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Background: There is growing evidence for an association between chronic renal disease (CKD) and adverse cerebrovascular events because of the overlap of several risk factors. The purpose of this study is to examine the epidemiology of CKD and the characteristics of risk factors for CKD in the population with ischaemic stroke., Methods: This retrospective study included 571 patients with ischaemic stroke. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD) study equation. Renal function was assessed according to the Kidney Disease Outcomes Quality Initiative (K/DOQI)-CKD classification., Results: Study demonstrated that the major factors associated with CKD in the ischaemic stroke patients were age, diabetes mellitus, hypertension, systolic blood pressure, LDL cholesterol and serum uric acid. Diabetes mellitus (OR 4·146, 95% CI 1·047-16·418, P = 0·043), hypertension and diabetes mellitus (OR 3·574, 95% CI 1·248-10·234, P = 0·018), serum uric acid (OR 1·010, 95% CI 1·006-1·013, P < 0·001) and LDL cholesterol (OR 1·431, 95% CI 1·063-1·928, P = 0·018) were independent risk factors associated with CKD in the patients with ischaemic stroke., Conclusions: The patients with ischaemic stroke may be considered as a high-risk population for CKD and be aggressively managed for CKD prevention. The high prevalence of CKD in population with ischaemic stroke prompts the need for greater public awareness about risks of CKD., (© 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)

The effect of Rh doping in Bi(12)TiO(20) (BTO) crystals on the photosensitivity and recording speed at 1064 nm is reported. Response time of 0.1 s is measured during real-time holographic recording without any preliminary treatments. Once the crystal is pre-excited with a green light, the detected response time becomes 0.02 s. A possibility to implement BTO:Rh crystal plate with liquid crystals into a hybrid organic/inorganic device is demonstrated, which opens perspectives for further near-infrared applications.

To assess the efficacy of quarantine for acute hemorrhagic conjunctivitis (AHC) outbreaks control in schools, by using the Compartment Model. Through combining the characters of both AHC and compartment model, we built a susceptive-infective-removal (SIR) model suited for AHC outbreaks control in schools, and then quarantine was added into the model to develop a susceptive-infective-quarantine-removal (SIQR) model. An outbreak of AHC in Changsha in 2011 was employed as a sample to assess the effect of quarantine for the prevention and control of AHC. Basic reproduction number (λ0) of the AHC outbreak without intervention was 6.80, thus the transmission speed of the disease became quite fast. If no intervention had been adopted, almost all the students, faculties and staff members would have been infected within 23 days, and the accumulative cases would become 738, with the total attack rate (TAR) as 99.73%. The peak of the outbreak was at Sep. 11th and the number of new cases was 126 on that day. The efficacy would have been different if quarantine forces had been taken at different time and differently. The bigger and earlier the quarantine force had been adopted, the lower morbidity peak and the smaller TAR would have been appeared, with better efficacy of outbreak control. If the quarantine rate had been taken at the level of 90% on the sixth day, the accumulative case would have been reduced to 132 and the TAR had become 17.84% consequently. Quarantine program could be used as a main intervention approach to be employed for ACH outbreak at schools.

Pure, TiO2-doped and TiO2/Ag-doped WO3 films were prepared by evaporation and electron beam evaporating. Raman spectroscopy and chronoamperometry were used to characterize the electrochromic properties of the samples. The correlation between the relative intensity of the Raman peaks, corresponding to the Raman sharp peak of the crystalline phase at 810 cm(-1) is negative, that is to say the higher the relative intensity of the Raman peaks, the smaller the coloration efficiency.

Background: Postoperative hemorrhage following cardiopulmonary bypass in heart valve replacement patients may be caused by a mismatch of protamine and heparin. We hypothesized that a 2-titration-guided protamine dose would reduce protamine-heparin mismatch and bleeding in those patients., Methods: Patients scheduled for elective cardiac valve replacement surgery (N = 60) were randomly divided into 3 groups. All patients received 2 titrations: the first at termination of cardiopulmonary bypass and the second at 5 minutes after the initial dose of protamine. In the control group, the initial protamine dose was based on the heparin dose received; the supplemental protamine dose was empirically determined. In the single-titration group, the initial dose was based on the first titration, while supplemental dose was empirically determined. In the 2-titration group, both initial and supplemental doses were based on titrations. Bleeding volumes were recorded from the time of first protamine dose to 24 hours after surgery., Results: Most patients needed supplemental protamine according to second titrations. In the 2-titration group, 12 patients received supplemental protamine, whereas only 1 patient in the single-titration group and 6 in the control group received supplemental protamine (P = 0.003). The blood loss was significantly less in the 2-titration group (526 ± 131 mL) than in the control group (730 ± 385 mL; P = 0.019)., Conclusions: A higher dosage of protamine based on 2 titrations reduced blood loss after surgery, supporting the hypothesis that inadequate dosage of protamine contributes to hemorrhage after valve replacement surgery., (Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Prolonged read-out process of a hologram recorded at near infrared with simultaneous green light exposure is measured in Ru-doped Bi12SiO20 crystal. The experimental results are confirmed by numerical simulations, suggesting two different traps involved in the space-charge transport mechanism. In addition, quasi-permanent holographic recording of image with fast updating speed by using two-wavelength recording is demonstrated.

Introduction: This study aims to test the serum levels of interleukin-33 (IL-33) and soluble ST2 (sST2) in patients with chronic kidney disease (CKD) and to evaluate their association with disease severity., Methods: Sixty-nine patients with CKD were enrolled, disease severity was assessed, and clinical data were collected. Twelve healthy volunteers served as healthy individuals. Serum IL-33 and sST2 were tested by enzyme-linked immunosorbent assay., Results: The patients were classified into five categories based on their estimated glomerular filtration rate (eGFR). No difference was found as to the serum concentration of IL-33 between CKD patients and healthy individuals (p = 0.656), while a higher serum level of sST2 was found in CKD patients (p = 0.003). The correlation analysis revealed a significant correlation between the serum level of sST2 and disease severity (r = 0.586; p < 0.001). A higher level of sST2 was found in CKD patients with elevated parathyroid hormone (p = 0.001). Serum sST2 correlated with parathyroid hormone (r = 0.412; p < 0.001), serum phosphorus (r = 0.545; p < 0.001), and serum calcium (r = -0.494; p < 0.001)., Conclusion: An elevated concentration of serum sST2 is found in CKD patients and correlates with disease severity. Serum sST2 may be also associated with parathyroid hormone disorder of CKD. The sST2 may have an important role in the development of CKD or as a marker of disease severity.

In order to investigate the transmission risk of H5N1 avian influenza viruses (AIV) from sewage in Changsha poultry markets, the evolution relationship and molecular characteristics of non-structural (NS) genes of H5N1 AIV from sewage were analyzed. Nine H5N1 AIV environmental sewage specimens were collected from Changsha poultry markets. The NS genes were amplifyed by PCR and then sequenced with TA cloning. Amino acid(aa) sequence alignment and phylogenetic tree analysis were conducted by Lasergene and Mega5 software. Eight NS genes TA cloning were constructed successfully. Phylogenetic tree indicated that they were belonged to the allele A subgroup. Aa homology analysis showed 90.1% 92.5% identity in NS1 proteins and 91.0% - 92.6% identity in NS2 proteins compared with reference viruses of the allele A (A/chicken/ Hubei/ w h/ 1999). The homologies of the amino sequences of NS1 and NS2 in this study were 93.8%-100.0% and 98.4%-100.0%, respectively. The C terminal of all eight H5N1 NS1 proteins from sewage in poultry markets carried a ESEV of PL motif and the 92 amino acids were E, furthermore, the 80 to 84aa were missed which were the characteristics of highly pathogenic AIV. The NS genes of H5N1 AIV from sewage in poultry markets have molecular characteristics of highly pathogenic and have the potential risk of H5N1 virus spreading.

