Raltegravir can be used safely in HIV-1-infected patients treated with warfarin

Drug co-administration often affects the patient response to warfarin through various mechanisms. We describe here five HIV-1-infected patients on treatment with warfarin in whom the use of raltegravir was associated with a favourable outcome.

Non-operative management of blunt liver injury: a new protocol for selected hemodynamically unstable patients under hypotensive resuscitation

BACKGROUND

The objective of this study was to evaluate our new protocol for performing non-operative management for selected unstable patients under hypotensive resuscitation using improved diagnostic imaging techniques.

METHODS

This retrospective study included 77 consecutive patients with blunt liver injury. They were divided into two groups: those treated before and those treated after the revision. Under the new protocol, we attempted to manage the patients non-operatively, usually with angioembolization, including those whose shock improved with fluid resuscitation and continuous loading, permitting the maintenance of a target systolic blood pressure of 80 mmHg. The outcomes of the two groups were evaluated and compared.

RESULTS

While comparing the groups, although there was no change in the liver-related morbidity and mortality rates, the urgent and overall laparotomy rates and transfusion requirements in 24 h significantly decreased after the protocol revision. While comparing the subgroups of high-grade injury (AAST Grades 3-5), the overall laparotomy rates and transfusion requirements in 24 h significantly decreased after the protocol revision.

CONCLUSIONS

All the selected unstable patients were successfully managed non-operatively after the protocol revision. The decrease in laparotomy rates and transfusion requirements confirmed the feasibility of our new protocol for these selected patients.

Longitudinal distortions and transversal fluctuations of an actin filament sliding on Myosin molecules

An actin filament sliding on myosin moleculesdemonstrates both longitudinal distortions and transversal fluctuationswith the linear dimension far exceeding the diameter of an actinmonomer. Local swaying of a single actin filament was identified byreading speckled fluorescent markers attached on the filament. Theaccuracy of reading each speckled marker was about 10.4 nm (r.m.s.).Longitudinal distortions of an actin filament at a low ATP concentrationof 20 μM were as much as 0.5 μm for the average filament lengthof 5.4 μm. The magnitude of transversal fluctuations was as much as60 nm, that was independent of the filament length. Both longitudinaldistortions and transversal fluctuations are suggested to play a pivotalrole for facilitating a smooth sliding movement of an actin filament.

Enhancement of cytokine expression in transiently transfected cells by magnetoliposome mediated hyperthermia

We investigated the enhancement of cytokine expression by heat treatment in transiently transfected glioma cells. The cells were transfected with plasmid bearing the interferon (IFN)-β gene under control of the MMTV promoter, which is inducible by glucocorticoid (dexamethasone). Then magnetite particles (10 nm diameter) as intracellular heating material were incorporated to the cells as the form of magnetoliposome. After 5 hours of incorporation, alternative magnetic field (384Oe, 118kHz) was applied for intracellular heating. IFN-β secreted in the medium was assayed and its concentration was compared to the extracellular heating induced expression, both in the presence and absence of dexamethasone. Higher IFN-β concentration was detected in intracellular heating even at lower temperature, 39 °C, than 43 °C in extracellular heating. The IFN-β expression level reached in the presence of dexamethasone was about three times higher than in the absence of inducer. In intracellular heating of 60 min, the surviving cell number reduced until 20%.

Adaptive fuzzy control of nutrients concentration in fed-batch culture of mammalian cells

An adaptive fuzzy controller was developed to control the glucose and glutamine concentrations in the reactor constant at the desired level. The parameter values of the controller change during the cultivation according to the culture phase which was detected by the lactate concentration. Cultivations with different glucose and glutamine set point concentrations of a recombinant BHK anchorage-dependent cell line were performed in a fed-batch reactor on-line connected with an HPLC system. Glucose and glutamine concentrations were satisfactorily controlled at each set point during all cultivation periods. Ammonia had a determining effect on productivity since it inhibited cell growth and protein specific production. Ammonia production increased with an increase of glutamine or a decrease of glucose set point concentrations, indicating the importance of glucose to glutamine ratio for the optimization of productivity in mammalian cell cultures.

Ultrashort echo time imaging of normal middle ear ossicles: a feasibility study

OBJECTIVE

The aim of this study was to assess the feasibility of ultrashort echo time (UTE) imaging in the visualization of middle ear ossicles in normal subjects.

