Over-expression of protein kinase C isoforms (α, δ, θ and ζ) in squamous cervical cancer

Protein kinase C was found to be significantly over-expressed in cancer samples compared to adjacent normal cervical tissues by proteomics in our previous study. The aim of this study was to examine protein kinase C expression and to analyze the expression patterns of protein kinase C isoforms in squamous cervical cancer at the protein levels and their associations with clinical and pathologic factors of squamous cervical cancer. First, Western blotting was used to examine protein kinase C expression in the specimens of tumors and matched adjacent normal tissues which were collected from 12 patients with squamous cervical cancer. Protein kinase C isoforms (α, δ, θ and ζ) expression were then detected by immunohistochemistry in other 43 cases of squamous cervical cancer tissues, 32 cases of corresponding adjacent normal cervical squamous epithelial tissue and 31 cases of cervical intraepithelial neoplasia. Western blot analysis revealed that protein kinase C expression was positive in squamous cervical cancer while it was not expressed in normal cervical tissues. On the other hand, immunohistochemical analysis suggested that, protein kinase C isoforms (α, δ, θ and ζ) expression was significantly higher in squamous cervical cancer compared to cervical intraepithelial neoplasia, as well as in cervical intraepithelial neoplasia compared with normal tissues, respectively.High levels of protein kinase C α expression were associated with cellular differentiation(P<0.05). Protein kinase C δ was significantly associated with tumor stage (P<0.05) and protein kinase C ζ was associated with lymphatic metastasis (P < 0.05). These findings indicate that protein kinase C isoforms expression in cervical lesions was associated with carcinogenesis and might play important roles throughout the process of cervical cancer development.

Study of scattering from a sphere with an eccentrically located spherical inclusion by generalized Lorenz-Mie theory: internal and external field distribution

Based on the recent results in the generalized Lorenz-Mie theory, solutions for scattering problems of a sphere with an eccentrically located spherical inclusion illuminated by an arbitrary shaped electromagnetic beam in an arbitrary orientation are obtained. Particular attention is paid to the description and application of an arbitrary shaped beam in an arbitrary orientation to the scattering problem under study. The theoretical formalism is implemented in a homemade computer program written in FORTRAN. Numerical results concerning spatial distributions of both internal and external fields are displayed in different formats in order to properly display exemplifying results. More specifically, as an example, we consider the case of a focused fundamental Gaussian beam (TEM(00) mode) illuminating a glass sphere (having a real refractive index equal to 1.50) with an eccentrically located spherical water inclusion (having a real refractive index equal to 1.33). Displayed results are for various parameters of the incident electromagnetic beam (incident orientation, beam waist radius, location of the beam waist center) and of the scatterer system (location of the inclusion inside the host sphere and relative diameter of the inclusion to the host sphere).

Using Spatial Prediction Model to Analyze Driving Forces of the Beijing 2008 HFMD Epidemic

Based on the spatial units of community, village and town in Beijing, the relationship betweent HFMD morbidity and the potential risk factors has been examined. According to the 6 selected risk factors (namely population density, disposable income of urban residents, the number of medical and health institutions, the number of hospital beds, average annual temperature and average annual relative humidity) significantly related to HFMD morbidity, the prediction performance of Classical Linear Regression Model(CLRM) and Spatial Lag Model(SLM) has been compared. The results showed that SLM achieved better effect and R square reached 0.82. It was showed that spatial effect played the crucial role in the HFMD morbidity prediction and its contribution attained 88%. However, CLRM showed low prediction accuracy and bias estimation. It was demonstrated that including spatial effect item into CLRM could greatly improve the performance of HFMD morbidity prediciton model.

Triennial Growth Symposium: important roles for L-glutamine in swine nutrition and production

L-Glutamine (Gln) has traditionally not been considered a nutrient needed in diets for livestock species or even mentioned in classic animal nutrition textbooks. This is due to previous technical difficulties in Gln analysis and the unsubstantiated assumption that animals can synthesize sufficient amounts of Gln to meet their needs. Consequently, the current (1998) version of NRC does not recommend dietary Gln requirements for swine. This lack of knowledge about Gln nutrition has contributed to suboptimal efficiency of global pig production. Because of recent advances in research, Gln is now known to be an abundant AA in physiological fluids and proteins and a key regulator of gene expression. Additionally, Gln can regulate cell signaling via the mammalian target of rapamycin pathway, adenosine monophosphate-activated protein kinase, extracellular signal-related kinase, Jun kinase, mitogen-activated protein kinase, and nitric oxide. The exquisite integration of Gln-dependent regulatory networks has profound effects on cell proliferation, differentiation, migration, metabolism, homeostasis, survival, and function. As a result of translating basic research into practice, dietary supplementation with 1% Gln maintains gut health and prevents intestinal dysfunction in low-birth-weight or early-weaned piglets while increasing their growth performance and survival. In addition, supplementing 1% Gln to a corn- and soybean-meal-based diet between d 90 and 114 of gestation ameliorates fetal growth retardation in gilts and reduces preweaning mortality of piglets. Furthermore, dietary supplementation with 1% Gln enhances milk production by lactating sows. Thus, adequate amounts of dietary Gln, a major nutrient, are necessary to support the maximum growth, development, and production performance of swine.

High resolution imaging of actin filaments in living cells under physilogically relevant conditions using apertureless near-field microscopy

Living cells were used to demonstrate the potential biological applications of the apertureless SNOM when operating under fluid. An oral epithelial squamous cell carcinoma cell line (H357) was imaged under physiological-like conditions using apertureless SNOM following staining with FITC-Phalloidin which preferentially stains intracellular actin filaments of the cytoskeleton. Compared with simultaneously obtained AFM topographic image, the apertureless SNOM data provides greater detail on these cellular structures and the spatial resolution of the apertureless SNOM fluorescence image appears to be about 100 nm.

Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

AIMS/HYPOTHESIS

The fractal dimension (D(f)) of the retinal vasculature is a global measure of its branching pattern complexity. We examined the relationship of retinal D(f) with diabetes.

METHODS

We conducted a cross-sectional study of 1,577 participants with diabetes and impaired glucose metabolism and normal controls from the population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Retinal D(f) was quantified from fundus photographs using a computer-based programme and diabetes status was determined by oral glucose tolerance test based on the WHO criteria.

RESULTS

After adjustment for age, sex and vascular risk factors, persons with higher retinal D(f) were more likely to have diabetes (OR 1.56; 95% CI 1.14-2.14, highest vs lowest fractal tertile). This relationship remained with further adjustment for retinal arteriolar calibre and presence of retinopathy (OR 1.64; 95% CI 1.19-2.27), and after excluding participants with retinopathy (OR 1.60; 95% CI 1.16-2.21). Retinal D (f) was not related to impaired glucose tolerance or impaired fasting glucose (OR 1.19; 95% CI 0.85-1.67).

