Late-onset capsular block syndrome: unusually delayed presentation

Capsular block syndrome (CBS) has been known to occur as a rare complication of cataract surgery with continuous curvilinear capsulorhexis and a posterior-chamber lens implant. Typically, it presents with reduced vision in the early postoperative period and is characterised by a forward displacement of the posterior-chamber intra-ocular lens and an accumulation of intra-capsular opaque material. Management of CBS is usually by Nd:YAG laser capsulotomy. In this report, we describe a unique case of very-delayed-onset CBS with good visual acuity, occurring 8 years after surgery. It was treated successfully with surgical removal of the opaque material.

Pre-treatment with Cobra venom factor alleviates acute lung injury induced by intestinal ischemia-reperfusion in rats

BACKGROUND

Previous studies have shown that complement activation is required for intestinal ischemia-reperfusion (IIR)-induced tissue damage. Cobra venom factor (CVF), a structural and functional homolog to the activated form of C3 (the central component of the complement system), can cause exhaustive activation of the alternative pathway and deplete the complement components.

AIM

This study aims to investigate the effect of CVF pretreatment on acute lung injury induced by IIR in rats.

MATERIALS AND METHODS

Lung injury was induced by clamping superior mesenteric artery (SMA) for 60 min followed by 4 h of reperfusion. CVF was given via the tail vein 24 h before the operation.

RESULTS

Histological results as well as lung edema determination and permeability assay showed the severe damages were induced in the lungs of rats in the IIR group, accompanying with the increases in the levels of pulmonary malondialdehyde (MDA), myeloperoxidase (MPO) activity, intercellular adhesion molecule-1 (ICAM-1), interleukin (IL)-8. Remarkably, CVF pretreatment significantly attenuated the morphological lung injury, lung edema and lung permeability, reduced the increase of the levels of MDA, MPO, ICAM-1 and IL-8 induced by IIR. In addition, the severe damage of intestinal and elevation of plasma diamine oxidase activity in the IIR rats were significantly alleviated by CVF pretreatment.

CONCLUSIONS

CVF pretreatment could significantly reduce the acute lung injury induced by IIR. The mechanism might include, at least in part, the inhibition of oxidant generation, infiltration of neutrophils, ICAM-1 expression and IL-8 release. CVF might be an efficient reagent for preventing the IIR injuries in clinical condition.

Probe of the solar magnetic field using the "cosmic-ray shadow" of the sun

We report on a clear solar-cycle variation of the Sun’s shadow in the 10 TeV cosmic-ray flux observed by the Tibet air shower array during a full solar cycle from 1996 to 2009. In order to clarify the physical implications of the observed solar cycle variation, we develop numerical simulations of the Sun’s shadow, using the potential field source surface model and the current sheet source surface (CSSS) model for the coronal magnetic field. We find that the intensity deficit in the simulated Sun’s shadow is very sensitive to the coronal magnetic field structure, and the observed variation of the Sun’s shadow is better reproduced by the CSSS model. This is the first successful attempt to evaluate the coronal magnetic field models by using the Sun’s shadow observed in the TeV cosmic-ray flux.

Laser-assisted solid-state synthesis of carbon nanotube/silicon core/shell structures

A single-step solid-state synthetic approach was developed for the synthesis of silicon-coated carbon nanotube (CNT) core/shell structures. This was achieved through laser-induced melting and evaporation of CNT-deposited Si substrates using a continuous wavelength CO2 laser. The synthesis location of the CNT/Si structures was defined by the laser-irradiated spots. The thickness of the coating was controlled by tuning the laser power and synthesis time during the coating process. This laser-based synthetic technique provides a convenient approach for solid-state, controllable, gas-free, simple and cost-effective fabrication of CNT/Si core/shell structures.

Cisplatin plus etoposide versus other platin-based regimens for patients with extensive small-cell lung cancer: a systematic review and meta-analysis of randomised, controlled trials

AIM

To determine whether the cisplatin plus etoposide (EP) combination was more efficacious and less toxic than other platinum-based regimens for patients with extensive-stage small-cell lung cancer.

METHODS

We performed an extensive literature search (from their inception to July 2010). Two reviewers independently assessed search results and methodological quality of included studies. Pooled hazard ratios (HRs) and relative risks (RRs) were calculated according to a random-effects model.

