Using spectral characterization to identify healthcare-associated infection (HAI) patients for clinical contact precaution

Healthcare-associated infections (HAIs) are a major problem in hospital infection control. Although HAIs can be suppressed using contact precautions, such precautions are expensive, and we can only apply them to a small fraction of patients (i.e., a limited budget). In this work, we focus on two clinical problems arising from the limited budget: (a) choosing the best patients to be placed under precaution given a limited budget to minimize the spread (the isolation problem), and (b) choosing the best patients to release when limited budget requires some of the patients to be cleared from precaution (the clearance problem). A critical challenge in addressing them is that HAIs have multiple transmission pathways such that locations can also accumulate 'load' and spread the disease. One of the most common practices when placing patients under contact precautions is the regular clearance of pathogen loads. However, standard propagation models like independent cascade (IC)/susceptible-infectious-susceptible (SIS) cannot capture such mechanisms directly. Hence to account for this challenge, using non-linear system theory, we develop a novel spectral characterization of a recently proposed pathogen load based model, 2-MODE-SIS model, on people/location networks to capture spread dynamics of HAIs. We formulate the two clinical problems using this spectral characterization and develop effective and efficient algorithms for them. Our experiments show that our methods outperform several natural structural and clinical approaches on real-world hospital testbeds and pick meaningful solutions.

Unlocking the Potential of Colloidal Quantum Dot/Organic Hybrid Solar Cells: Band Tunable Interfacial Layer Approach

Hybrid colloidal quantum dot (CQD)/organic architectures are promising candidates for emerging optoelectronic devices having high performance and inexpensive fabrication. For unlocking the potential of CQD/organic hybrid devices, enhancing charge extraction properties at electron transport layer (ETL)/CQD interfaces is crucial. Hence, we carefully adjust the interface properties between the ETL and CQD layer by incorporating an interfacial layer for the ETL (EIL) using several types of cinnamic acid ligands. The EIL having a cascading band offset (ΔEC) between the ETL and CQD layer suppresses the potential barrier and the local charge accumulation at ETL/CQD interfaces, thereby reducing the bimolecular recombination. An optimal EIL effectively expands the depletion region that facilitates charge extraction between the ETL and CQD layer while preventing the formation of shallow traps. Representative devices with an EIL exhibit a maximum power conversion efficiency of 14.01% and retain over 80% of initial performances after 300 h under continuous maximum power point operation.

Omni-directional wind-driven triboelectric nanogenerator with cross-shaped dielectric film

Triboelectric nanogenerators (TENGs) are actively being researched and developed to become a new external power unit for various electronics and applications. Wind is proposed as a mechanical energy source to flutter the dielectric film in wind-driven TENGs as it is clean, abundant, ubiquitous, and sustainable. Herein, we propose a TENG structure with dielectric films bent in four directions to collect the wind energy supply from all directions, unlike the conventional wind-driven TENGs which can only harvest the wind energy from one direction. Aluminum (Al) layer was intercalated within the dielectric film to improve electrostatic induction, resulting in improved triboelectric performances. Maximum open-circuit voltage (V_oc) of 233 V, short-circuit current (I_sc) of 348 µA, and output power density of 46.1 W m^- 2 at an external load of 1 MΩ under a wind speed of 9 m s^- 1 were revealed, and it faithfully lit "LED" characters composed of 25 LEDs.

Empathy With Patients and Post-Traumatic Stress Response in Verbally Abused Healthcare Workers

OBJECTIVE

The current study examined the differential empathic capacity, post-traumatic symptoms, and coping strategies in healthcare workers (HCWs) according to the exposure of verbal or physical workplace violence (WPV).

METHODS

Using online survey, a total of 422 HCWs employed at a training general hospital of South Korea participated and completed self-reporting questionnaires including the WPV questionnaire with coping strategy, the Jefferson Scale of Physician Empathy.

RESULTS

Those who experienced either only verbal violence or both physical and verbal violence had lower Jefferson Scale of Physician Empathy scores (p<0.05). Posttraumatic stress symptom severity was higher among people who experienced verbal violence than physical violence. HCWs' exposure to verbal violence was associated with severe posttraumatic symptoms and a low level of empathy with patients (p<0.05). More than half of the victims of verbal violence responded that they did not take any action, receive organizational protection, or peer support, while most physically-abused HCWs received institutional intervention or help from others.

CONCLUSION

Our findings highlight the critical importance of reducing verbal violence, which may represent a larger psychological burden compared to physical violence, by actively implementing effective strategies and policies at the institutional level.

Diagnostic Accuracy of MRI-Based Morphometric Parameters for Detecting Olfactory Nerve Dysfunction

BACKGROUND AND PURPOSE

Although olfactory dysfunction is a common cranial nerve disorder, there are no simple objective morphometric criteria to assess olfactory dysfunction. The aim of this study was to evaluate the diagnostic performance of MR imaging morphometric parameters for detecting olfactory dysfunction.

MATERIALS AND METHODS

This prospective study enrolled patients from those presenting with olfactory symptoms who underwent both an olfactory function test and MR imaging. Controls without olfactory dysfunction were recruited during the preoperative work-up for pituitary adenoma. Two independent neuroradiologists measured the olfactory bulb in 3D and assessed olfactory bulb concavity on MR imaging while blinded to the clinical data. Diagnostic performance was assessed using receiver operating characteristic curve analysis.

RESULTS

Sixty-four patients and 34 controls were enrolled. The patients were significantly older than the controls (mean age, 57.8 ± 11.9 years versus 47.1 ± 12.1 years; P < .001). Before age adjustment, the olfactory bulb height was the only olfactory bulb parameter showing a significant difference between patients and controls (1.6 ± 0.3 mm versus 2.0 ± 0.3 mm, P < .001). After age adjustment, all parameters and olfactory bulb concavity showed significant intergroup differences, with the olfactory bulb height having the highest area under the curve (0.85). Olfactory bulb height was confirmed to be the only significant parameter showing a difference in the detection of olfactory dysfunction in 22 pairs after matching for age and sex (area under the curve = 0.87, P < .001). Intraclass correlation coefficients revealed moderate-to-excellent degrees of inter- and intrareader agreement.

CONCLUSIONS

MR imaging morphometric analysis can differentiate patients with olfactory dysfunction, with the olfactory bulb height having the highest diagnostic performance for detecting olfactory dysfunction irrespective of age.

