Theophylline-Loaded Pectin/Chitosan Hydrochloride Submicron Particles Prepared by Spray Drying with a Continuous Feeding Ultrasonic Atomizer

Pectin/chitosan hydrochloride (CHC) particles containing theophylline were prepared by a spray-drying apparatus coupled with a continuous feeding ultrasonic atomizer and a heating column. The formation of the submicron particles was investigated at various compositions of pectin solutions added with a chitosan hydrochloride or calcium chloride solution as a crosslinking agent. Scanning electron microscopic (SEM) images showed the pectin/chitosan hydrochloride particles had spherical and smooth surfaces. Depending on the feeding concentrations, the produced particles had diameters in the range of 300 to 800 nm with a narrow size distribution. Furthermore, the theophylline (TH)-loaded pectin/CHC particles were also prepared by the same apparatus. The TH release from the submicron particles in phosphate-buffered saline at 37 °C was monitored in real-time by a UV-Visible spectrophotometer. The Ritger-Peppas model could well describe the TH release profiles. All the diffusional exponents (n) of the release systems were greater than 0.7; thus, the transport mechanism was not a simple Fickian diffusion. Particularly, the n value was 1.14 for the TH-loaded particles at a pectin/CHC weight ratio of 5/2, which was very close to the zero-order drug delivery (n = 1). Therefore, the constant drug-release rate could be achieved by using the spray-dried pectin/CHC particles as the drug carrier.

Development of a novel resin for provisional prostheses using hyperbranched polyurethane acrylate and triethylene glycol dimethacrylate - An in vitro study

PURPOSE

To develop a novel resin for provisional prostheses using hyperbranched polyurethane acrylate (HBPUA) and triethylene glycol dimethacrylate (TEGDMA) with promising mechanical properties and low volumetric shrinkage.

METHODS

Four groups including TIH3-0 (100 wt% TEGDMA), TIH3-30 (30 wt% HBPUA + 70 wt% TEGDMA), TIH3-60 (60 wt% HBPUA + 40 wt% TEGDMA), and TB-60 (60 wt% bisphenol A-glycidyl dimethacrylate + 40 wt% TEGDMA) were prepared and commercial Luxatemp (DMG) was used for comparison. Fourier transform infrared spectroscopy and gel permeation chromatography were used for material characterization. Mechanical properties including microhardness, flexural strength, flexural modulus, and load energy were measured before and after water immersion. Physical properties measurement included weight changes, solubility, water absorption, surface hydrophobicity, and volumetric shrinkage. Finally, biocompatibility was evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay.

RESULTS

The number- and weight-average molecular weights of the HBPUA were approximately 870 and 1480, respectively. The addition of HBPUA to TEGDMA increased the mechanical strength considerably. Although the weight changes and water absorption of TIH3-60 were higher than those of Luxatemp, the microhardness, flexural strength, flexural modulus, load energy, solubility, shrinkage, and biocompatibility of TIH3-60 were either comparable or superior to those of Luxatemp.

CONCLUSION

Based on the findings of the present study, TIH3-60 has potential for development as a new provisional material.

Investigations of the Influences of Processing Conditions on the Properties of Spray Dried Chitosan-Tripolyphosphate Particles loaded with Theophylline

The preparation of chitosan-tripolyphosphate (chitosan-TPP) particles by the spray drying had been reported word widely for a sustained release of drugs to prevent rapid drug metabolism. Although the spray drying is a straightforward procedure turning a liquid feed into a well-defined dry powder, seldom research works were focusing on how the processing parameters and liquid feeding constitutions of spray drying system might affect the properties of spray-dried chitosan particles loaded with drugs, such as the particle size and morphologies, which would be very important to drug encapsulation and dissolution of the drug delivery design. This study thus prepared the chitosan particles with theophylline (TH) loaded as a model drug and TPP as cross-linker at various spray drying conditions. Our results indicate the diameter of the TH/chitosan-TPP particles made by customized spray drying apparatus spans from 424 to 497 nm with a geometric standard deviation of less than 2. The corresponding release of TH was tunable by the chitosan-TPP matrix density under the selected spray drying temperature and the carrying air flow rate. These results suggest an indeed need for optimized spray drying processing conditions to make the ideal spray-dried TH/chitosan-TPP particles for the desired drug delivery.

