[Experience of Providing Intensive Rehabilitation Care to a School-Aged Child With Living-Donor Lobar Lung Transplantation]

The post-operative intensive care experience of a school-aged child who received living-donor bilateral lobar lung transplantation due to acute respiratory distress syndrome and interstitial pulmonary fibrosis is discussed in this paper. The patient received lungs donated by her parents in a "living-donor bilateral lobar lung transplantation" due to severe lung function impairment. The patient felt anxious due to her long-term hospitalization for preoperative evaluation, various invasive treatments, and postoperative rehabilitation. During the care period from October 25th, 2022, to December 29th, 2022, the author collected data via direct care, interviews, medical record reviews, and interactions with the patient and her family. An assessment of the patient's physical, mental, and social integrity was made, and the collected data were organized and analyzed to identify health issues such as lack of activity endurance, imbalanced nutrition below bodily requirements, and anxiety. After the lung transplantation operation, the interdisciplinary team worked collaboratively to develop a care plan to improve cardiopulmonary endurance and enhance the quality of care for the patient through early care and rehabilitation via proactive care. This care plan included encouraging the patient and her parents to express their fears and feelings and using flashcards to teach them about dietary management and the proper performance of lung rehabilitation. These measures encouraged the parents to engage in care, properly prepare for discharge care, and receive care education. As this is the first case of living-donor lobar lung transplantation in Taiwan, this valuable nursing experience is expected to provide future care teams with a reference on the related nursing process and care experience for similar cases.

Managing type 1 diabetes of a child: Parents' perspectives

PURPOSE

Managing type 1 diabetes (T1D) challenges children and their parents. Parents need to learn the necessary skills and later transfer the responsibility of care to their children as they develop. The transition process involves autonomy in behaviour and decision-making. This study explores the shared management experiences of Taiwanese parents and their children with type 1 diabetes.

DESIGN AND METHODS

This study employed a qualitative design using a grounded theory approach. Purposive sampling was used at a medical centre in Taiwan for participant recruitment. Twenty-nine parents of children who had been diagnosed with T1D were interviewed in-depth. Data were analysed using constant comparison and repeated verification.

RESULTS

After a child was diagnosed with T1D, the parents initiated 'Life-long lesson: Growing together with the child on the road to normality'. Three main categories emerged: 'confronting the disease diagnosis', 'establishing supportive and collaborative involvement' and 'assisting the child in building a sense of belonging'. Sub-categories within each significant category were also included.

CONCLUSIONS

Taiwanese parents perhaps have a controlling or directive role for a long period in their child's lives and shared management of their health condition. This study's findings can help healthcare workers better understand the process of parents' shared management of T1D with their children and how to best communicate with children about the disease and care in accordance with the child's stage of development.

A gap in the data: Defining, identifying, and tracking children with medical complexity in the child welfare system

BACKGROUND

Among nearly 400,000 children in US foster care, an estimated 10 % are medically complex. Yet, population-level data about children with medical complexity (CMC) served by the child welfare system, both for prevention and foster care services, are largely unavailable.

OBJECTIVE

To understand how US child welfare agencies define, identify, and track CMC.

PARTICIPANTS AND SETTING

Child welfare agencies across the US.

METHODS

Agencies were recruited to complete a survey as part of a larger study exploring how CMC are served by the child welfare system. Survey responses related to defining, identifying, and tracking CMC were included in analysis. Descriptive statistical analysis was conducted with Stata. Qualitative content and thematic analysis were applied to free text responses.

RESULTS

Surveys were completed by agencies from 28 states and 2 major cities. Nearly half of the agencies did not have a clear definition to identify CMC; those that did have a definition often lacked standardization. The majority of agencies could not easily identify CMC or access CMC-related data within data systems. Agencies described lack of a clear definition as a barrier to collecting population level data.

CONCLUSIONS

Many US child welfare agencies lack a clear definition to identify and track CMC, impacting the ability to tailor care and service delivery to meet their unique needs. To address this, a clear definition for CMC should be developed and consistently applied within child welfare data systems. Once CMC are identifiable, future research can collect population-level data and provide recommendations for best practices and policies.

Preserving Structural Consistency in the Generation of Synthetic CT in Pelvic MR-Only Radiation Treatment Planning

PURPOSE/OBJECTIVE(S)

MR-based synthetic CT (sCT) generation is necessary for MR-only radiotherapy to assist in radiation dose calculation, owing to no electronic density information in MR images. This study investigated the feasibility of synthesizing CT images from magnetic resonance (MR) images using generation antagonism networks (GANs) for MR radiotherapy of rectal cancer. Meanwhile, the transformer module and the contrast learning loss were introduced to improve the sCT.

MATERIALS/METHODS

The data set used in this study was the T2-weighted MR and CT image data of 108 patients with rectal cancer. Three-fold cross-validation was performed on all data sets. The transformer module was introduced into the plain CycleGAN, and the improved Patch Noise Contrastive Estimation (PatchNCE) loss was used as the loss function. The improved PatchNCE loss maintained the structural consistency of the MR and the synthetic CT by ensuring the consistency of the distribution of image patches on the MR-sCT image pair. The 2.5D images were taken as the input of our model, which refers to taking two consecutive adjacent layers in a specific layer. The CT-to-sCT image similarity was evaluated by metrics of mean absolute error (MAE), peak signal-to-noise ratio (PSNR), and Structure Similarity Index Measure (SSIM). The sCT dosimetric accuracy was verified against CT-based dose distributions for the photon plan. Relative dose differences in the planning target volume and organs at risk were computed.

RESULTS

The evaluation indicators of sCT images generated by our model were superior to the plain CycleGAN in the results of the three-fold cross-validation. MAE, PSNR and SSIM of our model were 42.850HU, 26.486 and 0.988, respectively, which were superior to 47.129HU, 25.167 and 0.978 of the plain CycleGAN. In addition, sCT generated by our model exhibited good continuity in the axial direction compared with plain CycleGAN. Furthermore, most of the relative differences in the DVH indicators were less than 1%.

CONCLUSION

The accuracy of sCT can be effectively improved by introducing a transformer module and comparative learning loss function. Moreover, all dosimetric differences were within clinically acceptable criteria for photon radiotherapy, demonstrating the feasibility of the MRI-only workflow for patients with rectal cancer.

Small Samples and Low-Cost Auto-Segmentation Method for Pelvic Organ-at-Risk Segmentation in Magnetic Resonance Images Using Deep-Learning

PURPOSE/OBJECTIVE(S)

In radiotherapy, magnetic resonance (MR) imaging has higher contrast of soft tissue, and no radiation compared with computed tomography (CT) scanning. Due to the high-cost of manual annotation, the deep-learning based automatic organ-at-risk (OAR) and target delineation algorithms are in high-demand, but the collecting of large amounts of high-quality annotated datasets remains difficulty. In this paper, we proposed a low-cost OAR segmentation method with semi-supervised annotation using small annotation samples of pelvic MR images.

MATERIALS/METHODS

This study consisted of 94 patients diagnosed with rectal cancer from April 2018 to March 2021 at Peking University People's Hospital. We used 17 slices of MR images with annotation and 78 slices without annotation to train a deep-learning based segmentation model. The bladder, femoral heads, rectum and small intestine were selected as OAR. Semi-supervised method and ensemble learning were used for generating training set using small sample with annotation. Post-processing algorithm was used to correct the self-annotation data. Two of 14 annotation samples were set as test set. As for un-labeled images, 40 of them were set as semi-supervised annotation train set, the rest were test set. Besides, both 2D and 3D auto-segmentation networks were evaluated.