CONCLUSIONS/INTERPRETATION

Individuals with diabetes, but not with impaired glucose metabolism, have greater retinal D(f), reflecting greater complexity of the retinal vasculature. Our findings suggest the presence of early microvascular changes in the retinal vasculature of persons with diabetes, even in the absence of overt retinopathy.

A first-principles approach to finite temperature elastic constants

A first-principles approach to calculating the elastic stiffness coefficients at finite temperatures was proposed. It is based on the assumption that the temperature dependence of elastic stiffness coefficients mainly results from volume change as a function of temperature; it combines the first-principles calculations of elastic constants at 0 K and the first-principles phonon theory of thermal expansion. Its applications to elastic constants of Al, Cu, Ni, Mo, Ta, NiAl, and Ni₃Al from 0 K up to their respective melting points show excellent agreement between the predicted values and existing experimental measurements.

A mixed-space approach to first-principles calculations of phonon frequencies for polar materials

We propose a mixed-space approach using the accurate force constants calculated by the direct approach in real space and the dipole-dipole interactions calculated by linear response theory in reciprocal space, making the accurate prediction of phonon frequencies for polar materials possible using the direct approach as well as linear response theory. As examples, by using the present approach, we predict the first-principles phonon properties of the polar materials α-Al(2)O(3), MgO, c-SiC, and h-BN, which are in excellent agreement with available experimental data.

Differential composition of proteomes in sow colostrum and milk from anterior and posterior mammary glands

Piglets obtaining milk from anterior and middle mammary glands (MG) grow faster than those suckling posterior MG, but the underlying mechanisms are not clear. The purpose of this study was to investigate the differential proteomes of colostrum and milk secreted by anterior and posterior MG. Six healthy primiparous sows with 7 pairs of MG were used; the first and the second pairs were defined as anterior MG and the sixth and seventh pairs as posterior MG. Colostrum and milk were collected at d 1 and 14 after parturition, respectively. Comparative proteomics analysis was performed to identify the differentially expressed proteins in colostrum and milk secreted by anterior and posterior MG. Results show that protein composition in colostrum and milk varied markedly with the anatomical location of MG. Immunoglobulins, lactadherin, and haptoglobin were upregulated (P < 0.05) in colostrum from anterior MG compared with posterior MG. Concentrations of immunoglobulins and lactoferrin in milk from anterior MG were greater (P < 0.05) than milk from posterior MG. Moreover, concentration of proteins from somatic cells was greater (P < 0.05) in milk from posterior MG compared with anterior MG. Most proteins, in which abundance was upregulated in colostrum and milk from anterior MG, contribute to passive immunity, intestinal development of suckling piglets and epithelial integrity, and the health of MG. Collectively, these results indicate that in comparison with posterior MG, anterior MG are more active in protein synthesis and produce more immunoglobulins and lactoferrin in colostrum and milk.

Food and nutrient consumption trends in older Australians: a 10-year cohort study

BACKGROUND/OBJECTIVES

Few longitudinal population-based cohort studies of older people have described dietary intakes over time. The objective of this study was to assess changes in the food and nutrient intake in a cohort of older Australians, using longitudinal data collected over 10 years.

SUBJECTS/METHODS

Population-based cohort of people aged 49 years and over at baseline (82% of those eligible) living in two postcode areas, west of Sydney. In 1992-1994, 3654 people were examined; 2334 were reexamined after 5 years and 1952 after 10 years (75% survivors at both examinations). A 145-item food frequency questionnaire was used to assess food and nutrient intake on each occasion, and 1166 participants provided usable dietary data at all three examinations.

RESULTS

Energy and sugar intake significantly increased among women over the 10-year period (P-value for trend <0.0001). Long-chain omega-3 fatty acid and fish intake significantly increased in both men and women (P-value for trend <0.0001). Folate intake significantly increased in both men and women (women: 325 dietary folate equivalents (DFE) vs 403 DFE; men: 346 DFE vs 425 DFE, P<0.0001). Wholemeal/grain bread consumption decreased in both men and women (P-value for trend <0.0001).

CONCLUSIONS

Many of the observed changes in diet over the 10-year period were consistent with current population dietary recommendations. Some changes, however, appear to have been due to poorer dietary choices. This information could be used to inform nutrition policy and programs targeted to older persons. These data highlight the need to identify barriers to better food choices.

Methotrexate treatment for ectopic pregnancy at the KK Women's and Children's Hospital, Singapore

INTRODUCTION

Ectopic pregnancy is an acute emergency in the first trimester where surgery is the mainstay of treatment. With the advent of improved diagnostic techniques like high-resolution transvaginal ultrasonography and expedient serum human chorionic gonadotrophin (HCG) assay, ectopic pregnancy is now diagnosed early. At this stage, the conceptus is often small, causing minimal or no symptoms. Medical management may then present an appealing alternative to surgery. Methotrexate has been widely used to treat ectopic pregnancy. A methotrexate ectopic treatment protocol was introduced by the Minimally Invasive Surgery Centre at KK Women's and Children's Hospital, Singapore. We present the results of this treatment.

METHODS

A prospective review of 110 cases of medical management of ectopic pregnancy since the implementation of the treatment protocol was undertaken. Demographical data, clinical presentation, treatment progress and outcome were captured using a computer database. All patients were managed as outpatients, and a telephone call-out service was provided to ensure that treatment side effects were monitored and potential treatment failures were identified early.

RESULTS

From August 2003 to October 2006, 93 (84.5 percent) patients with ectopic pregnancy were successfully treated with intramuscular methotrexate. 16 patients eventually required surgery and only one patient defaulted on follow-up. There was no major side effect detected in this cohort. The minor side effects reported included mucositis (19.1 percent) and abdominal pain (28.2 percent).

CONCLUSION

Methotrexate treatment of ectopic pregnancy is safe. Our treatment protocol enabled us to achieve a reasonable treatment success rate of 84.5 percent.

The formation of carbon nanostructures by in situ TEM mechanical nanoscale fatigue and fracture of carbon thin films

A technique to quantify in real time the microstructural changes occurring during mechanical nanoscale fatigue of ultrathin surface coatings has been developed. Cyclic nanoscale loading, with amplitudes less than 100 nm, is achieved with a mechanical probe miniaturized to fit inside a transmission electron microscope (TEM). The TEM tribological probe can be used for nanofriction and nanofatigue testing, with 3D control of the loading direction and simultaneous TEM imaging of the nano-objects. It is demonstrated that fracture of 10-20 nm thick amorphous carbon films on sharp gold asperities, by a single nanoscale shear impact, results in the formation of <10 nm diameter amorphous carbon filaments. Failure of the same carbon films after cyclic nanofatigue, however, results in the formation of carbon nanostructures with a significant degree of graphitic ordering, including a carbon onion.

Relationship of Type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss

AIMS

Type 2 diabetes and associated microvascular abnormalities are postulated to affect hearing. Our study reports on the relationship between Type 2 diabetes and the prevalence, 5-year incidence and progression of hearing impairment in a representative, older, Australian population.