Emergency attendances and hospitalisations for complications after transrectal ultrasound-guided prostate biopsies: a five-year retrospective multicentre study

INTRODUCTION

Transrectal ultrasound-guided (TRUS) prostate biopsy is an established procedure for diagnosis of prostate cancer. Complications after TRUS biopsy are not well reported in Hong Kong. This study evaluated the 5-year incidences of TRUS biopsy complications and potential risk factors for those complications.

METHODS

This was a retrospective review of biopsies performed from 2013 to 2017 in two local hospitals, using data retrieved from electronic medical records. The primary outcome was the occurrence of complications requiring either emergency attendances or hospitalisations within 30 days after biopsy. Potential risk factors were examined using multiple logistic regression analysis.

RESULTS

In total, 1699 men were included (mean age ± standard deviation: 67 ± 7 years; median prostate-specific antigen level: 7.9 μg/L [interquartile range, 5.5-12.6 μg/L]); 4.3% had pre-biopsy bacteriuria. Overall, 5.7% and 3.8% of post-biopsy complications required emergency attendances and hospitalisations, respectively. Gross haematuria and rectal bleeding requiring emergency attendances developed in 2.1% and 0.4% of men; 0.8% and 0.4% required hospitalisations. Furthermore, 1.5% of men developed acute urinary retention requiring hospitalisations; 1.9% and 1.2% had post-biopsy infections requiring emergency attendances and hospitalisations, respectively, and 0.9% had urosepsis requiring hospitalisations. Prostate volume >48 cc was associated with an increased risk of post-biopsy retention (odds ratio 2.75, 95% confidence interval: 1.23-4.17).

CONCLUSIONS

The rate of overall complications after TRUS biopsy was low. The most common complications requiring emergency attendances and hospitalisations were gross haematuria and acute urinary retention, respectively. Prostate volume >48 cc increased the risk of post-biopsy urinary retention.

Initial results of selective renal parenchymal clamping with an adjustable kidney clamp in nephron-sparing surgery: an easy way to minimise renal ischaemia

INTRODUCTION

A renal parenchymal clamp has been used at our centre since March 2012. It is used in position over the kidney to achieve optimal vascular control of a tumour while minimising parenchymal ischaemia. This study aimed to report the feasibility, surgical outcome, and oncological control of a kidney clamp in partial nephrectomy.

METHODS

This study was conducted at a teaching hospital in Hong Kong. Partial nephrectomies performed from January 2009 to March 2015 were reviewed. The tumour characteristics and surgical outcomes of kidney clamp were studied and compared with traditional hilar clamping.

RESULTS

A total of 92 patients were identified during the study period. Kidney clamps were used in 20 patients and hilar clamping in 72, with a mean follow-up of 27 and 37 months, respectively. For patients in whom a kidney clamp was applied, all tumours were exophytic to a different extent and the majority (90%) were located at the polar region. The PADUA (preoperative aspects and dimensions used for an anatomical) classification nephrometry score was also lower than those in whom hilar clamping was used (7.07 vs 8.34; P=0.002). The clamp was used in open, laparoscopic, and robot-assisted surgery. Operating time was shorter (207 ± 72 mins vs 306 ± 80 mins; P<0.001) and estimated blood loss was lower (205 ± 191 mL vs 331 ± 275 mL; P=0.045) with kidney clamp. No acute kidney injury occurred. Postoperative renal function was comparable between the two groups.

CONCLUSIONS

Partial nephrectomy using parenchymal clamping is safe and feasible in selected cases. The postoperative renal function and oncological control were satisfactory.

