Long-term Outcome of Endovascular Treatment for Mycotic Aortic Aneurysm.

OBJECTIVE/BACKGROUND: Endovascular repair (EVAR) of mycotic aortic aneurysm (MAA) has become an alternative treatment for high risk patients. The aim of this study was to evaluate long-term survival and outcomes. METHODS: Retrospective analysis of 40 consecutive patients with MAAs undergoing EVAR and subsequent intravenous antibiotic treatment between September 2009 and April 2015. Follow-up was truncated on 30 April 2015. Uni- and multivariate logistic regression were used to assess risk factors of adverse outcomes. Cumulative survival was calculated using the Kaplan-Meier method. RESULTS: Median age at repair was 73 years (range 48-88 years) and 31 (77%) were men. Eleven (27%) patients were infected with Salmonella, 12 (30%) with non-Salmonella species, and 17 (42%) had negative cultures. Anatomical locations included the aortic arch/thoracic area in 10 (25%), the paravisceral area in seven (17%), and the infrarenal area in 23 (57%). Ten (25%) patients presented with aneurysm rupture and underwent emergency repair. Median follow-up was 25 months (range 1-69 months). Cumulative 1 and 5 year survival rates were 71% and 53%, respectively. Persistent or recurrent infection occurred in 20% (n = 8). Patients with persistent infection were treated with long-term medical therapy, but all died (75%; n = 6) within 6 months of repair. No survival difference was found between patients with or without Salmonella infections. However, there was a trend toward better survival in culture negative patients. CONCLUSION: EVAR of MAA is an acceptable alternative treatment of MAA. However, persistent infection after endovascular treatment does occur and is often fatal without surgical treatment.

The effect of statins on cardiac allograft survival.

PURPOSE: In addition to having a lipid-lowering effect, statins also have an anti-inflammatory effect that may reduce allograft dysfunction by preventing cardiac allograft vasculopathy (CAV) and play an immunomodulatory role. We studied the effect of statins on cardiac allograft survival at the National Taiwan University Hospital (NTUH). MATERIALS AND METHODS: We retrospectively reviewed the patients undergoing heart transplantation at NTUH in the last 6 years. After transplantation, all patients received biochemical monitoring every month and echocardiographic examination regularly at NTUH. Protocol biopsy was performed in all except 18 pediatric patients. All patients received immunosuppressants, including tacrolimus or cyclosporine, everolimus or mycophenolate acid, and prednisolone. They were divided into statin and nonstatin groups according to whether or not a statin was taken. RESULTS: At NTUH, from 2007 to 2012, 168 heart transplantations were performed. The ages of the patients ranged from 6 to 74 years old with male predominance. The etiology was mainly dilated cardiomyopathy (52.4%) and ischemic cardiomyopathy (39.3%), including 7 retransplantations from severe CAV with heart failure. Twenty-three patients (17%) suffered from acute rejection. The overall 1-year actuarial survival rate was 86% ± 2% and the 5-year survival rate was 79% ± 3%. Seventy-eight patients (57.4%) took statins and the statin group has a better 5-year survival rate and freedom from cardiac death survival rate (P < .01). CONCLUSION: Our study showed that the use of statins after transplantation was associated with better survival.

Clinical features of myasthenia gravis in southern China: a retrospective review of 2,154 cases over 22 years.

The objectives of the study are to study the clinical features of myasthenia gravis in southern China. A retrospective study was carried out on all patients who were diagnosed with myasthenia gravis at the First Affiliated Hospital of Sun Yat-sen University during 1987-2009. Of the 2,154 myasthenia gravis patients, the gender ratio (male:female) was 1:1.15. The median age at onset was 18 years. There was a single peak distribution of age at onset, and 44.8 % were children (≤ 14 years) at first onset. 1,766 patients (82.0 %) only had ocular symptoms at onset. 1,451 patients (67.4 %) were classified as Osserman grade I. 250 unselected patients received anti-acetylcholine receptor antibodies test, in which only 51.2 % were positive. Computed tomography scan/magnetic resonance Imaging of chest were done in 1,354 patients, of which 899 patients (66.4 %) had thymic hyperplasia and 201(14.8 %) had thymoma. There were 150 patients (7.0 %) with myasthenia gravis combined with other autoimmune diseases, in which hyperthyroidism was most common (84 %). 189 (8.8 %) patients experienced 267 episodes of crisis. The rate of family myasthenia gravis was 1.6 % (35/2,154). In conclusion, the clinical features and demography of myasthenia gravis patients in this study are significantly different from prior studies on other regions and ethnic groups.

