Pharmacokinetics and safety of pegylated recombinant human granulocyte colony-stimulating factor in children with acute leukaemia.

AIMS: This open-label, phase I study evaluated the pharmacokinetics and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for the treatment of chemotherapy-induced neutropenia in children with acute leukaemia. METHODS: PEG-rhG-CSF was administered as a single 100 mcg/kg (3 mg maximum dose) subcutaneous injection at the end of each chemotherapy period when neutropenia occurred. Blood samples were obtained from patients treated with PEG-rhG-CSF. PEG-rhG-CSF serum concentrations were determined by an enzyme-linked immunosorbent assay. Population pharmacokinetic (PPK) analysis was implemented using the nonlinear mixed-effects model. Short-term safety was evaluated through adverse events collection (registered at clinicaltrials.gov identifier: 03844360). RESULTS: A total of 16 acute leukaemia patients (1.8-13.6 years) were included, of whom two (12.5%) had grade 3 neutropenia, six (37.5%) had grade 4 neutropenia, and eight (50.0%) had severe neutropenia. For PPK modelling, 64 PEG-rhG-CSF serum concentrations were obtainable. A one-compartment model with first-order elimination was used for pharmacokinetic data modelling. The current weight was a significant covariate. The median (range) of clearance (CL) and area under the serum concentration-time curve (AUC) were 5.65 (1.49-14.45) mL/h/kg and 16514.75 (6632.45-54423.30) ng·h/mL, respectively. Bone pain, pyrexia, anaphylaxis and nephrotoxicity were not observed. One patient died 13 days after administration, and the objective assessment of causality was that an association with PEG-rhG-CSF was "possible". CONCLUSIONS: The AUC of PEG-rhG-CSF (100 mcg/kg, 3 mg maximum dose) in paediatric patients with acute leukaemia were similar to those of PEG-rhG-CSF (100 mcg/kg) in children with sarcoma. PEG-rhG-CSF is safe, representing an important therapeutic option for chemotherapy-induced neutropenia in paediatric patients with acute leukaemia.

One-Pot Fabrication of Hierarchically Bicontinuous Polystyrene Monoliths with Homogeneous Skeletons and Glycopolymer Surfaces.

The hierarchically bicontinuous polystyrene monoliths (HBPMs) with homogeneous skeletons and glycopolymer surfaces are fabricated for the first time based on the medium internal phase emulsion (MIPE) templating method via activator generated by electron transfer for atom transfer radical polymerization (AGET ATRP). The synergistic self-assembly of amphiphilic diblock glycopolymer (ADG) and Pluronic F127 (PF127) at the oil/water interface via hydrogen bonding interaction contributes to the formation of bicontinuous MIPE with deformed neighboring water droplets, resulting in the highly interconnected HBPM after polymerization. There is a bimodal pore size distribution in the HBPM, that is, through pores (150-5000 nm) and mesopores (10-150 nm). The HBPMs as prepared show excellent biocompatibility, homogeneous skeletons, strong mechanical strength, and high bed permeability, overcoming the practical limitations of the second generation of polystyrene (PS) monoliths. Glycoprotein concanavalin A (Con A) can be easily and quickly separated by the HBPM in hydrophilic interaction chromatography (HILIC) mode. These results suggest the HBPMs have great potentials in catalysis, separations, and biomedical applications.

Mutual information network-based support vector machine strategy identifies salivary biomarkers in gastric cancer.

PURPOSE: To determine the vital salivary transcriptomic biomarkers for the early detection of gastric cancer via comparing classification efficiency of multiple candidate genes. METHODS: We firstly identified 5 kinds of candidate genes related to gastric cancer, including differential pathway genes (DPGs) based on the attract method, hub genes in differential pathways based on mutual information network (MIN) analysis, differentially expressed genes (DEGs) identified by Significance Analysis of Microarrays (SAM), informative genes (DEGs in differential pathways), and key genes (hub DEGs). Then, the classification efficiency of these 5 kinds of candidate genes were assessed using support vector machines (SVM) model. The genes with the best classification efficiency were considered as salivary biomarkers in gastric cancer. RESULTS: Using the attract method, we screened 5 differential pathways in gastric cancer, in which there were 349 DPGs. Based on these DPGs, MIN with 345 genes and 1313 interactions was constructed, from which we obtained 26 hub genes by topological analysis. Meanwhile, we identified 374 DEGs in gastric cancer. Combining DEGs with DPGs and hub genes respectively, we selected 16 informative genes and 5 key genes. SVM analysis showed that the key genes presented the best classification efficiency with AUC=0.99, specificity=1.00, sensitivity=0.98 and MCC=0.95, which would be considered as salivary biomarkers in gastric cancer. CONCLUSIONS: This study successfully explored several salivary biomarkers for the non-invasive detection of gastric cancer with high specificity and sensitivity, which might contribute to the early detection and treatment of gastric cancer.

