Depression, anxiety and quality of life in parents of children with epilepsy

OBJECTIVES

To assess the impact of childhood epilepsy on parental quality of life (QOL) and psychological health, and to investigate possible correlations between parental QOL and background variables as well as parental anxiety and depression.

SUBJECTS AND METHODS

Parents having an epileptic child (n = 263) and parents having a healthy child (n = 270) were enrolled. Groups were in balance for background variables. Short-Form Health Survey (SF-36) Questionnaire, Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) were applied to all parents. Patients were divided into the first visit group (newly diagnosed epilepsy) and follow-up visit group.

RESULTS

The parents of children with epilepsy had significantly lower QOL scores in SF-36 for all subscales and higher levels of depression and anxiety by using ZDS and ZAS. The factors correlated with parental QOL were seizure control, visit status, anxiety, depression, employment, cost of epilepsy, status epilepticus, drug side effect and age of parents.

CONCLUSIONS

Childhood epilepsy has a severe impact on parental QOL and psychological health, and recognition of possible correlations between parental QOL and background variables will be helpful to improve parental QOL.

Regulation of adipose-derived adult stem cells differentiating into chondrocytes with the use of rhBMP-2

BACKGROUND

Adipose tissue has been demonstrated to contain a population of progenitor cells that can differentiate into bone and cartilage. Studies have suggested that adipose-derived adult stem (ADAS) cells can be induced to differentiate into chondrocytes by transforming growth factor-beta (TGF-beta). In this study, we examined whether bone morphogenetic protein-2 (BMP-2), as a member of the TGF-beta superfamily, could regulate ADAS cells to differentiate into a chondrolineage.

METHODS

ADAS cells were isolated and induced by rhBMP-2. These cells were cultured in pellets for 2 weeks, and the chondrogenic phenotype was observed in vitro and in vivo. ADAS cells cultured without BMP-2 were used as controls.

RESULTS

After 2 weeks of culture, the differentiated ADAS cells reacted positively to Alcian blue and collagen II, and the content of collagen II protein was obviously up-regulated at day 14. Glycosaminoglycan (GAG) content gradually increased from day 2 to day 14 (P < 0.05). However, H&E staining and collagen II expression were weak, and there was a little collagen II protein and GAG detected in the control group. Additionally, the pellets of ADAS cells induced by rhBMP-2 were transplanted into BALB/C nude mice and formed cartilage lacuna at week 8 in vivo.

DISCUSSION

These data demonstrate that rhBMP-2 induce ADAS cells to differentiate into chondrocytes in vitro and in vivo. This is useful for basic and clinical studies aimed at repairing cartilage damage. But in a control group, ADAS cells tended towards differentiation into chondrocytes, which was affected by ITS. We will be exploring the mechanism further.

Systemic lupus erythematosus associated with Moyamoya syndrome: a case report and literature review

Moyamoya syndrome (MMS) is a rare, chronic progressive cerebrovascular occlusive disease that is characterized by a stenosis or occlusion of the bilateral internal carotid arteries and the circle of Willis arteries leading to the development of collateral vessels as visualized by cerebral angiography. We report a case of a 24-year-old woman with nephrotic syndrome whose biopsy showed membranous nephropathy. Ten months after the diagnosis she suffered sudden right hemiplegia and seizure. She was diagnosed with MMS by angiogram seven months ago and received decompressive craniotomy. The patient was admitted to our hospital and a diagnosis of systemic lupus erythematosus (SLE) was made. Glucocorticoids and tacrolimus were used to control the symptoms of SLE. Following one month of immunosuppressant treatment, the patient died of brain hemorrhage. This case alongside another six reviewed cases shows that an underlying cerebrovascular lesion of moyamoya in the vessels of patients with SLE is susceptible to cerebrovascular accidents.