RESULTS

The dice of bladder, femoral head left and right, rectum and small intestine between segmentation results and reference masks is 0.947, 0.983, 0.981, 0.900, 0.845 only using self-annotation and post-processing method of 2D segmentation model. And the dice of corresponding OAR is 0.871, 0.975, 0.975, 0.783, 0.724 using 3D segmentation network, 0.885,0.982, 0.982, 0.882, 0,814 using 2D segmentation network with supervised method (nnUNet). The 2D model outperformed 3D model with better segmentation performance, shorter inference time and fewer parameters.

CONCLUSION

The results proved that we can train a multi-OAR segmentation model only using small annotation samples and other unlabeled samples. Ensemble learning and post-processing methods are necessary for semi-supervised data annotation. For anisotropy data, 2D model shows better performance than 3D models.

Clinical prior Knowledge-Based One-Shot Learning for Automatic Delineation of Clinical Target Volumes in Adaptation Radiotherapy of Cervical Cancer

PURPOSE/OBJECTIVE(S)

Rapid and accurate delineation of clinical target volumes (CTV) of cervical cancer is the crux to ensure the efficiency and benefits of adaptation radiotherapy (ART). However, contour propagation using deformation image registration (DIR) is difficult to ensure the accuracy of CTV contours due to the significant tumor recession in next fraction, and the tumor progress in each fraction is not considered by conventional automatic delineation methods based on deep learning (DL). Currently, one-shot learning (OSL) is feasible to learn the tumor progress from former fractions to improve the accuracy of automatically delineating CTV.

MATERIALS/METHODS

We retrospectively collected 45 patients with cervical cancer from January 2021 to May 2022 in our department. All patients consist of a pair of planning CT and daily CT in ART. A personalized automatic delineation method based on one-shot learning was developed to delineate CTV in daily CT by learning the clinical prior knowledge from the CTV contours and images of planning CT. The performance of our proposed method was evaluated by dice similarity coefficient (DSC), 95% Harsdorff distance (95HD) and average surface distance (ASD) with human experts, and its automatic delineation performance were compared with DIR and DL in daily CT.

RESULTS

Our automatic delineation method OSL performed the best results in all evaluation metrics (denoted by mean ± standard deviation) as shown in Table 1, it is superior to method DL: 0.92 & 0.90 of DSC, 2.33 mm & 2.68 mm of HD95, 0.68 mm & 0.82 mm of ASD, P < 0.05 for DSC and ASD. Specifically, our method is significantly superior to the automatic delineation results by method DIR: 0.92 & 0.84 of DSC, 2.33 mm & 4.11 mm of HD95, 0.68 mm & 1.52 mm of ASD, P < 0.05 for all. In addition, OSL can significantly overcome the delineation problems in fuzzy boundary and delineation missing and perform better generalization for some unusual images, compared with DIR and DL.

CONCLUSION

We proposed an automatic delineation method based on one-shot learning for CTV of cervical cancer in ART, the results demonstrated that the proposed method could improve the precision and generalization of automatically delineating CTV compared against current popular methods. Therefore, it is potential to improve the quality and efficiency of ART for personalized patients and have a positive impact on tumor control and patient survival.

Dissolvable microgel-templated macroporous hydrogels for controlled cell assembly

Mesenchymal stem cells (MSCs)-based therapies have been widely used to promote tissue regeneration and to modulate immune/inflammatory response. The therapeutic potential of MSCs can be further improved by forming multi-cellular spheroids. Meanwhile, hydrogels with macroporous structures are advantageous for improving mass transport properties for the cell-laden matrices. Herein, we report the fabrication of MSC-laden macroporous hydrogel scaffolds through incorporating rapidly dissolvable spherical cell-laden microgels. Dissolvable microgels were fabricated by tandem droplet-microfluidics and thiol-norbornene photopolymerization using a novel fast-degrading macromer poly(ethylene glycol)-norbornene-dopamine (PEGNB-Dopa). The cell-laden PEGNB-Dopa microgels were subsequently encapsulated within another bulk hydrogel matrix, whose porous structure was generated efficiently by the rapid degradation of the PEGNB-Dopa microgels. The cytocompatibility of this in situ pore-forming approach was demonstrated with multiple cell types. Furthermore, adjusting the stiffness and cell adhesiveness of the bulk hydrogels afforded the formation of solid cell spheroids or hollow spheres. The assembly of solid or hollow MSC spheroids led to differential activation of AKT pathway. Finally, MSCs solid spheroids formed in situ within the macroporous hydrogels exhibited robust secretion of HGF, VEGF-A, IL-6, IL-8, and TIMP-2. In summary, this platform provides an innovative method for forming cell-laden macroporous hydrogels for a variety of future biomedical applications.

Facile Synthesis of Rapidly Degrading PEG-Based Thiol-Norbornene Hydrogels

An alternate synthesis route was developed to prepare norbornene-functionalized poly(ethylene glycol) (PEG) from reacting multiarm PEG with carbic anhydride. The macromer, PEGNB_CA, permits photo-cross-linking of thiol-norbornene hydrogels with kinetics comparable to conventional PEGNB macromer. In addition, PEGNB_CA provides an additional carboxylate group for further conjugation with amine-bearing molecules. Interestingly, PEGNB_CA thiol-norbornene hydrogels are highly susceptible to hydrolytic degradation through enhanced ester hydrolysis. The ester linkage is further weakened after the secondary conjugation, resulting in extremely rapid degradation of PEGNB hydrogels. More importantly, the degradation can be readily adjusted via tuning macromer compositions, with complete degradation time ranging from hours to weeks. The PEGNB_CA hydrogels are also highly cytocompatible toward various cell types, providing opportunities for future applications in tissue engineering and advanced biofabrication.

Neuroimaging Appearance of Cerebral Malignant Epithelioid Glioneuronal Tumors in Children

Malignant epithelioid glioneuronal tumor is a rare high-grade, aggressive brain tumor that shows both glial and neuronal differentiation on histopathology but is not included in the current World Health Organization classification. The neuroimaging appearance is variable but may be secondary to the size of the mass and/or location of the tumor. In our series, all epithelioid glioneuronal tumors were encountered in the supratentorial space and included pineal, temporal, and extratemporal lobar cerebral hemisphere locations. When large, the tumors demonstrate cystic degeneration and necrosis, hemorrhage, contrast enhancement, and regions of low apparent diffusion coefficient scalars consistent with patterns seen with other high-grade pediatric brain tumors. The tumors also have a propensity to spread into the meninges at presentation and for distant CSF spread on follow-up imaging.

Polystyrene-block-Polydimethylsiloxane as a Potential Silica Substitute for Polysiloxane Reinforcement

Here we report microphase-separated poly(styrene-block-dimethylsiloxane) (PS-b-PDMS) as a reinforcing filler in PDMS thermosets that overcomes the long-standing problem of aging in the processing of silica-reinforced silicone. Surprisingly, PS-b-PDMS reinforced composites display comparable mechanical performance to silica-modified analogs, even though the modulus of PS is much smaller than that of silica and there is no evidence of percolation with respect to the rigid PS domains. We have found that a few unique characteristics contribute to the reinforcing performance of PS-b-PDMS. The strong self-assembly behavior promotes batch-to-batch repeatability by having well-dispersed fillers. The structure and size of the fillers depend on the loading and characteristics of both filler and matrix, along with the shear effect. The reinforcing effect of PS-b-PDMS is mostly brought by the entanglements between the corona layer of the filler and the matrix, rather than the hydrodynamic reinforcement of the PS phase.