Molecular Sieve Based on a PMMA/ZIF-8 Bilayer for a CO-Tolerable H2 Sensor with Superior Sensing Performance

Semiconductor sensors equipped with Pd catalysts are promising candidates as low-powered and miniaturized surveillance devices that are used to detect flammable hydrogen (H₂) gas. However, the following issues remain unresolved: (i) a sluggish sensing speed at room temperature and (ii) deterioration of sensing performance caused by interfering gases, particularly, carbon monoxide (CO). Herein, a bilayer comprising poly(methyl methacrylate) (PMMA) and zeolitic imidazolate framework-8 (ZIF-8) is utilized as a molecular sieve for diode-type H₂ sensors based on a Pd-decorated indium-gallium-zinc oxide film on a p-type silicon substrate. While the PMMA effectively blocks the penetration of CO gas molecules into the sensing entity, the ZIF-8 improves sensing performances by modifying the catalytic activity of Pd, which is preferable for splitting H₂ and O₂ molecules. Consequently, the bilayer-covered sensor achieves outstanding CO tolerance with superior sensing figures of merit (response/recovery times of <10 s and sensing response of >5000% at 1% H₂).

High-Performance Photovoltaic Hydrogen Sensing Platform with a Light-Intensity Calibration Module

Although battery-free gas sensors (e.g., photovoltaic or triboelectric sensors) have recently appeared to resolve the power consumption issue of conventional chemiresistors, severe technical barriers still remain. Especially, their signals varying under ambient conditions such as light intensity restrict the utilization of these sensors. Insufficient sensing performances (low response and slow sensing rate) of previous battery-free sensors are also an obstacle for practical use. Herein, a photovoltaic hydrogen (H₂)-sensing platform having constant sensing responses regardless of light conditions is demonstrated. The platform consists of two photovoltaic units: (1) a palladium (Pd)-decorated n-IGZO/p-Si photodiode covered with a microporous zeolitic imidazolate framework-8 (ZIF-8) film and (2) a device with the same configuration, but without the Pd catalyst as a reference to calibrate the base current of sensor (1). The platform after calibration yields accurate response values in real time regardless of unknown irradiance. Besides, the sensing performances (e.g., sensing response of 1.57 × 10⁴% at 1% H₂ with a response time <15 s) of our platform are comparable with those of the conventional resistive H₂ sensors, which yield unprecedented results in photovoltaic H₂ sensors.

Diagnostic performance of MRI to detect metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis

AIM

To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of metastatic cervical lymph nodes.

MATERIALS AND METHODS

Ovid-MEDLINE and EMBASE databases were searched up until 12 June 2018. Eleven articles were included in the qualitative systematic review and nine of the 11 in the quantitative analysis. Two radiologists independently performed data extraction and methodological quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A qualitative systematic review and quantitative analysis were performed, followed by a meta-regression analysis to determine factors causing heterogeneity.

RESULTS

The pooled sensitivity and specificity in the diagnosis of metastatic cervical lymph nodes were 80% (95% confidence interval [CI]: 68-88%) and 85% (95% CI: 63-95%), respectively. The sensitivity and false-positive rate (correlation coefficient, 0.655) showed a positive correlation due to a threshold effect, which was responsible for heterogeneity across the studies, as indicated by a Q-test (p<0.01) and Higgins I² statistic (sensitivity, I²=90.11%; specificity, I²=92.49%). In the meta-regression analysis, fat-suppressed imaging, and the analysis method were significant factors influencing the heterogeneity in diagnostic performance.

CONCLUSIONS

MRI shows moderate diagnostic performance in the diagnosis of metastatic lymph nodes in patients with thyroid cancer in the neck. MRI may be an optional or complementary imaging method to ultrasound or computed tomography (CT) in thyroid cancer patients.

CT and MRI Findings of Glomangiopericytoma in the Head and Neck: Case Series Study and Systematic Review

Glomangiopericytoma is a rare sinonasal mesenchymal tumor of borderline or low malignant potential. We reviewed the CT and MR imaging findings of head and neck glomangiopericytoma via a retrospective case series study and systematic review. Our study revealed that glomangiopericytoma is a well-defined lobulated avidly enhancing soft-tissue mass with erosive bony remodeling that is most commonly found in the sinonasal cavity. Typically, it is hyperintense on T2-weighted images with vascular signal voids, has a high mean ADC value, and a wash-in and washout pattern on dynamic contrast-enhanced MR imaging. Although the CT findings are nonspecific, typical MR imaging findings, including those on the ADC map and dynamic contrast-enhanced MR imaging, may be helpful for differentiating glomangiopericytomas from other hypervascular tumors in the head and neck.

Ultrafast quantum beats of anisotropic excitons in atomically thin ReS2

Quantum beats, periodic oscillations arising from coherent superposition states, have enabled exploration of novel coherent phenomena. Originating from strong Coulomb interactions and reduced dielectric screening, two-dimensional transition metal dichalcogenides exhibit strongly bound excitons either in a single structure or hetero-counterpart; however, quantum coherence between excitons is barely known to date. Here we observe exciton quantum beats in atomically thin ReS2 and further modulate the intensity of the quantum beats signal. Surprisingly, linearly polarized excitons behave like a coherently coupled three-level system exhibiting quantum beats, even though they exhibit anisotropic exciton orientations and optical selection rules. Theoretical studies are also provided to clarify that the observed quantum beats originate from pure quantum coherence, not from classical interference. Furthermore, we modulate on/off quantum beats only by laser polarization. This work provides an ideal laboratory toward polarization-controlled exciton quantum beats in two-dimensional materials.

The Association between Facial Fracture Patterns and Traumatic Head Injury in Injured Motorcycle Riders According to Helmet Use Status

Objective

This study was undertaken to identify the association between facial fracture patterns and traumatic head injury in injured motorcycle riders.

Methods

Retrospective study design. We reviewed the medical records of patients who underwent facial bone computed tomography (CT) and brain CT simultaneously among the injured motorcycle riders between May 2009 and July 2011. Data collected included age, sex, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), facial fracture patterns, head protective device (helmet) use, alcohol intake, time of accident and seat position. Facial fracture patterns were grouped as upper, mid, and lower face. Traumatic head injury (THI) included skull fracture, brain haemorrhage and diffuse axonal injury.

Results

Of the 154 patients included, 138 (89.6%) were male, 57 (37%) had facial fracture, 69 (44.8%) wore helmets and 30 (19.5%) had THI. Their mean age was 29.0+15.0 years. After multivariate logistic regression analysis, THI was associated with GCS, seat position of riders and accident time. THI was correlated with the combination of upper and midfacial fractures in helmeted group and isolated upper facial fracture or the combination of upper and midfacial fractures in unhelmeted group. The rest of facial fracture patterns were not correlated with THI regardless of helmet.

Conclusions

The combination of upper and midfacial fractures are the risk factor of THI regardless of helmet. The patients with the combination of upper and midfacial fractures should be further evaluated for head injury regardless of helmet.