METHODS

The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss conducted in a defined suburban area, west of Sydney. Hearing loss was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz > 25 decibels hearing level (dB HL) in the better ear (bilateral hearing loss). Type 2 diabetes was defined from reported physician-diagnosed diabetes or fasting blood glucose > or = 7.0 mmol/l.

RESULTS

Age-related hearing loss was present in 50.0% of diabetic participants (n = 210) compared with 38.2% of non-diabetic participants (n = 1648), odds ratio (OR) 1.55 [95% confidence interval (CI) 1.11-2.17], after adjusting for multiple risk factors. A relationship of diabetes duration with hearing loss was also demonstrated. After 5 years, incident hearing loss occurred in 18.7% of participants with, and 18.0% of those without diabetes, adjusted OR 1.01 (CI 0.54-1.91). Progression of existing hearing loss (> 5 dB HL), however, was significantly greater in participants with newly diagnosed diabetes (69.6%) than in those without diabetes (47.8%) over this period, adjusted OR 2.71 (CI 1.07-6.86).

CONCLUSIONS

Type 2 diabetes was associated with prevalent, but not incident hearing loss in this older population. Accelerated hearing loss progression over 5 years was more than doubled in persons newly diagnosed with diabetes. These data explore further reported links between Type 2 diabetes and age-related hearing loss.

Angiotensin-converting enzyme gene and retinal arteriolar narrowing: the Funagata Study

The purpose of this study is to determine whether the angiotensin-converting enzyme (ACE) gene polymorphism is associated with retinal arteriolar narrowing, a subclinical marker of chronic hypertension. The Funagata Study examined a population-based sample of Japanese aged 35+ years; 368 participants had both retinal vessel diameter measurements and ACE insertion/deletion (ACE I/D) polymorphism analyses performed. Assessment of retinal vessel diameter and retinal vessel wall signs followed the protocols used in the Blue Mountains Eye Study. ACE gene polymorphisms D/D, I/D and I/I were present in 34 (9.2%), 170 (46.2%) and 164 (44.5%) participants, respectively, distributed in Hardy-Weinberg equilibrium. After multivariable adjustment, retinal arteriolar diameter was significantly narrower in subjects with the D/D genotype compared to subjects with I/D and I/I genotypes (mean difference -6.49 microm, 95% confidence interval (CI): -12.86 microm, -0.11 microm). Our study suggests that the ACE I/D polymorphism may be associated with subclinical structural arteriolar changes related to chronic hypertension.

Blood pressure control and awareness among patients with diabetes and hypertension attending a tertiary ophthalmic clinic

AIMS

To assess the proportion of patients who had diabetes and hypertension with optimal blood pressure (BP) control and to describe patients' awareness of the importance of BP control.

METHODS

A cross-sectional survey of out-patients with diabetes who attended the Royal Victorian Eye and Ear Hospital (Melbourne, Australia) was conducted between October 2006 and February 2007. Of 245 patients invited, 220 (90%) participated. Optimal BP control was defined as BP < 130/80 mmHg recorded at the latest visit; proportions of patients with awareness of BP control were defined non-exclusively by: (i) ability to recall a previous BP record and rate the appropriateness of that BP level; (ii) ability to recall the recommended optimal BP control level by current diabetes management guidelines; (iii) knowledge that optimal BP control is important to diabetes management; and (iv) knowledge that optimal BP control is important to eye health.

RESULTS

Of the 220 patients, 176 had both diabetes and hypertension. Of these, 49 of 176 (28%) had BP controlled optimally, and 30 of 176 (17%) recalled and rated a previous recorded BP level appropriately. Fewer than one in four (22%) acknowledged the recommended optimum BP level of < 130/80 mmHg, fewer than one in two (48%) rated BP as important to diabetes management, and one in three (35%) rated BP control as important to eye health.

CONCLUSIONS

In this sample of patients with diabetes and hypertension, fewer than one-third achieved the BP level recommended by clinical guidelines, and fewer than half were aware of the importance of BP control.

Anti-angiogenic factors and pre-eclampsia in type 1 diabetic women

AIMS/HYPOTHESIS

Elevated anti-angiogenic factors such as soluble fms-like tyrosine kinase 1 (sFlt1), a soluble form of vascular endothelial growth factor receptor, and endoglin, a co-receptor for TGFbeta1, confer high risk of pre-eclampsia in healthy pregnant women. In this multicentre prospective study, we determined levels of these and related factors in pregnant women with type 1 diabetes, a condition associated with a fourfold increase in pre-eclampsia.

METHODS

Maternal serum sFlt1, endoglin, placental growth factor (PlGF) and pigment epithelial derived factor were measured in 151 type 1 diabetic and 24 healthy non-diabetic women at each trimester and at term.

RESULTS

Approximately 22% of the diabetic women developed pre-eclampsia, primarily after their third trimester visit. In women with pre-eclampsia (diabetic pre-eclampsia, n = 26) vs those without hypertensive complications (diabetic normotensive, n = 95), significant changes in angiogenic factors were observed, predominantly in the early third trimester and prior to clinical manifestation of pre-eclampsia. Serum sFlt1 levels were increased approximately twofold in type 1 diabetic pre-eclampsia vs type 1 diabetic normotensive women at the third trimester visit (p < 0.05) and the normal rise of PlGF during pregnancy was blunted (p < 0.05). Among type 1 diabetic women, third trimester sFlt1 and PlGF were inversely related (r(2) = 42%, p < 0.0001). Endoglin levels were increased significantly in the diabetic group as a whole vs the non-diabetic group (p < 0.0001).

CONCLUSIONS/INTERPRETATION

Higher sFlt1 levels, a blunted PlGF rise and an elevated sFlt1/PlGF ratio are predictive of pre-eclampsia in pregnant women with type 1 diabetes. Elevated endoglin levels in women with type 1 diabetes may confer a predisposition to pre-eclampsia and may contribute to the high incidence of pre-eclampsia in this patient group.

The effect of site-directed mutagenesis of the ambient amino acids of leucine-based sorting motifs on the localization of chicken invariant chain

Two Leu residues and their ambient amino acid residues are known to exist in the cytosolic tail of chicken invariant chain (Ii), and these play an important role as motifs in mediating the sorting endocytic pathway. We performed 20 mutations via site-directed mutagenesis by the PCR megaprimer method to study the effect of some ambient amino residues of both Leu on the localization of chicken Ii. These mutated fragments were ligated to the vector pEGFP-C1. The recombinant plasmids were transiently transfected into COS-7 cells with Lipofectamine 2000. Furthermore, the fluorescence of located fusion proteins (green fluorescent protein-Ii) was observed with a fluorescence microscope. Our results indicated that 2 Leu-based motifs are required for chicken Ii intracellular localization, and both motifs independently mediate this function of the Ii. The other amino acid residues surrounding both Leu also influence Ii-induced endosomal vacuolation. In addition, we found that Pro19, which is near the Val17-Leu18 motif, was a key residue for chicken Ii intracellular localization. Not only is it critical for endocytic targeting to each Leu, but its unique mutation can also result in altering the function of chicken Ii.