Ectopic Cartilage Formation Induced by Mesenchymal Stem Cells on Porous Gelatin-Chondroitin-Hyaluronate Scaffold Containing Microspheres Loaded with TGF-β1

The study aimed to produce a novel porous gelatin-chondroitin-hyaluronate scaffold in combination with a controlled release of TGF-β1 and to evaluate its potentials in ectopic cartilage formation. The gelatin-chondroitin-hyaluronate scaffold was developed to mimic the natural extra cellular matrix of cartilage. Gelatin microspheres loaded with TGF-β1 (MS-TGFβ1) showed a fast cytokine release at initial phase (37.4%) and the ultimate accumulated release was 83.1% by day 18. Then MS-TGFβ1 were incorporated into scaffold. The MSCs seeded on scaffold with or without MS-TGFβ1 were incubated in vitro or implanted subcutaneously in nude mice. In vitro study showed that, compared to the scaffold, the scaffold/MS-TGFβ1 significantly augmented the proliferation of MSCs and GAG synthesis. Three weeks postoperatively histology observation showed that in MSCs/scaffold/MS-TGFβ1 implantation group, cells of newly formed ectopic cartilage were located within typical lacunae and demonstrated morphological characteristics of chondrocytes. Six weeks later the ectopic cartilage grew more and islands of cartilage were observed. The matrix was extensively metachromatic by safranin-O/Fast green staining. Immunohistochemical staining also indicated ectopic cartilage was intensely stained for type II collagen. Instead, in the MSCs/scaffold implantation group, no cartilage-like tissue formed and matrix showed negative or weak positive staining. The percentage of positive staining area was significantly larger in MSCs/scaffold/MS-TGFβ1 group (p<0.05) at each time point. The results indicated that the novel gelatin-chondroitin-hyaluronate scaffold with MS-TGFβ1 could induce the chondral differentiation of MSCs to form cartilage and might serve as a new way to repair cartilage defects.

Neuregulin-1 protects against doxorubicin-induced apoptosis in cardiomyocytes through an Akt-dependent pathway

In previous studies, it has been shown that recombinant human neuregulin-1(rhNRG-1) is capable of improving the survival rate in animal models of doxorubicin (DOX)-induced cardiomyopathy; however, the underlying mechanism of this phenomenon remains unknown. In this study, the role of rhNRG-1 in attenuating doxorubicin-induce apoptosis is confirmed. Neonatal rat ventricular myocytes (NRVMs) were subjected to various treatments, in order to both induce apoptosis and determine the effects of rhNRG-1 on the process. Activation of apoptosis was determined by observing increases in the protein levels of classic apoptosis markers (including cleaved caspase-3, cytochrome c, Bcl-2, BAX and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) staining). The activation of Akt was detected by means of western blot analysis. The study results showed that doxorubicin increased the number of TUNEL positive cells, as well as the protein levels of cleaved caspase-3 and cytochrome c, and reduced the ratio of Bcl-2/Bax. However, all of these effects were markedly antagonized by pretreament with rhNRG-1. It was then further demonstrated that the effects of rhNRG-1 could be blocked by the phosphoinositole-3-kinase inhibitor LY294002, indicating the involvement of the Akt process in mediating the process. RhNRG-1 is a potent inhibitor of doxorubicin-induced apoptosis, which acts through the PI3K-Akt pathway. RhNRG-1 is a novel therapeutic drug which may be effective in preventing further damage from occurring in DOX-induced damaged myocardium.

Physcion 8-O-β-glucopyranoside suppresses tumor growth of Hepatocellular carcinoma by downregulating PIM1

Hepatocellular carcinoma (HCC) presents one of leading causes of cancer-related mortality worldwidely. This study is aimed to investigate the anti-tumor activity of physcion 8-O-β-glucopyranoside (PG) in HCC. Our results have showed that PG significantly suppresses cell growth and induces apoptosis in vitro and in vivo. At molecular level, PG represses the expression of Pim family kinases 1 (PIM1), which is responsible for the anti-tumor effect of PG in HCC. Ectopic over-expression of PIM1 significantly abrogates the suppressing effect of PG on cell growth and inducing effect of PG on apoptosis. In contrast, knockdown of PIM1 by siRNA enhances the anti-tumor effect of PG in HCC cells.

