Singlet Molecular Oxygen: from COIL Lasers to Photodynamic Cancer Therapy.

Translation of experimental techniques from one scientific discipline to another is often difficult but rewarding. Knowledge gained from the new area can lead to long lasting and fruitful collaborations with concomitant development of new ideas and studies. In this Review Article, we describe how early work on the chemically pumped atomic iodine laser (COIL) led to the development of a key diagnostic for a promising cancer treatment known as photodynamic therapy (PDT). The highly metastable excited state of molecular oxygen, a1Δg, also known as singlet oxygen, is the link between these disparate fields. It powers the COIL laser and is the active species that kills cancer cells during PDT. We describe the fundamentals of both COIL and PDT and trace the development path of an ultrasensitive dosimeter for singlet oxygen. The path from COIL lasers to cancer research was relatively long and required medical and engineering expertise from numerous collaborations. As we show below, the knowledge gained in the COIL research, combined with these extensive collaborations, has resulted in our being able to show a strong correlation between cancer cell death and the singlet oxygen measured during PDT treatments of mice. This progress is a key step in the eventual development of a singlet oxygen dosimeter that could be used to guide PDT treatments and improve outcomes.

Pressure drop of two-phase helium along long cryogenic flexible transfer lines to support a superconducting RF operation at its cryogenic test stand.

BACKGROUND: Establishing a stand-alone cryogenic test stand is of vital importance to ensure the highly reliable and available operation of superconducting radio-frequency module in a synchrotron light source. Operating a cryogenic test stand relies strongly on a capability to deliver two-phase helium along long cryogenic transfer lines. A newly constructed cryogenic test stand with flexible cryogenic transfer lines of length 220 m at National Synchrotron Radiation Research Center is required to support a superconducting radio-frequency module operated at 126.0 kPa with a 40-W dynamic load for a long-term reliability test over weeks. It is designed based on a simple analytical approach with the introduction of a so-called tolerance factor that serves to estimate the pressure drops in transferring a two-phase helium flow with a substantial transfer cryogenic heat load. Tolerance factor 1.5 is adopted based on safety factor 1.5 commonly applied in cryogenic designs to estimate the total mass flow rate of liquid helium demanded. A maximum 60-W dynamic load is verified with experiment measured with heater power 60 W instead after the cryogenic test stand has been installed. RESULTS: Aligning the modeled cryogenic accumulated static heat load with the results measured in situ, actual tolerance factor 1.287 is obtained. The feasibility and validity of our simple analytical approach with actual tolerance factor 1.287 have been scrutinized by using five test cases with varied operating conditions. Calculated results show the discrepancies of the pressure drops between the estimated and measured values for both liquid helium and cold gaseous helium transfer lines have an underestimate 0.11 kPa and an overestimate 0.09 kPa, respectively. A discrepancy is foreseen, but remains acceptable for engineering applications from a practical point of view. CONCLUSIONS: The simple analytical approach with the introduction of a tolerance factor can provide not only insight into optimizing the choice of each lossy cryogenic piping element of the transfer lines in the design phase but also firm guidance for upgrading the present cryogenic transfer lines for its subsequent application.

Clinical and genetic profile of catecholaminergic polymorphic ventricular tachycardia in Hong Kong Chinese children.