Rough-Surface-Enabled Capacitive Pressure Sensors with 3D Touch Capability

Fabrication strategies that pursue "simplicity" for the production process and "functionality" for a device, in general, are mutually exclusive. Therefore, strategies that are less expensive, less equipment-intensive, and consequently, more accessible to researchers for the realization of omnipresent electronics are required. Here, this study presents a conceptually different approach that utilizes the inartificial design of the surface roughness of paper to realize a capacitive pressure sensor with high performance compared with sensors produced using costly microfabrication processes. This study utilizes a writing activity with a pencil and paper, which enables the construction of a fundamental capacitor that can be used as a flexible capacitive pressure sensor with high pressure sensitivity and short response time and that it can be inexpensively fabricated over large areas. Furthermore, the paper-based pressure sensors are integrated into a fully functional 3D touch-pad device, which is a step toward the realization of omnipresent electronics.

Spatially Pressure-Mapped Thermochromic Interactive Sensor

A thermochromic-based interactive sensor that can generate local color switching and pressure mapping is developed using a 2D array of resistive pressure sensor switch. This thermochromic-based interactive sensor will enable the visualization of localized information in arbitrary shapes with dynamic responses in the context of serial/parallel pressure mapping and quantifying capability without optoelectronic arrays.

Observational scores of dampness and mold associated with measurements of microbial agents and moisture in three public schools

We examined associations between observational dampness scores and measurements of microbial agents and moisture in three public schools. A dampness score was created for each room from 4-point-scale scores (0-3) of water damage, water stains, visible mold, moldy odor, and wetness for each of 8 room components (ceiling, walls, windows, floor, ventilation, furniture, floor trench, and pipes), when present. We created mixed microbial exposure indices (MMEIs) for each of 121 rooms by summing decile ranks of 8 analytes (total culturable fungi; total, Gram-negative, and Gram-positive culturable bacteria; ergosterol; (1→3)-β-D-glucan; muramic acid; and endotoxin) in floor dust. We found significant (P ≤ 0.01) linear associations between the dampness score and culturable bacteria (total, Gram-positive, and Gram-negative) and the MMEIs. Rooms with dampness scores greater than 0.25 (median) had significantly (P < 0.05) higher levels of most microbial agents, MMEIs, and relative moisture content than those with lower scores (≤0.25). Rooms with reported recent water leaks had significantly (P < 0.05) higher dampness scores than those with historical or no reported water leaks. This study suggests that observational assessment of dampness and mold using a standardized form may be valuable for identifying and documenting water damage and associated microbial contamination.

Metal oxide coated lithium cobalt fluorophosphate cathode materials for lithium secondary batteries--effect of aging and temperature

Lithium cobalt fluorophosphate (Li2CoPO4F) is a promising 5 V class cathode material for lithium secondary batteries. In this study, surface coating with ZrO2 improved the electrochemical activity of Li2CoPO4F with a maximum discharge capacity of 144 mA h g(-1). The effectiveness of ZrO2 coating was evaluated using aging analysis with a commercial electrolyte, i.e., 1 M LiPF6 in EC:DMC (1:1, v/v). The metal ion dissolution was reduced to 1/8th of that observed in the non-coated Li2CoPO4F. It was found that the thin coating layer had less or no contribution to the additional resistance for the cell, both at an open circuit potential and at a fully charged state; hence, the capacity of the cell was retained over cycling. Elevated temperature aging did not affect the intrinsic property of the coated Li2CoPO4F, as observed from the complete anodic and cathodic peaks from cyclic voltammetry studies after 30 days of storage at 50 degrees C. An increase in impedance was observed for aged cells, which could be due to the thick SEI layer formed during storage. The ZrO2 coating over Li2CoPO4F was crucial for the improved performance of electrode active material at higher operating potentials of up to 5.2 V.

Docking-based 3D-QSAR study of pyridyl aminothiazole derivatives as checkpoint kinase 1 inhibitors

Checkpoint kinase 1 (Chk1) is a promising target for the design of novel anticancer agents. In the present work, molecular docking simulations and three-dimensional quantitative structure-activity relationship (3D-QSAR) studies were performed on pyridyl aminothiazole derivatives as Chk1 inhibitors. AutoDock was used to determine the probable binding conformations of all the compounds inside the active site of Chk1. Comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) models were developed based on the docking conformations and alignments. The CoMFA model produced statistically significant results with a cross-validated correlation coefficient (q2) of 0.608 and a coefficient of determination (r2) of 0.972. The reliable CoMSIA model with q2 of 0.662 and r2 of 0.970 was obtained from the combination of steric, electrostatic and hydrogen bond acceptor fields. The predictive power of the models were assessed using an external test set of 14 compounds and showed reasonable external predictabilities (r(2)pred) of 0.668 and 0.641 for CoMFA and CoMSIA models, respectively. The models were further evaluated by leave-ten-out cross-validation, bootstrapping and progressive scrambling analyses. The study provides valuable information about the key structural elements that are required in the rational design of potential drug candidates of this class of Chk1 inhibitors.

Impact of internal spermatic artery preservation during laparoscopic varicocelectomy on recurrence and the catch-up growth rate in adolescents

OBJECTIVE

To investigate the effectiveness of laparoscopic varicocelectomy (LV) in adolescents with varicocele and analyze the impact of internal spermatic artery (ISA) preservation on surgical outcomes.

MATERIALS AND METHODS

Data on 92 adolescents with left varicocele who underwent LV between December 1998 and January 2011 were retrospectively analyzed. The mean age of the patients was 13.2 ± 2.1 years. Age, grade of disease, number of ligation veins, recurrence rates, and catch-up growth were analyzed in patients who underwent ISA preservation and ligation. The median duration of the follow-up was 21 months.

RESULTS

ISA preservation was performed on 50 patients (54%). There were no significant inter-group differences in terms of age, varicocele grade, number of ligation veins, and catch-up growth (93% vs. 90%). The patients who received artery preservation demonstrated a higher recurrence rate (22%) than those who received artery ligation (5%; p = 0.032). Among 13 patients who had persistent or recurrent varicocele, nine were treated with embolization and one was treated with magnification-assisted subinguinal varicocelectomy. None of these 10 patients demonstrated recurrence or testicular atrophy.

CONCLUSIONS

LV with ISA ligation can reduce the recurrence rate and results in the same catch-up growth rate in comparison with LV with ISA preservation.

