The prevalence of neovascularity in rotator cuff tendinopathy: comparing conventional Doppler with superb microvascular imaging.

AIMS: To determine the prevalence of neovascularity in the supraspinatus tendon of patients presenting with clinically painful unilateral rotator cuff tendinopathy (RCT) using conventional colour Doppler ultrasound (CDU), power Doppler ultrasound (PDU), and superb microvascular imaging (SMI). The association between Doppler findings and clinical scores was also assessed. METHODS: The bilateral supraspinatus of consecutive patients presented with unilateral RCT clinically were evaluated with grey-scale ultrasound (tendon thickening, heterogeneous echotexture, and hypoechogenicity), CDU, PDU, and SMI. The prevalence of neovascularity and grey-scale changes on duplex imaging techniques were analysed. The relationship between neovascularity on CDU, PDU, SMI, and pain/disability as determined using a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) were assessed. RESULTS: Fifty-nine patients (mean age 53 years, 39 women) were recruited. Of the symptomatic supraspinatus tendons, 42.4% (25/59) demonstrated neovascularity on SMI, compared to 6.8% (4/59) on PDU and 5.1% (3/59) on CDU. Of the asymptomatic supraspinatus tendons, 5.1% (3/59) depicted neovascularity on SMI but not on conventional Doppler techniques. SMI showed a significant correlation with the VAS (r2 = 0.560, p<0.001) and OSS (r2 = 0.62, p<0.001). PDU weakly correlated with the VAS and OSS (r2 = 0.312, p=0.016; r2 = 0.260, p=0.047, respectively) while CDU did not show a significant relationship. CONCLUSION: SMI is superior in demonstrating neovascularity and shows better correlation with pain and functional deficit compared to conventional Doppler in patients with painful RCT. SMI also showed vascularity to a lesser degree in the asymptomatic tendon. Further large-scale studies are needed to prove the diagnostic value of SMI in the assessment of RCT.

Relationship between objective and subjective hydration measures on sprint performance among soccer players during actual matches in hot and humid environment.

BACKGROUND: Studies that investigate the effect of hydration on soccer performance in the heat are mostly carried out in a laboratory-controlled environment or simulated setting. Generally, on site, hydration is measured subjectively. Hence, the relationships between objective and subjective hydration measures during actual soccer matches in natural hot and humid environment with performance remain unclear. METHODS: Forty-two soccer players (age: 27.34±3.62 years; BMI: 23.80±2.70 kg/m2; temperature: 30.8±1.92 °C; humidity: 82±1.4%) hydration status were assessed using urine specific gravity (USG) and bodyweight (BW) as the objective measures, meanwhile, thirst was measured subjectively using a thirst scale. For performance evaluation, 20 and 50 m sprint time were measured before and after match. RESULTS: The results showed a significant relationship between USG and sprint time (r=1.00, CI 0.98-0.99; P<0.05), and as expected, USG at post-match was significantly higher than pre-match (P<0.05) indicating dehydration. In line, changes (between post and pre-match) in BW also showed positive relationship with changes in sprint time (r=0.99, CI 0.98-0.99; P<0.05). Not to our expectation, the self-reported thirst level was not found to be correlated with USG and sprint time. CONCLUSIONS: Objective measures better reflect hydration status and predict sprint performance compared to subjective measure when playing in hot and humid environment. Players need to monitor their hydration status to maintain their sprint performances.

BACE inhibitor treatment of mice induces hyperactivity in a Seizure-related gene 6 family dependent manner without altering learning and memory.

