320-detector row CT coronary angiography: effects of heart rate and heart rate variability on image quality, diagnostic accuracy and radiation exposure

OBJECTIVES

To evaluate the effects of heart rate and heart rate variability on image quality, patient dose and diagnostic accuracy of 320-detector row CT.

METHODS

94 patients were prospectively enrolled. Heart rate was defined as the mean value of different intervals elapsing between two consecutive R waves in an electrocardiogram (R-R intervals) and the heart rate variability was calculated as the standard deviation from the average heart rate. The image quality was evaluated by four grades, according to motion artefacts ("step artefacts" and "blurring artefacts"). The diagnostic accuracy was analysed in 43 patients who were scheduled for invasive coronary angiography (ICA). The coeffects of heart rate and heart rate variability on image quality, radiation dose and diagnostic accuracy were evaluated by multivariate regression.

RESULTS

The mean image quality score was 1.2 ± 0.5 and the mean effective dose was 14.8 ± 9.8 mSv. The results showed that heart rate (74.0 ± 11.2 beats per minute) was the single factor influencing image quality (p<0.001) and radiation dose (p<0.001), while heart rate variability (3.7 ± 4.6) had no significant effect on them (p=0.16 and p=0.47, respectively). For 43 patients who underwent ICA, heart rate and heart rate variability showed no influence on the accuracy (p=0.17 and p=0.12, respectively). Overall sensitivity was 97.4% (37/38), specificity was 99.4% (351/353), positive predictive value was 94.9% (37/39) and negative predictive value was 99.7% (351/352).

CONCLUSION

320-detector row CT, with improved longitudinal coverage of detector, resolves step artefact and high patient dose caused by irregular heart rate. However, it is still recommended to control heart rate to a lower level to eliminate blurring artefact and radiation dose.

Genetic variants on 17q21 are associated with asthma in a Han Chinese population

A genome-wide study has shown an association between SNPs located on 17q21 and asthma. Such associations have been identified in several populations, but little is known about the Han Chinese population. We conducted a case-control study in a Han Chinese population to investigate the relationship between SNPs located on 17q21 and asthma; 241 asthmatic patients and 212 healthy controls were recruited from the outpatient clinics of the Nanfang Hospital, Guangdong Province, southern China. We genotyped six SNPs (rs8067378, rs8069176, rs2305480, rs4795400, rs12603332, and rs11650680) located on 17q21 with the Sequenom MassARRAY iPLEX platform. For two of these six loci (rs2305480 and rs8067378), there was evidence of association with asthma, and there was a weak association of asthma with rs8069176. We confirm that genetic variants on 17q21 are associated with asthma in the Han Chinese population.

High magnetic field quantum transport in Au nanoparticle-cellulose films

We report the magneto-transport properties of cellulose films comprising interconnected networks of gold nanoparticles (Au NPs). Cellulose is a biopolymer that can be made electrically conducting by cellulose regeneration in Au NP dispersions. The mechanism of electronic conduction in the Au-cellulose films changes from variable range hopping to metallic-like conduction with decreasing resistivity. Our experiments in high magnetic fields (up to 45 T) reveal negative magnetoresistance in the highly resistive films. This is attributed to the spin polarization of the Au NPs and the magnetic field induced suppression of electron spin flips during spin-polarized tunneling in the NP network.

T helper 17 cells and regulatory T-cell imbalance in paediatric patients with asthma

Asthma is a chronic inflammatory disorder of the lung, which is thought to be determined by the balance between the T helper (Th)2 and Th1 responses. This study evaluated whether the balance between Th17 cells and regulatory T cells (T(reg)) was impaired in asthma patients. The proportion of peripheral blood Th17 cells of the total CD4(+) cell population in asthma patients was significantly higher than in controls (mean ± SD 0.72 ± 0.5% versus 0.31 ± 0.4%, respectively). The proportion of peripheral T(reg) cells in asthma patients was significantly lower than in controls (mean ± SD 12.1 ± 4.6% versus 27.2 ± 7.5%, respectively). Analysis of mRNA generally confirmed the flow cytometry data, suggesting that the changes in cytokine levels were mediated at the transcription level. In paediatric asthma patients, the CD4(+) T-cell phenotype was skewed toward the Th17 phenotype, suggesting that a Th17/T(reg) functional imbalance plays a role in asthma.

Dynamical changes of ion current distribution for a Penning discharge source using a Langmuir probe array

A paralleled plate electrode and a 9-tip Langmuir probe array located 1 mm behind the extraction exit of a cold cathode Penning ion source are employed to measure the total current and the dynamical changes of the ion current in the 2D profile, respectively. Operation of the ion source by 500 V DC power supply, the paralleled plate electrode and the Langmuir probe array are driven by a bias voltage ranging from -200 V to 200 V. The dependence of the total current and the dynamical changes of the ion current in the 2D profile are presented at the different bias voltage. The experimental results show that the distribution of ion current is axial symmetry and approximate a unimodal distribution.