High-resolution impedance manometry facilitates assessment of pharyngeal residue and oropharyngeal dysphagic mechanisms

The utility of high-resolution impedance manometry (HRIM) for evaluating oropharyngeal dysphagia (OPD) has been investigated. These approaches are limited because of the sophisticated methodology. A method of transforming HRIM into a simple and useful diagnostic tool for evaluating OPD is needed. A videofluoroscopic swallowing study (VFSS) and HRIM were performed by independent blinded examiners in 26 consecutive healthy volunteers (12 men; median age, 56.5 years) and 10 OPD patients (five men; median age, 59.5 years). Upper esophageal sphincter (UES) relaxation parameters were measured using a standard HRIM protocol. Peristalsis and bolus transit of the pharyngoesophageal (PE) segment were assessed using an HRIM-modified protocol in which the catheter was pulled back 10 cm. PE bolus transits were evaluated with an impedance contour pattern (linear vs. stasis) method. A significant difference was observed between the manometric measures of healthy volunteers and OPD patients for only the duration of pharyngeal contraction (0.49 ± 0.19 vs. 0.76 ± 0.33 s, P = 0.04). The percentage agreement and kappa value for detecting pharyngeal residue between the VFSS and the impedance analysis were 100% and 1.00, respectively. HRIM allowed for comprehensive assessment of abnormal pharyngeal components that caused pharyngeal residue on VFSS in two patients; reduced base of the tongue versus weak pharyngeal contraction in one, and reduced relaxation of the UES versus reduced laryngeal elevation in the remaining patient. Our findings demonstrated that HRIM using a simple methodology (i.e., pull-back of the catheter) detected pharyngeal residue through a simple analysis of the impedance contour pattern (linear vs. stasis). Furthermore, HRIM facilitated a comprehensive assessment of OPD mechanisms and recognition of subtle abnormalities not yet visible to the naked eye on VFSS.

Pelvic congestion syndrome diagnosed using endoscopic ultrasonography

Pelvic congestion syndrome (PCS) presents with a non-cyclic pelvic pain lasting more than six months in duration in premenopausal women. Pelvic ultrasonography or computed tomography is usually the first imaging modality used to evaluate patients with suspected PCS. PCS is confirmed by visible congestion of the pelvic veins on selective ovarian venography. To our knowledge, the role of endoscopic ultrasonography (EUS) has not been reported. EUS showed multiple dilated structures especially on left side around the uterus and ovaries, which are compatible with other radiological investigations of PCS Although PCS is not typical areas within the scope of practice of endosonographers, it is useful to be familiar with the findings. We report a case of PCS that was diagnosed with the aid of EUS.

Extraskeletal myxoid chondrosarcoma of the neck

Extraskeletal myxoid chondrosarcoma is a rare malignant soft-tissue tumour that is typically in the deep soft tissues of the lower extremity. The tumour is usually a well-defined, multinodular soft-tissue mass without calcifications. A 62-year-old woman with a history of nasopharyngeal cancer presented with a palpable mass in the anterior neck. Radiologically, the lesion was a well-defined soft-tissue mass with the extensive calcifications on various imaging examinations. Although this lesion was histopathologically diagnosed as extraskeletal myxoid chondrosarcoma, the unusual imaging findings were challenging and very intriguing.

Effect of chemotherapy on the outcome of self-expandable metallic stents in gastric cancer patients with malignant outlet obstruction

BACKGROUND AND STUDY AIM

Chemotherapy has been suggested to affect the outcome of pyloric stent placement. This study aimed to investigate the association between the response to chemotherapy and pyloric stent outcome.

PATIENTS AND METHODS

Data from 113 patients with inoperable gastric cancer who received chemotherapy after pyloric stent placement at the National Cancer Center hospital were analyzed retrospectively. Chemotherapy response was assessed using the Response Evaluation Criteria in Solid Tumors. A Cox proportional hazards model was used to evaluate the effect of chemotherapy response on the complications of stents.

RESULTS

The stent migration rate was 15.9% (18/113) and the re-stenosis rate was 30.1% (34/113). The response rates to chemotherapy were higher in the first-line group than in the salvage chemotherapy group (second-line or more) (44.8% [26/58] vs. 3.6% [2/55], respectively; P < 0.001). The proportion of patients with long time-to-progression (> 8 weeks) was also higher in the first-line than the salvage chemotherapy group (81.0% [47 /58] vs. 61.8% [34 /55], respectively; P = 0.036). Although, the response to chemotherapy was not associated with stent migration or re-stenosis, a long time-to-progression (adjusted hazard ratio [aHR] = 0.29, 95% confidence interval [CI] 0.13-0.67) and first-line chemotherapy (aHR = 0.45, 95%CI 0.22-0.93) were protective factors against re-stenosis in the multivariate analysis. In patients who received first-line chemotherapy, the median duration of patency of covered and uncovered stents was 20 weeks (95%CI 11-29) and 33 weeks (95 %CI 18-48), respectively (P = 0.317).

CONCLUSIONS

A long time-to-progression and first-line chemotherapy were significant protective factors against re-stenosis. In chemotherapy-naïve gastric cancer patients with pyloric obstruction, placement of an uncovered stent followed by chemotherapy can be considered to increase stent patency.

Effects of Liver Function on Ionized Hypocalcaemia following Rapid Blood Transfusion

OBJECTIVE: Hypocalcaemia detrimentally affects the cardiovascular system and massive transfusion-related hypocalcaemia is particularly severe in end-stage liver disease patients undergoing liver transplantation (LT). This study, therefore, compared the severity and duration of ionized hypocalcaemia between patients with normal and impaired liver function. METHODS: Patients ( n = 26 per group) were transfused at a rate of 10 ml/kg within 10 min with packed red blood cells (PRBCs) during LT (group LP) or spinal surgery (group SP), or were infused with 0.9% normal saline during spinal surgery (group SN). Serum levels of ionized calcium were assessed before (T0), just after (T1), and at 20 (T2) and 60 min (T3) after transfusion. RESULTS: Transfusion with PRBCs caused more severe ionized hypocalcaemia than 0.9% normal saline at T1. In contrast to the faster (20 min) normalization in group SP, ionized hypocalcaemia in group LP persisted at T3. Serum ionized calcium levels at T3 showed correlations with vital signs, blood glucose, serum potassium, base deficit and lactate. CONCLUSION: Rapid blood transfusion caused more severe and prolonged ionized hypocalcaemia in patients with liver dysfunction than in those with normal liver function.

Levels of microbial agents in floor dust during remediation of a water-damaged office building

We examined the effects of remediation on loads of culturable fungi in floor dust collected from a large water-damaged office building during four cross-sectional surveys (2002, 2004, 2005, and 2007, respectively). We created a binary remediation variable for each year for each sampled workstation using information on remediation associated with water damage obtained from building management and used generalized linear mixed-effects models. We found significantly lower levels of culturable total and hydrophilic fungi at remediated workstations than at non-remediated workstations in 2004 and 2005 after completion of major remediation. The remediation effect, however, disappeared in 2007. The fraction of hydrophilic to total fungal concentrations was lowest in 2004, increased in 2005, and was highest in 2007. Our results indicate that the 2003 remediation lowered dust indices of dampness temporarily, but remediation was incomplete, consistent with a building assessment report of water infiltration. This study demonstrates the utility of longitudinal evaluation of microbial indices during remediation of water damage in this building, in which elimination of sources of moisture was not fully addressed. Our findings indicate that the fraction of hydrophilic fungi derived from concentrations of fungal species may be a useful index for assessing the long-term effectiveness of remediation.

