Stem-cell therapy for peripheral arterial occlusive disease.

OBJECTIVE: The aims of our study were to confirm the effectiveness via animal study and safety through clinical trials of using human cord blood-mononuclear cells (HCB-MNCs). DESIGN: We performed a dose-response animal study (HCB-MNCs: 4 × 106, 4 × 107 and 4 × 108) using a limb ischaemia model in dogs to assess angiogenic responses. Safety assessment in humans in terms of graft-versus-host-disease was also done by observing an uncontrolled case series. MATERIALS AND METHODS: Twelve animal ischaemic limbs and seven patients with thromboangiitis obliterans were treated with HCB-MNCs. These cells (4 × 108) were injected into the ischaemic limb muscle of patients. The results were analysed at 8 weeks for the animal study and at 6 months for patients. RESULTS: In the animal ischaemic models, the number of capillaries, angiogenic gene expression and the angiogenic factors were increased after HCB-MNC injection. In the clinical study, the seven patients experienced no graft-versus-host-disease or cardiac/cerebral complications during the follow-up period. CONCLUSION: This preliminary study suggests that HCB-MNC might be a safe source of stem cells for treating ischaemic limbs. However, further clinical studies are needed to establish the long-term safety and the clinical efficacy of HCB-MNC transplantation in patients with ischaemic limbs.

Retained surgical sponges after craniotomies: imaging appearances and complications.

Imaging within 24 to 48 hours after most neurosurgical procedures is a routine practice. Nonresorbable surgical sponges have radiopaque filaments readily visible on CT scans and plain film radiographs. However, the proton-poor barium sulfate responsible for this radio-opacity is generally not detectable on MR imaging in the immediate post-operative period. Findings on MR imaging become more evident with elapsing time and when a foreign-body reaction to the sponge manifests as a mass lesion, which can mimic residual or recurrent intracranial tumor or abscess. Although preventive measures by our surgical colleagues to ensure accurate and correct sponge counts before and after wound closure is paramount, even the most fastidious efforts may rarely result in an inadvertently retained surgical sponge. The role of the radiologist is to recognize the imaging findings of this entity and its potential complications so that appropriate and prompt management can be initiated.

Association between residence location and likelihood of kidney transplantation in Aboriginal patients treated with dialysis in Canada.

For reasons that are not well understood, Aboriginal people with end-stage renal disease (ESRD) have lower rates of kidney transplantation. We hypothesized that distance between residence location and the closest transplant center was greater in Aboriginal dialysis patients and would partially explain the lower rate of transplantation in this population. We studied a random sample of 9905 patients initiating dialysis in Canada between 1990 and 2000. We calculated the distance between residence location at dialysis inception and the closest transplant center. Cox proportional hazards models were used to examine the relation between residence location and the likelihood of transplantation over a median period of 2.3 years. The proportion of Aboriginal participants living 300 km from the closest transplant center was 25, 18, 18, and 39% respectively, compared with 55, 19, 11, and 15% among white subjects. The relative likelihood of transplantation was significantly lower for Aboriginal compared to white participants across all four distance strata, with no apparent effect of residence location. For example, the relative likelihood of transplantation was hazard ratio (HR) 0.47, 95% confidence interval (CI) (0.31-0.72) in Aboriginal participants residing 300 km from the closest transplant center. Results were similar for transplants from deceased donors and living donors, and in all seven regions studied. In conclusion, remote location of residence does not explain the lower rate of kidney transplantation among Aboriginal people treated for ESRD in Canada.

Distinct patterns of expression but similar biochemical properties of protein L-isoaspartyl methyltransferase in higher plants.