Whole-Organism Cellular Pathology: A Systems Approach to Phenomics

Phenotype is defined as the state of an organism resulting from interactions between genes, environment, disease, molecular mechanisms, and chance. The purpose of the emerging field of phenomics is to systematically determine and measure phenotypes across biology for the sake of understanding. Phenotypes can affect more than one cell type and life stage, so ideal phenotyping would include the state of every cell type within the context of both tissue architecture and the whole organism at each life stage. In medicine, high-resolution anatomic assessment of phenotype is obtained from histology. Histology's interpretative power, codified by Virchow as cellular pathology, is derived from its ability to discern diagnostic and characteristic cellular changes in diseased tissues. Cellular pathology is observed in every major human disease and relies on the ability of histology to detect cellular change in any cell type due to unbiased pan-cellular staining, even in optically opaque tissues. Our laboratory has shown that histology is far more sensitive than stereomicroscopy for detecting phenotypes in zebrafish mutants. Those studies have also shown that more complete sampling, greater consistency in sample orientation, and the inclusion of phenotypes extending over longer length scales would provide greater coverage of common phenotypes. We are developing technical approaches to achieve an ideal detection of cellular pathology using an improved form of X-ray microtomography that retains the strengths and addresses the weaknesses of histology as a screening tool. We are using zebrafish as a vertebrate model based on the overlaps between zebrafish and mammalian tissue architecture, and a body size small enough to allow whole-organism, volumetric imaging at cellular resolution. Automation of whole-organism phenotyping would greatly increase the value of phenomics. Potential societal benefits would include reduction in the cost of drug development, a reduction in the incidence of unexpected severe drug and environmental toxicity, and more rapid elucidation of the contributions of genes and the environment to phenotypes, including the validation of candidate disease alleles identified in population and personal genetics.

Hydrogen bonds of a novel resin cement contribute to high adhesion strength to human dentin

OBJECTIVE

The detachment of fiber posts from root canals is primarily caused by the loss of adhesion between dentin and cement; therefore, the purpose of this study was to formulate a novel resin cement that improves the bond strength of fiber posts to the dentin-cement interface.

METHODS

Three concentrations (30, 35, and 40wt.%) of bis[2-(methacryloyloxy)-ethyl] phosphate (2MP) were prepared as dentin bonding agent components. Isobornyl acrylate (IBOA) and ethylhexylacrylate (EHA) were used as key components to fabricate the resin cement (named IE cement). The adhesive strengths of IE cement to coronal and root canal dentin were tested after placement of specimens in a water bath at 100% humidity and 37°C for either 24h or 5 months. The microtensile bond test, the push-out bond test, and the fracture toughness test were performed. Four commercially available resin cements (Nexus(®) third generation (NX3), Variolink II, RelyX Unicem, and Panavia F 2.0) were used for comparisons. X-ray photoelectron spectroscopy (XPS) was used to analyze the interaction of collagen extracted from human dentin and 2MP as well as the fracture surfaces of the specimens submitted to the microtensile bond test.

RESULTS

The 35% concentration of 2MP, in combination with IBOA and EHA, was the most effective for improving the IE cement's bond strength to dentin. The XPS results revealed that the phosphate groups of 2MP formed hydrogen bonds with the collagen and that such bonds prominently decreased in number in the specimens that were stored for 5 months.

SIGNIFICANCE

The combination of 2MP, IBOA, and EHA can effectively increase the adhesive strength of IE cement to dentin via hydrogen bond formation.

