Magnetic behavior of bulk and fine particles of RCr2Si2C (R = La, Ce) compounds: possible magnetic ordering from Cr

The magnetic behavior of the quaternary compounds, RCr(2)Si(2)C (R = La, Ce), has been investigated by magnetization (M) and heat-capacity (C) measurements (1.8-300 K) in the bulk polycrystals and nano forms (<1 µm) obtained by high-energy balling. Our finding is that Cr appears to exhibit magnetic ordering of an itinerant type at low temperatures (<20 K) in the bulk form, as inferred from a combined look at all the data. The magnetic ordering gets gradually suppressed with increasing milling time. Evidence for a mixed-valence state of Ce for the bulk form is obtained from the tendency of magnetic susceptibility to exhibit a maximum above 300 K. However, this feature vanishes in the nano form, which exhibits a Curie-Weiss behavior above 200 K as though Ce tends towards trivalency in these fine particles; in addition, there is a weak upturn in C/T below 10 K in the bulk, which becomes very prominent in the milled Ce-based specimens at lower temperatures, as though heavy-fermion behavior gets stronger in smaller particles.

Dopamine and cAMP regulated phosphoprotein MW 32 kDa is overexpressed in early stages of gastric tumorigenesis

BACKGROUND

Gastric adenocarcinoma is a leading cause of cancer mortality. The role of dopamine and cAMP regulated phosphoprotein MW 32 kDa (DARPP-32) overexpression in the gastric tumorigenesis cascade remains unclear.

METHODS

The expression of DARPP-32 in the multistep carcinogenesis cascade was examined using immunohistochemistry analysis on 533 samples. The contribution of DARPP-32 in cellular transformation and molecular signaling was investigated using NIH3T3, AGS, and SNU16 cells.

RESULTS

The composite expression score (CES), calculated from immunostaining patterns, increased significantly from normal or gastritis to metaplasia, dysplasia, and adenocarcinoma (P < .001). In patients with normal stomach or gastritis and tumor samples, a 76% and 77% chance, respectively, was found (P < .001) that CES was higher in the tumor. High median CES correlated with well- or moderately differentiated (P = .03) gastric adenocarcinomas. NIH3T3 cells transfected with DARPP-32 demonstrated increased levels of phospho-AKT and a 5-fold increase in the number of foci as compared with the control (P = .02). DARPP-32 expression in AGS cells led to increased protein levels of phospho-AKT and BCL-2. For validation, the knockdown of endogenous DARPP-32 expression in SNU16 cells using shRNA resulted in decreased levels of phospho-AKT phosphorylation and BCL-2.

CONCLUSION

Our results suggest that DARPP-32 overexpression may participate in the transition to intestinal metaplasia and in the progression to neoplasia. The ability of DARPP-32 to transform NIH3T3 cells and to regulate AKT and BCL-2 underscores its possible oncogenic potential.

Hydrogen sensing characteristics of wet chemical synthesized tailored Mg0.5Zn0.5Fe2O4 nanostructures

Solution based synthesis routes are attractive for making tailor-made nanostructures for electroceramics in a simple and cost-effective way. The gas sensing characteristics of semiconducting oxide gas sensors strongly depend on the adsorption and desorption of gases over the sensing surface. The morphology of the sensing element is known to influence the adsorption and desorption of gases and thereby the sensing performance of the material. In the present work a Pechini based solution synthesis route is adopted in order to synthesize magnesium zinc ferrite gas sensors in nanoparticle, nanotube and thin film forms. The hydrogen gas sensing characteristics of these sensing elements are compared as a function of test gas concentration and operating temperature. The influences of the morphology of the magnesium zinc ferrite sensing elements on the hydrogen sensing characteristics are discussed.

Early Fascial Closure of the Damage Control Abdomen in Children

Traditional staged closure of the damage control abdomen frequently results in a ventral hernia, need for delayed abdominal wall reconstruction, and risk of multiple complications. We examined the potential benefits in children of early fascial closure of the damage control abdomen using human acellular dermal matrix (HADM). We reviewed our experience with five consecutive children sustaining intra-abdominal catastrophe and managed with damage control celiotomy. To accomplish early definitive abdominal closure, HADM was sewn in place as a fascial substitute; the skin and subcutaneous layers were approximated over silicone drains. The five patients ranged in age from 1 month to 19 years at the time of presentation. Intra-abdominal catastrophes included complex bowel injuries after blunt trauma in two children, necrotizing pancreatitis and gastric perforation in one teenager, necrotizing enterocolitis in one premature infant, and perforated typhlitis in one adolescent. All damage control wounds were dirty. Time range from initial celiotomy to definitive abdominal closure was 6 to 9 days. After definitive closure, one child developed a superficial wound infection. No patient developed a ventral hernia. After damage control celiotomy in children, early abdominal wall closure using HADM may minimize complications associated with delayed closure techniques and the need for additional procedures.

