Deliberate parent artery occlusion for non-saccular posterior cerebral artery aneurysms

Posterior cerebral aneurysms are rare vascular lesions and usually present as non-saccular or dissecting in nature. We present a retrospective review of our experience in the deliberate parent artery occlusion of posterior cerebral artery (PCA) aneurysms.From June 2006 to June 2010, 12 patients (seven men, five women) with posterior cerebral artery non-saccular aneurysms presented to our department and were treated by parent artery occlusion. There were eight (66.7%) aneurysms located at the P2 segment, two (16.7%) at the P2-3 junction, one (8.3%) at the P1-2 junction and one (8.3%) at the P3 segment. Ten of the 12 patients were treated by aneurysm together with parent artery occlusion and two were treated by proximal occlusion.The procedure was technically successful in all cases. Angiography was performed immediately after the procedure in all patients and showed occlusion of the parent vessel with no filling of the aneurysm. Only one patient (8.3%) developed procedure-related transient hemianopsia and recovered within one month. The other 11 patients showed no additional neurological symptoms after procedure. Deliberate parent artery occlusion by detachable coils appears to be well tolerated for P2 or distal segment of PCA in our limited case series. We propose that this technique could be a good treatment option in treating non-saccular aneurysms in this location.

Isolation and characterization of 21 novel polymorphic microsatellite loci in the Chinese soft-shelled turtle Pelodiscus sinensis

Twenty-one novel polymorphic microsatellite loci were isolated from the Chinese soft-shelled turtle, Pelodiscus sinensis (Trionychidae). This is a commonly consumed Asian species, especially in China, where it is reared in large numbers on farms. We screened 34 unrelated individuals from Wuhu of Anhui province in China and detected high levels of polymorphism for all 21 loci, with the number of alleles/locus ranging from 5 to 23 (mean 15.67). The expected and observed heterozygosities ranged from 0.421 to 0.946 and from 0.324 to 0.941, respectively. Hence, these microsatellites could facilitate studies on genetic diversity and population structure and marker-assisted breeding of this vulnerable species.

Minimum effective plasma concentration of efavirenz in treatment-naïve Chinese HIV-infected patients

To assess the relationship between mean efavirenz (EFV) plasma concentration and clinical effect during the first 48 weeks of combination antiretroviral therapy (cART), the baseline CD4 cell count was recorded and plasma EFV concentration and CD4 cell count were measured every 12 weeks. HIV-RNA viral load was determined in the 48th week of cART. In total, 42 subjects were recruited and grouped according to their mean concentration of EFV during the study period: groups A, B and C with EFV concentrations (mean) <2 mg/L (1.8 mg/L), 2-4 mg/L (2.9 mg/L) and >4 mg/L (5.5 mg/L), respectively. The CD4 cell counts in group C increased more quickly than in groups B and A, although this was not statistically significant (211 ± 176/μL versus 151 ± 145/μL and 172 ± 105/μL, respectively; P = 0.799). Groups B and C had higher rates of HIV viral load suppression than group A (P = 0.017). For treatment-naïve Chinese HIV-infected patients, EFV plasma concentrations above 2 mg/L appear to suppress HIV replication more effectively than concentrations below 2 mg/L.

Improving fatigue damage resistance of alumina through surface grading

Porcelain-veneered alumina crown restorations often fail from bulk fracture resulting from radial cracks that initiate at the cementation surface with repeated flexure of the stiffer crown layers on the soft dentin support. We hypothesized that bulk fracture may be substantially mitigated by grading the elastic modulus at the crown surfaces. In this study, we fabricated graded structures by infiltrating glass into dense alumina plates, resulting in a diminished modulus at the surface layers. The plates were then bonded to polycarbonate substrates and subjected to fatigue loading in water. Tests were terminated when fracture occurred at the cementation tensile surface or at the fatigue endurance limit (1 million cycles). Infiltrated specimens showed a significant increase in fatigue fracture loads over non-infiltrated controls. Our results indicate that controlled elastic gradients at the surface could be highly beneficial in the design of fracture-resistant alumina crowns.