BACE inhibitors, which decrease BACE1 (ß-secretase 1) cleavage of the amyloid precursor protein, are a potential treatment for Alzheimer's disease. Clinical trials using BACE inhibitors have reported a lack of positive effect on patient symptoms and, in some cases, have led to increased adverse events, cognitive worsening and hippocampal atrophy. A potential drawback of this strategy is the effect of BACE inhibition on other BACE1 substrates such as Seizure-related gene 6 (Sez6) family proteins which are known to have a role in neuronal function. Mice were treated with an in-diet BACE inhibitor for 4-8 weeks to achieve a clinically-relevant level of amyloid-ß40 reduction in the brain. Mice underwent behavioural testing and postmortem analysis of dendritic spine number and morphology with Golgi-Cox staining. Sez6 family triple knockout mice were tested alongside wild-type mice to identify whether any effects of the treatment were due to altered cleavage of Sez6 family proteins. Wild-type mice treated with BACE inhibitor displayed hyperactivity on the elevated open field, as indicated by greater distance travelled, but this effect was not observed in treated Sez6 triple knockout mice. BACE inhibitor treatment did not lead to significant changes in spatial or fear learning, reference memory, cognitive flexibility or anxiety in mice as assessed by the Morris water maze, context fear conditioning, or light-dark box tests. Chronic BACE inhibitor treatment reduced the density of mushroom-type spines in the somatosensory cortex, regardless of genotype, but did not affect steady-state dendritic spine density or morphology in the CA1 region of the hippocampus. Chronic BACE inhibition for 1-2 months in mice led to increased locomotor output but did not alter memory or cognitive flexibility. While the mechanism underlying the treatment-induced hyperactivity is unknown, the absence of this response in Sez6 triple knockout mice indicates that blocking ectodomain shedding of Sez6 family proteins is a contributing factor. In contrast, the decrease in mature spine density in cortical neurons was not attributable to lack of shed Sez6 family protein ectodomains. Therefore, other BACE1 substrates are implicated in this effect and, potentially, in the cognitive decline in longer-term chronically treated patients.

Antimicrobial Bacillus velezensis HC6: production of three kinds of lipopeptides and biocontrol potential in maize.

AIMS: To study the antimicrobial agents of the Bacillus velezensis strain HC6 and assess the application potential of B. velezensis HC6 in maize. METHODS AND RESULTS: We applied a dual culture technique to test the antimicrobial activity of B. velezensis HC6 against bacteria and fungi of common contaminated crops. Bacillus velezensis HC6 showed antagonistic action on pathogenic fungi, including Aspergillus and Fusarium, as well as pathogenic bacteria (especially Listeria monocytogenes). When applied in maize, B. velezensis HC6 could also inhibit the growth of multiple pathogenic fungi and reduce their production of aflatoxin and ochratoxin. Three kinds of antimicrobial lipopeptides, including iturin, fengycin and surfactin were identified in B. velezensis HC6 culture supernatant by high-performance liquid chromatography and MALDI-TOF mass spectrometry. Iturin and fengycin showed obvious antimicrobial activity to the tested fungal strains. CONCLUSIONS: Bacillus velezensis HC6 produces three kinds of lipopeptides which showed antimicrobial activity against several common pathogenic fungi and bacteria. Bacillus velezensis HC6 is potential to be biocontrol bacteria in maize. SIGNIFICANCE AND IMPACT OF THE STUDY: Bacillus velezensis HC6 shows obvious antimicrobial activity to important crops pathogenic fungi which usually produce mycotoxins that are harmful to animal and human health. We demonstrate that three different types of lipopeptides produced by B. velezensis contributed to the antimicrobial activity. Bacillus velezensis HC6 has the potential to be effective biocontrol agent in crops.

Removal of phosphate from River water using a new baffle plates electrochemical reactor.