PRACTICAL IMPLICATIONS

This study demonstrates the utility of longitudinal evaluation of microbial indices during remediation of water damage in this building, in which elimination of sources of moisture was incomplete. Our findings indicate that the fraction of hydrophilic fungi derived from concentrations of fungal species may be a useful index for assessing the long-term effectiveness of remediation.

Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer

AIMS

The authors aimed to compare the surgical performance and the short-term clinical outcomes of robotic assisted laparoscopic distal gastrectomy (RADG) with laparoscopy-assisted distal gastrectomy (LADG) in distal gastric cancer patients.

METHOD

From April 2009 to August 2010, 62 patients underwent LADG and 30 patients underwent RADG for preoperative stage I distal gastric cancer by one surgeon at the National Cancer Center, Korea. Surgical performance was measured using lymph node (LN) dissection time and number of retrieved LNs, which were viewed as surrogates of technical ease and oncologic quality.

RESULTS

In clinicopathologic characteristics, mean age, depth of invasion and stage were significantly different between the LADG and RADG group. Mean dissection time at each LN station was greater in the RADG group, but no significant intergroup difference was found for numbers of retrieved LNs. Furthermore, proximal resection margins were smaller, and hospital costs were higher in the RADG group. In terms of the RADG learning curve, mean LN dissection time was smaller in the late RADG group (n = 15) than in the early RADG group (n = 15) for 4sb/4d, 5, 7-12a stations, but numbers of retrieved LNs per station were similar.

CONCLUSION

With the exception of operating time and cost, the numbers of retrieved LNs and the short-term clinical outcomes of RADG were found to be comparable to those of LADG, despite the surgeon's familiarity with LADG and lack of RADG experience. Further studies are needed to evaluate objectively ergonomic comfort and to quantify the patient benefits conferred by robotic surgery.

A low dielectric study on hybrid plasma-polymer thin films of different ratio between toluene and TEOS

Organic-inorganic hybrid co-polymer thin films were deposited on silicon(100) substrates under the several ratio of TEOS (tetraethoxysilane) against toluene by plasma enhanced chemical vapour deposition (PECVD) method. Toluene and TEOS were utilized as organic and inorganic precursors each, and hydrogen and argon were also used as a bubbler and carrier gases, respectively. In order to compare the difference of the electrical and the mechanical properties of the plasma polymerized thin films, we grew the hybrid co-polymer thin films under the conditions of various ratio between toluene and TEOS with fixed RF (radio frequency using 13.56 MHz) powers at 30 W. The as-grown polymerized thin films were in first analyzed by FT-IR and XPS. The result of FT-IR showed that the co-polymer thin films were polymerized with fragmented each precursor. Also, XPS results showed the chemical species and binding energies of each species. Si 2p core-level spectra from the hybrid polymer thin film showed the status of Si oxidation number. Impedance analyzer was utilized for the measurements of I-V curves and capacitance values. Also, the thin films were analyzed for hardness and Young's modulus by nano-indenter.

CYP2A6 and ERCC1 polymorphisms correlate with efficacy of S-1 plus cisplatin in metastatic gastric cancer patients

Background:

We evaluated the association between polymorphisms of cytochrome P450 2A6 (CYP2A6)/excision repair cross-complementation group 1 (ERCC1)/X-ray repair cross-complementing group 1(XRCC1) and treatment outcomes of metastatic gastric cancer (MGC) patients treated with S-1/cisplatin.

Methods:

Among MGC patients (n=108), who received S-1 (40 mg m⁻² b.i.d., days 1–14) and cisplatin (60 mg m⁻², day 1) every 3 weeks, we analysed the wild-type allele (W) and variants (V) of CYP2A6 (*4, *7, *9, *10), and the polymorphisms of ERCC1 (rs11615, rs3212986) and XRCC1 (rs25487).

Results:

Patients having fewer CYP2A6 variants had better response rates (W/W vs W/V other than *1/*4 vs V/V or *1/*4=66.7 vs 58.3 vs 32.3% P=0.008), time to progression (TTP) (7.2 vs 6.1 vs 3.5 months, P=0.021), and overall survival (23.2 vs 15.4 vs 12.0 months, P=0.004). ERCC1 19442C>A (rs3212986) was also associated with response rate (C/C, 46.7% vs C/A, 55.3% vs A/A, 87.5%) (P=0.048) and TTP (4.4 vs 7.6 vs 7.9 months) (P=0.012). Patients carrying both risk genotypes of CYP2A6 (V/V or 1/*4) and ERCC1 19442C>A (C/C) vs those carrying none showed an adjusted odds ratio of 0.113 (P=0.004) for response, and adjusted hazard ratios of 3.748 (P=0.0001) for TTP and 2.961 (P=0.006) for death.

Conclusion:

Polymorphisms of CYP2A6 and ERCC1 19442C>A correlated with the efficacy of S-1/cisplatin.

Detection and characterization of enterovirus associated with herpangina and hand, foot, and mouth disease in Seoul, Korea

BACKGROUND

Human enteroviruses (HEVs) are a major cause of herpangina, HFMD (hand, foot, and mouth disease), and other neurological diseases in Seoul, Korea.

METHODS

A total of 56 specimens from hospitalized patients collected from February to December 2009 (37 females and 19 males) in Seoul were tested for HEV from stool, throat swab, and vesicle swab samples taken from patients with herpangina or HFMD using cell culture and RT-PCR in 2009. By the 1D gene, encoding the VP1 capsid protein, seven different HEV genotypes were detected with Coxsackievirus A2, A4, A5, A9, A16 (CA), Coxsackievirus B1 (CB), and Enterovirus 71 (EV71). The most prevalent genotype was CA16 (6, 10.7%), followed by CA2 (4, 7.1%), CA5 (4, 7.1%), EV71 (2, 3.6%), CA4 (1, 1.8%), CA9 (1, 1.8%), and CB1 (1, 1.8%). The 1D gene sequences of two EV71 strains were closely related with one another (98.5% nucleotide similarity) and belonged to the C4 genotype.

CONCLUSIONS

It is important to continuously survey the genetic characteristics of EV71 and CA16 from patients, which will provide useful data that aids in our understanding of HFMD infections in Seoul, Korea and may contribute to future control.

Viral agents associated with acute gastroenteritis in Seoul, Korea

BACKGROUND

The present study was carried out to describe the epidemiologic characteristics of viral gastroenteritis and determine the phylogenetic composition of norovirus strains detected in hospitalized children with acute gastroenteritis in Seoul, Korea.

