"Triple-low" radiation dose bronchial artery CT angiography before bronchial artery embolisation: a feasibility study

AIM

To explore the feasibility of a "triple-low" dose (low tube voltage, low tube current, and low contrast agent volume) bronchial artery computed tomography (CT) angiography (CTA) to replace routine dose bronchial artery CTA before bronchial artery embolisation (BAE).

MATERIALS AND METHODS

CTA was obtained from 60 patients with body mass index (BMI) < 30 kg/m2 using a 256 multi-section iCT system, and they were divided into two groups: (1) group A: 100 kVp, 100 mAs, 50 ml contrast medium (CM); (2) group B: 120 kVp, automatic tube current modulation (ACTM), 80 ml CM. CT attenuation of the thoracic aorta, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated, and subjective image quality scores and traceability scores assessed. The effective radiation dose was calculated.

RESULTS

The radiation dose was reduced by 79.7% in group A compared to group B (p<0.05). The CT attenuation of the thoracic aorta was increased by approximately 13% in group A compared to group B (p<0.05). Higher image noise, lower SNR, and CNR were obtained in group A compared to group B (all p<0.05). Both subjective image quality scores and traceability scores did not differ between groups A and B (both p>0.05).

CONCLUSION

It is feasible to use the "triple-low" dose CTA protocol for patients with a body mass index (BMI) < 30 kg/m2. The radiation dose was reduced by 79.7%, and the dose of contrast medium was reduced by 37.5% to ensure the diagnostic value.

Correlation between retinal vein pulse amplitude, estimated intracranial pressure, and postural change

Spaceflight associated neuro-ocular syndrome (SANS) is common amongst astronauts on long duration space missions and is associated with signs consistent with elevated cerebrospinal fluid (CSF) pressure. Additionally, CSF pressure has been found to be elevated in a significant proportion of astronauts in whom lumbar puncture was performed after successful mission completion. We have developed a retinal photoplethysmographic technique to measure retinal vein pulsation amplitudes. This technique has enabled the development of a non-invasive CSF pressure measurement apparatus. We tested the system on healthy volunteers in the sitting and supine posture to mimic the range of tilt table extremes and estimated the induced CSF pressure change using measurements from the CSF hydrostatic indifferent point. We found a significant relationship between pulsation amplitude change and estimated CSF pressure change (p < 0.0001) across a range from 2.7 to 7.1 mmHg. The increase in pulse amplitude was highest in the sitting posture with greater estimated CSF pressure increase (p < 0.0001), in keeping with physiologically predicted CSF pressure response. This technique may be useful for non-invasive measurement of CSF pressure fluctuations during long-term space voyages.

Menstrual Tracking Mobile App Review by Consumers and Health Care Providers: Quality Evaluations Study

BACKGROUND

Women's menstrual cycle is an important component of their overall health. Physiological cycles and associated symptoms can be monitored continuously and used as indicators in various fields. Menstrual apps are accessible and can be used to promote overall female health. However, no study has evaluated these apps' functionality from both consumers' and health care providers' perspectives. As such, the evidence indicating whether the menstrual apps available on the market provide user satisfaction is insufficient.

OBJECTIVE

This study was performed to investigate the key content and quality of menstrual apps from the perspectives of health care providers and consumers. We also analyzed the correlations between health care provider and consumer evaluation scores. On the basis of this analysis, we offer technical and policy recommendations that could increase the usability and convenience of future app.

METHODS

We searched the Google Play Store and iOS App Store using the keywords "period" and "menstrual cycle" in English and Korean and identified relevant apps. An app that met the following inclusion criteria was selected as a research app: nonduplicate; with >10,000 reviews; last updated ≤180 days ago; relevant to this topic; written in Korean or English; available free of charge; and currently operational. App quality was evaluated by 6 consumers and 4 health care providers using Mobile Application Rating Scale (MARS) and user version of the Mobile Application Rating Scale (uMARS). We then analyzed the correlations among MARS scores, uMARS scores, star ratings, and the number of reviews.

RESULTS

Of the 34 apps, 31 (91%) apps could be used to predict the menstrual cycle, and 2 (6%) apps provided information pertinent to health screening. All apps that scored highly in the MARS evaluation offer a symptom logging function and provide the user with personalized notifications. The "Bom Calendar" app had the highest MARS (4.51) and uMARS (4.23) scores. The MARS (2.22) and uMARS (4.15) scores for the "Menstrual calendar-ovulation & pregnancy calendar" app were different. In addition, there was no relationship between MARS and uMARS scores (r=0.32; P=.06).

CONCLUSIONS

We compared consumer and health care provider ratings for menstrual apps. Continuous monitoring of app quality from consumer and health care provider perspectives is necessary to guide their development and update content.

A global perspective on bacterial diversity in the terrestrial deep subsurface

While recent efforts to catalogue Earth's microbial diversity have focused upon surface and marine habitats, 12-20 % of Earth's biomass is suggested to exist in the terrestrial deep subsurface, compared to ~1.8 % in the deep subseafloor. Metagenomic studies of the terrestrial deep subsurface have yielded a trove of divergent and functionally important microbiomes from a range of localities. However, a wider perspective of microbial diversity and its relationship to environmental conditions within the terrestrial deep subsurface is still required. Our meta-analysis reveals that terrestrial deep subsurface microbiota are dominated by Betaproteobacteria, Gammaproteobacteria and Firmicutes, probably as a function of the diverse metabolic strategies of these taxa. Evidence was also found for a common small consortium of prevalent Betaproteobacteria and Gammaproteobacteria operational taxonomic units across the localities. This implies a core terrestrial deep subsurface community, irrespective of aquifer lithology, depth and other variables, that may play an important role in colonizing and sustaining microbial habitats in the deep terrestrial subsurface. An in silico contamination-aware approach to analysing this dataset underscores the importance of downstream methods for assuring that robust conclusions can be reached from deep subsurface-derived sequencing data. Understanding the global panorama of microbial diversity and ecological dynamics in the deep terrestrial subsurface provides a first step towards understanding the role of microbes in global subsurface element and nutrient cycling.