Local hypoxia is produced at sites of intratumour injection.

Intratumour injection, commonly used for gene or drug delivery but also associated with needle biopsy or insertion of invasive measuring devices, may damage tumour microvessels. To examine this possibility, SCCVII tumours grown subcutaneously in C3H mice were injected with a 26 gauge needle containing 0.1 ml of the fluorescent dye Hoechst 33342 to label cells lining the track of the needle. Hoechst-labelled cells sorted from these tumours were more sensitive to killing by hypoxic cell cytotoxins (tirapazamine, RSU-1069) and less sensitive to damage by ionizing radiation. Hoechst-labelled cells also bound the hypoxia marker pimonidazole when given by i.p. injection. Intratumour injection transiently increased hypoxia from 18 to 70% in the tumour cells adjacent to the track of the needle. The half-time for return to pre-treatment oxygenation was about 30 min; oxygenation of tumour cells along the track had recovered by 20 h after intratumour injection. This effect could have significant implications for intratumour injection of drugs, cytokines or vectors that are affected by the oxygenation status of the tumour cells as well as potential effects on biodistribution via local microvasculature.

Inactivation of p53 results in high rates of homologous recombination.

Using a plasmid substrate which integrates into the genome, we determined that the rate of homologous recombination was suppressed by p53. Human tumor cell lines, mutant or null for p53 had recombination rates 10000-times greater than primary fibroblasts. When isogenic cell pairs from tumor cells or primary fibroblasts were compared, differing only in one genetic change which inactivated p53, the recombination rate increased > 100-fold. Functional inactivation of p53 by dominant mutant p53, by large T antigen of SV40 virus, by E6 protein of human papilloma virus, or by genetic deletion led to the same result. Our results suggest that p53 suppresses spontaneous homologous recombination, and that p53 is not required for recombination to proceed. The mechanism of recombination suppression may be related to the reported association of p53 with Rad 51, but the functional consequences of this association are not yet established. It is suggested that suppression of homologous recombination is the means by which p53 maintains genetic stability.

[The clinical research of the tooth acid erosion disease in workers related to acid jobs]

Through investigation into 1671 workers who do six acid related jobs in fourteen factories,and 501 workers who work in non-acid condition in contrast.The paper has worked out the criteria of diagnosing occupational acid erosion disease,including the classified criteria of diagnosing single tooth acid erosion disease and the criteria of diagnosing different degrees of the tooth acid erosion disease in the oral cavity.It has also been found out that these are close relationships between the rate of suffering the occupational tooth acid erosion disease and the degree of the erosion,on the one hand and density of acid fog in the air and the types of acid workers are exposed ton and the length of the years working in such environment.

High frequency and error-prone DNA recombination in ataxia telangiectasia cell lines.

The only specific DNA repair defect found in ataxia telangiectasia (A-T) cells is mis-repair of cleaved DNA. In this report we measured DNA recombination, given its role in DNA repair and genetic instability. Using plasmids containing selectable reporter genes, we found a higher frequency of both chromosomal recombination (>100 times) and extra-chromosomal recombination (27 times) in SV40-transformed A-T cell lines compared with in an SV40-transformed normal fibroblast cell line. Southern analysis of single A-T colonies exhibiting post-integration recombination revealed that 24/27 had undergone aberrant rearrangements; recombination in normal fibroblast colonies was achieved by gene conversion in 8/11 clones and 10/11 clones showed unchanged copies of the plasmid. Using co-transfection of two integrating plasmids, each containing a separate deletion in the xgprt reporter gene, the 27 times difference in extra-chromosomal recombination was found when the plasmids were cleaved at a distance from the reporter gene. When the plasmids were cleaved within the reporter gene, the co-transfection frequency was reduced in A-T, but was increased in normal cells. We conclude that A-T cell lines have not only a high frequency chromosomal and extra-chromosomal recombination, but also exhibit error-prone recombination of cleaved DNA.

Microcomputer system for automatic identification of the Cryptococcus neoformans and its clinical application.