METHODS AND RESULTS

In total, 10,603 stool samples were collected from 2004 to 2008 and tested by RT-PCR or ELISA. In 4,170 (39.3%) samples at least one viral pathogen was present. Rotavirus (RoV) (1,864, 17.5%) was found to be the causative agent followed by norovirus (NoV) (1,845, 17.4%), human adenovirus (HAdV) (266, 2.5%), human astrovirus (HAstV) (194, 1.8%), and sapovirus (SV) (1, 0.009%). Five GI genotypes (GI-1, GI-3, GI-4, GI-8, and GI-9) and eight GII genotypes (GII-2, GII-3, GII-4, GII-6, GII-7, GII-12, GII-16, and GII-17) of NoV were identified in acute gastroenteritis patients in 2008.

CONCLUSIONS

The genetic characteristics of norovirus and the epidemiologic patterns of a viral pathogen from acute gastroenteritis patients may give potentially effective data for epidemiological studies in Seoul, Korea.

Generation of a recloned transgenic cat expressing red fluorescence protein

Somatic cells from a first-generation red fluorescence protein transgenic cat (first RFP TG cat) were used to produce a recloned RFP transgenic cat (Re-RFP TG cat) (Felis catus) that systemically expressed RFP. A total of 281 RFP cloned embryos were transferred into 13 surrogate mothers (mean=21+/-7.7 embryos/recipient). One surrogate cat was diagnosed pregnant (7.7%) and delivered one live kitten. The presence of the RFP gene in the mRNA and genomic DNA of the Re-RFP TG cat was confirmed by polymerase chain reaction analyses, and red fluorescence was detected in its internal organs and placental tissue samples. Analysis of nine feline-specific microsatellite loci confirmed that the Re-RFP TG cat was genetically identical to the donor cat. To test whether results such as normality of offspring and a low cloning success were due to epigenetic modifications, global methylation of placenta from the two first cloned RFP TG cats (77.08% and 82.29%) and the Re-RFP TG cat (76.38%) were compared by bisulfite mutagenesis sequencing analysis. In conclusion, although cloning efficiency was low, we demonstrated the successful use of a cloned first RFP TG cat as a donor cat to produce a Re-RFP TG cat. These results may facilitate future developments in biomedical models for human therapeutic applications.

Semen characteristics of genetically identical male cats cloned via somatic cell nucleus transfer

We investigated the sperm characteristics of four cloned male cats (Felis catus) to assess their reproductive potential. Fresh and frozen-thawed sperm were assessed for motility, viability, and morphology, and their functional competence was evaluated by in vitro fertilization (IVF) of domestic cat oocytes. All fresh semen characteristics varied among cats and collection times. Sperm concentration (x 10(6)/mL) of Cat A (512+/-140, range 368 to 685) was significantly higher, whereas that of Cat C (335+/-92, range 274 to 469) was significantly lower than that of Cloned B (459+/-159, range 336 to 510) and control cats (680+/-452, range 360 to 479). After thawing, motility and progressive motility of sperm from Cat B were significantly lower than that of the other cloned and control cats. The curvilinear, straight line, and average path velocities of sperm from Cat B were significantly higher, whereas the straightness was lower, than that of the other cloned and control cats. Frozen sperm from Cats A, B, and C successfully fertilized oocytes (cleavage=74.4%, 71.4%, and 86.2%, respectively) and produced embryos that developed to the blastocyst stage after IVF/In vitro culture (IVC) (34.4%, 26.7%, and 48.0%) at frequencies similar to the cleavage rate (82.0%) and blastocyst rate (43.9%) obtained with sperm from the control male. In conclusion, seminal characteristics of cloned male cats did not differ markedly from those of our noncloned, control male cats.

Subclinical cerebrovascular disease in mild cognitive impairment

BACKGROUND

Cerebrovascular disease (CVD) may contribute to mild cognitive impairment (MCI). We sought to determine the relation of white matter hyperintensity (WMH) volume and infarcts in brain MRI to MCI in a community-based sample.

METHODS

A total of 679 elderly persons without dementia underwent brain MRI. WMH and infarcts were quantified using research methods. WMH was adjusted for total cranial volume. The Petersen criteria were used to define MCI. MCI was further subclassified into amnestic and non-amnestic. We used logistic regression to relate WMH and infarcts to prevalent MCI.

RESULTS

WMH were associated with amnestic MCI (odds ratio [OR] = 1.9; 95% confidence interval [CI] 1.1, 3.4) but not non-amnestic MCI (OR = 1.2; 95% CI 0.4, 1.6) after adjusting for age, gender, ethnic group, education, and APOE-epsilon4. Infarcts were more strongly associated with non-amnestic MCI (OR = 2.7; 95% CI 1.5, 4.8) than amnestic MCI (OR = 1.4; 95% CI 0.9, 2.3). In secondary analyses using continuous cognitive scores as outcomes, WMH, but not infarcts, were related to memory, while infarcts were more strongly related with non-amnestic domains.

CONCLUSION

White matter hyperintensity (WMH) is more strongly related to amnestic mild cognitive impairment (MCI). Infarcts are more strongly related to non-amnestic MCI. The nature of WMH in amnestic MCI requires further study.

Effect of cytoplasmic lipid content on in vitro developmental efficiency of bovine IVP embryos

The objective was to evaluate the effect of cytoplasmic lipid content on the embryonic developmental efficiency of bovine in vitro embryo production (IVP) embryos. Ovaries from Korean native cows (Bos taurus coreanae) were collected from a local abattoir, and cumulus-oocyte complexes (COCs) were recovered from follicles 2 to 8mm in diameter. The oocytes were divided into three groups, dependent on their cytoplasm color: pale color (PC), brown color (BC), and dark color (DC). The COCs were fertilized using frozen-thawed semen from a single Hanwoo bull. Based on measurement of the cytoplasmic color intensity of oocytes after 22h of in vitro maturation (IVM), the DC group had lower (P<0.05) color intensity than that in the BC and PC groups (56.3+/-2.7, 93.3+/-5.1, and 123.9+/-12.0, respectively). Based on MitoTracker Green FM staining, the number of mitochondria in the DC (170.1+/-31.2) group was significantly higher than that in the BC (137.5+/-30.8) and PC (105.5+/-25.3) groups. The cleavage rate in the DC (81.5%) group was also higher than that in the PC (50.4%) group (P<0.05), as was the development rate to blastocyst stage (18.9% vs. 9.8%). Finally, cell numbers of blastocysts in the DC (150.8+/-28.0) group were higher (P<0.05) than that in the BC (107.6+/-17.8) and PC (80.5+/-12.3) groups. In conclusion, cytoplasm color was a useful selection parameter for abattoir-derived oocytes destined for IVP.

Learning curve for identification of sentinel lymph node based on a cumulative sum analysis in gastric cancer

BACKGROUND/AIMS

Lymph node metastasis is the most important point to consider when deciding on the modality of resection in patients with early gastric cancer. This study was conducted to evaluate the learning curve for identification of sentinel lymph nodes in patients with gastric cancer.

METHODS

The investigators included the results from 2 prospective series of sentinel lymph node mapping. Cumulative sum (CUSUM) analysis was performed to assess the learning curves for identification of sentinel lymph nodes at CUSUM target success rates of 95%.