Effects of Laser Annealing Parameters on Optical and Electrical Properties of ITO/Metallic Glass Alloy Bi-layer Films

AgAlMg (AAM) films with three different atomic percentage compositions are prepared, namely, Ag12Al62Mg26 (denoted as A1AM), Ag22Al46Mg32 (denoted as A2AM), and Ag36Al25Mg39 (denoted as A3AM). In addition, the AAM films are deposited with four different thicknesses, i.e., 3, 6, 9, and 12 nm. The indium-tin oxide thickness is assigned a constant value of 30 nm in every case. The results show that the optical transmittance of the AAM/IAAM films improves (i.e., increases) with a reducing AAM film thickness, while the electrical resistivity improves (i.e., reduces) with an increasing film thickness. It is shown that the IA2AM film with an AMM thickness of 9 nm yields the optimal compromise between the optical transmittance and the electrical resistivity. The as-deposited IAAM films are found to have optical transmittance and electric resistivity values of 65 % and 90 Ω/□, respectively. The IA2AM films are annealed using a near-infrared laser at different pulse energies with a wavelength of 1064 nm and repetition rates ranging from 100 ~ 400 kHz. For both films, the optical and electrical properties are enhanced as the pulse energy increases to a certain critical value due to a transition from an amorphous microstructure to a crystalline structure. Given a repetition rate of 400 kHz and a pulse energy of 1.03 μJ, the optical transmittance and sheet resistance of the IAAM film are found to be 80 % and 15 Ω/□, respectively. The corresponding value of the Haacke figure of merit changed from 0.15 × 10(-3) to 7.16 × 10(-3) Ω(-1) due to the optimal laser annealing conditions.

Laparoscopic liver resection: lessons learnt after 100 cases

OBJECTIVE

To share our institutional experience in laparoscopic liver resection and our learning curve after the first 100 cases of laparoscopic liver resection.

DESIGN

Case series with internal comparison.

SETTING

A regional hospital in Hong Kong.

PATIENTS

Our institution started performing laparoscopic liver resection since 2006. All patients who underwent laparoscopic liver resections from March 2006 to October 2012 were identified in a prospectively collected database. The demographic data and operative outcomes of these patients were extracted, and results of the early (from March 2006 to May 2010) and late (from June 2010 to October 2012) study periods were compared.

RESULTS

Between March 2006 and October 2012, 100 laparoscopic liver resections were performed for 98 patients in the Department of Surgery, Kwong Wah Hospital, Hong Kong. They were 69 (70%) males and 29 (30%) females, and the median age was 65 years. The final histological diagnoses were as follows: hepatocellular carcinoma (n=72), colorectal liver metastases (n=14), intrahepatic cholangiocarcinoma (n=4), and benign disease (n=10). There were more anatomical resections, major hepatectomies as well as resections of more anatomically challenging right-sided and posterosuperior lesions in the late versus the early period; however, operative outcomes remained comparable in both periods.

CONCLUSION

Laparoscopic hepatectomies are feasible with growing experience. Bearing in mind the diversity in the level of operative techniques with various types of laparoscopic liver resections, more experience is needed to overcome the learning curve.

Biphenyl liquid crystalline epoxy resin as a low-shrinkage resin-based dental restorative nanocomposite

Low-shrinkage resin-based photocurable liquid crystalline epoxy nanocomposite has been investigated with regard to its application as a dental restoration material. The nanocomposite consists of an organic matrix and an inorganic reinforcing filler. The organic matrix is made of liquid crystalline biphenyl epoxy resin (BP), an epoxy resin consisting of cyclohexylmethyl-3,4-epoxycyclohexanecarboxylate (ECH), the photoinitiator 4-octylphenyl phenyliodonium hexafluoroantimonate and the photosensitizer champhorquinone. The inorganic filler is silica nanoparticles (∼70-100 nm). The nanoparticles were modified by an epoxy silane of γ-glycidoxypropyltrimethoxysilane to be compatible with the organic matrix and to chemically bond with the organic matrix after photo curing. By incorporating the BP liquid crystalline (LC) epoxy resin into conventional ECH epoxy resin, the nanocomposite has improved hardness, flexural modulus, water absorption and coefficient of thermal expansion. Although the incorporation of silica filler may dilute the reinforcing effect of crystalline BP, a high silica filler content (∼42 vol.%) was found to increase the physical and chemical properties of the nanocomposite due to the formation of unique microstructures. The microstructure of nanoparticle embedded layers was observed in the nanocomposite using scanning and transmission electron microscopy. This unique microstructure indicates that the crystalline BP and nanoparticles support each other and result in outstanding mechanical properties. The crystalline BP in the LC epoxy resin-based nanocomposite was partially melted during exothermic photopolymerization, and the resin expanded via an order-to-disorder transition. Thus, the post-gelation shrinkage of the LC epoxy resin-based nanocomposite is greatly reduced, ∼50.6% less than in commercialized methacrylate resin-based composites. This LC epoxy nanocomposite demonstrates good physical and chemical properties and good biocompatibility, comparable to commercialized composites. The results indicate that this novel LC nanocomposite is worthy of development and has potential for further applications in clinical dentistry.

