Associations between Cerebral Embolism and Carotid Intraplaque Hemorrhage during Protected Carotid Artery Stenting.

BACKGROUND AND PURPOSE: Carotid artery stent placement in patients with intraplaque hemorrhage remains controversial because of the incidence of cerebral embolism after the procedure. The purpose of this study is to determine if intraplaque hemorrhage is a significant risk factor for cerebral embolism during carotid artery stent placement. MATERIALS AND METHODS: This prospective study assessed 94 consecutive patients with severe carotid stenosis. These patients underwent preprocedural carotid MR imaging and postprocedural DWI after carotid artery stent placement. Intraplaque hemorrhage was defined as the presence of high signal intensity within the carotid plaque that was >200% of the signal from the adjacent muscle on MPRAGE. We then analyzed the incidence of postprocedural ipsilateral ischemic events on DWI and primary outcomes within 30 days of carotid artery stent placement. RESULTS: Forty-three patients (45.7%) had intraplaque hemorrhage on an MPRAGE image. There was no significant difference in the incidence of postprocedural ipsilateral ischemic events and primary outcomes between the intraplaque hemorrhage and non-intraplaque hemorrhage group. However, postprocedural ipsilateral ischemic events were more frequently observed in the symptomatic group (17/41 [41.5%]) than in the asymptomatic group (8/53 [15.1%]; P = .005). CONCLUSIONS: Intraplaque hemorrhage was not a significant risk factor for cerebral embolism during carotid artery stent placement in patients with severe carotid stenosis. Symptomatic patients should receive more careful treatment during carotid artery stent placement because of the higher risk of postprocedural ipsilateral ischemic events.

Linear Versus Non-Linear Dose-Response Relationship Between Prenatal Alcohol Exposure and Meconium Concentration of Nine Different Fatty Acid Ethyl Esters.

Presence of individual fatty acid ethyl esters (FAEEs) in meconium is considered to be a reliable biomarker of prenatal alcohol exposure, and their concentration has been found to be linearly associated with poor postnatal development, supporting the widely extended idea that ethanol is a non-threshold teratogen. However, a growing number of epidemiological studies have consistently found a lack of adverse short- and long-term fetal outcomes at low exposure levels. We therefore aimed to investigate the relationship between the concentration of individual FAEEs and prenatal alcohol exposure in meconium samples collected within the first 6 to 12?h after birth from 182 babies born to abstainer mothers and from 54 babies born to women who self-reported either light or moderate alcohol ingestion in the second or third trimester of pregnancy. In most cases, the individual FAEE concentrations were negligible and not significantly different (P >0.05) between exposed and control babies. The concentrations appeared to increase linearly with the dose only in the few babies born to mothers who reported >3 drinks/week. These results provide evidence that the correlation between prenatal alcohol exposure and individual FAEE concentrations in meconium is non-linear shape, with a threshold probably at 3 drinks/week.

Physicochemical and sensory properties of milk supplemented with dispersible nanopowdered oyster shell during storage.

The current study was carried out to investigate the dispersibility of powdered oyster shell (POS), nanopowdered oyster shell (NPOS), and Zn-activated nanopowdered oyster shell (Zn-NPOS) in milk and to determine effects of adding oyster shell on the physicochemical and sensory properties of milk during storage at 4°C for 16 d. To ensure dispersibility, 10% (wt/vol) oyster shell was added to distilled water and stirred at 800 rpm for 2 h, and then the emulsifier 0.5% polyglycerol monostearate (PGMS) was added and stirred continually for 24 h. The particle sizes of POS, NPOS, and Zn-NPOS were 180µm, 389 nm, and 257 nm, respectively. The pH values of all milk samples ranged from 6.62 to 6.88 during storage, and the zeta-potential of milks with NPOS and Zn-NPOS added were more stable than that of milk with POS in low concentrations (0.5 and 1.0%, vol/vol) during storage. The L and a color values of the milks were not significantly influenced by treatment; however, the b value (yellow-blue color) significantly increased during storage after adding POS, NPOS, or Zn-NPOS. Sensory analysis revealed that sedimentation score significantly increased with POS-supplemented milk, but the NPOS- and Zn-NPOS-supplemented milks did not show sedimentation until after 8 d of storage. Based on the data obtained, we conclude that dispersible nanosized oyster shell at concentrations of 0.5 and 1.0% (vol/vol) could be supplemented to milk without significant adverse effects on physicochemical and sensory properties.

