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Multidisciplinary pulmonary embolism response teams (PERTs) have shown that timely triage expedites treatment. The use of artificial intelligence (AI) may help improve pulmonary embolism (PE) management with early CT pulmonary angiogram (CTPA) screening and accelerate PERT coordination. This study aimed to test the clinical validity of an FDA-approved PE AI algorithm. CTPA scan data of 200 patients referred due to automated AI detection of suspected PE were retrospectively reviewed. In our institution, all patients suspected of PE received a CTPA. The AI app was then used to analyze CTPA for the presence of PE and calculate the right-ventricle/left-ventricle (RV/LV) ratio. We compared the AI's output with the radiologists' report. Inclusion criteria included segmental PE with and without RV dysfunction and high-risk PE. The primary endpoint was false positive rate. Secondary end points included clinical outcomes according to the therapy selected, including catheter-directed interventions, systemic thrombolytics, and anticoagulation. Fifty-seven of 200 exams (28.5%) were correctly identified as positive for PE by the algorithm. A total of 143 exams (71.5%) were incorrectly reported as positive. In 8% of cases, PERT was consulted. Four patients (7%) received systemic thrombolytics without any complications. There were six patients (10.5%) who developed high-risk PE and underwent thrombectomy, one of whom died. Among 46 patients with acute PE without right heart strain, 44 (95%) survived. The false positive rate of our AI algorithm was 71.5%, higher than what was reported in the AI's prior clinical validity study (91% sensitivity, 100% specificity). A high rate of discordant AI auto-detection of suspected PE raises concerns about its diagnostic accuracy. This can lead to increased workloads for PERT consultants, alarm/notification fatigue, and automation bias. The AI direct notification process to the PERT team did not improve PERT triage efficacy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied., Methods: In a prospective, multi-institutional study, adult PwCF completed the 22-Question SinoNasal Outcome Test (SNOT-22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Lund-Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression., Results: Seventy-three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV 1 ). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV 1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores., Conclusions: Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient-reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF., Clinical Trials: NCT04469439., (© 2024 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.)

Triclosan (TCS), a biocide used in various day-to-day products, has been associated with several toxic effects in aquatic organisms. In the present study, biochemical and hematological alterations were evaluated after 14 d (sublethal) exposure of tap water (control), acetone (solvent control), 5, 10, 20, and 50 μg/L (environmentally relevant concentrations) TCS to the embryos/hatchlings of Cirrhinus mrigala, a major freshwater carp distributed in tropic and sub-tropical areas of Asia. A concentration-dependent increase in the content of urea and protein carbonyl, while a decrease in the total protein, glucose, cholesterol, triglycerides, uric acid, and bilirubin was observed after the exposure. Hematological analysis revealed a decrease in the total erythrocyte count, hemoglobin, and partial pressure of oxygen, while there was an increase in the total leucocyte count, carbon dioxide, and partial pressure of carbon dioxide and serum electrolytes. Comet assay demonstrates a concentration-dependent increase in tail length, tail moment, olive tail moment, and percent tail DNA. An amino acid analyzer showed a TCS-dose-dependent increase in various amino acids. Sodium dodecyl sulphate polyacrylamide gel electrophoresis analysis revealed different proteins ranging from 6.5 to 200 kDa, demonstrating TCS-induced upregulation. Fourier transform infrared spectra analysis exhibited a decline in peak area percents with an increase in the concentration of TCS in water. Curve fitting of amide I (1,700-1600 cm -1 ) showed a decline in α-helix and turns and an increase in β-sheets. Nuclear magnetic resonance study also revealed concentration-dependent alterations in the metabolites after 14 d exposure. TCS caused alterations in the biomolecules and heamatological parameters of fish, raising the possibility that small amounts of TCS may change the species richness in natural aquatic habitats. In addition, consuming TCS-contaminated fish may have detrimental effects on human health. Consequently, there is a need for the proper utilisation and disposal of this hazardous compound in legitimate quantities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Risk factors and treatment rates for substance use disorders (SUDs) differ by sex. Females often have greater childcare and household responsibilities than males, which may inhibit SUD treatment. We examined how SUD, medication for opioid use disorder (MOUD) receipt, and overdose rates differ by sex among parents with young children (<5 years)., Methods: Using deidentified national administrative healthcare data from Optum's Clinformatics® Data Mart Database version 8.1 (2007-2021), we identified parents aged 26-64 continuously enrolled in commercial insurance for ≥ 30 days and linked to ≥ 1 dependent child < 5 years from January 1, 2016-February 29, 2020. We used generalized estimating equations to estimate the average predicted prevalence of SUD diagnosis, MOUD receipt after opioid use disorder (OUD) diagnosis, and overdose by parent sex in any month, adjusting for age, race/ethnicity, state of residence, enrollment month, and mental health conditions., Results: From 2016 to 2020, there were 2,241,795 parents with a dependent child < 5 years, including 1,155,252 (51.5%) females and 1,086,543 (48.5%) males. Male parents had a higher average predicted prevalence of an SUD diagnosis (11.1% [11, 11.16]) than female parents (5.5% [5.48, 5.58]). Among parents with OUD, the average predicted prevalence of receiving MOUD was 27.4% [26.1, 28.63] among male and 19.7% [18.34, 21.04] among female parents, with no difference in overdose rates by sex., Conclusion: Female parents are less likely to be diagnosed with an SUD or receive MOUD than male parents. Removing policies that criminalize parental SUD and addressing childcare-related barriers may improve SUD identification and treatment., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Objective: Factors contributing to racial and ethnic disparities in medication for opioid use disorder (MOUD) receipt during pregnancy are largely unknown. We quantified the contribution of individual, healthcare access and quality, and community factors to racial-ethnic disparities in MOUD during pregnancy and postpartum among Medicaid-enrolled pregnant women with opioid use disorder (OUD)., Methods: This retrospective cohort study used regression and nonlinear decomposition to examine how individual, healthcare access and quality, and community factors explain racial-ethnic disparities in MOUD receipt among Medicaid-enrolled women with OUD who had a live birth from 2011 to 2017. The exposure was self-reported race and ethnicity. The outcomes were any MOUD receipt during pregnancy or postpartum. All factors included were identified from the literature., Results: Racial-ethnic disparities in individual, healthcare access and quality, and community factors explained 15.8% of the racial-ethnic disparity in MOUD receipt during pregnancy and 68.9% of the disparity in the postpartum period. Despite comparable healthcare utilization, non-White/Hispanic women were diagnosed with OUD 37 days later in pregnancy, on average, than non-Hispanic White women, which was the largest contributor to the racial-ethnic disparity in MOUD receipt during pregnancy (111.0%). The racial-ethnic disparity in MOUD receipt during pregnancy was the largest contributor (112.2%) to the racial-ethnic disparity in MOUD in the postpartum period., Conclusions: Later diagnosis of OUD in pregnancy among non-White/Hispanic women partially explains the disparities in MOUD receipt in this population. Universal substance use screening earlier in pregnancy, combined with connecting patients to evidence-based and culturally competent care, is one approach that could close the observed racial-ethnic disparity in MOUD receipt., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 American Society of Addiction Medicine.)

