Handedness anomaly in a non-collinear antiferromagnet under spin-orbit torque

Non-collinear antiferromagnets are an emerging family of spintronic materials because they not only possess the general advantages of antiferromagnets but also enable more advanced functionalities. Recently, in an intriguing non-collinear antiferromagnet Mn3Sn, where the octupole moment is defined as the collective magnetic order parameter, spin-orbit torque (SOT) switching has been achieved in seemingly the same protocol as in ferromagnets. Nevertheless, it is fundamentally important to explore the unknown octupole moment dynamics and contrast it with the magnetization vector of ferromagnets. Here we report a handedness anomaly in the SOT-driven dynamics of Mn3Sn: when spin current is injected, the octupole moment rotates in the opposite direction to the individual moments, leading to a SOT switching polarity distinct from ferromagnets. By using second-harmonic and d.c. magnetometry, we track the SOT effect onto the octupole moment during its rotation and reveal that the handedness anomaly stems from the interactions between the injected spin and the unique chiral-spin structure of Mn3Sn. We further establish the torque balancing equation of the magnetic octupole moment and quantify the SOT efficiency. Our finding provides a guideline for understanding and implementing the electrical manipulation of non-collinear antiferromagnets, which in nature differs from the well-established collinear magnets.

[Job Analysis of Nurse Care Coordinators for Chronic Illness Management in Primary Care Settings: Using Developing a Curriculum Process]

PURPOSE

This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job.

METHODS

A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators' jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task.

RESULTS

From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, 'assess the patient's general health status' was carried out most frequently. Nurse care coordinators perceived that 'check vital signs' and'strengthen patient competence to promote health behaviors' were more important than all other tasks. The most difficult task was 'develop professionalism as a nurse care coordinator'.

CONCLUSION

The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.

Chiral-spin rotation of non-collinear antiferromagnet by spin-orbit torque

Electrical manipulation of magnetic materials by current-induced spin torque constitutes the basis of spintronics. Here, we show an unconventional response to spin-orbit torque of a non-collinear antiferromagnet Mn₃Sn, which has attracted attention owing to its large anomalous Hall effect despite a vanishingly small net magnetization. In epitaxial heavy-metal/Mn₃Sn heterostructures, we observe a characteristic fluctuation of the Hall resistance under the application of electric current. This observation is explained by a rotation of the chiral-spin structure of Mn₃Sn driven by spin-orbit torque. We find that the variation of the magnitude of anomalous Hall effect fluctuation with sample size correlates with the number of magnetic domains in the Mn₃Sn layer. In addition, the dependence of the critical current on Mn₃Sn layer thickness reveals that spin-orbit torque generated by small current densities, below 20 MA cm^-2, effectively acts on the chiral-spin structure even in Mn₃Sn layers that are thicker than 20 nm. The results provide additional pathways for electrical manipulation of magnetic materials.

Pilot study of fractional microneedling radiofrequency for hidradenitis suppurativa assessed by clinical response and histology

BACKGROUND

Hidradenitis suppurativa (HS) is a devastating chronic inflammatory skin disease with frequent recurrences. Various systemic treatments and procedures have been used but the efficacy of fractional microneedling radiofrequency (FMR) has not been reported.

AIM

To evaluate the clinical and histological efficacy of FMR in the treatment of HS lesions.

METHODS

An 8-week, prospective, split-body, unblinded study was conducted, which enrolled 10 adult patients with mild to moderate HS to receive 3 sessions of FMR treatment biweekly. HS severity was assessed using the number and type of lesions, HS Physician Global Assessment (HS-PGA) and the modified Sartorius score (mSS). Skin biopsies were performed on participants to assess change in inflammation before and after FMR.

RESULTS

Severity of HS was significantly reduced on the FMR-treated side of the body, but not on the control side. Inflammatory HS lesions were significantly reduced after 4 weeks, while HS-PGA and mSS were significantly decreased after 6 weeks. Immunohistochemistry staining showed decreased expression of inflammatory markers including neutrophil elastases, interleukin (IL)-8 and IL-17, tumour necrosis factor-α, transforming growth factor-β1 and matrix metalloproteinases.

CONCLUSION

FMR may be a viable treatment option for mild to moderate HS.

Cardiorespiratory Responses to 10 Weeks of Exoskeleton-Assisted Overground Walking Training in Chronic Nonambulatory Patients with Spinal Cord Injury

Exercise intensity of exoskeleton-assisted walking in patients with spinal cord injury (SCI) has been reported as moderate. However, the cardiorespiratory responses to long-term exoskeleton-assisted walking have not been sufficiently investigated. We investigated the cardiorespiratory responses to 10 weeks of exoskeleton-assisted walking training in patients with SCI. Chronic nonambulatory patients with SCI were recruited from an outpatient clinic. Walking training with an exoskeleton was conducted three times per week for 10 weeks. Oxygen consumption and heart rate (HR) were measured during a 6-min walking test at pre-, mid-, and post-training. Exercise intensity was determined according to the metabolic equivalent of tasks (METs) for SCI and HR relative to the HR reserve (%HRR). Walking efficiency was calculated as oxygen consumption divided by walking speed. The exercise intensity according to the METs (both peak and average) corresponded to moderate physical activity and did not change after training. The %HRR demonstrated a moderate (peak %HRR) and light (average %HRR) exercise intensity level, and the average %HRR significantly decreased at post-training compared with mid-training (31.6 ± 8.9% to 24.3 ± 7.3%, p = 0.013). Walking efficiency progressively improved after training. Walking with an exoskeleton for 10 weeks may affect the cardiorespiratory system in chronic patients with SCI.

Effects of Wearable Powered Exoskeletal Training on Functional Mobility, Physiological Health and Quality of Life in Non-ambulatory Spinal Cord Injury Patients

BACKGROUND

Spinal cord injury (SCI) is a serious clinical condition that impacts a patient's physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients.

METHODS

Participants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timed-up-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale-International and the 36-Item Short-Form Health Survey version 2.

RESULTS

Ten participants finished 30 sessions of training and could ambulate independently. No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants.

CONCLUSION

In conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04055610.

Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-β1 signalling

BACKGROUND

Atrophic acne scar, a persistent sequela from acne, is undesirably troubling to many patients due to its cosmetic and psychosocial aspects. Although there have been some reports emphasizing the role of early inflammatory responses in atrophic acne scarring, evolving perspectives on the detailed pathogenic processes are promptly needed.

OBJECTIVES

Examining the histological, immunological and molecular changes in early acne lesions susceptible to atrophic scarring can provide new insights to understand the pathophysiology of atrophic acne scar.

