Molecular epidemiologic analysis of group A rotaviruses in adults and children with diarrhea in Wuhan city, China, 2000-2006

To compare epidemiologic features and genetic characteristics of group A rotaviruses causing diarrhea in children and adults, a survey was conducted in Wuhan, China, during the period of Dec. 2000-May 2006. A total of 3839 stool specimens from diarrheal patients from eight hospitals were analyzed. Winter seasonality was observed for rotavirus diarrhea in both adults and children, showing overall rotavirus-positive rates of 9.0 and 23.9%, respectively. Throughout the study period, G3 was the most frequent G serotype in both adults and children (detection rates 86.2 and 87.8%, respectively), and was mostly associated with VP4 genotype P[8], VP 6 genotype II (subgroup II), and NSP4 genotype B. G3 rotaviruses were differentiated into eight electropherotypes, among which seven types were found in specimens from both adults and children. VP7 gene sequences of G3 rotaviruses from adults and children (6 and 4 strains, respectively), detected in different years and different hospitals, showed extremely high sequence identities (99-100%) to each other and to a few G3 rotavirus strains reported in Asia. However, lower sequence identities (82-96%) were observed to most of the human and animal G3 rotaviruses reported so far, including some Chinese strains. These findings indicate that in Wuhan, China, epidemic and genetic features of rotaviruses are similar in adults and children, and it has been suggested that G3 rotaviruses that might have originated from the same rotavirus were circulating among children and adults as prevailing viruses. In this study, two rotavirus strains, G9P[8] strain L169, derived from an adult, and G4P[6] strain R479, derived from a child, were isolated and genetically analyzed. The VP7 gene of L169 belongs to a major lineage of G9 rotaviruses that are globally widespread, but is distinct from G9 rotaviruses reported previously in China. The strain R479 had a VP7 gene which was divergent from most G4 human rotaviruses and showed an unusual dual subgroup specificity, I + II. The R479 VP6 gene does not belong to the main clusters of subgroup I and II rotaviruses phylogenetically, but is related to those of the porcine rotaviruses and some unusual human rotaviruses represented by the RMC321 strain isolated in eastern India.

Gene expression profiling of bovine skeletal muscle in response to and during recovery from chronic and severe undernutrition1

Gene expression profiles of LM from beef cattle that underwent significant postweaning undernutrition were studied using complementary DNA (cDNA) microarrays. After 114 d of undernutrition, the RNA from LM showed 2- to 6-fold less expression of many genes from the classes of muscle structural proteins, muscle metabolic enzymes, and extracellular matrix compared with animals on a rapid growth diet. The expression levels of these genes had mostly returned to pretreatment levels after 84 d of realimentation. The gene expression changes associated with undernutrition and BW loss showed an emphasis on downregulation of gene expression specific to fast-twitch fibers, typical of starving mammals, with a preferential atrophy of glycolytic fast-twitch fibers. We also identified a small group of genes that showed 2- to 5-fold elevated expression in LM after 114 d of undernutrition. Putative roles for these genes in atrophying skeletal muscle are regulation of myogenic differentiation (CSRP3), maintenance of mesenchymal stem cells (CYR61), modulation of membrane function (TM4SF2), prevention of oxidative damage (SESN1), and regulation of muscle protein degradation (SQSTM1). A significant increase in stearoyl-CoA desaturase (SCD) gene expression was observed in atrophying muscle, suggesting either that increased fatty acid synthesis is part of the tissue response to caloric restriction, or that SCD plays another role in energy metabolism in the mixed cellular environment of bovine skeletal muscle.

Electrochemical degradation of 4-chlorophenol at nickel-antimony doped tin oxide electrode

The effectiveness of a novel nickel-antimony doped tin oxide electrode for electrochemical degradation of organic pollutants was investigated using 4-chlorophenol (4-CP) as a model toxic organic. The experimental results demonstrate that the optimal Ni content was at Ni:Sn=1:500 in atomic ratio in the precursor coating solution, whereas the Sb:Sn ratio was set at 8:500. Using the electrode prepared with the optimal Ni doping ratio for 4-CP degradation, the charge-based efficiencies were up to 89 microg C(-1) for 4-CP destruction and 15 microg C(-1) for TOC removal, which were considerably higher than the efficiencies observed for other electrodes. It is suggested that the enhancement of the electrode for electrochemical oxidation of organics could be attributed to the production of hydroxyl radicals in anodic water electrolysis.