METHODS

12 young adult volunteers (males/females = 6/6, age 25-44 years, mean 30.3 years) with normal hearing levels underwent MRI studies using a 3.0 T clinical unit with an eight-channel SENSE head coil. For each subject, the whole head was imaged using a three-dimensional dual-echo UTE imaging sequence with radial trajectory and the following parameters: field of view, 240 × 240 × 240 mm; matrix, 320 × 320; flip angle, 7°; repetition time/echo time (TE)1/TE2, 8.0 ms/0.14 ms/1.8 ms; acquisition voxel size, 0.75 × 0.75 × 0.75 mm; number of signals averaged, 1; imaging time, 27 min 20 s. Subsequently, subtraction images were obtained by subtracting long TE (1.8 ms) images from short TE (0.14 ms) images. By using these three images, the visibility of the bilateral middle ear ossicles was evaluated. Moreover, as a reference for the UTE findings, CT images of the temporal bone were obtained in one volunteer.

RESULTS

In all subjects, the middle ear ossicles were clearly visualized as a high signal intensity spot surrounded by a signal void of air on short TE images bilaterally, while they were not visible in long TE images in any of the subjects. The subtraction images provided better contrast of the ossicles.

CONCLUSION

We demonstrated the feasibility of UTE imaging of the middle ear ossicle in normal subjects.

SU-E-I-62: Investigation of Dominant Factors Affecting Fatigue in Image Reading of Radiologists

PURPOSE

To investigate dominant factors affecting fatigue in image reading of radiologists.

METHODS

Two kinds of fatigue were assessed in this study. One was fatigue in the central nervous system evaluated by the critical fusion frequency (CFF). The other was eye fatigue evaluated by a score determined from a questionnaire based on the oculomotor strain subscale from the Simulator Sickness Questionnaire (SSQ). When fatigue increases, the CFF and the SSQ score indicate low and high values, respectively. The fatigue of seventeen radiologists was assessed before and after their daily image reading. The reading times and the numbers of images were different among the assessments, and ranged about 1.5 - 5.0 hours and 1,000 - 12,000 images, respectively. The assessments of fatigue were repeated four times for each radiologist on different days. Finally, the measurements of the two kinds of fatigue were analyzed in terms of years of experience, age, sleeping time the previous night, ambient light conditions, reading time, and the numbers of interpreted images, series, and cases.

RESULTS

The CFF and SSQ score after image reading were significantly lower and higher than those measured before image reading, respectively. Younger and less experienced radiologists indicated a higher level of fatigue than older and more experienced radiologists in both the CFF and the SSQ score. When radiologists interpreted clinical images for longer hours, the SSQ score tended to be higher. On the other hand, there was little incremental difference in the CFF among different lengths of reading time. No obvious differences were observed in the other items.

CONCLUSIONS

Less experience with reading images, a younger age, and a longer reading time could be dominant factors affecting fatigue in image reading.

Optimum microcurrent stimulation intensity for galvanotaxis in human fibroblasts

OBJECTIVE

In this study, we develop methods to measure galvanotaxis of fibroblasts and determined the optimum conditions of electrical stimulation.

METHOD

An inverted 35mm dish containing cell suspensions (3×105 primary human skin fibroblasts, DMEM, and 10% FBS) was placed on the centre of a 100mm dish. The 35mm dish was removed 24 hours later, and culture medium was added to the 100mm dish. Fibroblasts were randomised (double-blind) into three groups, where electrical stimulation was given at varying intensities: 0UA (control), 50UA, and 100UA. Electrical stimulation (frequency=0.3Hz) was conducted, for a duration of 4 hours, with platinum electrodes in a CO2 incubator. We took pictures immediately before and 20 hours after stimulation. We calculated the migration ratio to the negative pole by dividing the area of attached fibroblasts after stimulation with that before stimulation.

RESULTS

The migration ratio to the negative pole was significantly higher in the 100UA group than in the control group (p<0.05). The ratios were 0.902±0.292 in the control group, 1.128±0.253 in the 50UA group, and 1.24±0.300 in the 100UA group.

CONCLUSION

This study observed the change in cell proliferation during the initial 24-hour period after plating and was thus able to quantitatively evaluate the migration. The results suggest that a low-intensity direct current promotes migration to the negative pole of human dermal fibroblasts, which is charged with positive electricity. Several clinical reports using the methods in this study showed the microcurrent efficacy for pressure ulcer healing. Electrical stimulation based on our in vitro experiment might be important for the development of physical therapy for pressure ulcers.