During the last 50 years, the human activities have significantly altered the natural cycle of phosphate in this planet, causing phosphate to accumulate in the freshwater ecosystems of some countries to at least 75% greater than preindustrial levels, which indicates an urgent need to develop efficient phosphate treatment methods. Therefore, the current study investigates the removal of phosphate from river water using a new electrochemical cell (PBPR). This new cell utilises perforated baffle plates as a water mixer rather than magnetic stirrers that require power to work. This study investigates the influence of key operational parameters such as initial pH (ipH), current density (Ј), inter-electrode distance (ID), detention time (t) and initial phosphate concentration (IC) on the removal efficiency, and influence of the electrocoagulation process on the morphology of the surface of electrodes. Overall, the results showed that the new reactor was efficient enough to reduce the concentration of phosphate to the permissible limits. Additionally, SEM images showed that the Al anode became rough and nonuniform due to the production of aluminium hydroxides. The main advantages of the electrocoagulation technique are: •The EC method does not produce secondary pollutants as it does not required chemical additives, while other traditional treatment methods required either chemical or biological additives [[1], [2], [3], [4]].•It has a large treatment capacity and a relatively short treatment time in comparison with other treatment methods, such as the biological methods [1,[5], [6], [7]].•The EC method produces less sludge than traditional treatment traditional chemical and biological treatment methods [8,9]. EC technology, like any other treatment method, has some drawbacks that could limit its performance. For instance, it still has a clear deficiency in the variety of reactor design, and the electrodes should be periodically replaced as they dissolve into the solution due to the oxidation process [2,10].

Associations of body condition score with health conditions related to overweight and obesity in cats.

OBJECTIVES: To explore the associations of cat body condition score with various health conditions, such as diabetes mellitus, dermatological conditions and hypertension, that have been shown to relate to overweight and/or obesity in cats, dogs or humans. MATERIALS AND METHODS: Electronic patient records between January 3, 2005 and June 21, 2015 were obtained from a cat-focused primary accession clinic in metropolitan Sydney where the body condition score of cats was routinely evaluated. Binomial logistic regression modelling was conducted to investigate the associations, after adjusting for age, sex and breed, between 21 health conditions and body condition score recorded on a 9-point scale. RESULTS: Fourteen of the 21 health conditions examined showed significant associations with an increased body condition score, particularly those of 7 and above. These were dermatological conditions, atopic dermatitis, musculoskeletal conditions, arthritis, hypertension, respiratory conditions, asthma, oral conditions, diarrhoea, general and lower urinary tract conditions, ophthalmic conditions, diabetes mellitus and allergic conditions. Additionally, cats with body condition score of 8 or 9 had significantly higher odds for gastrointestinal conditions and upper urinary tract conditions when compared with cats with body condition score of 5. CLINICAL SIGNIFICANCE: As far as we know, this is the first study reporting positive associations of high body condition score with atopic dermatitis, hypertension, asthma, diarrhoea, ophthalmic conditions and allergic conditions in cats. A large number of positive associations between health conditions and high body condition score indicates that excess fat mass should be given a greater emphasis in preventive health care for cats.

A hedgehog pathway-dependent gene signature is associated with poor clinical outcomes in Luminal A breast cancer.

PURPOSE: High expression of glioma-associated oncogene homolog-1 (GLI1) is associated with poor prognosis in estrogen receptor (ER) positive breast cancers. We sought to define a GLI1-dependent gene signature in ER-positive tumors that could further stratify patients at higher risk for disease recurrence and potentially lead to novel combination therapies. METHODS: We identified an inverse correlation between GLI1 expression and distant disease-free survival (DFS) using a dataset developed at MD Anderson Cancer Center (Hatzis dataset) containing clinical data from 508 breast cancer patients. Using a qPCR-based microarray platform, we identified genes differentially regulated by GLI1 in MCF7 cells and then determined if expression of these genes correlated with GLI1 expression in patient tumor samples. Statistical comparison between the groups was performed by ANOVA. Direct comparison of two groups was done by a two-tailed t test. Correlations between variables were done by Pearson's method. RESULTS: Expression of GLI1 and its target genes correlated significantly with worse distant DFS in breast cancer patients with Luminal A molecular subtype. Particularly, co-expression of GLI1 with EGFR and/or SNAI1, two of the identified GLI1 targets, was predictive of worse distant DFS in this subtype. Furthermore, patients with Luminal A tumors with a high GLI1 signature had a shorter distant DFS compared to the Luminal B subtype and the outcome for this group was comparable to patients with HER2-positive or basal-like tumors. CONCLUSION: We have identified a novel GLI1 gene signature that is associated with worse clinical outcomes among the patients with Luminal A subtype of breast cancer.

Acute effects of a single dose of tocotrienols on insulinemic and inflammatory responses in metabolic syndrome subjects after a high-fat challenge.