Background: Pegylated-interferon (PEG-IFN) and ribavirin (RBV), current standard treatment for hepatitis C virus (HCV) infection, are frequently associated with neutropenia and anemia, leading to high treatment discontinuation rates in HIV/HCV-coinfected patients. Our objective was to compare the effectiveness of intervening with hematologic growth factors versus dose reductions of standard HCV therapy for the management of treatment-induced hematologic disorders., Methods: Ninety-two HIV/HCV-coinfected, therapy-naive subjects received PEG-IFN alfa-2b 1.5 μg·kg⁻¹·wk⁻¹ and RBV 13 ± 2 mg·kg⁻¹·d⁻¹ for up to 48 weeks. Before treatment initiation, subjects were randomized to subsequently receive growth factors, recombinant human erythropoietin (rHuEPO) and/or granulocyte colony-stimulating factor, or dose reduction (RBV and/or PEG-IFN) for anemia and neutropenia management, respectively. We analyzed the ability of each management strategy to control anemia and neutropenia and the percentage of subjects who achieved a successful treatment outcome according to the different management strategies., Results: During treatment, 43 subjects developed anemia (human erythropoietin, n = 24; dose reduction, n = 19), whereas 25 subjects developed neutropenia (granulocyte colony-stimulating factor, n = 10; dose reduction, n = 15). After the intervention, the increase in both hemoglobin and absolute neutrophil counts did not differ between the 2 side effect management strategies. Sustained response percentages were similar comparing anemic and neutropenic subjects regardless of management strategy (anemia: recombinant human erythropoietin, 29% versus dose reduction, 21%, P = 0.92; neutropenia: granulocyte colony-stimulating factor, 40% versus dose reduction, 20%, P = 0.46)., Conclusions: Growth factor supplementation and dose reduction do not seem to differ as management strategies for anemia and neutropenia in HIV/HCV-coinfected individuals treated with PEG-IFN/RBV.

Objective: To realize the influence of climatic changes on the transmission of hemorrhagic fever with renal syndrome (HFRS), and to explore the adoption of climatic factors in warning HFRS., Methods: A total of 2171 cases of HFRS and the synchronous climatic data in Changsha from 2000 to 2009 were collected to a climate-based forecasting model for HFRS transmission. The Cochran-Armitage trend test was employed to explore the variation trend of the annual incidence of HFRS. Cross-correlations analysis was then adopted to assess the time-lag period between the climatic factors, including monthly average temperature, relative humidity, rainfall and Multivariate Elño-Southern Oscillation Index (MEI) and the monthly HFRS cases. Finally the time-series Poisson regression model was constructed to analyze the influence of different climatic factors on the HFRS transmission., Results: The annual incidence of HFRS in Changsha between 2000 - 2009 was 13.09/100 000 (755 cases), 9.92/100 000 (578 cases), 5.02/100 000 (294 cases), 2.55/100 000 (150 cases), 1.13/100 000 (67 cases), 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000 (87 cases), 0.75/100 000 (47 cases) and 1.02/100 000 (65 cases), respectively. The incidence showed a decline during these years (Z = -5.78, P < 0.01). The results of Poisson regression model indicated that the monthly average temperature (18.00°C, r = 0.26, P < 0.01, 1-month lag period; IRR = 1.02, 95%CI: 1.00 - 1.03, P < 0.01), relative humidity (75.50%, r = 0.62, P < 0.01, 3-month lag period; IRR = 1.03, 95%CI: 1.02 - 1.04, P < 0.01), rainfall (112.40 mm, r = 0.25, P < 0.01, 6-month lag period; IRR = 1.01, 95CI: 1.01 - 1.02, P = 0.02), and MEI (r = 0.31, P < 0.01, 3-month lag period; IRR = 0.77, 95CI: 0.67 - 0.88, P < 0.01) were closely associated with monthly HFRS cases (18.10 cases)., Conclusion: Climate factors significantly influence the incidence of HFRS. If the influence of variable-autocorrelation, seasonality, and long-term trend were controlled, the accuracy of forecasting by the time-series Poisson regression model in Changsha would be comparatively high, and we could forecast the incidence of HFRS in advance.

To simulate intervention measures in controlling an outbreak of acute hemorrhagic conjunctivitis on one school campus by using the Susceptible-Infected-Recovered (SIR) model, to provide evidence for preparedness and response to the epidemic. Classical SIR model was used to model the epidemic. Malthusian exponential decline method was employed to estimate the infective coefficient β for interventions. The initial value of parameters was determined based on empirical data. The modeling was implemented using Matlab 7.1 software. Without interventions, the outbreak was expected to experience three phrases: (1) early stage (the first 5 days) in which the epidemic developed slowly and could be intervened easily; (2) rapid growing stage (6 - 15 days) in which the number of infected cases increased quickly and the epidemic could not be well controlled; and (3) medium and late stage (16 days and later) in which more than 90% of the susceptible persons were infected but the intervention measures failed to prevent the epidemic. With the implementation of interventions, the epidemic was predicted to be controlled in the early stage, under the SIR model. The simulation based on the SIR model kept an acceptable consistency with the actual development of epidemic after the implementation of intervention measures. The SIR model seemed effective in modeling interventions to the epidemic of acute hemorrhagic conjunctivitis in the schools.

Objective: To explore the clinical effect of subtotal vertebrectomy, decompression and strut grafting in treating thoracolumbar burst fractures through posterolateral approach via posterior midline incision., Methods: From May 2005 to July 2008, 14 patients with thoracolumbar burst fractures were treated with subtotal vertebrectomy, decompression and strut grafting through posterolateral approach via posterior midline incision. There were 9 males and 5 females, ranging in age from 24 to 68 years, with an average of 42.3 years. All patients were single segment fractures, of them, T11 was in 1 case, T12 in 5, L1 in 5 and L2 in 3. According to AO classification in spinal fracture, type A3 was in 5 cases, B1 in 3, B2 in 3, C1 in 2, C2 in 1. According to the ASIA classification in neurological function, grade A was in 3 cases, B in 3, C in 5, D in 2, E in 1. The height of anterior border vertebral body, volume of spinal canal and neurological function were analyzed by X-ray films, CT scanning and ASIA classification preoperative, postoperative and at final follow-up., Results: Operative time was from 3.5 to 5.5 hours with the mean of 4.0 hours; bleeding during operation was from 800 to 2 600 ml with the mean of 1 300 ml. Two cases with nerve root injury recovered without special handling after 3-6 months; 1 case with leakage of cerebrospinal fluid restored through lumbar cerebrospinal fluid drainage; 1 case with pleura tear healed through closed thoracic drainage. No iatrogenic vascular injury or infection was found. The follow-up time was from 8 to 36 months with the mean of 16.5 months. All patients had neurofunctional recovery at different degree, except that 3 patients in grade A. The height of anterior border vetebral body restored from (42.25 +/- 11.87)% preoperatively to (94.38 +/- 3.08)% postoperatively, and (92.87 +/- 3.32)% at final follow-up (P<0.05); volume of spinal canal (the actual volume of spinal canal/normal volume of spine canal) increased from (45.63 +/- 6.88)% preoperatively to (95.26 +/- 3.31)% postoperatively, and (96.13 +/- 2.56)% at final follow-up (P<0.05). Cobb angle were corrected from (25.64 +/- 4.40) degrees preoperatively to (5.80 +/- 1.14) degrees postoperatively; Cobb angle lost from 0 degrees to 6 degrees at final follow-up with (8.10 +/- 2.65) degrees. All patients obtained complete bony fusion without pseudarthrosis formation at final follow-up., Conclusion: Subtotal vertebrectomy decompression and strut grafting through posterolateral approach via posterior midline incision is an effective and safe method in treating thoracolumbar burst fracture, which can restored height of intervertebral body, volume of spinal canal and physiological flexion of spinal column, and retain spinal permanent stability.