Early fascial closure of the damage control abdomen in children

Traditional staged closure of the damage control abdomen frequently results in a ventral hernia, need for delayed abdominal wall reconstruction, and risk of multiple complications. We examined the potential benefits in children of early fascial closure of the damage control abdomen using human acellular dermal matrix (HADM). We reviewed our experience with five consecutive children sustaining intra-abdominal catastrophe and managed with damage control celiotomy. To accomplish early definitive abdominal closure, HADM was sewn in place as a fascial substitute; the skin and subcutaneous layers were approximated over silicone drains. The five patients ranged in age from 1 month to 19 years at the time of presentation. Intra-abdominal catastrophes included complex bowel injuries after blunt trauma in two children, necrotizing pancreatitis and gastric perforation in one teenager, necrotizing enterocolitis in one premature infant, and perforated typhlitis in one adolescent. All damage control wounds were dirty. Time range from initial celiotomy to definitive abdominal closure was 6 to 9 days. After definitive closure, one child developed a superficial wound infection. No patient developed a ventral hernia. After damage control celiotomy in children, early abdominal wall closure using HADM may minimize comq plications associated with delayed closure techniques and the need for additional procedures.

Reducing gas sensing behavior of nano-crystalline magnesium-zinc ferrite powders

As an effective alternative of simple binary oxides, cubic spinel oxides are considered to be attractive to make sensitive and stable gas sensor, selective to a specific gas. We have focused the present work on the investigation of the gas sensing characteristics of cubic spinel based nano-crystalline magnesium zinc ferrite powders. A wet chemical synthesis route is adopted to synthesize nano-crystalline magnesium zinc ferrite powders. The phase formation behavior and microstructure evolution of the synthesized powder has been investigated using infrared spectroscopy in conjunction with X-ray diffraction analyses and electron microscopy. The n-type semiconducting magnesium-zinc ferrite ceramic exhibits reasonably good sensitivity towards a variety of gases including carbon monoxide, hydrogen, methane and nitrous oxide. It is demonstrated that these sensors can be made selective to hydrogen gas sensing by modulating the operating temperature. The conductance transients during response and recovery processes have been modeled using Langmuir adsorption isotherm and activation energies for gas adsorption and desorption processes have been estimated from the respective thermally activated kinetic processes.

Magnetic and electrical transport anomalies of RMAs(2) (R = Pr and Sm, M = Ag and Au)

The results of magnetization, heat capacity and electrical resistivity (ρ) studies of the compounds RMAs(2) (R = Pr and Sm; M = Ag, Au), crystallizing in an HfCuSi(2)-derived structure, are reported. PrAgAs(2) orders antiferromagnetically at T(N) = 5 K. The Au analog, however, does not exhibit long range magnetic order down to 1.8 K. We infer that this is due to subtle differences in their crystallographic features, particularly noting that both the Sm compounds with identical crystal structures as that of the former order magnetically nearly at the same temperature (about 17 K). It appears that, in PrAgAs(2), SmAgAs(2) and SmAuAs(2), there is an additional magnetic transition at a lower temperature, as though the similarity in the crystal structure results in similarities in magnetism as well. The ρ for PrAgAs(2) and PrAuAs(2) exhibits a negative temperature coefficient in some temperature range in the paramagnetic state. SmAuAs(2) exhibits a magnetic Brillouin-zone gap effect in ρ at T(N), while SmAgAs(2) shows a well-defined broad minimum well above T(N) around 45 K. Thus, these compounds reveal interesting magnetic and transport properties.

Potential pitfalls of a double PCL sign

The double posterior cruciate ligament (PCL) sign is seen on a midline sagittal MR image of the knee as a low-signal-intensity linear band paralleling the antero-inferior part of the PCL. Although the sign has a high specificity for a displaced bucket-handle tear of the medial meniscus, it can be mimicked by several normal and abnormal structures in the intercondylar region. Familiarity with these variants and identifying the other features supportive of meniscal injury will help to make a confident diagnosis of bucket-handle tear of the medial meniscus.

Coronary-to-pulmonary artery collateral in tetralogy of Fallot

Angiography in a 14-year-old boy with cyanosis since birth confirmed the diagnosis of tetralogy of Fallot with a subaortic ventricular septal defect, large overriding aorta, severe pulmonary stenosis, and a large collateral arising from the left circumflex artery. The collateral was isolated and ligated at its origin, and the patient underwent an uneventful repair with ventricular septal defect patch closure, infundibular resection, pulmonary valvotomy, and right ventricular outflow tract reconstruction with an autologous pericardial patch.