BACKGROUND/OBJECTIVES: Evidence shows that tocotrienols potentially reverse various chronic disease progressions caused by the metabolic syndrome. We aimed to investigate the acute effects of a single-dose supplementation of gamma and delta tocotrienols (γδ-T3, 1:4 ratio) compared with those in placebo on the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects. SUBJECTS/METHODS: Thirty metabolic syndrome subjects (15 men and 15 women) were recruited to a randomized, double-blinded and crossover study. The subjects were administered a single dose of 200 mg or 400 mg γδ-T3 emulsions or placebo incorporated into a glass of strawberry-flavored milkshake, consumed together with a high-fat muffin. Blood samples were collected at 0, 5, 15, 30, 60, 90, 120, 180, 240, 300 and 360 min after meal intake. RESULTS: Plasma vitamin E levels reflected the absorption of γδ-T3 after treatments. Postprandial changes in serum C-peptide, serum insulin, plasma glucose, triacylglycerol, non-esterified fatty acid and adiponectin did not differ between treatments, with women displaying delayed increase in the aforementioned markers. No significant difference between treatments was observed for plasma cytokines (interleukin-1 beta, interleukin-6 and tumor necrosis factor alpha) and thrombogenic markers (plasminogen activator inhibitor type 1 and D-dimer). CONCLUSIONS: Supplementation of a single dose of γδ-T3 did not change the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects.

Cloning and expression of the 1-aminocyclopropane-1-carboxylic oxidase gene from Agrostis stolonifera.

A gene encoding 1-aminocyclopropane-1-carboxylic oxidase (ACO), which catalyzes the terminal step in ethylene biosynthesis, was isolated from Agrostis stolonifera. The AsACO gene is composed of 975 bp, encoding 324 amino acids. Three exons interspersed by two introns form AsACO gDNA. A BLAST search of the nucleotide sequence revealed a high level of similarity (79-91%) between AsACO and ACO genes of other plants. A phylogenetic tree was constructed via BLAST in the NCBI, and revealed the highest homology with wheat TaACO. The calculated molecular mass and predicted isoelectric point of AsACO were 36.25 and 4.89 kDa, respectively. Analysis of subcellular localization revealed that AsACO is located in the nucleus and cytoplasm. The Fe(II)-binding cofactors and cosubstrate were identified, pertaining to the ACO family. The expression patterns of AsACO were determined by quantitative real time PCR. AsACO expression was highest in the stem, and was strongly up-regulated in response to ethephon, methyl jasmonate, salicylic acid, and cold temperature, but down-regulated in response to drought and NaCl treatment. The protein encoded by AsACO exhibited ACC oxidase activity in vitro. Taken together, these findings suggest that AsACO contains domains common to the ACO family, and is induced in response to exogenous hormones. Conversely, some abiotic stress conditions can inhibit AsACO expression.

Expression of an alfalfa (Medicago sativa L.) peroxidase gene in transgenic Arabidopsis thaliana enhances resistance to NaCl and H2O2.

Peroxidases (PODs) are enzymes that play important roles in catalyzing the reduction of H2O2 and the oxidation of various substrates. They function in many different and important biological processes, such as defense mechanisms, immune responses, and pathogeny. The POD genes have been cloned and identified in many plants, but their function in alfalfa (Medicago sativa L.) is not known, to date. Based on the POD gene sequence (GenBank accession No. L36157.1), we cloned the POD gene in alfalfa, which was named MsPOD. MsPOD expression increased with increasing H2O2. The gene was expressed in all of the tissues, including the roots, stems, leaves, and flowers, particularly in stems and leaves under light/dark conditions. A subcellular analysis showed that MsPOD was localized outside the cells. Transgenic Arabidopsis with MsPOD exhibited increased resistance to H2O2 and NaCl. Moreover, POD activity in the transgenic plants was significantly higher than that in wild-type Arabidopsis. These results show that MsPOD plays an important role in resistance to H2O2 and NaCl.