Selective extraction of berberine from Cortex Phellodendri using polydopamine-coated magnetic nanoparticles.

A new extraction agent featuring dopamine self-polymerized on magnetic Fe3 O4 nanoparticles has been successfully synthesized and evaluated for the SPE of berberine from the extract of the traditional Chinese medicinal plant, Cortex Phellodendri. The nanoparticles prepared possessed a core-shell structure and showed super-paramagnetism. It was found that these polydopamine-coated nanoparticles exhibited strong and selective adsorption for berberine. Among the chemical components present in C. Phellodendri, only berberine was adsorbed by the nanoparticles and extracted by a following SPE procedure. Various conditions such as the amount of polydopamine-coated nanoparticles, desorption solvent, desorption time and equilibrium time were optimized for the SPE of berberine. The purity of berberine extracted from C. Phellodendri was determined to be as high as 91.3% compared with that of 9.5% in the extract. The established SPE protocol combined advantages of highly selective enrichment with easy magnetic separation, and proved to be a facile efficient procedure for the isolation of berberine. Further, the prepared polydopamine-coated magnetic nanoparticles could be reused for multiple times, reducing operational cost. The applicability and reliability of the developed SPE method were demonstrated by isolating berberine from three different C. Phellodendri extracts. Recoveries of 85.4-111.2% were obtained with relative standard deviations ranging from 0.27-2.05%.

An integrated liposome-based microfluidic strategy for rapid colorimetric analysis: A case study of microRNA-21 detection.

In this study, a novel integrated liposome-based microfluidic platform combined with a smartphone was designed for the rapid colorimetric detection of microRNA-21 (miRNA-21) in real samples. The flowing surface-functionalized liposomes were first captured by nucleic acid-functionalized Au nanoparticles in the microfluidic chip. In the presence of miRNA-21, the DNA strand modified on the surface of Au nanoparticles hybridized with the target to form double-stranded products and was cleaved by duplex-specific nuclease (DSN) enzyme, causing the liposomes to be re-released. Then, as the liposomes in the colorimetric module were lysed and the "cellular" contents were released, a step-by-step "glucose-glucose oxidase-3,3',5,5'-tetramethylbenzidine (TMB)" colorimetric reaction process catalyzed by the G-quadruplex/hemin was triggered. The grayscale values were recorded and recognized by the smartphone camera for miRNA-21 analysis. The advantages of the present strategy included the portability of smartphone-based colorimetric assay, the encapsulation and transport of reactants by liposomes and the low solvent usage of microfluidic chip. Under optimal conditions, this assay exhibited a wide linear range from 1 pM to 1 nM (r2 = 0.9981), and the limit of detection of miRNA-21 was as low as 0.27 pM. Moreover, the high specificity of this strategy allowed its successful application to the rapid analysis of miRNA-21 in real blood serum samples of people with type 2 diabetes.

Accumulation rate and sources of plastic marine litter at nesting grounds of green turtles on the North Island of Qilianyu, Xisha Islands, South China Sea.

In this study, the accumulation rate of plastic litter was investigated by sampling quadrats placed on the North Island of Qilianyu, and the composition was analyzed and identified to determine its source. The results showed that the annual average accumulation rate of plastic litter on North Island was 0.64 ± 0.32 pieces·m-2·month-1, with a mass accumulation rate of 11.30 ± 7.73 g·m-2·month-1. The accumulation rate of plastic litter was mainly influenced by wind speed and direction, with higher accumulation rates occurring during the southwest monsoon season and tropical cyclones. ATR-FTIR analysis indicated that polyethylene (44 %) and polypropylene (41 %) were the most abundant types of polymers. This study reveals the current status of plastic litter pollution in green turtle nesting grounds on North Island in Qilianyu, which can be used as a reference for management strategies that mitigate plastic litter pollution.

