Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.

BACKGROUND AND STUDY AIMS: Although capsule endoscopy has become a central diagnostic tool for small-bowel evaluation, retention of a capsule remains a major concern. This study attempted to investigate the incidence and clinical outcomes of capsule retention, and to determine the factors predictive of spontaneous capsule passage after retention. PATIENTS AND METHODS: Through a nationwide multicenter survey, we retrospectively reviewed the records of 1291 patients who had a capsule endoscopy between February 2002 and July 2006 in Korea. Clinical and procedural characteristics and postprocedural outcomes were analyzed for the cases with capsule retention. RESULTS: Capsule retention occurred in 2.5 % of total cases (32/1291). The major diseases accompanying capsule retention were Crohn's disease, malignant tumors, and tuberculous enterocolitis, in decreasing order. In 11 of the 32 patients (34.4 %), early surgical or endoscopic interventions were instituted for diagnosis or treatment of diseases before retention symptoms developed. The remaining 21 (65.6 %) patients initially received medical treatments. Of these, 10 (31.3 %) ultimately underwent surgical intervention due to the development of symptoms of intestinal obstruction or medical treatment failure. The other 11 (34.4 %) eventually passed the capsule. The presence of a larger lumen diameter (greater than two-thirds of the capsule diameter) at the stricture site was associated with spontaneous passage. CONCLUSIONS: Our large-scale study suggests that retention occurs infrequently during capsule endoscopy. Moreover, a retained capsule might indicate the best intervention for the offending pathology, or it may spontaneously pass in the long run, particularly in patients with less small bowel stricture.

Identification of differentially expressed genes using annealing control primer-based GeneFishing in human squamous cell cervical carcinoma.

AIMS: To compare different gene expression patterns between squamous cell cervical carcinoma (SCC) and normal cervical tissue in Korean women and to identify those genes that are specifically or predominantly expressed in SCC by employing annealing control primer (ACP)-based GeneFishing polymerase chain reaction (PCR). MATERIALS AND METHODS: Cervical cancer specimens were obtained from patients enrolled at the Department of Obstetrics and Gynecology, Kang Nam St. Mary's Hospital, Catholic University of Korea. We used a common reference that was mixed with an equal amount of RNA extracted from patients without cervical cancer. The profiles of expressed genes were compared between the SCC and normal cervix identified using GeneFishing differentially expressed gene kits, screened by a BLAST search, and confirmed by semi-quantitative reverse transcription-PCR (RT-PCR). RESULTS: Almost 100 differentially expressed genes were identified in the control and SCC samples. Using 60 arbitrary ACPs, 50 differentially expressed genes were identified, and 30 up-regulated and 20 down-regulated expressed genes were sequenced. Among 50 clones selected by ACP-based GeneFishing PCR, six genes with different expression patterns were determined and confirmed by semi-quantitative RT-PCR. The functional roles of two up-regulated genes, fibrillarin and calgranulin A, and one down-regulated gene, clusterin, were previously identified. However, the functional roles of two up-regulated genes and one down-regulated gene were not identified. CONCLUSION: We identified distinctive gene expression profiles in Korean women with SCC using ACP-based GeneFishing PCR.

Diabetes and smoking as prognostic factors after cervical laminoplasty.

We reviewed 87 patients who had undergone expansive cervical laminoplasty between 1999 and 2005. These were divided into two groups: those who had diabetes mellitus and those who did not. There were 31 patients in the diabetes group and 56 in the control group. Although a significant improvement in the Japanese Orthopaedic Association score was seen in both groups, the post-operative recovery rate in the control group was better than that of the diabetic group. The patients' age and symptom duration adversely affected the rate of recovery in the diabetic group only. Smoking did not affect the outcome in either group. A logistic regression analysis found diabetes and signal changes in the spinal cord on MRI to be significant risk factors for a poor outcome (odds ratio 2.86, 3.02, respectively). Furthermore, the interaction of diabetes with smoking and/or age increased this risk. We conclude that diabetes mellitus, or the interaction of this with old age, can adversely affect outcome after cervical laminoplasty. However, smoking alone cannot be regarded as a risk factor.

Ceramic bioactivity: progresses, challenges and perspectives.

Bioactivity is a property of the ceramic surface which induces biological integration of living soft and hard tissues. The core mechanism of bioactivity is surface biomineralization of calcium phosphate nanocrystallites on ceramics with specific compositions and structures, inspiring acellular and cellular strategies for bio-interactive materials with new physical, chemical and biological functions. These include bioactive surface functionalizations on metallic, ceramic and polymeric substrata for biomedical materials with different mechanical properties, bioactive ceramic-polymer nanohybrids for soft tissue replacements and engineering, template-textured depositions of biomimetic nano-calcium phosphate for hybridization of bio-macromolecular and cellular functions, concerning which this paper reviews with in vivo and in vitro fundamentals and perspectives in tissue engineering.

