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Osteosarcoma (OSA) is the most common type of cancer that originates in the bone and usually occurs in young children. OSA patients were treated with neoadjuvant chemotherapy and surgery, and the results were disappointing. Marine antimicrobial peptides (AMPs) have been the focus of antibiotic research because they are resistant to pathogen infection. Piscidin-1 is an AMP from the hybrid striped bass (Morone saxatilis × M. chrysops) and has approximately 22 amino acids. Research has shown that piscidin-1 can inhibit bacterial infections and has antinociception and anti-cancer properties; however, the regulatory effects of piscidin-1 on mitochondrial dysfunction in cancer cells are still unknown. We aimed to identify the effects of piscidin-1 on mitochondrial reactive oxygen species (mtROS) and apoptosis in OSA cells. Our analyses indicated that piscidin-1 has more cytotoxic effects against OSA cells than against lung and ovarian cancer cells; however, it has no effect on non-cancer cells. Piscidin-1 induces apoptosis in OSA cells, regulates mtROS, reduces mitochondrial antioxidant manganese superoxide dismutase and mitochondrial transmembrane potential, and decreases adenosine 5′-triphosphate production, thus leading to mitochondrial dysfunction and apoptosis. The mitochondrial antioxidant, mitoTempo, reduces the apoptosis induced by piscidin-1. Results suggest that piscidin-1 has potential for use in OSA treatment.

To smoothly drive an electron microscope sampling container, we designed a novel stage that includes a piezoelectric actuator to achieve an automatic feeding system for microfluidic sampling processes, utilizing capillary action. The capacitive sensor measures the capacitance value that is used to identify the distance between the sample container and microfluidic samples; according to this value, the microcontroller adjusts the velocity of the piezoelectric actuator through pulse-width modulation and the microstepping motion is realized. We developed the automatic feeding system from this concept by using a linear piezoelectric actuator, a driving circuit, and a position-sensing integrated circuit. When the driving signal was at 100% duty ratio, the velocity of the sampling container achieved to 72 mm/s. To slowly approach liquid sample, driving the actuator at 5% duty cycle, the microstepping resolution was 1 µm. Moreover, a driving circuit for the piezoelectric actuator involving a phase-locked loop was developed to automatically track the resonance frequency of the piezoelectric actuator.

Studies are extremely limited for the investigation of the clinical outcome of da Vinci robot-assisted bilateral internal mammary artery (BIMA) grafting in coronary artery bypass grafting (CABG) surgery. This study aimed to explore the short-term outcome of da Vinci robot-assisted BIMA grafting through the left pleural space. Relevant data were collected from patients with multi-vessel coronary artery disease receiving two kinds of CABG: a group of patients receiving da Vinci robot-assisted CABG with BIMA grafting, and another group of patients receiving sternotomy CABG with BIMA grafting. Primary endpoints, which included cardiovascular and renal endpoints, were analyzed between the groups using the chi-square test, analysis of variance test, and Kaplan&ndash, Meier analysis. Compared with the conventional group (n = 22), the robotic group (n = 22) had a significantly longer operation time (12.7 &plusmn, 1.7 vs. 8.5 &plusmn, 1.5 hours, p &lt, 0.01) and a marginally lower mean of serum creatinine at baseline (1.2 &plusmn, 0.3 vs. 2.0 &plusmn, 1.7 mg/dL, p = 0.04). Primary endpoints (5, 22.7% vs. 12, 54.5%, p = 0.03) and renal endpoints (1, 4.5% vs. 7, 31.8%, p = 0.02) at six months were significantly reduced in the robotic group compared with the conventional group. There were no differences in cardiovascular endpoints at six months between the groups (1, 4.5% vs. 0, p = 1.00). The data showed that da Vinci robot-assisted BIMA grafting was safe, with equal cardiovascular events and lowered renal events at six months, as compared to conventional sternotomy BIMA grafting, despite the longer procedure time. The short-term study suggests that da Vinci robot-assisted BIMA grafting may be considered a favorable surgical option for patients with severe coronary artery disease.

