Immunity testing against COVID-19 from blood by an IoT-enabled and AI-controlled multiplexed microfluidic platform

Developing herd immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is pivotal for changing the course of the coronavirus disease 2019 (COVID-19) pandemic. However, the uncertainty of vaccine-induced immunity development and inequitable distribution of vaccines hinders the global vaccination effort. Therefore, routine serodiagnosis and ensuring effective vaccination on a time-to-time basis are essential for developing sustainable immunity against SARS-CoV-2. Herein, an AI-driven multiplexed point-of-care testing (POCT) platform capable of utilizing a microfluidic lab-on-a-chip (LOC) device has been proposed for analyzing bodily fluid response against SARS-CoV-2. The developed platform has been successfully utilized for the quantification of SARS-CoV-2 S-protein, N-protein, IgM, and IgG from human blood samples with limits of detection (LODs) as low as 0.01, 0.02, 0.69, and 0.61 ng/mL respectively. Finally, a data-receptive web-based dashboard system has been developed and demonstrated to provide real-time, territory-specific analysis of herd immunity progress from the test results. Thus, the proposed platform could be an imperative tool for healthcare authorities to analyze and restrain ongoing COVID-19 outbreaks or similar pandemics in the future by ensuring effective immunization.

Lithography-free interdigitated electrodes by trench-filling patterning on polymer substrate for Alzheimer's disease detection

Microelectrodes have played a crucial role in electrochemistry for the last few decades. However, the conventional lithographic processes, the key players in fabrication, are nonetheless technologically challenging, pricey, and lack reproducibility. In this work has developed a novel and low-cost patterned-replication fabrication technology for interdigitated electrode array (IDA) electrodes on the polymer substrate. Conventional UV-lithography has been utilized to fabricate the nickel IDA electrode pattern as a master mold on the stainless-steel substrate, which was replicated onto the polymer substrate by the hot-emboss technique. Then, gold was deposited on the replicated wafer by electron beam evaporation, and finally adhesive tape lift-off was used to obtain the gold IDA electrode. The fabricated IDA electrode was applied for electrochemical detection of various p-aminophenol (PAP) concentrations as a representative biomarker with a detection limit of 0.01 nM. Finally, different levels of amyloid beta 42 (Aß42) and amyloid beta aggregated (Aß Agg.), two Alzheimer's disease (AD) biomarkers, were measured using the developed IDA electrode via e-ELISA using enzyme by-products PAP. While quantified, the proposed IDA electrode successfully detects Aß42 and Aß Agg. with the lower detection limit (LOD) of 3.9 and 7.81 pg/ml, respectively.

Artificial Intelligence-Controlled Microfluidic Device for Fluid Automation and Bubble Removal of Immunoassay Operated by a Smartphone

There have been tremendous innovations in microfluidic clinical diagnostics to facilitate novel point-of-care testing (POCT) over the past decades. However, the automatic operation of microfluidic devices that minimize user intervention still lacks reliability and repeatability because microfluidic errors such as bubbles and incomplete filling pose a major bottleneck in commercializing the microfluidic devices for clinical testing. In this work, for the first time, various states of microfluid were recognized to control immunodiagnostics by artificial intelligence (AI) technology. The developed AI-controlled microfluidic platform was operated via an Android smartphone, along with a low-cost polymer device to effectuate enzyme-linked immunosorbent assay (ELISA). To overcome the limited machine-learning capability of smartphones, the region-of-interest (ROI) cascading and conditional activation algorithms were utilized herein. The developed microfluidic chip was incorporated with a bubble trap to remove any bubbles detected by AI, which helps in preventing false signals during immunoassay, as well as controlling the reagents' movement with an on-chip micropump and valve. Subsequently, the developed immunosensing platform was tested for conducting real ELISA using a single microplate from the 96-well to detect the Human Cardiac Troponin I (cTnI) biomarker, with a detection limit as low as 0.98 pg/mL. As a result, the developed platform can be envisaged as an AI-based revolution in microfluidics for point-of-care clinical diagnosis.

Smartphone-Based Fully Automated Optofluidic Device with Laser Irradiation-Induced Image Whitening

Herein, we have developed a fully automated optofluidic device to execute enzyme-linked immunosorbent assay (ELISA) using an active 96-well hybrid lab-on-a-chip (LOC) device. To automate the solution loading into the reaction zone of the device and the post-assayed signal analysis, laser irradiation-induced image whitening was utilized with a smartphone-based optical platform. Two optical phenomena were utilized in our platform to detect the liquid in the reaction chamber using a smartphone. First, by Fresnel's equation, the refraction difference between air and water resulted in the intensity change of the reflected light from the reaction chamber. Therefore, when the liquid was entering into the reaction chamber, the intensity of the reflected light was changed. Second, when the light intensity increases, the smartphone-captured image whitens out due to saturation, even when the red color light was incident. Therefore, by measuring the RGB value of the smartphone image, the intensity changes by the liquid movement in the reaction chamber were successfully monitored. Our platform showed a low detection limit of 7.81 pg/mL for the detection of the NT-proBNP human cardiac biomarker with almost a half standard deviation, compared to the manually operated LOC-based ELISA. As a fully automated LOC adopting a conventional 96-well ELISA platform, we thus concluded that the developed platform can be widely applied for point-of-care clinical tests.