Joint analysis of multiple cDNA microarray studies via multivariate mixed models applied to genetic improvement of beef cattle

In functional genomic laboratories, it is common to use the same microarray slide across studies, each investigating a unique biological question, and each analyzed separately due to computational limitations and/or because there is no hybridization of samples from different studies on one slide. However, the question of analyzing data from multiple studies is a major current issue in microarray data analysis because there are gains to be made in the accuracy of estimated effects by exploiting a covariance structure between gene expression data across studies. We propose an approach for combining multiple studies using multivariate mixed models, with the assumption of a nonzero correlation among genes across experiments, while imposing a null residual covariance. We applied this method to jointly analyze three experiments in genetics of cattle with a total of 54 arrays, each with 19,200 spots and 7,638 elements. The resulting seven-variate model contains 752,476 equations and 56 covariances. To identify differentially expressed genes, we applied model-based clustering to a linear combination of the random gene x variety interaction effect. We enhanced the biological interpretation of the results by applying an iterative algorithm to identify the gene ontology classes that significantly changed in each experiment. We found 118 elements with coordinate expression that clustered into distinct biological functions such as adipogenesis and protein turnover. These results contribute to our understanding of the mechanistic processes involved in adipogenesis and nutrient partitioning.

1H-NMR signal assignments and secondary structure analysis of martentoxin

Martentoxin is a peptide of 37 amino acid residues purified from the venom of the Chinese scorpion Buthus martensi Karch, which has been demonstrated to be an inhibitor of voltage-dependent sodium channel and voltage-dependent delayed rectifier potassium channel. To elucidate the molecular mechanism of this interaction, the structure of martentoxin was studied by 2D-NMR. The secondary structure of martentoxin consists of a triple-stranded beta-sheet connected to a alpha-helical structure. This helix encompasses 10 residues from Ser11 to Lys20. The three strands of beta-sheet probably comprise residues Gly2-Asp5, Q27-N30 and Glu33-Cys36, Cys30-Asn33 with a type I'beta turn centered on Asn31-Asn32. The results indicate that martentoxin possesses the conserved beta alpha beta beta structure of all the potassium channel toxins.

Genetic analysis of an ADRV-N-like novel rotavirus strain B219 detected in a sporadic case of adult diarrhea in Bangladesh

An unusual human rotavirus strain B219 was detected in a stool specimen from a 65-year old patient with diarrhea in Bangladesh during April 2002. Cloning and sequence analysis of five genes of the B219 strain indicated that this virus is genetically closely related to the ADRV-N strain, which caused an adult diarrhea outbreak in China, but distinct from groups A, B, and C rotaviruses known to cause diarrheal diseases in humans. Accordingly, rotavirus strains B219 and ADRV-N were considered to belong to a novel group of human rotavirus, and the ADRV-N-like novel human rotaviruses were suggested to be distributed to a geographically wider area.

Genotyping of human cystic echinococcosis in Xinjiang, PR China

The Xinjiang Uygur Autonomous Region, multi-ethnic province in northwestern China, is one of the most important foci of human cystic echinococcosis (CE) in the world. Two Echinococcus granulosus genotypes (G1 and G6) are known to infect the intermediate hosts in this area but, to date, the source of the human infection remains unclear. The current study aimed to genetically analyse 67 hydatid cysts removed from 47 CE patients for which epidemiological, clinical and serological data were also recorded. Mitochondrial cox 1 gene sequencing suggested that the E. granulosus G1 genotype is the major source of infection (45/47 CE patients). Nevertheless, for the first time in China, 2 patients were found with hydatid cysts of the G6 genotype. In addition, 45 E. granulosus gravid tapeworms, isolated from 13 dogs, were genotyped. The majority of adult worms (42/45) exhibited the G1 genotype, whereas 3 adult tapeworms with the G6 genotype were found in one dog, that also harboured E. granulosus tapeworms of the G1 genotype. This sympatric occurrence of G1 and G6 genotypes of E. granulosus, not only in the same area but also in the same definitive host, raises the interesting question of putative genetic recombination between these E. granulosus genotypes.