Dopamine transporter dysfunction in Han Chinese people with chronic methamphetamine dependence after a short-term abstinence

Single-photon emission-computed tomography (SPECT) after the administration of (99m)Tc-TRODAT-1 was performed on healthy subjects and subjects with methamphetamine (METH)dependence at time 1 (T1) after 24-48 h of abstinence, time 2 (T2) after 2 weeks of abstinence, and time 3 (T3) after 4 weeks of abstinence. In contrast to values in controls, the values of the striatal DAT specific uptake ratios (SURs) in subjects with METH dependence were significantly lower at T1 (n=25), T2 (n=9), and T3 (n=8); a mild increase in SURs was observed at T2 and T3, but values were still significantly lower than those in controls. In subjects with METH dependence, there was a trend for a negative correlation of striatal DAT SURs and craving for METH at T1. METH craving, anxiety and depression scores significantly decreased from T1 to T2 to T3. We conclude that Han Chinese people with METH dependence experience significant striatal DAT dysfunction, and that these changes may be mildly reversible after 4 weeks of abstinence, but that DAT levels still remain significantly lower than those in healthy subjects. The mild recovery of striatal DAT may parallel improvements in craving, anxiety and depression.

Effects of hydroxyethyl starch on hepatic production of cytokines and activation of transcription factors in lipopolysaccharide-administered rats

BACKGROUND

Hydroxyethyl starch (HES) is one of the most frequently used plasma substitutes. Some studies have indicated that HES may have anti-inflammatory effects. The present in vivo study was performed to investigate the effects of HES on hepatic production of cytokines and activation of transcription factors in sepsis.

METHODS

Adult male Sprague-Dawley rats were randomly divided into four groups: rats challenged with lipopolysaccharide (LPS) (5 mg kg(-1)) and treated with saline (64 ml kg(-1)); challenged with LPS (5 mg kg(-1)) and treated with HES (16 ml kg(-1)); injected with saline and treated with HES (16 ml kg(-1)); and saline control. Each hepatic tissue was collected in groups of rats 2 h after induction of endotoxemia for determination of tumour necrosis factor (TNF)-alpha levels, TNF-alpha mRNA expressions, and nuclear factor (NF)-kappaB, activator protein (AP)-1 activities or 3 h after LPS challenge for IL-1beta, IL-6, IL-8, IL-10 levels and the mRNA expressions.

RESULTS

Endotoxemia was associated with significant increases in hepatic proinflammatory cytokine productions and transcription factor activities. HES significantly reduced the increased hepatic levels of TNF-alpha, IL-1beta, IL-6, IL-8 and the mRNAs in the endotoxemic rats. Similarly, HES could inhibit hepatic NF-kappaB and AP-1 activations.

CONCLUSION

The results suggest that in sepsis HES may down-regulate hepatic inflammatory mediators production and these anti-inflammatory effects may act through inhibition of NF-kappaB and AP-1 activations.

Brain damage following severe acute normovolemic hemodilution in combination with controlled hypotension in rats

BACKGROUND AND AIM

The reduced oxygen content and perfusion pressure during acute normovolemic hemodilution (ANH) and controlled hypotension (CH) raise concerns about hypoperfusion and ischemic injury to the brain. In this study on rats, we examined the brain damage following four different degrees of ANH combined with CH.

METHODS

Forty rats were randomly assigned to receive a sham operation or CH and ANH [with a hematocrit (Hct) of 30, 25, 20 or 15%]. ANH was performed after baseline physiological parameters had been monitored for 20 min; 30 min later, CH was induced using sodium nitroprusside, and the mean arterial blood pressure was maintained at 50-60 mmHg for 1 h. Rats were killed 3.5 h after hemodilution. Ultrastructural alterations in the CA1 region of the rat hippocampus were observed, and serum concentrations of S100B and neuron-specific enolase (NSE) were measured before and after ANH.

RESULTS

The serum S100B concentration increased significantly in the Hct 20% + CH and Hct 15% + CH groups. However, there were no significant differences in the serum levels of NSE between the groups. In the CA1 region of the rat hippocampus, marked ultrastructural alterations, such as mitochondrial denaturalization and nucleus distortion, were observed in the Hct 20% + CH and Hct 15% + CH groups.

