Retraction: Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface

Retraction of 'Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface' by B. L. Wang et al., J. Mater. Chem. B, 2015, 3, 5501-5510, https://doi.org/10.1039/C5TB00597C.

[Liver transplantation for the treatment of acute liver failure in 3 cases with NBAS gene deficiency and literature review]

Objective: To investigate the clinical efficacy of liver transplantation in the treatment of acute liver in children with NBAS gene deficiency disease and their outcome. Methods: This retrospective study enrolled children with NBAS gene deficiency who were admitted to the Children's Hospital of Fudan University for liver transplantation from January 2013 to June 2022. The clinical data were collected and analyzed. Medical literature published before June 2022 was searched with the keywords of "NBAS" "neuroblastoma amplified sequence recurrent" "acute liver failure" "SOPH syndrome" "short stature with optic nerve atrophy" "Pelger-Huët anomaly" in PubMed, China National Knowledge Infrastructure and Wanfang database. Results: Liver transplantation was performed in 3 patients (2 males and 1 female) with NBAS deficiency. All patients presented with fever-triggered recurrent acute liver failure. The genetic detection found compound heterozygous NBAS gene pathogenic variants in them. The total episodes of acute liver failure before liver transplantation were 11, 2, and 4 respectively, and the age at liver transplantation was 3.5, 2.3, and 2.0 years respectively. During liver transplantation, patient 1 was in the convalescent phase of acute liver failure, patient 2 was in the acute phase, presenting with hepatic encephalopathy (grade V) and respiratory failure, and patient 3 was considered to be in the acute phase. After liver transplantation, patient 1 recovered normal liver function within 1 month and had no liver transplantation-related complications. Patient 2 had secondary epilepsy, intellectual disability, movement disorder, and transiently elevated transaminases. Patient 3 died of severe infection within 1 month. There was no literature in Chinese, 6 in English, 8 NBAS-deficient patients who were treated with liver transplantation. Total 11 patients presented with fever-triggered recurrent acute liver failure. Their age at liver transplantation ranged from 0.9 to 5.0 years. Postoperative complications occurred in 3 patients. Until the last visit, they were followed up for 0.7 to 14.0 years. Total 2 patients died and the 9 surviving patients did not develop acute liver failure. Conclusions: Liver transplantation is effective for the treatment of acute liver failure associated with NBAS gene disease. However, postoperative complications of liver transplantation may occur. The timing of liver transplantation still needs further research.

Characterization of microbial community profiles associated with quality of Chinese strong-aromatic liquor through metagenomics

AIMS

Microorganisms in fermentation pits (FPs) play key roles for Chinese-strong-aromatic-liquor (CSAL) production. However, the microbial community in the FPs is still poorly understood. Here, the aim of this study was to reveal the diversity and potential functions of microbiota in FPs.

METHODS AND RESULTS

Sequencing-by-synthesis-based metagenomic sequencing and annotation results revealed that the microbiota of FPs was primarily composed of Firmicutes (54·6%), Euryarchaeota (15·3%), Bacteroidetes (10·1%), Gammaproteobacteria (5·8%), Opisthokonta (5·7%) and Unclassified_Bacteria (2·3%). And 133 genera were identified as the dominant genera of this fermentative food. Lactobacillus, Sedimentibacter, Syntrophomonas, Methanoculleus, Methanobacterium, Bacillus, Clostridium, Galactomyces, Candida, Pichia, Penicillium and Aspergillus were defined as active populations for biosynthesizing the characteristic volatile compounds of CSAL. The study also revealed that the microbial community structures changed significantly with different cellar ages and over different geographical regions. (i) The presence of Bacteroidetes was the most distinctive feature that characterized the different FPs ages. (ii) Distinct contents of Gammaproteobacteria and Euryarchaeota were observed at different positions in the FPs. (iii) Euryarchaeota markedly contributed to the generation of the character of the liquors with distinct geographical associations.

CONCLUSIONS

This study demonstrated that the changes of microbial communities determined the different quality characteristics of CSAL.

SIGNIFICANCE AND IMPACT OF THE STUDY

This research contributes to a deeper understanding of the FPs microbial composition and shows a new microbial resource for biotechnological applications.