METHODS

We experimentally validated several early fundamental hallmarks accounting for the transition of early acne lesions to atrophic scars by comparing molecular profiles of skin and acne lesions between patients who were prone to scar (APS) or not (ANS).

RESULTS

In APS, compared with ANS, devastating degradation of elastic fibres and collagen fibres occurred in the dermis, followed by their incomplete recovery. Abnormally excessive inflammation mediated by innate immunity with T helper 17 and T helper 1 cells was observed. Epidermal proliferation was significantly diminished. Transforming growth factor (TGF)-β1 was drastically elevated in APS, suggesting that aberrant TGF-β1 signalling is an underlying modulator of all of these pathological processes.

CONCLUSIONS

These results may provide a basis for understanding the pathogenesis of atrophic acne scarring. Reduction of excessive inflammation and TGF-β1 signalling in early acne lesions is expected to facilitate the protection of normal extracellular matrix metabolism and ultimately the prevention of atrophic scar formation. What's already known about this topic? The dermis of atrophic acne scars shows alteration of extracellular matrix components such as collagen fibres. Inflammation in acne lesions is associated with the development of acne scars. What does this study add? Abnormalities in the metabolism of collagen fibres and elastic fibres were observed in the early developmental stages of acne lesions that were progressing into atrophic scars. Exacerbated inflammation and aberrant epidermal proliferation by increased transforming growth factor (TGF)-β1 signalling may affect the abnormal extracellular matrix metabolism. What is the translational message? Abnormal changes in elastic fibres and collagen fibres are found in the early developmental process of acne in patients who are prone to atrophic scarring. An early treatment regimen strongly inhibiting inflammation and TGF-β1 signalling to help the normal recovery of the extracellular matrix components is required to prevent atrophic scarring.

Dendropanax morbiferus leaf extract facilitates oligodendrocyte development

Treatment of multiple sclerosis is effective when anti-inflammatory, neuroprotective and regenerative strategies are combined. Dendropanax morbiferus (DM) has anti-inflammatory, anti-oxidative properties, which may be beneficial for multiple sclerosis. However, there have been no reports on the effects of DM on myelination, which is critical for regenerative processes. To know whether DM benefits myelination, we checked differentiation and myelination of oligodendrocytes (OLs) in various primary culture systems treated with DM leaf EtOH extracts or control. DM extracts increased the OL membrane size in the mixed glial and pure OL precursor cell (OPC) cultures and changed OL-lineage gene expression patterns in the OPC cultures. Western blot analysis of DM-treated OPC cultures showed upregulation of MBP and phosphorylation of ERK1/2. In myelinating cocultures, DM extracts enhanced OL differentiation, followed by increased axonal contacts and myelin gene upregulations such as Myrf, CNP and PLP. Phytochemical analysis by LC-MS/MS identified multiple components from DM extracts, containing bioactive molecules such as quercetin, cannabidiol, etc. Our results suggest DM extracts enhance OL differentiation, followed by an increase in membrane size and axonal contacts, thereby indicating enhanced myelination. In addition, we found that DM extracts contain multiple bioactive components, warranting further studies in relation to finding effective components for enhancing myelination.

Predictive value of a fragmented QRS complex in diagnosing patients with myocardial ischemia

Background

A fragmented QRS complex (fQRS) is caused by conduction abnormalities of the ventricle secondary to myocardial ischemia and/or scar in patients with myocardial infarction. However, the implications of the fQRS in the development of coronary artery disease with myocardial ischemia in those without a scar remain unknown.

Methods

We studied electrocardiograms (ECGs) obtained from 150 patients (60.5 ± 8.5 years, 102 men) with myocardial ischemia, which was confirmed by performing both, a nuclear exercise stress test and coronary angiography. We also studied ECGs obtained from 601 patients (58.5 ± 10.0 years, 315 men) who showed a negative nuclear exercise stress test (control group). Patients in whom the nuclear exercise stress test showed a myocardial scar were excluded.

Results

An fQRS was more commonly observed in patients with myocardial ischemia (n = 48, 32.0%) than in the control group (n = 133, 22.1%) (P = 0.011). The sensitivity, specificity, positive, and negative predictive values of fQRS in diagnosing myocardial ischemia were 32.0, 77.9, 26.5, and 82.1%, respectively. The fQRS (odds ratio 1.580, 95% confidence interval 1.020‐2.446, P = 0.040) was an independent predictor of myocardial ischemia after adjusting for age, sex, current smoking habits, ST‐T changes on ECG, as well as histories of hypertension, diabetes, and dyslipidemia. Moreover, the fQRS showed an incremental prognostic value over conventional risk factors (χ² = 5, P = 0.032) and over a combination of conventional factors and ST‐T changes (χ² = 9, P = 0.014).

Conclusions

The fQRS is a moderately sensitive and independent predictor of myocardial ischemia.

Evaluation of abundance of artificial radionuclides in food products in South Korea and sources

Food samples are collected nationwide from January 2016 to February 2017 and their contents of artificial radionuclides are measured to address the growing concerns regarding the radioactive contamination of food products in Korea. Specifically, 900 food samples are collected for this study and their contents of representative artificial radionuclides ¹³⁴Cs, ¹³⁷Cs, ^239,240Pu, and ⁹⁰Sr are analyzed. The analysis shows that the activity concentrations of ¹³⁷Cs in fish range from minimum detectable activity (MDA) to 340 mBq/kg of fresh weight. The concentration factor (CF) determined for ¹³⁷Cs as a measure of its bioavailability is calculated to be ca. 74 and found to be very similar to that (100) recommended by the International Atomic Energy Agency. With an MDA of <0.221 mBq/kg, the results reveal that ^239,240Pu values in fish are below the MDA. The activity concentrations of ¹³⁷Cs and ⁹⁰Sr are lower than the MDA in both shellfish and seaweed, while the activity concentrations of ^239,240Pu in shellfish range from 0.26 to 2.18 mBq/kg, and for seaweed samples range from 2.07 to 3.38 mBq/kg. The atom ratios of ²⁴⁰Pu/²³⁹Pu in shellfish caught at the Korean coast vary from 0.209 to 0.237, with a mean of 0.227. The higher ²⁴⁰Pu/²³⁹Pu atom ratio determined in shellfish is thought to be caused by the plutonium transported from the Pacific Proving Grounds rather than other sources such as the Fukushima nuclear power plant accident. The activity concentrations of ¹³⁷Cs in mushrooms are found to vary from 1.0 to 21.4 Bq/kg, with the highest concentrations observed in the Oak (shiitake) and Sarcodon asparatus. ¹³⁴Cs is detected in three mushroom specimens collected from Jeju Island and about 3-3.6% of ¹³⁷Cs present in the wild mushrooms native to the Jeju Island are introduced as a result of the Fukushima nuclear plant accident. The annual effective doses of ¹³⁷Cs received through consumption of mushrooms and fish are 2.0 × 10^-4 mSv yr^-1 and 3.9 × 10^-5 mSv yr^-1, and those values are negligible compared to the annual effective doses limit of 1 mSv yr^-1.