Acute cardiomyopathy is a health problem worldwide. Few studies have shown an association between acute cardiomyopathy and low vitamin D status. Paricalcitol, a vitamin D receptor activator, clinically benefits patients with advanced kidney disease. The effect of paricalcitol supplement on cardiac remodeling in cardiomyopathic rats is unknown. This experimental study investigated the effect of paricalcitol in rats with cardiomyopathy induced by isoproterenol.Prospective, randomized, controlled experimental study.Hospital-affiliated animal research institution.Eight-week-old male Wistar-Kyoto rats.Male Wistar-Kyoto rats were first injected intraperitoneally with isoproterenol to create a rat model of acute cardiomyopathy. Then paricalcitol was administered intraperitoneally to isoproterenol-injected rats at a dosage of 200 ng three times a week for 3 weeks. Relevant cardiomyopathy-related variables were measured regularly in three groups of rats, controls, isoproterenol, and isoproterenol plus paricalcitol. Rat hearts were obtained for evaluation of cardiac fibrosis using Masson trichrome staining and commercially available software, and evaluation of cell transition using immunofluorescence staining analysis.Isoproterenol infusions generated significant cardiac fibrosis (p0.001). Subsequent paricalcitol treatment attenuated the isoproterenol-induced cardiac fibrosis (p = 0.006). Fluorescence showed colocalization of endothelial and fibroblast cell markers (cluster differentiation 31 and α-smooth muscle actin, respectively) in the isoproterenol-treated hearts. Paricalcitol injections attenuated the isoproterenol-induced fluorescence intensity of two cell markers (p0.01).Paricalcitol injections may ameliorate isoproterenol-induced cardiac fibrosis possibly through regulating cell transition.

Kawasaki disease is the most common cause of pediatric acquired heart disease. The role of platelet endothelial cell adhesion molecule-1 in the inflammatory process has been documented. To date, no report has investigated the relationship between coronary artery lesions of Kawasaki disease and platelet endothelial cell adhesion molecule-1 polymorphisms.A total of 114 Kawasaki disease children with coronary artery lesions and 185 Kawasaki disease children without coronary artery lesions were recruited in this study. The TaqMan assay was conducted to identify the genotype in this case-control study.In three single nucleotide polymorphisms (Leu125Val, Ser563Asn, and Arg670Gly) of platelet endothelial cell adhesion molecule-1, we found that the Leu-Ser-Arg haplotype was associated with a significantly increased risk for coronary artery lesions in the chronic stage (odds ratio 3.05, 95% confidence interval 1.06-8.80, p = 0.039), but not for coronary artery lesions in the acute stage. Analysis based on the diplotypes of platelet endothelial cell adhesion molecule-1 also showed that Kawasaki disease with one or two alleles of Leu-Ser-Arg had a significantly increased risk of chronic coronary artery lesions (odds ratio 3.38, 95% confidence interval 1.11-10.28, p = 0.032) and had increased platelet counts after Kawasaki disease was diagnosed, as compared to those with other diplotypes.The haplotype of platelet endothelial cell adhesion molecule-1 Leu-Ser-Arg might be associated with the increased platelet counts and the following risk of chronic coronary artery lesions in a dominant manner in Kawasaki disease.