Cross-species hybridization of foot-and-mouth disease virus-infected BHK-21 cells using human and mouse oligonucleotide microarrays

Foot-and-mouth disease virus (FMDV) has a dual capacity to induce either acute or persistent infection in host animals. Establishment of an in vitro cell model of FMDV persistent infection facilitates the study of the mechanism underlying this type of infection. In this study, we analyzed gene expression profiles of both acute and persistent infections using cross-species microarrays. Our data suggest that human microarrays are more efficient than mouse microarrays in hybridization with cDNA from BHK-21 cells although the mouse is closer to the Syrian hamster in taxonomy. A set of differentially expressed genes (DEGs) that may be involved in the determination of acute or persistent infection was identified by using human or mouse microarrays. Seven common DEGs were found in both human and mouse arrays and showed similar fold changes. Among the DEGs, 33 genes were selected for further validation by using qRT-PCR and presented consistent results. The analysis of Gene Ontology Biological Processes indicated that various biosynthetic and metabolic processes were negatively regulated in the group of acute infection whereas multicellular organismal development processes were positively regulated in the group of persistent infection. Our study demonstrates the plausibility and utility of using cross-species microarrays to study FMDV-infected mammalian cells. The combined use of two types of microarrays can be more informative in exploring the mechanisms underlying the infections of FMDV.

[Primary hypogammaglobulinemia complicated with liver cirrhosis and literature review]

OBJECTIVE

To explore the pathogenesis, treatment and prognosis of primary hypogammaglobulinemia complicated with liver cirrhosis in a child.

METHOD

Pathogenesis, treatment and prognosis of X-linked agammaglobulinemia (XLA ) complicated with liver cirrhosis in a child were analyzed in Shanghai Children's Medical Center.Using"primary hypogammaglobulinemia"and"liver cirrhosis"as keywords, literatures were searched from Pubmed and Chinese data of Weipu and Wanfang data from January 1988 to January 2015.

RESULT

The patient was a 12 years old boy with the chief complaint of 3 times hematemesis with diagnosis of XLA in the past 7 years. He received treatment with immunoglobulin (Ig) monthly for 6 years. He had no hepatitis C virus( HCV ) infection and serologic tests for autoantibodies were negative. Anti-HBs, anti-HBe and anti-HBc were positive, which revealed previous hepatitis B virus(HBV) infection. Gastroscopy suggested esophageal gastric varices. Liver pathology showed liver cell degeneration, necrosis, fiber tissue hyperplasia and pseudolobuli. After hospitalization the boy underwent liver transplantation (LT). He was given tacrolimus (3 mg/d), prednisone (5 mg/d), lamivudine (150 mg/d) and acyclovir (900 mg/d) by oral administration after LT. After 3 months follow-up, the boy was alive and well with stable results of liver function tests. There were no report in Weipu and Wanfang data. A total of 19 cases, including 12 cases of common variable immunodeficiency, 3 cases of XLA, 2 cases of Hyper-IgM syndrome and 2 cases of congenital hypogammaglobulinemia were obtained from Pubmed published between January 1, 1988 and January 1, 2015. Seventeen of the cases had HCV infection. Two cases had autoimmune hepatitis. Of the HCV infected patients, 15 were given intravenous gamma globulin. Seven of the 19 cases survived. Among 5 cases who received liver transplantation, 3 cases died.

CONCLUSION

In addition to HCV infection and autoimmune hepatitis as causes of liver cirrhosis in primary hypogammaglobulinemia, chronic HBV infection is another cause. Intravenous gammaglobulin is an important way of transmitting HCV and HBV infection. The effect of liver transplantation remains to be evaluated via further follow-up and studies.

Bio-inspired terpolymers containing dopamine, cations and MPC: a versatile platform to construct a recycle antibacterial and antifouling surface

A new kind of bio-inspired terpolymer was synthesized by a conventional free radical terpolymerization of dopamine methacrylamide (DMA), 2-(dimethylamino)-ethyl methacrylate (DMAEMA) and 2-methacryloyloxyethyl phosphorylcholine (MPC) with azobisisobutyronitrile (AIBN) as an initiator. DMA consists of a biomimetic adhesive side chain covalently linked to a polymerizable methacrylate monomer. 1H NMR and gel permeation chromatography confirmed the successful synthesis of P(DMA-co-MPC-co-DMAEMA). The terpolymer could self-assemble on the macroscopic planar substrates with DMA as an anchor. After being quaternized by 1-bromo-heptane, terpolymers of P(DMA-co-MPC-co-DMAEMA+) with bactericidal function were obtained. The self-assembly terpolymer on the substrate was confirmed by X-ray photoelectron spectroscopy, water contact angle, spectroscopic ellipsometry and atomic force microscopy. The hydrophilicity and antifouling properties of the self-assembly coating increased greatly against bacteria, protein and cells with the increase of MPC content. As the existence of bactericidal cations for electrostatic targeting of bacteria as well as membrane lysis, the terpolymer coating showed excellent bactericidal function against E. coli and S. aureus. Biofilm inhibition assay showed that terpolymer coating was very efficient to resist bacterial adhesion and biofilm formation in a nutrient environment. Bacteria could be continuously "captured" and killed by the terpolymer coating, and then bacteria corpse was released into the solution. Importantly, this work provides a versatile strategy for the fabrication of a recycle antibacterial and antifouling surface to modify biomaterials.