Rationale and Objectives: To assess differences of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters at different postcontrast time points (TPs), and to explore the predictive value of DCE-MRI parameters for axillary lymph node (ALN) metastasis of breast cancer., Materials and Methods: A total of 107 breast cancer patients were included retrospectively, and 50 phases were collected on DCE-MRI for each patient. DCE-MRI parameters Ktrans, Kep, Ve, TTP, Peak, Washin, Washout, and AUC were extracted from the images at 67.8 seconds, 128.5 seconds, 189.2 seconds, 249.9 seconds, and 310.5 seconds (regard as TP1, 2, 3, 4, and 5). Wilcoxon signed rank test was used to compare DCE-MRI parameters at different postcontrast TPs. Logistic regression was performed to analyze the predictive value of DCE-MRI parameters for ALN metastasis of breast cancer, and receiver operating characteristic (ROC) curve was constructed to evaluate the predictive performance., Results: The difference of DCE-MRI parameters between TP1, 2, 3, 4, and 5 was statistically significant (p < 0.01) in breast cancer. The TPs are considered as the optimal TPs when DCE-MRI parameters values reach the maximum. The optimal TPs of Ktrans, Kep, and Ve were respectively at TP2, TP2, and TP4 (Ktrans 2 , Kep 2 , and Ve 4 ). The optimal TPs of TTP, Peak, and AUC were at TP5 (TTP 5 , Peak 5 , and AUC 5 ). AUC 5 showed the ability to predict ALN metastasis of breast cancer (area under ROC curve = 0.656, p < 0.05)., Conclusions: DCE-MRI parameters values were different at different postcontrast TPs. AUC 5 may be an independent predictor of ALN metastasis in breast cancer., (Copyright © 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Catalytic hydrogen reduction appears to be a promising strategy for nitrate removal. However, the danger and low utilization of H 2 are the disadvantages of catalytic hydrogen reduction. Sodium borohydride (NaBH 4 ), considered a potential candidate for hydrogen storage, has been investigated as an electron source for the catalytic reduction of contaminants. However, extensive use of NaBH 4 makes commercialization costly and causes environmental pollution. In this study, we prepared supported Cu/Pd bimetallic nanoparticles that could prestore hydrogen. No additional reducing agent was required during the nitrate reduction process. The performance and mechanism of Cu/Pd bimetallic nanoparticles for nitrate reduction are discussed. Good performance was obtained with high reactivity (99.04% nitrate removal efficiency) and high selectivity for N 2 (94.71%). The Cu/Pd bimetallic catalyst could be recovered by NaBH 4 for 5 cycles. Moreover, a 97.49% nitrate removal efficiency was obtained for actual wastewater, indicating good prospects for nitrate reduction applications., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Histone deacetylase 6 (HDAC6) has emerged as a critical regulator of many cellular pathways in tumors due to its unique structure basis and abundant substrate types. Over the past few decades, the role played by HDAC6 inhibitors as anticancer agents has sparked great interest of biochemists worldwide. However, they were less reported for gastric cancer therapy. In this paper, with the help of bioisosteric replacement, in-house library screening, and lead optimization strategies, we designed, synthesized and verified a series of 1,3-diaryl-1,2,4-triazole-capped HDAC6 inhibitors with promising anti-gastric cancer activities. Amongst, compound 9r displayed the best inhibitory activity towards HDAC6 (IC 50  = 30.6 nM), with 128-fold selectivity over HDAC1. Further BLI and CETSA assay proved the high affinity of 9r to HDAC6. In addition, 9r could dose-dependently upregulate the levels of acetylated α-tubulin, without significant effect on acetylated histone H3 in MGC803 cells. Besides, 9r exhibited potent antiproliferative effect on MGC803 cells, and promoted apoptosis and suppressed the metastasis without obvious toxicity, suggesting 9r would serve as a potential lead compound for the development of novel therapeutic agents of gastric cancer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Some studies have argued that native speakers of tonal languages have been shown to perceive lexical tone continua in a more categorical manner than speakers of non-tonal languages. Among these, Zhang and colleagues (NeuroReport 23 (1): 35-9) conducted an event-related potential (ERP) study using an oddball paradigm showing that native Mandarin speakers exhibit different sensitivity to deviant tones that cross category boundaries compared to deviants that belong to the same category as the standard. Other recent ERP findings examining consonant voicing categories question whether perception is truly categorical. The current study investigated these discrepant findings by replicating and extending the Zhang et al. study. Native Mandarin speakers and naïve English speakers performed an auditory oddball detection test while ERPs were recorded. Naïve English speakers were included to test for language experience effects. We found that Mandarin speakers and English speakers demonstrated qualitatively similar responses, in that both groups showed a larger N2 to the across-category deviant and a larger P3 to the within-category deviant. The N2/P3 pattern also did not differ in scalp topography for the within- versus across-category deviants, as was reported by Zhang et al. Cross-language differences surfaced in behavioral results, where Mandarin speakers showed better discrimination for the across-category deviant, but English speakers showed better discrimination for within-category deviants, though all results were near-ceiling. Our results therefore support models suggesting that listeners remain sensitive to gradient acoustic differences in speech even when they have learned phonological categories along an acoustic dimension.