Fully integrated rapid microfluidic device translated from conventional 96-well ELISA kit

In this work, a fully integrated active microfluidic device transforming a conventional 96-well kit into point-of-care testing (POCT) device was implemented to improve the performance of traditional enzyme-linked immunosorbent assay (ELISA). ELISA test by the conventional method often requires the collection of 96 samples for its operation as well as longer incubation time from hours to overnight, whereas our proposed device conducts ELISA immediately individualizing a 96-well for individual patients. To do that, a programmable and disposable on-chip pump and valve were integrated on the device for precise control and actuation of microfluidic reagents, which regulated a reaction time and reagent volume to support the optimized protocols of ELISA. Due to the on-chip pump and valve, ELISA could be executed with reduced consumption of reagents and shortening the assay time, which are crucial for conventional ELISA using 96-well microplate. To demonstrate highly sensitive detection and easy-to-use operation, this unconventional device was successfully applied for the quantification of cardiac troponin I (cTnI) of 4.88 pg/mL using a minimum sample volume of 30 µL with a shorter assay time of 15 min for each ELISA step. The limit of detection (LOD) thus obtained was significantly improved than the conventional 96-well platform.

Toward a disposable low-cost LOC device: heterogeneous polymer micro valve and pump fabricated by UV/ozone-assisted thermal fusion bonding

Herein, a heterogeneous polymer micro valve and pump with a polypropylene (PP) membrane was developed in a low-cost manner via UV/ozone-assisted thermal fusion bonding. The proposed fabrication technique allowed for a geometrically selective bonding; consequently, the membrane was prevented from bonding with the valve seat of the diaphragm micro-valve, without patterning a protection layer or introducing an additional structure. The developed device withstands 480 kPa of static pressure and up to 350 kPa of a vibration pressure, providing sufficient bonding strength for microfluidic actuations. The fabricated micro valve and pump are fully characterized and compared with a poly(dimethylsiloxane) (PDMS) membrane glass device, showing comparable valving and pumping performance. As a result, the robust PP membrane micro valve and pump are simply implemented in a facile manner, and demonstrated excellent performance, which is highly desirable for mass production of disposable lab-on-a-chip (LOC) devices.

Herein, a heterogeneous polymer micro valve and pump with a polypropylene (PP) membrane was developed in a low-cost manner via UV/ozone-assisted thermal fusion bonding.

Microfluidic Adapter Converting a 96-Well Cartridge into an Autonomous Microfluidic Device

In this study, an immunosensing platform by integrating a single array of conventional 96-well cartridges with low-cost polydimethylsiloxane (PDMS) pillars and thermoplastic chip was designed and developed to execute enzyme-linked immunosorbent assay (ELISA). The platform provides multiple (eight) reaction chambers for sequentially detecting multiple analytes under similar assay environments. For multiple immunoassays, the reaction chambers are consequently activated using a microvalve integrated with the sensing zones via the thermoplastic chip. Because the reaction zones are able to be selected and isolated from each other by the microvalve, multiple immunoassays can be implemented, avoiding cross-contamination. The performance of the sensing platform demonstrated its effectiveness in assaying with an optimal sample volume of 10 μL with an assay time of 10-15 min for different assay steps, which is much lower than the conventional immunoassay using 96-well plates. Thus, a low detection limit of 9.75 pg/mL is achieved using the developed platform to successfully detect the cardiac troponin I (cTnI). As a result, the cost-effectively made PDMS pillars and 96-well cartridge based hybrid immunosensing platform are widely applicable for high-throughput multiple lab-on-a-chip immunoassays.

Temporal Control of WNT Activity Regulates Tooth Number in Fish

Wnts determine cell polarity, cell proliferation, and cell differentiation during embryogenesis and play an essential role during tooth development initiation and morphogenesis. Wnt/β-catenin signaling has a time-dependent role in development because various signaling molecules that mutually interact are involved in the pathway, and tight regulation of the pathway is essential for normal development. Studies investigating how the Wnt/β-catenin signaling pathway controls the different stages of tooth development are rare. Specifically, the effects of Wnt/β-catenin signaling loss of function on different stages of tooth development are currently unknown. Here, we report the stage-dependent role of Wnt/β-catenin signaling in tooth development. In vivo loss and gain of function of Wnt/β-catenin signaling were implemented through the genetic overexpression of DKK1 with heat shock-inducible transgenic models and the pharmacologic inhibition of β-catenin destruction complex formation in zebrafish, respectively. We demonstrated that transient inhibition of Wnt/β-catenin signaling interrupted tooth development in a stage-dependent manner and conditional activation of Wnt/β-catenin signaling during 4V morphogenesis inhibited the development of 3V. These findings suggest that Wnt/β-catenin signaling plays an important role in the morphogenesis of teeth and the initiation of sequential tooth development in a stage-dependent manner.

