Landmark-wire technique of symptomatic subclavian artery occlusion

SUMMARY

The landmark at the opposite end of an occluded segment can be used for probing the occluded subclavian artery to be recanalized. Using this technique in three patients with symptomatic subclavian artery occlusion, we found the landmark-wire technique to be safe and effective for reopening completely occluded subclavian arteries. We also introduced a technique in which a protective device can be safely used throughout the stenting procedure.

Expression of clock genes Per1 and Bmal1 in total leukocytes in health and Parkinson's disease

BACKGROUND

There is a growing number of clinical studies that revealed a variety of behavioral and physiological desynchronies in patients with Parkinson's disease (PD). However, these desynchronies have not been defined at the molecular level.

METHODS

Using real-time RT-PCR assay, we analyzed the expression profiles of two principle clock genes, PER1 and BMAL1, in total leukocytes for 12 h during the evening, overnight and morning in subjects with PD and age/sex-matched healthy controls.

RESULTS

A difference in the expression pattern of BMAL1 but not PER1 was apparent during the dark span, where the relative abundance of BMAL1 was significantly lower in PD patients versus control subjects at 21:00, 00:00 and 06:00 h. Furthermore, expression levels of BMAL1 in PD patients correlated with their United Parkinson's Disease Rating Scale score at 06:00, 09:00 h, and with Pittsburgh Sleep Quality Index score at 06:00 h.

CONCLUSION

These results suggest that a peripheral molecular clock, as reflected in the dampened expression of the clock genes BMAL1 in total leukocytes, is altered in PD patients. In addition, the relative BMAL1 levels correlate positively with PD severity, which could provide a molecular basis to help monitor disease progression and response to investigational drugs.

Long pulse gastric electrical stimulation induces regeneration of myenteric plexus synaptic vesicles in diabetic rats

BACKGROUND

Gastric electrical stimulation (GES) may improve delayed gastric emptying in diabetic gastroparesis, but whether enteric nervous system (ENS) is directly involved in its mechanism of improvement in gastric motility is unclear. The aims were to investigate the correlation between the changes in ENS and effects of long pulse GES on them in diabetic rats induced by streptozotocin (STZ).

METHODS

Electron microscopy, immunohistochemistry, RT-PCR and western blot were used to evaluate changes of myenteric plexus neurons and synaptic vesicles in different stages of the diabetic rats. The effects of GES were detected by same methods after pacing wires were implanted and then diabetes was induced and followed by long pulse GES.

KEY RESULTS

Since 6 weeks after STZ injection, the nerve fibres were incompact and synaptic vesicles in myenteric neurons reduced. Furthermore, the myenteric neurons showed severe damage such as partial depletion of the axon, swelling of mitochondria and seriously decreased synaptic vesicles in 12 weeks after STZ injection. The synaptophysin and PGP9.5-positive area and expressions of synaptophysin mRNA and protein decreased with the duration of diabetes. Long pulse GES could induce increase of myenteric neuronal synaptic vesicles, synaptophysin and PGP9.5-positive area and in myenteric plexus. The synaptophysin mRNA and protein expression rose after GES, whatever GES beginning early or late, short-term or long-term.

CONCLUSIONS & INFERENCES

The longer duration of diabetes, the more significant damages to myenteric neurons and synaptic vesicles of diabetic rats; long pulse GES could induce regeneration of myenteric plexus synaptic vesicles, thereby reform gastric motility.