Background: Atherosclerotic cardiovascular disease is the leading cause of mortality of patients with type 2 diabetes mellitus, and both coronary artery disease (CAD) and diabetes mellitus are associated with inflammation. Emerging evidence suggests a relationship of the monocyte to high-density lipoprotein cholesterol ratio (MHR) with the incidence and severity of CAD. The aim of the present study was to examine the association of MHR with CAD in patients with type 2 diabetes mellitus., Methods: A total of 458 consecutive individuals were enrolled, comprising 178 type 2 diabetic patients, 124 type 2 diabetes with CAD, and 156 healthy volunteers as the controls. A multivariable logistic regression model was used to evaluate the relationship between the MHR and CAD in type 2 diabetes, and the receiver operating characteristic (ROC) curve of MHR was used for predicting the presence of CAD in type 2 diabetic patients., Results: Values of MHR were significantly higher in type 2 diabetic patients with CAD compared with those without CAD and the control group. Moreover, multivariate logistic regression analysis showed that MHR was an independent predictor of the presence of CAD in type 2 diabetic patients (OR = 1.361, 95% CI 1.245 - 1.487, p < 0.0001). Based on the receiver operating characteristic (ROC) curve, the cutoff value of MHR (> 8.2) in predicting the presence of CAD in type 2 diabetic patients yields a sensitivity and specificity of 83.74% and 62.15%, respectively, with an area under the curve of 0.795 (95% CI: 0.745 - 0.840)., Conclusions: The MHR is strongly associated with CAD in type 2 diabetes and might be a potential biomarker to predict the presence of CAD in type 2 diabetic patients.

Correction for 'Lanthanide separation using size-selective crystallization of Ln-MOFs' by Heng Ya Gao et al., Chem. Commun., 2017, DOI: 10.1039/c7cc01898c.