Surface modification of titanium substrate with a novel covalently-bound copolymer thin film for improving its platelet compatibility

Despite of its widely uses in various clinical applications, the titanium-based material still faces different challenges, such as hemocompatibility and anti-biofouling characteristics required in various situations. The objective of this investigation was to develop a novel surface modification strategy for titanium-based material to improve the platelet compatibility that is important in rigorous blood-contacting cardiovascular applications. In this work, a series of copolymers, which composed of novel 6-acryloyloxy hexyl phosphonic acid (AcrHPA) and sulfobetaine methacrylate (SBMA) was synthesized. The phosphonic acid group in these copolymers can impart covalent binding to the titanium substrate while the zwitterionic sulfobetaine functionality is considered being able to reduce the platelet adhesion and activation on the modified titanium substrate. NMR analyses suggested that copolymerization reaction is likely not an ideal statistical reaction but to add the monomers in a random order. Studies have shown that the composition of the monomers affected the surface characteristics and platelet compatibility of these covalent-bound AcrHPA-SBMA copolymers on titanium substrate. Contact angle analysis has shown the addition of SBMA can increase surface hydrophilicity of the spun-coated copolymers. In addition, AFM analyses have revealed that the surface roughness of the spun-coated copolymer layer were varied with the ratio of AcrHPA and SBMA. The most platelet compatible surface was noted on the one modified by the highest amount of SBMA added (i.e. 70 mol%) in copolymerization. In summary, the surface modification scheme presented here would be of potential as well as manufacturing process applicable for future development in blood-contacting titanium-based biomedical devices.

Platelet compatibility improvement by proper choice of acidic terminal functionality for mixed-charge self-assembled monolayers

In this study two different series of mixed-charge self-assembled monolayers (SAMs) prepared with -N(+)(CH(3))(3)-terminated alkanethiol and strong dissociated monovalent -SO(3)H acid-terminated or weaker dissociated divalent -PO(3)H(2) acid-terminated alkanethiol in pure ethanol were characterized. The influence of the acidity of the anionic functionality in the mixed-charge SAMs on the surface characteristics and platelet compatibility was investigated. X-ray photoelectron spectroscopy indicated that a nearly equivalent amount of countercharged terminal groups was noted on the surface of -SO(3)H/-N(+)(CH(3))(3) mixed SAMs, while "-N(+)(CH(3))(3) thiol poor" phenomena were found on -PO(3)H(2)/-N(+)(CH(3))(3) mixed SAMs instead. This was caused by the distinct differences in solvation capability between the acidic anionic functional groups and solvent molecules and/or the interactions among the terminal ends of the thiols. This acidity difference also affected other interfacial properties and the platelet compatibility. The mixed SAMs formed from the mixture of -SO(3)H- and -N(+)(CH(3))(3)-terminated thiols showed higher surface hydrophilicity and exhibited the least amount of platelets adhered, but these two mixed SAMs were all fairly negatively surface charged. The structure of the hydration layer near the surfaces was likely affected by the acidity of the anionic functionality, and this would cause such a distinct behavior in platelet compatibility. It was concluded that the hydrophilic surfaces with nearly equal amounts of surface positively and negatively charged components could exhibit better platelet compatibility. This work demonstrated that the nature of the acidic terminal ends of alkanethiol is also a key factor for preparing mixed-charge SAMs with good platelet compatibility.

Improving the surface biocompatibility with the use of mixed zwitterionic self-assembled monolayers prepared by a proper solvent