Epidemiology and risk factors of childhood acne in Korea: a cross-sectional community based study

BACKGROUND

The epidemiology of acne vulgaris appears to be evolving, with an increasingly earlier onset seen in childhood. Relevant studies have been rarely performed in Asia.

AIM

We sought to estimate the prevalence and clinical characteristics of acne among schoolchildren, and its association with treatment-seeking behaviour, body mass index (BMI), nutritional habits and other lifestyle elements.

METHODS

A cross-sectional study was conducted with elementary schoolchildren aged 7-12 years. Children were interviewed by self-administered questionnaires, and were subsequently evaluated by dermatologists.

RESULTS

Of 693 children enrolled, 36.2% were diagnosed with acne, and the prevalence increased with age. Additionally, clinical characteristics including severity, duration of disease and lesion distribution were significantly different between the lower (aged 7-9 years) and the higher (aged 10-12 years) grades. Subjective features including recognition about acne and treatment-seeking behaviours were also different between the two groups. Overweight or obesity (BMI ≥ 25 kg/m(2) at 18 years of age; OR = 2.7) and consumption of chocolates/sweets (OR = 1.6) were significant risk factors for acne.

CONCLUSIONS

In the current study, the prevalence of acne among elementary schoolchildren was high, but only a few children had received treatment. Physicians should be attentive to childhood acne, and educate patients and their parents about the need to treat it.

First Report of Cucumber mosaic virus in Saintpaulia ionantha in Korea

African violet (Saintpaulia ionantha) is an ornamental species of the family Gesneriaceae and is characterized by fleshy leaves and colorful flowers. This popular, exotic ornamental, originally from Kenya and Tanzania, is vegetatively produced from cutting and tissue culture (1). In May 2013, virus-like foliar symptoms, including a mosaic with dark green islands and chlorosis surrounding the veins, were observed on an African violet plant in a greenhouse located in Icheon, Korea. Cucumber mosaic virus (CMV) was identified in the symptomatic plant by serological testing for the presence of CMV coat protein (CP) with a commercial immunostrip kit (Agdia, Elkhart, IN). The presence of CMV was confirmed by serological detection with a commercially available double-antibody sandwich (DAS)-ELISA kit (Agdia). Sap from the serologically positive sample was mechanically inoculated to test plants using 10 mM phosphate buffer (pH 7.0). The virus (named CMV-AV1) caused necrotic local lesions on Chenopodium amaranticolor at 5 days post-inoculation (dpi), while mild to severe mosaic was observed in Nicotiana glutinosa, N. tabacum 'Samsun NN,' Cucurbita pepo 'Super-Top,' Physalis angulate, and Solanum lycopersicum 'Unicorn' 10 to 14 dpi. Examination of the inoculated plant leaves by DAS-ELISA and electron microscopy (leaf dips) showed positive reactions to CMV and the presence of spherical virions ∼28 nm in diameter, respectively. To verify whether CMV-AV1 is the cause of disease symptoms observed in African violet, virus-free African violet (10 plants) was mechanically inoculated by sap from local lesions on C. amaranticolor inoculated with CMV-AV1. At 8 weeks after inoculation, all plants produced systemic mosaic and chlorosis surrounding veins, resulting in strong DAS-ELISA reactions for CMV, whereas mock-inoculated African violet plants remained symptomless and virus-free. The presence of CMV-AV1 in all naturally infected and mechanically inoculated plants was further verified by reverse transcription (RT)-PCR. Total RNAs were extracted with the RNeasy Plant Mini Kit (Qiagen, Hilden, Germany), according to the manufacturer's instructions. RT-PCR was carried out with the One-Step RT-PCR Kit (Invitrogen, Carlsbad, CA) using a pair of primers, CPTALL3 and CPTALL5 (2), amplifying the entire CP gene and part of an intergenic region and 3'-noncoding region of CMV RNA3. RT-PCR products (960 bp) were obtained from all naturally infected and mechanically inoculated plants as well as from positive control (viral RNAs from virions), but not from healthy tissues. The amplified RT-PCR products were purified with QIAquick PCR Purification Kit (Qiagen) and sequenced using BigDye Termination kit (Applied Biosystems, Foster City, CA). Multiple alignment of the CMV-AV1 CP sequence (Accession No. AB842275) with CP sequences of other CMV isolates using MEGA5 software revealed that 91.8 to 99.0% and 71.0 to 73.0% identities to those of CMV subgroup I and subgroup II, respectively. These results provide additional confirmation of CMV-AV1 infection. CMV may pose a major threat for production of African violet since the farming of African violet plants is performed using the vegetative propagation of the African violet leaves in Korea. In particular, mosaic and chlorosis symptoms in African violet cause damage to ornamental quality of African violet. To our knowledge, this is the first report of CMV infection of African violet in the world. References: (1) S. T. Baatvik. Fragm. Flor. Geobot. Suppl. 2:97, 1993. (2) S. K. Choi et al. J. Virol. Methods 83:67, 1999.

Double-blind, randomized non-inferiority trial of a novel botulinum toxin A processed from the strain CBFC26, compared with onabotulinumtoxin A in the treatment of glabellar lines

BACKGROUND

Botulinum toxins have been widely used in cosmetic dermatology. Neurotoxin from the CBFC26 strain (NTC) is a recently developed botulinum toxin type A product manufactured through refined procedures.

OBJECTIVE

A double-blinded, randomized, multicentre-designed, phase III trial to investigate the non-inferiority of NTC to existing botulinum toxin A, onabotulinumtoxin A in the treatment of moderate to severe glabellar lines.

METHODS

A total of 272 subjects were randomized in a 1 : 1 ratio to receive 20 U of NTC or onabotulinumtoxin A. The primary endpoint was the response rate of physicians' assessment (PA) using the Facial Wrinkle Scale at week 4. The secondary endpoints included the response rate of PA at weeks 8, 12 and 16, and photographic assessment at weeks 4, 8, 12 and 16. Subjects' improvement assessment and subjective self-satisfaction levels were also investigated.