Objective Fabry disease, a rare X-linked disorder, can lead to exercise intolerance. In Taiwan, the cardiac variant of Fabry disease has a significantly higher prevalence than the classic variant. The cardiac variant of Fabry disease primarily involves the heart. Enzyme replacement therapy has been used to treat both variants. We aimed to study the impact of enzyme replacement therapy on exercise and cardiac structures between the classic (CL-FD) and cardiac variant (CV-FD) Fabry disease. Design and methods Retrospective analysis of 2 groups of patients with Fabry disease (5 patients with the classic variant and 5 with the cardiac variant), who were undergoing enzyme replacement therapy. Patients were assessed annually for 3 years using symptom-limited cycle ergometry and echocardiography. Results Subjects were 5 women, mean age 53 (standard deviation (SD) 14.05) years with CL-FD Fabry disease, and 5 men, mean age 65 (SD 2.35) years with CV-FD. The percentage of peak oxygen consumption to predicted value for all included patients was significantly lower (78.78% (SD 12.72)) than 100%. Annual serial measurement showed that peak metabolic equivalent and percentage of peak oxygen consumptiondecreased significantly over a period of 3 years in patients with CV-FD (p = 0.002, and p =0.004, respectively), but not in those with CL-FD. There were no significant changes in annual serial measurements of left ventricular mass or interventricular septal thickness in patients with either variant of Fabry disease over a period of 3 years. Conclusion Peak exercise capacity of the patients with Fabry disease was lower than that of normal peers. Peak exercise capacity decreased over time LAY ABSTRACT Patients with classic or cardiac variants of Fabry disease have lower exercise capacity than their healthy peers. It is recommended that patients commence enzyme replacement therapy at an early stage in order to improve clinical outcomes. This study examined the effects of enzyme replacement therapy on exercise capacity and the structure of the heart in 10 patients with Fabry disease who were undergoing enzyme replacement therapy. Measurements were taken each year for 3 consecutive years. No significant differences were found in the structure of the heart (left ventricular mass or interventricular septal thickness) between patients with these 2 types of Fabry disease. Peak exercise capacity decreased over time in patients with cardiac variant Fabry disease, but remained the same in patients with classic variant Fabry disease in patients withCV-FD, but remained the same in patients with CL-FD.

Background and Purpose Oxidative stress is an important pathogenic factor in the development of hypertension. Resveratrol, the main antioxidant in red wine, improves NO bioavailability and prevents cardiovascular disease. The aim of this study was to examine whether resveratrol decreases the generation of reactive oxygen species (ROS), thereby reducing BP in rats with fructose-induced hypertension. Experimental Approach Rats were fed 10% fructose with or without resveratrol (10 mg·kg−1·day−1) for 1 week or for 4 weeks with resveratrol treatment beginning at week 2; systolic BP (SBP) was measured by tail-cuff method. Endogenous in vivo O2− production in the nucleus tractus solitarii (NTS) was determined with dihydroethidium. Real-time PCR and immunoblotting analyses were used to quantify RNA and protein expression levels. Key Results In fructose-fed rats, ROS levels in the NTS were higher, whereas the NO level was significantly decreased. Also, RNA and protein levels of NADPH oxidase subunits (p67, p22-phox) were elevated, superoxide dismutase 2 (SOD2) reduced and AMP-activated PK (AMPK) T172 phosphorylation levels in the NTS were lower in fructose-fed rats. Treatment with the AMPK activator resveratrol decreased levels of NADPH oxidase subunits and ROS, and increased NO and SOD2 levels in the NTS of fructose-fed rats. Administration of resveratrol, in combination with fructose at week 0 and later at week 2, significantly reduced the SBP of fructose-fed rats. Conclusions and Implications Collectively, resveratrol decreased BP through the phosphorylation of AMPK, Akt and neuronal NOS in fructose-fed rats. These novel findings suggest that resveratrol may be a potential pharmacological candidate for the treatment of hypertension.

Background: Bilateral lesions of nucleus tractus solitarii in rat result in acute hypertension, pulmonary edema, and death within hours. The hypertension results from excessive catecholamine release. Catecholamine can activate connexin43 to regulate cell death. There is no study investigating the cardiopulmonary impacts of different adrenergic blockers and apoptosis mechanism in rat model. Methods: The authors microinjected 6-hydroxydopamine into nucleus tractus solitarii of the rat (n = 8 per group) and evaluated the cardiopulmonary changes after treatment with different concentrations of α1-blockers, α2-blockers, β-blockers, and α-agonists. Results: In the rat model, the authors found that prazosin (0.15 mg/kg) treatment could preserve cardiac output and reverse neutrophil infiltrations in lungs and lead to prevent pulmonary hemorrhagic edema. The time-dependent increases in connexin43 and terminal deoxynucleotidyl transferase dUTP nick end labeling–positive cells induced by 6-hydroxydopamine lesions were decreased after prazosin treatment (terminal deoxynucleotidyl transferase dUTP nick end labeling–positive cells at 6 h: 64.01 ± 2.41% vs. 24.47 ± 3.10%; mean ± SD, P < 0.001, in heart, and 80.83 ± 2.52% vs. 2.60 ± 1.03%, P < 0.001, in lung). However, propranolol caused further compromise of the already impaired cardiac output with consequence of rapid death. Phenylephrine enhanced the phenotype in the link between connexin43 expressions and terminal deoxynucleotidyl transferase dUTP nick end labeling–positive cells but not yohimbine. Connexin43 expressions and terminal deoxynucleotidyl transferase dUTP nick end labeling–positive cells were more decreased with prazosin (0.15 and 0.3 mg/kg) than that with prazosin (0.05 mg/kg) treatment. Conclusions: α1-Receptors are the keystones of the phenotype. In some brainstem encephalitis and brain injury with nucleus tractus solitarii involvement, early α1-receptor blockade treatment may prevent acute death from tissue apoptosis. α-Blockers can also decrease cerebral perfusion pressure, and further studies are needed in translation to brain injury with increased intracranial pressure.