In this study, the mixed self-assembled monolayers (SAMs) containing the mixture of long-chain alkanethiol, SH(CH(2))(11)NH(2) and SH(CH(2))(10)SO(3)H, was prepared as a model surface to examine the interaction between the biological environment and artificial surface. The 10% (v/v) NH(4)OH ethanolic solution and DMSO were chosen as the solvents for the preparation of these mixed SAMs and the "solvent effect" was discussed. X-ray photoelectron spectroscopy (XPS) has indicated that -SO(3)H/-NH(2) mixed SAMs formed from 10% (v/v) NH(4)OH ethanolic solution were surface "-SO(3)H poor", while a nearly equivalent amount of surface -SO(3)H functionality was presented on the mixed SAMs formed from DMSO. This has resulted from the different solvation capability between solvent molecules and the alkanethiol. Such solvent effects were also reflected in various surface properties such as surface wettability and surface zeta potential. The mixed SAMs formed from DMSO were more surface hydrophilic and less negatively surface charged than from 10% (v/v) NH(4)OH ethanolic solution. In addition, these mixed SAMs formed from DMSO exhibited the least amount of protein adsorbed as well as a better platelet compatibility than its counterpart from 10% (v/v) NH(4)OH ethanolic solution. These findings indicated that choosing a proper solvent for mixed zwitterionic SAM can greatly affect its surface properties and biocompatibility, such as to form a surface with near neutrality for reducing protein adsorption and subsequent platelet adhesion and activation.

Structural transformation of LiVOPO4 to Li3V2(PO4)3 with enhanced capacity

In the present investigation, we report the transformation of alpha-LiVOPO 4 to alpha-Li 3V 2(PO 4) 3, leading to an enhancement of capacity. The alpha-LiVOPO 4 sample was synthesized by a sol-gel method, followed by sintering at 550-650 degrees C in a flow of 5% H 2/Ar. The structural transformation of a triclinic alpha-LiVOPO 4 structure to a monoclinic alpha-Li 3V 2(PO 4) 3 structure was observed at higher sintering temperatures (700-800 degrees C in a flow of 5% H 2/Ar). The alpha-Li 3V 2(PO 4) 3 phase was characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, thermal gravimetric analysis, and X-ray absorption near edge spectrum (XANES) techniques. The valence shift of vanadium ions from +4 to +3 states was observed using in situ XANES experiments at V K-edge. The structural transformation is ascertained by the shape changes in pre-edge and near edge area of X-ray absorption spectrum. It was observed that the capacity was enhanced from 140 mAh/g to 164 mAh/g via structural transformation process of LiVOPO 4 to Li 3V 2(PO 4) 3.

Application of MVBC equation to predict mixed venous blood concentrations of sevoflurane in cardiac anaesthesia

We have proposed an equation for estimating the real-time mixed venous blood concentration (MVBC) of isoflurane in cardiac anaesthesia. However, information related to the application of our method to sevoflurane is lacking. We studied 12 patients undergoing cardiac surgery and anaesthetised with sevoflurane. At different time points, pulmonary arterial blood samples were collected for gas chromatography-mass spectrometry (GC-MS) to determine the real mixed venous concentrations of sevoflurane. The inspired and expired concentrations of sevoflurane, measured by a gas monitor, were used for the MVBC calculations. Using Bland-Altman analyses, we found that the calculated MVBCs accurately represent the actual concentrations of sevoflurane in pulmonary arterial blood, as shown by a near-zero percentage bias with a 0.14% precision between the two concentrations. The results demonstrated that our equation could be a useful method for estimating the pulmonary blood concentration of sevoflurane.

Thermal chip fabrication with arrays of sensors and heaters for micro-scale impingement cooling heat transfer analysis and measurements

The design and fabrication for a thermal chip with an array of temperature sensors and heaters for study of micro-jet impingement cooling heat transfer process are presented. This thermal chip can minimize the heat loss from the system to the ambient and provide a uniform heat flux along the wall, thus local heat transfer processes along the wall can be measured and obtained. The fabrication procedure presented can reach a chip yield of 100%, and every one of the sensors and heaters on the chip is in good condition. In addition, micro-jet impingement cooling experiments are performed to obtain the micro-scale local heat transfer Nusselt number along the wall. Flow visualization for the micro-impinging jet is also made. The experimental results indicate that both the micro-scale impinging jet flow structure and the heat transfer process along the wall is significantly different from the case of large-scale jet impingement cooling process.

Identification and characterization of mutations underlying Sanfilippo syndrome type A (mucopolysaccharidosis type IIIA)

Sanfilippo syndrome type A (mucopolysaccharidosis type IIIA; MPS IIIA) is caused by a deficiency of the lysosomal enzyme haparan N-sulphatase (NS). The genomic DNA segments of the NS gene from two Chinese patients with MPS IIIA were amplified by polymerase chain reaction, followed by DNA sequencing to study the molecular lesions. Four mutations (i.e. N42K, D235N, P293S and R377C) and five polymorphisms (i.e. IVS2-72A --> G, IVS2-26T --> C, IVS5+17C --> T, IVS5-37GC --> CTGT and R456H) were identified. Transfection of COS-7 cells with cDNA mutagenized to the corresponding mutations did not yield active enzyme, demonstrating the deleterious nature of the mutations. Western blot analysis revealed a 62-kDa precursor and 56-kDa mature forms for cells transfected with wild-type and polymorphic R456H enzymes. For cells transfected with mutant enzymes, the reduction in precursor and mature forms suggests an increased degradation of the mutant enzymes. The polymorphic DNA haplotype of the NS gene was analysed in 52 unrelated subjects. All five polymorphisms were in Hardy-Weinberg equilibrium. The strong non-random association among the five polymorphisms suggests little or no recombination in the NS gene.