Roles of Akt and ERK in mTOR-Dependent Antidepressant Effects of Vanillic Acid

Vanillic acid, an oxidized form of vanilla, is a flavoring agent with a creamy odor. Several studies have reported the neuroprotective effects of vanillic acid, which are predominantly associated with anti-inflammatory and antioxidative properties. The anti-inflammatory and antioxidative properties may result from Akt or ERK signaling activation. The activation of the mammalian target of rapamycin (mTOR), a key downstream target of Akt and ERK signaling, is a crucial therapeutic target for treating depression. However, the antidepressant effects of vanillic acid remain unknown. The present study applied the forced swim test (FST) to investigate the antidepressant effects of vanillic acid and its association with Akt, ERK, and mTOR signaling and upstream α-amino-3-hydroxy-5-methyl-4-isoxazolepropionaic acid receptor (AMPAR) in the prefrontal cortex (PFC) of mice. Vanillic acid demonstrated antidepressant effects by significantly reducing behavioral despair in the FST. None of the treatments changed locomotor activity. Additionally, vanillic acid increased AMPAR throughput, Akt, and mTOR signaling but not ERK signaling in the PFC. NBQX (an AMPAR blocker), MK 2206 (an Akt blocker), and rapamycin (an mTOR blocker) used in pretreatment attenuated the antidepressant effects of vanillic acid, but SL327 (an ERK inhibitor) did not. The immunochemical results indicated that the antidepressant effects of vanillic acid depend on the AMPAR-Akt-mTOR signaling transduction pathway. Our findings reveal an Akt-dependent, but ERK-independent, the mechanism underlying the antidepressant effects of vanillic acid, which may be beneficial for some patients with depression.

P861A quantitative CCTA evaluation in non-obstructive coronary artery disease for the diagnosis of vessel-specific ischemia: results from the prospective, multicenter, international CREDENCE trial

Aim

To improve the diagnosis of coronary vessel-specific ischemia in non-obstructive coronary artery disease (CAD) using a quantitative whole-heart coronary computed tomography angiography (CCTA) evaluation. To date, predictors of ischemia in non-obstructive CAD remain underexplored.

Methods

Within the CREDENCE trial, 612 patients with suspected CAD at 13 sites (64±10 years, 70% men) underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography with 3-vessel fractional flow reserve (FFR) measurements. For this specific analysis, only vessels with non-obstructive plaque (1–49% maximal diameter stenosis) by CCTA were included. The primary endpoint was coronary vessel-specific ischemia which was defined as FFR ≤0.80 (or ≥90% stenosis). Multivariable logistic regression modeling was performed to evaluate the effect of quantitative CCTA features beyond coronary stenosis on the prevalence of vessel-specific ischemia.

Results

FFR ≤0.80 (or ≥90% stenosis) was prevalent in 22.8% of 1,102 vessels with non-obstructive plaque. Using a step-wise approach, in addition to diameter stenosis (χ2=72), non-calcified PAV (χ2=126, P<0.001), lumen volume (χ2=175, P<0.001) and number of lesions with >30% stenosis (χ2=187, P=0.001) were independent CCTA-predictors of coronary vessel-specific ischemia (Figure 1). In the final model, diameter stenosis was no longer significantly associated with ischemia (P=0.236).

Figure 1

Conclusion

In vessels with non-obstructive plaque on CCTA, ischemia was present in approximately 20%. Measures of overall non-calcified plaque burden and smaller lumen volume were more important determinants of vessel-specific ischemia than maximal diameter stenosis.

Acknowledgement/Funding

NIH R01-HLL118019; Dalio Foundation and Michael J. Wolk Foundation

P868Temporal remodeling of coronary arteries during progression of atherosclerosis with serial coronary CT angiography using 3D metrics: results from the PARADIGM study

Aim

To determine compensatory enlargement and luminal reduction of coronary arteries during the progression of atherosclerosis with serial coronary computed tomography angiography (CCTA) by using volumetric measurements. To date, the impact of coronary plaque progression on temporal remodeling, as opposed to the static remodeling, has only been studied with invasive imaging modalities and primarily two-dimensional areas rather than three-dimensional volumes.

Methods

In total, 1,245 patients with suspected coronary artery disease (CAD) at 13 sites (61±9 years, 39% women) underwent serial CCTA with interscan interval of ≥2 years. The primary objective was to assess volumetric temporal remodeling, defined as the linear association between the change in coronary plaque, lumen and vessel volume at follow-up CCTA on a per-segment level. Temporal remodeling was determined in strata of low and high baseline plaque burden as well as different coronary segments at baseline. Linear regression analysis and Pearson's correlation coefficients were calculated to assess associations.

Results

Amongst 1,245 patients with 19,920 segments, the median interscan interval was 3.3 (IQR 2.6–4.8) years. For each 1 mm3 increase in plaque volume, the increase in vessel volume was 0.72 mm3 and the decrease in lumen volume was 0.28 mm3 (Figure 1, both p<0.001). Volumetric temporal remodeling was similar in low versus high PAV [0.70 mm3 vs 0.73 mm3 (p for interaction=0.491)] and left-main arteries versus all other segments [0.78 mm3 vs. 0.72 mm3 (p for interaction=0.336)], but not in proximal versus distal segments at baseline [0.75 mm3 vs. 0.61 mm3 (p for interaction=0.020)].

Figure 1. Volumetric temporal remodeling

Conclusion

In general, coronary plaque grows approximately 70% outward and 30% into the coronary lumen during the progression of atherosclerosis. Volumetric temporal remodeling is not limited by baseline plaque burden, but is potentially dependent on its location within the coronary artery tree.

Acknowledgement/Funding

NRF of Korea (Grant No. 2012027176); Dalio Institute of Cardiovascular Imaging and Michael J. Wolk Foundation

4182Sex specific patterns in the onset and manifestation of coronary atherosclerotic plaque; insights from the multi-center CCTA CONFIRM registry

Background

Pathobiologic data support varied atherosclerotic plaque characteristics which uniquely define risk in women as compared to men (i.e., plaque erosion versus rupture). The advent of noninvasive coronary computed tomographic angiography (CCTA) allows for further exploration as to a sex-specific signature of atherosclerotic plaque features unique to women and different from that of men. In this analysis, we compared sex differences in the age of onset of coronary atherosclerosis and varied plaque findings between women and men.

Methods

From the multicenter CONFIRM registry, the Leiden CCTA score (based on segmental plaque extent, location, severity, and composition) was calculated in women and men without prior CAD, with imputation for missing plaque data. First, women and men were matched on the Leiden CCTA score to allow assessment of differences in atherosclerotic profile. Second, the earliest age of women and men to display a median Leiden CCTA score >0, >2, >6, >8 was evaluated. Third, the prognostic value of previously established thresholds of the Leiden CCTA score was examined for all-cause mortality with Cox-proportional hazard analysis, and specifically a sex interaction.