Herein, we report an elaborate method, size-selective crystallization of Ln-MOFs, to isolate lanthanide (Ln) ions. Herein, 13 lanthanide ions, except for the radioactive Pm(iii) ion, were separated by four types of Ln-MOFs: type I (La-Pr), type II (Nd-Eu), type III (Gd-Ho), and type IV (Er-Lu). Further systemic investigation also suggested the highly selective separation of lanthanide ions by this method.

To investigate the influence of immunization routes onIgG, IgA and IgM production in systemic and mucosal compartments, we immunized mice with keyhole limpet hemocyanin (KLH) via oral, intranasal (i.n.) or subcutaneous (s.c.) routes alone or combined with the intravenous (i.v.) route. We found that administering antigen intravenously could affect antibody production and formation of antibody secreting cells (ASCs) depending on the immunization route previously used. Combined oral/i.v. immunization but not s.c./i.v. immunization caused a great increase of IgA ASCs in the spleen and enhanced IgA production in the small intestine and serum. Combined i.n./i.v. immunization could also increase IgA ASCs in the spleen and enhance IgA production in serum but had no effect on IgA production in the small intestine. Oral/i.v. immunization caused increase of IgG ASCs in both the spleen and bone marrow. In comparison, combined i.n./i.v. and s.c./i.v. immunization could increase IgG ASCs in the spleen but not in bone marrow. Intravenous administration of KLH in mice that had been immunized via oral, i.n. or s.c. routes caused some increase of IgM ASCs in the spleen but not in bone marrow. In conclusion, combined oral and i.v. administration of an antigen can induce fast and strong immune responses, especially for IgA, in both systemic and mucosal compartments., Competing Interests: The authors have declared that no competing interests exist.

Gravitational field-flow fractionation (GrFFF) is a useful technique for separation and characterization for micrometer-sized particles. Elution behavior of micrometer-sized particles in GrFFF was researched in this study. Particles in GrFFF channel are subject to hydrodynamic lift forces (HLF), fluid inertial forces and gravity, which drive them to different velocities by carrier flow, resulting in a size-based separation. Effects of ionic strength, flow rate and viscosity as well as methanol were investigated using polystyrene latex beads as model particles. This study is devoted to experimental verification of the effect of every factor and their comprehensive function. All experiments were performed to show isolated influence of every variable factor. The orthogonal design test was used to evaluate various factors comprehensively. Results suggested that retention ratio of particles increases with increasing flow rate or the viscosity of carrier liquid by adjusting external forces acting on particles. In addition, retention ratio increases as ionic strength decreases because of decreased electrostatic repulsion between particles and channel accumulation wall. As far as methanol, there is no general trend due to the change of both density and viscosity. On the basis of orthogonal design test it was found that viscosity of carrier liquid plays a significant role in determining resolution of micrometer-sized particles in GrFFF., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Minimally invasive video-assisted thyroidectomy (MIVAT), originally described by Miccoli, is considered to be the most widely practiced and easily reproducible procedure for selected patients with benign and/or malignant thyroid nodules. Modified techniques based on MIVAT, namely modified Miccoli's thyroid surgery (MMTS), were developed based on MIVAT. This study aimed to evaluate the preliminary results of MMTS compared with those of MIVAT. The enrolling criteria included a benign nodule <3.5 cm in diameter, a malignant tumor <2 cm, no previous neck surgery and no evidence of any suspected lymph node metastasis or local invasion. Unilateral lobectomy was considered for benign lesions and the additional dissection of central compartment (level VI) lymph nodes was applied for malignant disease. The modified techniques included carefully selecting the operative incision, expanding the operative space, embedding a drainage tube in situ and delicately suturing every layer inwards and crosswise, as well as measuring cervical motion. In addition to the comparison of surgical outcomes between MMTS and MIVAT, other surgical parameters, including operative time, blood loss, postoperative drainage, cosmetic satisfaction, peak angle of cervical rotation, length of hospitalization and complications, were retrospectively analyzed. A consecutive series of 70 patients, including 54 cases of benign and 16 cases of malignant disease, initially underwent MIVAT between April, 2008 and May, 2012, while 127 patients, including 98 benign and 29 malignant cases, subsequently underwent MMTS between September, 2011 and October, 2014. Patients who received MMTS exhibited significantly less blood loss (20.3±11.3 vs. 32.3±12.6 ml, P<0.01), lower volume of postoperative drainage (42.77±15.2 vs. 50.48±23.2 ml, P<0.01) and higher cosmetic satisfaction (94.6±3.5 vs. 88.9±2.7%, P<0.01), but a longer operative time (102±36 vs. 50.48±23.2 min, P<0.01) when compared with MIVAT. In addition, a better peak angle of cervical rotation (38.6±4.1° vs. 35.3±3.8°, P=0.25) and shorter length of hospitalization (4.25±1.08 vs. 4.51±1.30 days, P=0.52) was observed in the MMTS group, although the differences with the MIVAT group were not statistically significant. No complications were observed, apart from 2 cases of recurrent laryngeal nerve palsy and 1 case of transient hypocalcemia at the beginning of MIVAT. In conclusion, both MMST and MIVAT are safe and feasible methods of thyroidectomy; however, MMST is associated with less trauma and higher cosmetic satisfaction compared with MIVAT. Therefore, MMST may be used as a standard operative method and prospectively applicable for thyroidectomy, even for early-stage malignancies.