Primary cerebral anaplastic large cell lymphoma containing abundant reactive histiocytes and eosinophils. A case report and literature review

Primary cerebral anaplastic large cell lymphoma (ALCL) is very rare. We report on our experience with such a case and review the literature. A 46-year-old Taiwanese woman presented with headache, weakness of her right extremity, and limited eye movement. A solid mass (5 cm x 4 cm) at the left occipital lobe was almost completely removed. The neoplastic cells, some of which had reniform or embryo-like nuclei, were large and were admixed with abundant eosinophils, histiocytes, and some small lymphocytes. These neoplastic cells expressed CD30, CD43, granzyme B and T-cell intracellular antigen-1, but not ALK1, CD3, CD20, CD45, CD79a, cytokeratin, and EMA. They were positive for Epstein-Barr virus-encoded mRNA by in situ hybridization. Polymerase chain reaction study of formalin-fixed tissue showed a clonal gene arrangement of the T-cell receptor-gamma chain. ALCL of T-cell lineage with cytotoxic phenotype was diagnosed. The patient received cranial irradiation and has remained with no evidence of disease for 25 months of follow-up.

DNA sequence plays a major role in determining nucleosome positions in yeast CUP1 chromatin

The role of DNA sequence in determining nucleosome positions in vivo was investigated by comparing the positions adopted by nucleosomes reconstituted on a yeast plasmid in vitro using purified core histones with those in native chromatin containing the same DNA, described previously. Nucleosomes were reconstituted on a 2.5 kilobase pair DNA sequence containing the yeast TRP1ARS1 plasmid with CUP1 as an insert (TAC-DNA). Multiple, alternative, overlapping nucleosome positions were mapped on TAC-DNA. For the 58 positioned nucleosomes identified, the relative positioning strengths and the stabilities to salt and temperature were determined. These positions were, with a few exceptions, identical to those observed in native, remodeled TAC chromatin containing an activated CUP1 gene. Only some of these positions are utilized in native, unremodeled chromatin. These observations suggest that DNA sequence is likely to play a very important role in positioning nucleosomes in vivo. We suggest that events occurring in yeast CUP1 chromatin determine which positions are occupied in vivo and when they are occupied.

Simultaneous determination of fluorinated inhalation anesthetics in blood by gas chromatography-mass spectrometry combined with a headspace autosampler

Although the fluorinated inhalation anesthetics, including desflurane, sevoflurane, isoflurane, enflurane, and halothane are commonly used, fatal cases resulting from their abuse or misuse have been reported. To date, gas chromatography (GC) equipped with different kinds of detectors has been utilized to analyze inhalation anesthetics. However, none of them can detect desflurane reliably or analyze all five common anesthetics simultaneously. The purpose of the present work is to further modify the previously developed headspace (HS) GC-MS method for blood isoflurane determination to analyze and distinguish five common clinical inhalation anesthetics, simultaneously. The modified HS-GC-MS method adopts a 60 m x 0.25 mm I.D., 0.25 microm film thickness DB-5 capillary column along with an adequate GC temperature program, which gives the five inhalation anesthetics, including isoflurane and its isomer, enflurane, a high resolution. The method also takes both the volatility and the influence of the top space on the obtained concentration into consideration and therefore keeps the sample loss acceptable even for analyzing the highly volatile desflurane. Within a certain concentration range of the calibration standard (about 20-300 microg/ml), this method shows a good linearity with correlation coefficients greater than 0.999. In addition, both within- and between-run precision and accuracy results meet the validation requirements as well as the tested results of practical blood samples of desflurane. In summary, this is a reliable analytical method to simultaneously determine the concentration of five common inhalation anesthetics in blood. Such a method is very practical for both clinical and occupational monitoring, as well as for analytical toxicology.