Cholesterol Removal from Whole Egg by Crosslinked ß-Cyclodextrin.

This study was carried out to optimize cholesterol removal in whole egg using crosslinked ß-cyclodextrin (ß-CD) and to recycle the ß-CD. Various factors for optimizing conditions were concentration of the ß-CD, mixing temperature, mixing time, mixing speed and centrifugal speed. In the result of this study, the optimum conditions of cholesterol removal were 25% crosslinked ß-CD, 40°C mixing temperature, 30 min mixing time, 1,200 rpm mixing speed and 2,810×g centrifugal speed. The recycling was repeated five times. The cholesterol removal was 92.76% when treated with the optimum conditions. After determining the optimum conditions, the recyclable yields of the crosslinked ß-CD ranged from 86.66% to 87.60% in the recycling and the percentage of cholesterol removal was over 80% until third recycling. However, the cholesterol removal efficiency was decreased when the number of repeated recycling was increased. Based on the result of this study, it was concluded that the crosslinked ß-CD was efficient for cholesterol removal in whole egg, and recycling is possible for only limited repeating times due to the interaction of the ß-CD and egg protein.

Comparative study of flavor in cholesterol-removed Gouda cheese and Gouda cheese during ripening.

This study was performed to compare the flavor compounds of cholesterol-removed Gouda cheese (CRGC) and those of Gouda cheese (control) during ripening. The CRGC was made using milk treated with cross-linked ß-cyclodextrin (ß-CD). The solid-phase microextraction (SPME) method was used to extract flavor compounds from Gouda cheese. In both CRGC and control cheese, 31 flavor compounds were identified, including 6 free fatty acids, 5 esters, 5 ketones, 1 aldehyde, 3 lactones, 5 alcohols, and 6 miscellaneous compounds. Free fatty acids were the most abundant flavor compounds quantified in CRGC and control cheese. In the early stage of ripening, concentrations of flavor compounds in CRGC and control cheese were 16.42 and 10.38 mg/kg, respectively. At 6 mo, they increased to 40.90 and 67.89 mg/kg, respectively. A group of esters was the second abundant flavor compound in CRGC and control cheese. At the initial stage of ripening, total concentrations of esters were 12.94 (CRGC) and 10.95 mg/kg (control) and they increased to 22.73 (CRGC) and 27.68 mg/kg (control). Total concentrations of ketones were 1.96 (CRGC) and 6.49 mg/kg (control) at the initial stage of ripening. After 6 mo of ripening, total concentrations reached 11.32 (CRGC) and 52.43 mg/kg (control). In the case of the lactones, at the early stage of ripening, total concentrations of CRGC and control cheese were 0.63 and 0.84mg/kg, respectively, and then increased to 1.73 (CRGC) and 3.25mg/kg (control) at the end of ripening. Based on the results of this study, the flavor compounds of CRGC and control showed slightly different profiles during ripening.

Predictors of functional outcome after emergency carotid artery stenting and intra-arterial thrombolysis for treatment of acute stroke associated with obstruction of the proximal internal carotid artery and tandem downstream occlusion.

BACKGROUND AND PURPOSE: Patients who develop severe stroke symptoms due to acute internal carotid artery occlusion eventually in combination with a thromboembolic obstruction of the middle cerebral artery incur a major risk of developing extensive MCA infarction with a poor outcome. The purpose of this study was to evaluate the outcome for patients with tandem occlusions in the MCA and/or distal ICA, retrospectively, who had undergone stent implantation in the proximal segment of the ICA in addition to intra-arterial thrombolysis. MATERIALS AND METHODS: Thirty-five patients with tandem occlusions of the MCA and/or distal ICA and acute occlusion of the proximal ICA underwent stent implantation for the proximal ICA occlusion and IAT for the tandem occlusion. Clinical outcome measures were assessed on admission and at discharge by using the National Institutes of Health Stroke Scale as well as 3 months after treatment by using the modified Rankin Scale. RESULTS: The median NIHSS score on admission was 12 (range, 6-22). All patients had patent flow into the M1 and ICA after carotid artery stent placement and IAT. After the procedure, 19 patients (54.3%) were TICI grade III; 7 (20.0%), TICI grade IIb; and 9 (25.7%), TICI grade IIa. Symptomatic intracerebral hemorrhage occurred in 1 patient (2.9%). The overall mortality rate was 11.4% (4/35). At 3-month follow-up, the median NIHSS score was 4 (range, 1-17). NIHSS score at admission and TICI grade were all found to be independently associated with an unfavorable outcome at 3 months. CONCLUSIONS: Initial stroke severity, degree of successful revascularization, and the side of ischemia were found to independently predict the functional outcome at 3 months after treatment.