RESULTS

Response rates for maximum frown were 89.3% in the NTC group and 81.9% in the onabotulinumtoxin A group at week 4. NTC also resulted in comparable results for both the response rates of the other evaluation points and incidence of adverse events compared to those of onabotulinumtoxin A. In subjects' improvement assessment and photographic evaluations, NTC even demonstrated better results compared with onabotulinumtoxin A in the early phase after treatment. Analysis of these results strongly supports the non-inferiority of NTC to onabotulinumtoxin A in the efficacy and safety.

CONCLUSION

NTC is as effective as onabotulinumtoxin A in the treatment of glabellar lines, and both products were well tolerated.

Fungal peri-prosthetic joint infection after primary total knee replacement

We retrospectively reviewed 30 two-stage revision procedures in 28 patients performed for fungal peri-prosthetic joint infection (PJI) after a primary total knee replacement. Patients were followed for at least two years or until the infection recurred. The mean follow-up for patients who remained free of infection was 4.3 years (2.3 to 6.1). Overall, 17 patients were assessed as American Society of Anesthesiologists grade 3 or 4. The surgical protocol included removal of the infected implant, vigorous debridement and insertion of an articulating cement spacer. This was followed by at least six weeks of antimicrobial treatment and delayed reimplantation in all patients. The mean interval between removal of the prosthesis and reimplantation was 9.5 weeks (6 to 24). After reimplantation, patients took antifungal agents orally for a maximum of six months. Two knees became reinfected at one and two months post-operatively, respectively: one of these subsequently required arthrodesis because of uncontrolled infection. Fungal PJIs can be treated successfully by removal of all infected material, appropriate antimicrobial treatment and delayed reimplantation.

Complete biologic response to taxane based chemotherapy confirmed by [F]FDG PET/CT and surgery in a cancer of unknown primary site

Cancers of an unknown primary site are heterogenous with respect to their clinical and pathologic features. They are generally very aggressive, but specific favorable subsets have a better prognosis. For these favorable subsets, taxane based chemotherapy is very effective for a subset of woman with papillary serous peritoneal adenocarcinoma. A 52 year-old woman underwent [(18)F]-FDG PET/CT for routine health screening. On PET/CT, multiple hypermetabolic lymph nodes were detected in the paraaortic spaces, and there were no other hypermetabolic abnormalities. The patient was diagnosed with an unknown primary cancer that probably originated from the ovary or peritoneum, according to clinical studies and biopsy results. This was not a typical case of a favorable subset of cancer of an unknown primary site, but the tumor showed complete biologic response to taxane based chemotherapy as revealed by PET/CT, and necrotic tumor cells were confirmed by surgery.

p53 codon 72 polymorphism in patients with gastric and colorectal cancer in a Korean population

BACKGROUND

The common p53 codon 72 polymorphism has been investigated as a risk factor for cancer in different populations; however, the results have been inconsistent. This study investigated the risk of developing gastric or colorectal cancer associated with the p53 codon 72 polymorphism in a Korean population.

METHODS

We conducted a large-scale case-control study that included 2,213 gastric cancer patients; 1,829 colorectal cancer patients; and 1,700 healthy controls. Genotyping was performed with real-time polymerase chain reaction (PCR), using a TaqMan single-nucleotide polymorphism (SNP) genotyping assay.

RESULTS

The frequencies of Arg/Arg, Arg/Pro, and Pro/Pro genotypes of the p53 codon 72 polymorphism were 43.3, 42.0, and 13.0% in the gastric cancer patients; 40.5, 45.0, and 14.0% in the colorectal cancer patients; and 43.2, 45.6, and 11.2% in the controls, respectively. The Pro/Pro genotype was associated with an increased risk of gastric [age- and sex-adjusted odds ratio (OR) = 1.25, 95% confidence interval (CI) = 1.01-1.56, P = 0.04] and colorectal cancer (OR = 1.36, 95% CI = 1.07-1.72, P = 0.01). There were no significant interactions between the p53 codon 72 polymorphism and smoking or drinking.

CONCLUSIONS

Our results suggest that the Pro/Pro genotype is associated with modest increases in the risks of gastric cancer and colorectal cancer in a Korean population.

Abstract 4252: The addition of bevacizumab to paclitaxel overcomes chemoresistance to paclitaxel in a class III beta tubulin expressing gastric cancer cells

Background: Class III β tubulin (TUBB3) reduces microtubule stability and confers resistance to microtubule stabilizing taxanes, including paclitaxel and docetaxel. Expression of vascular endothelial growth factor (VEGF) is highly regulated by hypoxia and the regulation of VEGF expression by hypoxia is mediated by a hypoxia inducible factor-1a(HIF-1a), which increase transcription of the VEGF gene. Recent report showed hypoxia induces expression of TUBB3 by HIF-1a. Inhibition of VEGF system may decrease the expression of HIF-1a and TUBB3. This study was undertaken to investigate the synergistic antitumor effects of bevacizumab and palitaxel on TUBB3 expressing gastric cancer cells.

Methods: We evaluated the expressions of TUBB3 and HIF-1a under normoxic and hypoxic conditions in human gastric cancer cells. The chemoresistance of TUBB3 to paclitaxel was checked through knockdown of TUBB3. Expressions of TUBB3 and HIF-1a were measured under blocking of VEGFR1/2 with anti-FLT1 and anti-KDR antibodies. The effects of bevacizumab and paclitaxel on expressions of TUBB3 and HIF1a were monitored by western blot and MTT assay.

Results: The chemosensitivities to paclitaxel were increased by siTUBB3. Elevated expressions of TUBB3 and HIF-1a in gastric cancer cells under hypoxic conditions were reduced in the prescence of anti-KDR and anti-FLT1 antibodies. When we added the bevacizumab to paclitaxel, the protein expressions of TUBB3 and HIF-1a in gastric cancer cells under hypoxic conditions were significantly decreased as compared with paclitaxel alone. Apoptosis of gastric cancer cells were more increased in a combined treatment with bevacizumab and paclitaxel than paclitaxel alone. Tyrosine phosphorylation of Erk and Akt was also measured in gastric cancer cells under hypoxic conditions in the absence or prescence of anti-KDR, anti FLT-1 and paclitaxels. Hypoxia induced phosphorylation of Erk and Akt in gastric cancer cells was more decreased by addition of anti FLT-1 and anti KDR antibodies to paclitaxel as compared with paclitaxel alone.