Activation of the mouse Ig germline epsilon promoter by IL-4 is dependent on AP-1 transcription factors

Induction of germline (GL) epsilon transcripts, an essential step preceding Ig isotype switching to IgE, requires activation of transcription factors by IL-4 and a B cell activator, e.g., CD40 ligand or LPS. We demonstrate that AP-1 (Fos and Jun), induced transiently by CD40 ligand or LPS, binds a DNA element in the mouse GL epsilon promoter. AP-1 synergizes with Stat6 to activate both the intact GL epsilon promoter and a minimal heterologous promoter driven by the AP-1 and Stat6 sites of the mouse GL epsilon promoter. By contrast, C/EBP beta, which trans-activates the human GL epsilon promoter, inhibits IL-4 induction of the mouse promoter, probably by attenuating the synergistic interaction between AP-1 and Stat6. Furthermore, AP-1 does not trans-activate the human GL epsilon promoter. Thus, induction of GL epsilon transcripts in mice and humans may be regulated differently. In addition, although mouse GL epsilon transcripts have a half-life of approximately 100 min, the RNA level continues to increase for up to 24 h, and the promoter appears to be active for at least 2 days after B cell activation. Altogether, these data suggest that induction of AP-1 activity, although transient, is required for activation of the mouse GL epsilon promoter by IL-4-induced Stat6.

Remodeling of yeast CUP1 chromatin involves activator-dependent repositioning of nucleosomes over the entire gene and flanking sequences

The yeast CUP1 gene is activated by the copper-dependent binding of the transcriptional activator, Ace1p. An episome containing transcriptionally active or inactive CUP1 was purified in its native chromatin structure from yeast cells. The amount of RNA polymerase II on CUP1 in the purified episomes correlated with its transcriptional activity in vivo. Chromatin structures were examined by using the monomer extension technique to map translational positions of nucleosomes. The chromatin structure of an episome containing inactive CUP1 isolated from ace1Delta cells is organized into clusters of overlapping nucleosome positions separated by linkers. Novel nucleosome positions that include the linkers are occupied in the presence of Ace1p. Repositioning was observed over the entire CUP1 gene and its flanking regions, possibly over the entire episome. Mutation of the TATA boxes to prevent transcription did not prevent repositioning, implicating a chromatin remodeling activity recruited by Ace1p. These observations provide direct evidence in vivo for the nucleosome sliding mechanism proposed for remodeling complexes in vitro and indicate that remodeling is not restricted to the promoter but occurs over a chromatin domain including CUP1 and its flanking sequences.

Identification and characterization of a prevalent hepatitis B virus X protein mutant in Taiwanese patients with hepatocellular carcinoma

The aim of this study was to investigate whether there was a particular hepatitis B virus (HBV) X protein (HBx) mutant associated with Taiwanese patients with hepatocellular carcinoma (HCC). Initially, the entire coding region of HBx gene from the serum samples of 14 Taiwanese patients were sequenced. A novel mutant, HBx-A31, was preferentially found in patients with HCC. Sera from 67 patients with HCC and 100 patients with chronic hepatitis B were thus subjected for codon 31 analysis using a dual amplification created restriction site method. HBx-A31 was detected more frequently in patients with HCC (52% versus 12%; P<0.001) and in patients with liver cirrhosis (44% versus 6%; P<0.001). Site directed mutagenesis experiment revealed that HBx-A31 was less effective in transactivating HBV enhancer I-X promoter complex, less efficient in supporting HBV replication, and less potent in enhancing TNF-alpha induced increment of CPP32/caspase 3 activities in HepG2 cells. In conclusion, a prevalent HBx mutant was identified in Taiwanese patients with hepatocellular carcinoma. Development of this mutant might represent a strategy of the virus to escape immune surveillance and thus contribute to the process of multiple-step hepatocarcinogenesis.

Cytologic changes in hepatocellular carcinoma after percutaneous acetic acid injection. Correlation with helical computed tomography findings

OBJECTIVE

To illustrate the cytologic features of hepatocellular carcinoma (HCC) after percutaneous acetic acid injection (PAI) and to correlate the cytologic findings with helical computed tomography (CT) findings.

STUDY DESIGN

The study included 30 patients with 37 HCC who had undergone PAI. Baseline cytomorphology of HCC was evaluated by needle aspiration in all cases. PAI under ultrasound guidance was done every three to seven days. Upon completion of PAI, fine needle aspiration cytology was performed and followed by helical CT within two weeks. The degeneration of HCC after PAI was classified into two grades. Grade 1 showed incomplete degeneration (99% of nuclear area); grade 2 showed complete degeneration or severe degeneration with cell debris or amorphous material only. The specimens were stained with Riu's method (Romanowsky system).