CONCLUSION

Severe ANH (Hct < or = 20%) combined with CH may induce cerebral damage, as confirmed by marked ultrastructural alterations in the CA1 region of the rat hippocampus and significantly increased serum levels of S100B, and should be avoided.

Ketamine inhibits LPS-induced calcium elevation and NF-kappa B activation in monocytes

OBJECTIVE

To investigate whether ketamine could inhibit lipopolysaccharide (LPS)-induced intracellular calcium elevation and NF-kappa B activation in monocytes.

MATERIALS AND METHODS

Isolated rat monocytes were challenged with 10 microg/ml LPS with or without the presence of various concentrations of ketamine (10, 100, 1000 microM). Intracellular calcium was monitored by laser confocal microscopy. NF-kappa B activity of the nuclear extracts of monocytes was analyzed by electrophoretic mobility shift assay (EMSA).

RESULTS

LPS provoked a significant calcium elevation and enhanced NF-kappa B activity in monocytes. Ketamine above concentration of 100 microM inhibited endotoxin-induced intracellular calcium elevation and NF-kappa B activity. Ketamine itself had no effect on either of them.

CONCLUSIONS

These findings suggest that ketamine could suppress NF-kappa B in monocytes exposed to endotoxin, and this anti-inflammatory effect might act through attenuating intracellular calcium elevation.

Salinomycin and Sulforaphane Exerted Synergistic Antiproliferative and Proapoptotic Effects on Colorectal Cancer Cells by Inhibiting the PI3K/Akt Signaling Pathway in vitro and in vivo

Background

Both salinomycin (SAL) and sulforaphane (SFN) exert their antitumorigenic effects in various types of cancer We investigated whether combining salinomycin (SAL, an antibiotic ionophore) with sulforaphane (SFN, a phytochemical) exerted synergistic antiproliferative and proapoptotic activities in colorectal cancer (CRC) cells in vitro and in vivo by evaluating the proliferative and apoptotic responses of two CRC cell lines.

Materials and Methods

The combination index (CI) was calculated using the Chou-Talalay method, and the effects of the synergistic combination (CI<1) of lower doses of SAL and SFN were selected for further studies. Anti-tumor effect of the combination of SAL and SFN was tested both in vitro and in vivo.

Results

Cotreatment effectively inhibited proliferation, migration and invasion and enhanced apoptosis. The xenograft model also showed similar results. Furthermore, we evaluated the molecular mechanism behind SAL- and SFN-mediated CRC cell apoptosis. The combination treatment induced apoptosis in Caco-2 and CX-1 cells by inhibiting the PI3K/Akt pathway, which increased the expression of the tumor suppressor protein p53. The treatment also decreased the expression of the survival protein Bcl-2 and increased the expression of the proapoptotic protein Bax, which increased the Bax/Bcl-2 ratio, as well as enhanced poly ADP-ribose polymerase (PARP) cleavage. Upon inhibiting the PI3K/Akt pathway with LY294002 prior to cotreatment, we detected enhanced PARP cleavage compared to that in the cotreatment only group.

Conclusion

We investigated whether the combination of SAL and SFN had antiproliferative and proapoptotic effects in CRC cells both in vitro and in vivo. Cotreatment also significantly decreased migration and invasion compared to that of the control and SAL or SFN monotherapies. This novel combination of SAL and SFN might provide a potential strategy to treat CRC.