Time to surgery and survival in breast cancer

Background

This study aimed to investigate the effect of the time from diagnosis to breast cancer surgery on breast cancer patients’ prognosis.

Methods

Of the 1900 patients diagnosed with invasive (stage 1–3) breast cancer who underwent surgery in KUH between 2012 and 2019, 279 patients were enrolled in this study. All patients, including those who received neoadjuvant chemotherapy, were classified as Model 1 subjects, and those who received immediate surgical treatment were classified as Model 2 subjects. We conducted a Cox regression analysis to identify prognostic factors of breast cancer associated with the time from diagnosis to surgery.

Results

The univariate results indicated a sharp drop in both groups’ survival rates when the time to surgery was delayed for more than 8 weeks (Model 1 p = 0.000; Model 2 p = 0.001). In the multivariate analysis, the hazard ratio (HR) of Model 1increased (HR = 6.84, 95% CI 1.06–44.25) in response to a delay in surgery of more than 8 weeks. Smoking and the American Joint Committee on Cancer (AJCC) staging system had a negative effect on breast cancer prognosis, while hormone therapy had a positive effect.

Conclusion

For all patients, a delay in breast cancer surgery of more than 8 weeks was inversely associated with survival.

Marriage Intention among Korean Young Adults: Trends and Influencing Factors

The recent increase in the tendency of people to marry late or to opt out of marriage entirely is among the key contributors to Korea’s low fertility rate. One possible cause of this tendency may be a change in how marriage is valued among Korea’s youth. The marriage intentions of young adults can be classified into “positive”, “negative”, and “neutral”. Over time, positive marriage intentions have declined across all age groups (2010: 61% → 2020: 39%; ages 25–29), with no significant change in negative marriage intentions. In contrast, neutral marriage intentions have increased significantly (2010: 36% → 2020: 53%; ages 25–29). This phenomenon may be attributable to the increase in the number of young adults who prioritize survival over thinking about the future. However, neutral marriage values can be changed into positive values at any time. A holistic overview of Korean society is necessary to determine how the values of young adults might be influenced to align with a traditional life process.

Intrauterine Bigatti Shaver (IBS ® ) successful placental remnants removal, after caesarean section for a cervical pregnancy with placenta accreta

Placenta accreta located in a caesarean section scar is difficult to remove. The Intrauterine Bigatti Shaver (IBS®) has already been proven to be effective in placental remnant removal. Our case report highlights that the IBS® is also a safe method to remove placental remnants attached to a previous caesarean section scar performed for a cervical pregnancy and associated with placenta accreta.

Complete genome sequence and genetic organization of a Garlic virus D infecting garlic (Allium sativum) from northern India

The present paper describes first full genome sequence of the Garlic virus D (GarV-D) from northern India with a genome size of 8425 bp long ssRNA. The infected leaves and bulbs of garlic variety Yamuna Safed (G-282) plants suspected for GarV-D infection were collected with the aim to identify contagion virus during March, 2018. The total RNA was extracted from the pooled garlic plants using TRIzol reagent and sequenced using an Illumina HiSeq 2000 platform. BLASTn search in the NCBI database identified contagion as GarV-D (MK518067). It shared 83.63-85.83% nucleotide sequence identities with other (GarV-D) isolates from Argentina (KF550407, KF555653, KR819505) and 83.15% with isolates from China (MF795136, MF363012). Keywords: Allium sativum; Allexivirus; Garlic virus D; India.

[Non-suicidal self-injury and exposure to suicidal behaviors among Chinese adolescents: a longitudinal study]

Objective: Non-suicidal self-injury (NSSI) in adolescents appeared prevalent and multifactorial. This study was to examine the associations between exposure to suicidal behaviors and NSSI in the Chinese adolescents. Methods: Participants included for analyses were 5 154 adolescent students who participated in the baseline survey in 2015 and the first follow-up survey in 2016 of the Shandong Adolescent Behavior and Health Cohort, but with no history of NSSI at the baseline survey. A self-administered structured questionnaire was used to collect data on demographics, behavioral and emotional problems, lifetime and last-year NSSI. Data on the history of exposure to suicide attempt or death of a family member, friend, or close acquaintance were also collected. Multivariate logistic regression methods were used to examine the associations between exposure to suicidal behaviors and NSSI. Results: In the baseline survey, mean age of the 5 154 participants was (14.49±1.48) years, with 48.5% of the participants as girls. Of the participants, 9.0% reported having been exposed to suicidal behaviors, including 6.0% reported to suicide attempt, 4.9% to suicide death, 7.3% to suicidal behaviors of friends/close acquaintances, and 3.1% to suicidal behaviors of relatives. The prevalence rates of NSSI in the last year were significantly higher in adolescents who had been exposed to suicidal behaviors than those who had not (P<0.05). Results from the multivariate logistic regressions showed that exposure to suicide death (OR=1.91, 95%CI: 1.22-3.01) or to suicidal behaviors of relatives (OR=1.79, 95%CI: 1.02-3.12) were both significantly associated with the increased risk of NSSI. Conclusions: Experiences related to exposure to suicide-death or suicidal behaviors of relatives were associated with increased risk of NSSI in adolescents. After the suicide events, psychological counseling and health education programs set for high-risk groups were helpful in promoting physical and mental health and preventing the attempt of self-injury in teenagers.

P343Comparison of Focal Impulse and Rotor Modulation Ablation (FIRM) only versus second-generation cyroballoon ablation in patients with paroxysmal atrial fibrillation

Background

Rotors have been postulated to be a major driver of atrial fibrillation (AF). Initial studies demonstrated, that focal impulse and rotor modulation (FIRM) might be an effective therapy for the treatment of paroxysmal AF (PAF). However, data about FIRM-guided ablation strategies without PVI is sparse.