Properties of Milk Supplemented with Peanut Sprout Extract Microcapsules during Storage.

This study was carried out to investigate the physicochemical and sensory properties of milk with added powdered peanut sprout extract microcapsules (PPSEM) during the storage at 4°C for 16 d. The size of PPSEM varies from 3 to 10 µm as observed by the scanning electron microscopy (SEM). The pH values of all samples ranged from 6.8 to 6.6 during the storage. Release of resveratrol for 0.5 and 1% PPSEM addition was about 0.89 µl/ml and TBARS value found to lower during storage of 16 d. The a* and b* color values of high concentrations (1.5, 2.0, 2.5 and 3.0%) of PPSEM-added milk samples were significantly increased during the storage (p<0.05). The sensory test revealed that the overall acceptability of PPSEM (0.5 and 1%) added milk sample were quite similar to that of control. Based on the data, it was concluded that the low concentrations of the microcapsules (0.5 and 1.0%, w/v) could be suitable to produce the microcapsule-supplemented milk without significant adverse effects on the physicochemical and sensory properties of milk.

Balloon-expandable stent placement in patients with immediate reocclusion after initial successful thrombolysis of acute middle cerebral arterial obstruction.

We present the results of our approach for treating 12 consecutive cases of acute middle cerebral artery (MCA) stroke by performing balloon-expandable stent (BES) placement after immediate reocclusion due to the underlying stenosis after intra-arterial thrombolysis (IAT). We retrospectively reviewed the clinical outcomes of 12 patients with acute MCA stroke who underwent recanalization by BES placement in an underlying stenosis after IAT. The time to treatment, urokinase dose, duration of the procedure, recanalization rates and symptomatic hemorrhage were analyzed. Clinical outcome measures were assessed on admission and at discharge (the National Institutes of Health stroke scores [NIHSS]) as well as three months after treatment (modified Rankin scales [mRS]). The median NIHSS score on admission was 8.6. Four patients received IV rtPA. The median time from symptom onset to IAT was 236 minutes and the median duration of IAT was 62 minutes. The median dose of urokinase was 140,000 units. Initial recanalization after stent deployment (thrombolysis in cerebral ischemia attack grade of II or III) was achieved in all patients. Two patients died in the hospital due to aspiration pneumonia during medical management. In two patients, in-stent reocclusion occurred within 48 hours after stent deployment. At discharge, the median NIHSS score in ten patients (including the patients with reobstruction) was 2.4. The three-month outcome was excellent (mRS, 0-1) in eight patients. In this study, BES deployment was safe and effective in patients with an immediately reoccluded MCA after successful IAT.

Effect of Dioscorea opposita Thunb. (yam) supplementation on physicochemical and sensory characteristics of yogurt.

A study was conducted to examine the physicochemical, microbial, and sensory properties of yogurt made by supplementing powdered yam Dioscorea opposita Thunb. (YPT) at different concentrations (0.2, 0.4, 0.6, and 0.8%, wt/vol) into milk, which was pasteurized and then fermented at 43°C for 6 h and stored for 16 d. The pH values of all samples decreased, whereas viscosity values and mean microbial counts increased during storage. The L* and a* color values (indicators of lightness and redness, respectively) of yogurt samples were not remarkably influenced by adding YPT, whereas the b* values (indicating yellowness) significantly increased with the addition of YPT at all concentrations at 0 d of storage, probably due to the original yellow color of yam powder. In functional component analyses, when the concentration of YPT increased, the amount of allantoin and diosgenin proportionally increased. The content of allantoin was 3.22 and diosgenin 4.69 µg/mL when 0.2% (wt/vol) YPT was supplemented and did not change quantitatively during the storage period (16 d). The sensory test revealed that the overall acceptability scores of YPT-supplemented yogurt samples (0.2 to 0.6%, wt/vol) were quite similar to those of the control throughout the storage period of 16 d. Based on the data obtained from the present study, it was concluded that the concentrations (0.2 to 0.6%, wt/vol) of YPT could be used to produce YPT-supplemented yogurt without significant adverse effects on physicochemical, microbial, and sensory properties, and enhance functional components from the supplementation.