Purpose: To compare prostatic arterial embolization (PAE) and transurethral resection of the prostate (TURP) in the care of patients with benign prostatic hyperplasia (BPH)., Materials and Methods: This prospective randomized clinical trial was approved by the institutional review board. A total of 114 patients provided written informed consent and were randomly assigned to undergo PAE (n = 57) or TURP (n = 57). The groups were compared regarding relevant adverse events and complications. Functional results--including improvement of International Prostate Symptom Score (IPSS), quality of life (QOL), peak urinary flow, postvoiding residual urine volume, prostate-specific antigen (PSA) level, and prostate volume--were assessed at 1-, 3-, 6-, 12-, and 24-month follow-up between January 20, 2007, and January 31, 2012. Student t test, χ(2) test, Fisher exact test, and repeated measures analysis of variance were used, as appropriate., Results: Overall technical success rates for TURP and PAE were 100% and 94.7%, respectively; the clinical failure rates were 3.9% and 9.4%, respectively. The six functional results showed improvements after TURP and PAE at all follow-up time points when compared with preoperative values (P = .001). However, the TURP group showed greater degrees of improvement in the IPSS, QOL, peak urinary flow, and postvoiding residual urine volume at 1 and 3 months, as well as greater reductions in the PSA level and prostate volume at all follow-up time points, when compared with the PAE group (P < .05). The PAE group showed more overall adverse events and complications (P = .029), mostly related to acute urinary retention (25.9%), postembolization syndrome (11.1%), and treatment failures (5.3% technical; 9.4% clinical)., Conclusion: Both procedures resulted in significant clinical improvements in the treatment of BPH. However, the advantages of the PAE procedure must be weighed against the potential for technical and clinical failures in a minority of patients., (RSNA, 2013)

γδ T cells represent a relevant proportion of T lymphocytes that express T cell receptors (TCRs) encoded by the γ and δ T cell receptor genes. Whereas the most circulating γδ T cell type, Vδ2 T cells, has been described and studied intensively, the potential role of Vδ1 T cells remains largely unclear. Here, we identified that expanded peripheral blood Vδ1 T cells stimulated with anti-human TCR Vδ1 monoclonal antibody (mAb) in vitro predominantly expressed forkhead box p3 (Foxp3). In addition, these cells also expressed other regulatory T cell-related molecules, such as CD25, glucocorticoid-induced TNFR family-related protein and cytotoxic T lymphocyte-associated protein-4 (CTLA-4), and held the potent capacity for the production of transforming growth factor beta 1 (TGF-β1). These autocrine and/or paracrine TGF-β1 could bind TGF-β1 receptors on Vδ1 T cells and induce sustained Foxp3 expression. Moreover, Foxp3 expression coincided with high CD25 expression. CD25(high) Vδ1 T cells exhibited stronger suppression on CD4(+) T cell proliferation compared with TGF-β1-induced CD25(high) CD4(+) regulatory T cells. Therefore, our phenotypic and functional analyses first demonstrate the potential regulatory property of anti-human TCR Vδ1 mAb-activated Vδ1 T cells. These results will broaden our understanding about the role of peripheral blood Vδ1 T cells under physical and pathological conditions.

The synthesis of a chiral long-chain ionic liquid (IL), S-3-hexadecyl-1-(1-hydroxy-propan-2-yl)-imidazolium bromide ([C(16)hpim]Br), is presented. The adsorption and aggregation of this surface active IL in aqueous solution is described. The critical micelle concentration (cmc) measurement suggests that the chiral IL has superior capacity for micelle formation compared to traditional ionic surfactants. The relatively larger hydrophilic head group of the IL results in a larger maximum surface excess concentration (Gamma(max)) and a smaller minimum molecular cross-sectional area (A(min)). Electrical conductivity studies show a small degree of counterion binding to these micelles, which may increase the electrostatic repulsions between the hydrophilic heads of adjacent surfactant molecules. Both factors of the hydrophilic headgroup size and electrostatic repulsion in [C(16)hpim]Br micelles lead to a looser packing of the surfactant molecules in the micelles. As a result, a higher micropolarity and smaller mean aggregation number is observed. Moreover, the looser micellar packing of the [C(16)hpim]Br molecules results in a unusual upfield shift of the proton NMR signals in the hydrophobic chains after micelle formation. (1)H NMR and 2D ROESY spectroscopic analyses confirm a chiral arrangement of the micelles. Chiral IL micelles may have potential applications in the stereochemical recognition of surfaces or of biological structures., (2009 Elsevier Inc. All rights reserved.)