Transcutaneous bilirubinometers are widely used to screen neonatal jaundice. However, it was reported that their accuracy is compromised at low and high bilirubin levels. We used a photon diffusion theory-based method valid in the 450–600 nm wavelength region to overcome this obstacle. Our clinical study results showed that our system could properly determine the transcutaneous bilirubin concentrations at total serum bilirubin levels higher than 14 mg/dL, where a commercial bilirubinometer failed to provide proper results in several cases. These findings suggested that photon diffusion theory could be employed to improve the core algorithm of modern bilirubinometers and enhance their applicability.

Among enterovirus 71 infections, brainstem encephalitis progressing abruptly to cardiac dysfunction and pulmonary edema causes rapid death within several hours. However, no currently known early indicators and treatments can monitor or prevent the unexpectedly fulminant course. We investigate the possible mechanisms and treatment of fatal enterovirus 71 infections to prevent the abrupt progression to cardiac dysfunction and pulmonary edema by using an animal model.Treatment study.Research laboratory.Sprague-Dawley rats.We microinjected 6-hydroxydopamine or vitamin C into nucleus tractus solitarii of the rat and evaluated the cardiopulmonary changes after treatment with ganglionic blocker.The time course of changes in the heart and lungs of rats with brainstem lesions were investigated. Rats were administered 6-hydroxydopamine to induce brainstem lesions, causing acute hypertension in 10 minutes and acute elevations of catecholamines accompanied by acute cardiac dysfunction and increased strong expressions of connexin 43 gap junction protein in heart and lung specimens by immunohistochemical staining within 3 hours. Severe pulmonary hemorrhagic edema was produced within 6 hours, and the rats expired rapidly within 7 hours. After hexamethonium treatment, it was found that the acute hypertension induced by 6-hydroxydopamine lesions was immediately reversed and the acute high rise of catecholamine serum level was significantly attenuated within 3 hours, accompanied by preserved cardiac output and decreased expressions of connexin 43 in the heart and lungs. No pulmonary edema occurred and the rats survived for more than 14 hours.Early hexamethonium treatment attenuates acute excessive release of catecholamines to prevent cardiac dysfunction and pulmonary edema for increasing survival rate.

Idiopathic or congenital coronary artery ectasia (CAE) is an uncommon form of coronary artery disease. In adults, coronary artery ectasia is usually associated with atherosclerotic change and is well recognized clinical entity encountered during cardiac catheterization. Coronary artery dilatation in pediatric is usually associated with the sequelae of Kawasaki disease. Congenital coronary artery ectasia is uncommon and rarely reported in children. We present a case of an infant who have dilated coronary artery, she also had ventricular septal defect (VSD) and heart failure who had received VSD repair at infancy. There was no obstructive coronary artery disease, and no cause for the lesions could be identified. The prognosis and optimal management of such patients remains unknown. Antiplatelet therapy might be necessary for the patient to remain free of myocardiac ischemia.

A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles. This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations. This study investigated the biomechanics of the acromion, clavicle, hook plate, and screws. A smaller hook angle increases the stress on the middle third of the clavicle. A larger hook angle increases the force exerted by the clavicle hook plate on the acromion. The screw at the most medial position on the plate generated the highest stress. The highest stress on the implanted clavicle hook plate was on the turning corner of the hook. A clavicle hook plate with different hook angles may induce different biomechanical behaviors in the clavicle and acromion. Orthopedic surgeons must select a suitable clavicle hook plate based on the anatomical structure of each patient.