Vacuum-pack temporary abdominal wound management with delayed-closure for the management of ruptured abdominal aortic aneurysm and other abdominal vascular catastrophes: absence of graft infection in long-term survivors

Patients who undergo open repair of ruptured abdominal aortic aneurysms (rAAA) may require delayed abdominal wound closure to prevent the adverse consequences of intra-abdominal hypertension and abdominal compartment syndrome. However, surgeons may be reticent to use delayed abdominal closure techniques due to concern that such management may increase the risk of graft infection. We retrospectively reviewed our patient experience with rAAA and other vascular catastrophes in which vacuum-pack abdominal wound management with delayed closure was used between 2000 and 2007. Eighteen of 23 patients treated with delayed closure survived (78%). In five early deaths, graft infection was not clinically suspected. Sixteen of 20 rAAA patients survived, with abdominal wound closure achieved at a mean of 4 days. Mean follow up was 53 months, the longest among comparable series. Graft infection has not been encountered in this group. Our results suggest that the potential risk of graft infection should not outweigh the benefits of vacuum-pack temporary abdominal wound management with delayed closure in critically ill patients at high risk for intra-abdominal hypertension and abdominal compartment syndrome after major abdominal vascular procedures.

Vacuum-Pack Temporary Abdominal Wound Management with Delayed-Closure for the Management of Ruptured Abdominal Aortic Aneurysm and Other Abdominal Vascular Catastrophes: Absence of Graft Infection in Long Term Survivors

Patients who undergo open repair of ruptured abdominal aortic aneurysms (rAAA) may require delayed abdominal wound closure to prevent the adverse consequences of intra-abdominal hypertension and abdominal compartment syndrome. However, surgeons may be reticent to use delayed abdominal closure techniques due to concern that such management may increase the risk of graft infection. We retrospectively reviewed our patient experience with rAAA and other vascular catastrophes in which vacuum-pack abdominal wound management with delayed closure was used between 2000 and 2007. Eighteen of 23 patients treated with delayed closure survived (78%). In five early deaths, graft infection was not clinically suspected. Sixteen of 20 rAAA patients survived, with abdominal wound closure achieved at a mean of 4 days. Mean follow up was 53 months, the longest among comparable series. Graft infection has not been encountered in this group. Our results suggest that the potential risk of graft infection should not outweigh the benefits of vacuum-pack temporary abdominal wound management with delayed closure in critically ill patients at high risk for intra-abdominal hypertension and abdominal compartment syndrome after major abdominal vascular procedures.

Blunt posterior tracheal laceration and esophageal injury in a child

Blunt force trauma to the neck can result in the unusual injury pattern of laceration of the posterior tracheal wall in combination with esophageal injury. We present the report of a 10-year-old child who had blunt cervical trauma because of a bicycle accident and subsequently presented with profound subcutaneous emphysema. This case was addressed with operative management with a good result. The essential management principles for this rare constellation of injuries include a high index of suspicion, early control of the airway, endoscopic and radiographic diagnosis, and use of a buttressing strap muscle flap in the event of operative management to prevent delayed complications, including leak and tracheoesophageal fistula.

Selective substitution in orbital domains of a low doped manganite: an investigation from Griffiths phenomenon and modification of glassy features

An effort is made to study the contrast in magnetic behavior resulting from minimal disorder introduced by substitution of 2.5% Ga or Al in Mn site of La(0.9)Sr(0.1)MnO(3). It is considered that Ga or Al selectively create disorder within the orbital domains or on its walls, causing enhancement of Griffiths phase (GP) singularity for the former and disappearance of it in the latter case. It is shown that Ga replaces Mn(3+), which is considered to be concentrated within the domains, whereas Al replaces Mn(4+), which is segregated on the hole-rich walls, without causing any significant effect on structure or ferromagnetic transition temperatures. Thus, it is presumed that the effect of disorder created by Ga extends across the bulk of the domain having correlation over a similar length scale, resulting in enhancement of the GP phenomenon. In contrast, the effect of disorder created by Al remains restricted to the walls, resulting in the modification of the dynamics arising from the domain walls and suppresses the GP. Moreover, contrasting features are observed in the low temperature region of the compounds; a re-entrant spin-glass-like behavior is observed in the Ga-doped sample, while the observed characteristics for the Al-doped sample are ascribed only to modified domain wall dynamics with the absence of any glassy phase. Distinctive features in third-order susceptibility measurements reveal that the magnetic ground state of the entire series comprises of orbital domain states. These observations bring out the role of the nature of disorder on the GP phenomenon and also reconfirms the character of self-organization in low doped manganites.

Acquired left atrial-to-right ventricular shunt with mitral valve incompetence: a rare sequela after repair of atrioventricular septal defect

Acquired left ventricular-to-right atrial communication is encountered periodically. This condition is chiefly attributable to surgical mishaps, trauma, endocarditis, or endomyocardial biopsy. In a few instances, a Gerbode-like defect develops after the repair of an atrioventricular septal defect. Our search of the worldwide medical literature revealed just 1 report of a "mirror" occurrence of a Gerbode-like defect: a shunt between the left atrium and the right ventricle. Herein, we present the case of a 22-year-old woman who had severe mitral valve incompetence accompanying an acquired shunt between the left atrium and the right ventricle-a late sequela of the earlier repair of an atrioventricular septal defect. After surgical correction of the shunt and the associated mitral incompetence, the patient experienced a good outcome.Echocardiographic and intraoperative findings are presented, along with a plausible explanation for the mechanism and presentation of the condition in our patient. To our knowledge, this is only the 2nd report of an acquired shunt between the left atrium and the right ventricle, and the 1st such case to be accompanied by severe mitral valve incompetence.