Voxel-based detection of white matter abnormalities in mild Alzheimer disease

OBJECTIVE

To detect white matter abnormalities in patients with mild Alzheimer disease (AD) by diffusion tensor imaging and to determine their topographic relationship with gray matter atrophy.

METHODS

Thirteen patients with mild AD and 16 normal age-matched volunteers underwent diffusion tensor imaging and three-dimensional spoiled gradient-recalled sequence scanning. Voxel-based morphometry was conducted to detect regions of gray matter atrophy in the AD group relative to the control group. Fractional anisotropy (FA) maps were processed using SPM2 to make voxel-wise comparison of anisotropy in whole brain between the two groups. The relationship between locations of abnormalities in the white and gray matter was examined.

RESULTS

Significant reductions in anisotropy were found in the white matter of both medial temporal lobes, bilateral temporal stems, bilateral superior longitudinal fasciculi, bilateral internal capsules, and cerebral peduncles, as well as the white matter of left middle temporal gyrus and right superior parietal lobule, the body and genu of the corpus callosum, and the right lateral capsule in patients with AD. Although the decrease in FA was consistent with cortical volumetric reduction in both temporal lobes, the widespread involvement of bilateral superior longitudinal fasciculi was dominant in these white matter findings.

CONCLUSIONS

Voxel-wise comparison of whole-brain anisotropy revealed widely distributed disintegration of white matter in mild Alzheimer disease (AD). The white matter shows a different pattern of degeneration from gray matter and may be an independent factor in the progress of AD.

WNK4 kinase regulates surface expression of the human sodium chloride cotransporter in mammalian cells

Pseudohypoaldosteronism type II (PHA II) is caused by mutations of two members of WNK ((with no lysine (k)) kinase family. WNK4 wild type (WT) has been shown to inhibit the activity and surface expression of sodium chloride cotransporter (NCC) when expressed in Xenopus oocytes. Here, we have studied NCC protein processing in mammalian cells in the presence or absence of WNK4 WT and its mutants, E562K and R1185C, by surface biotinylation, Western blot, co-immunoprecipitation (Co-IP) and immunostaining. WNK4 WT significantly reduced NCC surface expression in Cos-7 cells (58.9+/-6.8% vs 100% in control, P<0.001, n=6), whereas its mutant E562K has no significant effect on NCC surface expression (92.9+/-5.3% vs 100%, P=NS, n=6). Another mutant R1185C still partially reduces surface expression of NCC (76.2+/-11.8% vs 100%, P<0.05, n=6). The reduction of NCC surface expression by WNK4 WT (62.9+/-3.3% of control group) is not altered by WT dynamin ((61.8+/-3.7% (P=NS)) or its mutant K44A ((65.4+/-14.1% (P=NS)). A Co-IP study showed that both WNK4 WT and WNK4 E562K interact with NCC. Furthermore, a proton pump inhibitor, bafilomycin A1, partially reverses the inhibitory effect of WNK4 WT on NCC expression. Our data suggest that WNK4 WT significantly inhibits NCC surface expression, which is not owing to an increase in clathrin-mediated endocytosis of NCC, but likely results from enhanced degradation of NCC through a lysosomal pathway.

The Lyapunov exponent of the EEG after administration of topiramate

The objective of our study was to investigate the effect of topiramate (TPM) on the Lyapunov exponent of EEG by means of quantitative pharmacoelectroencephalography (QPEEG) and nonlinear analysis methods. One dose of TPM was administrated to epileptics and healthy adults. EEG samples were obtained prior to and at regular intervals (at 0.5, 1, 2, 4, 6, 8, 12, 24 hours) within the 24 hours following the administration of TPM. EEG activity was processed with nonlinear analysis methods. The Lyapunov exponent of the scalp areas was calculated through 60 s epochs without artifacts after each recording. The statistical difference between baseline predrug assessment and each postdrug control was calculated by computing the paired t test. Results showed that the Lyapunov exponent increased first, then decreased, then increased finally. We conclude that TPM can change the complexity of EEG.