Clinical efficacy of chemotherapy combined with verapamil in metastatic colorectal patients

In order to determine the clinical efficacy and adverse reactions of chemotherapy and verapamil infusion through a target artery to treat colorectal cancer patients with metastasis after failure with previous conventional treatments. Patients with metastatic colon cancer (n = 36) received an infusion of verapamil, interleukin-2, oxaliplatin (or hydroxy camptothecin or irinotecan hydrochloride), fluorouracil and calcium folinate through target artery using the Seldinger puncture technique. From the second day of infusion, the patients were treated with fluorouracil and calcium folinate via systematic intravenous injection for 2-3 days. Efficacy was evaluated after at least two treatment courses. The objective response including complete or partial response was 58.3% in the 36 patients; clinical benefit rate, evaluated by Karnofsky Performance Status score was 91.7%; by weight was 83.3%; by the amount of painkiller consumed was 80.6%. No patient experienced side effects associated with heart function. Post-treatment, the P-R period, Q-T period, QRS, and heart rate were not significantly different than before treatment. Liver function was significantly improved. Side effects of chemotherapy were minor in comparison to those observed with intravenous chemotherapy. Infusion of verapamil and chemotherapy directly into pelvic tumor tissue can increase treatment efficacy and has been shown to be a relatively safe technique.

Methemoglobinemia misdiagnosed as ruptured ectopic pregnancy

A 22-year-old woman with an initial diagnosis of 'ruptured ectopic pregnancy' and 'hemorrhagic shock' was sent to the operation room for surgical treatment. The mucocutaneous color was deeply cyanosed and the pulse oximeter oxygen saturation (SpO2) was only 86% after tracheal intubation (100% O2). 'Chocolate-brown' blood was observed and methemoglobinemia was considered. Then the arterial blood gas (ABG) sample was obtained, an intravenous infusion of methylene blue and vitamin C followed. The patient recovered quickly, and later two other patients with similar symptoms were treated in the same way. The success was due to a correct diagnosis accompanied with prompt treatment and quick recognition of the etiology.

Longitudinal changes of dopamine transporters in heroin users during abstinence

RATIONALE

Chronic exposure to heroin results in decreased dopamine transporter levels. Jitai tablets, a traditional Chinese medicine, have been effective at increasing striatal dopamine transporter availability after 6 months of treatment. However, it remains unknown how long the heroin-induced impairment persists and whether dopamine transporter can be normalized following long-term abstinence or treatment.

OBJECTIVES

This study was to evaluate the time course of dopamine transporter changes in heroin users undergoing long-term abstinence and treatment with Jitai tablets for 1 year.

METHODS

Single-photon emission computed tomography using [(99m)Tc]TRODAT-1 was performed on 64 heroin users and 20 healthy subjects to assess striatal dopamine transporter availability at baseline, 3, 6, and 12 months. Heroin users were randomly assigned to treatment with either placebo or Jitai tablets. Depression and anxiety scores were measured before each imaging session.

RESULTS

Compared with healthy controls, significant reduction in dopamine transporter availability was found in heroin users at baseline in both the right (by ∼ 31.6%) and left striatum (by ∼ 33.2%). At 6 months, dopamine transporter availability was significantly higher in Jitai tablet-treated group than placebo group in the bilateral striatum (p < 0.01). At 12 months, dopamine transporter levels in both groups were upregulated substantially from baseline but still not recovered to normal levels in the left striatum (p < 0.05). Depression and anxiety scores significantly decreased at 3, 6, and 12 months (p < 0.05).

CONCLUSIONS

Our results confirmed that heroin abuse induces pronounced, long-term reduction in dopamine transporter. Treatment with Jitai tablets appears to stimulate recovery.

The Impact of Pretransplant Cytomegalovirus Infection on Acute Renal Allograft Rejection

BACKGROUND

The role of cytomegalovirus (CMV) infection in renal allograft rejection remains controversial; moreover, there are few studies on pretransplant infections. This study sought to investigate whether pretransplant CMV infections had negative effects on acute rejection episodes (ARE) and to evaluate the effect of preemptive treatment.

METHODS

This retrospective single-center study of 416 transplant recipients from October 1, 2000 to September 1, 2003 had CMV infections diagnosed by CMV antigenemia tests. The incidences of ARE were compared between CMV-infected and noninfected groups. Risk factors for ARE were analyzed. Based on preemptive treatment, pretransplant CMV-infected recipients were divided into ganciclovir-treated and nontreated groups and the incidence of ARE was compared between the two groups.