Multimedia manuscript: laparoscopic resection of hepatocellular carcinoma at segment 7: the posterior approach to anatomic resection

BACKGROUND

Open anatomical liver resections remain one of the most effective treatments of hepatocellular carcinoma (HCC) and results in better recurrence-free and overall survival compared to nonanatomical resections [1]. On the other hand, laparoscopic hepatectomies for HCC have recently emerged with the benefits of reduced blood loss, shorter hospital stay, and less severe wound pain [2, 3]. Classically, liver lesions considered suitable for laparoscopic resection were those small tumors (<4 cm) located over the anterior and left lateral segments [3]. However, we would like to expand the current indications and here we present our techniques of laparoscopic anatomical resection for a HCC that was located at right posteriosuperior segment 7.

METHODS

Our patient was a 60-year-old gentleman who had Child's A hepatitis B cirrhosis and was on entecavir. During a follow-up CT scan, a 2.6-cm segment 7 lesion with early arterial enhancement and contrast washout was noted and was subsequently confirmed with arteriogram. α-Fetoprotein was 3 ng/ml (normal < 20 ng/ml). The video demonstrates a posterior approach to laparoscopic resection of segment 7.

RESULTS

Operative time was 510 min. Blood loss was 800 ml and no perioperative transfusion was required. Postoperative recovery was uneventful and only simple oral analgesics were required for pain control. He was discharged on postoperative day 6. Histology showed a moderately differentiated hepatocellular carcinoma and all resection margins were clear. Subsequent follow-up CT scan 6 months after the operation showed no evidence of recurrence and α-fetoprotein level was normal.

CONCLUSIONS

Laparoscopic hepatectomy for HCC over the right posterior segment of the liver is feasible in selected patients with favorable results in terms of wound size, postoperative recovery, and hospital stay. Maximal liver conservation was achieved in performing oncologic anatomical resection of segment 7 instead of a posterior sectionectomy. On the other hand, a posterior approach was recommended because it allowed early intrahepatic control of pedicles and identification of the right hepatic vein to guide parenchymal transection along the intersegmental plane.

Methylprednisolone reduces the rates of postextubation stridor and reintubation associated with attenuated cytokine responses in critically ill patients

BACKGROUND

Treatment with corticosteroids can reduce the incidence of postextubation stridor (PES) and reintubation in critically ill adult patients, but the mechanisms remain unknown.

METHODS

A randomized, controlled clinical trial was conducted in an adult medical and surgical Intensive Care Unit (ICU) of a teaching hospital. Seventy-one patients who had a cuff leak percentage <24% of tidal volume received either a bolus injection of methylprednisolone at 40 mg (treated group, n=38) or normal saline (placebo group, n=33) 4 h prior to a planned extubation. The cuff leak percentage was re-assessed 1 h and 4 h post-injection. Eighty patients who had a cuff leak percentage ≥ 24% served as a control group. Plasma concentrations of multiple cytokines and C-reactive protein (CRP) were measured at baseline, 4 h and 24 h after the intervention.

RESULTS

The incidences of PES (15.8% vs. 39.4%, P<0.05) and reintubation rate (7.9% vs. 30.3%, P<0.05) were lower in the treated group compared to the placebo group. The plasma concentrations of IL-4 and IL-10 increased while the levels of IL-6 and IL-8 decreased at 24 h in the treated group compared to the placebo group. No difference in CRP levels was observed between the treated and placebo groups.