Distinctive cell cycle regulatory protein profiles by adenovirus delivery of p53 in human papillomavirus-associated cancer cells.

In this study, microarray analyses were performed to determine the time course of gene expression profiles in SiHa cells after infection with an adenovirus-expressing p53 (Adp53). We then investigated the consequences of Adp53 gene transfer on the expression level of six genes associated with cell cycle control and on apoptosis and cell cycle arrest in SiHa cells and compared these results with those from CaSki and HeLa cells. Gene expression profiling of the p53-targeted genes in SiHa cells revealed that p21, p53, and mdm2 protein expression was significantly upregulated at 24 and 48 h. Western blot results revealed that p21 and p53 expression levels had significantly increased after Adp53 infection. Cyclin-dependent kinase 4 levels were decreased 48 h after treatment in SiHa and CaSki cells. Proliferating cell nuclear antigen levels were unchanged after Adp53 infection. Only SiHa cells exhibited significant cell death. Cell cycle arrest at the G1 phase was induced in the SiHa and HeLa cells but was not induced at the G2/M and S phases in the CaSki cells. These data support the notion that the understanding of p53-dependent apoptosis and cell growth arrest could be applicable to advanced strategies in the development of preferential tumor cell-specific delivery.

Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments.

In this study, effects of different overdenture attachments on the stress distributions in the maxillary bone surrounding the overdenture implants are studied. Four different types of attachment are considered. They are rigid Dalbo Stud, movable Dalbo Stress Broken, movable Dalro, and movable O-ring attachments. Three-dimensional finite element analysis was conducted with commercial package to obtain the stress distributions in the maxillary bone. Varying the attachment types and angle of inclination of load, the stress distributions in the portions of compact bone and trabecular bone were monitored separately. The analysis was conducted by assuming two different boundary conditions at the interface between cap and overdenture abutment in order to evaluate influence of interface boundary condition on stress distribution in the maxillary bone. They were perfect bonding condition and contact with friction at the interfaces. However, it is preferable to assume perfect bond condition at the interface for rigid type attachment systems and contact with friction at the interface for movable type attachment systems. From the numerical results, it was found that the load transfer mechanism of the implant system is altered significantly by the types of the overdenture attachment and also special care must be taken to assign proper boundary conditions at the interface for the analysis. The movable type Dalro attachment generated the highest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for contact with friction. The rigid type Dalbo Stud attachment generated the smallest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for perfect bonding condition.

Evaluation of design parameters of osseointegrated dental implants using finite element analysis.

Finite element analyses were performed for various shapes of dental implant to study effects on stress distribution generated in the surrounding jaw bone and to determine an optimal thread shape for even stress distribution. It was found that the square thread shape filleted with a small radius was more effective on stress distribution than other dental implants used in the analyses. Additional analyses were performed on the implant with the thread shape obtained from previous analyses for varying other design parameters, such as the width of thread end and height of thread for various load directions, to determine the optimal dimensions of the implant. Stress distribution was more effective in the case when the width of thread end and the height of thread were 0.5p and 0.46p, respectively, where p is the screw pitch. Then, using the optimal implant thread dimensions determined previously, stress analyses were performed with various screw pitches and implant lengths, to investigate effects on stress distribution and to find the way to reduce the maximum effective stress generated in the jaw bone. Results show that the maximum effective stress decreased not only as screw pitch decreased gradually but also as implant length increased.

Molecular cloning of a soybean class III beta-1,3-glucanase gene that is regulated both developmentally and in response to pathogen infection.

We isolated and characterized a soybean gene (SGN1) encoding a basic beta-1,3-glucanase that is a plant class III isoform of beta-1,3-glucanase. The deduced amino acid sequence of the SGN1 gene is similar to that of the PR-Q'b gene, the basic class III beta-1,3-glucanase of tomato. Based on RNA blot hybridization, SGN1 gene expression was detected in all tissues of 4-day old seedlings, but it was present only in root tissue of 30-day old plants. GUS expression analysis carried out in transgenic tobacco plants harboring a SGN1::GUS reporter gene revealed the same expression pattern. Furthermore, the expression of SGN1 was strongly induced by a variety of defense-related signals, such as treatment with H(2)O(2), wounding, or treatment with fungal elicitor prepared from Phytophthora spp as well as inoculation with Pseudomonas syringae. However, the expression level of SGN1 was hardly induced with jasmonate, ethephon and salicylate. Overall the results suggest that the SGN1 may play a role in both plant development and plant defense against pathogen attack.