Antegrade and Retrograde Endoscopy for Treatment of Esophageal Stricture

Total or near-total esophageal stricture results from multiple processes. Traditional treatment with wire cannulation followed by serial dilation is often contraindicated due to poor visualization and the risk of perforation. We seek to demonstrate that combined antegrade and retrograde endoscopy are useful for treatment of total or near-total esophageal strictures. The gastrostomy tube is removed and the tract dilated. A standard endoscope is passed retrograde to the stricture. An antegrade endoscope is advanced until transillumination across the stricture is visualized. A biopsy forceps or needle is used to traverse the stricture in an antegrade fashion. The tract is cannulated with a stiff wire that is then brought out through the gastrostomy site. The stricture is serially dilated. The gastrostomy tube is replaced, and a nasogastric tube is left across the stricture for 3 to 4 weeks. The endoscope is withdrawn and an 18 or 20 Fr gastrostomy tube is left in place. A total of three patients with total esophageal strictures were treated using combined antegrade and retrograde esophagoscopy. All three patients regained the ability to swallow secretions. Importantly, there were no instances of esophageal perforation. This technique has broader application, including combination with minilaparotomy for patients without retrograde access. Further research is needed to determine durability of stricture dilation.

Antegrade and retrograde endoscopy for treatment of esophageal stricture

Total or near-total esophageal stricture results from multiple processes. Traditional treatment with wire cannulation followed by serial dilation is often contraindicated due to poor visualization and the risk of perforation. We seek to demonstrate that combined antegrade and retrograde endoscopy are useful for treatment of total or near-total esophageal strictures. The gastrostomy tube is removed and the tract dilated. A standard endoscope is passed retrograde to the stricture. An antegrade endoscope is advanced until transillumination across the stricture is visualized. A biopsy forceps or needle is used to traverse the stricture in an antegrade fashion. The tract is cannulated with a stiff wire that is then brought out through the gastrostomy site. The stricture is serially dilated. The gastrostomy tube is replaced, and a nasogastric tube is left across the stricture for 3 to 4 weeks. The endoscope is withdrawn and an 18 or 20 Fr gastrostomy tube is left in place. A total of three patients with total esophageal strictures were treated using combined antegrade and retrograde esophagoscopy. All three patients regained the ability to swallow secretions. Importantly, there were no instances of esophageal perforation. This technique has broader application, including combination with minilaparotomy for patients without retrograde access. Further research is needed to determine durability of stricture dilation.

The Oxford unicompartmental knee arthroplasty: a radiological perspective

Unicompartmental knee arthroplasty (UKA) is increasingly being performed in both specialist centres as well as district hospitals. The radiologists should be aware of the required preoperative imaging, the normal appearance, and complications of this procedure. Unfortunately, very little is available in the radiology literature. This review aims to provide a radiological perspective to an already widely used procedure.

Ghosal type hemato-diaphyseal dysplasia: a rare variety of Engelmann's disease

Ghosal type hemato-diaphyseal dysplasia is a recently described clinical entity. The authors describe such a case with severe anemia requiring transfusions and with clinical and radiological evidence of diaphyseal dysplasia. Very few such cases are reported in world literature.

Peri-operative Renal Function and Outcome after Orthotopic Heart Transplantation

BACKGROUND

Renal insufficiency is an established risk factor in patients undergoing cardiovascular surgery. We sought to evaluate the relationship between renal function and outcomes after orthotopic heart transplantation (OHT).

METHODS

We conducted a retrospective review of 622 adults who underwent 628 consecutive OHTs between 1994 and 2001 at our institution. The recipients were divided into either normal (Group 1) or impaired (Group 2) pre-operative renal function. Impaired renal function was defined as creatinine clearance (CrCl) < 40 ml/min (Cockroft-Gault formula). Meanwhile, patients in Group 1 (normal) were defined by CrCl > or = 40 ml/min. The primary end points of the study were early and late mortality. The secondary end point included post-operative renal failure defined by the requirement of dialysis or renal allograft in the early post-operative period. The Kaplan-Meier method was used to determine actuarial survival.

RESULTS

Early mortality was 7% (38/531) in Group 1 and 17% (16/96) in Group 2 (p = 0.002). Similarly, the death rate per 100 patient-years was 4.8 and 8.1 for the groups, respectively (p = 0.03). Nine percent of patients in Group 1 required post-operative dialysis (49/531), whereas 32% of recipients in Group 2 required this intervention (31/96) (p < 0.001). Early mortality was 41% for patients requiring post-operative dialysis and 3% for those not requiring such intervention (p < 0.001). Early mortality after post-operative dialysis was 41% (20/49) in Group 1 and 42% (13/31) in Group 2 (p = 0.2).