N-Butyl Cyanoacrylate Glue Versus Nonspherical Polyvinyl Alcohol Particles For Prostatic Arterial Embolization To Treat Benign Prostatic Hyperplasia: Safety and Efficacy.

PURPOSE: Our aim is to compare N-butyl cyanoacrylate (NBCA) glue and non-spherical polyvinyl alcohol (PVA) particles for prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH) to treat lower urinary tract symptoms (LUTS) and report their feasibility, safety, and short-term effectiveness. MATERIALS AND METHODS: 110 patients (mean age: 72.6 years) with BPH related to LUTS were divided into two groups, PAE was performed in one group with 250 - 355 µm non-spherical PVA particles. Whereas, the other group received a mixture of NBCA glue/ lipiodol for PAE. RESULTS: PAE was technically successful in all 110 patients (100 %). During 6 months follow up, we found that in patients who received NBCA glue, the mean of prostatic volume (PV) was significantly reduced compared to baseline (67.1 ± 8.5 to 40.2 ± 5.4), International Prostate Symptom Score (IPSS) (25.7 ± 4.3 to 7.2 ± 1.09), Quality of life (QoL) (4.43 ± 0.27 to 1.58 ± 2.27); whereas, the mean of Peak urinary flow (Qmax) increased significantly from baseline to 6 months (8.6 ± 2.3 to 15.4 ± 2.3), International Index of Erectile Function (IIEFS) (9.46 ± 1.51 to 19.3 ± 1.33). Meanwhile, non-spherical PVA particles used in the other group show that PV significantly reduced from baseline to 6 months (68.2 ± 8.32 to 38.8 ± 6.13), IPSS (25.0 ± 3.59 to7.24 ± 0.83), QoL (4.43 ± 0.24 to1.56 ± 0.55). The mean for Qmax increased from baseline to 6 months (7.19 ± 1.67 to15.1 ± 2.42), IIEFS (9.22 ± 1.30 to 19.5 ± 0.96). CONCLUSION: PAE with NBCA glue and non-spherical PVA particles is feasible, safe, and effective for patients with BPH related-LUTS. This gives the physicians options to choose between embolizing agents based on the architecture of the prostatic artery.

Novel in vivo-degradable cellulose-chitin copolymer from metabolically engineered Gluconacetobacter xylinus.

Despite excellent biocompatibility and mechanical properties, the poor in vitro and in vivo degradability of cellulose has limited its biomedical and biomass conversion applications. To address this issue, we report a metabolic engineering-based approach to the rational redesign of cellular metabolites to introduce N-acetylglucosamine (GlcNAc) residues into cellulosic biopolymers during de novo synthesis from Gluconacetobacter xylinus. The cellulose produced from these engineered cells (modified bacterial cellulose [MBC]) was evaluated and compared with cellulose produced from normal cells (bacterial cellulose [BC]). High GlcNAc content and lower crystallinity in MBC compared to BC make this a multifunctional bioengineered polymer susceptible to lysozyme, an enzyme widespread in the human body, and to rapid hydrolysis by cellulase, an enzyme commonly used in biomass conversion. Degradability in vivo was demonstrated in subcutaneous implants in mice, where modified cellulose was completely degraded within 20 days. We provide a new route toward the production of a family of tailorable modified cellulosic biopolymers that overcome the longstanding limitation associated with the poor degradability of cellulose for a wide range of potential applications.

[Biological characters of a coxsackievirus B3 variant strain isolated from a hand-foot-mouth disease patient with severe clinical symptoms].

OBJECTIVE: To analyze the genetic and biological characters of a new isolate of coxsackievirus B3 (CoxB3), i.e. FY-19 strain, and investigate its mechanistic role in causing different clinical symptoms of hand-foot-mouth disease (HFMD). METHODS: FY-19 strain, isolated from a patient with severe clinical symptoms from Fuyang, China in 2008, was identified by the serological parameters via the Lim Benyesh-Melnick (LBM) antiserum pools. Its genotype was further characterized by sequencing the whole genome. And its biological characters were also examined by proliferation kinetic and pathogenetic analysis. RESULTS: FY-19 strain was identified as CoxB3 showing 23.0%, 16.5% and 32.1% difference with Nancy strain in 3'-, 5'-noncoding and coding regions respectively. FY-19 also showed a high homology with other HFMD-related CoxB3 isolates in China. But its homology with non-HFMD-related CoxB3 isolates was lower (13.5% and 25.0% difference in 3'-NCR and coding region respectively). The viral replication kinetic analysis suggested that the FY-19 proliferation increased rapidly and peaked at 14 hours post-infection. In pathological analysis, FY-19 strain induced mortal pathology in sucking mice. CONCLUSION: Differences in genetic and biological characters exist between FY-19 and Nancy strains. Further analysis on the pathogenesis of this variant may aid in elucidating the mechanisms of HFMD.