Objective

To compare the safety and efficacy of FIRM-guided catheter ablation (without PVI; FIRM arm) and second generation cryoballoon (CB2, CB2 arm) based PVI in patients with paroxysmal atrial fibrillation (PAF) and de-novo catheter ablation of AF.

Methods

In this retrospective single-center study patients with PAF undergoing de-novo ablation of PAF between February 2016 and January 2017 were enrolled. Patients treated with FIRM-guided AF ablation as a standalone therapy without PVI were included and compared with patients undergoing CB2 based PVI. All patients in the FIRM arm were part of the randomized multicenter FIRMAP AF trial (results of this trial will be presented at this meeting). In patients undergoing FIRM-guided ablation, 3D electroanatomical mapping of both atria was performed. Rotor mapping using FIRM technology was conducted in spontaneous or induced AF. The procedural endpoint was the elimination of all rotors and focal impulses; no PVI was performed in those patients. In the CB2 arm, CB based PVI with the procedural endpoint of isolation of all veins was performed. Procedural data and arrhythmia-free survival after 12 months were compared.

Results

FIRM-guided and CB2 based AF ablation was performed in 22 and 86 patients, respectively. Follow up was completed in 20 and 79 patients LA diameter differed between groups. Otherwise, baseline characteristics did not differ between the FIRM group (mean age 60±11 years, 59.1% males) and the CB2 group (mean age 62±13, 62.4% male).

Arrhythmia-free survival including a 90-day blanking period was 25.0% (15/20) in the FIRM group and 86.1% (11/79) in the CB2 PVI group (p=0.000; Figure 1). Procedure duration was significantly longer in the FIRM group (152 [120; 176] minutes) compared to the CB2 PVI group (122 [110; 145] minutes) (p=0.031), whereas radiation dose was lower in the FIRM group (1266 [1027; 2281] cGy·cm2 vs. 3020 [1677; 4215] cGy·cm2). Adverse events (groin complications) occurred in 1 patient (1.2%) in the CB2 PVI group and 5 patients (22.7%) in the FIRM group.

Figure 1. Kaplan-Meier-survival curve dem

Conclusion

De novo ablation of PAF using a FIRM-guided AF ablation only (without PVI) is associated with poor arrhythmia-free survival after 12 months compared to CB2 PVI. These results underline the importance of PVI as the first-line approach in catheter ablation of AF.

Cortical thinning in epilepsy patients with postictal generalized electroencephalography suppression

BACKGROUND AND PURPOSE

The aim was to investigate the brain microstructural abnormalities in epilepsy patients with postictal generalized electroencephalographic suppression (PGES) using a cortical surface-based analysis.

METHODS

According to the video-electroencephalography records of epilepsy patients with generalized convulsive seizures, 30 patients with PGES (PGES+) and 21 patients without PGES (PGES-) were recruited. High-resolution T1-weighted images were acquired from each patient and 30 matched healthy control subjects. Cortical thickness was compared amongst the three groups using FreeSurfer software.

RESULTS

Patients with PGES showed reduced cortical thickness in the right paracentral lobule, inferior parietal lobule, supramarginal gyrus and middle temporal lobe compared with patients without PGES. In relation to healthy control subjects, the PGES+ group presented reduced cortical thickness in the right superior parietal lobule and supramarginal gyrus, whilst the PGES- group presented reduced cortical thickness in the left precuneus, precentral gyrus, lateral occipital gyrus, parahippocampal gyrus, superior parietal lobule and right caudal middle frontal gyrus.

CONCLUSIONS

Patients with PGES exhibited characteristic brain microstructural abnormalities, corroborating the PGES mechanisms at the brain level. The right-sided predominance of the detected PGES-related cortical thinning was the same as that of sudden unexpected death in epilepsy (SUDEP) cases and patients at high risk for SUDEP, implying that PGES and SUDEP may share a common abnormal brain substrate that is involved in the pathophysiology of these conditions.

Control of microbial sulfide production by limiting sulfate dispersal in a water-injected oil field

Oil production by water injection often involves the use of makeup water to replace produced oil. Sulfate in makeup water is reduced by sulfate-reducing bacteria to sulfide, a process referred to as souring. In the MHGC field souring was caused by using makeup water with 4mM (384ppm) sulfate. Mixing with sulfate-free produced water gave injection water with 0.8mM sulfate. This was amended with nitrate to limit souring and was then distributed fieldwide. The start-up of an enhanced-oil-recovery pilot caused all sulfate-containing makeup water to be used for dissolution of polymer, which was then injected into a limited region of the field. Produced water from this pilot contained 10% of the injected sulfate concentration as sulfide, but was free of sulfate. Its use as makeup water in the main water plant of the field caused injection water sulfate to drop to zero. This in turn strongly decreased produced sulfide concentrations throughout the field and allowed a decreased injection of nitrate. The decreased injection of sulfate and nitrate caused major changes in the microbial community of produced waters. Limiting sulfate dispersal into a reservoir, which acts as a sulfate-removing biofilter, is thus a powerful method to decrease souring.

Disrupted intrinsic and remote functional connectivity in heterotopia-related epilepsy

OBJECTIVES

Several neuroimaging studies have examined neural interactions in patients with periventricular nodular heterotopia (PNH). However, features of the underlying functional network remain poorly understood. In this study, we examined alterations in the local (regional) and remote (interregional) cerebral networks in this disorder.

METHODS

Twenty-eight subjects all having suffered from PNH with epilepsy, as well as 28 age- and sex- matched healthy controls, were enrolled in this study. Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) were calculated to detect regional neural function and functional network integration, respectively.

RESULTS

Compared with healthy controls, patients with PNH-related epilepsy showed decreased ALFF in the ventromedial prefrontal cortex (vmPFC) and precuneus areas. ALFF values in both areas were negative correlated with epilepsy duration (P < .05, Bonferroni-corrected). Furthermore, patients with PNH-related epilepsy had increased remote interregional FC mainly in bilateral prefrontal and parietal cortices, supramarginal gyrus, dorsal cingulate gyrus, and right insula; lower FC was found in posterior brain regions including bilateral parahippocampal gyrus and inferior temporal gyrus.