Effect of Irradiance and Exposure Duration on Temperature and Degree of Conversion of Dual-Cure Resin Cement for Ceramic Restorations

This study investigated the effects of irradiance and exposure duration on dual-cured resin cements irradiated through ceramic restorative materials. A single light-curing unit was calibrated to three different irradiances (500, 1000, and 1500 mW/cm²) and irradiated to three different attenuating materials (transparent acryl, lithium disilicate, zirconia) with 1-mm thicknesses for 20 or 60 seconds. The changes in irradiance and temperature were measured with a radiometer (or digital thermometer) under the attenuating materials. The degree of conversion (DC) of dual-cure resin cement after irradiation at different irradiances and exposure durations was measured with Fourier transform near infrared spectroscopy. Two-way analysis of variance revealed that irradiance ( p<0.001) and exposure duration ( p<0.001) significantly affected temperature and DC. All groups showed higher DCs with increased exposure times ( p<0.05), but there were no statistically significant differences between the groups irradiated with 1000 mW/cm² and 1500 mW/cm² ( p>0.05). Higher-intensity irradiances yielded higher temperatures ( p<0.05), but exposure time did not affect temperature when materials were irradiated at 500 mW/cm² ( p>0.05).

A disposable on-chip microvalve and pump for programmable microfluidics

In this work, a low-cost PDMS micro-pump and -valve have been designed and developed to control multiple reagents for enzyme-linked immunosorbent assay (ELISA) on a programmable lab-on-a-chip (LOC) platform. The micro pump and valves were precisely controlled by selectively pressurizing the PDMS channels and chamber to actuate the multiple reagents in a controlled manner. Selective pressurizing of the PDMS structures was initiated by a simple system that maneuvered a single roller bar operated by a programmed microprocessor. The performance of the micro-pump was fully characterized and a minimum fluid volume of 1 μL was controlled. Also, the on-chip microvalves were programmed to flow the multiple reagents to automatically process the multi-step ELISA procedures. By applying the proposed platform, 19.40 pg ml-1 cardiac troponin T (cTnT) was successfully detected on the LOC device by using multiple programmed valves as multiple steps of the enzyme-linked sandwich immunoassay. As a result, the developed micro-pump and -valve, which were successfully applied to actuate a series of solutions in a controlled manner, can be widely applied to lab-on-a-chip based bioassays.

On-chip signal amplification of magnetic bead-based immunoassay by aviating magnetic bead chains

In this work, a Lab-on-a-Chip (LOC) platform is used to electromagnetically actuate magnetic bead chains for an enhanced immunoassay. Custom-made electromagnets generate a magnetic field to form, rotate, lift and lower the magnetic bead chains (MBCs). The cost-effective, disposable LOC platform was made with a polymer substrate and an on-chip electrochemical sensor patterned via the screen-printing process. The movement of the MBCs is controlled to improve the electrochemical signal up to 230% when detecting beta-type human chorionic gonadotropin (β-hCG). Thus, the proposed on-chip MBC-based immunoassay is applicable for rapid, qualitative electrochemical point-of-care (POC) analysis.

Histogram analysis for smartphone-based rapid hematocrit determination

A novel and rapid analysis technique using histogram has been proposed for the colorimetric quantification of blood hematocrits. A smartphone-based "Histogram" app for the detection of hematocrits has been developed integrating the smartphone embedded camera with a microfluidic chip via a custom-made optical platform. The developed histogram analysis shows its effectiveness in the automatic detection of sample channel including auto-calibration and can analyze the single-channel as well as multi-channel images. Furthermore, the analyzing method is advantageous to the quantification of blood-hematocrit both in the equal and varying optical conditions. The rapid determination of blood hematocrits carries enormous information regarding physiological disorders, and the use of such reproducible, cost-effective, and standard techniques may effectively help with the diagnosis and prevention of a number of human diseases.

A smart pipette for equipment-free separation and delivery of plasma for on-site whole blood analysis

A novel device of smart pipette has been suggested to extract and deliver plasma from whole blood in a disposable format. By operating an on-chip disposable micropump, approximately 30 μL of plasma was obtained from 100 μL of whole blood within 5 min without any external equipment for point-of-care blood analysis.

A DN-mda5 transgenic zebrafish model demonstrates that Mda5 plays an important role in snakehead rhabdovirus resistance

Melanoma Differentiation-Associated protein 5 (MDA5) is a member of the retinoic acid-inducible gene I (RIG-I)-like receptor (RLR) family, which is a cytosolic pattern recognition receptor that detects viral nucleic acids. Here we show an Mda5-dependent response to rhabdovirus infection in vivo using a dominant-negative mda5 transgenic zebrafish. Dominant-negative mda5 zebrafish embryos displayed an impaired antiviral immune response compared to wild-type counterparts that can be rescued by recombinant full-length Mda5. To our knowledge, we have generated the first dominant-negative mda5 transgenic zebrafish and demonstrated a critical role for Mda5 in the antiviral response to rhabdovirus.

