory effects on lung tissues; these effects are mild relative to LPS but need to be considered in the context of therapeutic applications via pulmonary delivery if such concentrations of CM are used.

Urinary nitric oxide metabolite changes in spontaneous and induced onset active labor

BACKGROUND

The aim of this prospective, randomized study was to investigate the changes in urinary nitric oxide (NO) metabolite between the latent and the active phases of spontaneous and either prostaglandin E(1) (PGE(1)) or prostaglandin E(2) (PGE(2))-induced labors.

METHODS

Eighty-eight singleton pregnant women at 36-41(+) weeks' gestation without signs of fetal distress were enrolled. The first group consisted of 29 pregnant women in whom labor was induced by PGE(1) applied intravaginally. The second group consisted of 29 pregnant women with labor induced by PGE(2) applied intracervically. The third group consisted of 30 women, who had spontaneous active labor. Clinical data of the three groups were assessed as labor progressed.

RESULTS

Urinary nitric oxide/creatinine (U NO/Cr) decreased significantly after the onset of active labor in all three groups (p < 0.005), with the percentage decline of 42.2%, 28.6% and 10.1%, respectively. The magnitude of the difference in decline in U NO/Cr after active labor between the PGE(1)-induced and the spontaneous labor group was significantly reduced (p = 0.0047) after adjustment for potential confounders using the generalized estimating equations test (GEE). The duration of the latent phase was significantly shortened in the PGE(1)-induced group as compared with the spontaneous labor group (p < 0.01).

CONCLUSIONS

Decreased U NO/Cr may facilitate transition from the latent to the active phase either in spontaneous or induced labors. Our results indicate that U NO/Cr can serve as an easily obtained marker for use in controlling myometrial contractility and cervical ripening at the onset of active labor. The nitric oxide system is present in the human uterus and may contribute to uterine quiescence during pregnancy and show down-regulation in U NO/Cr at the initiation of active labor.

Constitutive expression of interleukin-18 and interleukin-18 receptor mRNA in tumour derived human B-cell lines

Interleukin-18 (IL-18) is a pro-inflammatory cytokine involved in the Th1 immune response and expressed by a variety of cell types. IL-18 is a member of the IL-1 family and plays an important role in autoimmune diseases and inflammation. Using reverse transcriptase-polymerase chain reaction (RT-PCR) mRNA expression of IL-18, IL-18 receptor alpha (IL-18R alpha), and beta (IL-18R beta) were studied in tumour derived human B-cell lines. Furthermore, we investigated IL-18 protein secretion by using enzyme linked immunosorbent assay (ELISA). The results, as presented in this report, suggest that IL-18, IL-18R alpha, and IL-18R beta mRNA are constitutively and ubiquitously expressed in human B-cell lines, but secretion of the functional protein does not occur. We therefore speculate that IL-18 possibly affects B-cells through paracrine actions.

Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units: an analysis of 90 episodes

AIM

To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit.

METHODS

Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome.

RESULTS

Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76%), with prior operation or invasive procedures (39%), had an indwelling intravascular catheter (79%) and exposure to antibiotic therapy (96%). A localized cutaneous infection was found in 53.3% of the episodes. The most common clinical diagnoses were catheter-related infections (54.4%), skin and soft tissue infections (21.1%), bacteraemia without a focus (20%) and pneumonia (16.7%). Metastatic infection occurred in 18% of these infants. Among the patients treated with vancomycin for < or = 14 d, 88.7% did not develop any complications, and 11.3% developed a recurrence.

CONCLUSIONS

MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for < or = 14 d seems to be adequate.

Actively Q-switched Nd:YVO4 laser using an electro-optic periodically poled lithium niobate crystal as a laser Q-switch

We demonstrate a low-voltage and fast laser Q-switching by using an electro-optic periodically poled lithium niobate (EO PPLN) crystal. The half-wave voltage measured from the EO PPLN crystal was 0.36 V x d (microm)/L (cm), where d is the electrode separation and L is the electrode length. When a 13-mm-long EO PPLN was used as a laser Q switch at 7-kHz switching rate, we measured an approximately 12-ns pulse width and approximately 0.74-kW laser pulses at 1064-nm wavelength from a diode-pumped Nd:YVO4 laser with continuous 1.2-W pump power at 809-nm wavelength.