Real-time holographic recording and an improvement of the response time in ruthenium (Ru)-doped Bi(12)SiO(20) (BSO) crystal at 1064 nm is obtained. Using green light pre-exposure, a significant operation speed of 60 ms is achieved. In addition, the ability for image reconstruction is demonstrated in Ru-doped BSO, supporting further applications as reversible media for real-time image processing at the near-IR spectral range., (© 2011 Optical Society of America)

Objective: To analyze the spatio-temporal process on 2009 influenza A (H1N1) pandemic in Changsha and the influencing factors during the diffusion process., Methods: Data were from the following 5 sources, influenza A (H1N1) pandemic gathered in 2009, Geographic Information System (GIS) of Changsha, the broad range of theorems and techniques of hot spot analysis, spatio-temporal process analysis and Spearman correlation analysis., Results: Hot spot areas appeared to be more in the economically developed areas, such as cities and townships. The cluster of spatial-temporal distribution of influenza A (H1N1) pandemic was most likely appearing in Liuyang city (RR = 22.70, P < 0.01). The secondary cluster would include districts as Yuelu (RR = 6.49, P < 0.01), Yuhua (RR = 81.63, P < 0.01). Xingsha township appeared as the center in the Changsha county (RR = 2.90, P < 0.01) while townships as Yutangping (RR = 19.31, P < 0.01), Chengjiao (RR = 73.14, P < 0.01) and Longtian appeared as the center in the west of Ningxiang county (RR = 14.43, P < 0.01) and Wushan as the center in the Wangcheng county (RR = 13.84, P < 0.01). As time went on, the epidemic moved towards the eastern and more developed regions. Regarding factor analysis, population, the amount of students, geographic relationship and business activities etc. appeared to be the key elements influencing the transmission of influenza A (H1N1) pandemic. At the beginning of the epidemic, population density served as the main factor (r = 0.477, P < 0.05) but during the initial and fast growing stages, it was replaced by the size of students to serve as the important indicator (r = 0.831, P < 0.01; r = 0.518, P < 0.01). However, during the peak of the epidemics, the business activities played an important role (r = -0.676, P < 0.01)., Conclusion: Groups under high risk and districts with high incidence rates were shifting, along with the temporal process of influenza A (H1N1) pandemic, suggesting that the protection measures need to be adjusted, according to the significance of influencing factors at different stages.

Acquiring the behavioral significance of sound has repeatedly been shown to correlate with long term changes in response properties of neurons in the adult primary auditory cortex. However, the molecular and cellular basis for such changes is still poorly understood. To address this, we have begun examining the auditory cortical expression of an activity-dependent effector immediate early gene (IEG) with documented roles in synaptic plasticity and memory consolidation in the hippocampus: Arc/Arg3.1. For initial characterization, we applied a repeated 10 min (24 h separation) sound exposure paradigm to determine the strength and consistency of sound-evoked Arc/Arg3.1 mRNA expression in the absence of explicit behavioral contingencies for the sound. We used 3D surface reconstruction methods in conjunction with fluorescent in situ hybridization (FISH) to assess the layer-specific subcellular compartmental expression of Arc/Arg3.1 mRNA. We unexpectedly found that both the intranuclear and cytoplasmic patterns of expression depended on the prior history of sound stimulation. Specifically, the percentage of neurons with expression only in the cytoplasm increased for repeated versus singular sound exposure, while intranuclear expression decreased. In contrast, the total cellular expression did not differ, consistent with prior IEG studies of primary auditory cortex. Our results were specific for cortical layers 3-6, as there was virtually no sound driven Arc/Arg3.1 mRNA in layers 1-2 immediately after stimulation. Our results are consistent with the kinetics and/or detectability of cortical subcellular Arc/Arg3.1 mRNA expression being altered by the initial exposure to the sound, suggesting exposure-induced modifications in the cytoplasmic Arc/Arg3.1 mRNA pool., (Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.)

Mouse models are increasingly contributing to our understanding of the neural genetics of sensory processing and memory. For example, strain differences have helped elucidate basic mechanisms of age-related hearing loss and auditory fear conditioning. Assessing sensory differences arising in acoustic communication contexts is also important for understanding natural audition. While this topic has not been well studied, it is currently being addressed through auditory neuroethological studies in the CBA/CaJ strain, where insights will help lay a foundation for future neural genetic studies. Here, we focus on the responses of adult females to ultrasonic vocalizations of males. We tested a group of female mice in a place-preference paradigm before and after auditory and olfactory experience with a male. A control group was housed with other female cagemates between trials. All females showed an initial preference for male calls that rapidly decayed over the course of a trial. However, only females that had been pair-housed with a male during the inter-trial interval displayed a reinstated interest in male vocalizations, suggesting possible group differences in the assessment of the calls' behavioral relevance. These findings provide a timeframe during which auditory processing of male ultrasounds might be expected to show a difference depending on behavioral relevance, and also suggest an importance of social interactions in maintaining call recognition., (© 2010 The Authors. Genes, Brain and Behavior © 2010 Blackwell Publishing Ltd and International Behavioural and Neural Genetics Society.)

The rapidly increasing use of the local field potential (LFP) has motivated research to better understand its relation to the gold standard of neural activity, single unit (SU) spiking. We addressed this in an in vivo, awake, restrained mouse auditory cortical electrophysiology preparation by asking whether the LFP could actually be used to predict stimulus-evoked SU spiking. Implementing a Bayesian algorithm to predict the likelihood of spiking on a trial by trial basis from different representations of the despiked LFP signal, we were able to predict, with high quality and fine temporal resolution (2 ms), the time course of a SU's excitatory or inhibitory firing rate response to natural species-specific vocalizations. Our best predictions were achieved by representing the LFP by its wide-band Hilbert phase signal, and approximating the statistical structure of this signal at different time points as independent. Our results show that each SU's action potential has a unique relationship with the LFP that can be reliably used to predict the occurrence of spikes. This "signature" interaction can reflect both pre- and post-spike neural activity that is intrinsic to the local circuit rather than just dictated by the stimulus. Finally, the time course of this "signature" may be most faithful when the full bandwidth of the LFP, rather than specific narrow-band components, is used for representation.

An important question in auditory neuroscience concerns how the neural representation of sound features changes from the periphery to the cortex. Here we focused on the encoding of sound onsets and we used a modeling approach to explore the degree to which auditory cortical neurons follow a similar envelope integration mechanism found at the auditory periphery. Our "forward" model was able to predict relatively accurately the timing of first spikes evoked by natural communication calls in the auditory cortex of awake, head-restrained mice, but only for a subset of cortical neurons. These neurons were systematically different in their encoding of the calls, exhibiting less call selectivity, shorter latency, greater precision, and more transient spiking compared with the same factors of their poorly predicted counterparts. Importantly, neurons that fell into this best-predicted group all had thin spike waveforms, suggestive of suspected interneurons conveying feedforward inhibition. Indeed, our population of call-excited thin spike neurons had significantly higher spontaneous rates and larger frequency tuning bandwidths than those of thick spike neurons. Thus the fidelity of our model's first spike predictions segregated neurons into one earlier responding subset, potentially dominated by suspected interneurons, which preserved a peripheral mechanism for encoding sound onsets and another longer latency subset that reflected higher, likely centrally constructed nonlinearities. These results therefore provide support for the hypothesis that physiologically distinct subclasses of neurons in the auditory cortex may contribute hierarchically to the representation of natural stimuli.