Conclusion: Our experiments show that a VEGF/VEGFR/pERK and, or pAKT pathway is activated by hypoxic gastric cancer cells to induce HIF-1a and TUBB3 expressions. Combined treatment with paclitaxel and bevacizumab, a recombinant humanized monoclonal antibody that binds to VEGF, synergistically decreased the expressions of HIF-1a and TUBB3 in gastric cancer cells in hypoxic conditions. With increasing use of taxanes in the treatment of gastric cancer, this study showed the potential synergistic antitumor effects of bevacizumab and paclitaxel in a TUBB3, a marker of resistance to paclitaxel, overexpressing gastric cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4252. doi:10.1158/1538-7445.AM2011-4252

Imatinib induced severe skin reactions and neutropenia in a patient with gastrointestinal stromal tumor

BACKGROUND

Imatinib mesylate has been used for the treatment of unresectable or metastatic gastrointestinal stromal tumors (GIST). The current recommended dose of imatinib is 400 mg/day that is increased to 800 mg/day in cases with disease progression. However, imatinib can be associated with diverse adverse events, which has limited its use. We report a case of severe adverse skin reactions with neutropenic fever during imatinib treatment in a patient with GIST.

CASE PRESENTATION

A 71-year-old man was admitted with a one month history of epigastric pain and a palpable mass in the right upper quadrant. An abdominal CT scan revealed a 20 x 19 cm intraabdominal mass with tumor invasion into the peritoneum. Needle biopsy was performed and the results showed spindle shaped tumor cells that were positive for c-KIT. The patient was diagnosed with unresectable GIST. Imatinib 400 mg/day was started. The patient tolerated the first eight weeks of treatment. However, about three months later, the patient developed a grade 4 febrile neutropenia and a grade 3 exfoliative skin rash. The patient recovered from this serious adverse events after discontinuation of imatinib with supportive care. However, the skin lesions recurred whenever the patient received imatinib over 100 mg/day. Therefore, imatinib 100 mg/day was maintained. Despite the low dose imatinib, follow up CT showed a marked partial response without grade 3 or 4 toxicities.

CONCLUSION

The recommended dose of imatinib for the treatment of GIST is 400 mg/day but patients at risk for adverse drug reaction may benefit from lower doses. Individualized treatment is needed for such patients, and we may also try sunitinib as a alternative drug.

Femoral lengthening in achondroplasia: magnitude of lengthening in relation to patterns of callus, stiffness of adjacent joints and fracture

Extensive limb lengthening may be indicated in achondroplastic patients who wish to achieve a height within the normal range for their population. However, increasing the magnitude of lengthening is associated with further complications particularly adjacent joint stiffness and fractures. We studied the relationship between the magnitude of femoral lengthening and callus pattern, adjacent joint stiffness and fracture of the regenerate bone in 40 femoral lengthenings in 20 achondroplastic patients. They were divided into two groups; group A had lengthening of less than 50% and group B of more than 50% of their initial femoral length. The patterns of radiological callus formation were classified according to shape, type and features. The incidence of callus features, knee stiffness and regenerate bone fracture were analysed in the two groups. Group B was associated with an increased incidence of concave, lateral and central callus shapes, adjacent joint and stiffness and fracture. Statistically, the incidence of stiffness in adjacent joints and regenerate bone fracture was significantly associated with the magnitude of lengthening. We suggest that careful radiological assessment of the patterns of callus formation is a useful method for the evaluation and monitoring of regenerate bone.

Phase II study of S-1 monotherapy in paclitaxel- and cisplatin-refractory gastric cancer

PURPOSE

S-1 is a fourth-generation oral fluoropyrimidine that was developed to mimic the effects achieved with protracted continuous infusion of 5-fluorouracil (5-FU). This phase II study evaluated the efficacy and safety of S-1 salvage chemotherapy in patients with paclitaxel- and cisplatin-refractory gastric cancer. The primary end point was progression-free survival; secondary end points were overall survival, safety, and clinical benefit.

METHODS

Patients were eligible for the study if they had histologically documented gastric adenocarcinoma previously treated with paclitaxel and cisplatin, age > or = 18 years, Eastern Clinical Oncology Group performance status < or =2, adequate organ function, and no evidence of gastrointestinal obstruction or passage disturbance. Patients were treated with a dose of S-1 based on body surface area (BSA) as follows: BSA < 1.25 m(2), 80 mg/day; 1.25 < or = BSA < 1.5 m(2), 100 mg/day; BSA > or= 1.5 m(2), 120 mg/day. The total dose was divided in two and administered twice daily for 4 weeks followed by a 2-week rest period.

RESULTS

Of the 53 patients enrolled in this study, 49 were evaluable. A total of 190 chemotherapy cycles were administered, and the median number of cycles was 2. Five patients (9.4%) had a partial response, and 18 (34%) had stable disease. Median progression-free survival and overall survival were 4.9 and 10.4 months, respectively. Grade 3/4 hematological toxicities included neutropenia in six patients (11%) but no cases of febrile neutropenia were found. Most of the non-hematological toxicities were diarrhea, asthenia, and mucositis, but none reached grade 3 or grade 4 in severity. Improvement of pain was observed in 17 patients (32.1%).

CONCLUSIONS

S-1 monotherapy provides active and safe salvage chemotherapy for patients with advanced gastric cancer who have been previously treated with paclitaxel and cisplatin.

Wnt5a Is Required for Endothelial Differentiation of Embryonic Stem Cells and Vascularization via Pathways Involving Both Wnt/β-Catenin and Protein Kinase Cα

In this study, we examined the signaling pathways activated by Wnt5a in endothelial differentiation of embryonic stem (ES) cells and the function of Wnt5a during vascular development. We first found that Wnt5a −/− mouse embryonic stem (mES) cells exhibited a defect in endothelial differentiation, which was rescued by addition of Wnt5a, suggesting that Wnt5a is required for endothelial differentiation of ES cells. Involvement of both β-catenin and protein kinase (PK)Cα pathways in endothelial differentiation of mES cells requiring Wnt5a was indicated by activation of both β-catenin and PKCα in Wnt5a +/− but not in Wnt5a −/− mES cells. We also found that β-catenin or PKCα knockdowns inhibited the Wnt5a-induced endothelial differentiation of ES cells. Moreover, the lack of endothelial differentiation of Wnt5a −/− mES cells was rescued only by transfection of both β-catenin and PKC α, indicating that both genes are required for Wnt5a-mediated endothelial differentiation. Wnt5a was also found to be essential for the differentiation of mES cells into immature endothelial progenitor cells, which are known to play a role in repair of damaged endothelium. Furthermore, a defect in the vascularization of the neural tissue was detected at embryonic day 14.5 in Wnt5a −/− mice, implicating Wnt5a in vascular development in vivo. Thus, we conclude that Wnt5a is involved in the endothelial differentiation of ES cells via both Wnt/β-catenin and PKC signaling pathways and regulates embryonic vascular development.