A modified laparoscopic ureterolithotomy by pulling ureter with Carter-Thomason fascial closure and ureter incision by broken 15th blade

BACKGROUND AND AIMS

To evaluate the efficacy and safety of a modified laparoscopic ureterolithotomy for the treatment of upper ureteral stones; this method involved the use of a Carter-Thomason fascial closure device, a broken 15th blade.

MATERIAL AND METHODS

From February 2009 to December 2012, 38 patients with unilateral upper ureteral stones were examined and classified into 2 groups: one group underwent conventional laparoscopic ureterolithotomy (n = 21) and the other group underwent modified laparoscopic ureterolithotomy (n = 17). The modified laparoscopic ureterolithotomy consisted of the use of a Carter-Thomason fascial closure to extract the black silk along with the nylon tape. The ureter incision was made with a modified instrument consisting of a needle holder with a broken 15th blade tip.

RESULTS AND CONCLUSIONS

Patient demographics were similar in both groups. No significant differences were detected between the conventional laparoscopic ureterolithotomy and modified laparoscopic ureterolithotomy groups with respect to operating time, estimated blood loss, and stone clearance rates. Drain-indwelling times were significantly shorter in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (3.2 ± 1.3 vs 4.7 ± 1.5 days). Hospital stay was significantly lesser in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (4.3 ± 1.2 vs 5.2 ± 1.2 days). No differences were detected in the ureteral stent indwelling time for the two groups. The use of the Carter-Thomason fascial closure facilitated ureter handling, and the use of a needle holder with a broken 15th blade tip enabled a sharp and precise ureteral incision. Our method allows early removal of the drain and thus earlier patient discharge.

Abstract P2-09-18: Identification of synergistic drug combination for HER2 positive breast cancer

Breast cancer is one of the leading causes of death worldwide. 25-30% of breast cancer has HER2 gene amplification, which tend to give rise to poorly-differentiated and high grade tumor with a higher likelihood of spreading. Currently, trastuzumab and lapatinib are the only two FDA-approved treatments that target HER2 positive breast cancer. However, resistance to both drugs is already reported. Since breast cancer is considered to be one of genetic diseases caused by multiple gene aberrations, we used synergistic drug combination as a strategy to overcome these growth signaling pathway abnormalities. To identify new drug combination with lapatinib, we performed a cell-based screen against a library of clinical drugs of 3,200 compounds. Triptolide, a traditional Chinese medicine emerged from the screen with strong synergistic effect with lapatinib in HER2 positive breast cancer cells. This effect was specific to HER2 positive breast cancer. The whole HER2 signaling pathway was inhibited and more cells underwent apoptosis. Besides, both HER2 protein and mRNA levels were decreased in cells treated with the combination. This drug combination was also effective in breast cancer xenograft models of mice. Together, these findings suggest that both triptolide and lapatinib can be used as a promising drug combination for HER2 positive breast cancer.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-09-18.

Formation of lipid bilayers inside microfluidic channel array for monitoring membrane-embedded nanopores of phi29 DNA packaging nanomotor

An efficient method to form lipid bilayers inside an array of microfluidic channels has been developed and applied to monitor the membrane-embedded phi29 DNA packaging motor with an electrochemical characterization on a lab-on-a-chip (LOC) platform. A push-pull junction capturing approach was applied to confine a small amount of the lipid solution inside a microchannel. The selective permeability between solvents and water in PDMS was utilized to extract the solvent from the lipid solution, resulting in a self-formation of the lipid bilayer in the microchannel array. Each microchannel was independently connected to a silver/silver chloride (Ag/AgCl) electrode array, leading to a high-throughput monitoring of the nanopore insertion in the formed lipid bilayers. The formation of multiple lipid bilayers inside an array of microchannels and the simultaneous electrical and optical monitoring of multiple bilayer provides an efficient LOC platform for the further development of single phi29 motor pore sensing and high throughput single pore dsDNA sequencing.

An on-chip whole blood/plasma separator using hetero-packed beads at the inlet of a microchannel

A disposable rapid on-chip whole blood/plasma separator has been simply implemented by packing two different sizes of silica beads at the inlet of a microchannel for application to point-of-care (POC) clinical diagnostics. Our suggested technique can be utilized to implement an integrated microfilter for a wide range of Lab-on-a-Chip (LOC) devices.

Factors associated with participation in providing buccal cell DNA for a genetic epidemiologic study

AIMS

Our aim was to investigate factors associated with participation in buccal cell DNA collection using a large-scale prospective cohort study.