Ganglioside mimicry by C.jejuni lipo-oligosaccharides (LOS) could induce the production of autoantibodies against gangliosides and the development of Guillain-Barré syndrome (GBS). The LOS biosynthesis region exhibits significant variation with different strains. Using PCR amplifications of genes from published LOS loci and sequencing the LOS biosynthesis loci, the eight GBS-associated C. jejuni strains from HeBei could be classified into four classes. The expression of sialylated LOS structures (class A) or non-sialylated LOS structures(class F, H and P) in the C. jejuni LOS is considered to be two different factors for the induction of GBS.

Objective: To analyze the feasibility of regular infusion with different concentrations of dextrose and blood glucose monitor in infant from 2 to 12 months during operation., Methods: Ninety ASA(American Society of Anesthesiologists) I-II infants (age 2-12 months) who undertook cleft lip and palate repair (excluding patients with congenital diabetes) were divided into three groups (30 cases per group). Group I patients were infused with normal saline, Group II with 2.5% (mass fraction) dextrose in normal saline and Group III with 5% (mass fraction) dextrose, all by a rate of 6-8 mL/ (kg x h). Once the patient was sent into the operation room, Electrocardiogram(ECG) and Pulse Oxygen Saturation[SpO(2)] monitor were applied regularly; and anesthesia was inducted and maintained with sevoflurane in oxygen. The infants' age, gender, weight, fasting time, operation time and duration of anesthesia were recorded and the blood glucose concentrations before infusion, 10 minutes and 30 minutes after induction as well as at the end of operation were recorded., Results: There were no differences in age, gender, weight, fasting time, operation time and duration of anesthesia among the three groups. The differences of blood glucose concentrations before induction had no statistical significance among the three groups. The blood glucose concentration after induction was higher than that before induction in each group. The occurrence of lower level of blood glucose in Group I was 13.3% (4/30, 2.8-4.3 mmol/L), with the lowest value being 3.1 mmol/L. None was detected hyperglycemia. In Group II, blood glucose value after induction was lower than Group III and higher than Group I at every time point and incidence rate of hyperglycemia was 10% (3/30, >11.1 mmol/L), with the highest value being 12.7 mmol/L. Blood glucose in Group III was higher than both Group I and Group II after infusion. Incidence rate of hyperglycemia in Group III was 70% (21/30, >11.1 mmol/L), with the highest value being 22.1 mmol/L. After induciton 5, 10 min and the end of operation, blood glucose values with group I were (5.8 + or - 1.3) mmol/L, (8.4 + or - 1.7) mmol/L and (10.6 + or - 2.8) mmol/L; group II were (6.3 + or - 1.4) mmol/L, (8.5 + or - 2.5) mmol/L and (11.3 + or - 2.9) mmol/L; group III were (6.6 + or - 1.5) mmol/L, (8.2 + or - 2.1) mmol/L and (12.2 + or - 3.5) mmol/L., Conclusion: 2.5% dextrose (at a rate of 6-8 mL/ (kg x h) is appropriate for infants during cleft lip and palate repair, while regular blood glucose monitor should be applied during operation.

Objective: Occluding the middle cerebral artery of small animals with an intraluminal filament to build a stroke model has gained increasing acceptance. In light of the growing demand for magnetic resonance imaging (MRI) studies using the clinical MRI scanner, large animal models can be superior to small animal models. In this work, we developed a modified rabbit model of stroke, which was assessed using clinical MRI scanner and compared with a most commonly silicone-coated filament model., Methods: We presented a focal cerebral ischemia in rabbits. The key feature of this modified method is the use of a guide wire as a 'nylon suture'. At 3 days after ischemia, the percentage of brain infarct volume, neurobehavioral score, intracranial hemorrhagic incidence and dynamic changes of T(2) and apparent diffusion coefficient values were assessed respectively and compared between the focal cerebral models., Results: Wire-induced models had more severe brain infarct size with less dispersion (32.7 +/- 6.5%, coefficient of variation=0.20) than that with filament models (25.4 +/- 8.9%, coefficient of variation=0.31; p<0.05). There were more significant MRI changes in the early stage, higher rate of technique success (wire, 20/20; filament, 17/20) and less intracranial hemorrhage (wire, 0/20; filament, 3/20) in wire-induced models than in filament-induced rabbits (p<0.05)., Conclusion: Our data suggest that wire-induced method can provide a useful tool for the earlier research of ischemia.

To demonstrate whether a calculated vascularity index (VI) can predict metastases of cervical lymph nodes, the VI values of the primary tumors were obtained by using 3-D sonography in 87 subjects with laryngeal cancer confirmed by laryngoscope and biopsy. N-staging of the subjects was determined by pathological nodal harvesting. The relationship between the VI and pathological N-staging was evaluated by correlation coefficient. To test the accuracy of the VI for predicting cervical lymph node involvement, a receiver operating characteristic (ROC) curve was constructed, and the best operating point was determined by Youden's index. For comparison, 2-D sonography was applied to detect metastatic cervical lymph nodes. The accuracy, sensitivity and specificity of the VI, 2-D sonography and a combination of the two methods for diagnosis of metastatic cervical lymph nodes were compared. There was a positive linear correlation between the VI and pN-staging (r=0.740, p<0.001). The area under the ROC curve for the VI was 0.919. The best operating point of the VI was 4.4565, which derived higher sensitivity than that of 2-D sonography (95% vs. 81%, p=0.031), but lower specificity (75% vs. 95%, p=0.012). The combination of the two methods yielded a higher accuracy (97% vs. 85% and 89%, p=0.002 and 0.016), a higher sensitivity to 2-D sonography (95% vs. 81%, p=0.031) and a higher specificity to VI (98% vs. 75%, p=0.002). The VI of laryngeal cancer can be a useful factor for predicting metastases of cervical lymph nodes.

Objective: To investigate the effects of sinusoidal magnetic field on isolated sarcoplasmic reticulum (SR) calcium release channel (RyR1) function., Methods: With the Ca2+ dynamic spectrum and isotope labeled methods, the Ca2+ release and [(3)H]-Ryanodine binding, the initial rates of NADH oxidation and the production of superoxide of SR exposed to 50 Hz sinusoidal magnetic field (MF) were investigated respectively., Results: 0.4 mT, 50 Hz sinusoidal MF exposure for 30 min increased SR Ca2+ release initial rate about 35% from (10.82 +/- 0.89) pmol.mg(-1) pro.s(-1) to (14.69 +/- 1.21) pmol.mg(-1) pro.s(-1); and the [(3)H]-Ryanodine binding by about 15% from (2.13 +/- 0.05) pmol/mg pro to (2.45 +/- 0.07) pmol/mg pro, which regulated by 1 mmol/L NADH with 1 mmol/L NAD+. Meanwhile MF upregulated the rate of NADH oxidation by about 22% from (0.88 +/- 0.11) x 10(-4) FI/s to (1.07 +/- 0.13) x 10(-4) FI/s and upregulated the production of superoxide by about 32% from (0.99 +/- 0.09) x 10(-5) FI/s to (1.31 +/- 0.06) x 10(-5) FI/s., Conclusion: 0.4 mT sinusoidal MF increases the activity of RyR1 within the low redox potential environment, and promotes NADH oxidase activity and superoxide production.

