Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience.

PURPOSE: Occult inguinal hernias (IH) predispose peritoneal dialysis (PD) patients to the symptomatic IH formation after starting PD, which may cause complications. We conducted a retrospective study to assess the benefit/risk profile of routine laparoscopic examination for occult IH (RLEOH) with a synchronous repair in patients receiving PD catheter placement. METHODS: 432 patients were enrolled in this study. Patients with an internal hernia sac at all sizes were deemed to have occult IH. We retrospectively reviewed data including demographic characteristics and operative details. We also measured incidence rates of symptomatic IH, metachronous IH repair, and catheter survival over a follow-up period after starting PD. RESULTS: These patients were classified into the RLEOH group (n = 365) and the non-RLEOH group (n = 67). The RLEOH group was subdivided into occult IH with a synchronous repair (n = 17; the subgroup A), no occult IH (n = 339; the subgroup B), and occult IH without a synchronous repair (n = 9; the subgroup C). The incidence rates of symptomatic IH developed after staring PD in subgroups A, B, and C were 0, 5.6, and 22.2%, respectively, whereas that in the non-RLEOH group was 13.4%. The RLEOH group had a reduced hazard ratio for metachronous IH repair compared with the non-RLEOH group (HR = 0.426; 95% CI 0.195-0.930, p = 0.032). None of our patients suffered from herniorrhaphy-related complications. CONCLUSION: RLEOH with a synchronous repair during PD catheter insertion confers clinical benefits in reducing the risk of developing IH after starting PD and the need for a metachronous repair. This is a safe and reasonable approach.

A functional study of proximal goat ß-casein promoter and intron 1 in immortalized goat mammary epithelial cells.

Goat ß-casein (CSN2) promoter has been extensively used to derive expression of recombinant therapeutic protein in transgenic goats; however, little direct evidence exists for signaling molecules and the cis-elements of goat CSN2 promoter in response to lactogenic hormone stimulation in goat mammary epithelial cells. Here, we use an immortalized caprine mammary epithelial cell line (CMC) to search for evidence of the above. Serial 5'-flanking regions deleted of promoter and intron 1 in goat CSN2 (-4,047 to +2,054) driven by firefly luciferase reporter gene were constructed and applied to measure promoter activity in CMC. The intron 1 region (+393 to +501) significantly decreased basal activity of the promoter. This finding contradicts other studies of the role of intron 1. The signal transducer and activator of transcription (STAT)5a played a significant role in activating promoter activity by prolactin stimulation. Hydrocortisone enhanced and prolonged the activity of STAT5a and promoter in CMC, but was independent of the glucocorticoid receptor response element. The minimum length of the CSN2 promoter segment in response to lactogenic stimulation was confirmed by 5' serial deletions. A cis-element located from -300 to -90 in proximal goat CSN2 promoter that is absent in bovine and human CSN2 promoter was newly identified. We demonstrated the presence of a STAT5a binding site (-102 to -82) and preservation of the guanosine nucleotide at position -90 based on responses to the presence of lactogenic hormone using internal deletions and point mutations of the predicted STAT5a binding site, and chromatin immunoprecipitation assay. Together, these findings demonstrate that the proximal -300 bp of goat CSN2 promoter containing the STAT5a binding site (-102 to -82) is the response element for lactogenic hormone stimulation. Additionally, intron 1 may be required for tissue or developmental stage-specific expression in mammary gland. The role of the far-distal regions of goat CSN2 promoter in high-level lactogenic hormone induction and specific expression require further examination.

Establishment of a novel, eco-friendly transgenic pig model using porcine pancreatic amylase promoter-driven fungal cellulase transgenes.