Molecular cloning and characterization of a chlorophyll degradation regulatory gene (ZjSGR) from Zoysia japonica.

The stay-green gene (SGR) is a key regulatory factor for chlorophyll degradation and senescence. However, to date, little is known about SGR in Zoysia japonica. In this study, ZjSGR was cloned, using rapid amplification of cDNA ends-polymerase chain reaction (PCR). The target sequence is 831 bp in length, corresponding to 276 amino acids. Protein BLAST results showed that ZjSGR belongs to the stay-green superfamily. A phylogenetic analysis implied that ZjSGR is most closely related to ZmSGR1. The subcellular localization of ZjSGR was investigated, using an Agrobacterium-mediated transient expression assay in Nicotiana benthamiana. Our results demonstrated that ZjSGR protein is localized in the chloroplasts. Quantitative real time PCR was carried out to investigate the expression characteristics of ZjSGR. The expression level of ZjSGR was found to be highest in leaves, and could be strongly induced by natural senescence, darkness, abscisic acid (ABA), and methyl jasmonate treatment. Moreover, an in vivo function analysis indicated that transient overexpression of ZjSGR could accelerate chlorophyll degradation, up-regulate the expression of SAG113, and activate ABA biosynthesis. Taken together, these results provide evidence that ZjSGR could play an important regulatory role in leaf chlorophyll degradation and senescence in plants at the molecular level.

UV photodecomposition of zinc acetate for the growth of ZnO nanowires.

The thermal annealing of zinc precursors to form suitable seed layers for the growth of ZnO nanowires is common. However, the process is relatively long and involves high temperatures which limit substrate choice. In this study the use of a low temperature, ultra-violet (UV) exposure is demonstrated for photodecomposition of zinc acetate precursors to form suitable seed layers. Comparisons are made between ZnO nanowire growth performed on seed layers produced through thermal annealing and exposure to UV. The dependence of growth density and nanowire diameter on UV exposure time is investigated. Growth quality is confirmed with energy dispersive x-ray (EDX) and x-ray diffraction analyses. The chemical composition of the exposed layers is investigated with EDX and x-ray photoelectron spectroscopy (XPS). Atomic force microscopy (AFM) is utilized to investigate morphological changes with respect to UV exposure. The diameter and density of the resultant growth was found to be strongly dependent on the UV exposure time. UV exposure times of only 25-30 s led to maximum density of growth and minimum diameter, significantly faster than thermal annealing. EDX, XPS and AFM analyses of the seed layers confirmed decomposition of the zinc precursor and morphological changes which influenced the growth.

Antimicrobial activity of recombinant mature bovine neutrophil ß-defensin 4 on mycobacterial infection.

BACKGROUND: Previous studies have shown that human cathelicidin and defensins have effective antimicrobial activity against Mycobacterium spp. OBJECTIVE: To investigate the antimycobacterial effect of mature bovine neutrophil ß-defensin (mBNBD) 4 against Mycobacterium spp. infection for the first time. DESIGN: mBNBD4 protein was expressed in Pichia pastoris GS115. We used immunofluorescent assay to detect whether the recombinant mBNBD4 had entered the macrophages. The antimycobacterial activity of mBNBD4 was tested through colony-forming unit (cfu) assay. Morphological changes in the cell wall of M. bovis treated with mBNBD4 were observed by scanning electron microscope. RESULTS: mBNBD4 was expressed and successfully purified from P. pastoris with intact antimicrobial activity. The recombinant protein was able to enter Raw 264.7 macrophages and exhibited potent in vitro bactericidal activity against M. smegmatis and M. bovis. The cell wall of M. bovis was disrupted after interaction with mBNBD4. Exogenous addition of mBNBD4 to both Raw 264.7 and THP-1 derived macrophages reduced the intracellular survival of M. bovis and M. tuberculosis relative to control cells. CONCLUSION: Our data show that mBNBD4 plays an important role in inhibiting mycobacterial growth and in controlling intracellular survival of mycobacteria. mBNBD4 could therefore an effective antimycobacterial molecule in combination with other measures.