OBJECTIVE: To report our experience in the management of catecholaminergic polymorphic ventricular tachycardia in Hong Kong Chinese children. METHODS: This case series study was conducted in a tertiary paediatric cardiology centre in Hong Kong. All paediatric patients diagnosed at our centre with catecholaminergic polymorphic ventricular tachycardia from January 2008 to October 2014 were included. RESULTS: Ten patients (five females and five males) were identified. The mean age at presentation and at diagnosis were 11.0 (standard deviation, 2.9) years and 12.5 (2.8) years, respectively. The mean delay time from first presentation to diagnosis was 1.5 (standard deviation, 1.3) years. They presented with recurrent syncope and six patients had a history of aborted cardiac arrest. Four patients were initially misdiagnosed to have epilepsy. Catecholaminergic polymorphic ventricular tachycardia was diagnosed by electrocardiogram at cardiac arrest (n=2), or provocation test, either by catecholamine infusion test (n=6) or exercise test (n=2). Mutations of the RyR2 gene were confirmed in six patients. Nine patients were commenced on beta-blockers after diagnosis. Despite medications, three patients developed aborted or resuscitated cardiac arrest (n=2) and syncope (n=1). Left cardiac sympathetic denervation was performed in five patients and an implantable cardioverter defibrillator was implanted in another. There was no mortality during follow-up. CONCLUSIONS: Catecholaminergic polymorphic ventricular tachycardia should be considered in children who present with recurrent syncope during exercise or emotional stress. Despite beta-blocker treatment, recurrent ventricular arrhythmias occur and may result in cardiac arrest.

Randomized clinical trial of goal-directed fluid therapy within an enhanced recovery protocol for elective colectomy.

BACKGROUND: Goal-directed fluid therapy (GDFT) has been compared with liberal fluid administration in non-optimized perioperative settings. It is not known whether GDFT is of value within an enhanced recovery protocol incorporating fluid restriction. This study evaluated GDFT under these circumstances in patients undergoing elective colectomy. METHODS: Patients undergoing elective laparoscopic or open colectomy within an established enhanced recovery protocol (including fluid restriction) were randomized to GDFT or no GDFT. Bowel preparation was permitted for left colonic operations at the surgeon's discretion. Exclusion criteria included rectal tumours and stoma formation. The primary outcome was a patient-reported surgical recovery score (SRS). Secondary endpoints included clinical outcomes and physiological measures of recovery. RESULTS: Eighty-five patients were randomized, and there were 37 patients in each group for analysis. Nine patients in the GDFT and four in the fluid restriction group received oral bowel preparation for either anterior resection (12) or subtotal colectomy (1). Patients in the GDFT group received more colloid during surgery (mean 591 versus 297 ml; P = 0·012) and had superior cardiac indices (mean corrected flow time 374 versus 355 ms; P = 0·018). However, no differences were observed between the GDFT and fluid restriction groups with regard to surgical recovery (mean SRS after 7 days 47 versus 46 respectively; P = 0·853), other secondary outcomes (mean aldosterone/renin ratio 9 versus 8; P = 0·898), total postoperative fluid (median 3750 versus 2400 ml; P = 0·604), length of hospital stay (median 6 versus 5 days; P = 0·570) or number of patients with complications (26 versus 27; P = 1·000). CONCLUSION: GDFT did not provide clinical benefit in patients undergoing elective colectomy within a protocol incorporating fluid restriction. REGISTRATION NUMBER: NCT00911391 (http://www.clinicaltrials.gov).

A systemic review of human papillomavirus studies: global publication comparison and research trend analyses from 1993 to 2008.

The term "human papillomavirus" has been used as the keyword during searching titles, abstracts, and keywords based on the online version of Science Citation Index (SCI), Web of Science from 1993 to 2008. Twelve document types were found among the 14,943 papers published in 1,072 journals that were listed in 99 SCI subject categories. All the articles referring to human papillomavirus were assessed by using the following aspects: characteristics of publication output, distribution of output in journals, publication output of source country, source institute, and analysis of word clusters in title, author keywords, and keywords plus. The results have shown that the USA ranked first using five publication indicators including total, single country, international, first author, and corresponding author publications. China has had the sharpest rise of publications since 2004. The top four European countries in 2008 were France, Germany, the UK, and Italy, respectively. Trend studies with word cluster analysis were performed with regards to the areas of immunology, screening methodology, behavioral sciences, economics, and meta-analysis. All those areas have shown a sharp upward rise since 2004. In addition, hypermethylation-induced inactivation of the p16 gene in the early stages of oncogenesis has been getting more interest in recent years.

Unusual giant abdominal leiomyoma in a young man: a case report.