Association between self-rated health and incident severe hypertension among men: a population-based cohort study

INTRODUCTION

Self-rated health (SRH) is a consistent predictor of cardiovascular disease and mortality. However, the intermediate biological mechanisms behind this association are not clear. We examined the longitudinal relationship between SRH and incident severe hypertension.

METHODS

We studied a population-based cohort of 1,298 participants (mean age 62.5 years, range 49-84 years), at the baseline examination (1992-1994) residing in the Blue Mountains region, west of Sydney, Australia, and re-examined after five years (1997-1999). Main outcome-of-interest was incident severe hypertension (systolic blood pressure [BP] 160 mmHg or above, diastolic BP 100 mmHg or above, or a combination of self-reported hypertension diagnosis and use of antihypertensive medications) among baseline individuals without severe hypertension.

RESULTS

Among men, those with fair/poor SRH had significantly higher odds of incident severe hypertension, compared to individuals with excellent SRH. Multivariable odds-ratio (OR) (95 percent confidence intervals [CI]) comparing fair/poor SRH to excellent SRH was 1.93 (1.04-3.56) (p-trend was 0.03). This association was not observed in women comparing fair/poor SRH to excellent SRH: OR 0.96, 95 percent CI 0.57-1.62 (p-trend was 0.70). Subgroup analyses stratified by age, smoking, body mass index, diabetes mellitus and BP categories, supported this male gender-specific pattern of association.

CONCLUSION

This data suggests an association between poor SRH and incident hypertension among men, but not among women. These results suggest that at least part of the previously-reported association between poor SRH and mortality may be mediated by its relation to incident severe hypertension.

Stereoselectivity in metabolism of ifosfamide by CYP3A4 and CYP2B6

The aim was to identify the hepatic cytochromes P450 (CYPs) responsible for the enantioselective metabolism of ifosfamide (IFA). The 4-hydroxylation, N2- and N3-dechloroethylation of IFA enantiomers were monitored simultaneously in the same metabolic systems using GC/MS and pseudoracemate techniques. In human and rat liver microsomes, (R)-IFA was preferentially metabolized via 4-hydroxylation, whereas its antipode was biotransformed in favour of N-dechloroethylation. CYP3A4 was the major enzyme responsible for metabolism of IFA enantiomers in human liver. The study also revealed that CYP3A (human CYP3A4/5 and rat CYP3A1/2) and CYP2B (human CYP2B6 and rat CYP2B1/2) enantioselectively mediated the 4-hydroxylation, N2- and N3-dechloroethylation of IFA. CYP3A preferentially supported the formation of (R)-4-hydroxyIFA (HOIF), (R)-N2-dechloroethylIFA (N2D) and (R)-N3-dechloroethylIFA (N3D), whereas CYP2B preferentially mediated the generation of (S)-HOIF, (S)-N2D and (S)-N3D. The enantioselective metabolism of IFA by CYP3A4 and CYP2B1 was confirmed in cDNA transfected V79 cells.

Enantiomer–enantiomer interaction of ifosfamide in the rat

The objective of this study was to study the enantiomer-enantiomer interaction of ifosfamide (IFA) in a rat model. Following intravenous administration of individual IFA enantiomers or pseudo-racemates to male Sprague-Dawley rats, two enantiomers and their metabolites, 4-hydroxyIF (HOIF), N2-dechloroethylIF (N2D), N3-dechloroethylIF (N3D), and isophosphoramide (IPM), were quantified using gas chromatography/mass spectrometry (GC/MS) and isotope dilution techniques. In addition, the mutual inhibition in the metabolism between two stereoisomers was also investigated in vitro using rat liver microsomes. Pharmacokinetic parameters were similar between (R)-IFA and (S)-IFA when individual enantiomers were intravenously administered to rats separately. However, in the rats administered with the IFA racemate, half-life, mean residence time (MRT), and area under the concentration-time curve (AUC) values of (S)-IFA were significantly increased with total body clearance (CLT) being decreased. No significant difference in volumes of distribution (Vss), and renal clearance (CLr) and blood cell partition was observed between two enantiomers regardless of (R)-IFA and (S)-IFA being administered separately or in combination as a racemate. The results from the in vitro metabolism and inhibition experiment suggested that each IFA enantiomer inhibited the metabolism of its antipode in a competitive manner. It is concluded that the enantiomeric interaction of IFA mainly occurred in the process of metabolism with (S)-IFA being affected to a larger extent.

Retinopathy predicts coronary heart disease mortality

BACKGROUND

Retinopathy lesions are fairly common findings in clinic settings and may predict risk of coronary heart disease (CHD).

OBJECTIVE

To examine whether retinopathy independently predicts a risk of CHD-related mortality in people with and without diabetes.

METHODS

In an Australian population-based cohort of people with (n = 199) and without (n = 2768) diabetes (Blue Mountains Eye Study, total n = 2967), the presence and severity of retinopathy was assessed from retinal photographs. 12-Year cumulative CHD deaths were ascertained from Australian National Death Index records.

RESULTS

Over 12 years, 353 participants (11.9%) had incident CHD-related deaths. Retinopathy was present in 57/199 (28.6%) participants with, and in 268/2768 (9.7%) without, diabetes. The presence of retinopathy increased the CHD mortality rate per person-year by an amount (0.005) equivalent to the presence of diabetes itself (12-year CHD mortality rate per person-year of 0.010 in people with neither diabetes nor retinopathy, 0.015 in those with diabetes alone, 0.016 in those with retinopathy alone). After adjusting for cardiovascular risk factors, retinopathy remained an independent predictor of CHD death both in people with diabetes (hazard ratio (HR) = 2.21, 95% CI 1.20 to 4.05) and in those without diabetes (HR = 1.33, 95% CI 1.02 to 1.83). Moderate retinopathy was associated with adjusted HR = 6.68 (95% CI 2.24 to 20.0) in people with diabetes and adjusted HR = 2.29 (95% CI 1.10 to 4.76) in people without diabetes.

CONCLUSIONS

A finding of retinopathy in people with or without diabetes may signal increased CHD risk. The increased CHD mortality associated with retinopathy in people without diabetes was equivalent to the presence of diabetes itself.

Education, socio-economic status and age-related macular degeneration in Asians: the Singapore Malay Eye Study

BACKGROUND/AIMS

Low socio-economic status is increasingly being identified as a risk marker for chronic diseases, but few studies have investigated the link between socio-economic factors and age-related macular degeneration (AMD). The present study aimed to assess the association between socio-economic status and the prevalence of AMD.

METHODS

A population-based cross-sectional study of 3280 (78.7% response rate) Malay adults aged 40-80 years residing in 15 south-western districts of Singapore. AMD was graded from retinal photographs at a central reading centre using the modified Wisconsin AMD scale. Early and late AMD signs were graded from retinal photographs following the Wisconsin grading system. Socio-economic status including education, housing type and income were determined from a detailed interview.

