Reconsideration of the relevance of mild wedge or short vertebral height deformities across a broad age distribution

Based on an evaluation of vertebral fracture prevalence on lateral radiographs across all age groups in a large cohort, mild or wedge-shaped vertebral body changes identified among adults should be managed as osteoporosis or at least considered as a risk factor for osteoporotic fracture, since they are rare among young subjects.

INTRODUCTION

Radiographic assessment of vertebral fractures is limited by the inability to distinguish mild fractures from congenital mild wedge deformities or vertebrae of short vertebral height. We attempted to quantify the expected background prevalence of these deformities by measuring vertebral fracture prevalence across all age groups in a large hospital-based retrospective Chinese cohort.

METHODS

We reviewed eligible lateral chest radiographs from patients admitted to Peking Union Medical College Hospital during 2011 using the Genant semiquantitative method for vertebral fracture assessment (T4-L2). We evaluated fracture prevalence among subjects by sex, 10-year age group, and fracture severity grades subjectively. We further analyzed characteristics of subjects with mild (grade I) fractures to estimate the relative contribution of congenital mild wedge deformities.

RESULTS

A total of 10,720 subjects (5,396 men and 5,324 women) with lateral chest radiographs were evaluated. Subjects ranged in age from 0.5 to 97 years with a mean of 51.8 ± 17.4 years (men 52.8 ± 17.6 years; women 50.8 ± 17.2 years). When stratified by 10-year age groups, the prevalence of vertebral fractures was relatively low until about 40 years of age, after which prevalence increased for both genders. Fractures (13 fractures for 9 males and 6 fractures for 5 females) seen in subjects younger than 40 years of age were almost exclusively mild grade fractures. No fractures were identified in subjects younger than 20 years of age.

CONCLUSIONS

Mild or wedge-shaped vertebral body changes on lateral radiographs are rare among young subjects, indicating that when mild vertebral deformities are found among adults, they are likely to be the product of aging and not congenital variation. Clinically, therefore, mild vertebral body changes should be managed as osteoporosis or at least considered as a risk factor for osteoporotic fracture.

Isolation of a goose parvovirus from swan and its molecular characteristics

Goose parvovirus (GPV) causes high mortality and morbidity in goslings and Muscovy ducklings. In this study, a GPV was isolated from a 20-day old swan in Shanghai, China. Complete genome of the swan isolate contained 5,050 nt and showed the highest homology with Taiwanese GPV isolates from 1982. In comparison with the Chinese mainland GPV isolates reported previously, the swan isolate shows two deletions, particularly at positions 67-80 and 334-347 in inverted terminal repeats (ITRs). These findings suggest that the swan could serve as a potential host for GPV and provide insights into molecular characteristics and etiology of GPV.

Magnetic sensing technology for molecular analyses

Magnetic biosensors, based on nanomaterials and miniature electronics, have emerged as a powerful diagnostic platform. Benefiting from the inherently negligible magnetic background of biological objects, magnetic detection is highly selective even in complex biological media. The sensing thus requires minimal sample purification and yet achieves a high signal-to-background contrast. Moreover, magnetic sensors are also well-suited for miniaturization to match the size of biological targets, which enables sensitive detection of rare cells and small amounts of molecular markers. We herein summarize recent advances in magnetic sensing technologies, with an emphasis on clinical applications in point-of-care settings. Key components of sensors, including magnetic nanomaterials, labeling strategies and magnetometry, are reviewed.

Study of individualization therapy for 61 patients with cesarean scar pregnancy

OBJECTIVE

To investigate the clinical value of the individualization therapy for cesarean scar pregnancy (CSP).

MATERIALS AND METHODS

According to the individual characteristics of the CSP in 61 patients admitted and treated by the People's Hospital of Yuyao City, China between March 2010 and February 2013, methotrexate (MTX) with leucovorin (CF) or uterine artery chemotherapy embolization (UACE) were used to kill the embryos, stanch, and prevent bleeding. Guided by hysteroscopy or B ultrasound, uterine curettage was carried out under the surveillance of laparoscopy if necessary.