Antenatal taurine supplementation for improving brain ultrastructure in fetal rats with intrauterine growth restriction

Changes in brain ultrastructure of fetal rats with intrauterine growth restriction (IUGR) were explored and the effects of antenatal taurine supplementation on their brain ultrastructure were determined. Fifteen pregnant rats were randomly divided into three groups: control group, IUGR model group and IUGR group given antenatal taurine supplements. Taurine was added to the diet of the taurine group at a dose of 300 mg/kg/d from 12 days after conception until natural delivery. Transmission electron microscopy was used to observe ultrastructural changes in the brains of the newborn rats. At the same time, brain cellular apoptosis was detected using TUNEL, and the changes in protein expression of neuron specific enolase and glial fibrillary acidic protein were analyzed using immunohistochemistry. The results showed that: 1) The average body weight and cerebral weight were significantly lower in the IUGR group than in the control group (p<0.01) and both of them were less so after taurine was supplemented (p<0.01). 2) Transmission electron microscopy revealed that brain cortex structures were sparse IUGR rats, showing many scattered apoptotic cells, decreased numbers of synapses, lower glial cell proliferation, and fewer neurons, more sparsely arranged, while these factors were significantly improved with taurine supplementation. 3) The results of TUNEL showed that the counts of apoptotic brain cells in IUGR groups were significantly increased from those in control groups and that taurine could significantly decrease brain cell apoptosis (p<0.001). 4) The results of immunohistochemistry showed that antenatal taurine-supplementation could significantly increase the counts of neuron specific enolase and glial fibrillary acidic protein immunoreactive cells in fetal rats with IUGR (p<0.001). It can be concluded that it IUGR has a significant detrimental influence on the development of fetal rat brains, and antenatal supplement of taurine can significantly improve the IUGR fetal brain development.

H63D polymorphism in the hemochromatosis gene is associated with sporadic amyotrophic lateral sclerosis in China

BACKGROUND AND PURPOSE

The H63D polymorphism in the hemochromatosis (HFE) gene has been reported as a risk factor for amyotrophic lateral sclerosis (ALS) in Europe and America, but no data have been reported for Asia. Here, we investigated the possible association between H63D and sporadic ALS (sALS) in a Chinese Han population.

METHODS

A total of 195 individuals with sALS from three centers in China and 405 unrelated healthy controls were recruited. All subjects were genotyped by restriction fragment length polymorphism (RFLP) analysis.

RESULTS

Sporadic ALS was significantly related to the H63D polymorphism in heterozygous carriers (odds ratio 3.10, 95%CI: 1.49-6.47, P=0.002).

CONCLUSIONS

The HFE H63D polymorphism may contribute to the development of sALS in Chinese.

Matrix metalloproteinase levels in acute aortic dissection, acute pancreatitis and other abdominal pain

BACKGROUND

Acute aortic dissection (AAD) is a life-threatening emergency. Patients with AAD who have abdominal pain are easily confused with patients with surgical acute abdomen. Matrix metalloproteinases (MMPs) play an important role in the pathophysiology of AAD. This study was undertaken to compare serum MMP-9 levels in patients with acute abdomen and those with AAD presenting as abdominal pain in the emergency department.

METHODS

Blood samples were collected within 1 h and 24 h after admission to the emergency department. Serum levels of MMP-9, lipoprotein (a) (LP(a)) and high-sensitivity C-reactive protein (hsCRP) were measured in 20 healthy controls, 20 patients with acute pancreatitis, 20 with other acute abdomen and 20 patients with AAD with abdominal pain by enzyme-linked immunosorbent assay and immunoturbidimetric assay, respectively.

RESULTS

Serum MMP-9, LP(a) and hsCRP levels were significantly higher in the three groups of patients than in the healthy controls, with no significant fluctuation within 24 h of admission in any group. Mean serum MMP-9 levels in patients with acute pancreatitis (768 (95% CI 651 to 885) ng/ml within 1 h; 708 (95% CI 677 to 740) ng/ml at 24 h) were significantly higher than in patients with other acute abdomen (244 (95% CI 182 to 266) ng/ml within 1 h; 259 (95% CI 219 to 299) ng/ml at 24 h) and lower than in patients with AAD (1052 (95% CI 921 to 1183) ng/ml at 1 h; 1107 (95% CI 973 to 1241) ng/ml at 24 h) (all p<0.05). No significant difference was detected in serum LP(a) and hsCRP levels among the three groups of patients.

CONCLUSIONS

Patients with AAD who have abdominal pain have significantly higher serum MMP-9 levels than patients with surgical acute abdomen.

Distinct differences in tachykinin gene expression in ulcerative colitis, Crohn's disease and diverticular disease: a role for hemokinin-1?