Competition between humans and livestock for cereal and legume grains makes it challenging to provide economical feeds to livestock animals. Recent increases in corn and soybean prices have had a significant impact on the cost of feed for pig producers. The utilization of byproducts and alternative ingredients in pig diets has the potential to reduce feed costs. Moreover, unlike ruminants, pigs have limited ability to utilize diets with high fiber content because they lack endogenous enzymes capable of breaking down nonstarch polysaccharides into simple sugars. Here, we investigated the feasibility of a transgenic strategy in which expression of the fungal cellulase transgene was driven by the porcine pancreatic amylase promoter in pigs. A 2,488 bp 5'-flanking region of the porcine pancreatic amylase gene was cloned by the genomic walking technique, and its structural features were characterized. Using GFP as a reporter, we found that this region contained promoter activity and had the potential to control heterologous gene expression. Transgenic pigs were generated by pronuclear microinjection. Founders and offspring were identified by PCR and Southern blot analyses. Cellulase mRNA and protein showed tissue-specific expression in the pancreas of F1 generation pigs. Cellulolytic enzyme activity was also identified in the pancreas of transgenic pigs. These results demonstrated the establishment of a tissue-specific promoter of the porcine pancreatic amylase gene. Transgenic pigs expressing exogenous cellulase may represent a way to increase the intake of low-cost, fiber-rich feeds.

A retrospective study of implant-abutment connections on crestal bone level.

This study compared the effects of external hex, internal octagon, and internal Morse taper implant-abutment connections on the peri-implant bone level before and after the occlusal loading of dental implants. Periapical radiographs of 103 implants (63 patients) placed between 2002 and 2010 were collected, digitized, standardized, and classified into groups based on the type of implant-abutment connection. These radiographs were then analyzed with image-processing software to measure the peri-implant crestal bone change during the healing phase (4 months after implant placement) and at loading phases 1 and 2 (3 and 6 months after occlusal loading, respectively). A generalized estimating equation method was employed for statistical analysis. The amount of peri-implant crestal bone change differed significantly among all time-phase pairs for all 3 types of implant-abutment connection, being greater in the healing phase than in loading phase 1 or 2. However, the peri-implant crestal bone change did not differ significantly among the 3 types of implant-abutment connections during the healing phase, loading phase 1, or loading phase 2. This retrospective clinical study reveals that the design of the implant-abutment connection appears to have no significant impact on short-term peri-implant crestal bone change.

Prognostic significance of the number of examined lymph nodes in node-negative gastric adenocarcinoma.

AIM: In this study, we investigated the prognostic significance of the number of examined lymph nodes in node-negative gastric adenocarcinoma (GC). PATIENTS AND METHODS: A total of 1194 node-positive and 1030 node-negative GC patients undergoing potentially curative gastrectomy was enrolled in this study. Patients were stratified into 3 groups according to the number of examined lymph nodes: group 1, ≤ 15; group 2, 16-25; group 3, >25. RESULTS: Patients with node-negative GC had significantly favorable survival compared with those with node-positive. Among patients with node-negative T2-T4 disease, the percentage of locoregional relapse was higher in those with <25 examined lymph nodes than in those with ≥ 25 examined lymph nodes. The number of examined lymph nodes affected the overall survival rates for patients with node-negative T2-T4 GC but not for patients with T1 lesions. Tumor size, tumor location, the number of examined lymph nodes, T status, and the presence of perineural invasion were significant prognostic factors as determined by multivariate analysis in node-negative GC. CONCLUSIONS: No survival benefit of examining ≥ 15 lymph nodes was noted for patients with node-negative T1 GC. Extensive lymphadenectomy in patients with node-negative T2-T4 lesions in whom the number of examined lymph nodes was >25 had favorable survival.

Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses.