Increased lipolysis in adipose tissues is associated with elevation of systemic free fatty acids and insulin resistance in perilipin null mice

Elevated plasma levels of free fatty acids (FFAs) are thought to restrict glucose utilization and induce insulin resistance. Plasma FFA concentrations are primarily governed by lipolysis in adipocytes. Perilipin surrounds the lipid droplet in adipocytes and has a dual role in lipolysis regulation. Perilipin null mice studied by two independent laboratories exhibited similar phenotypes of reduced adipose mass and resistance to diet-induced obesity, but have inconsistent metabolic parameters such as plasma levels of FFA, glucose, and insulin. This discrepancy may be due to differences in genetic background, generation, and nutritional status of the animals examined. In this study, we examined the major metabolic parameters in 129/SvEv perilipin null mice fasted for 4 h and observed increased plasma concentrations of FFA, glycerol, glucose, and insulin. An increase in the score for the homeostasis model assessment of insulin resistance index confirmed the insulin resistance in perilipin null mice, which may be attributed to the plasma FFA elevation. Basal lipolysis was increased in adipose tissues or primary adipocytes isolated from perilipin null mice with increased mass and activity of hormone-sensitive lipase and adipose triglyceride lipase. The increased lipolytic action may accelerate FFA efflux from the adipose tissues to the bloodstream, thereby accounting for systemic FFA elevation and, hence, insulin resistance in perilipin null mice.

Novel and recurrent mutations in the filaggrin gene in Chinese patients with ichthyosis vulgaris

BACKGROUND

Ichthyosis vulgaris (IV) is a common inherited skin disorder, and the filament aggregating protein (filaggrin) is a key protein involved in skin barrier function. Mutations in the filaggrin gene (FLG) have recently been identified as the cause of IV. However, there have been no reports of FLG mutations in mainland Chinese families with IV.

OBJECTIVES

To identify FLG mutations in Chinese patients with IV.

METHODS

Eleven unrelated Chinese families with IV were examined for FLG mutations with denaturing high-performance liquid chromatography prescreening and sequencing. SNaPShot was employed to obtain a high-throughput screening for the identified mutations.

RESULTS

Three mutations - one novel mutation (Q1256X) and two known mutations (3321delA and E2422X) - were identified in these families. The novel mutation, Q1256X, found in a Chinese family with IV, was located in filaggrin repeat 3. Mutation 3321delA, previously found in Japanese patients, was present in eight Chinese families with IV. Mutation E2422X, previously found in a Dutch patient of Chinese origin, was present in two Chinese families with IV. Neither of the null mutations, Q1256X and E2422X, were found in 100 unrelated control cases from the Chinese population; however, the mutation ratio for 3321delA was 3% in these controls.

CONCLUSIONS

Our study suggests that each population may have a unique and prevalent set of FLG mutations.

Function analysis of a new type I PKS-SAT domain by SAT-EAT domain replacement

The function of a new starter unit acyltransferase (SAT) domain SAT-EF080951 (GenBank accession number) encoded in a new type I polyketide synthase (PKS) gene cluster EF568935 (GenBank accession number) isolated for this study was analyzed by domain replacement with an extender unit AT (EAT) domain of avermectin PKS. It was shown that the SAT-EF080951 incorporated malonyl-CoA specifically in vivo, which contradicted the specificity that we had previously determined by substrate binding test in vitro. The result of this study indicates that type I PKS-SAT can alter its specificity in vivo and functions well in extender units and proved the feasibility of the SAT-EAT domain replacement in type I PKS. We propose that SAT-EAT replacement strategy could be a novel route for increasing the diversity of new polyketides combinatorially biosynthesized. The new type I PKS-SAT-EF080951 studied herein may be further employed for related studies on enzymology or combinatorial biosynthesis of polyketides.

Balloon kyphoplasty for acute osteoporotic compression fractures

We reviewed the effectiveness of balloon kyphoplasty in the treatment of acute symptomatic vertebral compression fractures. We assessed radiographic and functional outcome in 11 patients with a 24.3 month follow-up from a retrospectively monitored series of 11 patients who underwent balloon kyphoplasty (BKP). A visual analogue scale (VAS) and the short McGill questionnaire (MPQ) were used to assess average symptoms. Eleven patients with 19 treated vertebrae completed the study. The VAS showed significant improvement after treatment: the initial score was 9.1+/-0.6 (mean+/-SD), falling to 2.7+/-1.07 by 24.3 months (P<0.001). The MPQ also showed a significant improvement (P<0.001) at follow-up. A new fracture was seen in one patient affecting two vertebrae adjacent to the treated level. On CT following the procedure, there was cement leakage in the disc in 9% of cases. BKP is a minimally invasive procedure that has been shown to be effective in the treatment of acute symptomatic vertebral compression fractures. It appears that BKP is associated with a low incidence of procedure-related complications and cement extravasation.