It is controversial to observe or close symptomatic congenital coronary artery fistula in infants. We herein describe a medium-sized symptomatic congenital coronary artery fistula that underwent rapid spontaneous closure in an infant aged

Introduction: Acceleration on the +G z axis increases pressure in the cardiac chambers. Our research was designed to study whether: 1) such acceleration would impair cardiac function; and 2) a "preconditioning" exposure to +G z would protect the heart from any such effects. Methods: There were 45 male Sprague-Dawley rats that were randomly divided into 3 groups of 15: 1) control without acceleration (CTRL); 2) exposure to 5 min of + 15 G z (EXP); and 3) pretreatment whereby the 5-min exposure was preceded by two exposures of 30 s at + 15 G z (PRE). Within each group of 15, subsets of 7 animals were used to study: 1) echocardiographic heart function or 2) myocardial injury [lactic dehydrogenase (LDH) and malondialdehyde (MDA)], and 1 animal was used to examine the histology of cardiac tissue. Results: Acceleration (EXP) was found to have a significant effect on cardiac function; specifically the early diastolic myocardial velocity (E m ) and systolic myocardial velocity (S m ) in both ventricles decreased in EXP compared to CTRL, while PRE significantly reduced this effect. The systolic mitral annular velocity in the left ventricular lateral wall was significantly less affected in PRE than in EXP (1.99 ± 0.65 vs. 1.2 ± 0.39 cm ·s -1 , P = 0.017). Enzyme levels showed only minor changes. In histology, no neutrophil infiltration was found in three groups. Conclusions: These results suggest that short bouts of acceleration might offer cardiac protection. Confirmation using larger animal models may allow application of the concept to pilots preparing to undertake sustained high G maneuvers and may explain some aspects of the "G layoff" effect.

Objective: Secondary confirmation of endotracheal (ET) tube position by ultrasound image. Design: Prospective, randomized study. Setting: A medical center-based tertiary pediatric intensive care unit. Patients: A total of 59 patients aged from newborn to 17 yrs old underwent ET tube insertion because of cardiopulmonary arrest or impending respiratory failure. Intervention: Ultrasound imaging was performed immediately before and after the ET tube placement procedure. The most frequently used ultrasonic scanning window was the subxiphoid window at the mid-upper abdominal, just beneath the xiphoid process and the lower margin of liver. The sector angle was set as wide as possible (90 degrees) so that the bilateral diaphragm could be well scanned. Measurements and Main Results: Using the ultrasound imaging method, we successfully identified all of two esophageal intubations and eight incidents of initial ET tube misplacement, which had been positioned down to the right main bronchus. Finally, we successfully identified all 59 of the correct placements of ET tubes in the trachea. Conclusions: Ultrasound imaging of diaphragm motion is a useful, quick, noninvasive, portable, and direct anatomic method for assessment of ET tube position. We think it should be considered the method of choice for the secondary confirmation of the ET tube position.

Oxidative stress is an important pathogenic factor in the development of hypertension. Resveratrol, the main antioxidant in red wine, improves NO bioavailability and prevents cardiovascular disease. The aim of this study was to examine whether resveratrol decreases the generation of reactive oxygen species (ROS), thereby reducing BP in rats with fructose-induced hypertension.Rats were fed 10% fructose with or without resveratrol (10 mg·kg(-1) ·day(-1) ) for 1 week or for 4 weeks with resveratrol treatment beginning at week 2; systolic BP (SBP) was measured by tail-cuff method. Endogenous in vivo O2 (-) production in the nucleus tractus solitarii (NTS) was determined with dihydroethidium. Real-time PCR and immunoblotting analyses were used to quantify RNA and protein expression levels.In fructose-fed rats, ROS levels in the NTS were higher, whereas the NO level was significantly decreased. Also, RNA and protein levels of NADPH oxidase subunits (p67, p22-phox) were elevated, superoxide dismutase 2 (SOD2) reduced and AMP-activated PK (AMPK) T172 phosphorylation levels in the NTS were lower in fructose-fed rats. Treatment with the AMPK activator resveratrol decreased levels of NADPH oxidase subunits and ROS, and increased NO and SOD2 levels in the NTS of fructose-fed rats. Administration of resveratrol, in combination with fructose at week 0 and later at week 2, significantly reduced the SBP of fructose-fed rats.Collectively, resveratrol decreased BP through the phosphorylation of AMPK, Akt and neuronal NOS in fructose-fed rats. These novel findings suggest that resveratrol may be a potential pharmacological candidate for the treatment of hypertension.