N-alkyl perfluorooctanesulfonamides (C8F17SO2NHCnH2n+1, FC8-HCn, n = 2, 4, 6, 8) were shown to form aggregates in dimethyl sulfoxide (DMSO). Surface tension results revealed that the dissolution of FC8-HCn reduced the surface tension of DMSO in a manner analogous to common surfactants in aqueous solutions. Maximum surface excess amount (Gamma(max)) and minimum surface area per molecule (Amin) at the air-liquid interface were estimated. Gamma(max) decreases and Amin increases with an increase of the hydrocarbon chain length of FC8-HCn. Steady-state fluorescence and NMR measurements demonstrated that both fluorocarbon and hydrocarbon chains of FC8-HCn molecules were incorporated inside the aggregates. UV-vis spectroscopy confirmed the formation of aggregates and determined the critical micelle concentration (cmc) of FC8-HC6 and FC8-HC8 solutions. The thermodynamic parameters DeltaG(0)(agg), DeltaH(0)(agg), and DeltaS(0)(agg) for the aggregate formation of FC8-HCn in DMSO derived from the temperature dependence of the cmc revealed that the aggregate formation is an enthalpy-driven process, which was further confirmed by isothermal titration calorimetry (ITC) measurements. Moreover, the absolute values of DeltaG(0)(agg) and DeltaH(0)(agg) increase with an increase of the hydrocarbon chain length of FC8-HCn at 298 K., (Copyright 2009 Elsevier Inc. All rights reserved.)

Background: Esophageal perforation remains a devastating event that is difficult to diagnose and manage. The overall mortality associated with esophageal perforation can approach 20%, and delay in treatment of more than 24 hours after perforation can result in a doubling of mortality. The treatment option for esophageal perforation with mediastinitis is not very clear and still controversial., Methods: Between April 2000 and March 2004, 6 males and 2 females, with ages ranging from 2 to 6 years (mean, 3.8 years), underwent videothoracoscopic drainage for esophageal perforation with mediastinitis., Results: The mean hospital length of stay for patients in our series was 34.1 days (range, 14-47 days). There was no perioperative mortality. All patients were discharged from hospital without major sequelae., Conclusions: Minimally invasive videothoracoscopic drainage is a feasible and effective method for esophageal perforation with mediastinitis in children.

Cre recombinase has become a ubiquitous tool in transgenic strategies for regulation of transgene expression in a tissue-specific manner. We report analysis of two SM22alphaCre lines and their ability to mediate genomic recombination in five independent Cre-responsive transgenic lines. One of the SM22alphaCre lines developed was a tet-on system based on the reverse tetracycline transactivator. Our goal was to use this strategy to inhibit the Notch signaling pathway specifically in smooth muscle cells. Our responder transgenes contained a constitutively expressed marker gene (chloramphenicol acetyltransferase, CAT), flanked by loxP sites in direct orientation, upstream of Notch-related transgenes. We developed two dominant negative Notch transgenic responder lines activated by Cre-mediated DNA recombination. The first is the extracellular domain of human Jagged1, and the second is the extracellular domain of the human Notch2 receptor. Despite high expression of the marker gene in all responder lines, we found that Cre-mediated genomic recombination between these five lines was highly variable, ranging from 46 to 93% of individuals using an SM22alphaCre activating strain, or 8-58% of individuals using an inducible SM22alphartTACre. In all cases examined, detection of recombination by PCR correlated with expression of the transgene as determined by Western blot analysis. Our studies reflect the variability in recombination success based on the responder strain, presumably due to inaccessibility of the locus of integration of the responder allele.

The solubilities of beta-cyclodextrin (beta-CD), ionic liquid (IL) 1-butyl-3-methylimidazolium hexafluorophosphate (bmimPF6), and their mixture in water were determined, and the conductivity of these aqueous solutions was measured. It was demonstrated that beta-CD and bmimPF6 could enhance the solubility of each other, and the solubility curves of each were linear with gradients of about 1. The conductivity decreased remarkably with increasing beta-CD concentration, and a discernible break in the conductivity curve could be observed when beta-CD and bmimPF6 were equimolar in the solution. The solubility and conductivity results indicated that inclusion complexes (ICs) of 1:1 stoichiometry were formed. The inclusion compounds were further characterized by using powder X-ray diffraction (XRD) analysis, 13C CP/MAS (cross-polarization magic-angle spinning) NMR and 1H NMR spectroscopy, and thermogravimetric analysis (TGA). The results showed that the ICs were a fine crystalline powder. The host-guest system exhibited a channel-type structure and each glucose unit of beta-CD was in a similar environment. The decomposition temperature of the ICs was lower than that of bmimPF6 and beta-CD individually.