RESULTS

Fifty-four cases of patients were treated by UACE. MTX with CF was used,in seven cases. Uterine curettage was performed in 44 cases under the guidance of hysteroscopy. Six cases were under the surveillance of the B ul- trasound and both hysteroscopic guidance and B ultrasound surveillance were used in seven cases. The lesions disappeared in two cases after transabdominal excision and two cases after UACE. All of the 61 patients were cured without hysterectomy.

CONCLUSION

Selection of individualization treatment programs according to the characteristics of the disease could improve the efficacy and prognosis of patients with CSP. The appropriate timing to perform curettage was five to seven days after embryo killing in order to reduce bleeding and shorten the course of the disease.

Midazolam suppresses osteogenic differentiation of human bone marrow-derived mesenchymal stem cells

OBJECTIVE

Previous study showed that peripheral-type benzodiazepine receptors (PBRs) are expressed in human mesenchymal stem cells (hMSCs) and diazepam was found to inhibit hMCSs viability in high concentration. Midazolam, a benzodiazepine derivative, is widely used as an intravenous sedative in hospital. Peripheral-type benzodiazepine receptors (PBRs) affect a broad spectrum of cellular functions. We tested the cell viability and osteogenic differentiation of hMSCs.

PATIENTS AND METHODS

Bone marrow was collected from 12 patients during the operation of spine internal fixation. Cultivated with basal medium, the hBMSCs were incubated with or without midazolam (0.1, 1, 5, 10, 15, 20 µM, respectively). Cell viability were tested with MTS assay after 2, 4, 6 hours respectively. Cell morphology was observed and recorded at 6 hour. After cultivated with osteogentic medium, the hBMSCs were incubated with or without midazolam (5, 10, 15, 20 µM, respectively). Alkaline phosphatase (ALP) activity and alizarin red S staining were measured. Cultivated with osteogentic medium with or without treatment of 15 µM midazolam, the mRNA expression of ALP, type 1 collagen (COL1), Runx2 and PPARγ was analyzed by real-time RT-PCR.

RESULTS

The treatments of midazolam inhibited cell viability to 85%-16% respectively (p < 0.05). Rounded up phenomenon with floating cells, Membrane-blebbed cells and cytoplasmic contraction were observed after 10, 15 or 20 µM midazolam treatment. The ALP activity and Calcium deposition of hBMSCs exposed to 15 and 20 µM midazolam was significantly inhibited at 7, 14 and 21 days (p < 0.05). And the mRNA expression of ALP, COL1 and PPARγ was significantly suppressed in the hBMSCs cultured with 15 µM midazolam (p < 0.05).

CONCLUSIONS

Midazolam exert negative effect on cell viability and osteogenic differentiation of cultured hBMSCs. During sedation in critical care, the use of midazolam may suppress activity of hBMSCs.

Differentiation of tuberculosis from lymphomas in neck lymph nodes with multidetector-row computed tomography

BACKGROUND

Tuberculosis (TB) of the cervical lymph nodes may mimic lymphoma.

OBJECTIVE

To evaluate multidetector-row computed tomographic (MDCT) imaging criteria for differentiating between the two diseases.

MATERIALS AND METHODS

We retrospectively reviewed the anatomical distribution and CT enhancement patterns of the nodes in 81 patients, 27 (33%) with untreated TB and 54 (67%) with untreated lymphomas involving cervical lymph nodes. Of the patients with lymphomas, 19 (35%) had Hodgkin's disease and 35 (65%) had non-Hodgkin's lymphoma.