Abdominal leiomyomas are extremely rare intra-abdominal tumors. We present a the case of a 24-year-old male with an abdominal leiomyoma who presented with a chief complaint of a huge mass in the midepigastrium that was suddenly detected 5 days prior to admission. An abdominal leiomyoma with central hemorrhage was found on exploratory laparotomy; the tumor was completely resected. To the best of our knowledge, no similar case has been reported in the literature.

Acute abdominal pain caused by spontaneous hemorrhagic infarction of a solitary plexiform neurofibroma of lesser omentum.

A 32-year-old female patient visited the emergency room because of sudden onset of abdominal pain, which was found to be induced by hemorrhagic infarction of a plexiform neurofibroma arising from the lesser omentum. No other classic clinical characteristics of systemic von Recklinghausen's disease had been seen up until now. The tumor, classified as sporadic plexiform neurofibroma, rarely occurs in the digestive tract. This diagnosis was confirmed by exploratory laparotomy with complete resection of the tumor. Here, we describe the rare case of a sporadic intra-abdominal plexiform neurofibroma and discuss the clinical characteristics and management of plexiform neurofibroma.

Profile of gelatinolytic capacity of raw goat milk and the implications for milk quality.

Both endogenous and exogenous proteinases occur in milk, and they can have beneficial or detrimental effects on dairy production. Because the lactation length of dairy goats is shorter and the somatic cell count (SCC) of goat milk is generally greater compared with dairy cows, the objectives of the present study were to investigate the prevalence of major proteinases in raw goat milk, their association with SCC and production stage, and their effects on milk quality. Milk samples were collected from individual goats in consecutive weeks for different durations, covering regular lactation, late lactation, and post-milk stasis. Long-term (monthly) or short-term (weekly) fluctuations of milk fibrinolytic and gelatinolytic capacities of individual goats were revealed chronologically on fibrin and gelatin zymograms, respectively. In a separate trial involving milk samples from 23 goats at random production stages, the percentage of ultracentrifuge force-precipitable casein of total milk protein was calculated to represent milk quality and was assessed to evaluate its correlation with the corresponding proteolytic capacities. The results for regular milk indicate that gelatinase B was more abundant than gelatinase A when they first appeared at SCC of approximately 1 x 10(6)/mL. During the last month before milk stasis, both gelatinases A and B were found to be prevalent and prominent in milk regardless of the broad SCC range recorded there. Fibrinolytic activity and the active form of gelatinase A were only regularly detected in post-stasis secretions and were scarce before stasis. The results of the milk quality trial indicate that milk of relatively high proteinase capacity tended to have a low casein ratio. Correlation analysis confirmed a significant relationship between gelatinase capacity of goat milk and production stage, SCC, or casein ratio. It is suggested that an elevation of gelatinolytic capacity of goat milk coincides with an increase in somatic cell number accompanying the extension of lactation length, which is unfavorable for the production of a more desirable quality of goat milk.

New symptomatic compression fracture after percutaneous vertebroplasty at the thoracolumbar junction.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures after vertebroplasty at the thoracolumbar junction. MATERIALS AND METHODS: We conducted a retrospective analysis of 53 patients treated with percutaneous vertebroplasty at the thoracolumbar junction (T12, L1). The follow-up period was 15-27 months. The occurrence of new symptomatic vertebral compression fractures was recorded after vertebroplasty. We evaluated patient age and sex, amount of injected cement, vacuum clefts in the collapsed bodies, initial wedge angle of the compression fracture, change of the wedge angle after vertebroplasty, intradiskal cement leak, and percentage of height restoration of the vertebral body. In this report, we surveyed the possible risk factors for new symptomatic vertebral compression fractures. RESULTS: Thirty-nine (74%) of the 53 patients had fluid and/or air in the compression fracture at the thoracolumbar junction (T12, L1). Eight (20.5%) of the 39 patients with vacuum clefts had new symptomatic compression fracture after vertebroplasty between 1 month and 4 days after surgery to 23 months and 4 days after surgery. The patients with new symptomatic compression fracture had higher initial wedge angle and wedge angle change (more than 7 degrees ) after vertebroplasty than those without fractures; these data were considered statistically significant. CONCLUSIONS: The incidence of vacuum clefts in the compression fracture at the thoracolumbar junction is high (74%). The severity of initial wedge angle and wedge angle change affects the incidence of new symptomatic compression fracture.

Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis: experience with 78 patients.

STUDY DESIGN: This is a retrospective study of surgical correction of thoracolumbar kyphosis caused by ankylosing spondylitis. OBJECTIVE: To report the surgical results of thoracolumbar kyphosis deformity corrected with transpedicular wedge osteotomy performed by a single surgeon at a university hospital. SUMMARY OF BACKGROUND DATA: There has not been a large series in the literature reporting on results of the Thomasen-type closing wedge osteotomy for correction of kyphosis deformity secondary to ankylosing spondylitis, nor has two-level osteotomy of this type in one patient ever been described. METHODS: From 1991 through 1998, 92 transpedicular wedge osteotomies were performed in 78 patients with ankylosing spondylitis for correction of fixed flexion deformity of the thoracolumbar spine. RESULTS: The mean amount of correction for each level of osteotomy was 34.5 degrees (range, 15 degrees -60 degrees ). The largest amount of overall correction for a single patient was 100 degrees. Most of the osteotomies (64 of 92) were done at L2 and L3. Fourteen patients with severe deformity required staged two-level osteotomy. Excellent and good results were obtained in 77 patients (98.7%) at the final follow-up. There was no mortality, nor were there any major neurological complications. CONCLUSIONS: Transpedicular wedge osteotomy can effectively and safely correct kyphotic deformity of the thoracolumbar spine caused by ankylosing spondylitis, regardless of rigidity of the spinal curves. Two-level osteotomy can provide sufficient correction for severe cases.

Monitoring effluents from an air toxic control device using continuous nonmethane organic carbon analyzer.

Nonmethane organic carbon (NMOC) is a measure of total organic carbon other than methane in an air emission. It is a convenient way of expressing total organic emissions in terms of carbon. Development of a continuous NMOC (referred to as the C-NMOC) analyzer was recently reported. A microsorbent trap called the microtrap is the key component of this instrument. The microtrap selectively concentrates the organic compounds and then desorbs them as an injection pulse for NMOC detection. The process of concentration and injection is quite fast, and the analysis can be carried out every few seconds to every few minutes. The characteristics of this instrument as applied to on-line monitoring are presented in this article. Its applicability is demonstrated by monitoring emissions from an air toxic control device. The instrument performed well with the oxygenated, chlorinated, aliphatic, and aromatic hydrocarbons in this study. The instrument also demonstrated linear response and high sensitivity.

Diagnostic imaging of heel pain and plantar fasciitis.

Heel pain or calcaneodynia is a common clinical complaint which has a myriad of causes ranging from plantar fasciitis to stress fracture. In many instances, the etiology of the heel pain is difficult to ascertain simply on the basis of history and physical examination. Therefore, the clinician may enlist various diagnostic imaging modalities to clarify the source of pain. Of all the imaging techniques, magnetic resonance imaging (MRI) has proven its worth in the diagnosis of heel pain. This article outlines the various causes of heel pain and their associated imaging findings.

Peripheral color contrast. A new screening test for preglaucomatous visual loss.

A new test of peripheral color contrast is described. A high-definition color monitor driven by a personal computer with a graphics interface card displays an annulus subtending 25 degrees at the eye. The color contrast between the annulus and the background can be varied. Forty-five degrees of the annulus is randomly removed in one of four quadrants. Patients are asked to identify the position of the gap while fixating a central spot. The minimum color contrast between annulus and background at which the identification is possible is between 13-16% for the protan, deuteran, and tritan axis in normal subjects. This threshold value changes little with age, refractive error, or pupillary aperture, and test-retest variability is low. Testing one eye takes only 1-2 min. The test was applied to ocular-hypertensive and glaucomatous patients. All patients with glaucoma had thresholds greater than two standard deviations (SD) above the normal mean. In addition, 97% of glaucoma patients had thresholds greater than four SDs, and 95% had thresholds more than five SDs above the normal mean. Most patients with ocular hypertension and clinical signs indicating a low or medium risk of conversion to glaucoma had thresholds under the upper limit of normal. High-risk patients with ocular hypertension fell into two groups. One approximated to normal; the other had elevated thresholds, which in many cases were more than four SDs above the normal mean. The epidemiologic consequences of this test are discussed.