RESULTS

One hundred eighty four recipients had CMV infections pretransplant; the infection rate was 44.2%. Fifty five recipients had ARE among the pretransplant CMV-positive group, which was significantly higher than that in the noninfected group (29.9% vs 19.5%, P = .014). But the rejection subgroups and renal function recovery had no significant differences. While the presence of pretransplant infection was an independent predictor of ARE (RR = 1.807), severity showed no significant impact on ARE. Among 184 pretransplant CMV infection recipients, the incidences of ARE were 14.3% and 18.0% in ganciclovir-treated versus nontreated patients, respectively (P = .650).

CONCLUSIONS

Pretransplant CMV-positive recipients were at greater risk of ARE. Pretransplant CMV infection was an independent risk factor for ARE. Preemptive antiviral treatment did not show protective effects against ARE related to CMV infection-mediated immunological injuries.

Availability of dopamine transporters in heroin-dependent subjects: A 18F-FECNT PET imaging study

This study was to reconfirm the reduced dopamine transporter (DAT) availability in heroin-dependent subjects and validate the use of 2β-carbomethoxy-3β-(4-chlorophenyl)-8-(2-fluoroethyl)-nortropane (¹⁸F-FECNT) as a PET radiotracer to assess the changes of striatal DAT in drug addicted subjects. Herein, we assessed DAT standardized uptake values (SUV) of ¹⁸F-FECNT in the striatum and cerebellum of 20 heroin-dependent subjects and 10 healthy controls and analyzed the correlation between DAT availability and heroin withdrawal symptom scores and anxiety/depression rating scales in heroin-dependent subjects, as well as the relationship between the withdrawal symptoms scores and age. The striatal DAT availability in heroin-dependent subjects was significantly lower (by ~15.7-17.6%) than that in healthy controls. Age was positively related to heroin withdrawal symptom scores. The withdrawal symptom scores in older patients (Age: 49.5±2.5) were significantly higher (by ~20%) than those in younger patients (Age: 30.9±4.8). These results confirm that chronic heroin use induces striatal DAT reduction, suggesting that ¹⁸F-FECNT could be used as an alternative PET imaging radioligand for in vivo imaging of DAT in drug addicted subjects. Moreover, older patients might suffer more severe withdrawal symptoms than younger patients, suggesting that older patients with heroin withdrawal could be given more medication.

Low versus high radioiodine activity for ablation of the thyroid remnant after thyroidectomy in Han Chinese with low-risk differentiated thyroid cancer

AIM

The aim of this study was to compare the efficacy and adverse effects of radioiodine (¹³¹I) therapy between two groups of patients with low-risk differentiated thyroid cancer (DTC) who received 30 mCi or 100 mCi radioiodine for ablation of the thyroid remnant after total thyroidectomy.

METHODS

The study cohort was 173 patients, 85 of whom were given 30 mCi of radioiodine and the others were given 100 mCi of radioiodine. Follow-up involved neck ultrasonography, measurement of serum levels of thyroglobulin and whole-body scans to evaluate the response of radioiodine treatment. All patients were assessed for adverse effects.

RESULTS

Of the 173 patients, 170 (98.3%) patients finally achieved successful ablation. The prevalence of successful ablation was 77.6% in the low-dose group versus 71.5% in the high-dose group after the first dose administration (P=0.36), 79% in the low-dose group versus 88% in the high-dose group after the second dose administration (P=0.416), and 97.6% in the low-dose group versus 98.9% in the high-dose group after the final ablation (P=0.54). We found no significant differences between the two groups. No patient had an adverse effect with a severity grade ⩾2 and the prevalence of adverse effects in the high-dose group was higher than that in the low-dose group, especially for nausea, neck pain, and sore throat.

CONCLUSION

These data suggest that a low dose of radioiodine is as effective as a high dose of radioiodine for ablation of the thyroid remnant after total thyroidectomy for low-risk DTC. Moreover, low-dose radioiodine therapy is associated with a lower prevalence of adverse events.