RESULTS

Twelve randomised, controlled trials involving seven different platinum-based chemotherapy regimens were included into this meta-analysis. The meta-analysis showed that compared with EP regimen, irinotecan plus cisplatin (IP) might decrease the risk of death (HR = 0.87, 95% confidence interval (CI) 0.78-0.97, P = 0.01) (five trials), unlike the sensitivity analysis (HR = 0.91, 95% CI 0.81-1.02, P = 0.12), progression-free survival (HR = 0.95, 95% CI 0.86-1.05, P = 0.28) and overall response rate (RR 1.08, 95% CI 0.93-1.24) that were not superior for IP. IP regimen produced more non-haematological toxicities and less haematological toxicities. One trial found that etoposide + cisplatin + epirubicin + cyclophosphamide and cisplatin + etoposide + ifosfamide regimen might prolong the overall survival respectively. Etoposide + cisplatin + epirubicin + cyclophosphamide regimen also might improve progression-free survival but with high rate of haematological toxicities. None of the other trials included in the study demonstrated a significant improvement in survival.

CONCLUSIONS

There is no strong evidence that any clinical advantage for extensive small-cell lung carcinoma patients requiring chemotherapy when comparing EP with other platin-based regimens, with exception of IP that might prolong overall survival. The decision to prescribe which chemotherapy should take into consideration both cost and treatment preference.

Simultaneous versus staged bilateral unicompartmental knee replacement

We prospectively followed 171 patients who underwent bilateral unicompartmental knee replacement (UKR) over a period of two years. Of these, 124 (72.5%) underwent a simultaneous bilateral procedure and 47 (27.5%) underwent a staged procedure. The mean cumulative operating time and length of hospital stay were both shorter in the simultaneous group, by 22.5 minutes (p < 0.001) and three days (p < 0.001), respectively. The mean reduction in haemoglobin level post-operatively was greater by 0.15 g/dl in the simultaneous group (p = 0.023), but this did not translate into a significant increase in the number of patients requiring blood transfusion (p = 1.000). The mean hospital cost was lower by $8892 in the simultaneous group (p < 0.001). There was no significant difference in the rate of complications between the groups, and at two-year follow-up there was no difference in the outcomes between the two groups.

We conclude that simultaneous bilateral UKR can be recommended as an appropriate treatment for patients with bilateral medial compartment osteoarthritis of the knee.

Cite this article: Bone Joint J 2013;95-B:788–92.

Remote ischemic preconditioning improves spatial learning and memory ability after focal cerebral ischemia-reperfusion in rats

OBJECTIVE

Using a rodent model of middle cerebral artery occlusion (MCAO), we investigated the effect of remote ischemic preconditioning (RIPC) on spatial learning and memory ability after focal cerebral ischemia-reperfusion (I/R).

METHOD

Thirty-six male Sprague-Dawley rats were randomly allocated into 3 groups (n=12, each): sham group, rats were subjected to sham operations without MCAO and RIPC; I/R group, rats were subjected to 1h of MCAO followed by 3 days of reperfusion; I/R+RIPC group, rats were subjected to RIPC and 1h MCAO followed by 3 days of reperfusion. The spatial learning and memory ability of the rats was measured by the Morris water maze task.The activity of cholineacetyltransferase (ChAT) in the hippocampus CA1 region was observed by an immunohistochemistry method.

RESULTS

In the Morris water maze task, MCAO elicited a significant decrease of the ability of spatial learning and memory in contrast to the sham group. Meanwhile, RIPC induced a significantly shorter prolongation of the escape latency (p<0.05); greater number passing through the platform (p<0.05) and less time for exploring the target quadrant (p<0.05) as compared with values for the I/R group. Furthermore, the number of ChAT positive cells in the CA1 region in the I/R+RIPC group was strikingly more than those of the I/R group (p<0.05).

CONCLUSIONS

RIPC could improve the ability of spatial learning and memory after focal cerebral ischemia-reperfusion probably due to its protection of the cholinergic neurons in the hippocampal CA1 region.