RESULTS

TB predominantly involved the upper cervical nodes. The supraclavicula fossa nodes on MDCT were involved more often in Hodgkin's disease (n = 15, 79%) and non-Hodgkin's lymphoma (n = 25, 71%) than in TB (n = 3, 11%). Tuberculous lymphadenopathy commonly showed peripheral enhancement, frequently with a multilocular appearance. Peripheral enhancement was significantly more frequent in TB (n = 19, 70%) than in Hodgkin's disease (n = 1, 5%) and non-Hodgkin's lymphoma (n = 1, 3%), but homogeneous enhancement was less common in the TB group.

CONCLUSION

Our findings indicate that a specific enhancement pattern of lymphadenopathy seen on MDCT was useful in differentiating between untreated TB and lymphomas of the cervical lymph nodes.

A rat model of diabetic artery calcification

OBJECTIVES

The aim of this study was to develop a rat model that shares the similarities of calcification in diabetes.

METHODS

Male Wistar rats received a high-fat diet during 8 weeks followed by a low dose of streptozotocin. Half of them were treated with vitamin D3 and nicotine (VDN) 1 week after streptozotocin injection (DM) (DM+VDN). The others were treated with vehicle (DM). Arterial calcification was facilitated by vitamin D3 and nicotine in age-matched rats (VDN). Measurements of metabolic parameters, aortic calcium content, von Kossa staining, alkaline phosphatase activity and immunohistochemistry for osteopontin were performed. The expression of genes and proteins associated with calcification were also examined.

RESULTS

Treatment with VDN alone resulted in a small but not significant elevation of calcium content in aorta. However, in DM+VDN, aortic calcium content increased significantly as compared to the VDN. This calcification had also dramatically increased, as shown by von Kossa staining. Mechanistic studies revealed that addition of VDN treatment in diabetic rats enhanced both activity and mRNA expression of alkaline phosphatase. This treatment in diabetic- rats also enhanced the expression of core binding factor α 1 and its downstream protein osteopontin. In aorta, strong immunostaining for osteopontin was observed in DM+VDN. The result was also confirmed by Western blot analysis.

CONCLUSION

These results suggest that a model of accelerated arterial calcification in diabetes have been established and this model could be useful to investigate mechanisms related to vascular complication in diabetes.

Differentiation between tuberculosis and lymphoma in mediastinal lymph nodes: Evaluation with contrast-enhanced MDCT

AIM

To determine the specific imaging criteria on contrast-enhanced multidetector computed tomography (MDCT) for differentiating between tuberculosis and lymphoma in mediastinal lymph nodes.

MATERIALS AND METHODS

The anatomical distribution and enhancement patterns of mediastinal lymph nodes on contrast-enhanced MDCT were reviewed in 37 patients with tuberculosis and 54 patients with lymphoma. Of the patients with lymphoma, 18 had Hodgkin's disease and 36 had non-Hodgkin's lymphoma.

RESULTS

Region 10R was involved more often in tuberculosis than in Hodgkin's disease and non-Hodgkin's lymphoma. Region 6 had a higher tendency to be affected in Hodgkin's disease and non-Hodgkin's lymphoma compared with tuberculosis. Tuberculosis showed peripheral enhancement in 78% of cases, frequently with a multilocular appearance, compared to Hodgkin's disease and non-Hodgkin's lymphoma, which showed peripheral enhancement in only 6 and 3% of cases, respectively. Homogeneous enhancement was more commonly seen in lymphoma (83% for Hodgkin's disease, and 83% for non-Hodgkin's lymphoma) than in tuberculosis (8%). In the determination of tuberculosis, results showed that when a peripheral enhancement pattern was seen, sensitivity was 78%, specificity was 96%, and accuracy was 89%. In the determination of lymphoma, results showed that when a homogeneous enhancement pattern was seen, sensitivity was 83%, specificity was 92%, and accuracy was 87%.

CONCLUSION

The findings of the present study indicate that specific anatomical distribution and enhancement patterns of lymphadenopathy shown on contrast-enhanced MDCT can be useful in differentiating tuberculosis from lymphoma of mediastinal lymph nodes.