RESULTS

The cytologic changes after PAI included decreased cell number, reduced cellular aggregation, degeneration of cytoplasm and nucleus, and eosinophilic or basophilic background in all tumors. In all the 37 tumors without enhancement on helical CT, grade 2 degeneration was detected.

CONCLUSION

Our results reveal that grade 2 degeneration alone, demonstrated cytologically, could indicate almost complete necrosis of HCC after PAI, probably implying no need for booster PAI.

Primary hepatic epithelioid hemangioendothelioma: case report

Hepatic epithelioid hemangioendothelioma (HEH) is a very rare vascular tumor of the liver. It usually affects adult women and presents as multiple hepatic nodules with mainly peripheral distribution. It poses special difficulties for clinicians in its diagnosis and treatment because of its non-specific clinical manifestations and findings on imaging, and it is easy to be misdiagnosed pathologically. Its clinical course and prognosis are variable but supposed to be intermediate between hemangioma and angiosarcoma. The primary treatments of choice are radical resection or liver transplantation. We report a 62-year-old man with right upper quadrant abdominal pain of several days' duration, who was initially misdiagnosed as having a liver abscess. Finally, HEH was diagnosed on the basis of positive immunohistochemical staining for factor VIII-related antigen in tumor cells. This case could serve to highlight the pitfalls in diagnosing this rare tumor. Increasing the index of suspicion and familiarity with the radiological and histological characteristics of this tumor would facilitate the accurate diagnosis and thus avoid unnecessary interventions.

Rhabdomyolysis-induced acute renal failure after morphine overdose--a case report

The 39-year-old male in this report was a victim of C4 spinal cord injury for 7 years. He was regularly followed up at our pain clinic and psychiatric out-patient department (OPD) for treatment of his chronic pain with morphine, anticonvulsant and sedatives. At the night of December 15, 1997, he took approximately 0.1 gm of morphine and a certain number of flurazepam pills. On the next day, he experienced numbness and paresis in both legs in association with painful swelling of both thighs. Then he sought medical advice at our hospital and was admitted for investigation on December 20, 1997. Laboratory examination revealed elevated creatine kinase activity, increased urine myoglobin concentration and raised plasma creatinine, signifying the development of acute muscle damage. The excreted urine morphine concentration was as high as 6,384 ng/mL. Increased PYP uptake in the proximal portion of both thighs was noted on muscle scan. These abnormalities were resolved gradually over two weeks under conservative treatment. Morphine-induced rhabdomyolysis complicated by acute renal failure was highly suspected.

Succinylcholine-induced cardiac arrest in unsuspected becker muscular dystrophy--a case report

A five year-old boy undergoing elective tonsillectomy sustained cardiac arrest following the administration of a single dose of succinylcholine during induction of anesthesia. With a 10-minute cardiopulmonary resuscitation (CPR) during which intravenous calcium gluconate, epinephrine, and sodium bicarbonate were given and DC counter shock applied, we were successful to restore cardiac activity without neurological sequelae. The cause of cardiac arrest we speculated was hyperkalemia, possibly secondary to succinylcholine-induced rhabdomyolysis. It is suggested that succinylcholine should not be used in patients with known or suspected muscular dystrophy.

Interaction of stat6 and NF-kappaB: direct association and synergistic activation of interleukin-4-induced transcription

Signal transducer and activator of transcription 6 (Stat6) and NF-kappaB are widely distributed transcription factors which are induced by different stimuli and bind to distinct DNA sequence motifs. Interleukin-4 (IL-4), which activates Stat6, synergizes with activators of NF-kappaB to induce IL-4-responsive genes, but the molecular mechanism of this synergy is poorly understood. Using glutathione S-transferase pulldown assays and coimmunoprecipitation techniques, we find that NF-kappaB and tyrosine-phosphorylated Stat6 can directly bind each other in vitro and in vivo. An IL-4-inducible reporter gene containing both cognate binding sites in the promoter is synergistically activated in the presence of IL-4 when Stat6 and NF-kappaB proteins are coexpressed in human embryonic kidney 293 (HEK 293) cells. The same IL-4-inducible reporter gene is also synergistically activated by the endogenous Stat6 and NF-kappaB proteins in IL-4-stimulated I.29mu B lymphoma cells. Furthermore, Stat6 and NF-kappaB bind cooperatively to a DNA probe containing both sites, and the presence of a complex formed by their cooperative binding correlates with the synergistic activation of the promoter by Stat6 and NF-kappaB. We conclude that the direct interaction between Stat6 and NF-kappaB may provide a basis for synergistic activation of transcription by IL-4 and activators of NF-kappaB.