CONCLUSIONS

Focal spontaneous hypofunction, as assessed by ALFF, correlates with epilepsy duration in patients with PNH-related epilepsy. Abnormalities existed both within the default-mode network and then across the whole brain, demonstrating that intrinsic brain dysfunction may be related to specific network interactions. Our findings provide novel understanding of the connectivity-based pathophysiological mechanisms of PNH.

Perilesional and contralateral white matter evolution and integrity in patients with periventricular nodular heterotopia and epilepsy: a longitudinal diffusion tensor imaging study

BACKGROUND AND PURPOSE

This study aimed to assess the evolution of perinodular and contralateral white matter abnormalities in patients with periventricular nodular heterotopia (PNH) and epilepsy.

METHODS

Diffusion tensor imaging (DTI) (64 directions) and 3 T structural magnetic resonance imaging were performed in 29 PNH patients (mean age 27.3 years), and 16 patients underwent a second scan (average time between the two scans 1.1 years). Fractional anisotropy and mean diffusivity were measured within the perilesional and contralateral white matter.

RESULTS

Longitudinal analysis showed that white matter located 10 mm from the focal nodule displayed characteristics intermediate to tissue 5 mm away, and normal-appearing white matter (NAWM) also established evolution profiles of perinodular white matter in different cortical lobes. Compared to 29 age- and sex-matched healthy controls, significant decreased fractional anisotropy and elevated mean diffusivity values were observed in regions 5 and 10 mm from nodules (P < 0.01), whilst DTI metrics of the remaining NAWM did not differ significantly from controls. Additionally, normal DTI metrics were shown in the contralateral region in patients with unilateral PNH.

CONCLUSIONS

Periventricular nodular heterotopia is associated with microstructural abnormalities within the perilesional white matter and the extent decreases with increasing distance from the nodule. In the homologous contralateral region, white matter diffusion metrics were unchanged in unilateral PNH. These findings have clinical implications with respect to the medical and surgical interventions of PNH-related epilepsy.

Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension

Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).

GS-9857 in patients with chronic hepatitis C virus genotype 1-4 infection: a randomized, double-blind, dose-ranging phase 1 study

GS-9857, an inhibitor of the hepatitis C virus (HCV) nonstructural protein (NS) 3/4A, demonstrates potent activity against HCV genotypes 1-6 and improved coverage against commonly encountered NS3 resistance-associated variants (RAVs). In this study, the safety, tolerability, antiviral activity and pharmacokinetics (PK) of GS-9857 were evaluated in patients with chronic HCV genotype 1-4 infection. Patients with genotype 1-4 infection received placebo or once-daily GS-9857 at doses ranging from 50 to 300 mg for 3 days under fasting conditions. GS-9857 was well tolerated; all reported adverse events (AEs) were mild or moderate in severity. Diarrhoea and headache were the most commonly reported AEs. Grade 3 or 4 laboratory abnormalities were observed in 17% of patients receiving GS-9857; there were no Grade 3 or 4 abnormalities in alanine aminotransferase, aspartate aminotransferase or alkaline phosphatase levels. GS-9857 demonstrated potent antiviral activity in patients with chronic HCV infection, achieving mean and median maximum reductions in HCV RNA of ≥3 log10 IU/mL following administration of a 100-mg dose in patients with HCV genotype 1a, 1b, 2, 3 or 4 infection. The antiviral activity of GS-9857 was unaffected by the presence of pretreatment NS3 RAVs. In patients with genotype 1-4 infection, GS-9857 exhibited linear PK and was associated with a median half-life of 29-42 h, supporting once-daily dosing. Thus, the tolerability, efficacy and pharmacokinetic profile of GS-9857 support its further evaluation for treatment of patients with chronic HCV infection.

Development and application of EST-based markers specific for chromosome arms of rye (Secale cereale L.)

To develop a set of molecular markers specific for the chromosome arms of rye, a total of 1,098 and 93 primer pairs derived from the expressed sequence tag (EST) sequences distributed on all 21 wheat chromosomes and 7 rye chromosomes, respectively, were initially screened on common wheat 'Chinese Spring' and rye cultivar 'Imperial'. Four hundred and fourteen EST-based markers were specific for the rye genome. Seven disomic chromosome addition lines, 10 telosomic addition lines and 1 translocation line of 'Chinese Spring-Imperial' were confirmed by genomic in situ hybridization and fluorescencein situ hybridization, and used to screen the rye-specific markers. Thirty-one of the 414 markers produced stable specific amplicons in 'Imperial', as well as individual addition lines and were assigned to 13 chromosome arms of rye except for 6RS. Six rye cultivars, wheat cultivar 'Xiaoyan 6' and accessions of 4 wheat relatives were then used to test the specificity of the 31 EST-based markers. To confirm the specificity, 4 wheat-rye derivatives of 'Xiaoyan 6 × German White', with chromosomes 1RS, 2R and 4R, were amplified by some of the EST-based markers. The results indicated that they can effectively be used to detect corresponding rye chromosomes or chromosome arms introgressed into a wheat background, and hence to accelerate the utilization of rye genes in wheat breeding.

Evaluation of traumatic subarachnoid hemorrhage using susceptibility-weighted imaging

BACKGROUND AND PURPOSE

SWI is an MR imaging technique that is very sensitive to hemorrhage. Our goal was to compare SWI and CT to determine if SWI can show traumatic SAH in different parts of the subarachnoid space.

MATERIALS AND METHODS

Twenty acute TBI patients identified by CT with SAH underwent MR imaging scans. Two neuroradiologists analyzed the CT and SWI data to decide whether there were SAHs in 8 anatomical parts of the subarachnoid space.