Hydroxyethyl Starch Inhibits Intestinal Production of Cytokines and Activation of Transcription Factors in Endotoxaemic Rats

We studied the effect of hydroxyethyl starch (HES) on intestinal production of cytokines and activation of transcription factors in sepsis. Septic rats, induced by intraperitoneal lipopolysaccharide (LPS) (5 mg/kg), were treated with intravenous HES (16 ml/kg) or saline (64 ml/kg). Rat ileal tissues were collected at 2 h, 3 h or 6 h after LPS challenge. Levels of tumour necrosis factor alpha (TNF-α), interleukin (IL) 1β, IL-6, IL-8 and IL-10, cytokine mRNAs, activities of nuclear factor kappa-B (NF-κB) and activator protein-1 (AP-1), and the number of ileal myeloperoxidase (MPO)-positive cells were determined for each group. HES significantly reduced the LPS-induced increase in intestinal levels of TNF-α, IL-1β, IL-6, IL-8 and their corresponding mRNAs. HES also decreased the number of MPO-positive cells induced by LPS and inhibited activation of NF-κB and AP-1. The results suggest that in sepsis, HES may down-regulate intestinal pro-inflammatory cytokine production via suppression of NF-κB and AP-1 activation.

1.0T MR-guided percutaneous coaxial cutting needle biopsy in pancreatic lesion diagnosis

BACKGROUND

Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US.

PURPOSE/HYPOTHESIS

To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1.0T high-field MR scanner.

STUDY TYPE

Prospective.

POPULATION

Thirty-one patients with 31 pancreatic lesions underwent MR-guided percutaneous coaxial cutting needle biopsy.

FIELD STRENGTH/SEQUENCE

1.0T T₂ WI-TSE PDW-aTSE T₁ WI-TFE.

ASSESSMENT

Final diagnosis was confirmed by surgery and clinical follow-up for at least 12 months. The accuracy, sensitivity, and specificity were calculated. Complications were recorded.

STATISTICAL TESTS

There was no statistical analysis in this study.

RESULTS

The procedure was technically successful and final biopsy samples were adequate for histopathological examination in all patients. Biopsy pathology revealed malignant pancreatic tumor in 25 patients (25/31, 80.6%), and benign pancreatic lesions were present in six patients (6/31, 19.4%). The final diagnosis was pancreatic malignancy in 27 patients and benign disease in four patients, which was confirmed by surgery and clinical follow-up. Two biopsy results were false-negative. The diagnostic accuracy in biopsies was 93.5% (29 of 31). The sensitivity to detect a malignant disease was 92.6% (25 of 27), and the specificity was 100%. All patients tolerated the procedure well; minor peripancreatic hemorrhage was found in two patients after the procedure, and none had major complications either during or after the procedure.

DATA CONCLUSION

MRI-guided percutaneous biopsy of pancreatic lesions using an open 1.0T high-field scanner has high diagnostic accuracy, which is feasible and safe for use in clinical practice.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:382-388.

Characterization of a new HLA-B allele, B*15:179:02

A novel HLA-B allele, B*15:179:02, has been identified during typing of donors in Anhui province, China.

Regulatory mechanism of TGF-β1/SGK1 pathway in tubulointerstitial fibrosis of diabetic nephropathy

OBJECTIVE

The aim of this study was to clarify the potential function of transforming growth factor-β1/serum/glucocorticoid-regulated kinase 1 (TGF-β1/SGK1) pathway in diabetic nephropathy-induced tubulointerstitial fibrosis.

MATERIALS AND METHODS

Type 2 diabetes mellitus (T2DM) model was successfully established in rats by high-sucrose-high-fat diet combined with streptozotocin (STZ) induction. Subsequently, blood glucose level, renal function and pathological changes in kidneys of T2DM and control rats were evaluated. Western blot and quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) were conducted to determine the protein and mRNA expression levels of TGF-β1, SGK1, fibronectin (FN) and α-smooth muscle actin (α-SMA) in rat kidney tissues, respectively.