An international perspective of active euthanasia: attitudes of nurses in seven countries

This exploratory study examines the ethical justification that cancer care and dementia care nurses gave for active voluntary euthanasia. A convenient sample of 319 nurses working in seven countries was interviewed using a structured interview guide. The great majority of the nurses could not ethically justify active voluntary euthanasia. Even if the law changed, only 96 of the total sample viewed active voluntary euthanasia as ethical. For those nurses who could ethically justify active voluntary euthanasia, the majority did so because of the patients' suffering.

Enhanced phosphorylation of a 65 kDa protein is associated with rapid induction of stress proteins in 9L rat brain tumor cells

Induction of heat-shock proteins and glucose-regulated proteins in 9L rat brain tumor cells can be differentially elicited by sodium arsenite, cadmium chloride, zinc chloride, copper sulfate, sodium fluoride, and L-azetidine-2-carboxylic acid. The kinds of stress protein induced by the above chemicals varied considerably, mainly determined by the nature and the concentration of the chemicals, as well as the treatment protocols. In addition, at the concentrations where stress proteins can be induced, the above chemicals were able to suppress general protein synthesis and were cytotoxic. Enhanced phosphorylation of a protein with an apparent molecular weight of 65 kDa was detected during the induction of stress proteins except in azetidine treatments during which uptake of phosphate by the cells was impaired after prolonged incubation. The phosphate moiety on the 65 kDa phosphoprotein appeared to be alkaline-stable and two-dimensional gel electrophoresis revealed that the phosphoprotein resolved into four isoforms with isoelectric points ranging from 5.1 to 5.6. Enhanced phosphorylation of the same protein was also detected in heat-shocked and withangulatin A-treated 9L cells in which stress proteins were induced. It is suggested that this phosphoprotein may be a common target for heat stress response-stimulated phosphorylation and important in the further metabolic responses of the cell to stress.

[Experimental studies on the symptom-complex mechanism of pi man zao shi of dachengqi decoction]

Experiments have shown that Dachengqi Decoction can inhibit the activity of G-germs which commonly grow in the intestinal tract, inactivate the endotoxin directly in vitro, reduce the amplitude of fever caused by endotoxin injected intravenously, promote the gastric secretion and gastric retaining in rats, and increase the level of glycogen in liver. It also has some other effects. All these actions contribute to the explanation on the efficacy of Dachengqi Decoction to purge off the internal heat.

Okadaic acid as an inducer of the 78-kDa glucose-regulated protein in 9L rat brain tumor cells

Okadaic acid (OA), a potent inhibitor of protein phosphatases 1 and 2A, has been widely used as a tool for unravelling the regulation of cellular metabolic processes involving protein phosphorylation/dephosphorylation. It has recently been found that OA can induce reversible hyperphosphorylation of vimentin and reorganization of intermediate filaments [Lee et al., J. Cell. Biochem. 49: 378-393, 1992]. We report here that OA specifically induced the synthesis of a 78-kDa protein, which was identified as the 78-kDa glucose-regulated protein (GRP78) by two-dimensional sodium dodecylsulfate-polyacrylamide gel electrophoresis and peptide mapping. The induction of GRP78 by OA was dose-dependent and reversible. For 7 h treatments, GRP78 synthesis was initially enhanced under 50 nM OA and became the highest (about 6-fold) under 200 nM OA. Meanwhile, under 200 nM OA, GRP78 synthesis was initially enhanced after 4 h and reached its maximal level (about 8-fold) after 15 h of treatment. Subsequently, upon removal of OA, the level of OA-induced GRP78 was reduced to basal level after 12 h of recovery. Induction of GRP78 synthesis by OA was abolished in cells pretreated with actinomycin D and cycloheximide, indicating that it was regulated at the transcriptional level and its induction required de novo protein synthesis. Furthermore, OA suppressed protein glycosylation, and the result lent support to the hypothesis that suppression of protein glycosylation may correlate with induction of GRP78 synthesis.

A survey of 790 cases of astrocytoma

790 cases of cerebral astrocytoma, which consisted of 181 cases of astrocytoma grade I, 282 cases of grade II, and 327 cases of grade III-IV, histopathologically verified, are presented. The sex and age distribution, topographical distribution of the tumours, and clinical manifestations are analyzed. A total of 862 operations were performed, and 69 cases (8.6%) were operated on more than twice for recurrence. The operative mortality was 7.7%. 179 of the survivors following operation received a combined treatment with radiotherapy and/or chemotherapy. Based on the follow-up study of 170 cases, the factors which may correlate with the length of survival, are discussed.