RESULTS

Of the participants, 3265 had photographs of sufficient quality for grading of AMD. Early AMD was present in 168 (5.1%) and late AMD in 21 (0.6%). After adjusting for age, gender, smoking, hypertension, diabetes and body mass index, participants with lower educational levels were significantly more likely to have early AMD (multivariate OR 2.2, 95% CI 1.2 to 4.0). This association was stronger in persons who had never smoked (multivariate OR 3.6, 95% confidence CI 1.4 to 9.4). However, no association with housing type or income was seen.

CONCLUSIONS

Low educational level is associated with a higher prevalence of early AMD signs in our Asian population, independent of age, cardiovascular risk factors and cigarette smoking.

Complement factor H polymorphisms, renal phenotypes and age-related macular degeneration: the Blue Mountains Eye Study

Complement factor H (CFH) is a key regulator of the alternative pathway of complement and its mutations have been associated with membranoproliferative glomerulonephritis type II, atypical hemolytic uremic syndrome and age-related macular degeneration (AMD), suggesting that alternative pathway dysregulation is a common pathogenetic feature of these ocular and renal conditions. In this study we tested the hypothesis that common CFH variants have a global role in renal function in the Australian population-based Blue Mountains Eye Study (BMES). We replicated the association of I62V with estimated glomerular filtration rate (GFR; P=0.017) and creatinine clearance (CRCL; P=0.015). The minor allele of I62V (G) was deleterious: adding one copy of the G allele decreased GFR/CRCL by approximately 0.98 ml min(-1) per 1.73 m(2) (95% confidence interval (CI): 0.97, 0.99). We also replicated the association of Y402H with AMD and provided an unbiased estimate of population attributable risk (PAR). The minor allele of Y402H (C) was deleterious: the odds ratio estimate of CC genotype compared to TT was 1.87 (95% CI: 1.44, 2.45). The PAR of the C allele was estimated as 0.22 (95% CI: 0.15, 0.28). In summary, in the BMES population we confirmed the association between I62V and renal function, as measured by the estimated GFR, plus the association of Y402H with both early- and late-stage AMD.

Low-dose haloperidol prevents post-operative nausea and vomiting after ambulatory laparoscopic surgery

BACKGROUND

We evaluated the prophylactic effect of low-dose haloperidol (1 mg) on post-operative nausea and vomiting (PONV) in women undergoing ambulatory laparoscopic surgery. Droperidol (0.625 mg) and saline were controls.

METHODS

One hundred and fifty women undergoing ambulatory laparoscopic surgery under general anaesthesia were enrolled in this randomized, double-blind, and placebo-controlled study. After tracheal intubation, the haloperidol group (n=50) received intravenous haloperidol (1 mg), the droperidol group (n=50) received intravenous droperidol (0.625 mg), and the saline group (n=50) received intravenous saline.

RESULTS

Haloperidol- and droperidol-group patients reported a lower incidence of PONV [24% and 23% vs. 49% (saline group); P<0.05] and requested fewer doses of rescue antiemetics [13% and 16% vs. 38% (saline group); P<0.05] during the first four post-operative hours. During the 24-h post-operative period, haloperidol- and droperidol-group patients also reported a lower incidence of PONV [31% and 32% vs. 62% (saline group); P<0.01]. No differences were found between the haloperidol and droperidol groups.

CONCLUSION

Like droperidol (0.625 mg), prophylactic intravenous haloperidol (1 mg) significantly reduced the incidence of PONV in women undergoing ambulatory laparoscopic surgery.

Population prevalence and incidence of Parkinson’s disease in an Australian community

BACKGROUND

Parkinson's disease (PD) is the second most common neurodegenerative disorder affecting older individuals. Few studies have determined the prevalence and incidence of this disease in Australia. The aim of the study was to estimate the prevalence and 10-year incidence of PD in the Australian community.

METHODS

In the Blue Mountains Eye Study (BMES), a population-based health survey of Australian residents aged 49 years or more, we determined the cross-sectional prevalence (BMES2, 1997-1999, n = 3509) and 10-year incidence (BMES1, 2 and 3, 1992-1994, 1997-1999 and 2002-2004, respectively, n = 2545) of PD. We screened participants who took PD medications. PD diagnosis was confirmed by contacting the participant's medical/general practitioners.

RESULTS

Nineteen new cases of PD were identified over the 10-year period, a 10-year incidence of 0.84% (95% confidence interval (CI) 0.54-1.33%). In the cross-sectional study, 16/3509 participants were confirmed to have PD (0.46%), with age-specific prevalence rates of 0.48% in persons aged 60-69 years, 0.82% for ages 70-79 years and 0.56% in persons aged 80 years or older. No PD cases were identified among participants less than 60 years of age. When age standardized to the 2001 Australian population, the prevalence of PD was 362 per 100,000 (95%CI 183-541) among persons aged 50 years or older and 104 per 100,000 for the Australian population at all ages, assuming no prevalent cases in persons aged less than 50 years.

CONCLUSION

This study estimates a 0.46% (95%CI 0.23-0.68) prevalence of PD patients treated with medications aged 50 years or older and a 10-year incidence of 0.84% (95%CI 0.54-1.33).

The metabolic syndrome and retinal microvascular signs in a Japanese population: the Funagata study

AIMS

To determine the relationship of metabolic syndrome and its components with retinopathy and other retinal microvascular signs in a Japanese population.

METHODS

The Funagata study recruited 1961 (53.3% of eligible) Japanese aged 35 or older. The metabolic syndrome was diagnosed primarily using definitions of the International Diabetes Federation. Retinopathy and retinal microvascular signs were assessed from fundus photographs. Retinal arteriolar and venular diameters were measured using a computer-assisted programme.

RESULTS

Data were available for analysis in 1638 persons for retinopathy and retinal microvascular signs and 921 persons for retinal vessel diameters. Various components of the metabolic syndrome were associated with retinal microvascular signs: a larger waist circumference was associated with wider venular diameter and retinopathy lesions; a higher blood pressure level was associated with focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar wall reflex and narrower arteriolar diameter; and a higher triglyceride level was associated with enhanced arteriolar wall reflex. Overall, persons with the metabolic syndrome were more likely to have retinopathy (odds ratio 1.64, 95% CI: 1.02 to 2.64) and wider venular diameter 4.69 microm (95% CI: 1.20 to 8.19 microm) than persons without the metabolic syndrome.

CONCLUSION

We report associations of metabolic syndrome components with retinopathy and wider venular diameter in Japanese adults. These data suggest that metabolic abnormalities, indicated by metabolic syndrome components, are associated with microvascular changes in the retina. There was no synergistic effect of the metabolic syndrome on retinal microvascular changes beyond its individual components.

The relationship of retinal vascular calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

AIMS/HYPOTHESIS

The aim of the study was to examine the relationship of retinal vascular calibre with glucose intolerance, diabetes and retinopathy in a population-based cohort.