METHODS

Of the 183,634 Korea Medical Insurance Corporation (KMIC) prospective cohort study enrollees, 44,773 (36,794 men) were randomly selected. Buccal cell collection kits were mailed and collected from March to September 2004. Epidemiologic characteristics measured at baseline (1990 or 1992) and during follow-up (1998) were compared between respondents and nonrespondents.

RESULTS

Among the 13,084 (29.2%) respondents, 78.7% submitted usable samples (DNA concentration ≥3 μg). After adjustments for either or both age and family history of chronic disease, participation in men was positively associated with old age, a family history of chronic disease, low subjective health status, and regular exercise, and negatively associated with current smoking status. In women, only old age was associated with participation. Low body mass index (BMI) (<18.5 kg/m(2)), blood pressure, total cholesterol, and fasting blood glucose level were negatively associated with participation in men after adjustments for age and family history of chronic disease, but not in women, except for low BMI.

CONCLUSIONS

In this study, collecting buccal cell DNA by mailed survey has a low success rate (29%), and there appear to be a nonresponse bias and gender differences in the collection process.

Self-aligned nanogaps on multilayer electrodes for fluidic and magnetic assembly of carbon nanotubes

A self-aligned nanogap between multiple metal layers has been developed using a new controlled undercut and metallization technique (CUMT), and practically applied for self-assembly of individual carbon nanotubes (CNTs) over the developed nanogap. This new method allows conventional optical lithography to fabricate nanogap electrodes and self-aligned patterns with nanoscale precision. The self-aligned nickel (Ni) pattern on the nanogap electrode works as an assembly spot where the residual iron (Fe) catalyst at the end of the CNT is magnetically captured. The captured CNT is forced to be aligned parallel to the flow direction by fluidic shear force. The combined forces of magnetic attraction and fluidic alignment provide massive self-assembly of CNTs at target positions. Both multiwalled nanotubes (MWNTs) and single walled nanotubes (SWNTs) were successfully assembled over the nanogap electrodes, and their electrical characteristics were fully characterized. The CNTs self-assembled on the developed electrodes with a nanogap and showed a very reliable and reproducible current-voltage (I-V) characteristic. The method developed in this work can envisage the mass fabrication of individual CNT-assembled devices which can be applied to nanoelectronic devices or nanobiosensors.

The precise self-assembly of individual carbon nanotubes using magnetic capturing and fluidic alignment

A new method for the self-assembly of a carbon nanotube (CNT) using magnetic capturing and fluidic alignment has been developed and characterized in this work. In this new method, the residual iron (Fe) catalyst positioned at one end of the CNT was utilized as a self-assembly driver to attract and position the CNT, while the assembled CNT was aligned by the shear force induced from the fluid flow through the assembly channel. The self-assembly procedures were successfully developed and the electrical properties of the assembled multi-walled carbon nanotube (MWNT) and single-walled carbon nanotube (SWNT) were fully characterized. The new assembly method developed in this work shows its feasibility for the precise self-assembly of parallel CNTs for electronic devices and nanobiosensors.

Operative treatment of congenital torticollis

There were 47 patients with congenital muscular torticollis who underwent operative release. After a mean follow-up of 74 months (60 to 90), they were divided into two groups, one aged one to four years (group 1) and the other aged five to 16 years (group 2). The outcomes were assessed by evaluating the following parameters: deficits of lateral flexion and rotation, craniofacial asymmetry, surgical scarring, residual contracture, subjective evaluation and degree of head tilt. The craniofacial asymmetry, residual contracture, subjective evaluation and overall scores were similar in both groups. However, group 2 showed superior results to group 1 in terms of the deficits of movement, surgical scarring and degree of head tilt. It is recommended that operative treatment for congenital muscular torticollis is postponed until the patient can comply successfully with post-operative bracing and an exercise programme.

Surgical treatment for congenital arteriovenous malformation: 10 years' experience

OBJECTIVES

We report our 10 years experience of the surgical treatment of congenital arteriovenous malformation (AVM).

METHODS

We retrospectively reviewed the medical records of 145 patients with AVM who visited Samsung Medical Center in Korea from 1994 to 2003. Among the 145 patients, 21 patients were operated on. Preoperative embolo/sclerotherapy was done in 20 out of the 21 patients.

RESULTS

The surgically treated AVMs were 13 cases of head and neck lesions, four cases of upper extremity lesions, one case each of back lesion, uterus lesion, lower extremity lesion and multiple site lesions. There were 10 patients with the extratruncular infiltrating type, nine patients with the extratruncular limited type, one patient with a truncular superficial AV fistula and one patient with a mixed type. Fourteen cases were operated on for cosmetic reasons and since they had localized lesions, and five cases were operated on for tissue necrosis. Fourteen cases were cured by a single operation, yet seven cases needed several sessions of operation to cure the AVM or to promote wound healing after surgery.

CONCLUSION

The surgical treatment of AVM is a challenging issue for vascular surgeons. To minimise the complications related to surgery, a multidisciplinary team approach should be considered.