Characteristic of a triple-cathode vacuum arc plasma source

In order to generate a better ion beam, a triple-cathode vacuum arc plasma source has been developed. Three plasma generators in the vacuum arc plasma source are equally located on a circle. Each generator initiated by means of a high-voltage breakdown between the cathode and the anode could be operated separately or simultaneously. The arc plasma expands from the cathode spot region in vacuum. In order to study the behaviors of expanding plasma plume generated in the vacuum arc plasma source, a Langmuir probe array is employed to measure the saturated ion current of the vacuum arc plasma source. The time-dependence profiles of the saturated current density of the triple vacuum arc plasma source operated separately and simultaneously are given. Furthermore, the plasma characteristic of this vacuum arc plasma source is also presented in the paper.

The dependence of extracted current on discharge gas pressure in neutral beam ion sources on HL-2A tokamak

The discharge gas pressure is a key factor to influence the extracted current of ion source. In this paper, the dependence of extracted current on discharge gas pressure was investigated in detail at different arc discharge currents. The discharge gas pressure with a very broad range (0.1 Pa-2.7 Pa) was scanned for the first time. It is turned out that, with the increasing of discharge gas pressure, the extracted current increases and the arc voltage decreases at different arc currents; however, when the discharge gas pressure exceeds a certain value, the extracted current decreases. For the same discharge gas pressure, the higher the arc current, the higher the arc voltage and the extracted current are. The arc efficiency was also calculated, and its dependence on gas pressure was almost the same with the dependence of extracted current on gas pressure, but at the same discharge gas pressure, the lower the arc current, the higher the arc efficiency is and the lower the extracted current is.

Are bone mineral density loci associated with hip osteoporotic fractures? A validation study on previously reported genome-wide association loci in a Chinese population

Osteoporosis is a heritable disease characterized mainly by low bone mineral density (BMD) and/or osteoporotic fractures (OF). Most genome-wide association studies on osteoporosis have focused on BMD, whereas little effort has been expended to identify genetic variants directly linked to OF. To determine whether BMD-loci are also associated with OF risk, we performed a validation study to examine 23 BMD-loci reported by recent genome-wide association studies for association with hip OF risk. Our sample consisted of 700 elderly Chinese Han subjects, 350 with hip OF and 350 healthy matched controls. We identified four BMD-loci that were significantly associated with hip OF in this Chinese population, including 7q21 (FLJ42280, P = 1.17 × 10(-4) for rs4729260; P = 0.008 for rs7781370), 6p21 (MHC, P = 0.004 for rs3130340), 13q14 (TNFSF11, P = 0.012 for rs9533090; P = 0.018 for rs9594759; P = 0.020 for rs9594738; P = 0.044 for rs9594751), and 18q21 (TNFRSF11A, P = 0.015 for rs884205). The SNP rs4729260 at 7q21 remained significantly associated, even after conservative Bonferroni's correction. Our results further highlight the importance of these loci in the pathogenesis of osteoporosis, and demonstrate that it is feasible and useful to use OF as the direct phenotype to conduct genetic studies, to enhance our understanding of the genetic architecture of osteoporosis.

Quantification of the human lateral geniculate nucleus in vivo using MR imaging based on morphometry: volume loss with age

BACKGROUND AND PURPOSE

Because it is a small subcortical structure, the precise measurement of the human LGN is still a technical challenge. In this article, we identify the LGN in vivo, measure its volume based on high-resolution MR imaging, and then relate its volume to subject age to evaluate the potential clinical application.

MATERIALS AND METHODS

A semiautomatic LGN isolation method was developed on scans obtained with 1.5T MR imaging, which involves highlighting the surrounding landmarks, obtaining candidate LGN voxels with a region-growing algorithm, and isolating the LGN from the ventral diencephalon. The method was accessed with a test-retest reliability on the results from 55 healthy subjects at different ages.

RESULTS

This method showed high test-retest within-subject reliability (ICC, 0.950 and 0.948 in left and right hemispheres, respectively) among 3 independent measurements in each subject. The unilateral volume was highly variable, ranging from 52 to 102 mm(3) in the left and 66 to 105 mm(3) in the right hemisphere, with significantly larger volumes on the right (86 mm(3)) than on the left (77 mm(3)). The combined bilateral volumes (controlled for ICV) significantly decreased in size with progressing age from 20 to 65 years (r = -0.512, P = .000). There was no sex difference in bilateral LGN volumes (male/female: 163.1 ± 18.2/162.2 ± 21.4 mm(3)).