METHODS

The Australian Diabetes, Obesity and Lifestyle study recruited adults aged > or =25 years old from across Australia. Participants were classified using an oral glucose tolerance test as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), known diabetes or newly diagnosed diabetes. Digital retinal photographs were taken of all participants with diabetes, IGT and IFG, and a sample of those with NGT, and graded for the presence of retinopathy. Retinal vascular calibre was measured from photographs by a computer-assisted method.

RESULTS

Of the 1,998 participants with gradable retinal images, 16% had known diabetes, 17% newly diagnosed diabetes, 42% IGT, 6% IFG and 19% NGT. After multivariable adjustment, retinal arteriolar calibre was significantly larger in people with known diabetes (178.9 microm) compared with participants with NGT (174.6 microm, p = 0.02), IGT/IFG (175.5 microm, p = 0.02) or newly diagnosed diabetes (175.6 microm, p = 0.047). One SD increase in mean arteriolar calibre was associated with higher odds of diabetes compared with NGT (odds ratio [OR] = 1.28, 95%CI = 1.06-1.55). After multivariable adjustment, each SD increase in venular calibre was associated with higher odds of having retinopathy in persons with IGT/IFG (OR = 1.78, 95%CI = 1.36-2.34) or in persons with diabetes (OR = 1.68, 95%CI = 1.23-2.29).

CONCLUSIONS/INTERPRETATION

Diabetes is associated with larger retinal arteriolar calibre and retinopathy with larger retinal venular calibre. The contrasting associations may reflect different underlying pathophysiological processes in the natural history of diabetes.

Body mass index and its effects on retinal vessel diameter in 6-year-old children

PURPOSE

To examine the relationship between body mass index (BMI) and other anthropometric measures with retinal vessel diameter in children.

METHODS

A random cluster sample of 34 schools was selected in the Sydney metropolitan area during 2003-04, and 1740 children aged 6 years participated in The Sydney Childhood Eye Study. Retinal images were taken and vessel diameter was measured using a computer-imaging program. Anthropometric measures, including weight, height, waist circumference, BMI and body surface area (BSA), were obtained and defined using standardized protocols. Data on confounders, including ocular parameters, ethnicity, birth parameters and blood pressure, were similarly collected.

RESULTS

Mean BMI was 16.2 kg/m(2) (+/-2.1 s.d.) in 1608 (92.4%) children with complete data. After controlling for age, sex, ethnicity, axial length of the eyeball, birth weight and mean arterial blood pressure, children with BMI above the cardiovascular risk threshold (defined as BMI>16.1 kg/m(2) in boys and BMI>15.9 kg/m(2) in girls) had mean retinal venular diameter 2.1 microm larger than those with BMI below this threshold (P=0.026). Increasing weight and BSA were also positively associated with wider retinal venules. Children in the highest quartile of BMI had mean retinal arteriolar diameter 2.2 microm smaller than those in the lowest quartile. Increasing waist circumference and shorter height were also associated with narrower retinal arterioles.

CONCLUSIONS

In this sample of 6-year-old children, greater BMI, weight and BSA were associated with wider retinal venules, while greater BMI and larger waist circumference were associated with narrower retinal arterioles. These findings suggest a possible effect of increased body mass and adiposity on early microvascular structural alterations in childhood, long before the development of cardiovascular disease.

Change in health-related quality of life after cataract surgery in a population-based sample

PURPOSE

To assess the long-term outcomes from cataract surgery on self-rated health, and health-related quality of life (HRQOL) in a population-based older sample.

METHODS

Participants of the Blue Mountains Eye Study at the baseline (n=3654), 5 (n=2335), and 10-year follow-up (n=1952) were interviewed and examined. Questionnaires included an assessment of self-rated health and HRQOL using the 36-item Short-Form Health Survey (SF-36). Incident cataract surgery was defined if participants had cataract surgery since baseline, and confirmed via lens photographic grading.

RESULTS

There was no statistically significant difference in the proportions of participants who experienced a change in self-rated health between those who had incident cataract surgery (14.1% improvement; 29.1% deterioration) and non-surgical subjects (16.7% improvement; 27.0% deterioration). We found no association between incident cataract surgery and the odds for 10-year change in self-rated health, after multivariate adjustment. In contrast, participants who had incident cataract surgery had a significant improvement in the mean scores of 'mental health' domain of HRQOL (+1.60 vs-2.04, P=0.02) and in the mental component score (+1.43 vs-0.82, P=0.02) than participants who did not undergo surgery. Cataract surgery during follow-up had no significant influence on change in mean scores of other domains or in their physical component score of the SF-36 (-2.57 in participants who had incident surgery vs-2.29 in non-surgical participants, P=0.78).

CONCLUSIONS

We confirmed long-term improvement following cataract surgery in the mental but not in the physical domain of the SF-36 or in answers to a specific self-rated health question.

Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomised controlled trial

We compared the prophylactic anti-emetic efficacy of midazolam and ondansetron in 90 patients scheduled for minor gynaecological (hysteroscopy) or urological (ureteroscopy) procedures planned to last 1-2 h under sevoflurane anaesthesia with spontaneous ventilation of the lungs via a laryngeal mask airway. Midazolam 2 mg or ondansetron 4 mg were administered intravenously 30 min before the end of surgery. The proportions of patients who experienced postoperative nausea and vomiting in the first 24 h (30% and 27% for the midazolam and ondansetron groups, respectively) were similar in the two groups. The incidence of postoperative nausea and vomiting was significantly smaller in both groups than predicted according to the patients' underlying risks (midazolam group: p = 0.018; ondansetron group: p = 0.017). There were no significant differences in average sedation scores or pain scores. Treatment using ondansetron for anti-emetic prophylaxis did not provide a superior benefit compared to midazolam in the present study.

Five-year incidence and progression of diabetic retinopathy in a defined older population: the Blue Mountains Eye Study

AIMS

To determine 5-year incidence and progression of diabetic retinopathy in an older Australian population-based cohort.

METHODS

During the period 1992-1994, the Blue Mountains Eye Study examined 3654 residents aged 49+years (82.4% of those eligible), living in two urban postcode areas, west of Sydney, Australia. Participants were subsequently invited to attend 5-year follow-up exams. After excluding 543 (14.8%) who died during the follow-up period, 2334 persons (75.0%) were re-examined during 1997-1999. The examination included a comprehensive questionnaire, blood pressure measurement, standardised refraction, Zeiss stereo retinal photographs, and estimation of fasting blood glucose. Diabetic retinopathy was graded from the retinal photographs, using the modified Early Treatment Diabetic Retinopathy Scale classification (15-step scale).

RESULTS

Of participants with diabetes diagnosed at baseline, 150 were re-examined, including 139 with gradable fundus photographs. The cumulative 5-year incidence of diabetic retinopathy was 22.2% before 95% confidence interval (CI) 14.1-32.2%. Retinopathy progression (1+ steps) was documented in 25.9% (95% CI 18.8-34.0%) of participants with retinopathy and gradable photographs at both visits; in 58.3% of these cases, a 2+ -step progression was documented. Progression to proliferative retinopathy occurred in only 4.1% of those with retinopathy at baseline. The only baseline risk factors associated with retinopathy progression, after adjusting for age and gender, were increase in fasting blood glucose, odds ratio (OR) 1.2 (95% CI 1.1-1.4)/mmol/l, and increase in diabetes duration, OR 2.3 (95% CI 1.0-5.3)/10 years.