Determination of dichloroacetic acid and trichloroacetic acid in drinking water by acidic methanol esterification and headspace gas chromatography

A simple and rapid headspace method for gas chromatographic determination of dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) in drinking water was developed. Acidic methanol esterification followed by a headspace technique using a capillary column gas chromatograph (GC) equipped with an electron capture detector (ECD) was applied to determine the levels of DCAA and TCAA in drinking water. The major advantages of this method are the use of acidic methanol as the derivatization agent instead of the hazardous diazomethane, and esterification is carried out in water instead of organic solvent. DCAA and TCAA methyl esters produced in the reaction were determined directly by a headspace GC/ECD method. The linear correlation coefficients at concentrations ranging from 0 to 60 microg/L were 0.992 and 0.996 for DCAA and TCAA, respectively. The relative standard deviations (RSD, %) for the determination of DCAA and TCAA in drinking water were 15 and 21.3%, respectively (n=3). The detection limits of this method were 3 and 0.5 microg/L for DCAA and TCAA, respectively, and the recovery was 68-103.2% for DCAA and TCAA.

Effect of thermal treatment on carbon-doped silicon oxide low dielectric constant materials

Carbon-doped silicon oxide (SiOCH) low dielectric constant (low-k) material is a good candidate for advanced interconnect technology. Good thermal stability of the dielectric is required due to the many thermal processes involved during IC fabrication. The thermal stability of tetramethylcyclotetrasiloxane (TMCTS) based plasma-enhanced chemical vapor deposition (PECVD) carbon doped low-k material with annealing temperature from 400 to 800 degrees C in N2 was studied. The thermal stability temperature of TMCTS based carbon doped low-k material is 600 degrees C. Above 600 degrees C annealing, the thermal energy can break Si-CH3, Si-C, Si-H, and C-H bonds leading to outgasing, which results in film composition change, weight loss, and thickness shrinkage. Film composition changes, especially carbon loss and oxygen incorporation, can degrade its reliability extremely. Carbon is desorbed in the form of CH4, CO, and other hydrocarbon.

Desloratadine prevents compound 48/80-induced mast cell degranulation: visualization using a vital fluorescent dye technique

BACKGROUND

Desloratadine is a selective H1-antihistamine used in the treatment of allergic rhinitis and chronic idiopathic urticaria. Desloratadine inhibits the release of allergic inflammatory mediators in vitro. We studied the impact of desloratadine on mast cell degranulation due to activation and re-activation by the secretagogue, compound 48/80.

METHODS

Rat peritoneal eluate containing 5-6% mast cells were activated by a low concentration of compound 48/80 in a medium containing the vital fluorescent dye, Sulforhodamine-B (SFRM-B, 200 microg/ml), which is engulfed by activated mast cells. The fluorescent image of activated mast cells was captured digitally and the total fluorescent area was analyzed when desloratadine was applied before or after compound 48/80.

RESULTS

Mast cells were not activated by desloratadine (10(-4) M), SFRM-B (200 microg/ml), or diluent alone. A low concentration of compound 48/80 (0.125 microg/ml) induced fluorescence, while mast cells lost fluorescent images due to further degranulation on re-exposure to compound 48/80. Desloratadine (10(-8)-10(-4) M), inhibited compound 48/80-induced mast cell degranulation in a concentration-dependent manner. Desloratadine also reduced the loss of fluorescent images due to re-exposure to compound 48/80.

CONCLUSIONS

Desloratadine may have a mast cell stabilizing effect at low concentrations in response to repeated mast cell activation in vitro.

Influence of cultivating conditions on the alpha-galactosidase biosynthesis from a novel strain of Penicillium sp. in solid-state fermentation

AIMS

The work is intended to achieve optimum culture conditions of alpha-galactosidase production by a mutant strain Penicillium sp. in solid-state fermentation (SSF).

METHODS AND RESULTS

Certain fermentation parameters involving incubation temperature, moisture content, initial pH value, inoculum and load size of medium, and incubation time were investigated separately. The optimal temperature and moisture level for alpha-galactosidase biosynthesis was found to be 30 degrees C and 50%, respectively. The range of pH 5.5-6.5 was favourable. About 40-50 g of medium in 250-ml flask and inoculum over 1.0 x 10(6) spores were suitable for enzyme production. Seventy-five hours of incubation was enough for maximum alpha-galactosidase production. Substrate as wheat bran supplemented with soyabean meal and beet pulp markedly improved the enzyme yield in trays.