Diagnosing and optimizing water treatment processes by using particle counter: a case study in Korea

The goal of the flocculation process is to change the particle size distribution to best suit the subsequent processes. Although several methods exist to evaluate the flocculation process, no single universally accepted method has yet to be developed. The purpose of this paper is to present experiences whereby particle counting was used in the diagnosis and optimization of the flocculation process. A commercially available on-line continuous particle counter has been used in evaluating the design and the operation of this process at two conventional Water Treatment Plants. The evaluation is based on particle dynamics, i.e., the change of the number of small and large particles. Some design deficiencies in the distribution channel and flocculation process have been identified from this method, and thus some operational parameters are suggested for optimum performance. Because the optimum condition may be site-specific, the method presented in this paper will be beneficial in the evaluation of the flocculation process at other water treatment plants.

Discoid lateral meniscus in children: clinical manifestations and morphology

The authors investigated the correlation between the clinical manifestations and the morphology of discoid lateral meniscus. Thirty-eight children, age 5 to 17 years, with 39 cases of discoid lateral meniscus underwent an arthroscopic procedure and magnetic resonance imaging. The two most frequent preoperative clinical manifestations were pain and extension block. In 19 cases without surface tear, the most frequent clinical manifestation was extension block. In the sagittal magnetic resonance images, the mean thickness of the anterior portion of the discoid lateral meniscus (7.77 mm) in the group with extension block exceeded that (4.02 mm) in the group without extension block. Extension block was significantly more common in patients with the anterior hypertrophy type and the slab (anterior-posterior diffusely hypertrophic) type than in the posterior hypertrophy type by the modified Hall classification. As a result, extension block was significantly correlated with the morphology of the menisci. Also, the thickened anterior portion of the discoid lateral meniscus may be considered one of the mechanical factors that limit knee extension.

Antibacterial activity of xanthorrhizol from Curcuma xanthorrhiza against oral pathogens

The antibacterial activity of xanthorrhizol, isolated from the methanol extract of Curcuma xanthorrhiza roots, was evaluated against oral microorganisms in comparison with chlorhexidine.

An examination of the stress distribution in a soft-lined acrylic resin mandibular complete denture by finite element analysis

PURPOSE

The aim of this study was to calculate the effect of a soft liner on stress distribution within a mandibular complete denture. Although patients have welcomed soft-lined complete dentures, early fracture is one of the main reasons for failure. To minimize and prevent prosthesis fracture, the understanding of the stress distribution within a prosthesis is important.

MATERIALS AND METHODS

A 3-dimensional finite element model of a mandibular complete denture for a severely reduced residual alveolar ridge was constructed. The stress was calculated with linear static finite element analysis. The stress distribution in the soft-lined acrylic resin mandibular complete denture was compared with that of a conventional acrylic resin denture. The resulting stresses were displayed in terms of von Mises equivalent stress and the major principal stresses according to 5 different loading conditions: vertical loads in premolar, molar, and incisor regions; and oblique loads in premolar and molar regions.

RESULTS

Oblique loads produced higher levels of stress in the labial notch regions than vertical loads, where tension was the primary mode of stress. Significantly reduced levels of von Mises stress were calculated in soft-liner layers under all loading conditions. Acrylic resin denture base portions, however, exhibited higher levels of von Mises stress in soft-lined complete dentures.

CONCLUSION

Three-dimensional finite element analysis gave a realistic explanation of denture fractures and patient response to mandibular complete dentures with and without soft linings. Control of excess lateral occlusal contact might be helpful to reduce the probability of a fracture in soft-lined mandibular complete dentures.

Residual monomer concentrations in denture-base acrylic resin after an additional, soft-liner, heat-cure cycle

OBJECTIVES

To determine the effects on methylmethacrylate (MMA) monomer concentration of a second heat-cure cycle introduced for the purpose of processing a denture soft-liner.

METHODS

Two denture-base resins (Lucitone199 and Trevalon; Dentsply International, York, PA, USA) were selected. Heat-cure cycles were S (73 degrees C/90 min + 100 degrees C/30 min); L (73 degrees C/9 h); SM (S + 100 degrees C/2 h); LM (L + 100 degrees C/2 h). Cycles SM and LM thus simulated the effect of a further, soft-liner, heat-cure cycle. Groups (n = 6) of the specimens of the denture-base were prepared in the form of thin polymer disks. Monomer was then obtained from the broken fragments of disks by acetone extraction. Concentrations of MMA monomer were determined by reversed-phase high performance liquid chromatography (HPLC). Two-way ANOVA and independent sample t-tests were used to compare the results.

RESULTS

The cycle S, applied to Lucitone199, gave a mean concentration of 1.95 wt% MMA (SD 0.24). The cycle L gave the highest level of residual concentration of MMA monomer in both materials. Cycles SM and LM, applied to Trevalon and Lucitone199, gave significant reductions of residual concentration of MMA monomer (p < 0.05).