Protein L-isoaspartyl methyltransferase is a widely distributed repair enzyme that initiates the conversion of abnormal L-isoaspartyl residues to their normal L-aspartyl forms. Here we show that this activity is expressed in developing corn (Zea mays) and carrot (Daucus carota var. Danvers Half Long) plants in patterns distinct from those previously seen in winter wheat (Triticum aestivum cv Augusta) and thale cress (Arabidopsis thaliana), whereas the pattern of expression observed in rice (Oryza sativa) is similar to that of winter wheat. Although high levels of activity are found in the seeds of all of these plants, relatively high levels of activity in vegetative tissues are only found in corn and carrot. The activity in leaves was found to decrease with aging, an unexpected finding given the postulated role of this enzyme in repairing age-damaged proteins. In contrast with the situation in wheat and Arabidopsis, we found that osmotic or salt stress could increase the methyltransferase activity in newly germinated seeds (but not in seeds or seedlings), whereas abscisic acid had no effect. We found that the corn, rice, and carrot enzymes have comparable affinity for methyl-accepting substrates and similar optimal temperatures for activity of 45 degrees C to 55 degrees C as the wheat and Arabidopsis enzymes. These experiments suggest that this enzyme may have specific roles in different plant tissues despite a common catalytic function.

Drug-resistant pulmonary tuberculosis in a tertiary referral hospital in Korea.

OBJECTIVES: To estimate the resistance rate and to correlate the clinical characteristics of resistant tuberculosis with the patients of pulmonary tuberculosis who were referred to the university hospital. METHODS: We prospectively performed sensitivity tests for all patients who were diagnosed as active tuberculosis by sputum smear or sputum culture from January, 1995 to June, 1996. Patients profile, previous treatment history, patterns of drug resistance, initial chest films and other clinical findings were analysed. RESULTS: Overall, 24(26.0%) of the 92 patients had resistance to at least one drug and 8(8.6%) had resistance to isoniazid(INH) and rifampin(RFP). Among the 66 patients without previous tuberculosis therapy, 11(16.6%) were drug-resistant and 2(3.0%) were multi-drug resistant. Among the 26 patients with previous therapy, 13(50.0%) were drug-resistant and 6(23.0%) were multi-drug resistant. For all 92, resistance to INH was most common (19.5%), followed by RFP (9.7%) and ethambutol (9.7%). Drug resistance was significantly high in previously treated patients and in cavity-positive patients. Treatment failure was also high in previously treated patients with resistant tuberculosis. In patients with primary resistance, treatment failure was not observed. CONCLUSION: Sensitivity tests are strongly recommended in all culture positive patients with previous therapy but, in patients with primary resistance, sensitivity tests are not required. Proper combination chemotherapy should be given under careful surveillance.

Dental management of neonates requiring prolonged oral intubation.

An orotracheal route is frequently the preferred method of intubation for premature infants. Nasal intubation may contribute to airway obstruction and possible hypoxia, further contributing to labored breathing. Additional complications include occlusion of the nasal aperture during a crucial period of development, nasal infections, and hypertrophy of the nasal lining. Oral mucosa is less susceptible to damage than nasal mucosa; however, orotracheal tubes must be stabilized against displacement from tongue and jaw movements to prevent discomfort and subsequent tissue trauma. Problems associated with rehabilitation of very-low-birth-weight neonates and other infants requiring long-term oral intubation include palatal grooving, acquired cleft palate, and damage to the primary dentition. Various intraoral aids have been used to reduce pressure application from intubation and feeding tubes on the palatal tissues. References to these procedures have yet to be reported in the prosthodontic literature. This article presents a rational for design and construction of an intraoral device which protects the palatal tissues and stabilizes the orotracheal tube.

Interphase cytogenetics of lung tumors using in situ hybridization: numerical aberrations.