CONCLUSIONS

CrCl < 40 ml/min is a useful marker for increased post-operative renal failure and mortality. Recipients who require post-operative dialysis have greatly increased mortality regardless of pre-operative CrCl. Dialysis in patients after heart transplantation carries a prohibitive risk. Dialysis as a bridge to renal transplantation may reduce this high mortality rate.

Inhibition of Chronic Rejection by Antibody Induced Vascular Accommodation in Fully Allogeneic Heart Allografts

BACKGROUND

The potential role of altered antibody responses as an effector protective mechanism to induce graft accommodation has been widely investigated in xenogeneic responses. Here we investigate the protective effects of antibody binding to vascular endothelium in a fully mismatched allogeneic model of heart transplantation.

METHODS

ACI recipients of WF cardiac grafts were treated either with allochimeric [alpha1h ]-RT1.A class I major histocompatibility complex (MHC) extracts (1 mg/rat, p.v. day 0) or high dose of CsA (10 mg/kg/day, p.o., day 0-6). Cardiac allografts were evaluated at 100 days posttransplant by immunohistology for evidence of chronic rejection and/or vascular accommodation. Activation of apoptotic or antiapoptotic mechanisms was verified by DNA fragmentation (TUNEL) analysis.

RESULTS

Allochimeric therapy resulted in inhibition of chronic rejection, absence of neointimal formation and induction of vascular accommodation of fully allogeneic WF hearts in ACI hosts. Such accommodation was evident by IgG and IgM vascular endothelial binding and marked reduction of DNA fragmentation. In contrast, CsA therapy resulted in marked neointimal proliferation, without evidence of vascular accommodation. Immunohistochemical analysis failed to demonstrate vascular endothelial antibody binding. Further, severe chronic rejection following CsA treatment was accompanied by marked DNA fragmentation.

CONCLUSION

Alteration of humoral immunity induces vascular accommodation in allogeneic transplantation. Vascular accommodation is the underlying mechanism for inhibition allograft vasculopathy following allochimeric MHC class I therapy.

Does duration of donor brain injury affect outcome after orthotopic pediatric heart transplantation?

OBJECTIVE

We tested the hypothesis that duration of donor brain injury and death would have an adverse effect on recipient rejection and mortality in pediatric heart transplantation.

METHODS

Ninety-three cardiac transplants were performed at our center from July 1, 1997, through June 30, 2003. The primary study end points were the number of rejection episodes and the time to first rejection. Secondary outcomes were early and late mortality.

RESULTS

Among 88 recipients of 93 cardiac allografts, 5 (6%) and 1 (1%) received second and third allografts, respectively. Overall patient mortality (3 early and 2 late) was 6% (5/88), and overall graft loss was 6% (6/93). Median time from donor brain injury to declaration of brain death (brain injury interval), time from brain death to donor cardiectomy (brain death interval), and graft ischemia time were 38, 24, and 3.3 hours, respectively. Cox regression analysis (adjusting for United Network for Organ Sharing status, ventilator dependence, extracorporeal membrane oxygenation and ventricular-assist device status, diagnosis of congenital heart disease, sex and cytomegalovirus mismatches, and type of immunosuppression) demonstrated that recipients of donor hearts with relatively long periods from brain injury to death declaration or from death to organ removal had significantly improved rejection-free survival (hazard ratios 0.3, P = .01, and 0.5, P = .05, for brain injury and brain death times, respectively). Prolonged donor heart ischemia did not impact rejection rate. Increasing brain injury interval, brain death interval, and graft ischemia time had no significant effect on mortality.

CONCLUSION

Longer brain injury and death intervals correlated with improved freedom from rejection but had no effect on mortality.

Influence of sweet tasting solutions on opioid withdrawal

The effect of the ingestion of palatable fluids on the suppression of opioid withdrawals in the opioid-dependent rats was studied. Physical dependence was induced by administration of morphine over a period of 6 days. Withdrawals were precipitated with naloxone (1 mg/kg, s.c.) 4 h after the last morphine injection on the 6th day. Test drugs (10-30% sucrose solution) were given orally for 2 h prior to naloxone-induced withdrawal in 14 h water deprived rats. Somatic signs of withdrawals were scored by using the global Gellert-Holtzman rating scale. Animals pretreated with low doses of sucrose solution (10-15%) did not produce any effect on the global withdrawal scale whereas a significant decrease on the global withdrawal scores was observed at higher doses of sucrose solution (20-30%) as compared to the controls. All the individual behavioral signs of withdrawals were significantly suppressed in a dose-related manner at higher doses of sucrose solutions whereas minimal suppression was observed for facial fasciculation/teeth chattering. These findings provide support that ingestion of high concentrations of sucrose solutions for shorter duration may activate the endogenous opioid system and appears to have an important role in modifying morphine withdrawals.

Posttransplant administration of allochimeric major histocompatibility complex class-I-molecules induces true transplantation tolerance

BACKGROUND

Allochimeric class-I major histocompatibility complex (MHC) molecules that contain donor-type immunogenic epitopes displayed on recipient-type sequences were shown to induce transplantation tolerance when administered at the time of transplantation. Here, we investigated the ability of posttransplant allochimeric administration to induce tolerance and concomitantly inhibit chronic rejection.