SIGNIFICANCE

The HPLC method was suitable for determining the amount of residual monomer in the denture-base acrylic resin. A further (soft-liner) heat-cure cycle had a statistically significant effect on reducing residual monomer concentrations, and this may have an effect upon mechanical properties.

Genu valgum in children with coxa vara resulting from hip disease

Three patients with chronic hip disease and progressive coxa vera deformity also had an unrecognized compensatory ipsilateral genu valgum until the primary hip deformity had been corrected operatively. This unrecognized genu valgum may become subtly worse in a growing child because of lateralization of the mechanical axis of the lower extremity with respect to the knee joint. Operative correction of coxa vara acutely moves the mechanical axis farther laterally, causing the occult genu valgum to become clinically apparent. The genu valgum may subtly worsen over time in a growing child because of lateralization of the lower extremity mechanical axis with respect to the knee joint, with the resulting abnormal Hueter-Volkmann forces across the physis causing progressive genu valgum. Recognition of occult genu valgum before correcting coxa vara in children allows the surgeon the better to advise the family about the need for possible subsequent operations on the knee.

Effect of the distraction rate on the activity of the osteoblast lineage in distraction osteogenesis of rat's tibia. Immunostaining study of the proliferating cell nuclear antigen, osteocalcin, and transglutaminase C

The purpose of this study was to investigate kinetics of the osteoblast lineage in the periosteum and endosteum according to different distraction rates in distraction osteogenesis of rat's tibia. An osteotomy was performed on 144 rats at the proximal diaphysis of the left tibia. The lengthening process was started after a latency period of 3 days, with varying distraction rates of 0.25 mm (group I), 0.5 mm (group II), 0.75 mm (group III), 1.0 mm (group IV) and proceeded until a 3.5 mm length gain was achieved. The animals that had an osteotomy alone, without lengthening, served as a control (group V). Immunohistochemical staining of proliferating cell nuclear antigen (PCNA), osteocalcin, and transglutaminase C (TGase C) were done on the four animals in each group sacrificed at post-distraction days 1, 3, 5, 7, 14, and 28 in order to observe the temporal changes among the experimental and control groups. Also, in order to compare the staining rates at a given length gain among the groups, animals in each group were additionally sacrificed 2 days post-distraction in group II; 2 and 4 days in group III; and 1.5, 2 and 2.5 days in group IV. The results of the expression rates of PCNA, osteocalcin, and TGase C in each group were analyzed quantitatively. The immunohistochemical study on callotasis of rat's tibia revealed that the osteoblast lineage in the periosteum is more activated than that in the endosteum for proliferation and differentiation by distraction, suggesting that the periosteum plays a more important role in neoosteogenesis in the distraction gap. Daily distraction rates ranging from 0.25 mm to 0.75 mm in two increments is appropriate for successful distraction osteogenesis of rat's tibia, but the rate of 0.25 mm a day is significantly better than that of 0.75 mm as was made evident in the immunohistochemical observations.

Chemopreventive effect of green tea (Camellia sinensis) against cigarette smoke-induced mutations (SCE) in humans

Green tea (Camellia sinensis) is consumed daily between the meals or after meals in Japan and other Asian countries. In recent years, green tea and its major polyphenolics have been demonstrated to prevent chemically induced tumors in a variety of experimental animal models system. The exact mechanism(s) of its anticarcinogenic activity remains to be elucidated, but green tea polyphenolics have demonstrated antimutagenic, anticarcinogenic, antioxidant, and antipromotional effects, including inhibition of Phase I and inducing Phase II enzymes. Enzyme activities of glutathione peroxidase, catalase, and quinone reductase, and glutathione S-transferase are also induced. However, a paucity of green tea effects in humans prompted us to investigate antimutagenic effects of green tea against smoke-induced mutation in humans. Chemopreventive effects of green tea and coffee among cigarette smokers were examined in 52 clinically healthy male subjects between 20-51 years of age. Blood specimens were obtained from non-smokers (Group I), smokers (II), smokers consuming green tea (III), and smoker/coffee drinkers (IV). The mean years of cigarette smoking (> 10 cigarettes/day) of Groups II, III, and IV ranged from 13.4-14.7 years. Daily intake of green tea and coffee was 3 cups/day/6 months (III and IV). The frequencies of sister-chromatid exchange (SCE) in mitogen-stimulated peripheral lymphocytes from each experimental group were determined and statistically analyzed. SCE rates were significantly elevated in smokers (9.46 +/- 0.46) vs. non-smokers (7.03 +/- 0.33); however, the frequency of SCE in smokers who consumed green tea (7.94 +/- 0.31) was comparable to that of non-smokers, implying that green tea can block the cigarette-induced increase in SCE frequency. Coffee, by contrast, did not exhibit a significant inhibitory effect on smoking-induced SCE.