CONCLUSIONS

These data provide 5-year cumulative incidence of diabetic retinopathy in a defined older population. Increase in diabetes duration and elevated baseline fasting blood glucose level predicted retinopathy incidence.

Expression of matrix metalloproteinases of human lens epithelial cells in the cultured lens capsule bag

AIM OF PURPOSE: To observe the different expression of matrix metalloproteinases (MMPs) between pre- and postoperation of sham cataract surgery in vitrohuman lens capsule bag model from the same donor eye in order to investigate a possible role of MMPs in posterior capsule opacification (PCO).

METHODS

Sham cataract surgeries were performed in six human donor eyes. Immunohistochemical staining was used to detect the expression of MMP-2 and -9 of human lens epithelial cells (LECs) on the anterior capsulorhexis. LEC migration on posterior capsule of human lens from the same donor eye was observed in a modified capsule bag model without pin. Total MMP-2 and -9 protein production were determined by enzyme-linked immunosorbent assay at days 2, 10, 20, and 30 postoperation, respectively.

RESULTS

MMP-2 and -9 could not be detected immunohistochemically on the anterior capsulorhexis preoperation of cataract. Lens epithelia cells at the equator began to migrate by day 4. A confluent monolayer of lens epithelia cells was present on the posterior capsule at day 20. Total MMP-2 and -9 protein production increased with time with maximum levels reached on day 30.

CONCLUSION

MMP-2 and -9 were showed to be upregulated following sham cataract surgery. MMP expression could play an important role in PCO.

Has evidence changed practice?: appropriateness of carotid endarterectomy after the clinical trials

OBJECTIVE

To assess how appropriateness of and indications for carotid endarterectomy (CEA) have changed following the publication of several large international randomized controlled trials (RCTs) designed to rationalize use of CEA.

METHODS

The New York Carotid Artery Surgery Study (NYCAS) is a population-based cohort study of all CEAs performed on elderly patients from January 1998 through June 1999 in New York State. Detailed clinical data were abstracted from medical charts to assess indications for and appropriateness of surgery using a list of 1,557 indications for CEA developed by national experts using RAND appropriateness methods. Deaths and strokes within 30 days of surgery were ascertained and confirmed by two physicians.

RESULTS

Among the 9,588 patients, the mean age was 74.6 years and 93.6% had 70 to 99% carotid stenosis. Nearly three-quarters of patients (72.3%) underwent CEA for asymptomatic stenosis, 18.6% for TIA, and 9.1% for stroke. Overall, 87.1% of operations were done for appropriate reasons, 4.3% for uncertain reasons, and 8.6% for inappropriate reasons (vs 32% inappropriate before the RCTs, p < 0.0001). Among procedures judged inappropriate, the most common reasons were high comorbidity in asymptomatic patients (62.2%), operating after a major stroke (14.2%), or for minimal stenosis (10.5%). Among asymptomatic patients, those with high comorbidity had over twice the risk of death or stroke compared to those without high comorbidity (7.13% vs 2.69%, p < 0.0001).

CONCLUSIONS

Since publication of the randomized controlled trials, there has been a reduction in the proportion of patients undergoing carotid endarterectomy (CEA) for inappropriate reasons. The shift toward many asymptomatic patients undergoing CEA is concerning because the net benefit from surgery for these patients is low and is reduced further for patients with high comorbidity.

Ethnic differences in refraction and ocular biometry in a population-based sample of 11–15-year-old Australian children

PURPOSE

To examine the prevalence of refractive error and distribution of ocular biometric parameters among major ethnic groups in a population-based sample of 11-15-year-old Australian children.

METHODS

The Sydney Myopia Study examined 2353 students (75.3% response) from a random cluster-sample of 21 secondary schools across Sydney. Examinations included cycloplegic autorefraction, and measures of corneal radius of curvature, anterior chamber depth, and axial length.

RESULTS

Participants mean age was 12.7 years (range 11.1-14.4); 49.4% were female. Overall, 60.0% of children had European Caucasian ethnicity, 15.0% East Asian, 7.1% Middle Eastern, and 5.5% South Asian. The most frequent refractive error was mild hyperopia (59.4%, 95% confidence interval (CI), 53.2-65.6), defined as spherical equivalent (SE) +0.50 to +1.99 D. Myopia (SE-0.50 D or less) was found in 11.9%, 95% (CI 6.6-17.2), and moderate hyperopia (SE> or =+2.00 D) in 3.5%, 95% (CI 2.8-4.1). Myopia prevalence was lower among European Caucasian children (4.6%, 95% CI 3.1-6.1) and Middle Eastern children (6.1%, 95% CI 1.3-11.0) than among East Asian (39.5%, 95%, CI 25.6-53.5) and South Asian (31.5%, 95%, CI 21.6-41.4) children. European Caucasian children had the most hyperopic mean SE (+0.82 D) and shortest mean axial length (23.23 mm). East Asian children had the most myopic mean SE (-0.69 D) and greatest mean axial length (23.86 mm).

CONCLUSION

The overall myopia prevalence in this sample was lower than in recent similar-aged European Caucasian population samples. East Asian children in our sample had both a higher prevalence of myopia and longer mean axial length.

Selection of bacteria able to control Fusarium oxysporum f. sp. radicis-lycopersici in stonewool substrate

AIMS

Tomato foot and root rot (TFRR), caused by Fusariumoxysporum f. sp. radicis-lycopersici (Forl), is an economically important disease of tomato. The aim of this study was to develop an efficient protocol for the isolation of bacteria, which controls TFRR based on selection of enhanced competitive root-colonizing bacteria from total rhizosphere soil samples.

METHODS AND RESULTS

A total of 216 potentially enhanced bacterial strains were isolated from 17 rhizosphere soil samples after applying a procedure to enrich for enhanced root tip colonizers. Amplified ribosomal DNA restriction analysis, in combination with determination of phenotypic traits, was introduced to evaluate the presence of siblings. One hundred sixteen strains were discarded as siblings. Thirty-eight strains were discarded as potential pathogens based on the sequence of their 16S rDNA. Of the remaining strains, 24 performed equally well or better than the good root colonizer Pseudomonas fluorescens WCS365 in a competitive tomato root tip colonization assay. Finally, these enhanced colonizers were tested for their ability to control TFRR in stonewool, which resulted in seven new biocontrol strains.

CONCLUSIONS

The new biocontrol strains, six Gram-negative and one Gram-positive bacteria, were identified as three Pseudomonas putida strains and one strain each of Delftia tsuruhatensis, Pseudomonas chlororaphis, Pseudomonas rhodesiae and Paenibacillus amylolyticus.