Fibula osteal flap with proximal peroneal perforator skin paddle for composite oromandibular reconstruction: A case report.

RATIONALE: Cutaneous perforators of peroneal vessels are divided into proximal and distal perforators on the basis of perforator distributions and musculocutaneous or septocutaneous properties. The traditional fibular osteocutaneous free flap is raised over the distal two-thirds of the fibula with a skin paddle based on distal perforators, which is affixed to the posterior crural septum. However, the skin pedicle may not be available due to anatomic variations or intraoperative injuries. Herein, because of the absence of distal perforators, we reserved and expropriated proximal perforators originating from the musculocutaneous branch of the superior part of the peroneal artery before it divided into nutrient and arcuate arteries and successfully harvested a separate osteal fibula and proximal perforator skin paddle with a single vascular pedicle-peroneal vessel. PATIENT CONCERNS: A 62-year-old man with a 6-month history of mandibular swelling and soft tissue invasion was referred to us. DIAGNOSIS: Panoramic radiography and computed tomography showed an irregular radiolucent lesion of the mandibular body, and histopathological analysis confirmed a follicular-pattern ameloblastoma. INTERVENTIONS: The diseased mandible and soft tissue were resected and reconstructed with a vascularized fibular osteal flap with the proximal perforator skin paddle. OUTCOMES: The mandibular contour was successfully restored; the skin paddle in the mouth was in good condition after 8 months of follow-up. LESSONS: The proximal perforator is reliable and practical for supplying a skin paddle and has significant potential for future applications. We recommend reserving the proximal perforator skin paddle as a backup flap when planning to raise a fibula flap, since unavailability or injury of the traditional fibular skin island based on distal perforators occurs frequently. This approach can avoid the exploration for a second donor site, save surgical time, and reduce surgical complexity. Moreover, we anticipate more frequent use of the proximal perforator flap in the future because of its flexibility and large volume, and since it can be combined with the osteal fibula or fibular osteocutaneous flap. However, an understanding of the traits of the proximal perforator and determination of its peroneal origin by computed tomography angiography is crucial for predesigning fibular osteal flaps with a proximal perforator skin paddle.

A pH-responsive bioassay for paper-based diagnosis of exosomes via mussel-inspired surface chemistry.

The analysis of exosomes, which shows an increasing potential as prognostic biomarkers for non-invasive cancer diagnosis, can reveal their biological functions and disease associations. Nevertheless, the development of a convenient and quantitative method for determination of exosomes is still challenging. Herein, a novel approach for exosome quantification using pH test paper is developed via HRP-mediated promotion of mussel-inspired surface engineering and reagent-free functionalization of urease molecules. Uerase can hydrolyse urea into ammonia and carbon dioxide, and simultaneously raise the pH value of the solution. By establishing the relationship between exosome recognition and the change of pH value of the sensing solution, we can directly employ the low-cost, widely used and commercially available pH test paper to quantitatively analyse exosomes. The pH-responsive bioassay enables sensitive detection of exosomes with a detection of limit down to 4.46 × 103 particles/µL and can be successfully applied for determination of exosomes in clinical specimens. The versatility and reliability of our sensing platform may open up opportunities towards paper-based diagnosis of cancer.

[Current situation and strategy on perforation repair].

Perforations are common complications of root canal therapy. In clinic, perforations that were improperly and untimely repaired can seriously affect the prognosis of teeth after root canal treatment. At present, the status of perforation repair in our country is worrisome. This paper focused on the progress of perforation repair in the country by discussing the current situation of repair methods and materials. This review aims to improve knowledge and aid clinical doctors in the sophistication of perforation repair in order to improve the retention rate of root-canal-treated teeth.

Endovascular Treatment of 12 Cases of Renal Arteriovenous Malformations: The Experience of 1 Center and an Overview of the Literature.