METHODS

Allochimeric (alpha1h(1/u))-RT1.Aa class-I MHC antigenic extracts were administered by way of the portal vein into ACI recipients of Wistar-Firth (WF) hearts at days +3, +7, and +10 posttransplantation in conjunction with subtherapeutic oral cyclosporine.

RESULTS

Delayed posttransplant allochimeric administration induced donor-specific transplantation tolerance to rat cardiac allografts. In contrast, delayed delivery of unaltered donor- or recipient-type MHC extracts failed to prolong allograft survival. In addition, histopathologic examination or estimation of transplant vascular sclerosis by neointimal index assessment, following delayed allochimeric therapy, revealed intact global architecture and minimal intimal thickening, respectively.

CONCLUSION

Allochimeric MHC class-I therapy is a unique and novel clinically applicable approach for induction of "true" transplantation tolerance where chronic rejection is concomitantly abrogated.

A comparison of total intravenous with balanced anaesthesia for middle ear surgery: effects on postoperative nausea and vomiting, pain, and conditions of surgery

We compared postoperative nausea and vomiting (PONV), pain and conditions for surgery in patients scheduled for middle ear surgery. In a double-blind study, 100 patients were randomly allocated to receive either balanced anaesthesia (group A) using fentanyl, propofol and isoflurane, or total intravenous anaesthesia (group B) using propofol and remifentanil infusions. Pain scores, nausea/vomiting scores, conditions for surgery and analgesic requirements were recorded for 18 h post operatively. In the recovery ward, patients in group B suffered significantly less PONV (p = 0.026) with a reduced requirement for anti-emetic medication (p = 0.023); however, this difference was not maintained on the ward. The overall incidence of PONV was 34% and 17% in groups A and B, respectively. Initial pain scores were higher in group B in the recovery ward (p = 0.003) and patients required more morphine administration (p = 0.002); however, pain scores were similar on the ward. Conditions for surgery were found to be better in group B.

Hyperalgesic response in rats fed sucrose from weaning to adulthood: role of VMH

The ventromedial nucleus of hypothalamus (VMH) is implicated in food intake, food preference, nociception and its modulation by palatable food. Palatable drink for 5-48 h in adult rat produced hyperalgesia, which is mediated by VMH. The effect of palatable dietary supplement after weaning on the nociceptive response in adult rats has not been reported. Whether or not VMH influences these nociceptive responses is also not known. The present study was therefore undertaken to investigate the effect of VMH lesion on the nociceptive responses in adult rats ingesting (ad libitum) sucrose from weaning. Weanling rats received sucrose solution in addition to drinking water and laboratory pellets (sucrose-fed group), while the control group of rats received laboratory pellets alone. On attaining adulthood, the behavioral responses, namely tail flick latency (TFL), thresholds of tail flick (TF), vocalization during stimulus (SV), and vocalization after discharge (VA) to phasic and formalin pain rating (FP) to tonic noxious stimuli, were noted in pre- and post-VMH lesion states of both groups of rats. In chronic sucrose-fed rats, the TFL was not affected, the thresholds of TF, SV and VA were significantly decreased (P<.001) and the FP was increased in comparison to the control group, suggesting a hyperalgesic response to chronic sucrose ingestion. After the VMH lesion, in sucrose-fed rats, the thresholds of TF, SV and VA remained unaltered, while the FP was attenuated and TFL decreased. In control rats, VMH lesion produced a hyperalgesic response to both the phasic and tonic noxious stimuli. The data indicate that chronic sucrose feeding and VMH lesion differentially affect the nociceptive responses to the phasic and tonic noxious stimuli. These results suggest that chronic sucrose feeding from weaning to adulthood produces hyperalgesia to both the tonic and phasic noxious stimuli (except TFL), which is probably mediated by VMH.

Genetic screening using the colour change of a PNA-DNA hybrid-binding cyanine dye

As the relationship between human genes and various malfunctions and diseases becomes revealed at an ever-increasing pace, the need arises for the development of rapid genetic screening methods for diagnostic purposes. Genetic diseases show great diversity. Some are caused by a few characteristic localised mutations, while others arise from a large number of variations. Hence, it is unlikely that a single, general diagnostic method that applies to all cases will ever exist. Instead, a combination of methods is frequently applied. Here we propose the use of a dramatic colour change that a cyanine dye, 3,3'-diethylthiadicarbocyanine, displays upon binding to DNA-PNA duplexes. This method could become an inexpensive, fast and simple genetic screening test by visual inspection, with no need for complicated equipment. Our results demonstrate that this diagnostic method may be sufficiently sensitive to discriminate between even a fully complementary and a single mutation DNA sequence.