The interplay between excitation and inhibition in the auditory cortex is crucial for the processing of acoustic stimuli. However, the precise role that inhibition plays in the distributed cortical encoding of natural vocalizations has not been well studied. We recorded single units (SUs) and local field potentials (LFPs) in the awake mouse auditory cortex while presenting pup isolation calls to animals that either do (mothers) or do not (virgins) recognize the sounds as behaviorally relevant. In both groups, we observed substantial call-evoked inhibition. However, in mothers this was earlier, longer, stronger, and more stereotyped compared to virgins. This difference was most apparent for recording sites tuned to tone frequencies lower than the pup calls' high-ultrasonic frequency range. We hypothesize that this auditory cortical inhibitory plasticity improves pup call detection in a relatively specific manner by increasing the contrast between call-evoked responses arising from high-ultrasonic and lateral frequency neural populations.

There is a growing consensus that the auditory system is dynamic in its representation of behaviorally relevant sounds. The auditory cortex in particular seems to be an important locus for plasticity that may reflect the memory of such sounds, or functionally improve their processing. The mechanisms that underlie these changes may be either intrinsic because they depend on the receiver's physiological state, or extrinsic because they arise from the context in which behavioral relevance is gained. Research in a mouse model of acoustic communication between offspring and adult females offers the opportunity to explore both of these contributions to auditory cortical plasticity in a natural context. Recent works have found that after the vocalizations of infant mice become behaviorally relevant to mothers, auditory cortical activity is significantly changed in a way that may improve their processing. Here we consider the hypothesis that maternal hormones (intrinsic factor) and sensory experience (extrinsic factor) contribute together to drive these changes, focusing specifically on the evidence that well-known experience-dependent mechanisms of cortical plasticity can be modulated by hormones.

Caspase-12 has been localized to endoplasmic reticulum (ER) and showed to involve ER stress-induced apoptosis. In the present work we investigated the temporospatial alterations of caspase-12 immunoreactivity in the penumbra following cerebral ischemia/reperfusion in rabbit. Transient cerebral ischemia was produced by intraluminal occlusion of the middle cerebral artery for 2 h followed by 1 h, 6 h, 1 day, 3 days, 7 days and 14 days of reperfusion. Caspase-12 immunohistochemistry was first increased in the penumbra 1 h after reperfusion, with a peak at day 1 to day 3, and then gradually decreased to basal level at day 14. The number of TUNEL-positive cells and ultrastructural observation of brain sections in the penumbra showed a similar change at the same time points. ER mediated by caspase-12 participated in apoptosis induced by cerebral ischemia/reperfusion injury, which may provide a new area for therapeutic intervention to ameliorate outcomes following cerebral ischemia.

Objective: To compare the analgesic efficiency and adverse effects of postoperative patient-controlled intravenous analgesia (PCIA) with lornoxicam and sufentanil in patients undergoing oral maxillofacial surgery., Methods: 200 ASA (American Society of Anesthesiologists) I-II patients who undertook oral maxillofacial operation were divided into two groups: lornoxicam group (group L) and sufentanil group (group S), with 100 patients in each group. The effectiveness was assessed with visual analogue scale (VAS), Prince-Henry score (PHS) and Ramsay sedation Score (RSS) at different time points: 4, 8, 12, 24 and 48 h after the beginning of analgesia. The analgesic efficacy of analgesia and the adverse effects during analgesia period were observed., Results: Statistical analysis revealed no significant difference in VAS, PHS and RSS at 4, 8, 12, 24, 48 h and the overall satisfaction on analgesia therapy. The percentage of nausea, vomiting and dizziness was significantly lower in group L than that in group S (1% vs 9%, 0 vs 4%, 0 vs 3%, P<0.05)., Conclusion: Lornoxicam could provide an identical efficacy as sufentanil in the postoperative PCIA in patients undergoing oral maxillofacial surgery. In addition, lornoxicam caused less adverse effects.

Perisinusoidal hepatic stellate cells (HSC) are the principal fibrogenic cells in the liver. In animal models, HSC apoptosis is the predominant clearance mechanism of activated HSC, although data evaluating whether the same processes occur in humans are limited. We conducted a cross-sectional study to evaluate the association between HSC apoptosis and fibrosis stage in subjects with chronic hepatitis C virus (HCV) infection (n = 44) and HCV-negative controls with normal liver histology (n = 9). We used immunohistochemical techniques to identify activated (alpha-smooth muscle actin+), proliferative (Ki-67+) and apoptotic (terminal deoxynucleotidyl transferase [TdT]-mediated dUTP nick end-labelling+) HSC in liver biopsy specimens from all subjects. The same pathologist enumerated positive cells per high-power field (HPF, x 200) in 20 periportal/lobular areas. HSC apoptosis was decreased in HCV-positive subjects compared with controls (median 0.4, range 0.0-3.1 vs 1.1, 0.2-3.5 cells/HPF, P = 0.02). Among HCV-positive subjects, HSC apoptosis was decreased in those with moderate to advanced fibrosis (P = 0.04) compared with those with mild fibrosis. By multivariate analysis, HSC apoptosis decreased by an average of 0.14 cells/HPF (95% confidence interval 0.01-0.28 cells/HPF) per increase in fibrosis stage (P = 0.04). While the number of activated and proliferative HSC was significantly increased in HCV-infected subjects compared with that in uninfected controls, the numbers of these cells did not differ between HCV-infected subjects with mild vs moderate/advanced fibrosis. In conclusion, the number of apoptotic HSC was significantly decreased in HCV-infected subjects with advanced fibrosis. In chronic HCV infection, inhibition of HSC apoptosis may be one mechanism by which fibrosis progresses.

Objective: The objectives of this study were to report the incidence of gastrojejunal anastomic strictures that occurred in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery and to determine the time course of presentation, associated perioperative factors, and response to balloon dilation., Subjects and Methods: All 126 patients who underwent LRYGB at the Cleveland Clinic Foundation between July 2003 and February 2005 were included. We utilized a transoral 21-mm circular stapler for the gastrojejunostomy. Patients with symptoms of anastomotic strictures underwent upper endoscopy by one surgeon (B.C.). A stricture was defined by the inability to pass a 10-mm gastroscope through the anastomosis. Balloon dilation was performed to 12 mm. Records were analyzed retrospectively and statistical analysis including Pearson chi(2) statistics, Fisher's exact test and Student's t test were used when appropriate., Results: Symptomatic anastomotic strictures occurred in 29 (23%) patients. All patients presented with nausea, vomiting and dysphagia. The median time to diagnosis was 52 days (25-309 days). Symptoms resolved after one dilation in 25 (86%) of patients. Two and three dilations were required in 1 (3.5%) and 3 (10.5%) of patients, respectively. No patients had complications or required more than 3 dilations. Age, preoperative body mass index (BMI), and intraoperative blood loss did not correlate with stricture formation. Although nonsteroidal anti-inflammatory drugs were used by 46 (41%) of patients after surgery, there was no correlation with stricture formation., Conclusion: Symptomatic anastomotic strictures developed in nearly a quarter of patients who underwent LRYGB utilizing a transoral 21-mm circular stapled gastrojejunal anastomosis. A single endoscopic balloon dilation was usually adequate. Strictures were not predicted by perioperative factors., (Copyright 2009 S. Karger AG, Basel.)

In this study, the impact of surfactant molecular composition (saturated sorbitan monolaurate or unsaturated sorbitan monooleate) on polymer/surfactant assemblies was examined. Specifically, the associations between the cationic chitosan and the uncharged surfactants were monitored by surface tension, turbidity, and conductivity measurements. Bright field, confocal laser scanning, and transmission electron microscopy revealed that nanometer-sized chitosan/surfactant aggregates comprised of a chitosan-rich shell and a chitosan-poor core agglomerate at high surfactant concentrations to yield micrometer-scaled supramolecular structures with highly ordered internal structure. The size and architecture of these chitosan/surfactant assemblies were dependent on the structure and concentration of the surfactant employed. The association mechanism among chitosan, surfactant, and the chitosan/surfactant aggregates was discussed in terms of the semirigid polyelectrolyte character of chitosan and the hydrophobic character of sorbitan esters. This study provides important insight into the structural and physical parameters of surfactant that govern the formation of multicompartment polymer/surfactant assemblies.