RESULTS

Fifty-five areas with SAH were identified by both CT and SWI. Ten areas were identified by CT only and 13 by SWI only. SAH was recognized on SWI by its very dark signal intensity surrounded by CSF signal intensity in the sulci or cisterns. Compared with the smooth-looking veins, SAH tended to have a rough boundary and inhomogeneous signal intensity. In many instances, blood in the sulcus left an area of signal intensity loss that had a "triangle" shape. SWI showed 5 more cases of intraventricular hemorrhage than did CT.

CONCLUSIONS

SAH can be recognized by SWI through its signal intensity and unique morphology. SWI can provide complementary information to CT in terms of small amounts of SAH and hemorrhage inside the ventricles.

Metformin influences cardiomyocyte cell death by pathways that are dependent and independent of caspase-3

AIMS/HYPOTHESIS

Metformin has been shown to increase fatty acid oxidation, an effect mediated by AMP activated protein kinase (AMPK). We hypothesised that metformin could prevent both caspase-3 activation and apoptosis when induced by palmitic acid.

MATERIALS AND METHODS

Cardiomyocytes were incubated with 1 mmol/l palmitic acid, in the absence or presence of metformin (1-5 mmol/l). Following 1 to 16 h, cell damage was evaluated by measuring lactate dehydrogenase released into the incubation medium, and Hoechst staining. To investigate the mechanism of metformin's effect on cardiomyocytes, substrate utilisation and phosphorylation of AMPK and acetyl-CoA carboxylase were measured. Intracellular mediators of apoptosis were also evaluated.

RESULTS

Incubation of myocytes with palmitic acid for 16 h increased apoptosis, an effect that was partly blunted by 1 and 2 mmol/l metformin. This beneficial effect of metformin was associated with increased AMPK phosphorylation, palmitic acid oxidation and suppression of high-fat-induced increases in (1) long chain base biosynthesis protein 1 levels, (2) ceramide levels, and (3) caspase-3 activity. Unexpectedly, 5 mmol/l metformin dramatically increased apoptosis in myocytes incubated with high fat. This effect was associated with a robust increase in glycolysis, lactate accumulation, and a significant drop of pH in the myocyte incubation medium.

CONCLUSIONS/INTERPRETATION

Our study demonstrates that metformin reduces high-fat-induced cardiac cell death, probably through inhibition of ceramide synthesis. However, at high concentrations, metformin causes proton and lactate accumulation, leading to cell damage that is independent of caspase-3.

A high frequency of allelic loss in oral verrucous lesions may explain malignant risk

Verrucous carcinoma (VC), a variant of squamous cell carcinoma (SCC), is distinct from SCC in morphology and behavior. The underlying genetic changes involved in the development of VC and its precursor verrucous hyperplasia (VH) are unknown. This study determined whether chromosomal regions frequently lost during the development of SCC are also lost in the VH/VC variant. Twenty-five VH and 17 VC were analyzed for loss of heterozygosity (LOH) at 19 loci on 7 chromosome arms using microsatellite analysis. These data were compared with those from 47 reactive hyperplasias, 92 dysplasias (54 low- and 38 high-grade), and 41 SCCS: The results showed that VC/VH shared many of the losses present in dysplasia/SCC but differed in two aspects. First, VC/VH showed early acquisition of loss, compared with a gradual accumulation of losses from dysplasias to SCC. The LOH pattern of VH was similar to that of high-grade dysplasia and sharply different from reactive hyperplasia. The loss in VH often involved multiple arms (in 60% of VH vs 0% of reactive lesions). Only a marginal elevation of loss was observed at 9p (p = 0.06) and 4q (p = 0.05) from VH to VC because of the high degree of loss already present in VH. Second, a strikingly lower frequency of loss at 17p was noted in VH/VC compared with dysplasia/SCC and may indicate human papillomavirus (HPV) involvement. The finding of high-risk LOH profiles in VH may partly account for the high-progression risk seen for VH and also has potentially important clinical implications. The difficult pathological diagnosis of VH/VC from reactive hyperplasia frequently requires repeated biopsies and results in delay in diagnosis and significantly increased mortality/morbidity. Microsatellite analysis might facilitate this differential diagnosis.

Surface-enhanced raman spectra of some anti-tubercle bacillus drugs

Surface-enhance Raman (SER) spectra of pyrazinamide (PZA), isoniazid (INAZ), and isonicotiamide (INCT) in silver sols have been studied over a range of solution concentration and pH. A linear calibration curve has been obtained for each of the sample molecules, and the lower limits of detection are estimated to be 5 ng for PZA and INAZ, and 10 ng for INCA. The variation of SER intensity with the sample solution pH is explained in terms of the charge of the sample species and the stability of the sols. The normal Raman and infrared spectra for the pure drug samples have also been collected, from which some vibration assignments for the molecules are given. The absorption behaviors of the molecules on the silver particle surfaces are also suggested.

Selected contribution: redistribution of pulmonary perfusion during weightlessness and increased gravity

To compare the relative contributions of gravity and vascular structure to the distribution of pulmonary blood flow, we flew with pigs on the National Aeronautics and Space Administration KC-135 aircraft. A series of parabolas created alternating weightlessness and 1.8-G conditions. Fluorescent microspheres of varying colors were injected into the pulmonary circulation to mark regional blood flow during different postural and gravitational conditions. The lungs were subsequently removed, air dried, and sectioned into approximately 2 cm(3) pieces. Flow to each piece was determined for the different conditions. Perfusion heterogeneity did not change significantly during weightlessness compared with normal and increased gravitational forces. Regional blood flow to each lung piece changed little despite alterations in posture and gravitational forces. With the use of multiple stepwise linear regression, the contributions of gravity and vascular structure to regional perfusion were separated. We conclude that both gravity and the geometry of the pulmonary vascular tree influence regional pulmonary blood flow. However, the structure of the vascular tree is the primary determinant of regional perfusion in these animals.