CONCLUSIONS

Under optimum culture conditions, the alpha-galactosidase activity from Penicillium sp. MAFIC-6 indicated 185.2 U g(-1) in tray of SSF.

SIGNIFICANT AND IMPACT OF THE STUDY

The process on alpha-galactosidase production in laboratory scale may have a potentiality of scaling-up.

A predictive model for the release of slightly water-soluble drugs from HPMC matrices

A model to predict the fraction of slightly water-soluble drug released as a function of release time (t, h), HPMC concentration (C(H), w/w), drug solubility in distilled water at 37 degrees C (C(s), g/100 mL), and volume of drug molecule (V, nm3) was derived when theophyline, tinidazole, and propylthiouracil were selected as model drugs. The model is log (M(t)/M(infinity)) = 0.8683 logt-0.1930C(s) logt + 0.5406V logt-1.227C(H) + 0.1594C(s) + 0.4423C(H)C(s) - 0.8655 (n = 130, r = 0.9969), where Mt is the amount of drug released at time t, Minfinity is the amount of drug released over a very long time, which corresponds in principle to the initial loading, n is the number of samples, and r is the correlation coefficient. The model was validated using sulfamethoxazole and satisfactory results were obtained. The model can be used to predict the release fraction of variousslightly water-soluble drugs from HPMC matrices having different polymer levels.

Atmospheric deposition, mineralization and leaching of nitrogen in subtropical forested catchments, South China

In recent years, China has conducted considerable research focusing on the emission and effects of sulphur (S) on human health and ecosystems. By contrast, there has been little emphasis on anthropogenic nitrogen (N) so far, even though studies conducted abroad indicate that long-range atmospheric transport of N and ecological effects (e.g. acidification of soil and water) may be significant. The Sino-Norwegian project IMPACTS, launched in 1999, has established monitoring sites at five forest ecosystems in the southern part of PR China to collect comprehensive data on air quality, acidification status and ecological effects. Here we present initial results about N dynamics at two of the IMPACTS sites located near Chongqing and Changsha, including estimation of atmospheric deposition fluxes of NOx and NHx and soil N transformations. Nitrogen deposition is high at both sites when compared with values from Europe and North America (25-38 kg ha(-1) yr(-1)). About 70% of the deposited N comes as NH4, probably derived from agriculture. Leaching of N from soils is high and nearly all as NO3-. Transformation of N to NO3- in soils results in acidification rates that are high compared to rates found elsewhere. Despite considerable leaching of NO3- from the root zone of the soils, little NO3- appears in streamwater. This indicates that N retention or denitrification, both causing acid neutralization, may be important and probably occur in the groundwater and groundwater discharge zones. The soil flux density of mineral N, which is the sum of N deposition and N mineralization, and which is dominated by the N mineralization flux, may be a good indicator for leaching of NO3- in soils. However, this indicator seems site specific probably due to differences in land-use history and current N requirement.

Study on the ecological distribution of alveolar Echinococcus in Hulunbeier Pasture of Inner Mongolia, China

A study on the ecological distribution of alveolar Echinococcus was carried out in the Hulunbeier Pasture of Inner Mongolia, China during 1998 and 1999. Animals examined included wolves (Canis lupus), red foxes (Vulpes vulpes), sand foxes (Vulpes corsac), domestic dogs (Canis familiaris), Microtus brandti, Meriones unguiculatus, Citellus dauricus, Allactaga sibirica, Phodopus sungorus and Ochotona daurica. Three wolves were found to be infected with E. granulosus. Two sand foxes were infected with E. multilocularis. The majority of infections of alveolar echinococcus was found in M. brandti. Based on the structure of metacestodes found in the livers of naturally infected M. brandti, 3 main variants were observed. Type I had small alveolar cysts with thin cyst walls. Type II had a larger cyst with a thick cyst wall. Infection of laboratory mice with the gravid segments isolated from the naturally infected sand foxes led to the formation of mature Type I alveolar metacestodes in the lungs and Type II metacestodes in the livers of infected animals, respectively.