OBJECTIVES: Congenital renal arteriovenous malformations (rAVMs) represent rare vascular diseases. The heterogeneous vascular architecture of each rAVM determines the endovascular treatment techniques employed. We reported our experience with the endovascular treatment of a series of rAVMs. MATERIALS: This retrospective study consisted of 12 patients with 12 rAVMs who underwent renal arterial embolization (RAE) in our hospital. Embolic materials, including particles, liquid embolic agents (n-butyl 2-cyanoacrylate, Onyx, and ethanol), and coils, were selectively used based on the decisions of interventional radiologists. Technical success was defined as the complete occlusion of the feeding arteries and nidus on postprocedure renal arteriography. Clinical success was defined as the resolution of hematuria or the disappearance of rAVM-relevant symptoms. RESULTS: The median follow-up period was 13.5 months (range: 4-72). The technical success based on 12 procedures in 12 patients was 83.3% (10 of 12). In the 2 procedures that technically failed, the existence of multiple fine feeding arteries arising from the proximal portion of different segmental renal arteries explains the incomplete embolization. One of the 2 patients achieved clinical success without additional RAE. The other patient had recurrent hematuria 25 months after initial treatment, which was successfully managed conservatively with hemostatic agents. Thus, the clinical success was 91.7% (11 of 12). CONCLUSIONS: Renal artery embolization with the selective use of various embolic materials is an effective treatment for patients with rAVMs. The existence of multiple fine feeding vessels arising from the proximal portion of different segmental renal arteries is likely to affect the technical success of treatment.

Effects of acrylate/acrylamide polymers on the adhesion, growth and differentiation of Muse cells.

BACKGROUND: Acrylate/acrylamide copolymers have excellent optical properties and biocompatibility and are ideal biomaterials that have been widely used in tissue engineering. Multilineage-differentiating stress-enduring cells (Muse cells) are a specific subset of mesenchymal stem cells that have an excellent potential for the regenerative medicine. OBJECTIVE: This study was designed to investigate the effects of acrylate/acrylamide copolymers on the adhesion, proliferation and pluripotent-like properties of Muse cells, which were derived from normal human dermal fibroblasts by long-term trypsin incubation. METHODS: In an initial experiment, Muse cells were seeded on primary microarrays containing micro-spots of 275 different mixtures of acrylate/acrylamide. Each mixture was composed of two of 11 different monomers in various proportions, and was replicated in four micro-spots each. According to the adhesion and growth characteristics of Muse cells on those substrates, specific polymer candidates for Muse cells were selected and secondary microarrays were prepared. We then observed the effects of those specific polymer candidates on the adherence, proliferation and differentiation of Muse cells and suitable candidates for their optimal culture were identified. RESULTS: According to the adhesion and growth patterns of Muse cells on the primary microarrays, ten suitable mixtures of acrylate/acrylamide copolymers were identified. Muse cells grew well on six of those combinations and around the four other combinations of those polymer mixtures. Muse cells cultured on three of those combinations proliferated and differentiated into long spindle-shaped cells that looked like fibroblasts, while Muse cells cultured on one combination formed clusters that were ring-shaped. Muse cells cultured on some of those combinations of acrylate/acrylamide proliferated and formed clusters that appeared to be very healthy, whereas Muse cells cultured on other combinations formed clusters that expanded outwards. CONCLUSIONS: These results identified a polymer combination that was optimum for the adhesion, proliferation and maintenance of Muse cells in an undifferentiated state.

A novel ordered nano hydroxyapatite coating electrochemically deposited on titanium substrate.

A novel porous nano hydroxyapatite (HA) coating has been prepared on commercially pure titanium substrate by a modified electrochemical deposition method. The physico-chemical and biological properties of the coating were characterized by SEM, XRD, FTIR, Raman, and in vitro cell culture test respectively. The SEM patterns show a uniform microporous morphology consisting of wirelike crystals at nanometer scale. It is suggested that under controlled deposition conditions, the primary HA nanowires grow and self-assemble to construct an ordered microporous nest-like morphology, thus to form a nano-micro two-level structure. The XRD results demonstrate that the HA nanowires are orderly arranged with their c-axis preferentially perpendicular to the substrate surface. The Raman and IR spectra affirm that the main component of the coating is well crystallized HA. An interdigitation phenomenon of the MG63 human osteosarcoma cells with the HA nanowires is observed in the in vitro test, indicating excellent biocompatibility and bioactivity for the prepared coating.