RESULTS

One surgeon performed 135 sentinel lymph node mappings for 2 prospective series. The success rate exceeded 90%. The learning period for gastric cancer sentinel node mapping was calculated to be 26 cases for achieving a 95% success rate. Multiple logistic regression analysis for successful detection of sentinel nodes showed that surgical experience of sentinel lymph node mapping was an independent factor for successful detection of sentinel nodes.

CONCLUSIONS

This study suggests that the learning period for identification of sentinel lymph nodes in gastric cancer would be 26 cases. In clinical trials for gastric cancer with sentinel lymph node mapping, the learning curve should be considered to minimize bias due to surgical factors.

Elucidation of binding mode and three dimensional quantitative structure-activity relationship studies of a novel series of protein kinase B/Akt inhibitors

Protein kinase B (PKB; also known as Akt kinase) is located downstream in the PI-3 kinase pathway. Overexpression and constitutive activation of PKB/Akt leads to human prostate, breast and ovarian carcinomas. A series of 69 PKB/Akt inhibitors were examined to explore their binding modes using FlexX, and three-dimensional quantitative structure-activity relationship (3D-QSAR) studies based on comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) were performed to provide structural insights into these compounds. CoMFA produced statistically significant results, with cross-validated q ( 2 ) and non-cross validated correlation r(2) coefficients of 0.53 and 0.95, respectively. For CoMSIA, steric, hydrophobic and hydrogen bond acceptor fields jointly yielded 'leave one out' q(2) = 0.51 and r(2) = 0.84. The predictive power of CoMFA and CoMSIA was determined using a test set of 13 molecules, which gave correlation coefficients, r(2)(predictive) of 0.58 and 0.62, respectively. Molecular docking revealed that the binding modes of these molecules in the ATP binding sites of the Akt kinase domain were very similar to those of the co-crystallized ligand. The information obtained from 3D contour maps will allow the design of more potent and selective Akt kinase inhibitors.

Probing Interfacial Characteristics of Rubrene/Pentacene and Pentacene/Rubrene Bilayers with Soft X-Ray Spectroscopy

The electronic structure of rubrene/pentacene and pentacene/rubrene bilayers has been investigated using soft X-ray absorption spectroscopy, resonant X-ray emission spectroscopy, and density-functional theory calculations. X-ray absorption and emission measurements reveal that it has been possible to alter the lowest unoccupied and the highest occupied molecular orbital states of rubrene in rubrene/pentacene bilayer. In the reverse case, one gets p* molecular orbital states originating from the pentacene layer. Resonant X-ray emission spectra suggest a reduction in the hole-transition probabilities for the pentacene/rubrene bilayer in comparison to reference pentacene layer. For the rubrenepentacene structure, the hole-transition probability shows an increase in comparison to the rubrene reference. We also determined the energy level alignment of the pentacene-rubrene interface by using X-ray and ultraviolet photoelectron spectroscopy. From these comparisons, it is found that the electronic structure of the pentacene-rubrene interface has a strong dependence on interface characteristics which depends on the order of the layers used.

Effect of postnatal catch-up growth on blood pressure in children at 3 years of age

Size at birth and early postnatal growth rates appear to be important determinants of cardiovascular diseases. We examined whether intrauterine growth restriction or the subsequent catch-up postnatal weight gain leads to higher blood pressure in early life to confirm that size at birth and early postnatal growth rates appear to be important determinants of blood pressure changes in early life. Of 407 children born between December 2001 and November 2002 in hospital based-birth cohorts, 102 were followed up at 3 years of age (24.2%) at Ewha Womans University Hospital in Seoul, Korea. At 3 years of age, those who had a low birth weight still belonged in the lower-weight group than the others. The subjects' systolic blood pressure was correlated with their current weight (r=0.41) and weight gain (r=0.39), but not with their birth weight. Those with a higher current weight and higher weight gain based on birth weight (conditional weight gain) had the highest blood pressure. Systolic blood pressure increased by 0.2 mm Hg for every 100-g increase in weight at 3 years and, independently, by 1.5 mm Hg for every 100-unit increase in conditional weight gain. This study suggests that birth weight is not directly associated with blood pressure, but accelerated growth, which occurs mostly in those born with a low birth weight, seems to affect blood pressure in early life.

Benign Breast Diseases Associated With Cyclosporine Therapy in Renal Transplant Recipients

PURPOSE

Our aim was to correlate the radiologic characteristics of cyclosporine-induced benign breast diseases with clinical and pathologic findings.

MATERIALS AND METHODS

The clinical, mammographic, and ultrasonographic records of 33 female renal transplant recipients who received cyclosporine were retrospectively reviewed. Eleven patients had 46 breast masses on ultrasonography. We performed core needle biopsies on 20 masses and reviewed the pathologic findings.

RESULTS

Among 33 female renal transplant recipients, 11 (33%) had 46 benign breast lesions detected on ultrasonography. We performed core needle biopsies on 20 of the 46 masses. On pathologic examination, 12 were fibroadenomas, 6 showed fibrocystic changes, and 2 revealed dense fibrosis. Regardless of the final pathologic diagnosis, more than half of the lesions revealed severe lymphatic and venular swellings. Among 11 patients with breast lesions on ultrasonography, 10/11 (91%) showed multiplicity, and 7/11 (64%) bilaterality. Mammographically, patients with breast lesions revealed heterogeneous or extremely dense breast patterns, and 8 of 11 patients, circumscribed masses. Twenty-two patients without breast lesions showed scattered fibroglandular densities (n = 7), or heterogeneously dense (n = 11) or extremely dense (n = 4) breast patterns, and 3 of 22 patients showed vague or asymmetric densities that needed further evaluation.

CONCLUSION

The development of new breast lesions in patients after renal transplantation should suggest a diagnosis of cyclosporine-induced benign breast disease including fibroadenoma, fibrocystic changes, and dense fibrosis.

Cats cloned from fetal and adult somatic cells by nuclear transfer

This work was undertaken in order to study the developmental competence of nuclear transfer (NT) into cat embryos using fetal fibroblast and adult skin fibroblast cells as donor nuclei. Oocytes were recovered by mincing the ovaries in Hepes-buffered TCM199 and selecting the cumulus oocyte complexes (COCs) with compact cumulus cell mass and dark color. Homogenous ooplasm was cultured for maturation in TCM199+10% fetal bovine serum (FBS) for 12 h and used as a source of recipient cytoplast for exogenous somatic nuclei. In experiment 1, we evaluated the effect of donor cell type on the reconstruction and development of cloned embryos. Fusion, first cleavage and blastocyst developmental rate were not different between fetal fibroblasts and adult skin cells (71.2 vs 66.8; 71.0 vs 57.6; 4.0 vs 6.1% respectively; P < 0.05). In experiment 2, cloned embryos were surgically transferred into the oviducts of recipient queens. One of the seven recipient queens was delivered naturally of 2 healthy cloned cats and 1 stillborn from fetal fibroblast cells of male origin 65 days after embryo transfer. One of three recipient queens was delivered naturally of 1 healthy cloned cat from adult skin cells of female origin 65 days after embryo transfer. The cloned cats showed genotypes identical to the donor cell lines, indicating that adult somatic cells can be used for feline cloning.