Somatic embryogenesis from leaf explants of Australian fan flower, Scaevola aemula R. Br

Somatic embryogenesis from leaf explants of Scaevola aemula R. Br. was achieved. Somatic embryos were induced from explants cultured on MS medium supplemented with 0.2 mg/ 2,4-dichlorophenoxyacetic acid and 0.2-0.5 mg/l 6-benzylaminopurine (BAP). Various developmental stages of somatic embryos were found on this medium-from globular embryos to germinated embryos. The transfer of globular embryos to MS medium containing 0.5 mg/l BAP resulted in a high frequency of shoot regeneration. Leaf explants cultured on MS medium containing different combinations of BAP and alpha-naphthaleneacetic acid formed adventitious shoots and roots. Histological examination confirmed the process of somatic embryogenesis. Induction of somatic embryogenesis in Scaevola provides a system for studying embryogenesis in Australian native plants and will facilitate the improvement of these plants using genetic transformation techniques.

Endovascular treatment of brain-stem arteriovenous malformations: safety and efficacy

Our purpose was to evaluate the safety and efficacy of endovascular treatment of brain-stem arteriovenous malformations (AVMs), reviewing six cases managed in the last 5 years. There were four patients who presented with bleeding, one with a progressive neurological deficit and one with obstructive hydrocephalus. Of the six patients, one showed 100%, one 90%, two 75% and two about 50% angiographic obliteration of the AVM after embolisation; the volume decreased about 75% on average. Five patients had a good outcome and one an acceptable outcome, with a mild postprocedure neurological deficit; none had further bleeding during midterm follow-up. Endovascular management of a brain-stem AVM may be an alternative to treatment such as radiosurgery and microsurgery in selected cases. It may be not as risky as previously thought. Embolisation can reduce the size of the AVM and possibly make it more treatable by radiosurgery and decrease the possibility of radiation injury.

A mixture model-based cluster analysis of DNA microarray gene expression data on Brahman and Brahman composite steers fed high-, medium-, and low-quality diets

The objective of this study is to explore aspects of the statistical analysis of gene expression response at the muscle tissue level to varying levels of energy and protein in the diet. Eleven Brahman and Brahman composite steers (weighing 302 +/- 9.8 kg, on average) were allocated randomly into high- (HIGH), medium- (MED), and low- (LOW) quality forage diets for 27 d. After this period, a biopsy of the longissimus dorsi muscle was taken from each animal and total RNA was extracted to generate the labeled target for microarray experimentation. These targets were hybridized to a complementary DNA (cDNA) microarray of 9,274 probes from cattle muscle and subcutaneous fat cDNA libraries. After edits, 151,904 expression intensity levels of 4,747 genes were analyzed. Emphasis was given to the choice of power transformation of the intensity channel readings and to the consistency of readings within each diet quality group. The statistical approach to isolate differentially expressed genes was based on model-based clustering via a mixture of normal distributions estimated through maximal likelihood. The base-2 logarithm was found to be the optimal power transformation to normalize gene intensity levels. A two-sample t-statistic was defined as a measure of possible differential expression. For each of the three diet contrasts, HIGH vs. LOW, HIGH vs. MED, and MED vs. LOW, three clusters were found, two of which contained more than 94% genes with almost no altered gene expression levels, whereas the third cluster contained the remaining genes with a differential expression. Results from the HIGH vs. LOW contrast identified 27 genes with a greater than 95% posterior probability of belonging to the cluster of differentially expressed genes.

Functional significance of conserved glycine 127 in a human dual-specificity protein tyrosine phosphatase

Using site-directed mutagenesis and steady-state kinetic measurements, the functional role of the conserved glycine 127 in a human vaccinia H1-related phosphatase (VHR) was investigated. The mutations of Gly127 to Ala and Pro resulted in a significant decrease in k(cat)/K(m), and increase in K(i) for arsenate, indicating that flexibility at the Gly127 site has a large effect on substrate binding and catalytic activity. No substantial decrease in k(cat)/K(m) and increase in K(i) values were observed for G127 deletion mutant. This showed the conformational flexibility of the PTP loop also affected the enzymatic activity of VHR. Our data suggest that the flexibility of the PTP loop in VHR is probably controlled by Gly127, and that even subtle changes in the loop flexibility may interfere with substrate binding and enzymatic reaction.