Frequency chirped light at large detuning with an injection-locked diode laser.

We have developed a laser system to generate frequency-chirped light at rapid modulation speeds (∼100 MHz) with a large frequency offset. Light from an external cavity diode laser with its frequency locked to an atomic resonance is passed through a lithium niobate electro-optical phase modulator. The phase modulator is driven by a ∼6 GHz signal whose frequency is itself modulated with a RF MHz signal (<200 MHz). A second injection locked diode laser is used to filter out all of the light except the frequency-chirped ±1 order by more than 30 dB. Using this system, it is possible to generate a 1 GHz frequency chirp in 5 ns.

Palmitic acid in the sn-2 position of dietary triacylglycerols does not affect insulin secretion or glucose homeostasis in healthy men and women.

BACKGROUND/OBJECTIVES: Dietary triacylglycerols containing palmitic acid in the sn-2 position might impair insulin release and increase plasma glucose. SUBJECTS/METHODS: We used a cross-over designed feeding trial in 53 healthy Asian men and women (20-50 years) to test this hypothesis by exchanging 20% energy of palm olein (PO; control) with randomly interesterified PO (IPO) or high oleic acid sunflower oil (HOS). After a 2-week run-in period on PO, participants were fed PO, IPO and HOS for 6 week consecutively in randomly allocated sequences. Fasting (midpoint and endpoint) and postprandial blood at the endpoint following a test meal (3.54 MJ, 14 g protein, 85 g carbohydrate and 50 g fat as PO) were collected for the measurement of C-peptide, insulin, glucose, plasma glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1, lipids and apolipoproteins; pre-specified primary and secondary outcomes were postprandial changes in C-peptide and plasma glucose. RESULTS: Low density lipoprotein cholesterol was 0.3 mmol/l (95% confidence interval (95% CI)) 0.1, 0.5; P<0.001) lower on HOS than on PO or IPO as predicted, indicating good compliance to the dietary intervention. There were no significant differences (P=0.58) between diets among the 10 male and 31 female completers in the incremental area under the curve (0-2 h) for C-peptide in nmol.120 min/l: GM (95% CI) were PO 220 (196, 245), IPO 212 (190, 235) and HOS 224 (204, 244). Plasma glucose was 8% lower at 2 h on IPO vs PO and HOS (both P<0.05). CONCLUSION: Palmitic acid in the sn-2 position does not adversely impair insulin secretion and glucose homeostasis.

Antimycobacterial activity of Pichia pastoris-derived mature bovine neutrophil ß-defensins 5.

Tuberculosis (TB) is an ongoing threat to global health, and the lack of effective therapies for treating it is also a global problem. Previous studies have shown that human cathelicidin and defensins have effective antimicrobial activity against Mycobacterium spp. To our knowledge, there are no reports on the antimycobacterial effects of bovine neutrophil ß-defensins so far. Here, we identified the antimicrobial effect of mature bovine neutrophil ß-defensins (mBNBD) 5 against Mycobacterium infection both in vitro and in vivo. The mBNBD5 protein was expressed in Pichia pastoris. To increase the yield of ß-defensins, a purification method was employed by adding a 6-His·tag to the C-terminus of the mBNBD5 gene. Our results indicated that recombinant mBNBD5 protein was successfully expressed and purified from Pichia pastoris with intact antimicrobial activity. The recombinant protein exhibited potent bactericidal activity in vitro against M. smegmatis and M. bovis, with a dose-dependent manner and a time-dependent manner. The electron microscope results showed that the bacterial cell wall of M. bovis was disrupted when incubated with mBNBD5 for 72 h. Our data also indicated that the exogenous addition of mBNBD5 could reduce the survival of Mycobacterium spp., especially M. tuberculosis and M. bovis in RAW 264.7 macrophages. These results provide foundations for the development of mBNBD5 as a potential new therapeutic agent for TB treatment.

Flexographic printing-assisted fabrication of ZnO nanowire devices.