Physicochemical, microbial, and sensory properties of yogurt supplemented with nanopowdered chitosan during storage.

This study was carried out to determine the possibility of adding nanopowdered chitosan (NPC) into cholesterol-reduced yogurt to improve the functionality of yogurt and the effects of adding NPC on the physicochemical, microbial, and sensory properties of the products during storage. The pH values and mean lactic acid bacteria counts of NPC-added (0.3 to approximately 0.7%, wt/vol) and cholesterol-reduced yogurt ranged from 4.19 to 4.41 and from 4.75 x 10(8) to 9.70 x 10(8) cfu/mL, respectively, when stored at 4 degrees C for 20 d, thereby indicating a possibility of prolonging the shelf life of yogurt. In color, the a* and b* values for cholesterol-reduced yogurt were not significantly influenced by the addition of NPC (0.1 to approximately 0.7%, wt/vol); however, the L* values significantly decreased with the addition of the greatest concentration (0.7%, wt/vol) of NPC at 0-d storage. The sensory test revealed that the astringency scores significantly increased at 0-d storage when the greatest concentration (0.7%, wt/vol) of NPC was added into cholesterol-reduced yogurt. Based on the data obtained from the current study, it is concluded that concentrations (0.3 to ~0.5%, vol/vol) of NPC could be used to produce an NPC-added and cholesterol-reduced yogurt without significantly adverse effects on the physicochemical, microbial, and sensory properties.

Mapping differences in consumer perception of sharp cheddar cheese in the United States.

There is tremendous variability in flavor profiles of sharp or aged U.S. cheddar cheese due to varied practices among commercial facilities and the lack of legal definitions for these terms. This study explored U.S. consumer perception and liking of commercial sharp or aged cheddar cheese profiles. Flavor profiles of 29 representative sharp cheddar cheeses were documented by descriptive sensory analysis with a trained panel. A total of 9 representative cheddar cheeses were selected and evaluated by consumers in 3 regional locations: east coast (Raleigh, N.C.; n = 150), midwest (Champaign, Ill.; n = 75), and west coast (Pullman, Wash.; n = 100). Consumers assessed the cheeses for overall liking and other consumer liking attributes. External preference mapping revealed 5 distinct consumer segments. The segment membership distribution between east coast and midwest consumers was similar while the west coast distribution was distinct (P < 0.05). A larger proportion of west coast consumers were present in segment 3, which consisted of consumers with specific likes for cheeses characterized by intense flavors of free fatty acid, brothy, and nutty flavors and salty and sour tastes. Consumer preferences in other segments differed from segment 3 due to their liking of at least 1 sensory attribute generally associated with young or mild cheddar cheese flavor. Key drivers of liking for these segments included whey flavor for segments 1 and 4 and milkfat flavor for segment 5. Segment 2 consumers liked most of the cheeses tested except those with dominant whey flavor. A sharp or aged cheddar cheese label means different things to different consumers and liking profiles are not defined by consumer location.

The accelerated ripening of cholesterol-reduced Cheddar cheese by crosslinked beta-cyclodextrin.