Osteopontin (OPN) is a secreted, arginine-glycine-aspartic acid (RGD)-containing phosphoprotein proteolytically modified by members of the matrix metalloproteinase (MMP) family. We previously defined the MMP-3 and MMP-7 cleavage sites in OPN and found increased adhesive and migratory activity of a pool of MMP-cleaved fragments compared to full-length OPN. In the present study, we performed mutational analysis of recombinant full-length OPN and generated recombinant OPN fragments corresponding to the MMP-cleaved fragments, which have apparent molecular weights of 40, 32, and 25 kD by SDS-PAGE. Single residue mutations in 167L and 211L do not abrogate MMP cleavage although processing of the putative C-terminal fragment appears to be affected by a 167L to 167A mutation. The N-terminal 40-kD fragment was a stronger adhesive substrate compared to full-length OPN despite the observation that full-length OPN displayed greater binding in soluble phase to endothelial cell surfaces. While the 32-kD fragment showed significant binding to endothelial cell surfaces, the C-terminal 25-kD fragment did not interact with cell surface. Our data indicate that the increased adhesive activity of MMP-cleaved OPN was accountable by the N-terminal 40-kD fragment. We further analyzed receptor binding, using competition with peptides representing the alpha4beta1 and alpha9beta1 binding sites in the 40-kD N-terminal fragment. Using Jurkat cells, we found that a peptide corresponding to 131ELVTDFPTDLPATE144 had no effect on cell adhesion, whereas the peptide SVVYGLR competitively inhibited cell adhesion. These results suggest that a shorter motif that is found in MMP-cleaved OPN, 162SVVYG166, is sufficient to mediate cell adhesion of Jurkat cells to receptors, including the beta1 integrins, which have been previously characterized to bind the SVVYGLR sequence.

The authors attempted to describe the clinical manifestations of portal-systemic myelopathy (PSM) after transjugular intrahepatic portosystemic shunt (TIPS) creation. PSM was developed in four of 212 (1.89%) patients who underwent TIPS procedures in our hospital. Three men and one woman, ranging in age from 41 to 56 years, with a history of posthepatitis cirrhosis and recurrent bleeding from gastroesophageal varices had intrahepatic shunts created with 10-mm-diameter Wallstents. Shunt patency was confirmed by color Doppler ultrasonography (US) in each patient after TIPS creation. Progressive spastic paraparesis involving the lower extremities occurred between 5 weeks and 5 months after TIPS creation in the four patients. Neurologic examination showed evidence of spasticity in all cases, with ankle clonus, extensor plantar responses, and lower extremity hyperreflexia. All sensory modalities remained intact. Cytologic examination of cerebrospinal fluid from each patient was normal. There was no evidence of spinal cord compression on the imaging studies. PSM is a rare syndrome that includes spastic paraparesis with intact sensation. Initially noted in patients who have undergone surgical placement of a portacaval shunt, it also may occur after TIPS creation.

Purpose: To increase the dose of drug delivered to a tumor while maintaining tolerable systemic side effects, an interventional technique of isolated lower extremity infusion was investigated., Materials and Methods: Experiments were performed in eight dogs. Four dogs were treated by a combination of intraarterial (IA) femoral cisplatin infusion at a dose of 2.0 mg/kg with drug removal from the ipsilateral extremity venous blood by a dialyzer. The other four dogs comprised the control group. In these animals, left femoral arterial IA cisplatin infusion was performed without dialysis. Leukocyte and platelet counts, blood urea nitrogen (BUN) levels, and serum creatinine levels were recorded before and after the treatment. Subsequently, two human patients with inoperable osteosarcoma were treated with the isolated infusion., Results: In the experiments, 85%-90% of the free platinum that entered the dialyzer was removed. The peak systemic plasma cisplatin concentrations in animals undergoing dialysis were reduced by 81.25% compared to those in animals undergoing femoral IA infusion without hemodialysis. There were no significant changes in the hematologic profiles or BUN and serum creatinine levels in the experimental animals. However, in the control group, all dogs developed myelosuppression and severe renal toxicity after IA infusion of the same dose of cisplatin. Clinically, immediate relief of symptoms related to the primary tumor was achieved in both human patients after the combination of isolated IA infusion and embolotherapy., Conclusion: Single-pass hemodialysis removed a significant amount of cisplatin after regional IA infusion, reduced systemic toxicity, and permitted survival of the experimental animals. In two patients with osteosarcoma, percutaneous isolated lower extremity chemotherapeutic infusion therapy and embolotherapy were performed safely with partial responses.