A critical role of thrombin/PAR-1 in ADP-induced platelet secretion and the second wave of aggregation

BACKGROUND

The stable or second wave of platelet aggregation often observed in ADP-stimulated platelet-rich plasma (PRP) with an artificially lowered extracellular calcium level has been attributed to enhanced thromboxane A2 (TXA2 ) generation and inhibition of ectonucleotidase activity. However, the role of thrombin in ADP-induced platelet secretion and the second wave of aggregation is unknown.

OBJECTIVES AND METHODS

We employed aggregometry, flow cytometry, immunoblotting and ELISA to determine whether and how thrombin participates in ADP-induced platelet secretion and the second wave of aggregation.

RESULTS

ADP induces a phosphoinositide 3-kinase (PI3K) pathway-dependent thrombin generation, presumably resulting from the cleavage of αII b β3 -associated prothrombin. Generated thrombin subsequently activates protease-activated receptor-1 (PAR-1) and mediates dense granule secretion and the second wave of platelet aggregation in ADP-stimulated citrated PRP. Thus, ADP-induced dense granule secretion and the second wave of platelet aggregation in PRP were similarly and non-additively blocked by thrombin inhibitor hirudin, PAR-1 antagonist SCH-79797 or PI3K inhibitor wortmannin. Moreover, ADP stimulation caused the dissociation of prothrombin from αII b β3 and an increased plasma thrombin level; both were prevented by wortmannin. Furthermore, the wortmannin-inhibited second wave of platelet aggregation by ADP was restored by a subaggregation concentration of PAR-1 activating peptide SFLLRN. Blocking TXA2 production with indomethacin or restoring extracellular calcium to physiological concentration did not influence this thrombin/PAR-1 dependence.

CONCLUSIONS

A PI3K-dependent thrombin generation and the resultant PAR-1 activation serve as an indispensable mechanism to relay the platelet activation process induced by ADP.

Pharmacokinetics of a new immediate-release compound omeprazole capsule and its comparison with the enteric-coated formulation under fasting and fed conditions

The present study was conducted to describe the pharmacokinetic profile of immediate-release compound omeprazole capsule and compare it with the enteric-coated formulation under fasting and fed condition.This study was designed to phase I, open-label, randomized, 3-part clinical trial. 12 subjects in part one received single doses (20 mg and 40 mg) and repeated doses (20 mg). Different 30 subjects in part 2 (fasting condition) and part 3 (fed condition) received either compound omeprazole capsule (40 mg) or delayed-release omeprazole (40 mg) separated by 7 days.Compound omeprazole capsule showed dose non-proportionality in the range from 20 mg to 40 mg. The AUC0-t of 20 mg omeprazole is 78% higher after repeated doses. The C max was higher and T max was lower for compound omeprazole capsule than delayed-release omeprazole. 90% CIs for AUC0-t of the 2 periods (test/reference) under fasting and fed conditions were 106.3% (102.2%~109.2%) and 104.1% (93.4%~109.6%), respectively. Presence of food reduced the rate (C max) and extent (AUC0-t) of systemic exposure of the test and reference formulations from 1 462 to 777 ng · mL-1, 1 055 to 602 ng · mL-1, 2 597 to 1 852 ng · h · mL-1 and 2 454 to 1 873 ng · h · mL-1, respectively.Exposed dose of omeprazole in subjects with compound omeprazole capsule was time- and dose-dependent. Compared with delayed-release omeprazole, compound omeprazole capsule had rapid but similar degree of absorption of omeprazole.

Aberrant intrinsic brain activity and cognitive deficit in first-episode treatment-naive patients with schizophrenia

BACKGROUND

Given the important role of the default mode network (DMN) in cognitive function and the well-known neurocognitive deficit in schizophrenia, it is intriguing to examine systematically the relationship between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia. Method First-episode, treatment-naive patients with schizophrenia (FES) (n = 115) and healthy controls (n = 113) underwent resting-state functional magnetic resonance imaging (fMRI) scans and neurocognitive tests. Intrinsic neural activities evaluated by using the fragment amplitude of low-frequency fluctuations (fALFF) and the resting-state functional connectivity assessed by seed-based correlational analysis were compared between patients and controls. Aberrant intrinsic activities and DMN connectivity in patients were then correlated to neurocognitive performance and clinical symptoms.