Results

In total, 11,678 women (age 58.5±12.4 years) and 13,272 men (age 55.6±12.5 years) were included. Of the patient subset matched on Leiden CCTA score (10,266 women, score 4.1±6.0 and 10,266 men, Leiden score 4.1±6.0, P=0.589), women were characterized by less obstructive CAD (≥50% stenosis) (17.5% vs 19.1%, P=0.003), more frequent non-obstructive left main plaque (10.1% vs 8.9%, P=0.004) and a lower number of segments with non-calcified or mixed plaque, but an equal number of calcified plaques. The earliest age when women and men have a median Leiden CCTA score above 0, 2, 4, 6, or 8 was consistently 14 to 16 years later for women. A visual representation of the CAD development delay is shown in Figure 1. Adjusted for age, the hazard ratio for death (827 events) for a score 6–20, and >20 (compared with 0–6) was 1.95 (95% CI 1.56–2.42), and 3.44 (95% CI 2.40–4.93) for women, respectively, and 1.63 (95% CI 1.31–2.03), 2.22 (95% CI 1.64–3.00) for men, respectively (P-interaction 0.006). Despite the low number of events, women <50 years with a score >20 were at 12.8 (95% CI 3.58–45.73) times increased risk.

Conclusion

There is an approximate 15-year delay in onset of coronary atherosclerosis for women compared to men. The burden of atherosclerotic plaque is associated with a higher relative hazard for death among women than men. The pattern of more nonobstructive CAD, especially in the left main coronary artery, but also less non-calcified plaque supports a sex-specific plaque signature which may uniquely define risk among women as compared to men.

Acknowledgement/Funding

The research reported in this manuscript was funded, in part, by the National Institute of Health (Bethesda, MD, USA) under award number R01 HL115150.

In Situ Formed Pt3Ti Nanoparticles on a Two-Dimensional Transition Metal Carbide (MXene) Used as Efficient Catalysts for Hydrogen Evolution Reactions

The design of efficient catalysts capable of delivering high currents at low overpotentials for hydrogen evolution reactions (HERs) is urgently needed to use catalysts in practical applications. Herein, we report platinum (Pt) alloyed with titanium (Ti) from the surface of Ti₃C₂T_x MXenes to form Pt₃Ti intermetallic compound (IMC) nanoparticles (NPs) via in situ coreduction. In situ X-ray absorption spectroscopy (XAS) indicates that Pt undergoes a temperature-dependent transformation from single atoms to intermetallic compounds, and the catalyst reduced at 550 °C exhibits a superior HER performance in acidic media. The Pt/Ti₃C₂T_x-550 catalyst outperforms commercial Pt/Vulcan and has a small overpotential of 32.7 mV at 10 mA cm^-2 and a low Tafel slope of 32.3 mV dec^-1. The HER current was normalized by the mass and dispersion of Pt, and the mass activity and specific activity of Pt/Ti₃C₂T_x-550 are 4.4 and 13 times higher, respectively, than those of Pt/Vulcan at an overpotential of 70 mV. The density functional theory (DFT) calculations suggest that the (111)- and (100)-terminated Pt₃Ti nanoparticles exhibit *H binding comparable to Pt(111), while the (110) termination has an *H adsorption that is too exergonic, thus poisoned in the low overpotential region. This work demonstrates the potential of MXenes as platforms for the design of electrocatalysts and may spur future research for other MXene-supported metal catalysts that can be used for a wide range of electrocatalytic reactions.

Thin Biobased Transparent UV-Blocking Coating Enabled by Nanoparticle Self-Assembly

A waterborne, UV-blocking, and visually transparent nanocomposite coating was formulated with ZnO nanoparticles and 2-hydroxyethyl cellulose (HEC). The coating is highly effective (<5% UV and ∼65% visible transmittance), and the film thickness (0.2-2.5 μm) is ∼100 times thinner than the conventional coatings of similar UV-blocking performance. The superior properties are due to the fractal structures of ZnO nanoparticles assembled within the HEC matrix, revealed by scanning electron microscopy and small-angle X-ray scattering (SAXS). Changing the binder to 2-hydroxyethyl starch (HES) diminishes the UV-blocking performance, as ZnO nanoparticles form dense globular aggregates, with an aggregation number measured by SAXS 3 orders of magnitude larger than the HEC coating. Since HEC and HES share the same repeating glucose unit in the polymer backbone, it suggests that the conformational characteristics of the binder polymer have a strong influence on the nanoparticle aggregation, which plays a key role in determining the optical performance. Similar structures were achieved with TiO₂ nanoparticles. This study not only offers a cost-effective and readily scalable method to fabricate transparent UV-blocking coating but also demonstrates that the unique fractal aggregation structures in a nanocomposite material can provide high performance and functionality without fully dispersing the nanoparticles.

Sensitivity enhancement of methacrylic acid gel dosimeters by incorporating iodine for computed tomography scans

PURPOSE

Polymer gel dosimeters provide three-dimensional absorbed dose information and have gradually become a popular tool for quality assurance in radiotherapy. This study aims to incorporate iodine into the MAGAT-based gel as radiation sensitizer and investigate whether it can be used to measure the radiation dose and slice thickness for CT scans.

METHODS

The nMAGAT(I) gel was doped with 0.03, 0.05, and 0.07-M iodine. The absorbed dose was delivered using a CT scanner (Alexion 16, Toshiba Medical Systems, Japan) with tube voltages of 80, 100, 120, and 135 kVp. The irradiated nMAGAT(I) gel was read using a cone beam optical CT scanner to produce dose-response curves. The nMAGAT(I) gel was used to obtain the slice sensitivity profile (SSP) and the CT dose index (CTDI) for quality assurance of CT scans.

RESULTS

The 0.07-M iodine-doped nMAGAT(I) gel exhibited maximum sensitivity with the dose enhancement ratio of 2.12. The gel was chemically stable 24 h after its preparation, and the polymerization process was completed 24-48 h after the irradiation. For CT quality assurance, the full width at half maximum measured by the nMAGAT(I) gel matched the nominal slice thickness of CT. The CTDI at center, CTDI at peripheral, and weighted CTDI obtained by the nMAGAT(I) gel differed from those obtained by the ionization chamber by -4.2%, 3.1%, and 0.7%, respectively.

CONCLUSIONS

The nMAGAT(I) gel can be used to assess radiation doses and slice thickness in CT scans, thus rendering it a potential quality assurance tool for CT and other radiological diagnostic applications.

Dynamics of ultra-thin polystyrene with and without a (artificial) dead layer studied by resonance enhanced dynamic light scattering

Using non-invasive, marker-free resonance enhanced dynamic light scattering, the dynamics of capillary waves on ultrathin polystyrene films' coupling to the viscoelastic and mechanical properties have been studied. The dynamics of ultrathin polymer films is still debated. In particular the question of what influence either the solid substrate and/or the fluid-gas interface has on the dynamics and the mechanical properties of films of glass forming liquids as polymers is in the focus of the present research. As a consequence, e.g., viscosity close to interfaces and thus the average viscosity of very thin films are prone to change. This study is focused on atactic, non-entangled polystyrene thin films on the gold surface. A slow dynamic mode was observed with Vogel-Fulcher-Tammann temperature dependence, slowing down with decreasing film thickness. We tentatively attribute this relaxation mode to overdamped capillary waves because of its temperature dependence and the dispersion with a wave vector which was found. No signs of a more mobile layer at the air/polymer interface or of a "dead layer" at the solid/polymer interface were found. Therefore we investigated the influence of an artificially created dead layer on the capillary wave dynamics by introducing covalently bound polystyrene polymer brushes as anchors. The dynamics was slowed down to a degree more than expected from theoretical work on the increase of density close to the solid liquid interface-instead of a "dead layer" of 2 nm, the interaction seems to extend more than 10 nm into the polymer.