Different proinflammatory reactions in fatal and non-fatal enterovirus 71 infections: implications for early recognition and therapy

AIM

The mechanism of pulmonary oedema, a life-threatening manifestation of enterovirus 71 (EV71) encephalitis, is unclear. Our aim was to assess the relationship of proinflammatory cytokines to EV71-related pulmonary oedema.

METHODS

Proinflammatory responses in 33 EV71 patients with various complications and 21 normal healthy children were measured using an enzyme-linked immunosorbent assay.

RESULTS

EV71 patients with both encephalitis and pulmonary oedema were found to have much higher levels of blood interleukin-6 (IL-6) (947 +/- 1239 vs 4.9 +/- 3.1 pg/ml, p = 0.0003), tumour necrosis factor-alpha (TNF-alpha) (22.4 +/- 29.5 vs 5.3 +/- 1.0 pg/ml, p = 0.0035), interleukin Ibeta (IL-1beta) (48.4 +/- 85.2 vs 4.9 +/- 10.1 pg/ml, p = 0.01), white blood cell count (28.3 +/- 7.6 vs 15.5 +/- 6.8 10(9)/L, p > or = 0.0001) and blood glucose (501 +/- 186 vs 165 +/- 117 mg/dL, p = 0.0009) than patients with EV71 encephalitis alone. In fact, the cytokine levels in patients with encephalitis only or in those without complications were not significantly different from the levels found in normal children. The sensitivity, specificity, positive and negative predictive values of IL-6 > 70 pg/ml for EV71 encephalitis with pulmonary oedema were all 100%.

CONCLUSION

Patients with EV71-related encephalitis combined with pulmonary oedema were found to have significantly elevated levels of proinflammatory cytokines and the best predictor for this complicated condition was found to be the level of serum IL-6.

School-aged children with Kawasaki disease: high incidence of cervical lymphadenopathy and coronary artery involvement

OBJECTIVE

We describe 10 school-aged children with Kawasaki disease (KD) with a high incidence of cervical lymphadenopathy and coronary abnormality.

METHODS

Based on a database of 1002 children with KD in Chang Gung Children's Hospital from January 1983 to March 2001, 10 (1%) school-aged patients (five boys, five girls) who met the diagnostic criteria of KD were included for analysis.

RESULTS

Cervical lymphadenopathy was noted in all (100%) of these patients. Unilateral neck mass mimicking acute suppurative infections not responding to antibiotic therapy was the initial presentation in nine (90%) of the 10 patients. The mean interval between disease onset and diagnosis was 9.9 +/- 3.3 days (range, 6-15 days). Seven (70%) of these patients responded to one course of high-dose intravenous immunoglobulin (IVIG) therapy (2 g/kg) and oral aspirin (80-100 mg/kg per day), two (20%) required a second course of IVIG, and one (10%) responded to high-dose aspirin treatment only. Coronary artery abnormality (dilatation or aneurysm) was documented by echocardiography in seven (70%) patients (four boys, three girls). In six patients, the coronary artery abnormalities resolved in 1 year, while one patient had persistent right coronary artery aneurysm, which necessitated continued anticoagulant and low-dose aspirin therapy.

CONCLUSION

The incidence of school-aged children among patients with KD is about 1% in our hospital. These patients are notable for the high incidence of initial manifestations of unilateral neck mass and coronary artery involvement. This disease should be listed as the differential diagnosis in school-aged children presenting with fever and neck mass that do not respond to antibiotic therapy.

Nonlinear multiwavelength conversion based on an aperiodic optical superlattice in lithium niobate

We have demonstrated what is to our knowledge the first successful achievement of multiwavelength conversion in an aperiodic optical superlattice (AOS) lithium niobate crystal with equalized gain. The two AOS devices in our experiment, numerically synthesized from 2857 crystal blocks with a unit block thickness of 3.5 microm, have fundamental wavelengths of 1540 and 1545 nm for double-wavelength second-harmonic generation (SHG) and of 1540, 1545, and 1553 nm for triple-wavelength SHG at 50 degrees C. Our experiment and simulation show that the output spectrum of an AOS wavelength converter is fairly insensitive to typical fabrication errors.