Temperature sensitivity of passive holographic wavelength-division multiplexers-demultiplexers

We derive a set of concise formulas to characterize the temperature sensitivity of holographic wavelength-division multiplexers-demultiplexers (H-MUX's-H-DMUX's). The normalized parameters such as dispersion abilities, central wavelength shift rate, and variations of insertion loss hold for general grating-based wavelength-division multiplexing-demultiplexing (WDM-WDDM) structures. The results are applicable to both wide-WDM-WDDM and dense ones working in 800-, 1300-, and 1550-nm optical wavelength windows, regardless of whether their input-output ports are single-mode or multimode fibers. Detailed analysis and experiments are carried out on a fully packaged four-channel H-MUX-H-DMUX. The experimental results at temperatures from 25 to 80 degrees C fit nicely with the theoretical prediction. We conclude that passive grating-based H-MUX's-H-DMUX's are promising for meeting the requirements on temperature sensitivity in optical data communications and telecommunications. Most of the analysis can be applied to other types of Bragg-grating-based WDM-WDDM.

Hepatocyte-specific mutation establishes retinoid X receptor alpha as a heterodimeric integrator of multiple physiological processes in the liver

A large number of physiological processes in the adult liver are regulated by nuclear receptors that require heterodimerization with retinoid X receptors (RXRs). In this study, we have used cre-mediated recombination to disrupt the mouse RXRalpha gene specifically in hepatocytes. Although such mice are viable, molecular and biochemical parameters indicate that every one of the examined metabolic pathways in the liver (mediated by RXR heterodimerization with PPARalpha, CARbeta, PXR, LXR, and FXR) is compromised in the absence of RXRalpha. These data demonstrate the presence of a complex circuitry in which RXRalpha is integrated into a number of diverse physiological pathways as a common regulatory component of cholesterol, fatty acid, bile acid, steroid, and xenobiotic metabolism and homeostasis.

[Diagnosis and treatment of early colorectal cancer]

OBJECTIVES

To study the diagnostic methods of early colorectal neoplasm before operation and to evaluate the value of these methods for selection.

METHODS

Fifteen patients with early colorectal neoplasms were examined pre-operatively by general colonoscopy to observe macroscopic appearance, by magnifying endoscopy to classify pit pattern type, and by endoscopic ultrasonography (EUS) to assess the penetrating depth of cancer invasion as well as regional lymph node metastases. According to these findings, diagnosis and clinical staging were made and proper treatment protocols were established.

RESULTS

The diameter of the tumors ranged from 1 to 6 cm. Most lesions were subpedunculate type (8/15, 53%). Eight cases belonged to pit pattern type III L + V (8/15, 53%). EUS showed mucosal cancer in 11 cases and submucosal cancer in 4. No lymph node metastasis was observed in any cases. Treatment methods included endoscopic polypectomy or endoscopic mucosa resection (EMR) in 6 cases, endo-surgery combined with open surgery in 2, and open surgery in 7. Pathological diagnosis showed mucosal carcinoma in 12 cases, submucosal carcinoma in 3. The accuracy of EUS was 93%.

CONCLUSIONS

Magnifying endoscopy and EUS are useful for diagnosis of early colorectal cancer before operation, and correct preoperative staging of colorectal neoplasms is of significance in guiding treatment.

[The effect of memory T lymphocytes on IgE production by B lymphocytes in patients with bronchial asthma]

OBJECTIVE

To study the role of CD(4)(+) CD(45)RO(+) T lymphocytes in the pathogenesis of bronchial asthma.

METHODS

CD(4)(+) CD(45)RO(+) T lymphocyte subsets were isolated from peripheral blood of patients with bronchial asthma and healthy donors. Then they were cultured with self-B lymphocytes and designated as pokeweed mitogen (PWM)-stimulated and non-stimulated group. Secreted IgE was measured in the supernatant.

RESULTS

CD(4)(+) CD(45)RO(+) T lymphocytes had a positive role on IgE production by B lymphocytes from patients of bronchial asthma in non-stimulated group, but the positive role did not exit in the presence of PWM. The effect of activated and non-activated CD(4)(+) CD(45)RO(+) T lymphocytes from patients with bronchial asthma on the secretion of IgE by B lymphocytes were further investigated.

CONCLUSION

The function of activated CD(4)(+) CD(45)RO(+) T lymphocytes returned to normal level. It is suggested that CD(4)(+) CD(45)RO(+) T lymphocytes have adverse effects on IgE production in patients with bronchial asthma; which may be related to the pathogenesis of asthma.

[Research on the separation behavior of acidic drugs in capillary electrophoresis with reversed direction of electroosmotic flow]

The separation behavior of acidic drugs in capillary electrophoresis with reversal of electroosmotic flow was investigated systematically. Acetylsalicylic acid and its related compound salicylic acid were employed as objective drugs. The cationic surfactant cetyltrimethylammonium bromide (CTAB) was used as reversed reagent for electroosmotic flow. The experimental conditions, such as, cationic surfactant concentration, buffer pH and organic additives, which affected migration time, peak shape and column efficiency, were studied in detail. The experimental results indicated that high speed analysis could be achieved in the capillary electrophoresis with reversed electroosmotic flow induced by cationic surfactant when acidic drugs were analysed. The poor peak shape and low column efficiency caused by the interactions of CTAB with acidic anions would be improved by adding proper organic additive, such as, beta-cyclodextrin or acetonitrile.