In this study, the use of flexographic printing was investigated for low cost, high volume production of devices incorporating nanowires through the printing of zinc acetate precursors on a substrate used to form zinc oxide (ZnO) seeds for the growth of nanowires using a hydrothermal growth technique. The printing of precursors allows the selective area growth of ZnO nanowires, which has implications in high-yield production of devices incorporating ZnO nanowires. The work presented here achieved printed line widths of <60 µm with low edge distortion (<3 µm) using a printing plate with a line width of 50 µm. The hydrothermally grown ZnO nanowires show uniform density of growth over the printed area with nanowire diameters between 40 and 60 nm on both silicon and polyimide substrates. Energy-dispersive x-ray spectra showed contamination-free crystals with a 1:1 (zinc to oxygen) stoichiometry. Crystal orientation is along the c-axis with high quality crystalline structure shown using x-ray diffraction spectroscopy and high resolution transmission electron microscopy. A ZnO nanowire gas sensor, fabricated using the flexographic printing technique, is demonstrated. Such a printing-assisted fabrication offers low cost, high volume production of devices incorporating ZnO nanowires, ranging from gas sensors to field emission devices.

Profile of anesthetic infection control in Taiwan: a questionnaire report.

STUDY OBJECTIVE: To evaluate compliance of anesthesiologists and nurse anesthetists with personal hygiene and anesthetic equipment disinfection procedures in Taiwan. DESIGN: Survey instrument. SETTING: Anesthesiologists and nurse anesthetists working in medical and non-medical centers in Taiwan. PARTICIPANTS: 81 anesthesiologists and 181 nurse anesthetists working in medical and non-medical centers. MEASUREMENTS AND MAIN RESULTS: Questionnaires were sent to 500 anesthesiologists and nurse anesthetists in Taiwan. Two hundred sixty-two (52%) completed questionnaires (127 from medical centers and 135 from non-medical centers). Completed questionnaires were divided into two groups: those from medical centers (Group A) and those from non-medical centers (Group B). There was no significant difference in personal hygienic practices (wearing gloves and washing hands) between Groups A and B. There were significant differences between anesthesiologists and nurse anesthetists in wearing gloves (65.3% vs. 82%; P = 0.001) and hand washing (52.6% vs. 70.4%; P = 0.003). Medical center anesthesiologists and nurse anesthetists performed better than their non-medical-center counterparts when using disinfection procedures and disinfectants for laryngoscope blades and the cleaning of fiberscopes. CONCLUSIONS: Teaching programs should include anesthesia infection control in the curriculum for anesthesiologists and nurse anesthetists.

Endoscopic ultrasound-guided drainage of abdominal abscesses and infected necrosis.

Traditionally abdominal abscesses have been treated with either surgical or radiologically guided percutaneous drainage. Surgical drainage procedures may be associated with considerable morbidity and mortality, and serious complications may also arise from percutaneous drainage. Endoscopic ultrasound (EUS)-guided drainage of well-demarcated abdominal abscesses, with adjunctive endoscopic debridement in the presence of solid necrotic debris, has been shown to be feasible and safe. This multicenter review summarizes the current status of the EUS-guided approach, describes the available and emerging techniques, and highlights the indications, limitations, and safety issues.

Use of endoscopic snare to extract a large rectosigmoid foreign body with review of literature.

Rectal foreign bodies are common and various shapes and sizes have been described in literature. Large objects impacted high in the rectosigmoid junction pose a challenge for endoscopic extraction. We describe a method that successfully removed a 15x6x3.5-cm shampoo bottle impacted in the rectosigmoid junction. A 50-year-old man had passed a shampoo bottle up into his rectum. Examination revealed a lax sphincter but the bottle could not be felt. Contrast x-rays showed a well-delineated bottle in the rectosigmoid junction with no evidence of bowel perforation. A flexible sigmoidoscope with an endoscopic snare was used to "lasso" the foreign body and deliver it out. A check sigmoidoscopy after extraction showed no bleeding or perforation. This technique is a safer and less morbid method of extracting impacted high rectal foreign bodies, in the absence of perforation. It should be attempted before open surgical removal.