Purpose: To evaluate delayed complications after esophageal expandable metallic stent placement., Materials and Methods: From April 1993 to December 1997, 90 expandable metallic stents were placed in 82 consecutive patients with inoperable malignant esophageal obstruction (n = 49) or malignant esophagorespiratory fistula (n = 33). Stents used included covered Gianturco-Rosch Z stents (n = 20), Wallstents (covered, n = 31; uncovered, n = 13), and Ultraflex stents (covered, n = 8; uncovered, n = 10). Patients were followed prospectively and monitored for delayed complications, defined as major (hemorrhage, tracheal compression, stent migration, perforation or fistula formation, granulomatous obstruction, tumor ingrowth and overgrowth, funnel phenomenon, and stent covering disruption) or minor (reflux, chest pain, and food impaction)., Results: Mean survival was 4.5 months after stent placement (range, 3 weeks to 26 months). The overall incidence of delayed complications was 64.6%, with 17 patients (20.7%) experiencing more than one complication. The rates of delayed complications in patients with Z stents, Wallstents, and Ultraflex stents were 75.0%, 68.1%, and 44.4%, respectively (P <.05). Most complications were life-threatening and occurred more frequently when stents were placed in the proximal third of the esophagus, compared with more distally (P <.05). Thirteen patients (15.9%) died from complications directly related to stent placement., Conclusion: Esophageal stent placement for malignant obstruction or fistula is associated with a substantial incidence of delayed complications.

Objectives: The objectives of this study were to determine the anatomic and physiological factors most responsible for the severe symptoms and poor prognosis of infants with scimitar syndrome., Background: Whereas the diagnosis of scimitar syndrome is often made incidentally in older children and adults who undergo chest radiography for diverse reasons, infants in whom the diagnosis is made typically present with severe symptoms and have a poor prognosis., Methods: The clinical, catheterization and imaging data of 13 consecutive infants with scimitar syndrome who underwent cardiac catheterization in the 1st 6 months of life were reviewed, with emphasis on the pulmonary artery pressure, pulmonary and cardiovascular anatomy, therapeutic interventions and outcome., Results: Twelve of the 13 infants had pulmonary hypertension at the time of diagnosis. Six patients died despite specific treatment. Eleven of 13 infants had associated cardiac malformations and 9 had large systemic arterial collateral channels to the right lung. Seven patients had anomalies involving the left side of the heart, especially varying degrees of hypoplasia of the left heart or aorta, and six of these patients died. Ten patients underwent surgical or transcatheter therapy in the 1st year of life. Systemic arteries to the right lung were ligated in three patients and occluded by transcatheter embolization in four. Balloon angioplasty was carried out in two patients, one with stenosis of the left-sided pulmonary veins and one with stenosis of the anomalous right pulmonary vein. The latter had placement of a balloon-expandable stent. In both patients, pulmonary vein stenosis progressed. Six patients had surgical repair of associated cardiovascular anomalies, and two required repair of extracardiac congenital anomalies. Occlusion of the anomalous systemic arteries was generally associated with clinical improvement, but congestive heart failure and pulmonary hypertension recurred in those patients with associated cardiovascular anomalies, whose condition subsequently responded after correction of the shunt lesions., Conclusions: The severe symptoms and pulmonary hypertension found in infants with scimitar syndrome have many causes. Anomalous systemic arterial supply, pulmonary vein stenosis and associated cardiovascular anomalies play a significant role, and the ultimate outcome of individual infants depends on the feasibility of treating these anomalies in early infancy.

The computed tomographic (CT) images of 52 patients of small peripheral lung nodule < 3 cm proved pathologically were reviewed. Air bronchogram (AB) was found in 14 nodules on thin-section CT images, in which well or moderately differentiated small adenocarcinomas were only seen with lipidic growth. Squamous-cell, large-cell carcinomas and small benign lung nodules had no AB sign both on CT image and in pathologic specimens.

Dipolar paramagnetic shifts for protons of yeast iso-1-cytochrome c have been calculated by using an optimized g-tensor and the X-ray crystallographic coordinates of the reduced form of yeast iso-1-cytochrome c [Louie, G. V., & Brayer, G. D. (1990) J. Mol. Biol. 214, 527-555]. The calculated values are compared with the observed paramagnetic shift determined from over 450 nonequivalent protons that have been assigned in both oxidation states [Gao, Y., Boyd, J., Williams, R. J. P., & Pielak, G. J. (1990) Biochemistry 29, 6994-7003]. There is good agreement between the calculated and the experimental data with a few exceptions. This indicates that, overall, the solution structures must be very similar in both the reduced and oxidized states in solution as is the case in crystals. The differences between observed and calculated shift values for the molecule in solution are most readily explained by slight movement of the heme and certain changes in diamagnetic shift due to small rearrangements of a few residues and some considerable changes in a few hydrogen bonds. It is also known that small differences exist between the structures of the two oxidation states in crystals but the hydrogen-bond changes are not so easily observed there. Structural changes from nuclear magnetic resonance data are in reasonable agreement with those deduced from crystallography, but additional information is clearly available concerning changes in hydrogen bonding.