Epidemiology and prevention of hepatitis B virus infection in China

The concept of a hepatitis B vaccine was first introduced into China in 1978. China has been one of the first two developing countries to enact the universal hepatitis B vaccination programme for newborn babies in 1992, and has made tremendous achievements in the control of hepatitis B virus (HBV) infection since then. China now has both low and high endemic regions regarding HBV prevalence co-existing. Although China's drive to stop HBV spread has resulted in changes in HBV epidemic patterns, for the eventual elimination HBV infection in China, it is important to understand the current status of its epidemiology and the aspects of HBV transmission in different regions. More efforts are needed to improve and develop strategies for the control of HBV infection in China, particularly after implementing the policy of universal HBV immunization for all newborns.

Palmitic acid and docosahexaenoic acid opposingly regulate the expression of insulin-degrading enzyme in neurons

Previous results show that treatment with saturated fatty acids, such as palmitic acid (PA), induces the pathology of Alzheimer's disease (AD), while treatment with polyunsaturated fatty acids, such as docosahexaenoic acid (DHA), protects against AD pathology. However, the pharmacological mechanism underlying these opposite effects of fatty acids on AD is not well understood. Here, we show that PA treatment significantly reduced the expression of insulin-degrading enzyme (IDE), an important protease responsible for the degradation of amyloid-beta (A beta) in neural cells, while incubation with DHA up-regulated IDE levels in primary hippocampal neurons. Moreover, pre-incubation with PA attenuated the DHA-induced IDE expression. Taken together, these results suggest the opposite effects of saturated fatty acids and polyunsaturated fatty acids on the expression of IDE, indicating a novel mechanism underlying the pharmacological function of fatty acids in AD intervention.

The clinical study of repairing cauda equina fibres with fibrin glue after lumbar fracture and dislocation

STUDY DESIGN

A retrospective study.

OBJECTIVES

To study the outcome of repair of cauda equina fibres with fibrin glue after lumbar fracture and/or dislocation.

METHODS

Seven acute cases and one chronic case of L2 or L3 fracture and/or dislocation complicated with complete cauda equina injury were selected. Sural nerve or ventral roots of injured cauda equina were chosen to repair the motor cauda equina fibres with fibrin glue after open reduction and internal fixation of the unstable vertebrae. The functional recovery after surgery was observed.

RESULTS

Recovery of the strength of thigh muscles (iliopsoas, quadriceps femoris, gluteus maximus, adductors) was observed in all seven acutely injured patients (t=3.74, P<0.05), but not in the chronic one. Neither recovery of leg muscles nor sensation of the lower extremities was observed in any case.

CONCLUSIONS

The cauda equina ventral roots injured after lumbar fracture and/or dislocation can be repaired with fibrin glue and motor recovery is expected.

FSH aggravates periodontitis-related bone loss in ovariectomized rats

Alveolar bone loss is one of the prominent pathologic and clinical features of periodontitis. Recently, the direct effect of follicle-stimulating hormone (FSH) on bone resorption has been demonstrated. However, the effect of FSH on alveolar bone loss remains unknown. This study tested the hypothesis that FSH would exacerbate periodontitis-related alveolar bone loss. Experimental periodontitis was induced in ovariectomized rats, and the rats were treated with extrinsic FSH or its inhibitor, leuprorelin. After mandibles were collected, we performed morphological examinations to evaluate bone loss, enzyme histochemical tests for osteoclasts, and immunohistochemical examinations for FSH receptor (FSHR). The results showed that FSH significantly increased alveolar bone resorption compared with non-FSH-treated ovariectomized rats (P < 0.05), and the number of FSHR-positive cells was positively correlated with alveolar bone loss area (r = 0.682, P < 0.01). Our results suggested that FSH can aggravate alveolar bone loss by FSHR, independent of estrogen.