Neuregulin-1 (Nrg1)/erbB signaling regulates neuronal development, migration, myelination, and synaptic maintenance. The Nrg1 gene is a schizophrenia susceptibility gene. To understand the contribution of Nrg1 signaling to adult brain structure and behaviors, we studied the regulation of type III Nrg1 expression and evaluated the effect of decreased expression of the type III Nrg1 isoforms. Type III Nrg1 is transcribed by a promoter distinct from those for other Nrg1 isoforms and, in the adult brain, is expressed in the medial prefrontal cortex, ventral hippocampus, and ventral subiculum, regions involved in the regulation of sensorimotor gating and short-term memory. Adult heterozygous mutant mice with a targeted disruption for type III Nrg1 (Nrg1(tm1.1Lwr+/-)) have enlarged lateral ventricles and decreased dendritic spine density on subicular pyramidal neurons. Magnetic resonance imaging of type III Nrg1 heterozygous mice revealed hypofunction in the medial prefrontal cortex and the hippocampal CA1 and subiculum regions. Type III Nrg1 heterozygous mice also have impaired performance on delayed alternation memory tasks, and deficits in prepulse inhibition (PPI). Chronic nicotine treatment eliminated differences in PPI between type III Nrg1 heterozygous mice and their wild-type littermates. Our findings demonstrate a role of type III Nrg1 signaling in the maintenance of corticostriatal components and in the neural circuits involved in sensorimotor gating and short-term memory.

Introduction: Prediction of the propensity of a compound to induce Torsades de Pointes continues to be a formidable challenge to the pharmaceutical industry. Development of an in vitro model for assessment of proarrhythmic potential offers the advantage of higher throughput and reduced compound quantity requirements when compared to in vivo studies. A rabbit isolated heart model (SCREENIT) has been reported to identify compounds with proarrhythmic potential based on the observance of compound-induced triangulation and instability of the monophasic action potential (MAP), ectopic beats, and reverse-use dependence of prolongation of the MAP duration. Previous reports have indicated that this model qualitatively identifies proarrhythmic compounds and suggest the use of this model to assign safety margins for human clinical use. The intent of this series of studies was to evaluate the impact of study design on the proarrhythmic concentration predicted by this model., Methods: Nine compounds of varying proarrhythmic potential and a negative control were tested in a blinded fashion using a series of different experimental protocols: Compounds were tested at multiple concentration ranges and extended perfusion times were also evaluated., Results: In general when the dataset is viewed as a whole, the model did identify proarrhythmic compounds, however the concentration at which action potential prolongation, triangulation, instability, reverse-use dependence and ectopic beats occurred often varied based on the concentration range selected. Further analysis using extended compound perfusion times demonstrated that variability may be due in part to lack of adequate equilibration of compound with the cardiac tissue., Discussion: We report that the model correctly identified proarrhythmic agents in a qualitative manner, but that study design impacts the proarrhythmic concentration derived from the model.

Plasticity studies suggest that behavioral relevance can change the cortical processing of trained or conditioned sensory stimuli. However, whether this occurs in the context of natural communication, where stimulus significance is acquired through social interaction, has not been well investigated, perhaps because neural responses to species-specific vocalizations can be difficult to interpret within a systematic framework. The ultrasonic communication system between isolated mouse pups and adult females that either do or do not recognize the calls' significance provides an opportunity to explore this issue. We applied an information-based analysis to multi- and single unit data collected from anesthetized mothers and pup-naïve females to quantify how the communicative significance of pup calls affects their encoding in the auditory cortex. The timing and magnitude of information that cortical responses convey (at a 2-ms resolution) for pup call detection and discrimination was significantly improved in mothers compared to naïve females, most likely because of changes in call frequency encoding. This was not the case for a non-natural sound ensemble outside the mouse vocalization repertoire. The results demonstrate that a sensory cortical change in the timing code for communication sounds is correlated with the vocalizations' behavioral relevance, potentially enhancing functional processing by improving its signal to noise ratio.

The effect of subphase pH (5.5 and 10.5) on the structure of behenic-acid monolayers was investigated during Mg(2+) adsorption by means of Grazing Incidence X-ray Diffraction (GIXD) and Brewster Angle Microscopy (BAM). The final phase corresponding to an ion superlattice commensurate to the behenic-acid cell is pH-independent. In contrast, the sequence of phases evidenced from the initial L(2)-phase to this final state presents at pH 10.5 an additional stage associated to a film condensation toward the L' (2)-phase. The structures of the intermediate states preceding the superstructure nucleation are slightly different, both with a short-range fatty-acid order. Finally, a laser light effect that could result from visible light absorption by the inorganic complexes is evidenced in the final state as well as in the intermediate phases.

There is a growing interest in the use of mice as a model system for species-specific communication. In particular, ultrasonic calls emitted by mouse pups communicate distress, and elicit a search and retrieval response from mothers. Behaviorally, mothers prefer and recognize these calls in two-alternative choice tests, in contrast to pup-naïve females that do not have experience with pups. Here, we explored whether one particular acoustic feature that defines these calls-- the repetition rate of calls within a bout-- is represented differently in the auditory cortex of these two animal groups. Multiunit recordings in anesthetized CBA/CaJ mice revealed that: (i) neural entrainment to repeated stimuli extended up to the natural pup call repetition rate (5 Hz) in mothers; but (ii) neurons in naïve females followed repeated stimuli well only at slower repetition rates; and (iii) entrained responses to repeated pup calls were less sensitive to natural pup call variability in mothers than in pup-naïve females. In the broader context, our data suggest that auditory cortical responses to communication sounds are plastic, and that communicative significance is correlated with an improved cortical representation.

Neuroscientists are increasingly embracing mice as a means to address central nervous system questions at a molecular level. Examples abound from sensory systems like olfaction and vision. The use of mice to study central auditory processing, however, has remained relatively limited. In this commentary, I draw on some of the successes from other fields to highlight directions in which mouse models may contribute valuable and otherwise unattainable insights into the neural circuitry and plasticity within central auditory stations. Efforts towards this are beginning and would benefit from increased collaboration to generate useful transgenic mouse models for such studies.

Objective: To investigate the effects of power frequency magnetic field on the Ca2+ transport dynamics of isolated sarcoplasmic reticulum vesicles., Methods: The assays of Ca2+ uptake time course and the Ca2+-ATPase activity of sarcoplasmic reticulum vesicles were investigated by using dynamic mode of spectrometry with a Ca2+ dye; Ca2+ release channel activation was examined by 3H-ryanodine binding and Ca2+ release assays; membrane fluidity of sarcoplasmic reticulum vesicles was examined by fluorescence polarization, without or with exposure to the vesicles at a 0.4 mT, 50 Hz sinusoidal magnetic field., Results: 0.4 mT, 50 Hz sinusoidal magnetic field exposure caused about a 16% decline of the initial Ca2+ uptake rate from a (29.18 +/- 3.90) pmol.mg(-1).s(-1) to a (24.60 +/- 3.81) pmol.mg(-1).s(-1) and a 26% decline of the Ca2+-ATPase activity from (0.93 +/- 0.05) micromol.mg(-1).min(-1) to (0.69 +/- 0.07) micromol.mg(-1).min(-1) of sarcoplasmic reticulum vesicles, whereas caused a 15% increase of the initial Ca2+ release rate from (4.83 +/- 0.82) pmol.mg(-1).s(-1) to (5.65 +/- 0.43) pmol.mg(-1).s(-1) and a 5% increase in 3H-ryanodine binding to the receptor from (1.10 +/- 0.12) pmol/mg to (1.16 +/- 0.13) pmol/mg, respectively., Conclusion: The decline of Ca2+-ATPase activity and the increase of Ca2+ release channel activity should result in a down-regulation of Ca2+ dynamic uptake and an up-regulation of Ca2+ release induced by exposing the sarcoplasmic reticulum to a 0.4 mT, 50 Hz power frequency magnetic field.