Evolution of a specific fluorogenic derivatization of ivermectin for bioanalytical applications. A review

The evolution of the fluorogenic derivatization of ivermectin is traced through a series of continual modifications that have resulted in improvements in speed and sensitivity. Since the original development of this selective analytical technique, the reaction time has been shortened from 24 h at 100 degrees C to < 30 s at room temperature and, through modifications of the derivatization reagent and catalyst, the sensitivity has also been increased 50-fold to 20 pg of analyte with no significant decrease in precision. A procedure is reported, based on the use of fluorescence derivatization, which eliminates the use of solid-phase columns for sample preparation and fluorophore isolation, and is faster and less cumbersome than previous methods. The method was evaluated with cattle and canine plasma samples over the concentration range 1.0-40 ng ml-1 of ivermectin. It has an accuracy of 1.9% (mean relative error) over this concentration range and a precision of 5.6% (RSD) at the 1 ng ml-1 ivermectin concentration level in a 1 ml plasma sample.

Identification of the secondary degradates of L-648,548 in an animal health formulation

L-648,548 is a semisynthetic analog of avermectin. During stability investigations of this compound in an animal health formulation, two new degradates were discovered. These degradates (L-648,548 phenol and its 8,9-Z isomer) were identified as the reaction products of 5-oxo-L-648,548 formed by oxidation of L-648,548. Addition of base to the reaction medium containing 5-oxo-L-648,548 was found to catalyze the formation of L-648,548 phenol via a postulated dehydration by an E1cb elimination followed by the rapid tautomerization of the C5 carbonyl. Photolysis of L-648,548 phenol with visible light (including ambient laboratory lighting) was found to readily produce 8,9-Z-L-648,548 phenol. This transformation was confirmed to be exclusively a photoinduced process.

Surgical correction of idiopathic medical femoral torsion

We reviewed 28 hips in 14 patients with severe bilateral idiopathic medial femoral torsion which had been corrected by intertrochanteric rotation osteotomy using crossed pins for fixation and a hip spica. There were 10 girls and 4 boys with a mean age of 7 years and 9 months. All had functional and cosmetic disability before operation. The average follow up was for 3 years and 9 months. Full correction was achieved in 27 hips. In one partial avascular necrosis of the femoral head occurred one year after operation and was treated by an acetabular augmentation procedure with a satisfactory outcome.

Chemopreventive effect of green tea (Camellia sinensis) among cigarette smokers

Chemopreventive effects of green tea and coffee among cigarette smokers were examined in 52 clinically healthy male subjects between 20 and 52 years of age. Blood specimens were obtained from nonsmokers (group I), smokers (group II), smokers consuming green tea (group III), and smokers drinking coffee (group IV). The mean number of cigarette smoking years (> 10 cigarettes/day) in groups II-IV ranged from 13.4 to 14.7 years. Daily intake of green tea and coffee was 2-3 cups/day for 6 months (groups III and IV). The frequencies of sisterchromatid exchange (SCE) in mitogen-stimulated peripheral lymphocytes from each experimental group were determined and analyzed statistically. SCE rates were elevated significantly in smokers (9.46 +/- 0.46) versus nonsmokers (7.03 +/- 0.33); however, the frequency of SCE in smokers who consumed green tea (7.94 +/- 0.31) was comparable to that of nonsmokers, implying that green tea can block the cigarette-induced increase in SCE frequency. Coffee, in contrast, did not exhibit a significant inhibitory effect on smoking-induced SCE.

A modified Wagner technique for femoral lengthening in skeletally mature patients with poliomyelitis

A modified Wagner technique using an Orthofix was employed for femoral lengthening in 62 skeletally mature patients with residual poliomyelitis. The first stage was similar to that of the original Wagner technique. However, distraction was started after 5 to 7 days at a rate of 1.5 mm per day. At the second stage, a neutralization plate was applied and a corticocancellous iliac strut graft inserted in the distracted site, preferably under compression. Cast immobilisation was not used and a long leg brace with a thigh corset allowed early knee movement and weightbearing. The average age at operation was 26 years and 6 months. The period of follow-up averaged 3 years and 2 months, and the average amount of lengthening was 4.2 cm. The overall rate of complication was 34%.

Liquid chromatographic determination of ivermectin in animal plasma with trifluoroacetic anhydride and N-methylimidazole as the derivatization reagent

Ivermectin is a potent anthelmintic agent which was detected at low concentrations in cattle plasma by LC after conversion to a fluorescent derivative. This was accomplished by reaction with acetic anhydride (AA) and pyridine for 24 h at 100 degrees C or with AA and N-methylimidazole (NMIM) for 1 h at 95 degrees C. Substituting trifluoroacetic anhydride (TFAA) for AA reduced the reaction time to less than 30 s at 25 degrees C, yielding an intensely fluorescent derivative with substantially fewer reagent by-products. The need for further sample preparation after derivatization with TFAA-NMIM was thereby eliminated, and detection limits of less than 20 pg ml-1 ivermectin could be achieved with 1 ml of plasma by a considerably simpler analytical procedure.