Expression of HMGI(Y) associated with malignant phenotype of human gastric tissue

AIMS

We evaluated the association between HMGI(Y) expression and the detection of malignant cells by simple reverse transcriptase-polymerase chain reaction (RT-PCR) and correlated the level of HMGI(Y) expression and the clinicopathological data in gastric cancer.

METHODS AND RESULTS

We analysed HMGI(Y) expression in 62 gastric cancer tissues and 28 normal gastric tissues by RT-PCR and immunohistochemical study. HMGI(Y) expression evidenced by RT-PCR was observed in 42 (67.7%) of 62 gastric cancer samples, whereas eight (28.6%) of 28 normal gastric tissues were positive (P = 0.001). In immunohistochemical staining for HMGI(Y), 48 (77.4%) of 62 gastric cancers were positive for HMGI(Y), whereas four (6.5%) of 62 normal gastric mucosae around the tumour were weakly positive, particularly in cells of some hyperplastic glands (P < 0.001). There was no significant correlation between the levels of HMGI(Y) expression and stage, tumour size, histological grade, invasion depth, or lymph node metastasis.

CONCLUSIONS

Our results suggest that HMGI(Y) expression could be associated with malignant phenotype in human gastric tissue, and that HMGI(Y) may contribute to gastric tumorigenesis.

The effect of a disrupted yhjQ gene on cellular morphology and cell growth in Escherichia coli

The 5' upstream region of the cellulose synthase operon ( bcs operon) has been isolated by cloning from Escherichia coli. A gene encoding YhjQ is located 1.0 kb upstream of the bcs operon in E. coli. The function of YhjQ remains unknown. Insertional inactivation of the yhjQ gene causes abnormal cell division, resulting in incomplete partition of the chromosome and filamentous cells of various sizes. These results suggest that the product of yhjQ may affect normal doubling and cellular morphology.

Nuclear factor-kappa B activation pathway in intestinal epithelial cells is a major regulator of chemokine gene expression and neutrophil migration induced by Bacteroides fragilis enterotoxin

Although intestinal epithelial cells are known to up-regulate the expression of several chemokine genes in response to the stimulation with B. fragilis enterotoxin (BFT), there has been little understanding on the cellular mechanisms of BFT-induced mucosal inflammation. To test whether nuclear transcriptional factor-kappa B (NF-kappaB) is involved in the process, we stimulated intestinal epithelial cells with BFT, and evaluated the signalling NF-kappaB pathways. BFT increased signals of NF-kappaB in HT-29 and T84 epithelial cell lines as well as primary human colon epithelial cells. NF-kappaB molecules activated by BFT stimulation were composed of p65 and p50 heterodimers. In contrast, BFT decreased the signals of IkappaBalpha and IkappaB epsilon, as assessed by immunoblot. Super-repressors of IkappaBalpha, IkappaB kinase (IKK)beta, and NF-kappaB inducing kinase (NIK) inhibited an up-regulated transcription of downstream target gene (CXCL8) of NF-kappaB. Moreover, blocking the activation of NF-kappaB by MG-132 or antisense p50 oligonucleotide transfection resulted in down-regulated expression of chemokines such as CXCL1, CXCL8, and CCL2 in BFT-stimulated HT-29 cells. In addition, NF-kappaB inhibition suppressed the BFT-induced neutrophil transepithelial migration in T84 cells. These results indicate that NF-kappaB can be a central regulator of chemokine gene expression in BFT-stimulated intestinal epithelial cells and may be an important regulator of neutrophil migration.

Identification of structural domains affecting transactivation potential of Nm23

The strong transactivation activity of the C-terminal half (amino acids 76-152) of Nm23 was reported previously. Here we examined a structural domain preventing or necessary to its transactivation activity. The C-terminal 1/4 (amino acids 109-152) was sufficient for transactivation, but the C-terminal half with a longer N-terminal extension (amino acids 58-152) caused the loss of the transactivation ability. Furthermore, coexpression of the N-terminal half with the C-terminus of Nm23-H1 blocked the transactivation activity of the C-terminal half, where direct interaction of both truncated proteins was demonstrated in vitro. Transactivation activities in the C-terminal halves of the known mutants (P96S, H118F, S120G, and S120A) exhibiting differential antimetastasis effects were also tested. Significant reduction of transactivation activity was observed only in H118F, indicating that NPD kinase active-site histidine is required. This suggests that transactivation potential of Nm23 is related to NDP kinase activity but not to metastasis suppressor activity.

The effect of aspirin and prostaglandin E(1) on the patency of microvascular anastomosis in the rats

The purpose of this study was to evaluate the effect of oral prostaglandin E(1)(PGE(1)) on the patency of the microvascular anastomosis of the carotid artery in rat. A total of 48 rats were used, and divided into three groups. The first group (A) was used as a control with no medical agent being used after anastomosis, the second group (B) was medicated with aspirin, and the third group (C) was medicated with oral PGE(1). In each group, four rats were sacrificed serially on every post-operative 3, 5, 10 and 15 days after arterial anastomosis. Patency and histologic evaluations at the anastomotic site were observed. The results revealed that the PGE(1) therapied group showed highest patency rate (100%), lesser formation of mural thrombosis, and also minimal changes in the intimal hyperplasia and medial fibrosis. From these findings, we could conclude that PGE(1) has superior effect on maintaining the patency after microvascular surgery.

Fine-needle aspiration cytology of pleuropulmonary blastoma: a case report with unusual features

Pleuropulmonary blastoma (PPB) is a rare and aggressive intrathoracic neoplasm of childhood, typically presenting as a pulmonary and/or pleural-based mass with cystic, solid, or combined features. Histologically, the tumor is well characterized with a mixture of primitive mesenchymal and variably differentiated sarcomatous components, and the cytologic features described in the three previous reports are also compatible to the histologic ones. Now, we present another case of PPB showing unusual features. A 3-yr-old boy presented with a pleural- or chest wall-based tumor. The fine-needle aspiration cytologic smears were highly cellular with poorly differentiated cells showing variable size and shape rather than those of typical blastemal cells. The histologic findings were also distinctive, exhibiting diffuse sheets of poorly differentiated cells without typical blastemal cell component. Diagnosis was confirmed by the support of immunohistochemical and ultrastructural features. The patient underwent a typical aggressive clinical course to death within 8 mo after diagnosis.