This study investigated the effects of bone stiffness (elastic modulus) and three-dimensional (3D) bone-to-implant contact ratio (BIC%) on the primary stabilities of dental implants using micro-computed tomography (micro-CT) and resonance frequency analyses. Artificial sawbone models with five values of elastic modulus (137, 123, 47.5, 22, and 12.4 MPa) comprising two types of trabecular structure (solid-rigid and cellular-rigid) were investigated for initial implant stability quotient (ISQ), measured using the wireless Osstell resonance frequency analyzer. Bone specimens were attached to 2 mm fibre-filled epoxy sheets mimicking the cortical shell. ISQ was measured after placing a dental implant into the bone specimen. Each bone specimen with an implant was subjected to micro-CT scanning to calculate the 3D BIC% values. The similarity of the cellular type of artificial bone to the trabecular structure might make it more appropriate for obtaining accurate values of primary implant stability than solid-bone blocks. For the cellular-rigid bone models, the ISQ increased with the elastic modulus of cancellous bone. The regression correlation coefficient was 0.96 for correlations of the ISQ with the elasticity of cancellous bone and with the 3D BIC%. The initial implant stability was moderately positively correlated with the elasticity of cancellous bone and with the 3D BIC%.

Investigation of genetic relationships among Taiwan black pigs and other pig breeds in Taiwan based on microsatellite markers.

The aim of this study was to investigate the genetic relationships between Taiwan black pigs (TBP) and other pig breeds by means of 15 fluorescent-labeled microsatellite markers. DNA from a total of 299 TBP from eight private farms and 234 purebred pigs representing six breeds and one synthetic line was used. Among the 15 microsatellite loci, polymorphism information content (PIC) values were all above 0.500; the numbers of observed alleles were all greater than the numbers of effective alleles (10.1 vs. 4.3 in averages). But 13 of the 15 microsatellite markers significantly deviated from the Hardy-Weinberg equilibrium (HWE); moreover, 13 of the 15 tested populations also deviated from the HWE. The inbreeding coefficient (F(IS)) indicated that two TBP populations (TBP-3 and TBP-4) had heterozygote deficiency (P < 0.01). The pair-wise F(ST), representing the genetic diversity between the two populations, ranged from 0.0332 to 0.3809. Meishan and Taoyuan breeds with black hair were previously considered closely related to TBP; however, the result of genetic relationship refuted this assumption. In conclusion, TBP is more similar to the European than Chinese breeds, and further investigations will need to clarify it more accurately.

Characterization of hTERT-immortalized caprine mammary epithelial cells.

The aim of this article is to demonstrate and characterize caprine mammary epithelial cells (CMC) immortalized with human telomerase reverse transcriptase (hTERT) gene. Five immortalized CMCs were assigned to either myoepithelial or luminal epithelial groups based on their morphology and expression of cell lineage-specific intermediate filaments. Telomeric repeat amplification protocol revealed various telomerase activities in CMCs associated with their distinct proliferation potential. Karyotypic analysis showed three CMCs retained their modal Capra hircus chromosome number (2n = 60), whereas the remaining two CMCs were abnormal at 2n = 19 and 2n = 36. CMCs with abnormal karyotypes lost p53 protein after chemical-induced DNA damage and showed anchorage-independent growth in soft agar assay. In terms of functional differentiation, luminal CMCs organized into alveolus-like structures when grown in Matrigel. Furthermore, αs1- and ß-casein gene was induced in luminal CMCs in response to lacto-hormones stimulation. Together these results showed that hTERT-immortalized CMCs retained major characteristics of mammary epithelial cells, and stability of the genome is required for maintaining normal mammary epithelium function. Application of CMCs can provide valuable models to study alveologenesis and lactogenesis of mammary epithelium and test the feasibility of recombinant constructs designed for the generation of transgenic livestock.

BPR1J-097, a novel FLT3 kinase inhibitor, exerts potent inhibitory activity against AML.