CONCLUSION

A single injection of methylprednisolone at the dose used 4 h prior to planned extubation effectively reduced the incidence of PES and the reintubation rate. These beneficial effects were associated with the up-regulation of IL-4 and IL-10 and the down-regulation of IL-6 and IL-8 in the critically ill adult patients.

Evolution of the haemagglutinin gene of the influenza A(H1N1)2009 virus isolated in Hong Kong, 2009–2011

Phylogenetic analysis of the haemagglutinin (HA) gene shows that the influenza A(H1N1)2009 viruses collected in Hong Kong clustered in two main branches characterised by the E391E and E391K amino acids. The main branch E391K evolved in two sub-branches with N142D and S202T mutations that first appeared in March and July 2010, respectively, with the latter becoming the predominant strain. These genetic variants that emerged display similar antigenic characteristics. Concurrent with genetic surveillance, laboratories should continue monitoring the circulating viruses antigenically.

Evolution of the haemagglutinin gene of the influenza A(H1N1)2009 virus isolated in Hong Kong, 2009-2011

Phylogenetic analysis of the haemagglutinin (HA) gene shows that the influenza A(H1N1)2009 viruses collected in Hong Kong clustered in two main branches characterised by the E391E and E391K amino acids. The main branch E391K evolved in two sub-branches with N142D and S202T mutations that first appeared in March and July 2010, respectively, with the latter becoming the predominant strain. These genetic variants that emerged display similar antigenic characteristics.Concurrent with genetic surveillance, laboratories should continue monitoring the circulating viruses antigenically.

Use of intrinsic clearance for prediction of human hepatic clearance

IMPORTANCE OF THE FIELD

The use of intrinsic metabolic stability/clearance and other in vitro pharmacokinetic data for the selection of drug candidates for clinical evaluation during discovery lead optimization has become one of the primary focuses of research organizations involved in new drug discovery. Using intrinsic clearance determined from human liver microsomal preparations and/or hepatocyte to predict human clearance has become more acceptable.

AREAS COVERED IN THIS REVIEW

This review focuses on the current methods for determining intrinsic clearance and scaling to predict human hepatic clearance, and novel physiologically-based models for improvement of human hepatic clearance prediction. Published microsomal metabolic stability data and in-house hepatocyte clearance data were compared with published in vivo human hepatic clearance data. Various scaling models and the effect of protein binding were examined.

WHAT THE READER WILL GAIN

Use of a novel microfluidic model and other physiologically-based models are presented. Microsomal metabolic clearance requires correction for protein binding and in vitro microsomal binding in order to better predict in vivo hepatic clearance of compounds that are mainly eliminated by hepatic metabolism.

TAKE HOME MESSAGE

Metabolic clearance obtained using hepatocytes may work well in combination with the well-stirred model. Novel models incorporating flow and protein binding in the system may be the most complete models for prediction of human in vivo metabolism.

Increase of plasma insulin by racecadotril, an inhibitor of enkephalinase, in Wistar rats

Racecadotril is known as an inhibitor of enkephalinase. Increase of plasma insulin by racecadotril has been observed in rats while the mechanism of the action remains obscure. In the present study, intravenous injection of male Wistar rats with racecadotril significantly decreased blood glucose levels. However, this effect of racecadotril was not modified by naloxone at the dose sufficient to block opioid receptors. Thus, the blood glucose-lowering action of racecadotril might be through an endogenous opioid independent mechanism. Otherwise, we found that C-peptide content was also raised by racecadotril in parallel with the increase of insulin in Wistar rats. Thus, the blood glucose-lowering action of racecadotril was related to insulin secretion, but not through the inhibition of plasma insulin degradation. In addition, racecadotril showed no direct effect on insulin secretion in isolated islets or cultured HIT-T15 beta cells. The increase of plasma insulin and blood glucose-lowering action induced by racecadotril were reduced by pretreatment with atropine and enhanced by physotigmine. Direct inhibition of cholinesterase was not observed in brain homogenates treated with racecadotril. Moreover, actions of racecadotril were significantly reduced in rats receiving hemicholinium-3 at a sufficient dose to decrease endogenous acetylcholine. Activation of cholinergic tone is possibly involved in the blood glucose-lowering effect of racecadotril. Our results suggested that racecadotril increased insulin secretion to lower blood glucose mainly via regulation of parasympathetic tone in Wistar rats.