The complete genome sequence of pepper severe mosaic virus and comparison with other potyviruses

The complete nucleotide sequence of pepper severe mosaic virus (PepSMV) was determined. The viral genome consisted of 9890 nucleotides, excluding a poly (A) tract at the 3' end of the genome. The PepSMV RNA genome encoded a single polyprotein of 3085 amino acid residues, resulting in ten functionally distinct potyviral proteins. The lengths of the 5' nontranslated region (NTR) and the 3' NTR were 164 and 468 nucleotides, respectively. The genome organization of the virus was typical for members of the genus Potyvirus in the family Potyviridae. The coat protein amino acid sequence identity between PepSMV and the other 45 potyviruses ranged from 53.4 to 79.7%. Sequence alignments and phylogenetic analyses of the potyviral polyprotein sequences revealed that PepSMV was the closest to potato virus Y (PVY) and closely related to members of the PVY subgroup. Our genome sequence data clearly confirmed that PepSMV belongs to a separate species in the genus Potyvirus.

Duration curve analysis for the assessment of pathogen loading from diffuse sources

Pathogen level of surface waters has received great attention for protecting public health. In this study, total coliform, fecal coliform and Escherichia coli concentrations were monitored as the pathogen indicator organisms at six monitoring stations in the Geum River, Korea. Rainfall runoff from two agricultural-forestry watersheds was analyzed for their microbial aspect as well. Total coliform concentration of the Geum River showed high correlation with the flow rate. To estimate total coliform loading on the Geum River in probability scale, the duration curve method was applied. In addition, a standard duration curve reflecting the water quality criteria was constructed to determine water quality compliance. Under the assumption of linearity between flow rate and total coliform concentration of the Geum River, total coliform duration curve revealed that total coliform concentrations exceed the desired criteria mainly due to pollutants from diffuse sources.

Zantedeschia mosaic virus causing leaf mosaic symptom in calla lily is a new potyvirus

Anovel virus, Zantedeschia mosaic virus (ZaMV-KR), causing mosaic and malformation symptoms was isolated from calla lily ( Zantedeschia spp.) in Korea and its biological and molecular properties were characterized. The virus was distinct from Dasheen mosaic virus, an Araceae-infecting potyvirus, by serological and sequence analyses. Multiple alignments of the CP amino acid sequence between the virus and other potyviruses showed 51.8 to 62.1% identity. Phylogenetic analyses of the CP revealed that the virus could be clustered with Plum pox virus and Turnip mosaic virus. Sequence comparison of the CP gene between the virus and three other ZaMV isolates from Taiwan showed over 93.9% identity, and most of amino acids changes occurred in the N-terminal region. Sequence comparison of 3' NTR revealed homology levels of 27.0 to 47.9% between the virus and other potyviruses. Our results support ZaMV as a distinct species of the genus Potyvirus.

Completion of nucleotide sequence and generation of highly infectious transcripts to cucurbits from full-length cDNA clone of Kyuri green mottle mosaic virus

The nucleotide sequence of the genome of the type strain of Kyuri green mottle mosaic virus (KGMMV-C1) has been completely determined. The genome structure and sequence of the virus were compared to those of Yodo strain of KGMMV (KGMMV-Y). The genome of KGMMV-C1 is 6,514 nucleotides long consisting of 5' and 3' nontranslated regions (NTRs) and four open reading frames coding for 131 kDa and 189 kDa viral replicases, 28 kDa movement protein and 17 kDa coat protein. The nucleotide and amino acid sequences identities of the four encoded proteins and two NTRs between KGMMV-C1 and KGMMV-Y were 85.6% to 93.9% and 87.6% to 95.5%, respectively. Full-length cDNA of KGMMV-C1 was directly amplified by reverse-transcription polymerase chain reaction (RT-PCR) with a set of S'-end primer anchoring T7 RNA promoter sequence and 3'-end primer. This full-length RT-PCR product allowed RNA to be transcribed in vitro. The T7 promoter-anchored RT-PCR product was cloned and used as templates for transcription for plant inoculation test. Capped transcript RNAs transcribed from the full-length cDNA clone as well as capped transcript RNAs from the uncloned RT-PCR products were infectious and caused symptoms characteristic of KGMMV when mechanically inoculated to systemic host plants such as zucchini squash, cucumber and Nicotiana benthamiana. Transcript-derived progeny virus was indistinguishable from the wild-type virus with the same biological and biochemical properties. To our knowledge, this is the first report of the generation of a biologically active KGMMV clone, driven by the T7 promoter, that is highly infectious to cucurbitaceous plants.

N-nitrosocarbofuran, but not carbofuran, induces apoptosis and cell cycle arrest in CHL cells

Carbofuran (CF) is one of the most widely used carbamate pesticides in the world applied for insect and nematode control. Due to its widespread use in agriculture and households, contamination of food, water, and air has become serious, and consequently adverse health effects are inevitable in humans, animals, wildlife and fish. It has been reported that CF alone or in combination with other carbamate insecticides influences the level of reproductive and metabolic hormones such as thyroxine and corticosterone, and results in impairment of endocrine, immune and behavioral functions. In this study, we evaluated the effects of CF and its metabolite, the N-nitroso derivative N-nitrosocarbofuran (NOCF), on genotoxicity, cell growth, cell cycle and apoptosis of Chinese hamster lung fibroblast (CHL) cells. NOCF, but not CF, induced genotoxicity determined by Ames test. NOCF inhibited the growth of Chinese hamster lung fibroblast (CHL) cells with an IC(50) of 12.8 microM. NOCF induced apoptosis of CHL cells, which was demonstrated by morphological changes, DNA fragmentation and flow cytometric analysis. Treatment of CHL cells with NOCF induced significant G(2)/M cell cycle arrest. Caspase-3, an executioner of apoptosis was also activated by the treatment of CHL cells with NOCF. These results suggest that NOCF, that is an important metabolite of CF, leads to the induction of cell cycle arrest and apoptosis in CHL cells.