BACKGROUND: Activating mutations of Fms-like tyrosine kinase 3 (FLT3) constitute a major driver in the pathogenesis of acute myeloid leukaemia (AML). Hence, pharmacological inhibitors of FLT3 are of therapeutic interest for AML. METHODS: The effects of inhibition of FLT3 activity by a novel potent FLT3 inhibitor, BPR1J-097, were investigated using in vitro and in vivo assays. RESULTS: The 50% inhibitory concentration (IC(50)) of BPR1J-097 required to inhibit FLT3 kinase activity ranged from 1 to 10 nM, and the 50% growth inhibition concentrations (GC(50)s) were 21±7 and 46±14 nM for MOLM-13 and MV4-11 cells, respectively. BPR1J-097 inhibited FLT3/signal transducer and activator of transcription 5 phosphorylation and triggered apoptosis in FLT3-driven AML cells. BPR1J-097 also showed favourable pharmacokinetic property and pronounced dose-dependent tumour growth inhibition and regression in FLT3-driven AML murine xenograft models. CONCLUSION: These results indicate that BPR1J-097 is a novel small molecule FLT-3 inhibitor with promising in vivo anti-tumour activities and suggest that BPR1J-097 may be further developed in preclinical and clinical studies as therapeutics in AML treatments.

Electron microscopy investigations of V defects in multiple InGaN/GaN quantum wells and InGaN quantum dots.

The mechanism of high emission of InGaN-based multiple quantum wells, which exhibit exceptionally high light emission efficiency despite their high defect density, is still not fully understood. Here, we deal with this problem, showing the details of structure and formation of V defects in the multiple quantum wells and reviewing interpretations proposed so far. Then, we show a structural investigation of three-dimensional high-density quantum dots, fabricated instead of quantum wells in the active layer. The shape and size of the InGaN quantum dots and the SiN(x) masks for the growth of the dots have been revealed using high-angle annular dark field scanning transmission electron microscopy, energy dispersive X-ray spectroscopy nanoanalysis and high-resolution transmission electron microscopy.

Variations in bone density at dental implant sites in different regions of the jawbone.

The survival rate of dental implants is markedly influenced by the quality of the bone into which they are placed. The purpose of this study was to determine the trabecular bone density at potential dental implant sites in different regions of the Chinese jawbone using computed tomography (CT) images. One hundred and fifty-four potential implant sites (15 in the anterior mandible, 47 in the anterior maxilla, 55 in the posterior mandible, and 37 in the posterior maxilla) were selected from the jawbones of 62 humans. The data were subjected to statistical analysis to determine any correlation between bone density (in Hounsfield units, HU) and jawbone region using the Kruskal-Wallis test. The bone densities in the four regions decreased in the following order: anterior mandible (530 +/- 161 HU, mean +/- s.d.) approximately equal anterior maxilla (516 +/- 132 HU) > posterior mandible (359 +/- 150 HU) approximately equal posterior maxilla (332 +/- 136 HU). The CT data demonstrate that trabecular bone density varies markedly with potential implant site in the anterior and posterior regions of the maxilla and mandible. These findings may provide the clinician with guidelines for dental implant surgical procedures (i.e., to determine whether a one-stage or a two-stage protocol is required).

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity.

We determined the association between the severity of erectile dysfunction (ED) and traditional cardiovascular risk factors, including metabolic syndrome (MS). A total of 141 ED patients were divided into three groups on the basis of ED severity, which was determined using the International Index of Erectile Function (IIEF) scores. The prevalence of MS among the ED patients was 32.6%. Significantly lower IIEF scores were noted in patients with MS than in patients without MS (7.6+/-6.4 vs 11.6+/-7.4, P=0.003). As assessed by the anthropometric indices of body mass index, waist circumference and waist-to-hip ratio, obesity was detected in 58.9, 54.6 and 32.6% of the patients, respectively. Of the 141 patients, 39 had mild, 24 had moderate and 78 had severe ED. Statistically significant differences were noted among the different ED severity groups with regard to the presence of hypertension, systolic blood pressure, presence of MS and number of MS components. Multivariate analysis showed that the odds ratio for high-low-density lipoprotein (LDL) cholesterol level in moderate and severe ED, determined with reference to mild ED, were 9.346 and 6.452, respectively. The presence of MS, number of MS components, and certain traditional cardiovascular risk factors, particularly high-LDL cholesterol level and hypertension, may influence the severity of ED.