Nanostructured Ti-catalyzed MgH2 for hydrogen storage

Nanocrystalline Ti-catalyzed MgH(2) can be prepared by a homogeneously catalyzed synthesis method. Comprehensive characterization of this sample and measurements of hydrogen storage properties are discussed and compared to a commercial MgH(2) sample. The catalyzed MgH(2) nanocrystalline sample consists of two MgH(2) phases-a tetrahedral β-MgH(2) phase and an orthorhombic high-pressure modification γ-MgH(2). Transmission electron microscopy was used for the observation of the morphology of the samples and to confirm the nanostructure. N(2) adsorption measurement shows a BET surface area of 108 m(2) g(-1) of the nanostructured material. This sample exhibits a hydrogen desorption temperature more than 130 °C lower compared to commercial MgH(2). After desorption, the catalyzed nanocrystalline sample absorbs hydrogen 40 times faster than commercial MgH(2) at 300 °C. Both the Ti catalyst and the nanocrystalline structure with correspondingly high surface area are thought to play important roles in the improvement of hydrogen storage properties. The desorption enthalpy and entropy values of the catalyzed MgH(2) nanocrystalline sample are 77.7 kJ mol(-1) H(2) and 138.3 J K(-1) mol(-1) H(2), respectively. Thermodynamic properties do not change with the nanostructure.

Activation of Notch1 signaling in stromal fibroblasts inhibits melanoma growth by upregulating WISP-1

The tumor microenvironment is emerging as an important target for cancer therapy. Fibroblasts (Fbs) within the tumor stroma are critically involved in promoting tumor growth and angiogenesis through secretion of soluble factors, synthesis of extracellular matrix and direct cell-cell interaction. In this work, we aim to alter the biological activity of stromal Fbs by modulating the Notch1 signaling pathway. We show that Fbs engineered to constitutively activate the Notch1 pathway significantly inhibit melanoma growth and tumor angiogenesis. We determine that the inhibitory effect of 'Notch-engineered' Fbs is mediated by increased secretion of Wnt-induced secreted protein-1 (WISP-1) as the effects of Notch1 activation in Fbs are reversed by shRNA-mediated blockade of WISP-1. When 'Notch-engineered' Fbs are co-grafted with melanoma cells in SCID mice, shRNA-mediated blockade of WISP-1 reverses the tumor-suppressive phenotype of the 'Notch-engineered' Fbs, significantly increases melanoma growth and tumor angiogenesis. Consistent with these findings, supplement of recombinant WISP-1 protein inhibits melanoma cell growth in vitro. In addition, WISP-1 is modestly expressed in melanoma-activated Fbs but highly expressed in inactivated Fbs. Evaluation of human melanoma skin biopsies indicates that expression of WISP-1 is significantly lower in melanoma nests and surrounding areas filled with infiltrated immune cells than in the adjacent dermis unaffected by the melanoma. Overall, our study shows that constitutive activation of the Notch1 pathway confers Fbs with a suppressive phenotype to melanoma growth, partially through WISP-1. Thus, targeting tumor stromal Fbs by activating Notch signaling and/or increasing WISP-1 may represent a novel therapeutic approach to combat melanoma.

ERCC6 founder mutation identified in Finnish patients with COFS syndrome

Cerebro-oculo-facio-skeletal (COFS) syndrome is an autosomal recessive disorder characterized by microcephaly, congenital cataracts, facial dysmorphism, neurogenic arthrogryposis, growth failure and severe psychomotor retardation. We report a large consanguineous pedigree from northern Finland with six individuals belonging into four different sibships and affected with typical COFS syndrome phenotype. Two deceased patients have been published previously in 1982 as the first cases exhibiting cerebral calcifications typical for this disorder. Two living and one of the deceased patients were all shown to possess a novel homozygous mutation in the ERCC6 [Cockayne syndrome B (CSB)] gene, thereby confirming the diagnosis on molecular genetic level even for the earlier published cases. Genealogical investigation showed a common ancestor living in a northeastern village in Finland in the 18th century for all six patients implying a founder effect.