[Infantile systemic hyalinosis: a case report and literature review]

Objective: To investigate the clinical, pathological and gene mutation features of infantile systemic hyalinosis(ISH). Method: Data of a child with ISH seen in Haikou Hospital were retrospectively analyzed for the diagnosis and differential diagnosis of infantile systemic hyalinosis and the relevant reports in literature were reviewed. Result: A 1 year and 1 month old boy showed limbs joint stiffness, limited mobility and double knee flexion at his first month of life. At third month, red rashes appeared on the body and gradually became purple, most of them were seen on the back and they were higher than the skin surface, uneven and did not fade when pressed. Undergoing X-ray the boy showed double knee varus deformity. Histopathological examination of the neck skin lesions proved hyalinosis. The gene examination revealed ANTXR2 exon 13, c. 1073 delC/c.1074 delT mutations, which were hot spots mutation of ISH, then the diagnosis of ISH was confirmed. Using "Infantile systemic hyalinosis" as a keyword, literature in Wanfang network, PubMed and China National Knowledge Infrastructure from 1978 to 2015 was searched, we found 48 foreign cases, one Chinese Taiwan case. All the cases had joint contractures. Short stature and skin lesions with hyperpigmentation in 40 cases, gingival hyperplasia in 36 cases, perianal nodules in 32 cases, skin thickening in 31 cases, osteoporosis in 30 cases, recurrent diarrhea in 30 cases, repeated infections in 25 cases; 49 cases were reported as autosomal recessive genetic disease, of whom 18 cases underwent genetic testing, the pathogenic gene was located in the fourth chromosome q21 position, the gene was encoded as capillary morphogenesis Protein 2 (CMG2), also known as anthrax toxin receptor 2 (ANTXR2), but there were various mutation spots in the gene. Among the 18 cases, 9 were of frameshift, 8 of missense and 1 of splice defect . Onset ages were mainly within 4 months after birth. Without special treatment most patients died at about 2 years of age due to repeated infections. Conclusion: ISH is a rare disease, which occurs at early age. ISH has special clinical features: joint contracture and limited mobility, special skin rash and pigmentation, skin hyaline degeneration of pathological examination. ISH is an autosomal recessive genetic disease with mutation gene located in the fourth chromosome q21 position. Currently there is no effective treatment for ISH, with which patients are prone to die of recurrent infections.

Measuring the solubility of solids in non-solvents: case of polystyrene in alkanes

We introduce a simple and sensitive technique for measuring extremely low solubilities with a small sample size and small solvent volume. This technique involves measuring the decrease in the thickness of a supported thin film after exposure to a drop of known volume of solvent and removal of the solution. The feasibility of measuring very small changes in film thickness directly translates to the ability to measure extremely low solubility while at the same time using only μL of solvent. We apply the technique to the case of polystyrene with M_w values in the range 2500 g/mol to 22200 g/mol in alkane solvents and show that we can easily measure a solubility of 0.1 g/L using only 1[Formula: see text] g of material and 3[Formula: see text] L of solvent for each sample.

Gel Point Suppression in RAFT Polymerization of Pure Acrylic Cross-Linker Derived from Soybean Oil

Here we report the reversible addition-fragmentation chain transfer (RAFT) polymerization of acrylated epoxidized soybean oil (AESO), a cross-linker molecule, to high conversion (>50%) and molecular weight (>100 kDa) without macrogelation. Surprisingly, gelation is suppressed in this system far beyond the expectations predicated both on Flory-Stockmeyer theory and multiple other studies of RAFT polymerization featuring cross-linking moieties. By varying AESO and initiator concentrations, we show how intra- versus intermolecular cross-linking compete, yielding a trade-off between the degree of intramolecular linkages and conversion at gel point. We measured polymer chain characteristics, including molecular weight, chain dimensions, polydispersity, and intrinsic viscosity, using multidetector gel permeation chromatography and NMR to track polymerization kinetics. We show that not only the time and conversion at macrogelation, but also the chain architecture, is largely affected by these reaction conditions. At maximal AESO concentration, the gel point approaches that predicted by the Flory-Stockmeyer theory, and increases in an exponential fashion as the AESO concentration decreases. In the most dilute solutions, macrogelation cannot be detected throughout the entire reaction. Instead, cyclization/intramolecular cross-linking reactions dominate, leading to microgelation. This work is important, especially in that it demonstrates that thermoplastic rubbers could be produced based on multifunctional renewable feedstocks.

Polysaccharides of Trametes versicolor Improve Bone Properties in Diabetic Rats

This study investigates the effects of Trametes versicolor (L.:Fr.) Pilát (TVP, also known as Yunzhi) on bone properties in diabetic rats. Forty-five male Wistar rats (8 weeks old) were fed either a chow diet (control) or a high-fat diet throughout the study period of 28 days. Animals in the high-fat-diet group were injected with nicotinamide and streptozotocin to induce diabetes mellitus (DM). The DM rats were divided into a group receiving distilled water (vehicle) and another group receiving TVP at 0.1 g/kg weight by gavage. Relative to the vehicle group, TVP gavage lowered postprandial blood sugar (225 ± 18 mg/dL for TVP vs 292 ± 15 mg/dL for vehicle, p < 0.001) on day 26. Compared to the vehicle group, TVP mitigated DM-induced bone deterioration as determined by increasing bone volume of proximal tibia (22.8 ± 1.4% for TVP vs 16.8 ± 1.3% for vehicle, p = 0.003), trabecular number (p = 0.011), and femoral bone strength (11% in maximal load, 22% in stiffness, 14% in modulus, p < 0.001), and by reducing loss of femoral cortical porosity by 25% (p < 0.001). Our study demonstrates the protective effect of TVP on bone properties was mediated through, in part, the improvement of hyperglycemic control in DM animals.

Effects of medium components and culture conditions on mycelial biomass and the production of bioactive ingredients in submerged culture of Xylaria nigripes (Ascomycetes), a Chinese medicinal fungus

The optimal culture conditions were investigated to maximize the production of mycelial biomass and bioactive ingredients in submerged cultivation of Xylaria nigripes, a Chinese medicinal fungus. The one-factor-at-a-time method was used to explore the effects of medium components, including carbon, nitrogen, mineral sources, and initial pH of the medium and environmental factors, such as culture temperature and rotation speed, on mycelial growth and production of bioactive ingredients. The results indicated that the optimal culture temperature and rotation speed were 25°C and 100 rpm in a medium with 20 g fructose, 6 g yeast extract, and 2 g magnesiun sulfate heptahydrate as carbon, nitrogen, and mineral sources, respectively, in 1 L distilled water with an initial medium pH of 5.5. With optimal medium components and conditions of cultivation, the maximal production of mycelial biomass was 6.64 ± 0.88 g/L, with maximal production of bioactive ingredients such as extracellular polysaccharides (2.36 ± 0.18 mg/mL), intracellular polysaccharides (2.38 ± 0.07 mg/g), adenosine (43.27 ± 2.37 mg/g), total polyphenols (36.57 ± 1.36 mg/g), and triterpenoids (31.29 ± 1.17 mg/g) in a shake flask culture. These results suggest that different bioactive ingredients including intracellular polysaccharides, adenosine, total polyphenols and triterpenoids in mycelia and extracellular polysaccharides in broth can be obtained from one simple medium for submerged cultivation of X. nigripes.