A microfluidic hepatic coculture platform for cell-based drug metabolism studies

Within the global pharmaceutical and biotech industries, there is significant interest in identifying in vitro screening systems that are more human-relevant-i.e., that offer greater utility in predicting subcellular and cellular physiological responses in humans in vivo-and that thereby allow investigators to reduce the incidence of costly late-stage failures during pharmaceutical clinical trials, as well as to reduce the use of animals in drug testing. Currently incumbent in vitro screening methods, such as culturing human hepatocytes in suspension, while useful, are limited by a lack of long term cellular function. In order to address this limitation, we have established an integrated, microfluidic, in vitro platform that combines the patented HmuREL((R)) microdevice with a hepatic coculture system. In the present report, we use this platform to study clearance and metabolite generation of a battery of molecular entities. The results show that the flow-based coculture system is capable of clearing, with improved resolution and predictive value, compounds with high, medium, and low clearance values. In addition, when coculture is coupled with flow, higher metabolite production rates are obtained than in static systems.

Surveillance and outcome of liver metastasis in patients with colorectal cancer who had undergone curative-intent operation

OBJECTIVE

To assess the outcome of patients diagnosed to have liver metastasis by ultrasonography, following curative-intent resection of colorectal adenocarcinoma.

DESIGN

Prospective study.

SETTING

Regional hospital, Hong Kong.

PATIENTS

A total of 650 patients who underwent curative-intent resection of colorectal adenocarcinoma between January 2000 and December 2006.

MAIN OUTCOME MEASURES

Pattern of liver recurrence, treatment and outcome after recurrence, and overall patient survival.

RESULTS

Of the 650 patients, 553 (85%) were followed up per protocol. Of 104 patients who developed systemic recurrence, 45 (43%) had liver-only metastases. The resection rate for liver metastases was 38% (17/45). The median survival of such patients was significantly longer than those who did not undergo liver metastasectomy (50 vs 26 months, P=0.017).

CONCLUSION

Our ultrasonography-based surveillance protocol was low-cost, simple, and effective in detecting asymptomatic liver metastases, so that curative-intent metastasectomy could be performed. Further prospective studies are required to determine the optimal frequency and imaging mode for surveillance, so as to improve the resectability of liver-only colorectal metastases as well as overall patient survival.

Effect of transgenes on global gene expression in soybean is within the natural range of variation of conventional cultivars

Current safety assessment for novel crops, including transgenic crops, uses a targeted approach, which relies on compositional analysis. The possibility that transgene expression could lead to unintended effects remains a debated issue. This study used transcriptome profiling as a nontargeted approach to evaluate overall molecular changes in transgenic soybean cultivars. Global gene expression was measured in the first trifoliate leaves of two transgenic and three conventional soybean cultivars using the soybean Affymetrix GeneChip. It was found that gene expression differs more between the two conventional cultivars than between the transgenics and their closest conventional cultivar investigated and that the magnitudes of differences measured in gene expression and genotype (determined by SSR analysis) do not necessarily correlate. A MySQL database coupled with a CGI Web interface was developed to store and present the results ( http://soyxpress.agrenv.mcgill.ca/). By integrating the microarray data with gene annotations and other soybean data, a comprehensive view of differences in gene expression is explored between cultivars.