OBJECTIVES: Since conventional cytogenetic analysis for bronchogenic carcinogenesis is limited by the difficulty to get enough number of high quality metaphase spreads, the development of new method to overcome above problems is strongly needed. Therefore, the introduction of non-radioactive in situ hybridization (ISH) with pericentromeric chromosome probes gave us the way to investigate the genetic events during carcinogenic process. We applied this method on lung cancer tissue to validate the possibility of this method for general usage and to analyze numerical chromosome aberration status and their clinical correlations. METHODS: A set of satellite DNA probes specific for chromosome 3, 7, 9, 11, and 17 was hybridized directly to paraffin-embedded tissue section of 30 non-small cell lung cancers. Mean chromosome index of each chromosome and frequency of polysomy for each chromosome were calculated. RESULTS: Mean chromosome indices for chromosome 3, 7, 9, 11, and 17 were 1.10, 1.13, 1.17, 1.12, and 1.17, respectively. Polysomy for a set of chromosomes was detected in all 30 cases except 4 cases which showed hypoploidy only for chromosome 3 or 7 in 2 cases and diploidy only for chromosome 3 or 11 in 2 cases. Among the set of chromosomes, mean chromosome index and polysomy frequency for chromosome 9 & 17 were significantly higher than that for others. Mean chromosome index or polysomy pattern for each chromosome was not much different among cell types or clinical stages. CONCLUSIONS: Our results show that chromosome ISH can be used to screen for numerical chromosome aberrations on paraffin tissue sections and further studies for ISH analysis with different probes on same tumor area or double-target ISH in large scale are needed to confirm above results and to elucidate the specific meanings.

Detection of Cryptosporidium oocysts from out-patients of the Severance Hospital, Korea.

A total of 230 randomly collected formalin-fixed fecal samples (submitted to the Severance Hospital, Yonsei University) were selected for tests for human cryptosporidiosis. The stool specimens were examined for Cryptosporidium oocysts by acid-fast (AF) stain, auramin-rhodamine (AR) stain, and monoclonal antibody (mAb) OW3 fluorescence method specific for oocyst wall. Of the 230 stool specimens, 21% were identified by the AF method, 22% were identified by the AR method, and 10% were identified by the mAb fluorescence method, indicating that human Cryptosporidium infections have been existing in Korea.

Cloning and characterization of cDNAs coding for heavy and light chains of a monoclonal antibody specific for pre-S2 antigen of hepatitis B virus.

Binding specificity of a monoclonal antibody (mAb) (kappa, gamma 2b) H8 which can react with the pre-S2 peptide of hepatitis B virus (HBV) was determined by Western blot analyses. From the hybridoma cell line secreting mAb H8, poly(A)+ RNA was prepared and used as a template for cDNA synthesis and cloning. Full-length cDNAs coding for the heavy and kappa light chains of the mAb were cloned from the cDNA library and characterized by nucleotide (nt) sequence analyses and N-terminal amino acid sequencing. The sequence analyses revealed that both heavy and light chain-specific cDNAs are functional, and the variable regions of the heavy and light chains are members of mouse heavy chain subgroup III(c) and light chain group I, respectively. Comparison of the nt sequences with mouse immunoglobulin genes listed in the GenBank data base show that the cDNAs have not been previously reported. The cDNAs will be used for the construction of a therapeutic antibody for HBV infection.

A case of thalamic aphasia with postmortem verification.

This study discusses a case of aphasia after dominant thalamic lesion, a hemorrhagic infarction. Unlike other such cases, both repeated standardized assessment and postmortem verification were available. The patient was assessed at 3 weeks and again at 9 weeks postonset. The aphasia demonstrated the syndrome common to dominant thalamic hemorrhage: fluent but paraphasic output sometimes deteriorating to jargon, comprehension less impaired than this type of output usually indicates, and the least impairment in repetition. As sometimes reported in previous cases, semantic paraphasias were more common than phonemic paraphasias. The lesion was located in the dorsal aspect of the lateral nucleus, but it extended into the pulvinar, including the anterior superior lateral aspect which has been implicated in language by previous studies. Thus, data from this case are consistent with an involvement of the dominant pulvinar in language and suggest that this role involves the semantic aspects of language.