[An adult case of congenital Horner's syndrome with heterochromia iridis--with special reference to alteration of Horner's sign associated with development].

It is well known that when the Horner's syndrome is congenital, a defect in pigmentation of the iris is usual; all or part of the iris remains light brown. We reported an adult case of congenital Horner's syndrome with remission and relapse of unilateral ptosis. A 25-year-old man was admitted to our hospital for ophthalmologic surgical treatment of right ptosis. According to the patient's mother, the patient was delivered with the aid of forceps at birth, and the right ptosis was observed during the first few days of his life. At 2 to 3 years of age, his parents noted lighter color of the right eye. The right ptosis was gradually improved as he grew older. However, he developed right ptosis again with left meralgia paresthesia since eighteen age. At age 25 years, he was noted to have right ptosis, right miosis (the left pupil measured 4.5 mm in diameter and the right 3.0 mm), right heterochromia iridis with pigmented iris nevi, and left meralgia paresthesia . Laboratory data of urine, blood and CSF as well as radiological studies of chest X-ray, skull X-ray, spine X-ray, brain MRI and spinal cord MRI showed unremarkable. Sweating test was intact, pharmacologic test to Horner's syndrome with 5% cocaine and 1.25% 1-epinephrine indicated that the damage was pointed to the post ganglionic sympathetic neuron. Ten patients with congenital Horner's syndrome reported in Japan since 1953 were reviewed including our case. Ten of eleven were male and Horner's sign was recorded on the left eye in 8 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Inflammatory pseudotumor of the spleen--case report and literature review.

Inflammatory pseudotumor (IPT) of the spleen is an extremely rare benign lesion. We herein report an additional case of a 64-year-old man with IPT of spleen to compare with seven cases previously reported in the literature. However, the immunohistochemical studies has demonstrated to polyclonality of plasma cells which was comparable to these seven previously reported cases. The clinical and pathological findings, as well as the possibilities of etiology and pathogenesis are also described.

Changing attitudes of neonatologists toward ventilator support.

Two identical questionnaires were completed by neonatologists in Southern California, one in 1979 and the other in 1985. All questions addressed only the issue of ventilator support. Respondents were asked to assume both parents wished ventilator support withheld or discontinued. In 1985, despite parents' wishes, neonatologists were more willing to start and continue ventilator support in smaller and less mature infants than in 1979. In 1985, but not 1979, respondents frequently would use ventilator support significantly more than they thought they should. Additionally, in both 1979 and 1985 it was more difficult for respondents to withhold ventilator support in infants with acquired versus congenital problems.

Quantitative study of characteristic aqueous humor transferrin, serum transferrin and desialized serum transferrin in aqueous humor.

Total transferrin (Tf) concentration and relative percentages of its subfractions, ie, characteristic aqueous humor Tf (Tfah), serum Tf (Tfs) and desialized serum Tf (Tau), in the aqueous humor of 30 patients were determined. According to the total Tf concentration, these patients were divided into the group with intact or mildly damaged blood aqueous barrier (BAB), consisting of cataract, glaucoma and central retinal artery occlusion patients, and the severely damaged BAB group, consisting of uveitis patients. In the intact or mildly damaged group, Tfah, Tfs and Tau revealed constant ratios of 60%, 26% and 14%; while in the severely damaged group, a relatively high concentration of Tfs was observed. There is only Tfs in the serum, therefore, theoretically, damage of the BAB should lead to an immediate increase of the relative concentration of Tfs in the aqueous humor. Because it did not occur until the BAB had been severely damaged, the possibility of an intraocular interchange of the 3 Tf subfractions is suggested.