Inhibition of N-acetyltransferase activity and gene expression in human colon cancer cell lines by diallyl sulfide

Diallyl sulfide (DAS) is one of the major components of garlic (Allium sativum) and is widely used in the world for food. In this study, DAS was selected for testing the inhibition of arylamine N-acetyltransferase (NAT) activity (N-acetylation of 2-aminofluorene) and gene expression (mRNA NAT) in human colon cancer cell lines (colo 205, colo 320 DM and colo 320 HSR). The NAT activity was examined by high performance liquid chromatography and indicated that a 24 h DAS treatment decreases N-acetylation of 2-aminofluorene in three colon (colo 205, 320 DM and colo 320 HSR) cancer cell lines. The NAT enzymes (protein) were analyzed by western blotting and flow cytometry and it indicated that DAS decreased the levels of NAT in three colon (colo 205, 320 DM and colo 320 HSR) cancer cell lines. The gene expression of NAT (mRNAT NAT) was determined by polymerase chain reaction (PCR), it was shown that DAS affect mRNA NAT expression in examined human colon cancer cell lines. This report is the first to demonstrate that DAS does inhibit human colon cancer cell NAT activity and gene expression.

Patient effective dose from sentinel lymph node lymphoscintigraphy in breast cancer: a study using a female humanoid phantom and thermoluminescent dosemeters

The aim of this study was to measure the dose delivered to patients undergoing sentinel lymph node lymphoscintigraphy by taking into account both the transmission scan dose using a (57)Co flood source and the (99)Tc(m) internal emission dose. An adult female humanoid phantom and a set of thermoluminescent dosimeters were used in the measurements. The choice of measurement organs in the humanoid was guided by the recommendations described in the International Commission on Radiological Protection report number 60. A (57)Co flood source was used in external transmission to irradiate the humanoid at posterior, left lateral, left posterior oblique, right lateral and right posterior oblique positions. Four (99)Tc(m) deposits as internal emission sources were used to simulate patient peritumoural injection. The individual effective doses for external transmission and internal emission, normalized to the cumulated activity and expressed in micro Sv(MBq x h)(-1) were then calculated. The effective dose for a transmission scan was on average 0.061 micro Sv(MBq x h)(-1) for each (57)Co flood source position and for internal emission 0.312 micro Sv(MBq x h)(-1) and 0.291 micro Sv(MBq x h)(-1) for left and right breast injection, respectively. Using these results, the effective dose from both transmission and emission sources can be calculated according to the nuclear medicine scanning protocol and surgical procedure of the individual institution. For our protocols, the patient receives a maximum effective dose of 52 micro Sv for the 1 day protocol (18 MBq injection) and 204 micro Sv for the 2 day protocol (74 MBq injection) if only the sentinel lymph node is excised. If other tissues containing radioactivity are removed, the patient effective dose will be reduced by about 50% and 6%, respectively, for the 1 day protocol and 2 day protocol. Although the doses are low compared with other radiological examinations, the results are informative for patients concerned about radiation exposure for this new imaging technique.

Curcumin inhibited the arylamines N-acetyltransferase activity, gene expression and DNA adduct formation in human lung cancer cells (A549)

It is well known that N-acetyltransferase (NAT) plays an important role in the arylamine metabolism. We analysed the response of A549 human lung cancer cells for N-acetylation of 2-aminofluorene (AF) to curcumin. After curcumin treatment, the NAT activity was examined by HPLC, AF-DNA adduct formation was examined by HPLC, and NAT gene expression by polymerase chain reaction were detected. The NAT activity in the human A549 cells and cytosols was suppressed by curcumin in a dose-dependent manner. The results also demonstrated that gene expression (NAT1 mRNA) in human lung A549 tumor cells was inhibited and decreased by curcumin. After the incubation of human lung A549 tumor cells with AF with or without curcumin co-treatment, the cells were recovered and DNA was prepared and hydrolyzed to nucleotides. The adducted nucleotides were extracted into butanol and analyzation of AF-DNA adducts was done by HPLC. The results also demonstrated that curcumin decreases AF-DNA adduct formation in the human lung A549 tumor cells.