Background and Aims: The significance of normal alanine aminotransferase (ALT) levels in patients with HIV/hepatitis C virus (HCV) coinfection is not well understood., Methods: We performed a cross-sectional retrospective analysis on consecutive HIV/HCV-coinfected patients (n = 89) who underwent a liver biopsy during a 2-year period. Similar data were also collected on HCV-monoinfected patients (n = 117)., Results: Mean ALT levels and the percentage of patients with normal ALT (< or =40 U/L) levels were similar in HIV/HCV-coinfected (mean +/- SD, 81.7 +/- 56.1 U/L; 21%) and HCV-monoinfected patients (97.3 +/- 100.7 U/L; 18%; P = 0.19 and 0.54, respectively). Coinfected patients, however, had significantly advanced necroinflammation (P= 0.001) and fibrosis (P = 0.02) compared with monoinfected patients. The percentage of patients with advanced necroinflammation (grades 3 or 4) was lower in HCV-monoinfected patients with normal ALT levels compared with those with elevated ALT (5% vs 20%, respectively). In contrast, the percentage of coinfected patients with advanced necroinflammation was similar whether the patient had normal or elevated ALT levels (32% vs 37%, respectively)., Conclusions: In coinfected patients, normal ALT levels are not an indicator of mild necroinflammation and may not portend a more benign disease course.

Little is known about the neural bases of the reduced auditory and cortical processing speeds that have been recorded in language-impaired, autistic, schizophrenic, and other disabled human populations. Although there is strong evidence for genetic contributions to etiologies, epigenetic factors such as perinatal anoxia (PA) have been argued to be contributors, or causal, in a significant proportion of cases. In this article, we explored the consequences of PA on this elementary aspect of auditory behavior and on auditory system function in rats that were briefly perinatally anoxic. PA rats had increased acoustic thresholds and reduced processing efficiencies recorded in an auditory behavioral task. These rats had modestly increased interpeak intervals in their auditory brainstem responses, and substantially longer latencies in poststimulus time histogram responses recorded in the primary auditory cortex. The latter were associated with degraded primary auditory cortex receptive fields and a disrupted tonotopy. These processing deficits are consistent with the parallel behavioral and physiological deficits recorded in children and adults with a history of language-learning impairment and autism.

Background: Minimal acute pre-operative weight loss significantly reduces liver size and intra-abdominal adipose tissue. We hypothesize that these changes will reduce intra-operative complications and reduce the difficulty of laparoscopic Roux-en-Y gastric bypass (LRYGBP)., Methods: This is a retrospective chart review of consecutive patients who had undergone isolated LRYGBP between July 2003 and March 2005. All patients participated in our institution's medically supervised Weight Management Program before surgery., Results: 48 patients (Weight Loss Group) had an average percent loss of excess weight (%EWL) of 4.6; whereas 47 patients (No Weight Loss Group) gained an average of 4.8% of excess weight over an average period of 2.4 and 3 months (P=0.09), respectively. There were no differences between the two groups in age, gender, ASA class, co-morbidities, or BMI at operation. The Weight Loss Group had less intra-operative blood loss (102 vs 72 ml, P=.03). The surgeon was also less likely to report an enlarged liver in the Weight Loss Group (P=.02). Finally, the operation was less likely to deviate from the standard LRYGBP when patients lost weight (P=.02). No differences were seen in operative time, length of hospital stay, wound infections, or major complications., Conclusion: Acute preoperative weight loss is associated with less intra-operative blood loss and reduces the need for intraoperative deviation from the standard LRYGBP. A larger series with a greater reduction in excess weight is necessary to determine the maximal benefits of acute preoperative weight loss.

Previous reports have suggested that the imbalance of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) activity may contribute to prosthetic loosening. However, the mechanisms controlling these enzymes in the periprosthetic environment is unknown. We examined the effect of Co2+ and Cr3+ ions on the expression of genes encoding MMP-1, one of the principal proteinases capable of degrading native fibrillar collagens in the extracellular matrix (ECM), its inhibitor TIMP-1, and TNF-alpha, a cytokine that plays a central role in the induction of implant osteolysis. Human U937 macrophages were incubated in suspension or on phosphorylcholine (PC)-polymer coated surfaces for 24h with Co2+ and Cr3+ ions. The level of mRNAs was determined by reverse transcription-polymerase chain reaction (RT-PCR). Results show that both Co2+ and Cr3+ ions induce the expression of MMP-1, TIMP-1, and TNF-alpha mRNA in a dose-dependent manner in cell suspensions. Tyrosine kinase inhibitors have different effects on these stimulatory effects. Indeed, genistein has only partial inhibitory effect on MMP-1 and TIMP-1, with even less effect on TNF-alpha expression. In contrast, herbimycin A completely blocks MMP-1 and TNF-alpha while partially inhibiting TIMP-1. However, Co2+ and Cr3+ ions had no effect on the expression of MMP-1 and TIMP-1 in macrophages cultured on the PC-polymer, suggesting that the attachment of U937 macrophages to the PC-polymer surfaces may modify their gene expression. In fact, MMP-1 and TIMP-1 seems to be constitutively up-regulated in this condition. However, the effect of Co2+ and Cr3+ ions on macrophages cultured on PC-polymer coated surfaces is similar to what was observed in suspension. Together, these findings indicate that activation of MMP-1, TIMP-1, and TNF-alpha by Co2+ and Cr3+ ions is regulated by tyrosine kinases.

Background: In patients with sporadic primary hyperparathyroidism, preoperative localization studies may discover a solitary mediastinal parathyroid adenoma. In this circumstance a 1-gland mediastinal exploration, either cervical or thoracoscopic, may be curative., Methods: In an 18-month period, 5 of 120 consecutive patients underwent an initial 1-gland mediastinal exploration for a solitary mediastinal parathyroid adenoma and 2 patients had a 1-gland mediastinal exploration for persistent hyperparathyroidism. Clinical presentation, imaging studies, surgical techniques, and outcomes were reviewed., Results: Sestamibi scans showed a mediastinal parathyroid adenoma in all 7 patients. Computed tomography provided anatomic localization of middle mediastinal parathyroid adenomas. A cervical approach was used in 4 patients who had a superior mediastinal parathyroid adenoma. Thoracoscopic excision was performed in 3 patients with a middle mediastinal parathyroid adenoma. No complications occurred. Calcium and parathyroid hormone levels normalized in all patients., Conclusions: Sporadic primary hyperparathyroidism caused by a solitary mediastinal parathyroid adenoma can be treated successfully with 1-gland mediastinal exploration either by a cervical or a thoracoscopic approach as indicated by localization imaging.

Background: Computed tomography (CT) is insensitive to small metastatic deposits in patients with pancreatic cancer. This study aimed to evaluate additional staging information obtained by laparoscopy in the subset of patients with locally extending pancreatic cancer but no evidence of distant disease using computed tomography., Methods: Between April 2000 and February 2004, 74 patients with locally unresectable pancreatic cancer and no evidence of metastasis detected by high-quality pancreas protocol computed tomography underwent outpatient staging laparoscopy and peritoneal lavage cytology., Results: Occult tumor was found during staging laparoscopy in 25 of the 74 patients (34%). The results were positive for peritoneal lavage cytology in 27% (20/74), for liver lesions in 16% (12/74), and for peritoneal implants in 7% (5/74) of the patients. Body and tail tumors were twice as likely as pancreatic head tumors to have unsuspected metastasis (53% vs 28%)., Conclusions: Even the best computed tomography scan is not adequate for accurate staging of locally extended pancreatic cancer because occult distant disease will be found in half of the patients with left-sided disease and one-fourth of those with right-sided pancreatic cancer.