This study was carried out to investigate the influence of salt content on cholesterol-reduced Cheddar cheese obtained by a treatment with crosslinked beta-cyclodextrin (beta-CD) and to find if the ripening process was accelerated in cholesterol-reduced cheese. The crosslinked beta-CD used was made by adipic acid. A primary study indicated that the chemical and rheological properties were not changed by the salt addition and the composition of Cheddar cheese treated with crosslinked beta-CD was similar to untreated Cheddar cheese. Approximately 91 to 92% cholesterol reduction was observed in the cheeses that were treated using beta-CD. In a subsequent study, we found accelerated ripening by the crosslinked beta-CD based on the productions of short-chain free fatty acids and free amino acids. In rheological properties, elasticity, cohesiveness, and gumminess scores in the cholesterol-reduced Cheddar cheese were significantly greater at 5 wk ripening than those in the control at 4 mo ripening. At the early stage of ripening, most flavor properties such as rancidity, bitterness, and off-flavor in the cholesterol-reduced cheese were greater. With ripening, however, those scores changed to similar or lower scores than those in the control. The present study indicated that the crosslinked beta-CD treatment for cholesterol removal showed accelerated ripening effect on the properties of Cheddar cheese.

The CYP3A4*18 genotype in the cytochrome P450 3A4 gene, a rapid metabolizer of sex steroids, is associated with low bone mineral density.

Osteoporosis is influenced by genetic factors. The interindividual variability in the activity of CYP3A, the metabolic enzyme of sex hormones, may result from genetic polymorphisms. In a study of 2,178 women of ages 40-79 years, the presence of the CYP3A4*18 variant was found to be significantly associated with low bone mass. In vitro functional analyses indicate that CYP3A4*18 is a gain-of-function mutation in sex steroid metabolism, resulting in rapid oxidation of estrogens and testosterone; in vivo pharmacokinetics using midazolam (MDZ) verify the altered activity of the CYP3A4*18, showing lower metabolic turnover in the mutant than in the wild type. Molecular modeling reveals the structural changes in the substrate recognition sites of CYP3A4*18 that can cause changes in enzymatic activity and that potentially account for the difference between the catalytic activities of estrogen and MDZ, depending on the genotype. The results indicate that a genetic variation in the CYP3A4 gene--as a gain-of-function mutation in the metabolism of certain CYP3A substrates, including sex steroids--may predispose individuals to osteoporosis.

The effect of high pressure-low temperature treatment on physicochemical properties in milk.

This study was carried out to investigate the effect of high pressure-low temperature (HPLT) treatment on physicochemical properties and nutrients in milk. The milk was treated at 200 MPa and -4 degrees C for 10, 20, and 30 min. Protease and lipase activities of HPLT-treated milk were highly inactivated compared with that of raw milk. Among time treatments, the 30-min treatment showed the lowest activities compared with others. Absorbance of thiobarbituric acid increased with time in HLPT-treated milks; however, no difference was observed between the raw milk and milk treated for 10 min. The concentrations of short-chain fatty acids except C(4) in HPLT-treated milks increased with time. The total free amino acids in HPLT-treated milks were greater than that of the raw milk for the 30-min treatment. L-Ascorbic acid, niacin, and riboflavin in HPLT-treated milks were significantly lower compared with concentrations in raw milk. For color, the L-value of HPLT-treated milks was significantly lower than that of the raw milk; however, there was no difference in the a-value for 10 min and in the b-value at 20 min between the raw milk and the HPLT-treated milks.

Differentiation of tumour-stage mycosis fungoides, psoriasis vulgaris and normal controls in a pilot study using serum proteomic analysis.

BACKGROUND: Serum proteomic analysis is an analytical technique utilizing high-throughput mass spectrometry (MS) in order to assay thousands of serum proteins simultaneously. The resultant 'proteomic signature' has been used to differentiate benign and malignant diseases, enable disease prognosis, and monitor response to therapy. OBJECTIVES: This pilot study was designed to determine if serum protein patterns could be used to distinguish patients with tumour-stage mycosis fungoides (MF) from patients with a benign inflammatory skin condition (psoriasis) and/or subjects with healthy skin. METHODS: Serum was analysed from 45 patients with tumour-stage MF, 56 patients with psoriasis, and 47 controls using two MS platforms of differing resolution. An artificial intelligence-based classification model was constructed to predict the presence of the disease state based on the serum proteomic signature. RESULTS: Based on data from an independent testing set (14-16 subjects in each group), MF was distinguished from psoriasis with 78.6% (or 78.6%) sensitivity and 86.7% (or 93.8%) specificity, while sera from patients with psoriasis were distinguished from those of nonaffected controls with 86.7% (or 93.8%) sensitivity and 75.0% (or 76.9%) specificity (depending on the MS platform used). MF was distinguished from unaffected controls with 61.5% (or 71.4%) sensitivity and 91.7% (or 92.9%) specificity. In addition, a secondary survival analysis using 11 MS peaks identified significant survival differences between two MF groups (all P-values <0.05). CONCLUSIONS: Serum proteomics should be further investigated for its potential to identify patients with neoplastic skin disease and its ability to determine disease prognosis.