In this study, microcomputer image processing and pattern recognition technology, and the knowledge of morphology and optical characteristics of Cryptococcus neoformans were used for identification of Cryptococcus neoformans. Four groups of mice were lethally infected with standard strain, Wuhan strain, American B-2643 strain and Var. Shanghainesis of the Cryptococcus neoformans. The samples collected included mice brain, lung, kidney, liver, small intestine tissue and were observed under a light microscope. More than 600 images of the fungus were input into a microcomputer. A system of computer for automatic identification of the Cryptococcus neoformans was developed. The technique involved image preprocessing, image segmenting, coding of line-length on the edge, curve fitting, extracting of image feature, building of image library and feature data bank etc.. And then, 768 images of the clinical samples and other fungus samples whose morphological features tend to be confused with Cryptococcus neoformans were input into microcomputer and subjected to automatic identification. The Cryptococcus neoformans was accurately identified within 15 min, and the consistency rate with results of routine culture was 98%.

Carbachol, glycine and gamma aminobutyric acid also activate cardiovascular neurons of pontomedulla responsive to glutamate.

Thirty-three cats under intraperitoneal chloralose (40 mg/kg) and urethane (400 mg/kg) anesthesia were used to explore the effect of microinjections (100 nl) of carbachol (CCh, 0.5 M), a cholinergic analogue, glycine (Gly, 1 M) and gamma aminobutyric acid (GABA, 0.4 M) on the cardiovascular-reactive sites in the pontomedulla that responded to microinjection of monosodium glutamate (Glu, 0.25 M, 100 nl) resulting in changes of systemic arterial pressure (SAP). Brain sites under exploration included gigantocellular tegmental field and lateral tegmental field (FTG-FTL), the dorsomedial (DM) and ventrolateral (VLM) medulla which produced pressor responses; caudal VLM (CVLM) and paramedian reticular nucleus (PRN) which produced depressor responses. It was found that CCh produced significant fall of SAP in DM and VLM while the rise of SAP in the same site by Glu. CCh produced SAP decrease in CVLM similar to Glu. GABA significantly caused a slight to moderate increase of SAP in FTG-FTL, DM and VLM, and decrease of SAP in CVLM, all in direction similar to that of Glu. Gly produced significant and marked increase of SAP in DM and VLM similar to Glu both in magnitude and duration. Gly produced increase of SAP in CVLM but the fall of SAP by Glu. PRN was relatively non-reactive except a few microinjections of CCh which produced hypotension. In conclusion, the cardiovascular-reactive sites in the pontomedulla that respond to Glu may also react to other chemicals or neurotransmitters. It is highly possible that multiple receptors of different nature co-exist in neurons of some cardiovascular regions in the pontomedulla.

[Growth capability of epithelial cell line of human poorly differentiated nasopharyngeal carcinoma and its response to Chinese medicinal herbs and marine drugs].

By 3H-TdR incorporation, dye exclusion and cell colony-forming tests, the capability of short-term in vitro growth of the epithelial cell line of human poorly differentiated nasopharyngeal carcinoma (CNE-2Z) was assayed. At the same time, its response to 54 kinds of Chinese medicinal herbs and marine drugs was studied. The results showed that the 3H-TdR incorporation rate of cells was 1.8 +/- 0.02%, reproduction rate was 60.9 +/- 13.0% and colony-forming rate, 40.8 +/- 3.5%. As to the ratios of the three cell growth indexes and response to medicines, the Chinese medicinal herbs and marine drugs causing the reduction of colony-forming and cell survival ratios were predominant (64.8% and 40.7%). The results indicate that the majority of drugs possess the cytotoxic and inhibitory effect on cell reproduction to different degrees. The composite cell response to every kind of drug could be divided into 6 types: descending, ascending, peaked, valley-like, depressed and stable. The depressing type drugs might inhibit or arrest the cell growth of nasopharyngeal carcinoma and are worthy of further study.

Effects of cadmium on cadmium smelter workers.

The effects of cadmium on 65 workers in a cadmium-refining plant in the People's Republic of China were investigated. The average airborne cadmium oxide concentrations ranged from 0.004 to 0.187 mg/m3 at most worksites. Except for some vague symptoms and reports of anosmia, no significant abnormalities were found in the clinical examinations. The level of cadmium in the blood and urine was increased in the majority of the cadmium-exposed subjects. Nine cases (13.8%) with suspected or mild renal tubular damage were found in this study.