Growth and grazing rates of the heterotrophic dinoflagellate Polykrikos kofoidii on red-tide and toxic dinoflagellates

We investigated growth rates, grazing rates, and prey selection of Polykrikos kofoidii when feeding on several species of red-tide and/or toxic dinoflagellates. Polykrikos kofoidii ingested all prey species used in this study, exhibiting positive growth on Lingulodinium polyedrum, Scrippsiella trochoidea, Ceratium furca, Gymnodinium catenatum, Gyrodinium impudicum, Prorocentrum micans, and the toxic dinoflagellate Amphidinium carterae, but not on P. minimum. Specific growth rates of P. kofoidii increased rapidly with increasing density of L. polyedrum, S. trochoidea, C. furca, and G. catenatum before saturating between 500-2,000 ng C ml(-1). Specific growth rates increased continuously when P. kofoidii was fed the other prey species. Maximum specific growth rates of P. kofoidii on G. catenatum (1.12 d(-1)), S. trochoidea (0.97 d(-1)), and L. polyedrum (0.83 d(-1)) were higher than those on C. furca (0.35 d(-1)), A. carterae (0.10 d(-1)), P. micans (0.06 d(-1)), G. impudicum (0.06 d(-1)), and P. minimum (-0.03 d(-1)). Threshold prey concentrations (where net growth = 0) were 54-288 ng C ml(-1). Maximum ingestion and clearance rates of P. kofoidii on these dinoflagellates were 5-24 ng C pseudocolony(-1) d(-1) and 1.0-5.9 microl pseudocolony(-1) h(-1), respectively. Polykrikos kofoidii strongly selected L. polyedrum over S. trochoidea in prey mixtures. Polykrikos kofoidii exhibited higher maximum growth, ingestion, and clearance rates than previously reported for the mixotrophic dinoflagellate Fragilidium cf. mexicanum or the heterotrophic dinoflagellates Protoperidinium cf. divergens and P. crassipes, when grown on the same prey species. Grazing coefficients calculated by combining field data on abundances of Polykrikos spp. and co-occurring red-tide dinoflagellate prey with laboratory data on ingestion rates obtained in the present study suggest that Polykrikos spp. sometimes have a considerable grazing impact on prey populations.

Zucchini green mottle mosaic virus is a new tobamovirus; comparison of its coat protein gene with that of kyuri green mottle mosaic virus

A novel virus we call zucchini green mottle mosaic virus (ZGMMV) was isolated from zucchini squash and its properties were determined. The size and shape of its virions, and other properties suggest that the virus is a tobamovirus. The coat protein (CP) genes of ZGMMV and kyuri green mottle mosaic virus (KGMMV), which also infects zucchini squash plants, were cloned and their nucleotides sequences were determined. The CP genes of ZGMMV and KGMMV are composed of 161 amino acid residues, and they share 77.6% amino acid identity. Western blot analysis showed that the two viruses are serologically related but not identical. Comparison of the sequences with those of sixteen other tobamoviruses revealed that the two viruses had much higher identity to cucumber green mottle mosaic virus (CGMMV), another tobamovirus infectious to cucurbit plants, than other tobamoviruses. The nucleotide and amino acid sequences of ZGMMV were from 29.5 to 78.4% and from 29.3 to 77.6% identical, respectively, to those of other tobamoviruses. The predicted virion assembly origins of the two tobamoviruses were located in the CP region of the genomic RNAs, and the predicted secondary structures were more similar to that of CGMMV than those of other tobamoviruses. The seventeen tobamo-viruses could be classified into three main subgroups based on the phylogenetic tree analysis on the CP gene, and ZGMMV and KGMMV formed a third subgroup together with CGMMV and sunn-hemp mosaic virus (SHMV). These results show that ZGMMV is a previously unknown member of the Tobamovirus genus.

Modeling of the Permeate Flux during Microfiltration of BSA-Adsorbed Microspheres in a Stirred Cell

A study on the variation of the permeate flux was performed in a stirred cell charged with microspheres, to investigate the effects of the stirrer speeds (300, 400, and 600 rpm) and the BSA concentration (0.1, 0.2, 0.4, and 0.8 g/L) under constant pressure. The permeate flux increased over time before the saturation point, but it began to decrease after that point. An increase of the BSA concentration and the stirrer speed resulted in the rapid increase of the permeate flux. This is contrary to the observation of the conventional filtration experiments using a stirred cell. A resistance-in-series model was employed for the modeling of the permeate flux. The cake resistance (R(c), induced by the concentration polarization of microspheres) and the fouling resistance (R(f), induced by the adsorption of BSA inside the membrane pore) must be considered simultaneously for the modeling. These modeling results were in good agreement with the experimental data. These can be applied to the special system considering both R(c) and R(f) as well as the general filtration systems using a stirred cell. Copyright 2000 Academic Press.

Inhibition of Helicobacter pylori hemagglutination by polysaccharide fractions from roots of Panax ginseng

Polysaccharides from the roots of Panax ginseng were extracted by hot water and fractionated by using ethanol precipitation and ion exchange chromatography. Fractions FC (crude extract), F1 (fraction precipitated by ethanol), F1N (fraction unbound to DEAE-Sepharose CL-6B), and F1A (bound fraction) were obtained. Their carbohydrate analyses showed that acidic fraction F1A contains higher amounts of galactose, arabinose and uronic acids, in comparison to FC and F1. Fraction F1N mainly consists of glucose. The inhibition of Helicobacter pylori-induced hemagglutination revealed different inhibitory activities of these fractions. In particular, acidic fraction F1A showed a remarkable inhibitory activity (minimum inhibition concentration was 0.25 mg/ml) among the polysacharide fractions. However, digestion of the fraction F1A with pectinase resulted in a lower molecular weight oligosaccharide fraction F1AP which was non-inhibitory at the concentration of 4 mg/ml. Comparison of inhibitory activities and carbohydrate compositions of isolated fractions indicates that the activity correlated with the contents of galactose, arabinose, and uronic acids. These data suggest that acidic polysaccharides may be responsible for the inhibitory activity.

Effects of partial bladder outlet obstruction and its relief on types I and III collagen and detrusor contractility in the rat

Bladder outlet obstruction induces a rapid hypertrophy characterized by increased bladder mass and collagen deposition. An increase in collagen is likely to reduce the contractility and compliance of bladder wall. This study was undertaken to investigate the effects of partial bladder outlet obstruction and its relief on types I and III collagen, and the relationship between detrusor contractility and collagen types. A total of 40 female rats was used for experiment and divided into one control, one obstruction, and three recovery groups. The contractility to field stimulation was recorded; total collagen and collagen concentration were quantified. The localization of types I and III collagen and the expression of pro-alpha1(I) and alpha1(III) collagen mRNA were determined by immunohistochemical staining and Northern blot hybridization, respectively. Contractile response to field stimulation was reduced after obstruction and recovered following relief. The total amount of collagen increased after obstruction and decreased after relief; however, collagen concentration decreased after obstruction and increased following relief. Contractility correlated negatively with total collagen but positively with collagen concentration. The protein deposition of types I and III collagen was localized in lamina propria and muscle bundles in all groups. The expression of types I and III collagen gene was up regulated after obstruction, but down regulated after relief. Negative correlation between contractility and gene expressions of collagen types was significant. These data suggest that the change in localization and quantity of collagen types leads to morphologic changes of bladder and can have an impact on the contractility of detrusor. Neurourol. Urodynam. 19:29-42, 2000.