CONCLUSIONS

Using our new technique, we were able to reliably determine the human LGN volume in vivo, which was found to decline with age. The volumes obtained by our method corresponded well with previously reported postmortem values, so our method may be considered to be superior for investigating the pathology of LGN.

Mutations analysis in filaggrin gene in northern China patients with atopic dermatitis

BACKGROUND

Recently, we have reported filaggrin mutations (FLG) of atopic dermatitis in southern China. However, there have been few detailed reports of FLG mutations of patients with AD in northern China by now.

OBJECTIVES

The present aim was to establish the mutation spectrum of FLG gene in AD patients in northern China.

METHODS

A total of 339 cases met Hanifin and Rajka diagnostic criteria of AD were recruited. A comprehensive sequencing of the entire FLG coding region in these patients was conducted. All detected FLG null mutations were screened in a cohort of 301 normal controls.

RESULTS

Seven novel mutations (478insA, Q1070X, 4026delT, Q1712X, Q2397X, 7145del4 and 8001del4) and eleven reported mutations (3222del4, 3321delA, 4271delAA, S1515X, Q1790X, 5757del4, 6834del5, Q2417X, E2422X, 7945delA and K4671X) in AD were identified. Mutations 3321delA and K4671X were two of the most common mutations in AD. FLG null mutations were present in 26.0% of AD patients. FLG null alleles (compound genotypes) were significantly higher in AD (P < 0.001) than in the controls. The compound genotypes for all FLG variants were significantly associated with IV (P < 0.001) and palmar hyperlinearity (P < 0.001). The common mutation, K4671X, was significantly associated with AD-coexistent allergic rhinitis (P = 0.005).

CONCLUSIONS

Our study increases the total number of FLG mutations. We clearly demonstrated that FLG loss-of-function mutations were significantly associated with AD in northern China. The FLG null mutations in the Chinese population differed not only from that in the European population but also from that in sub-populations of Asians outside of the Chinese mainland.

The effect of pressure pad location of spinal orthosis on the treatment of adolescent idiopathic scoliosis (AIS)

Patient with moderate AIS is usually prescribed with spinal orthosis aiming to mechanically support and prevent the spine from further deterioration. In the conventional fitting method, pre-brace X-ray is the main reference, thus, the pressure pad of spinal orthosis may not be accurately located to the strategic areas because the spinal deformities could change 3-dimensionally once pressure pad is applied. A high correlation (r > 0.98) between Cobb's angle and spinous process angle (SPA) was found in the recent studies. With the advancements of 3D clinical ultrasound (3D CUS), tracing SPA along a scoliotic spine becomes possible and this can be used to estimate Cobb's angle. This study aimed to evaluate the effect of pressure pad location of spinal orthosis in the treatment of AIS and 3D CUS was used to trace SPA for estimation of Cobb's angle. The in-brace X-rays were assessed for confirmation of treatment effectiveness. The subjects were divided into ultrasound-guided fitting group A (n=21) and conventional fitting group B (n=22). In the group A, pressure pads were tested at 5 locations - the prescribed location as in the conventional fitting (referred to the pre-brace X-ray), and 1 cm and 2 cm above and below the prescribed location, and 3D CUS was applied to trace the SPA in these 5 pad locations, and the pad location with the lowest estimated Cobb's angle was selected in the final fitting. The assessments of in-brace X-rays showed that the mean Cobb's angle of group A decreased from 28.9° (pre-brace) to 18.6° (immediate in-brace) while the mean Cobb's angle of group B decreased from 27.1° (pre-brace) to 22.5° (immediate in-brace). There was a significant difference (p < 0.05) in the correction of Cobb's angle between the two groups. The results showed that accurate pressure pad location does play an important role in the reduction of Cobb's angle and 3D CUS can be considered as a non-invasive and effective assessment tool to improve orthotic treatment of AIS.

Hydatidiform mole in a perimenopausal and primary infertility patient: case report

We present a case of a 56-year-old woman with primary infertility who complained of amenorrhea for five months and vaginal bleeding for two months. Initially she was misdiagnosed with endometrial cancer due to her disease history and older age, but eventually a diagnosis of complete hydatidiform mole was confirmed and then laparoscopic total hysterectomy was performed. The patient has been followed-up as an outpatient for more than one year, and hads an excellent prognosis. To our knowledge, this is the first case of hydatidiform mole in a woman with primary infertility during the perimenopausal stage. Even though hydatidiform mole is rare in primary infertility patients during perimenopause, it should always be considered in case of misdiagnosis.