The Fruiting Bodies, Submerged Culture Biomass, and Acidic Polysaccharide Glucuronoxylomannan of Yellow Brain Mushroom Tremella mesenterica Modulate the Immunity of Peripheral Blood Leukocytes and Splenocytes in Rats with Impaired Glucose Tolerance

The prevalence of diabetes mellitus (DM), a chronic disease with hyperglycemia and impaired immune function, is increasing worldwide. Progression from impaired glucose tolerance (IGT) to type 2 DM has recently become a target for early intervention. The fruiting bodies (FB) and submerged culture mycelium (CM) of Tremella mesenterica, an edible and medicinal mushroom, have been demonstrated to have antihyperglycemic and immunomodulatory activities in type 1 DM rats. Herein, we investigated the effects of acidic polysaccharide glucuronoxylomannan (GX) extracted from CM on the immunocyte responses. Male Wistar rats were injected with streptozotocin (65 mg/kg) plus nicotinamide (200 mg/kg) for the induction of IGT, and gavaged daily with vehicle, FB, CM, or GX (1 g/kg/day). Rats injected with saline and gavaged vehicle were used as controls. Two weeks later, peripheral blood leukocytes (PBLs) and splenocytes were collected. Ingestion of FB, CM, and GX significantly decreased blood glucose levels in the postprandial period and in oral glucose tolerance test, and partially reversed T-splenocytic proliferation in IGT rats. CM significantly decreased T-helper lymphocytes in the PBLs and B-splenocytes. In addition, FB, CM, and GX significantly reversed the IGT-induced decreases in tumor necrosis factor-α production; GX significantly increased interleukin-6 production in T-lymphocytes in the PBLs and splenocytes; and CM and GX significantly reversed IGT-induced decrease in interferon-γ production in T-lymphocytes in the spleen. In conclusion, FB, CM, and acidic polysaccharide GX of T. mesenterica may increase T-cell immunity via the elevation of proinflammatory and T-helper cytokine production in rats with impaired glucose tolerance.

The learning experiences of student nurses in pediatric medication management: a qualitative study

BACKGROUND

Traditionally, the 'five rights' (right patient, right route, right drug, right time, and right dose) principle is taught to be practiced during every medication administration process. Nursing educators use this principle to evaluate student performance. However, health care unit factors and education system characteristics that can contribute to student errors should not be underestimated. Students often felt stressed when medicating children during clinical practicum. The voices of these students are rarely represented.

OBJECTIVE

To understand students' experiences and perceptions of medication administration during their pediatric clinical practicum.

DESIGN

A descriptive qualitative study design was adopted.

SETTING

A university in Northern Taiwan.

PARTICIPANTS

A total of 34 undergraduate students who had completed a pediatric clinical practicum participated in a one-on-one interview.

METHODS

Each student was interviewed according to a semi-structured interview guide and was encouraged to disclose individual feelings and thoughts toward their experiences in pediatric medication administration.

RESULTS

Eight themes emerged. The findings suggest that to decrease students' anxiety and increase their competence, pediatric instructors should improve their teaching strategies to better prepare students for clinical training. Providing self-directed learning activities and resources to improve students' familiarity with medication and medication safety knowledge is necessary. Instructors should provide students with a secure environment to discuss their medication errors.

CONCLUSION

The 'nine rights' should be taught in fundamental nursing courses to enhance students' awareness during the medication administration process, and students should continue to practice the 'nine rights' in later pediatric clinical courses. Equal importance should be given to system failures that impact patient safety.

Resilience among caregivers of children with chronic conditions: a concept analysis

The purpose of this concept analysis is to uncover the essential elements involved in caregivers’ resilience in the context of caring for children with chronic conditions. Walker and Avant’s methodology guided the analysis. The study includes a literature review of conceptual definitions of caregiver resilience in caring for children with chronic conditions. The defining attributes and correlates of caregiver resilience are reviewed. Concept analysis findings in a review of the nursing and health-related literature show that caregiver resilience in the context of caring for chronically ill children can be defined within four main dimensions, ie, disposition patterns, situational patterns, relational patterns, and cultural patterns. Empiric measurements of the impact of caregiver resilience applied to caregivers with children with chronic conditions are also reported in the analysis. The findings of this concept analysis could help nurses and health care providers to apply the concept of caregiver resilience in allied health care and be applied to further studies.

The effectiveness of an e-learning program on pediatric medication safety for undergraduate students: a pretest-post-test intervention study

BACKGROUND

Safe medication management is a major competency taught in the nursing curriculum. However, administering pediatric medications is considered a common clinical stressor for Taiwanese students. A supplemental e-learning program that helps students fill the gap between basic nursing skills and pediatric knowledge on medication safety was developed.

OBJECTIVE

To evaluate the effectiveness of an e-learning program to increase pediatric medication management among students who take pediatric nursing courses.

DESIGN

This intervention study used a historical comparison design.

SETTING

A university in Northern Taiwan.

PARTICIPANTS

A total of 349 undergraduate nursing students who took pediatric nursing courses participated. Eighty students in the comparison group received regular pediatric courses, including the lectures and clinical practicum; 269 students in the intervention group received an e-learning program, in addition to the standard pediatric courses.

METHODS

Between February 2011 and July 2012 pediatric medication management, including pediatric medication knowledge and calculation ability, was measured at the beginning of the first class, at the completion of the lectures, and at the completion of the clinical practicum. The program was evaluated qualitatively and quantitatively.

RESULTS

The intervention group had significantly higher pediatric medication management scores at completion of the lecture course and at the completion of the clinical practicum than the comparison group based on the first day of the lecture course, after adjusting for age, nursing program, and having graduated from a junior college in nursing. Overall, the students appreciated the program that included various teaching modalities content that related to the administration of medication.

CONCLUSION

Using an e-learning program on pediatric medication management is an effective learning method in addition to sitting in a regular lecture course. The different emphases in each module, provided by experienced instructors, enabled the students to be more aware of their role in pediatric medication safety.

A Systematic Review of the Mysterious Caterpillar Fungus Ophiocordyceps sinensis in Dong-ChongXiaCao ( Dōng Chóng Xià Cǎo) and Related Bioactive Ingredients

The caterpillar fungus Ophiocordyceps sinensis (syn.Cordyceps sinensis), which was originally used in traditional Tibetan and Chinese medicine, is called either "yartsa gunbu" or "DongChongXiaCao ( Dōng Chóng Xià Cǎo)" ("winter worm-summer grass"), respectively. The extremely high price of DongChongXiaCao, approximately USD $20,000 to 40,000 per kg, has led to it being regarded as "soft gold" in China. The multi-fungi hypothesis has been proposed for DongChongXiaCao; however, Hirsutella sinensis is the anamorph of O. sinensis. In Chinese, the meaning of "DongChongXiaCao" is different for O. sinensis, Cordyceps spp., and Cordyceps sp. Over 30 bioactivities, such as immunomodulatory, antitumor, anti-inflammatory, and antioxidant activities, have been reported for wild DongChongXiaCao and for the mycelia and culture supernatants of O. sinensis. These bioactivities derive from over 20 bioactive ingredients, mainly extracellular polysaccharides, intracellular polysaccharides, cordycepin, adenosine, mannitol, and sterols. Other bioactive components have been found as well, including two peptides (cordymin and myriocin), melanin, lovastatin, γ-aminobutyric acid, and cordysinins. Recently, the bioactivities of O. sinensis were described, and they include antiarteriosclerosis, antidepression, and antiosteoporosis activities, photoprotection, prevention and treatment of bowel injury, promotion of endurance capacity, and learning-memory improvement. H. sinensis has the ability to accelerate leukocyte recovery, stimulate lymphocyte proliferation, antidiabetes, and improve kidney injury. Starting January 1(st), 2013, regulation will dictate that one fungus can only have one name, which will end the system of using separate names for anamorphs. The anamorph name "H. sinensis" has changed by the International Code of Nomenclature for algae, fungi, and plants to O. sinensis.