[Effect of aging on proliferative and differentiation capacity of human periodontal ligament stem cells].

OBJECTIVE: To evaluate the effect of aging on the proliferative and differentiation capacity of human periodontal ligament stem cells (PDLSCs). METHODS: Human periodontal ligament tissues were obtained from surgically extracted third molars from 6 subjects aged 18-20 years (group A) and 6 subjects aged 45-50 years (group B). The proliferative capacity of PDLSCs isolated from the tissues was examined with MTT assay, and the osteogenic and adipogenic differentiation capacity of the cells were evaluated using alizarin red staining and oil red O staining. SA-ßG expression was analyzed to assess the cell senescence. In both groups, PDLSCs were induced for osteogenic differentiation for 7 days, and the differentiation ability of the cells was assessed by examining alkaline phosphatase (ALP) activity and by detecting the expressions of osteocalcin (OCN) and ALP using Western blotting. RESULTS: Human PDLSCs were successfully isolated from the 12 teeth and were characterized as MSCs. The PDLSCs derived from donors of different ages were all capable of osteogenic and adipogenic differentiation, but their proliferative and osteogenic differentiation capacity decreased with the donors' age. The cells also exhibited an age- related increase in adipogenic differentiation capacity and SA-ßG expression. In both groups, the cells induced in osteogenic medium showed increased OCN expression and ALP activation, and the increments were more obvious in group A. CONCLUSION: Human PDLSCs can be isolated from periodontal ligament tissues even from donors of advanced ages, but their proliferative and differentiation capacity decreases and their adipogenic differentiation capacity increases with age.

[Difference of in vitro osteogenic differentiation and osteoclast capacity between stem cells from human exfoliated deciduous teeth and dental pulp stem cells].

OBJECTIVE: To compare the osteogenic differentiation potential and osteoclast capacity between stem cells from human exfoliated deciduous teeth (SHED) in the physiological root resorption period and dental pulp stem cells (DPSCs). METHODS: SHED and DPSCs were isolated, purified and cultured in vitro. The two stem cells were examined with ALP staining at 14 days and with alizarin red staining at 21 days of osteogenic induction, and the expressions of the genes associated with osteogenesis and osteoclastogenesis were detected using real-time PCR. RESULTS: The isolated SHED and DPSCs both showed an elongate spindle-shaped morphology. After osteogenic induction of the cells, Alizarin red staining visualized a greater number of mineralized nodules in SHED than in DPSCs (P<0.05), and SHED also exhibited a stronger ALP activity than DPSCs (P<0.05). RT-PCR test results showed that the two stem cells expressed RANKL,OCN, ALP, OPG and Runx2 mRNA after osteogenic induction, but the expression levels of Runx2, OCN and ALP were lower in DPSCs than in SHED (P<0.05), and the ratio of RANKL/OPG was significantly higher in SHED (P<0.05). CONCLUSIONS: Compared with DPSCs, SHED has not only the ability of osteogenic differentiation but also an osteoclast capacity, which sheds light on the regulatory role of SHED in physiological root resorption bone remodeling.

Technical feasibility of embolizing aneurysms with glue (N-butyl 2-cyanoacrylate): experimental study in rabbits.