[Simultaneous determination of the enantiomers of verapamil and norverapamil in plasma by high performance capillary electrophoresis]

An analytical method has been developed to determine simultaneously plasma concentration of the enantiomers of verapamil and its major metabolite, norverapamil, using capillary zone electrophoresis. Trimethyl-beta-cyclodextrin was selected as chiral selector. Good separation was achieved under the conditions as below: Running electrolyte was pH 2.5, 60 mmol.L-1 phosphate buffer containing 60 mmol.L-1 trimethyl-beta-cyclodextrin; capillary: 30 cm x 75 microns (ID), coated; setpoint of capillary temperature: 20 degrees C; detector: UV 200 nm; injection: electromigration at 12 kV for 7 s; running voltage: 14 kV. Solvent of sample was doubly deionized water. The migration times of enantiomers were less than 12 min. The good linear range was from 300.0 ng.ml-1 to 2.50 ng.ml-1. Relative standard deviations of assay accuracy and precision were less than 12%. It fits for routine therapeutic monitoring as it is highly efficient, rapid, sensitive, with less solvent and sample consumption and automation.

Antimetastatic effects of electrochemotherapy and of histoincompatible interleukin-2-secreting cells in the murine Lewis lung tumor

Murine Lewis lung (3LL) tumors are characterized by the appearance of lung metastases after a regular period following their s.c. transplantation. We tested the respective efficiencies of various antitumor treatments: (i) electrochemotherapy (ECT), i.e. the systemic injection of bleomycin associated with electric pulses, locally delivered, that permeabilizes the tumor cells; (ii) intratumoral injection of histoincompatible cells that have been engineered in vitro to secrete high amounts of interleukin-2; and (iii) the combination of these two treatments. The growth of the s.c. transplanted tumors was followed up and the number of lung metastases was counted 14 days after the treatment. ECT alone resulted in the reduction of both the size of the tumor and the number of lung metastases. This latter effect can be partially explained by the effects of ECT on the s.c. tumor mass from which 3LL cells escape to colonize the lungs. The injection of IL-2-secreting cells alone had no effect on the s.c. mass and only a limited effect on the number of lung metastases. However, the combined treatment ECT plus IL-2-secreting cells resulted in antimetastatic effects potentiation that could result from stimulation of a non-specific immune response through an increase of NK activity.

Electrochemotherapy on liver tumours in rabbits

Electrochemotherapy (ECT) is a new therapeutic approach combining the effects of a low-permeant cytotoxic drug, bleomycin (BLM), administered i.v. and cell-permeabilizing electric pulses (EPs) locally delivered to tumours. The transient permeabilization of the cell membrane by the EPs allows free access of BLM to its intracellular targets, largely enhancing BLM's cytotoxic effects. ECT efficacy has been proved so far on transplanted subcutaneous murine tumours and on subcutaneous metastases in humans. Here, we present the first study of the effects of ECT on tumours transplanted to livers in rabbits. We used a recently developed EP applicator consisting of an array of parallel and equidistant needles to be inserted in tissues. Effects of EPs alone or of ECT were assessed by histological analysis, tumour growth rates and survival of the treated animals. A transient blood hypoperfusion was seen in the electropulsed areas, with or without BLM, related to EP-dependent vasoconstriction but this had no major effects on cell survival. Long-term effects depended on the presence of BLM at the time of EP delivery. Almost complete tumour necrosis was observed after ECT, resulting from both BLM direct cytotoxic effects on electropermeabilized tumour cells and indirect effects on the tumour vessels. A large reduction in tumour growth rate and significantly longer survival times were scored in comparison with control rabbits. Moreover, ECT of liver tumours was well tolerated and devoid of systemic side-effects. When ECT was associated with a local interleukin 2-based immunotherapy, increased local anti-tumour effectiveness as well as a large decrease in the number of metastases were observed. Thus, ECT could become a novel treatment modality for liver tumours and other solid internal malignancies.

Cryoelectron microscopic examination of human immunodeficiency virus type 1 virions with mutations in the cyclophilin A binding loop

The human immunodeficiency virus type 1 capsid protein contains a conserved P217X4PX2PX5P231 motif. Mutation at Pro-222 decreases virion incorporation of cyclophilin A, while mutation at Pro-231 abolishes infectivity. Although viral RNA incorporation and protease cleavage of the Gag precursor were not affected by these mutations, cryoelectron microscopy revealed a loss of virion maturation in P231A particles.

Investigation of the metabolism of 7-(4-chlorbenzyl)-7,8,13,13a-tetrahydroberberine chloride in the rat

The metabolism of 7-(4-chlorbenzyl)-7,8,13,13a-tetrahydroberberine chloride (CTHB), a compound with promising pharmacological effects against arrhythmia, was investigated in rat bile. A metabolite and unchanged CTHB were found in the bile. Characterization and structural elucidation of the metabolite was achieved by LC/MS and LC/NMR. The following metabolic pathway is proposed: CTHB is metabolized by demethylation at position 10 to produce a new entity.

Host's immune response in electrotherapy of murine tumors by direct current

Electrotherapy by low level direct current has been demonstrated to have antitumor effects in different murine tumor models and in clinics. Electrotherapy in "field" configuration, where electrodes are placed subcutaneously outside of the tumor in a way that tumor lies in between the electrodes, was performed in immunodeficient nude and immunocompetent mice. Electrotherapy was much more effective in immunocompetent mice based on the observed tumor growth retardation, thus demonstrating that antitumor effectiveness of electrotherapy greatly depends on host's immune response. Further experiments were conducted by combining electrotherapy with concomitant immunotherapy in order to potentiate the antitumor effect of electrotherapy. Immunotherapy consisted of local delivery of genetically engineered cells selected for IL-2 secretion. This combined treatment was much more effective than any of the treatments alone.

[Application of adaptive resonance theory network to the quality evaluation of radix Sophorae flavescentis]

ART1 and ART2 models of adaptive resonance theory network have been employed in quality evaluation of 40 Radix Sophorae Flavescentis samples collected from different regions of China. Based on the UV data of MeOH extract and IR data of CHCL3 extract, Shannon information theory has been used for feature selection. The results consist with those of traditional appraisal.