Central venous access is an important aspect of medical treatment in intensive care units. We frequently require central venous catheterization (CVC) for total parenteral nutrition (TPN), intravenous antibiotics, multiple transfusions, and chemotherapy. The primary aim of this study is to demonstrate that percutaneous central venous catheterization in patients with body weight (BW) less than 10 kg can be conducted by the subclavian vein rather than the traditional femoral vein. Between January 1998 and December 2003, we performed 70 subclavian vein catheterizations (SVCs) in 46 patients with BW less than 10 kg in the pediatric intensive care unit (PICU) of a tertiary medical center. We divided patients according to their body weight into two groups, BW less than 5 kg and BW between 5 and 10 kg. We found SVC had a high total success rate, 92.9% (65/70), for the whole group. Success rate was 83.3% (15/18) for the BW less than 5 kg group and 96.2% (50/52) for the BW 5-10 kg group. In this study we found percutaneous subclavian venous catheterization in children with BW below 10 kg to be a relatively safe procedure with low risk of complication and no risk of mortality.

Agenesis of corpus callosum (ACC) often accompanies other neural migration disorders and its prognosis must take these disorders and other associated abnormalities into account. Isolated complete ACC, i.e., agenesis of corpus callosum without other central nervous system anomaly, is rare. A total of six patients, aged nine months to 15 years, with isolated complete ACC diagnosed by brain image study in the past eight years of our hospital were evaluated for associated defects and prognosis. Isolated complete ACC without associated congenital heart disease (CHD) was found in four of the six patients (4/6), of whom three had normal development so far. The other two patients (2/6) were found to have associated CHD and both had poor prognosis. This result suggests that checking for any associated CHD may play an important prognostic role for isolated complete ACC patients. Therefore, it is recommendable that prenatal brain MRI and fetal echocardiography should be performed for evaluation and for genetic consultation whenever ACC is suspected.

We report the case of a newborn who suffered right atrial laceration during delivery. To our knowledge, there has been no previous report of blunt injury causing right atrial laceration with hemopericardium complicated by cardiac tamponade in the perinatal period.

Background: Central venous catheterization is an important procedure for infant patients for a number of different purposes, including nutritional support, surgical operation, hemodynamic monitoring, and multiple lines for critical care medications. Subclavian vein catheterization (SVC) is one of the central vein catheterization techniques. SVC can be performed from 4 different locations: right supraclavicular (RSC), left supraclavicular (LSC), right infraclavicular (RIC), and left infraclavicular (LIC). The purpose of this study was to evaluate the relative effectiveness and complication risks of these 4 SVC locations in infants. Methods: In our pediatric intensive care unit, which is part of a tertiary medical center, a well-trained fellow doctor performed the following catheterizations: 21 RSC, 24 LSC, 24 RIC, and 22 LIC, for a total of 91 SVC operations in infants. The patients were placed in the Trendelenburg position. The site of puncture was decided by the operator. Statistical significance was analyzed according to Fisher's exact test and 2-sample t test. Results: The overall success rate was 90.1% (82 out of 91 operations). No statistically significant differences were noted among these 4 groups, either in the success or complication rate. There were 6 cases of arterial puncture (5 supraclavicular and 1 infraclavicular, p = 0.09), 2 cases of pneumothorax (1 RSC and 1 RIC), and 2 cases of malpositioned catheter (1 RSC and 1 RIC). There was no mortality. Conclusion: In our study, we found that there was no statistically significant difference among the 4 SVC locations in effectiveness of operation or in risk of complication. There was a tendency to damage the subclavian arteries through the supraclavicular route. (J Chin Med Assoc 2006;69(4):153-156)