BACKGROUND

In the intestine, the tachykinins substance P (SP) and neurokinin A (NKA) are found in neurons and have key roles in motility, secretion, and immune functions. A new tachykinin, hemokinin (HK-1), has been identified in non-neuronal cells in recent years and its role in intestinal inflammation is unclear. We aimed to examine the expression of genes encoding tachykinin peptides and receptors in colon from patients with ulcerative colitis (UC), Crohn's disease (CD), and acute diverticular disease (DD).

METHODS

Human colon segments were dissected into mucosa and muscle, and evaluated for tachykinin and tachykinin receptor gene expression by real-time PCR.

KEY RESULTS

In UC mucosa, the TAC4 gene (encoding HK-1) was 10-fold more abundant than in control mucosa (P < 0.01). Similarly, TAC1 (encoding SP and NKA) and TACR1 (encoding NK1 receptor) displayed 6-fold and 12-fold upregulation, respectively, in UC mucosa, but no change occurred in UC muscle. In contrast to UC, no difference was observed for any tachykinin genes in CD mucosa. In CD muscle, expression of TAC1 (P < 0.01), TAC4 and TACR1 (both P < 0.05) were moderately upregulated. In DD, there was a decrease in TACR1 (P < 0.05), and TACR2 (encoding NK2 receptor, P < 0.0001) in muscle compared with control. Histological staining showed increased collagen fibers between muscle bundles in DD smooth muscle.

CONCLUSIONS & INFERENCES

We provide evidence for the first time that HK-1, like SP, may be involved in the pathophysiology of inflammatory bowel disease. Distinctly different expression patterns of tachykinin-related genes occur in UC, CD and DD.

Simultaneous operation of concomitant diseases in the esophagus and lung

The aim of this study was to retrospectively review our experience of performing simultaneous operations on concomitant diseases in the esophagus and lungs. From January 1998 to July 2009, simultaneous operations were performed on 13 patients with concomitant esophageal and pulmonary diseases, using coordinated surgical approaches. Among the 13 patients, six had primary cancers in the esophagus and lungs, five had primary esophageal cancer accompanied by a benign pulmonary disease, one had benign diseases in both esophagus and lung, and one had primary esophageal cancer with metastasis to the left lower lung. All patients survived the operations. Two major complications occurred postoperatively. One complication was bronchopleural fistula and the other was intrathoracic gastric laceration. Both patients recovered after additional treatments. Simultaneous operation of concomitant diseases in the esophagus and lungs is feasible and safe in selected patients who have received careful preoperative assessment, well-designed surgical approach, and proper perioperative management.

Age-associated differences in the inhibition of mitochondrial permeability transition pore opening by cyclosporine A

BACKGROUND

Inhibiting mitochondrial permeability transition pore (mPTP) opening is a key protection of the myocardium from ischemia/reperfusion (I/R) injury. Here, we investigated age-associated differences in the ability of cyclosporine A (CsA) to protect the heart and to modulate mPTP opening during I/R injury in vivo and its opening induced by reactive oxygen species (ROS) in vitro.

METHODS

Fischer 344 male rats were assigned from their respective age groups, young or old groups, to (1) I/R or (2) I/R+CsA. All animals were subjected to 30 min of ischemia following 120 min of reperfusion to determine myocardial infarct size in vivo. To measure mPTP opening in vivo, left ventricular tissues were collected 10 min after reperfusion and nicotinamide adenine dinucleotide (NAD(+)) levels were measured. In parallel experiments, rat ventricular myocytes were prepared from young and old hearts, loaded with tetramethylrhodamine ethylester and then subjected to oxidative stress in the presence or absence of CsA, and the mPTP opening time was measured using laser scanning confocal microscopy.

RESULTS

CsA reduced myocardial infarct size in young I/R rats. Whereas CsA failed to significantly affect myocardial infarct size in old I/R rats, NAD(+) levels were better preserved in young CsA-treated rats, but this relative improvement was not observed in old rats. CsA also significantly prolonged the time necessary to induce mPTP opening in young cardiomyocytes, but not in cardiomyocytes isolated from the old rats.

CONCLUSIONS

mPTP regulation is dysfunctional in the aged myocardium and this could account for loss of cardioprotection with aging.