Effects of implant surface roughness and stiffness of grafted bone on an immediately loaded maxillary implant: a 3D numerical analysis.

This study investigated the effects of the stiffness of a maxillary sinus graft and the surface roughness of an immediately loaded implant using a non-linear three-dimensional finite element (FE) analysis (3D). Six FE models were created, including two stiffness values of grafted bone (345 and 3450 MPa of elastic modulus) and three conditions of implant-bone interfaces (Frictional coefficient of 0.3 for machined surface, 0.45 for rough implant surface and a bonded implant-bone interface for an osseointegrated implant). Computer tomographic images of a human skull were used to construct a posterior maxillary model. All implants were designed via the computer aided design software with a spiral threaded configuration. Three loading scenarios were investigated for each of the six models; axial loading and lateral loadings at 30 degrees and 60 degrees . The results showed that a 60 degrees lateral loading has scored the highest level of bone stresses among the three loading conditions. Immediately loaded implants with 0.3 frictional coefficient have suffered the highest bone stresses which were higher than those with bonded interface by about 57%. Increasing the frictional coeffecient to 0.45, however, did not show any benefits in reducing the peak bone stress. Raising the stiffness of grafted bone diminished the bone stress by about 10% in both the immediately loaded and the osseointegrated implants. It was also noted that increasing graft stiffness and implant surface roughness reduced the sliding at the implant-bone interface which may improve the implant stability and long-term survival.

Stress analysis of implant-supported partial prostheses in anisotropic mandibular bone: in-line versus offset placements of implants.

Three-dimensional, anisotropic finite element models were executed to investigate the biomechanical effects of in-line and offset placements of implants on implant-supported partial prostheses. Three implant placements of finite element models were created: in-line, buccal offset and lingual offset placements. The mesh models of a cadaver mandibular segment and a three-united crown containing the 2nd premolar, the 1st molar and the 2nd molar were constructed by computer tomography images. The material properties of mandible were applied as transversely isotropic and linearly elastic. Two loading modes (100N), vertical and oblique, were evaluated in all models. Insignificant difference was observed in implant stresses between the in-line and offset placements under the vertical loading mode. Under the oblique loading, however, the offset placement decreased the implant stress by a maximum of 17%. The maximum stress at cortical bone and trabecular bone around each implant did not show conspicuous difference between the in-line and offset placements. This study demonstrated the mechanisms of how stresses were distributed between the in-line and offset placements. Even though the offset placements showed the benefit of decreasing implant stresses, justified from the bone stress the offset placements provided no advantage for the stress decreasing over the in-line placement.

Heart failure due to giant congenital aorto-right atrial fistula: report of a case.

Coronary arterio-venous fistula (CAVF) is a rare coronary artery anomaly. We demonstrated the rare findings of a large congenital aorto-right atrial fistula with initial presentation of heart failure symptoms. Transthoracic echocardiography and transesophageal echocardiography made the accurate diagnosis. Further haemodynamic and angiographic study proved this large CAVF with extraordinary oxygen saturation step-up (26%) and large pulmonary to systemic shunt (Qp/Qs = 4.25). It was corrected by surgery because of evidence of heart failure and the possible risk of endocarditis and coronary steal effect.

Groove pancreatitis: case report and literature review.

Groove pancreatitis is a form of chronic pancreatitis affecting the groove between the head of the pancreas, the duodenum and the common bile duct. It was first described by Becker in 1973. Differentiation between groove pancreatitis and pancreatic head carcinoma is often difficult. Herein, we report a 24-year-old man with groove pancreatitis presenting with epigastralgia, jaundice, fever and vomiting. The diagnosis was confirmed by computed tomography of the abdomen, endoscopic retrograde cholangiopancreatography and surgical exploration. The operative procedures involved were pancreatic biopsy and choledochotomy with T-tube drainage. The patient had an uneventful postoperative course.

Growth inhibition of human endothelial cells by the phyto-oestrogen biochanin A, a metabolite of genistein.