RESULTS

Compared to controls, patients with FES showed decreased fALFF in the bilateral medial prefrontal cortex (MPFC) and the orbitofrontal cortex (OFC), and increased fALFF in the bilateral putamen. Increased functional connectivity with the DMN was observed in the left insula and bilateral dorsolateral PFC (DLPFC) in patients with FES. In patients, aberrant fALFF in the bilateral OFC were correlated with cognitive processing speed; fALFF in the left OFC and right putamen were correlated with the clinical factors excited/activation and disorganization; and increased DMN functional connectivity in the left insula was correlated with the clinical factors positive, excited/activation, disorganization and neurocognitive deficit in the domain of sustained attention.

CONCLUSIONS

These associations between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia may provide important insights into the neural mechanism of the disease.

Etiology of Moldy Core, Core Browning, and Core Rot of Fuji Apple in China

'Fuji' apple fruit were collected in Shaanxi Province, China, and 186 fungal isolates were obtained from the fruit core region. Fungi were isolated from fruit with symptomless core regions, as well as from the core regions of fruit showing browning, typical moldy core, or core rot. Based on phylogenetic and morphological analysis, all fungi were identified to species. Pathogenicity was determined by cutting apple fruit into halves and daubing spore suspensions containing 1 × 10⁴ up to 1 × 10⁸ spores/ml on the carpel in the core region. Pathogenicity varied significantly among genera, with Alternaria and Cladosporium spp. causing core browning at lower spore concentrations and moldy core at higher spore concentrations. Combinations of pathogens initiated more browning and moldy core than the pathogens applied alone. Epicoccum and Phoma spp. predominated in dry core rot, whereas primarily Trichothecium but also Fusarium and Penicillium spp. caused wet core rot. Core browning was introduced as a new type of core symptom, along with moldy core, dry core rot, and wet core rot. Alternaria alternata, A. tenuissima, A. arborescens, Cladosporium cladosporioides, and C. tenuissimum were the main pathogens causing core browning and moldy core.

Focal dermal hypoplasia: updates

Focal dermal hypoplasia (FDH), or Goltz-Gorlin syndrome, is a rare syndrome and may result in multisystem disorders. Several reviews of FDH have been published. However, the last comprehensive review of this disorder appeared more than 20 years ago. To date, a number of new clinical manifestations have been reported and considerable knowledge has accumulated regarding etiology and pathogenetic mechanisms. The purpose of this review is to gather these more recent data and to provide organized and reliable information. So we reviewed 159 cases of FDH that had been reported from 1990 to 2012, summarized the new discoveries, and suggested a potential standard for the diagnosis of FDH. We also reported on a Chinese girl with FDH, who was clinically and histologically in accord with FDH, as an example.

Choice of microsatellite markers for identifying homozygosity of mitotic gynogenetic diploids in Japanese flounder Paralichthys olivaceus

A set of 72 microsatellite markers distributed evenly among 24 linkage groups were selected from the published genetic linkage maps of Japanese flounder Paralichthys olivaceus. In two normal diploid full-sib families, the test for Mendelian inheritance showed that genotypic segregation deviations were not significant at all analysed loci. To estimate microsatellite-centromere map distances, four meiotic gynogenetic diploid lines were produced by the activation of eggs using UV irradiated sperm of red seabream Pagrus major and cold-shock treatment to block the extrusion of the second polar body. Under the assumption of complete interference, 21 markers were located in the centromeric region, 39 in the telomeric region and the rest in the intermediate region of linkage groups. A total of 192 mitotic gynogenetic diploids from one spawn were identified by these markers. Genotype analysis showed that the number of homozygous individuals decreased as microsatellite-centromere map distance increased on each linkage group.

Establishment of Eimeria tenella (local isolate) in chicken embryos

Development of an in vitro Eimeria (E.) tenella model could be valuable as a tool for vaccine, coccidiostats or molecular biology research. 1.0 × 10,000 sporozoites per 0.1 mL were inoculated into the allantoic cavity of ten-day-old chicken embryos. The complete life-cycle of E. tenella was accomplished in eight-nine days at 37 °C and 70% humidity. The addition of 100 U insulin to the embryos could remarkably improve the output of oocysts. The development of the parasite within the embryos was systematically observed, allowing guidelines to be set regarding the appropriate times at which different developmental stages of the parasite may be sampled.