Simultaneous bilateral carotid stenting in high-risk patients

BACKGROUND AND PURPOSE

The safety and efficacy of SBCAS have not been evaluated in detail. The purpose of our study was to evaluate the outcome after SBCAS in high-risk patients compared with unilateral stent placement.

MATERIALS AND METHODS

Between March 2002 and October 2008, a total of 205 consecutive high-risk patients underwent CAS at our institution. Of these patients, 30 (14.6%) underwent SBCAS (n = 24) and staged SBCAS (n = 6). Patients who underwent unilateral CAS (n = 175) during the same period served as controls. The stroke risk factors, procedural results, and outcome at 30 days and 6 months, as well as the restenosis rate at 6 months, were compared by using either the chi(2) test or the Kruskal-Wallis equality-of-populations rank test.

RESULTS

Our data revealed no significant differences in the stroke risk factors between the SBCAS and the control group. HPS occurred more commonly in SBCAS (ie, 16.7%, 4/24) compared with 2.9% (5/175) in the control group (P = .014). However, there was no statistical significance between 2 groups in the event rate of stroke (minor and/or major stroke), death, or restenosis at 6 months.

CONCLUSIONS

There was no significant difference in outcome at 6 months following stent placement between SBCAS and unilateral CAS in the high-risk patient group, even though HPS occurred more commonly after SBCAS.

Impacts of residence time during storage on potential of water saving for grey water recycling system

Grey water recycling has been generally accepted and is about to move into practice in terms of sustainable development. Previous research has revealed the bacteria re-growth in grey water and reclaimed municipal water during storage. However, in most present grey water recycling practices, impacts of water quality changes during storage on the system's performance and design regulation have not been addressed. In this paper, performance of a constructed wetland based grey water recycling system was analysed by taking the constraint of residence time during storage into account using an object based household water cycle model. Two indicators, water saving efficiency (WSE) and residence time index (RTI), are employed to reflect the system's performance and residence time during storage respectively. Results show that WSE and RTI change with storage tank volumes oppositely. As both high WSE and RTI cannot be achieved simultaneously, it is concluded that in order to achieve the most cost-effective and safe solution, systems with both small grey and green tanks are needed, whilst accepting that only relatively modest water saving efficiency targets can be achieved. Higher efficiencies will only be practicable if water quality deterioration in the green water tank can be prevented by some means (e.g. disinfection).

Sequential injection analysis in capillary format with an electroosmotic pump

A system of sequential injection analysis (SIA) in capillary format based on an electroosmotic pump is introduced. The system exhibits excellent reliability and reproducibility (relative standard deviation 0.6-0.8%) for both simple and complex chemical reaction systems. The simplicity and flexibility of the field-decoupled electroosmotic pump has been found to be ideally suited for SIA. There is significant potential for miniaturizing the necessary instrumentation.

Biphasic effects of forskolin on tau phosphorylation and spatial memory in rats

To explore the role of protein kinase A (PKA) in regulating tau phosphorylation and spatial memory, we injected forskolin, an activator of PKA, at different concentrations into the rat brains. We found that forskolin at concentrations up to 80 microM enhanced tau phosphorylation and was associated with prominent spatial memory impairment. Higher concentrations of forskolin, up to 200 microM, were associated with reduced phosphorylation levels of tau and no memory deficits. Forskolin elevated cAMP and activated PKA in a dose-dependent manner. When infused at 200 microM, forskolin also resulted in the activation and overexpression of protein phosphatase-2A (PP-2A) and attenuated the okadaic acid-induced PP-2A inhibition. These data suggest that the upregulation of PKA by forskolin to a certain level may activate PP-2A but that the latter can ameliorate the PKA-induced tau phosphorylation and memory impairment in the rats.