First Report of Southern Blight of Mexican Petunia (Ruellia brittoniana) Caused by Sclerotium rolfsii in Taiwan

Mexican petunia (Ruellia brittoniana) is an herbaceous flowering perennial with strikingly colored flowers, widely cultivated commercially as a potted plant and a popular garden plant. In July of 2010, root and stem rot that caused death was observed on Mexican petunia at the flower nursery of the Council of Agriculture & Chiayi County in Taiwan. Plants had rotted and girdled stem bases. Necrotic areas were covered with fans of white mycelium as well as abundant spherical sclerotia. A fungus was isolated from infected tissue and sclerotia, and maintained on potato dextrose agar (PDA) plates incubated at 25°C without light. Colonies were white, cottony, often forming fans; pure cultures were prepared by transferring hyphal tips to PDA. Sclerotia formed after 10 days, initially white becoming dark brown with age, and 0.5 to 0.6 mm in diameter. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS4 and ITS5 (2) and sequenced. The resulting sequence of 687 bp was uploaded in NCBI. The sequence was 98% similar to sequences of Athelia rolfsii (Sclerotium rolfsii) in NCBI (Accession No. JN543691.1). Koch's postulates were performed using two inoculation techniques. The soil near the base of healthy Mexican petunia plants (four plants per pot) were exposed to recently matured sclerotia (10 sclerotia per plant) developed from pure fungal cultures or 10-mm-diameter agar plugs of mycelium (one plug per plant). Noninoculated plants, in a separate pot, were used as a control. All plants were incubated in a growth chamber at 28 to 33°C. Disease symptoms occurred on all inoculated plants by 5 to 7 days and included yellowing of leaves, basal stem rot, and wilt. Ten days after inoculation, inoculated plants were dead whereas control plants remained healthy. The pathogenicity test was repeated twice with similar results and S. rolfsii was reisolated from infected plants in each test. The pathogen has been reported to cause substantial loss of Mexican petunia in Louisiana (1). The disease is becoming more common in Taiwan and could cause losses in Mexican petunia production. To our knowledge, this is the first report of disease on Mexican petunia caused by S. rolfsii in Taiwan. References: (1) G. E. Holcomb. Plant Dis. 88:770, 2004. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, 1990.

First Report of Southern Blight of Iresine herbstii Caused by Sclerotium rolfsii in Taiwan

Widely cultivated commercially, Iresine herbstii Hook is a potted herbaceous plant popular for its foliage, which varies from a dark red to brownish maroon. In the summer of 2010, a sudden wilt of I. herbstii plants was observed at a recreational farm in Taipei City in northern Taiwan. The initial symptoms were water-soaked lesions that became soft and then rotted. Necrotic areas on the stems were covered with fans of white mycelium as well as abundant spherical, brown sclerotia. A fungus was isolated from both infected tissue and sclerotia and maintained on potato dextrose agar (PDA) plates incubated at 25°C without light. Colonies were white and cottony, often forming mycelial fans. Pure cultures were prepared by transferring single hyphal tips to PDA. Sclerotia formed after 7 days. Sclerotia were initially white becoming dark brown with age and were 0.8 to 1 mm in diameter at maturity. These are typical features of Sclerotium rolfsii. Koch's postulates were performed by inoculating five healthy, potted I. herbstii plants with 10 fresh sclerotia placed on the soil surface around the base of each plant. In a second test, five healthy potted plants were inoculated with a single 10-mm-diameter mycelial agar plug placed at the stem base of each plant. Five noninoculated plants served as controls. All plants were incubated in a growth chamber at 25 to 35°C. Basal stem rot and wilt developed within 4 days on plants inoculated with sclerotia or mycelial plugs. All plants were dead by 7 days after inoculation whereas the controls remained healthy. The fungus was reisolated from the symptomatic tissue and produced sclerotia and mycelium consistent with S. rolfsii. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS4 and ITS5 (3) and sequenced. The resulting sequence of 687 bp was uploaded in NCBI (Accession No. JN543691.1). The sequence was 98% similar to sequences of Athelia rolfsii (anamoprh S. rolfsii). This disease has been observed on many species of plants (1, 2). To our knowledge, this is the first report of I. herbstii caused by S. rolfsii in Taiwan or any other part of the world. References: (1) T. T. Chang. Bull. Taiwan For. Res. Inst. 9:191, 1994. (2) Y. N. Wang et al. J. Exp. For. Nat. Taiwan Univ. 20:45, 2006. (3) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

Differential expression of centrosome-associated proteins in human brain tumors: a possible role of hNinein isoform 6 in cell differentiation

Dysregulated centrosomal expression has been observed in high grade gliomas. Thus, this study aimed to examine the expression of Aurora family kinase and various centrosomal proteins, including centrin, γ-tubulin, and hNinein isoforms, in human brain tumors, including 29 meningiomas, 34 astrocytomas, 6 pituitary adenomas, and 6 metastatic tumors. mRNA expression was evaluated using reverse transcription polymerase chain reaction. The role of hNinein isoform 6 expression in cell differentiation was assessed in BrdU-treated IMR-32 cells. Differential expression of centrosomal proteins of brain tumors and cell lines was observed. Specifically, centrin 2 and centrin 3 expression levels were classified as moderate or abundant in >97% of samples in the meningioma group, 63% of astrocytomas, >83% of metastatic and pituitary tumors. Alternatively, hNinein isoform 6 expression was only detected in normal brain and astrocytoma tumors (17/34); however, it was not expressed in meningioma (0/29), metastatic tumors (0/6) (P < 0.001). Of the six neuroblastoma cell lines analyzed only IMR-32 cells expressed hNinein isoform 6. Furthermore, downregulated expression of hNinein isoform 6 and upregulation of γ-tubulin was correlated to astrocytoma tumor grade (P < 0.001). Increased hNinein isoform 6 mRNA expression was observed in response to BrdU treatment, and its expression was greater in teratomas as compared to embryonic stem cells. Further studies are necessary to determine if hNinein isoform 6 functions as a tumor-suppressor gene in brain tumors. Differential centrosomal protein expression may result in altered centrosome function that is observed the in progression of various brain tumors.

Acute necrotizing eosinophilic myocarditis in a young woman

Eosinophilic myocarditis is recognized by severe heart failure and marked eosinophilia infiltration resulting from different etiologies. Acute necrotizing eosinophilic myocarditis, the initial presentation of the disease, is rare and often fatal, with unique echocardiographic pictures, and followed by endocardial thrombosis and chronic endomyocardial fibrosis. We report a young female with acute lymphoblastic leukemia who presented fever and acute heart failure syndrome. The echocardiography showed severe left ventricle diastolic dysfunction with preserved ejection fraction. Systemic eosinophilia and the unique echocardiographic images made the diagnosis of acute necrotizing eosinophilic myocarditis. The patient survived after intensive cytotoxic chemotherapy including high-dose steroid.