Properties of cholesterol-reduced butter made with beta-cyclodextrin and added evening primrose oil and phytosterols.

The present study was carried out to examine changes in the chemical and sensory properties of butter in which the cholesterol was reduced and to which evening primrose oil (EPO) and phytosterols were added. Crosslinked beta-cyclodextrin (beta-CD) made from adipic acid was used, and approximately 90% of the cholesterol was removed. The color measurement values "L" and "a" were significantly different between the control (butter with no beta-CD treatment and no added EPO and phytosterols) and treatment A (butter treated with 10% crosslinked beta-CD); however, the color values for "L" and "a" were similar. The color value "b" in treatment B (butter treated with 10% crosslinked beta-CD and 5% phytosterols and 3% EPO added) was significantly higher than in the other treatments. The thiobarbituric acid value of treatment B was significantly higher than that of the control and treatment A. Scores for hardness, elasticity, and cohesiveness were significantly lower in the control than in treatment A. Differences in sensory characteristics did not result from the beta-CD treatment but from the addition of EPO and phytosterols. In microscopic examinations, no noticeable differences were found among the treatments, and a smooth texture and a fine, uniform crystalline structure were observed. Results indicated that about 90% of the cholesterol was reduced by crosslinked beta-CD and that the beta-CD treatment itself did not adversely influence the chemical and sensory properties of the butter. However, the addition of EPO and phytosterols to the butter appeared to impair its sensory properties, especially in terms of rancidity and overall acceptability.

In vitro study of microencapsulated isoflavone and beta-galactosidase.

This study was designed to find the optimum conditions for isoflavone or beta-galactosidase microencapsulation and to examine the release efficiency of microcapsules in simulated gastrointestinal conditions. Coating materials were either medium-chain triacylglycerol (MCT) or polyglycerol monostearate (PGMS). The highest rate of microencapsulation was found at 15:1 (w/w) ratio of MCT to isoflavone or beta-galactosidase as 70.2 or 75.4%, respectively. When PGMS was used as the coating material, 91.5% beta-galactosidase was microencapsulated with 15:1 mixture (w/w). In vitro study, less than 6.3-9.3% of isoflavone was released in simulated gastric fluid (pH 2-5) during 1 h incubation. Comparatively, isoflavone release increased dramatically to 87.8% at pH 8 for 1 h incubation in simulated intestinal fluid and was maintained thereafter. The release of beta-galactosidase showed a similar trend to that of isoflavone. It appeared in the range of 12.3-15.2% at pH 2-5; however, it increased significantly to 80.6% as the highest value at pH 8. Among the released isoflavones, 53.5% was converted into the aglycone form of isoflavone at pH 8 for 3 h incubation. The present study indicated that isoflavone or beta-galactosidase could be microencapsulated with fatty acid esters and released effectively in simulated intestinal condition.

Crosslinking of beta-cyclodextrin on cholesterol removal from milk.

This study was designed to develop crosslinking of beta-cyclodextrin (beta-CD), and determine the optimum conditions of different factors (mixing time, mixing temperature, and mixing speed) on cholesterol reduction from milk. Crosslinked beta-CD was prepared with epichlorohydrin. When milk was treated with different conditions, the cholesterol removal rate was in the range of 79.4 to 83.3% with 1% crosslinked beta-CD addition, which were not significantly different among treatments. After cholesterol removal from milk, the used crosslinked beta-CD was washed for cholesterol dissociation and reused. For recycling study, the cholesterol removal rate in first trial was 81.8%, which was mostly same as that using new crosslinked beta-CD. With five trials repeatedly using the same sample, the mean cholesterol removal rate was 81.2%. The present study indicated that the optimum conditions on cholesterol removal using crosslinked beta-CD were 10 min mixing with 400 rpm speed at 5 degrees C with about 80% cholesterol removal. In addition, crosslinked beta-CD resulted in the effective recycling efficiency almost 100%.