This study examined the growth regulatory effects of a phyto-oestrogen, biochanin A, on a transformed human endothelial cell line ECV304 in vitro. Biochanin A was found to inhibit cell proliferation in a dose-dependent fashion and this effect was influenced by the concentration of serum present in the culture medium. In the absence of serum, the calculated IC50 of biochanin A was 0.18 +/- 0.1 microm compared to an IC50 of m at 10% serum. At low cell density, the growth inhibitory effects of biochanin A were more evident than at high cell density. Co-administration of a synthetic oestrogen diethylstilboestrol with biochanin A did not suppress the growth regulatory effects of biochanin A treatment. We conclude that biochanin A inhibits the cell proliferation of human endothelial cells at concentrations that are physiologically achievable in vivo and that this effect may play an important role in the cancer-preventing activity of the phyto-oestrogens.

Chronic pancreatitis with pancreas divisum treated with pylorus-preserving pancreatoduodenectomy: a case report.

Pancreas divisum, the most common congenital variant of pancreatic ductal anatomy, occurs when the ventral and dorsal pancreatic-buds fail to fuse. Herein, we report on a 42-year-old male suffering from chronic pancreatitis with pancreas divisum. Magnetic resonance cholangiopancreatography confirmed this diagnosis. A pylorus-preserving pancreatoduodenectomy was then performed. Pathological examination of the pancreas demonstrated chronic pancreatitis without malignancy. The postoperative clinical course was uneventful, and the patient was discharged 10 days after surgery.

Regulation of inducible nitric oxide synthase by dietary phytoestrogen in MCF-7 human mammary cancer cells.

We examined the effects of the phytoestrogen biochanin A on the growth of the MCF-7 human breast cancer cell line. The results showed that biochanin A treatment induced dose- and time-dependent inhibition on MCF-7 cell growth at concentrations above 20 microg x mL(-1). An examination of treated MCF-7 cell morphology revealed condensation of the chromosome and dehydration of the cytoplasm, suggesting apoptosis as an important factor in biochanin A-related cell growth inhibition. The results also showed that at a concentration of 40 microg x mL(-1), biochanin A decreased the levels of inducible nitric oxide synthase, thus inhibiting the production of nitric oxide, a known second messenger and inducer of apoptosis, and affecting the overall cell protein pattern. No significant difference in superoxide dismutase protein levels were, however detected at concentrations of 40 or 100 microg x mL(-1) of biochanin A. The data suggest that the inhibitory effects of biochanin A on human breast cancer cell growth are linked to inducible nitric oxide synthase and the associated production of nitric oxide.

Optimizing lipase activity, enantioselectivity, and stability with medium engineering and immobilization for beta-blocker synthesis.

Lipase from Pseudomonas cepacia showed poor activity and moderate enantioselectivity (E) in pure aqueous systems for hydrolysis of a racemic mixture (+/-)-1-chloro-2-acetoxy-3-(1-naphthyloxy)-propane, which is a potential intermediate for beta-blocker synthesis. However, addition of polar organic solvents to the reaction can change both the activity and the enantioselectivity for this chiral reaction significantly. It was observed, in general, that the activity increases and the enantioselectivity decreases with the increase in the polarity of the organic solvent added to the medium. Among the six solvents chosen (i.e., dimethylsulfoxide [DMSO], 1, 4-dioxane, dimethylformamide [DMF], acetone, 1-propanol, and tetrahydrofuran [THF]), maximum activity and minimum enantioselectivity was obtained with DMSO, whereas minimum activity and maximum enantioselectivity was obtained with THF as the cosolvents. In the subsequent studies, native or polyethylene glycol (PEG)-modified lipase was immobilized by entrapping in Caalginate gel beads. In a fixed-bed continuous reactor containing these catalyst beads, the enzyme was found to be at least three times more enantioselective than the native form in a batch reactor. This fixed-bed reactor with the beads could be operated with high concentration of acetone (33% v/v) for about 1 month without a significant loss of enzyme activity and enantioselectivity.