Identification of a critical lysine residue at the active site in glyceraldehyde-3-phosphate dehydrogenase of Ehrlich ascites carcinoma cell. Comparison with the rabbit muscle enzyme

The involvement of the lysine residue present at the active site of Ehrlich ascites carcinoma (EAC) cell glyceraldehyde-3-phosphate dehydrogenase (Gra3PDH) was investigated by using the lysine specific reagents trinitrobenzenesulfonic acid (TNBS) and pyridoxal phosphate (PP). Both TNBS and PP inactivated EAC cell Gra3PDH with pseudo-first-order kinetics with the rate dependent on modifier concentration. Kinetic analysis, including a Tsou plot, indicated that both TNBS and PP apparently react with one lysine residue per enzyme molecule. Two of the substrates, d-glyceraldehyde-3-phosphate and NAD, and also NADH, the product and competitive inhibitor, almost completely protected the enzyme from inactivation by TNBS. A comparative study of Gra3PDH of EAC cell and rabbit muscle indicates that the nature of active site of the enzyme is significantly different in these two cells. A double inhibition study using 5,5'-dithiobis(2-nitrobenzoic acid) and TNBS and subsequent reactivation of only the rabbit muscle enzyme by dithiothreitol suggested that a cysteine residue of this enzyme possibly reacts with TNBS. These studies on the other hand, confirm that an essential lysine residue is involved in the catalytic activity of the EAC cell enzyme. This difference in the nature of the active site of EAC cell Gra3PDH that may be related to the high glycolysis of malignant cells has been discussed.

Adenotonsillectomy in children: a comparison of morphine and fentanyl for peri-operative analgesia

This study compared the effectiveness and side-effects of intra-operative fentanyl with fentanyl and morphine for elective adenotonsillectomy in a double-blind study, in 60 children randomly allocated to receive either intravenous fentanyl 1 microg x kg(-1) intra-operatively or intramuscular morphine 100 microg x kg(-1) at induction. All children received a standard anaesthetic induction with intravenous fentanyl 1 microg x kg(-1) and propofol 4-5 mg x kg(-1) and maintenance with oxygen, nitrous oxide and isoflurane. Pain scores, emetic episodes and supplemental morphine requirements were recorded for 24 h postoperatively. The overall incidence of postoperative vomiting was high in both groups: 70% in the fentanyl group and 78% in the morphine group. The incidence of postoperative vomiting was lower in the fentanyl group (p < 0.03) in the first 4 h, but similar by 24 h. Children who received morphine at any time in the first 24 h had more median (range) episodes of vomiting [2 (0-7)] than children receiving fentanyl only [l (0-3); p < 0.03]. Administration of rescue anti-emetics, pain scores in recovery and pain scores over the next 24 h were similar between the two groups.

Urinary stress incontinence in obese women: tension-free vaginal tape is the answer

OBJECTIVE

To determine the effectiveness of the tension-free vaginal tape (TVT) in obese women with genuine stress incontinence (GSI), in whom obesity is often considered a relative contraindication to surgical treatment by traditional approaches, e.g. Burch colposuspension and slings (which are difficult and carry increased morbidity) or injectable agents (which although simple, are unpredictable and expensive).

PATIENTS AND METHODS

Data on 242 consecutive women with urodynamically proven GSI were collected prospectively. The women were subdivided into three groups with a body mass index (BMI) of < 25, 25-29 and >or=30; obesity was defined as a BMI of >or=30. All procedures were performed under spinal anaesthesia. The King's validated quality of life (QoL) questionnaires (version 7) were completed before and 6 months after surgery. The subjective results were defined as a cure, significant improvement or failure.

RESULTS

Almost 90% of the obese women with GSI were cured, while the remaining 10% noted a considerable improvement in their symptoms. There was no significant difference in cure rates among the three groups. There was a highly significant (P < 0.001) improvement in QoL in all groups.

CONCLUSION

The TVT is at least as effective in obese women as in those with a lower BMI. The TVT is a simple and minimally invasive procedure, with low morbidity even in the obese group. TVT can be offered confidently to all obese women with GSI.

SopE acts as an Rab5-specific nucleotide exchange factor and recruits non-prenylated Rab5 on Salmonella-containing phagosomes to promote fusion with early endosomes

Rab-GTPase regulates the fusion between two specific vesicles. It is well documented that, for their biological function, Rab proteins need to be prenylated for attachment to the vesicle membrane. In contrast, we showed in the present investigation that SopE, a type III secretory protein of Salmonella, translocates onto Salmonella-containing phagosomes (LSP) and mediates the recruitment of non-prenylated Rab5 (Rab5:DeltaC4) on LSP in GTP form. Simultaneously, SopE present in infected cell cytosol acts as an Rab5-specific exchange factor and converts the inactive Rab-GDP to the GTP form. The non-prenylated Rab5 subsequently promoted efficient fusion of LSP with early endosomes. This is the first demonstration that a prenylation-deficient Rab protein retains biological activity and can promote vesicle fusion, if it is recruited on the membrane by some other method.