Transumbilical single-port laparoscopic hysterectomy using traditional laparoscopic instruments: a report of 20 cases

PURPOSE OF INVESTIGATION

We studied 20 cases of transumbilical single-port laparoscopic hysterectomy (TSPLH) to evaluate the feasibility and safety of the TSPLH.

METHODS

Perioperative items and complications were observed: mean operation time, blood loss, gas pass time, out of bed activity time, postoperative analgesic rate, pain perception by visual analogue score (VAS), port site infection, hospital stay, postoperative fever rate and patient satisfaction score were measured.

RESULTS

All procedures were performed successfully, and no case was transferred to 4-port laparoscopic hysterectomy (LH). No postoperative complication occurred during the period of two month follow-up.

CONCLUSION

TSPLH is a feasible and safe method for hysterectomy, although it may be little more time consuming. Nonetheless, it is welcomed by patients who are more concerned about cosmetic outcomes. Future studies are needed to improve the instruments to shorten the surgery time and confirm its advantages.

Pro-inflammatory cytokine-stimulated first trimester decidual cells enhance macrophage-induced apoptosis of extravillous trophoblasts

OBJECTIVE

As human blastocyst-derived extravillous trophoblasts (EVTs) invade the early decidua, they are positioned to interact with immune cells and resident decidual cells, and remodel spiral arteries into high capacity vessels that increase blood flow to the developing fetal-placental unit. Shallow EVT invasion elicits incomplete vascular transformation and reduces uteroplacental blood flow that presages adverse pregnancy outcomes. Excess macrophages in the decidua induce EVT apoptosis via tumor necrosis factor-alpha (TNF-α) secretion. Our previous observation that pro-inflammatory cytokines enhance neutrophil and macrophage activator granulocyte-macrophage colony-stimulating factor (GM-CSF) expression in first trimester decidual cells is now extended to include: (1) the specific macrophage activator M-CSF; (2) macrophage activation and subsequent enhancement of EVT apoptosis by both GM-CSF and M-CSF.

STUDY DESIGN

Quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay assessed M-CSF expression in first trimester decidual cells incubated with interleukin-1 beta (IL-1β) or TNF-α. Peripheral monocyte-derived macrophages pre-incubated with conditioned media from decidual cell cultures were co-cultured with a first trimester EVT cell line, HTR-8/SVneo cells. Macrophage activation was examined and EVT apoptosis evaluated by DNA fragmentation, caspase activation and cell membrane asymmetry.

RESULTS

IL-1β or TNF-α significantly enhanced M-CSF expression in first trimester decidual cells. The conditioned media from these cultures activates macrophages, which promote caspase 3/7-dependent EVT apoptosis with antibodies against GM-CSF or M-CSF blocking this effect.

CONCLUSIONS

Pro-inflammatory cytokines increases synthesis of M-CSF in first trimester decidual cells. Both GM-CSF and M-CSF activate macrophages, which initiate caspase-dependent EVT apoptosis.

Association of apolipoprotein A5 gene polymorphisms and serum lipid levels

BACKGROUND AND AIMS

Apolipoprotein (APO) A5 gene polymorphisms have been associated with increased plasma triglyceride (TG), but the results are inconsistent. The present study was undertaken to detect the APOA5 gene polymorphisms and their associations with lipid profiles in the Guangxi Hei Yi Zhuang and Han populations.

METHODS AND RESULTS

Genotyping of the APOA5 -1131T>C, c.553G>T and c.457G>A was performed in 490 subjects of Hei Yi Zhuang and 540 participants of Han Chinese aged 15-89 years. The -1131C allele frequency was higher in high total cholesterol (TC) than in normal TC subgroups in both the ethnic groups (P<0.05). The c.553T allele frequency was higher in high TG than in normal TG subgroups (P<0.01), in high APOB than in normal APOB subgroups in Hei Yi Zhuang (P<0.05), or in females than in males in Han (P<0.01). The c.457A allele frequency in Han was higher in high TG than in normal TG subgroups, in low APOA1 than in normal APOA1 subgroups, in males than in females, or in normal APOB than in high APOB subgroups (P<0.05-0.01). The levels of TC, low-density lipoprotein cholesterol and APOB in Hei Yi Zhuang were correlated with -1131T>C genotype or allele, and the levels of TG were associated with c.553G>T genotype (P<0.05). The levels of TG, APOA1 and APOB in Han were correlated with c.457G>A genotype or allele, and the levels of TC were associated with -1131T>C allele (P<0.05).

CONCLUSIONS

The differences in the lipid profiles between the two ethnic groups might partly result from different APOA5 gene-environmental interactions.