BACKGROUND AND PURPOSE: Liquid embolic agents may have potential as a therapeutic option to reconstruct a defective vessel wall. We evaluated the feasibility of transarterial glue embolization in surgically constructed carotid artery aneurysms. METHODS: Reconstruction of arterial wall defects with use of glue casts was performed in 16 surgically constructed aneurysms of carotid arteries in rabbits. Via the transfemoral route, glue was injected without balloon protection through a microcatheter into the aneurysmal sac with (n = 8) and without (n = 8) a framework of coils. To identify safe and effective methods, four concentrations (28%, 33%, 40%, 50%) of glue-iodized oil mixtures were used in four aneurysms each. Immediate (n = 16) and 2-month follow-up (n = 10) postembolization angiograms were obtained to evaluate the residual aneurysmal sac and the carotid artery patency. RESULTS: Continuous column injection of glue was possible in all aneurysms, without fragmented migration of the injected glue cast. Catheter sticking or breakage did not occur during catheter retrieval. Glue embolization without a framework of coils (n = 8) resulted in complete obliteration of the aneurysmal sac in five aneurysms and incomplete obliteration with a small residual lumen in three. Two aneurysms resulted in carotid occlusion after catheter removal. A follow-up angiogram (n = 4) showed decreased residual lumen in two aneurysms, no change in the complete aneurysm occlusion in one, and carotid occlusion in one. Glue embolization with a coil framework (n = 8) resulted in complete obliteration of the aneurysmal sac in six aneurysms and incomplete obliteration with a small residual lumen in two. A small amount of spillage occurred in one owing to the improper position of the microcatheter caused by a difficult neck angle to the parent artery. Follow-up angiograms (n = 6) showed decreased residual lumen in one of two aneurysms and no change of the complete occlusion in five of six aneurysms. CONCLUSION: Effective glue embolization into the aneurysmal sac is technically feasible. Microcatheter position within the aneurysm, concentration of glue, and direction of the aneurysmal neck angle all must be considered. With a coil framework, glue injection was more complete, without deformity or spillage of the glue from the aneurysm.

Irradiation impairment of umami taste in patients with head and neck cancer.

BACKGROUND: Previous studies have reported the alteration of the four basic tastes (sweet, salty, sour and bitter) in patients with head and neck cancer (HNC) during radiotherapy. However, there has been no investigation on the function of umami taste, a novel basic taste recognized recently, during head and neck irradiation. OBJECTIVE: To investigate the recognition threshold of umami and the four basic tastes at different irradiation dose intervals during radiotherapy for head and neck cancer. METHODS: In 30 patients with malignant neoplasm of head and neck, objective taste thresholds were examined by use of a whole-mouth method at pre-radiotherapy, irradiation doses at 15, 30, 45, and 60 Gy, respectively. Subjective taste loss and some distresses were recorded simultaneously. RESULTS: Sweet, sour, salty, and bitter tastes showed temporarily and slightly increased thresholds during the treatment, but no statistical difference was found between the threshold at pre-radiotherapy and that at 15, 30, 45, and 60 Gy in any taste quality (all P > 0.05). Significantly impaired threshold of umami taste was revealed at 30 Gy (P < 0.05) and remained throughout the following treatment (at 45 and 60 Gy, both P < 0.01). Subjective taste impairment, appetite loss and satisfaction with the current state tended to deteriorate significantly during the irradiation. Mean body weight of the patients experienced a continuous loss, decreasing from an average of 60.4 kg before treatment to 57.3 kg at 60 Gy (P < 0.01). Scores of satisfaction with current state showed a significant correlation with umami taste thresholds (P = 0.035). CONCLUSION: The clinical impairment pattern of umami taste is different from that of the other four basic tastes in HNC patients during radiotherapy. Impaired umami taste acuity plays an important role in impacting the quality of life of the patients irradiated to the head and neck.

Transarterial embolization with cyanoacrylate for severe arterioportal shunt complicated by hepatocellular carcinoma.

PURPOSE: To evaluate the efficacy and safety of cyanoacrylate glue embolization in the treatment of severe arterioportal shunt (APS) presenting with hepatofugal portal venous flow in hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: Between July 2000 and January 2010, 27 HCC patients with severe APS presenting with hepatofugal portal venous flow underwent transarterial angiography and treatment. Among them, four patients were excluded from the study. Twelve patients underwent transarterial chemoperfusion and embolization of APS with cyanoacrylate glue between January 2006 and January 2010 (Emb group), and the other 11 patients undergoing only transarterial chemoperfusion without embolization of APS between July 2000 and December 2005 served as a control group (non-Emb group). The change of APS, survival rates, and procedure related complications were analyzed. RESULTS: In the Emb group, APS was improved in all of the 12 patients after initial glue embolization; long-term APS improvement with hepatopetal portal flow was achieved in 80 % (8 of 10) patients who underwent follow-up angiography. Survival rates in the Emb group were 67 % at 6 months, 33 % at 1 year, and 8 % at 2 years, whereas those in the non-Emb group were 0 % at 6 months (P < 0.05). Median survival time in the Emb group was 275 days, which was longer than that of 107 days in the non-Emb group (P = 0.001). There were no major complications in both groups. CONCLUSION: The preliminary experience suggests that glue embolization may be an effective and safe therapy in the management of severe APS accompanied by HCC and also improve patient survival.