RESULTS

Blood glucose (BG), glycosylated hemoglobin (GHb), serum creatinine (Scr) and blood urea nitrogen (BUN) in T2DM rats were significantly higher than those of control rats (p<0.05). The morphology of glomeruli and renal tubules in rats of control group were normal. In contrast, T2DM rats showed significant lesions in glomeruli, renal tubules, and renal interstitium. Furthermore, the relative expression levels of TGF-β1, SGK1, FN, and α-SMA in kidney tissues of T2DM rats were remarkably higher than those of controls (p<0.05).

CONCLUSIONS

The TGF-β1/SGK1 pathway is closely related to tubulointerstitial fibrosis in T2DM rats.

An Outbreak of Head Rot of Cabbage Caused by Rhizoctonia solani AG2-1 in Central China

In July of 2007, an outbreak of head rot of cabbage (Brassica oleracea) occurred on more than 2,500 ha in Changyang County, Hubei Province, China. On average, yields were reduced by approximately 50%. Affected plants were first observed in 2006, and symptoms were considered physiological or nutritional disorders by growers. In 2007, the more extensive summer rains favored an increase in disease severity. Initial symptoms consisted of irregular, brown-to-black lesions on leaves and sometimes a wet decay of the base of outer leaves. Lesions expanded until entire heads were rotted. Rhizoctonia solani was recovered consistently from symptomatic plant tissues. Five isolates were used to evaluate cultural and morphological characteristics of the pathogen. On potato dextrose agar (PDA), all isolates yielded colonies that became brown after 5 days of incubation. The hyphae, 4.9 to 8.0 μm in diameter, branched at right or acute angles near the septa and each cell usually had six to eight nuclei. Dark brown sclerotia, 0.5 to 5 mm in diameter, appeared after 10 days of incubation. Genomic DNA of a representative isolate, CY-1, was extracted, and the rDNA-internal transcribed spacer sequence showed 99.5% identity to R. solani AG2-1 (Accession No. EU513147) in GenBank. Pathogenicity tests were completed in the laboratory by placing 6-mm-diameter mycelial plugs from 3-day-old PDA cultures of the five isolates onto 30 cabbage leaves detached from 5-week-old cabbage plants. The inoculated leaves were incubated at 28°C with 95% relative humidity in a controlled environment chamber. Two days after inoculation, black, wet lesions were observed on all inoculated leaves, while no symptoms were apparent on leaves inoculated with noncolonized PDA plugs. Koch's postulates were fulfilled by reisolating R. solani from diseased leaves. R. solani AG1 (1), AG2-1 (2), and AG4 (4) have been reported as causal agents of diseases of cabbage and related plants, and AG2-1 has been previously isolated from cabbage grown in southwest China (3), but to our knowledge, this is the most severe outbreak reported from China. References: (1) G. S. Abawi and S. B. Martin. Plant Dis. 69:158, 1985. (2) L. Corazza et al. Eur. J. Plant Pathol. 101:341, 1995. (3) H. R. Li and H. H. Zhu. J. Yunnan Agric. Univ. 3:247, 1993. (4) G. H. Yang et al. Plant Pathol. 56:351, 2007.

Impact of clinical condition at restarting dialysis on outcome after kidney allograft loss: a single-center experience

BACKGROUND

The purpose of this paper was to determine the impact of the clinical condition of the patient at the restart of dialysis on long-term survival after renal graft loss.

METHODS

We performed an analysis of 110 patients with renal allograft failure compared with 115 hemodialysis patients without kidney transplantation.

RESULTS

There was a relatively high glomerular filtration rate, low serum albumin, and greater prevalence of infection among graft loss patients compared with the never-transplanted patients. Patient survival after allograft loss was significantly lower than that of never-transplanted patients (P = .024) with 63.4% patients succumbing in the first 3 months. Serum hepatitis B virus (HBV) positivity, cardiovascular disease (CVD) and malnutrition were independent risk factors for graft loss patient upon COX regression analysis.

CONCLUSIONS

Serum HBV positive, complicated with CVD and malnutrition were independent risk factors for the graft loss among patients who restarted hemodialysis. More attention should be paid to treat complications of transplant recipients in K/DOQI 4 and 5 stages.