First Report of Zonate Leaf Spot of Cinnamomum kanehirae Caused by Hinomyces moricola in Taiwan

Cinnamomum kanehirae, a native tree of Taiwan, is an important tree that hosts popular medicinal fungi. In the winter of 2011, zonate leaf spots were observed at a nursery garden in Wu-Lai, Taiwan. Initial symptoms included small brown lesions on leaves that became larger leaf spots after expanding or fusing together, causing a leaf blight and eventually defoliation. Sporophores on the host were generally hypophyllous but sometimes amphigenous, solitary, erect, easily detachable. The upper portion of the sporophore was considered an individual conidium and consisted of a pyramidal head that was fusiform to ventricose, 320 to 580 μm long and 100 to 130 μm wide at the broadest point. Branches within the pyramidal head were short and compact, and dichotomously or trichotomously branched. The sporophore initials were hyaline, broad, septate, tapering toward an acute apex, and sometimes constricted at the basal septum. Sclerotia were observed in older lesions, grey or black, spherical, and 1 to 2.5 mm in diameter. The fungus was isolated from infected tissue and sporophores, maintained on potato dextrose agar (PDA) at 20°C in darkness. Sclerotia were produced on PDA after 4 to 5 weeks and were irregular or spherical, but sporophores didn't develop on agar medium. The fungus was identified as Hinomyces moricola on the basis of morphological characteristics (1). Koch's postulates were performed by inoculating four 1-year-old, asymptomatic, potted C. kanehirae plants; every plant was inoculated with sporophores from infected leaves on each of five leaves. Four noninoculated plants were kept in separate pots and served as controls. All plants were covered with transparent plastic bags individually and incubated in a growth chamber at 18 to 20°C. Symptoms were observed after 2 to 4 days on every inoculated plant but not on uninoculated plants. The leaf spots were similar to those originally observed. The pathogen was reisolated from spots of inoculated plants. The pathogenicity test was repeated once. H. moricola is known to cause severe defoliation on woody and annual plants, including at least 73 host species and 36 families distributed in the eastern United States and Japan (2). References: (1) N.-S. Tomoko et al. Mycoscience. 47:351, 2006. (2) J. C. Trolinger et al. Plant Dis. Reptr. 62:710, 1978.

Usefulness of multidetector-row computed tomography in diagnosis of anomalous origin of left coronary artery arising from the pulmonary artery

Anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) is a rare congenital heart defect that affects approximately 1 in 300,000 live births and accounts for 0.5% of all congenital heart disease. Without surgical intervention, most patients with this anomaly die in infancy. The diagnosis of ALCAPA syndrome is sometimes difficult, especially in children, because it often presents with atypical symptoms and signs. Echocardiography can yield some findings that are highly indicative of this syndrome. Cardiac catheterization usually establishes the diagnosis, but it is invasive and painful. Multidetector-row computed tomography (MDCT) is a valuable alternative tool to confirm the diagnosis of ALCAPA syndrome. In this report, we describe a 24-year-old woman with a dilated right coronary artery detected by transthoracic echocardiography, showing an interventricular abnormal flow over the diastolic phase of the cardiac cycle and the left main coronary artery not merging with the ascending aorta. The diagnosis of ALCAPA syndrome was confirmed by MDCT.

Differential expression of centrosomal proteins at different stages of human glioma

Background

High-grade gliomas have poor prognosis, requiring aggressive treatment. The aim of this study is to explore mitotic and centrosomal dysregulation in gliomas, which may provide novel targets for treatment.

Methods

A case-control study was performed using 34 resected gliomas, which were separated into low- and high-grade groups. Normal human brain tissue was used as a control. Using immunohistochemical analysis, immunofluorescent microscopy, and RT-PCR, detection of centrins 1 and 2, γ-tubulin, hNinein, Aurora A, and Aurora B, expression was performed. Analysis of the GBM8401 glioma cell line was also undertaken to complement the in vivo studies.

Results

In high-grade gliomas, the cells had greater than two very brightly staining centrioles within large, atypical nuclei, and moderate-to-strong Aurora A staining. Comparing with normal human brain tissue, most of the mRNAs expression in gliomas for centrosomal structural proteins, including centrin 3, γ-tubulin, and hNinein isoforms 1, 2, 5 and 6, Aurora A and Aurora B were elevated. The significant different expression was observed between high- and low-grade glioma in both γ-tubulin and Aurora A mRNA s. In the high-grade glioma group, 78.6% of the samples had higher than normal expression of γ-tubulin mRNA, which was significantly higher than in the low-grade glioma group (18.2%, p < 0.05).

Conclusions

Markers for mitotic dysregulation, such as supernumerary centrosomes and altered expression of centrosome-related mRNA and proteins were more frequently detected in higher grade gliomas. Therefore, these results are clinically useful for glioma staging as well as the development of novel treatments strategies.

Effect of Adlay ( Coix lachryma-jobi L. var. ma-yuen Stapf) Testa and its phenolic components on Cu2+-treated low-density lipoprotein (LDL) oxidation and lipopolysaccharide (LPS)-induced inflammation in RAW 264.7 macrophages

The aims of this study were to investigate the effects of adlay testa (AT) on Cu(2+)-treated low-density lipoprotein (LDL) oxidation, 2,2'-diphenyl-1-picrylhydrazyl (DPPH)-scavenging capacity, and lipopolysaccharide (LPS)-induced inflammation in RAW 264.7 macrophages and determine its active components. The AT ethanolic extract (ATE) was partitioned into four fractions by various solvents as follows: n-hexane (ATE-Hex), ethyl acetate (ATE-Ea), n-butanol (ATE-Bu), and water (ATE-H(2)O). ATE-Ea and ATE-Bu were further fractionated into ATE-Ea-a-ATE-Ea-h and ATE-Bu-A-ATE-Bu-F, respectively, by column chromatography. Results showed that ATE-Ea, ATE-Bu, ATE-Ea-e, and ATE-Bu-C expressed antiradical, antioxidative, and anti-inflammatory activities with respect to the DPPH-scavenging capacity, LDL protection effect, and nitric oxide (NO) inhibitory activity. Inflammation was further modulated by ATE-Ea, ATE-Bu, ATE-Ea-e, and ATE-Bu-C through downregulating the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) proteins. The following components were found in ATE-Ea-e and ATE-Bu-C after purification and high-performance liquid chromatographic analysis: chlorogenic acid (CGA), vanillic acid (VA), caffeic acid (CA), p-coumaric acid (PCA), ferulic acid (FA), and 2-O-beta-glucopyranosyl-7-methoxy-4((2)H)-benzoxazin-3-one (GMBO). Results showed that CGA, CA, and FA were the major components responsible for the antioxidative and anti-inflammatory activities of ATE-Ea-e and ATE-Bu-C. Subsequently, each gram of ATE-Bu-C had 30.3 mg of CGA, 9.02 mg of CA, and 189 mg of GMBO, while each gram of ATE-Ea-e had 1.31 mg of VA, 3.89 mg of PCA, and 47.6 microg of FA. In conclusion, ATE has antioxidative and anti-inflammatory activities, and its effects are partially related to its phenolic components. Thus, ATE has the potential to be developed as a functional food targeting chronic diseases.

High uptake in schneiderian papillomas of the maxillary sinus on positron-emission tomography using fluorodeoxyglucose

Schneiderian papillomas are benign tumors of the nasal cavity and paranasal sinuses often asymptomatic in their early stages. We report a case of a maxillary sinus oncocytic schneiderian papilloma first detected by positron-emission tomography by using fluorodeoxyglucose (FDG). Schneiderian papillomas demonstrate increased FDG uptake, similar to that of other oncocytic tumors, making it important for otolaryngologists and radiologists to realize that high uptake of FDG does not necessarily indicate a malignant lesion.