SIGNIFICANCE AND IMPACT OF THE STUDY

We describe a fast method for the isolation of bacteria able to suppress TFRR in stonewool, an industrial plant growth substrate. The procedure minimizes the laborious screens that are a common feature in the isolation of biocontrol strains.

Neuroendocrine actions and regulation of hypothalamic neuropeptide Y during lactation

The expression of neuropeptide Y (NPY) and its co-messenger, agouti-related peptide (AgRP), in arcuate neurons of the hypothalamus is increased during lactation in rats. Our research has been addressing the questions of the physiological actions of these peptides during lactation and the physiological signals associated with lactation that result in increased expression of their genes. Our studies indicate that NPY and AgRP exert pleiotropic actions during lactation that help integrate neuroendocrine regulation of energy balance with controls over anterior and posterior pituitary hormone secretion. Further, reciprocal signaling to the NPY/AgRP system by leptin and ghrelin is responsible for the changes in expression of these hypothalamic peptides in lactating animals, and thus, may contribute to regulation of food intake and the various neuroendocrine adaptations of lactation.

Study on the effects of mechanical pressure to the ultrastructure and secretion ability of mandibular condylar chondrocytes

During mandibular movement, condyle is subjected to repetitive compression and the mandibular condylar chondrocytes (MCCs) can detect and respond to this biomechanical environment by altering their metabolism. The present study was undertaken to investigate the effects of pressure to the ultrastructure, aggrecan synthesis, nitric oxide (NO) and prostaglandin F(1)alpha(PGF(1)alpha) secretion in MCCs. In vitro cultured rabbit MCCs were incubated and pressed under continuous pressure of 90kPa for 60min and 360min by hydraulic pressure controlled cellular strain unit. The ultrastructure, aggrecan mRNA expression, activity of nitric oxide synthase (NOS) and PGF(1)alpha secretion were investigated. Besides, nitric oxide inhibitor was used together with pressure to investigate the role of NO in mechanical effects. The appearance of MCC on TEM showed that after been pressed under 90kPa for 60min, the cellular processes became elongated and voluminous, together with aggrecan mRNA increasing. Under 90kPa for 360min, some of the cells showed distinct sign of apotosis and the aggrecan mRNA decreased. Pressure of 90kPa could cause increase of NOS activity and decrease of PGF(1)alpha composition. Inhibitor experiments indicated that pressure-induced upregulation of aggrecan mRNA and inhibition of PGF(1)alpha synthesis was partly mediated by NO. Continuous pressure could cause changes on the ultrastructure and function of MCC, as well as up-regulation of aggrecan synthesis, increase of NO secretion and decrease of PGF(1)alpha composition. NO was the upstream molecule, which mediated the response of aggrecan and PGF(1)alpha to mechanical pressure.

Predicting postoperative nausea and vomiting with the application of an artificial neural network

BACKGROUND

Several medications have proved to be useful in preventing postoperative nausea and vomiting (PONV). However, routine antiemetic prophylaxis is not cost-effective. We evaluated the accuracy and discriminating power of an artificial neural network (ANN) to predict PONV.

METHODS

We analysed data from 1086 in-patients who underwent various surgical procedures under general anaesthesia without antiemetic prophylaxis. Predictors used for ANN training were selected by computing the value of chi(2) statistic and information gain with respect to PONV. The configuration of the ANN was chosen by using a software tool. Then the training of the ANN was performed based on data from a training set (n=656). Testing validation was performed with the remaining patients (n=430) whose outcome regarding PONV was unknown to the ANN. Area under the receiver operating characteristic (ROC) curves were used to quantify predictive performance. ANN performance was compared with those of the Naïve Bayesian classifier model, logistic regression model, simplified Apfel score and Koivuranta score.

RESULTS

ANN accuracy was 83.3%, sensitivity 77.9% and specificity 85.0% in predicting PONV. The areas under the ROC curve follow: ANN, 0.814 (0.774-0.850); Naïve Bayesian classifier, 0.570 (0.522-0.617); logistic regression, 0.669 (0.623-0.714); Koivuranta score, 0.626 (0.578-0.672); simplified Apfel score, 0.624 (0.576-0.670). ANN discriminatory power was superior to those of the other predicting models (P<0.05).

CONCLUSIONS

The ANN provided the best predictive performance among all tested models.

[Cloning of genes transactivated by nonstructural protein 4A of hepatitis C virus.]

BACKGROUND

To construct a subtractive cDNA library of genes transactivated by NS4A protein of hepatitis C virus with suppression subtractive hybridization technique (SSH).

METHODS

The mRNA was isolated from Hep G2 cells transfected pcDNA3.1(-)-NS4A and pcDNA3.1(-) empty vector, respectively, then the cDNA was synthesized. SSH method was employed to analyze the differentially expressed RNA sequence between the two groups. The twice enriched PCR products were subcloned into T/A vectors to set up the subtractive library. Amplification of the library was carried out with E.coli strain JM109. The cDNA was sequenced and analyzed in comparison with those in GenBank with Blast search after PCR.

RESULTS

The amplified library contained 36 positive clones. Colony PCR showed that 36 clones contained 200-1000 bp inserts. Sequence analysis was performed in 25 clones, and the full length sequences were obtained with bioinformatics method. Altogether 20 kinds of coding sequences were achieved, which consisted of 18 kinds of known and 2 kinds of unknown ones. The obtained sequences may be target genes transactivated by NS4A protein of HCV, among which some genes coding for proteins involved in cell cycle regulation, cell apoptosis, signal transduction pathway and tumour development.

CONCLUSION

A subtractive library of genes transactivated by NS4A protein of HCV was constructed successfully, which brought some new clues for studying the biological functions and pathogenesis of the viral proteins.

Prevalence of mitochondrial DNA haplogroups in an Australian population

Mitochondrial DNA (mtDNA) haplogroups are 'neutral polymorphisms' in the mtDNA genome, which have accumulated and persisted along maternal lineages as the human population has migrated worldwide. Three ethnically distinct lineages of human mtDNA populations have been identified: European, characterized by nine haplogroups H, I, J, K, T, U, V, W and X; African, characterized by superhaplogroup L and Asian, characterized by superhaplogroup M. We studied the prevalence of mtDNA haplogroups in participants of the Blue Mountains Eye Study, a large population-based survey of vision conducted between 1991 and 2000 of non-institutionalized permanent residents aged 49 years or older from two suburban postcode areas, west of Sydney, Australia. Total DNA isolated from either hair follicles or blood was available for 3377 of the 3509 participants (96.2%) to determine mtDNA haplogroups by polymerase chain reaction/restriction fragment length polymorphism analysis. Approximately 94.2% of samples could be assigned to one of the nine major European haplogroups, whereas a further 1.2% included the African (L) and Asian (M) superhaplogroups. The five principal haplogroups represented were H (42.9%), U (14.1%), J (10.7%), T (9.2%) and K (8.1%), which together included 85% of this population.