Long-term results of percutaneous endourologic management of renal infundibular stricture

PURPOSE

The long-term result of percutaneous endourologic management in the relief of infundibular stricture is not clear. We reviewed the long-term efficacy in our series of patients.

PATIENTS AND METHODS

Twenty-seven patients underwent percutaneous endourologic management between August 1990 and February 1996. This study included the 21 who could be followed for more than 2 years (mean 4.8 years). The causes of stricture were tuberculosis (N = 18; 86%) and stone (N = 3; 14%). We made a cold-knife incision in eight patients; the others underwent only dilation with fascial dilators from 20F to 30F. Success was defined as symptomatic improvement and radiographic resolution of obstruction.

RESULTS

The overall success rate was 76% (16 of 21). Seven of the eleven patients (64%) with concomitant ureteral stricture had a successful result. In the nine patients with multiple infundibular strictures, five procedure (56%) were successful. The success rates of the cold-knife or fascial dilator were 88% (7 of 8) and 69% (8 of 13), respectively. In the five patients in whom the procedure failed, ureteral stricture was associated in four and multiple infundibular strictures in four. All of them had tuberculous infundibular strictures. No significant difference in the success rate was observed according to the duration of indwelling catheter. There was no significant complication except pyelonephritis in four patients, which was controlled with conservative treatment.

CONCLUSIONS

Percutaneous endourologic management is an effective and safe procedure to treat renal infundibular stricture. Risk factors for failure are multiple infundibular strictures and concomitant ureteral stricture. If the procedure does fail, other treatments have not been compromised. Cold-knife incision seems to be more effective than dilation.

Continuous separation of serum proteins using a stirred cell charged with carboxylated and sulfonated microspheres

We contrived a new separation system using a stirred cell charged with uncoupled microsphere similar to the chromatographic separation. Microspheres, carboxylated PS/PMAA and sulfonated PS/PNaSS, were prepared by emulsifier-free emulsion polymerization. To complement the submicron size weakness and the absence of ligands, we employed the latex form, the dispersion of microsphere, and took advantage of interaction relationships between proteins and microspheres. Adsorption isotherm is contemplated to investigate continuous separation behaviours of serum proteins. Selectivity of separation is in the following order: PS/PNaSS-2.0 (high sulfonated) < PS/PNaSS-0.3 (low sulfonated) < PS/PMAA-0.5 (low carboxylated). Unlike previous works on batch separation, not only the adsorbed amount in equilibrium (Cm), but also adsorption coefficient (K), played an important role in continuous separation. Functional groups (carboxyl and sulfonate), induced from the co-monomer, also affected the adsorption behaviours.

Collagen studies for pediatric ureteropelvic junction obstruction

OBJECTIVES

Ureteropelvic junction (UPJ) obstruction is the most common form of urinary tract obstruction in pediatrics. There is controversy regarding the need for early surgical intervention in many patients with apparent neonatal UPJ obstruction. To demonstrate the differences in type and amount of collagen in adult and pediatric UPJ obstruction, collagen studies were performed.

METHODS

The experimental groups are 9 pediatric patients with UPJ obstruction and 13 adult patients with UPJ obstruction. Six patients with normal UPJ were assigned as controls for each experimental group. The collagen content of UPJ was quantitated by hydroxyproline analysis. Immunohistochemical staining and Western blotting for collagen types I and III were performed.

RESULTS

The collagen content of pediatric UPJ was significantly lower in value than that of adult UPJ (P < 0.05). Immunohistochemical staining revealed that collagen type I was located in interfascicular space and collagen type III was located in intrafascicular space in both age groups. In Western blotting the relative intensity of collagen type III for pediatric UPJ was weaker than that of adult groups.

CONCLUSIONS

These results suggest that a larger series of patients should be examined to determine whether quantitative analysis for collagen types I and III would provide some kind of prognostic test for UPJ outcome in pediatric patients.

Percutaneous endoscopic management of upper ureteral stricture size of stent

PURPOSE

We determined the optimal size (6F versus 14/7F) of stent after endoscopic surgery based on clinical data.

MATERIALS AND METHODS

Between 1989 and 1993 we performed percutaneous endopyelotomy and endoureterotomy in 40 cases of ureteropelvic junction or upper ureteral strictures. The causes of stricture were primary in 20 cases, tuberculosis in 9, previous operation in 6 and others in 5. After endoscopic management we placed 6F internal stents in 25 patients (13 in primary and 12 in secondary cases) or 14/7F endopyelotomy stents in 15 patients (7 in primary and 8 in secondary cases) for 6 to 8 weeks (average 54.2 days). Coexisting stones or infundibular strictures were managed simultaneously. All patients have been followed for a minimum of 7 months postoperatively (range 7 to 55, average 38).

RESULTS

Overall success rate was 84% (92.3 in primary and 75% in secondary cases) with the 6F stent and 93.3% (85.7% in primary and 100% in secondary cases) with the 14/7F endopyelotomy stent.

CONCLUSIONS

The small number of patients in each group did not reach statistical significance. However, there was a definite trend for better results with the use of 14/7F stents in patients with secondary stricture (100% versus 75%), although the difference in success rates between 6F and 14/7F stents was not significant statistically (p = 0.13).

Cochlear fistula in chronic otitis media with cholesteatoma

Labyrinthine fistula in chronic otitis media with cholesteatoma most commonly involves the horizontal semicircular canal. We report three cases of cochlear fistula in chronic otitis media with cholesteatoma. All of them had a long history of otorrhea. One patient had total hearing loss of the affected side. The other two patients had conductive hearing loss. Radical mastoidectomy had been done in all cases. Cholesteatoma in the tympanic cavity destroyed the basal turn of the cochlea. These fistulas were sealed with muscle or Gelfoam with streptomycin. We found no fistula in the semicircular canal in any of the three cases. We report three cases of cochlear fistula in chronic otitis media with cholesteatoma, and review the literature.