Effect of VMH lesion on sucrose-fed analgesia in formalin pain

The ingestion of sucrose (ad libitum) produces an immediate analgesic response to phasic noxious stimuli. The underlying mechanism for the analgesic effect of sucrose is attributed to its palatability, which mediates analgesia probably by the release of beta-endorphin in the hypothalamus. The present study was designed to explore the role of ventromedial hypothalamus in the mediation of sucrose-fed analgesia. Adult male albino rats each received (20%) sucrose solution orally through a separate bottle until they had ingested 4-5 ml. Their behavioral responses to tonic noxious stimulus in a formalin test were studied in pre- and postsucrose-fed rats of control and in the VMH lesion groups. The average pain rating of a 60-min session significantly (p < 0.01) decreased after sucrose feeding in control rats, from 1.94 +/- 0.13 to 1.45 +/- 0.14, but sucrose feeding by the VMH lesion rats did not alter their tonic nociceptive response from a 1.70 +/- 0.07 presucrose-fed state to a 1.71 +/- 0.08 postsucrose-fed state. VMH lesion per se did not alter the nociceptive response in comparison with controls. The results suggest that sucrose feeding produces analgesia to tonic noxious stimulus, which is abolished by lesion of the VMH, thereby indicating a significant role of VMH in sucrose-fed analgesia.

Ventromedial hypothalamic mediation of sucrose feeding induced pain modulation

Electrophysiological and behavioural studies suggest a modulatory role of ventromedial nucleus of the hypothalamus (VMH) in nociceptive behaviour. Lesion of the VMH produces hyperalgesia and a greater preference for sucrose solution. Hyperalgesia is also produced by sucrose feeding. To explore specifically the contribution of glucoreceptor neurons of the VMH in the mediation of sucrose-fed hyperalgesia, 2-deoxy-D-glucose (2-DG, antimetabolite of glucose) was slowly albeit continuously infused (1 microl/h for 7 days by microinfusion pumps) into the VMH of adult male rats. Simultaneously, the rats underwent tests for their nociceptive responses in control and sucrose-fed states. The tests for nociception, namely, tail flick latency (TFL), thresholds of tail flick (TF), vocalization during stimulus (SV), vocalization after discharge (VA) were recorded at 0500 h. The tests were repeated after 6, 12, and 48 h in 1 M saline (control group) and 2-DG (experimental group) microinfused rats. Rats were presented with sucrose (20%) solution for 48 h at 0500 h ad libitum in addition to food pellets and tap water. Infusion of 2-DG per se in the VMH led to hypoalgesia (in threshold of TF, SV, VA) while feeding sucrose for 6-12 h per se led to hyperalgesia (in TFL, threshold of SV and VA). Sucrose feeding to 2-DG rats, however, attenuated the hypoalgesia of 2-DG as well as the hyperalgesia of sucrose feeding. The results suggest that the VMH glucoreceptor neurons probably modulate sucrose mediated phasic pain responses.

Evaluation of antidiarrhoeal profile of Jussiaea suffruticosa linn. extract in rats

The antidiarrhoeal potential of a methanol extract of the aerial parts of Jussiaea suffruticosa Linn. (MEJS) was studied with several experimental models of diarrhoea in rats. MEJS treated rats showed significant inhibitory activity against castor oil induced diarrhoea and PGE(2) induced enteropooling. It also showed a significant reduction in gastrointestinal motility following a charcoal meal in rats. The extract exhibited significant antidiarrhoeal potential at doses of 100,200 and 300 mg/kg in all the animal models and thus established the efficacy of MEJS as a potent antidiarrhoeal agent.

Apoptotic germ-cell death and testicular damage in experimental diabetes: prevention by endothelin antagonism

This paper explores the role of endothelins (ETs) in diabetes-induced testicular damage by investigating, in a temporal manner, testes from streptozotocin (STZ)-induced diabetic rats. Testicular and epididymal weights and testicular morphology were assessed. Cell death was evaluated by light microscopy using conventional staining and morphology, and by apoptotic cell staining using the Terminal deoxynucleotidyl transferase-mediated dUTP Nick End-Labeling (TUNEL) technique. Expression of endothelin-1 (ET-1) mRNA was evaluated by a semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) method. Furthermore, effects of a mixed ETA and ETB receptor antagonist, bosentan, were studied. Testicular weights did not show any change at 1 month of follow-up, but were decreased after 6 months of diabetes. However, epididymal weights were significantly decreased at the end of both time periods in the diabetic rats. Morphological evaluations of the testes from diabetic rats showed a reduction in seminiferous tubular diameter, an increase in the number of empty testicular tubules and an increase in vascular density. Furthermore, degenerated germ cells and TUNEL-positive cells were significantly higher in diabetic rats than in control animals. The changes in diabetic animals were associated with increased ET-1 mRNA expression and were prevented by bosentan treatment. Administration of bosentan prevented decreased testicular weights, reduced seminiferous tubule diameters, increased vascular densities and incidences of degenerated and apoptotic germ cells and empty tubules in diabetic rats at the long-term follow-up. These results demonstrated that an ET-1 mediated pathway might be involved in testicular injury and germ-cell apoptosis in diabetes.