High resolution transmission electron microscope observation of zero-strain deformation twinning mechanisms in Ag

We have observed a new deformation-twinning mechanism using the high resolution transmission electron microscope in polycrystalline Ag films, zero-strain twinning via nucleation, and the migration of a Σ3{112} incoherent twin boundary (ITB). This twinning mechanism produces a near zero macroscopic strain because the net Burgers vectors either equal zero or are equivalent to a Shockley partial dislocation. This observation provides new insight into the understanding of deformation twinning and confirms a previous hypothesis: detwinning could be accomplished via the nucleation and migration of Σ3{112} ITBs. The zero-strain twinning mechanism may be unique to low staking fault energy metals with implications for their deformation behavior.

Protective role of HO-1 for alcohol-dependent liver damage

BACKGROUND/AIMS

Alcoholic liver disease is continuously increasing in developed countries being a leading cause of death worldwide. Chronic ethanol consumption induces oxidative stress by accumulation of reactive oxygen intermediates (ROI) while reducing the cellular antioxidant defense. Induction of heme oxygenase-1 (HO-1) may protect primary human hepatocytes (hHeps) from such damage. Thus, the aim of this study was to investigate the potential of polyphenols to protect hHeps from ethanol-dependent oxidative damage.

METHODS

hHeps were isolated by collagenase perfusion. ROI and cellular glutathione (GSH) were measured by fluorescent-based assays. Cellular damage was determined by lactate dehydrogenase (LDH) leakage and staining for apoptosis and necrosis. Nuclear translocation of Nrf2 and HO-1 expression were analyzed by Western blot.

RESULTS

Ethanol and TGF-β rapidly increase ROI and reduce GSH in hHeps, causing apoptosis with a release of approximately 40% total LDH after 72 h. Similar to incubation with hemin preincubation and co-incubation of cells with nifedipine, verapamil and quercetin significantly reduce oxidative stress and resulting cellular damage, in a dose-dependent manner, by initiating nuclear translocation of Nrf2 which in turn induces HO-1 under the control of p38 and ERK. Blocking of HO-1 activity with ZNPP9 reverses the protective effect of all three substances.

CONCLUSION

Our results suggest that increasing HO-1 activity in hHeps protects them from oxidative stress-dependent damage. As polyphenols have great potential to induce HO-1 expression, they may play an important role for future therapeutic strategies to protect liver from oxidative stress-dependent damage observed during chronic alcohol consumption.

Pharmacokinetics of verapamil in diabetic rats induced by combination of high-fat diet and streptozotocin injection

The aim of this study was to investigate effects of type 2 diabetes on the pharmacokinetics of verapamil after intravenous administration. Diabetes mellitus (DM) rats were induced by combination of high-fat diet (HFD) and streptozotocin. Plasma concentrations of verapamil in DM rats, rats fed with HFD, and control (CON) rats were measured after intravenous administration of 1 mg/kg verapamil and corresponding pharmacokinetic parameters were estimated. Area under the plasma concentration in DM rats was significantly smaller than that in CON rats. In vitro microsomal study showed that intrinsic clearance of verapamil in DM rats was significantly higher than those in CON rats. Compared to CON rats, higher intrinsic clearance was also observed in HFD rats. Western blot results demonstrated higher levels of CYP3A2 in DM and HFD rats, which was in line to activity of CYP3A. All the results gave a conclusion that diabetes may enhance metabolism of verapamil in rat, and the enhancement may partly result from induction of CYP3A.

A clinical case-control study on the association between mannose-binding lectin and susceptibility to HIV-1 infection among northern Han Chinese population

Mannose-binding lectin (MBL) is a key molecule of the innate immune system and a competent to bind carbohydrates of a variety of microorganisms, resulting in complement activation and opsonophagocytosis against various pathogens. However, there is no systemic investigation on the MBL's role in innate immune responses against HIV-1 infection among northern Han Chinese. This study investigated the association between MBL and HIV-1 infection susceptibility among northern Han Chinese. A total of 91 HIV-1 infected patients and 91 HIV-1 seronegative healthy individuals were recruited. Six polymorphisms of MBL2 gene were genotyped by pyrosequencing. The quantitative measurement of serum MBL concentration and MBL complex activity were performed by ELISA. The CD4+ T-cell counts were determined by flow cytometry. The plasma viral loads of 91 HIV-1 infected patients were determined by bDNA method. The results show that there is an association between MBL and HIV-1 infection susceptibility among northern Han Chinese. The individuals with B variant, low serum MBL concentration and low MBL complex activity are more susceptible to HIV-1 infection.