The high value of high-resolution computed tomography in predicting the activity of pulmonary tuberculosis

SETTING

A 2500-bed medical centre in southern Taiwan.

OBJECTIVE

To study the clinical value of high-resolution computed tomography (HRCT) in predicting the activity of pulmonary tuberculosis (TB).

DESIGN

HRCTs were performed prospectively in 148 patients whose chest radiographs (CXRs) showed highly suspicious signs of pulmonary TB, predominantly upper lung field infiltration. The HRCT findings, interpreted independently by a pulmonologist and a radiologist, were used to predict the activity of pulmonary TB.

RESULTS

Pulmonologist-interpreted and radiologist-interpreted HRCTs showed high sensitivity (both 93%), specificity (83 vs. 88%), accuracy (86 vs. 90%), positive predictive values (76 vs. 83%) and negative predictive values (both 95%). Kappa statistic indicates good inter-reader agreement.

CONCLUSION

HRCT has a high value in predicting the activity of pulmonary TB. It is a useful tool in this regard when a patient with suspected pulmonary TB lacks microbiologic proof, when clinical condition makes invasive diagnosis impossible or when a patient has completed anti-tuberculosis treatment with no compatible unequivocal CXR.

Pigtail drainage in the treatment of tuberculous pleural effusions: a randomised study

BACKGROUND

Tuberculous pleurisy can result in obvious clinical symptoms, pleural fibrosis, and pleural thickening. Some studies of tuberculous pleurisy have suggested that symptomatic improvement and minimisation of sequelae can be achieved by completely draining the effusion during treatment, although the results have not been conclusive.

METHODS

Sixty one patients with tuberculous pleurisy were divided into two groups; 30 patients received pigtail drainage combined with antituberculosis (TB) drug treatment and 31 received only anti-TB drugs. Outcome measurements were assessed for a period of 24 weeks after treatment and included symptom scores and the incidence of residual pleural thickening (RPT).

RESULTS

Although the duration of dyspnoea was significantly shortened by the use of pigtail drainage (median 4 days (IQR 4-5) v 8 days (IQR 7-16), p<0.001), a comparison of combined mean (SD) visual analogue scale (VAS) scores showed no significant difference between the groups after one week of treatment (57.1 (33.2) v 68.5 (44.7) or at any time during the follow up period. The incidence of RPT of more than 10 mm in the group treated with pigtail drainage and anti-TB drugs was 26% compared with 28% in the group receiving drug treatment only. The incidence of RPT levels of more than 2 mm in the two groups was 50% and 51%, respectively. No statistical difference between the two groups in terms of forced vital capacity was found at the end of treatment (median (IQR) 85.5% (69-94) of predicted v 88% (78-96) of predicted).

CONCLUSION

The addition of pigtail drainage to an effective anti-TB regimen is not clinically relevant and does not reduce the level of RPT.

Improvement in the performance of automated spike detection using dipole source features for artefact rejection

OBJECTIVE

We evaluated the use of an efficient dipole source algorithm to improve performance of automated spike detection by identifying false detections caused by artefacts.

METHODS

Automated spike detections were acquired from 26 patients undergoing prolonged electroencephalograph (EEG) monitoring. Data from 6 patients were used to develop the method and data from 20 patients were used to test the method. To provide a standard against which to evaluate the results, an electroencephalographer (EEGer) visually categorized all automated detections before the dipole models were calculated for all events. The event categories (as defined by the EEGer) were then combined with properties of the dipole model and features were identified that differentiated spike and artefact detections. The resulting method was then applied to the testing data set.

RESULTS

Residual variance and eccentricity of the dipole models differentiated artefact and spike detections. A separate set of rules defining eye blink artefact was also developed. The combined criteria removed a mean of 53.2% of artefact from the testing data set. Some spike detections (4.3%) were also lost.

CONCLUSIONS

The features of the dipole source of a detected event can be used to differentiate artefacts from spikes. This algorithm is computationally light and could be implemented on-line.