Effects of zidovudine-selected human immunodeficiency virus type 1 reverse transcriptase amino acid substitutions on processive DNA synthesis and viral replication

Certain amino acid substitutions in the reverse transcriptase (RT), including D67N, K70R, T215Y, and K219Q, cause high-level resistance of human immunodeficiency virus type 1 (HIV-1) to zidovudine (3'-azidothymidine; AZT) and appear to approximate the template strand of the enzyme-template-primer complex in structural models. We studied whether this set of mutations altered RT-template-primer interaction as well as their effect on virus replication in the absence of inhibitor. When in vitro polymerization was limited to a single association of an RT with an oligodeoxynucleotide-primed heteropolymeric RNA template (a single processive cycle), recombinant-expressed mutant 67/70/215/219 RT synthesized 5- to 10-fold more high-molecular-weight DNA products (>200 nucleotides in length) than wild-type RT. This advantage was maintained as deoxynucleoside triphosphate (dNTP) concentrations were decreased to limiting levels. In contrast, no difference was seen between wild-type and mutant RTs under conditions allowing repeated associations of enzyme with template-primer. Because intracellular dNTP concentrations are low prior to mitogenic stimulation, we compared replication of mutant 67/70/215/219 virus and wild-type virus in peripheral blood mononuclear cells (PBMC) stimulated before and after infection. In the absence of inhibitor, mutant 67/70/215/219 virus had a replication advantage in PBMC stimulated with phytohemagglutinin and interleukin-2 after infection, but virus replication was similar in PBMC stimulated before infection in vitro. The results confirm that RT mutations D67N, K70R, T215Y, and K219Q affect an enzyme-template-primer interaction in vitro and suggest that such substitutions may affect HIV-1 pathogenesis during therapy by increasing viral replication capacity in cells stimulated after infection.

[Radix Sophorae flavescentis quality by chemical pattern recognition]

The PCA method and NLM technology were used to study on quality of 40 Radix Sophorae Flavescentis samples collected from different regions of China. The results showed were unanimous with that of traditional appraisal.

Effect of low-dose endotoxin on pulmonary vascular permeability following acute hemorrhagic shock

The purpose of the current study was to determine the effect of low-dose Escherichia coli lipopolysaccharide (LPS) on pulmonary vascular permeability when administered after hemorrhagic shock (40% of baseline cardiac output) followed by resuscitation. Animals were monitored for 3-4 h after LPS infusion. Thirty minutes prior to termination of the experiment, 3 mCi of 125I-human serum albumin was injected intravenously to calculate a permeability index from the left lung lavage and plasma 125I ratios. The two control groups were (1) shock only (no LPS, n = 4), and (2) LPS only (no shock, n = 8). The permeability index for the shock-only group was 0.0015 +/- 0.0007 (mean +/- SE) and that for the LPS-only group was 0.0035 +/- 0.0014. The permeability index for the experimental group (shock followed by LPS, n = 10) was 0.0071 +/- 0.0030 (p > 0.05). Similarly, there was no difference in the wet-to-dry ratios between the three groups. The shock+LPS group required more intravenous fluids to maintain mean arterial blood pressure at control values than the LPS-only group (p < 0.003). We conclude that hemorrhagic shock and resuscitation do not lead to an acute increased permeability of the lung when it is subsequently challenged by a low dose of bacterial LPS.

Oxidative release of nitrite from 2-nitrotoluene by a three-component enzyme system from Pseudomonas sp. strain JS42

Pseudomonas sp. strain JS42 utilizes 2-nitrotoluene (2NT) as the sole source of carbon and energy for growth. Intact cells catalyze the oxidation of 2NT to 3-methylcatechol and nitrite in a reaction that requires molecular oxygen. Cell extracts oxidized 2NT to 3-methylcatechol and nitrite in the presence of NAD(P)H and ferrous iron. Ion-exchange chromatography yielded three protein fractions (A, B, and C) which were all required for the oxidation of 2NT to 3-methylcatechol and nitrite. Component B (reductase2NT) catalyzed a NAD(P)H-dependent reduction of cytochrome c. Solutions of component A (ISP2NT) were brown and showed absorption maxima at 458 and 324 nm. Two major bands with M(r)s 52,500 and 28,000 were observed when ISP2NT was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Component C could be replaced by ferredoxin NAP from the Pseudomonas putida NCIB 9816-4 naphthalene dioxygenase system and was given the designation ferredoxin2NT. Experiments with 18O2 showed that both oxygen atoms were added to the aromatic ring of 2NT to yield 3-methylcatechol. The enzyme is a new multicomponent enzyme system which we have designated 2NT 2,3-dioxygenase.

[Analysis of active ingredients in wuren liguid]

The active ingredients and their relative concentration in Wuren liquid were analyzed by GC/MS. It has been found that there are concentrative antimicrobiological ingredients in the liquid such as phenols, benzoic acids, fatty acids, and so on. The results have confirmed the effectiveness of Wuren liquid in disinfection, germ-killing and treatment of skin diseases.

The use of filter hybridization techniques for the identification, differentiation and classification of plant viruses

In attempts to use dot-blot hybridization tests for the identification of viruses or for assigning them to a certain taxonomic group we found that hybridization signals may be given not only by the homologous virus, but also by heterologous viruses belonging to the same or different taxonomic groups. Possible reasons for this phenomenon, which was observed with uncloned as well as with cloned cDNAs, are discussed. Quantitative dot-blot hybridization tests with extracted viral RNAs proved to be very sensitive in differentiating closely related viruses which were barely distinguishable in serological tests. Estimates on the degree of homology between the RNAs of different viruses may be influenced by a number of experimental parameters, such as competition for the available cDNA between homologous and heterologous RNAs or homologous RNAs in different concentrations on the same sheet of nitrocellulose, saturation phenomena due to close packaging of highly concentrated RNA on the blot and, of course, stringency conditions during washing procedures. Taking these parameters into account we have reestimated the degree of homology between the RNAs of 5 tombusviruses. Our new data suggest that the order of sequence for the relationships among these 5 tombusviruses is similar to that proposed by Koenig and Gibbs (1986) on the basis of serological data.