Purpose: Although conventional sonography has been used widely in evaluation of the abdominal and cervical esophagus, its use in the thoracic esophagus is seldom mentioned. The aim of this study was to assess whether conventional sonography could demonstrate the thoracic esophagus and to determine this structure's normal sonographic appearance and measurements., Methods: Transthoracic sonography was performed in 253 healthy volunteers ranging in age from 12 to 72 years (mean, 41 +/- 15 years). The subjects were examined while supine with their hands raised over their heads; the transducer was placed along the left side of the sternum sequentially from the first to the fifth intercostal spaces. The ultrasound beam was directed to the thoracic aorta using the heart as an acoustic window. The detectable length of the thoracic esophagus was measured in the longitudinal scan from the upper most part visualized to the point at which it penetrated the diaphragm. The esophageal thickness was measured on the anterior wall at the level of the left atrium., Results: In 188 (74%) of the 253 subjects, the thoracic esophagus could be demonstrated by sonography, except for the portion under the first and second intercostal spaces. In 3 of these 188 subjects, the esophagus also was not visualized at the third intercostal space. In these 188 subjects, the esophageal wall was shown as 3 layers. The esophageal lumen appeared as 1 or 2 hyperechoic bands in longitudinal sonograms. In 163 subjects, gas artifact and the comet-tail sign, with downward movement, were seen in the esophageal lumen after swallowing. The mean demonstrable length of the thoracic esophagus was 10.2 +/- 1.9 cm and the mean thickness 3.2 +/- 0.3 mm., Conclusions: Most of the thoracic esophagus can be visualized by sonography, except for a short portion at the back of the left main bronchus. The heart and the thoracic aorta are 2 important landmarks in scanning., (2004 Wiley Periodicals, Inc.)

Objective: To evaluate the perioperative risk factors of the cleft palate repair in Pierre Robin sequence patients at early age and to investigate how to control the risk factors., Methods: Six consecutive patients with Pierre Robin sequence underwent primary repair of cleft palate in Department of Oral Maxillofacial Surgery, Peking University School of Stomatology from June 2001 to February 2004. The patients underwent von Longenbeck operation by the same perioperative observation of serum oxygen saturation were obtained for these patients. patients included 4 males and 2 females with age of 9 months to 5 surgeon. Pre- and post-operative polysomnographic studies and years., Results: All the patients suffered various degree of hypoxaemia during the period of intubation. There was only one patient who had hypoxaemia within the first 2 hours during postanaesthetic recovery period. No obvious difference was found in apnea and hypopnea index (AHI) among the patients before and after operation., Conclusions: Severe hypoxaemia may happen in perioperative period when the patients with PRS underwent cleft palate repair. Most patients with PRS could undergo cleft palate repair safely performed by experienced surgeon at early age under comprehensive consideration and careful control of the risk factors.

Coinfection with HIV and hepatitis C virus (HCV)-specific immune responses, increases hepatic inflammation, accelerates hepatic fibrosis, and is associated with deceased treatment responses. We quantified intrahepatic lymphocyte and hepatocyte phenotypes in HCV-infected patients with (n = 38) and without (n = 41) HIV infection. A single pathologist counted positive cells in 5 portal and 5 lobular areas. Coinfected patients had 6.81 +/- 1.9 fewer CD4 cells per portal field (10.58 +/- 1.12 vs. 4.97 +/- 1.09 cells/high-power field [HPF]; P < 0.001) and 0.48 +/- 0.15 more apoptotic lymphocytes per lobular field (0.16 +/- 0.06 vs. 0.64 +/- 0.15 cell/HPF; P = 0.002) than monoinfected patients. The number of portal CD4 cells was not associated with the peripheral CD4 cell number. Portal and lobular CD8 cells did not differ between the 2 groups. Portal proliferative hepatocytes were increased in coinfected patients with HIV RNA levels of >400 copies/mL (1.13 +/- 0.32 cells/HPF; P = 0.01) compared with those with undetectable HIV RNA (0.46 +/- 0.09 cell/HPF) and monoinfected patients (0.45 +/- 0.08 cell/HPF). In conclusion, HIV coinfection is associated with fewer portal CD4 cells and increased lobular lymphocyte apoptosis that may impact on the natural history of HCV infection.

Purpose: Although conventional sonography is used widely for evaluation of the gastroesophageal junction, its use in the cervical esophagus is still limited. The aim of this study was to assess the use of sonography to demonstrate this portion of the esophagus., Methods: The cervical esophagi in 60 cadavers and 435 healthy volunteers were examined sonographically. Among the healthy subjects 182 were scanned with a transducer operating at 7.5 MHz, 183 with a 10.0-MHz transducer, and 70 with a 12.0-MHz transducer. Sonographic layer patterns were compared among the groups. Sonographic and histologic analyses were also performed on 3 cadaveric esophageal specimens to correlate the sonographic appearances with the anatomical findings., Results: Scans of the cadavers showed that the cervical esophagus lay between the trachea and vertebrae, with its origin at the midline; it gradually moved to the left as it descended toward the trunk. It moved to the right when the cadaver's head was turned to the left and the trachea was pushed gently to the left. Based on these anatomical characteristics, visualization of the cervical esophagus was optimized by scanning from both the left and the right lateral approaches, with manipulation of the trachea as needed. In scans of the 435 healthy subjects, the esophageal wall was shown as 5 layers in 423 (97.2%) and as 7 layers in the remaining 12 (2.8%). The demonstration rate of the 7-layer pattern was significantly higher for subjects scanned at 12.0 MHz than for those scanned at 10.0 and 7.5 MHz (p < 0.01). The layers demonstrated sonographically corresponded to histological structures evident on microscopy., Conclusions: The left lateral approach is essential to sonography of the cervical esophagus. However, the right wall of the esophagus is best seen from the right. In transverse scans, the cervical esophagus wall usually appears to be composed of 5 layers, although 7 layers can also appear, especially as the transducer frequency is increased., (Copyright 2004 Wiley Periodicals, Inc.)

Objective: To search the marker proteins of Guillain-Barré syndrome (GBS)-associated Campylobacter jejuni (C. jejuni) by comparing the protein maps of GBS-associated C. jejuni strains with that of non-GBS-associated C. jejuni strains., Methods: The whole-cell proteins of eight GBS-associated and eight non-GBS-associated C. jejuni strains were separated using the two-dimensional gel electrophoresis respectively. The differentially expressed proteins between the two sets of strains were identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) after in-gel tryptic digestion., Results: Twenty differentially expressed spots were found with seventeen identified ones using MSCOT database. These proteins were identified as wlaX protein and some other proteins involving in energy metabolism (malate dehydrogenase, triosephosphate isomerase, Ni/Fe-hydrogenase small chain, cysteine synthase, branched-chain amino acid aminotransferase), cell process (heat shock protein, iron-uptake ABC transport system periplasmic iron-binding protein, alkyl hydroperoxide reductase), cell envelope (flagellin, UDP-N-acetylenolpyruvoylglucosamine reductase) etc., Conclusion: WlaX proteins were probably associated with LPS biosynthesis or virulence of C. jejuni. WlaX protein and flagellin protein were the possible marker-proteins of GBS-associated C. jejuni strains.