[Soft tissue reconstruction strategy for sacral tumor resection].

Objective: To investigate the clinical strategy and effect of soft tissue reconstruction after sacral tumor resection in different planes. Methods: The data of 27 consecutive patients who underwent primary or secondary sacral tumor resection and soft tissue reconstruction from June 2012 to June 2021 at Dongnan Hospital of Xiamen University (the 909th Hospital) were retrospectively analyzed. There were 11 males and 16 females, aged (M(IQR)) (46.2±23.6) years (range: 16 to 72 years). Sacrospinous muscle, gluteus maximus and vertical rectus abdominis muscle flap were selected for soft tissue reconstruction according to the tumor site and the size of tissue defect. the postoperative follow-up was performed. The operative methods, intraoperative conditions, complications and disease outcomes were summarized. Results: Among the 27 patients with sacral tumor, the tumor plane was located in S1 in 8 cases, S2 in 5 cases and S3 or below in 14 cases. There were 12 patients with tumor volume≤400 cm3 and 15 patients with tumor volume>400 cm3. Operation time was 100(90) minutes (range: 70 to 610 minutes), intraoperative blood loss was 800(1 600) ml (range: 400 to 6 500 ml). Soft tissue reconstruction was performed by transabdominal rectus abdominis transfer repair in 2 cases, extraperitoneal rectus abdominis transfer repair in 1 case, gluteus maximus transfer repair in 5 cases, gluteus maximus advancement repair in 13 cases, and sacrospinous muscle transfer repair in 6 cases. Postoperative complications occurred in 6 cases, including 1 case of incision infection, 4 cases of skin border necrosis, and 1 case of delayed infection due to fracture of internal fixator 3 years after operation, all of them were cured. The follow-up time was (35±21) months. Among the patients, 6 patients had recurrence, 2 patients with Ewing sarcoma died of lung metastasis 1 year after operation, 4 patients with metastatic cancer died of primary disease, and the remaining patients survived without disease. Conclusion: Choosing different soft tissue reconstruction strategies according to sacral tumor location and tissue defect size can effectively fill the dead space after sacral tumor resection, reduce postoperative complications and improve the prognosis of patients.

MiR-548b-3p inhibits proliferation and migration of breast cancer cells by targeting MDM2.

OBJECTIVE: The aim of this study was to explore the expression and biological functions of micro ribonucleic acid (miR)-548b-3p in breast cancer (BC), and to investigate its potential molecular mechanism. PATIENTS AND METHODS: The expression level of miR-548b-3p in BC tissues and cells was detected by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Subsequently, the impacts of miR-548b-3p on the proliferation, apoptosis, and cycle, as well as migration and invasion of BC cells, were explored using colony formation assay and 5-ethynyl-2'-deoxyuridine (EdU) staining, flow cytometry, and transwell assay, respectively. The possible downstream target genes of miR-548b-3p were predicted via bioinformatics and verified through qRT-PCR and Western blotting. Furthermore, Dual-Luciferase reporter gene assay was employed to confirm whether miR-548b-3p could directly bind to murine double minute 2 (MDM2). RESULTS: QRT-PCR results showed that miR-548b-3p expression was significantly downregulated in 37 out of 43 BC tissues. Subsequent in-vitro experiments indicated that the overexpression of miR-548b-3p significantly inhibited the proliferation and metastasis, whereas promoted the apoptosis of BC cells. Bioinformatics predicted that MDM2 was the downstream target gene of miR-548b-3p. After overexpression of miR-548b-3p, qRT-PCR, and Western blotting results revealed that the expression of MDM2 was remarkably downregulated. Dual-Luciferase reporter gene assay further confirmed that miR-548b-3p could directly bind to MDM2. CONCLUSIONS: MiR-548b-3p expression was significantly downregulated in BC. In addition, lowly expressed miR-548b-3p repressed the proliferation and metastasis of BC cells through targeted regulation of MDM2.

Sidestream Dark Field (SDF) imaging of oral microcirculation in the assessment of systemic sclerosis.

INTRODUCTION: Systemic sclerosis (SSc) is a systemic disease characterised by abnormalities in small blood vessels, skin and organ fibrosis. It is assessed using generalised skin thickening scores, autoantibodies and nailfold capillaroscopy. Sidestream Dark Field imaging (SDF) is a non-invasive imaging tool that assesses microcirculation. This study aims to investigate the potential of using SDF as a diagnostic tool in SSc. METHOD: Oral microcirculation of 20 patients with SSc was compared to 20 age and gender matched controls using SDF imaging. Sublingual, buccal and incisor regions of the mouth were examined. All volunteers were female averaging 48.0 (24-64) years old. Vasculature was assessed by calculating the De Backer score and Functional Capillary Density (FCD) on an imaging software. RESULTS: At all regions of the mouth, SSc patients had a significantly lower De Backer score compared to controls (SSc 3.484 ±â€¯0.1361/mm vs Control 5.184 ±â€¯0.1896/mm, unpaired t-test p < 0.0001). The SSc patients showed significantly lower FCDs compared to controls at all areas as well (SSc 19.65 ±â€¯0.9445% vs Control 29.45 ±â€¯1.681%, unpaired t-test, p < 0.0001). The incisor regions had significantly higher De Backer and FCD scores than buccal and sublingual regions in both control and SSc patients (one way anova, p < 0.05). De Backer/FCD scores showed significant correlation against Rodnan Skin Scores in patients with SSc (Pearson correlation, p < 0.05). CONCLUSIONS: SSc patients showed decreased oral vasculature compared to controls. SDF imaging has shown the ability to be a useful diagnostic tool in the assessment of SSc.

Synergistic action of Bacillus subtilis, Escherichia coli and Shewanella putrefaciens along with Pseudomonas putida on inhibiting mild steel against oxygen corrosion.

Microbial biofilm can effectively alter the electrochemical characteristics at metal/solution interface that can either accelerate or decelerate corrosion. The present paper reports about microbiologically induced corrosion inhibition (MICI) using Pseudomonas putida as a dominant bacterium under aerobic condition. Effective corrosion inhibition is achieved by the synergistic metabolic action of P. putida along with Escherichia coli, Bacillus subtilis or Shewanella putrefaciens. The synergistic metabolic actions of these bacteria in biopassivation are analysed with various aspects such as electrochemical impedance spectroscopy (EIS), Fourier transform infrared spectroscopy (FT-IR), field emission scanning electron microscopy (FESEM) and confocal laser scanning microscopy (CLSM). Surface topography is quantitatively analysed using optical scanning profilometry (OSP). The binary culture system containing P. putida + E. coli and P. putida + S. putrefaciens achieves an inhibition efficiency of 90% and 85% respectively, despite S. putrefaciens being a corrosion causing bacteria. The P. putida + E. coli system could form a stable biofilm on mild steel surface, with a high corrosion potential (- 329 mV vs. Ag/AgCl/KCl sat'd) and a low corrosion rate (1.65 × 10-1 mmpy). The presence of B. subtilis in the culture promotes corrosion against normal predictions. In the present case, the metabolic activities of the bacterial system on the mild steel surface cause depletion of oxygen in the medium that leads to suppression of corrosion. In addition, the biofilm could form an effective protective barrier on the metal surface that can suppress diffusion of corrosion products resulting in enhanced corrosion inhibition efficiency.

Effects of Vitamin B12 on postoperative cognitive dysfunction induced by isoflurane anesthesia in rats.

OBJECTIVE: Postoperative cognitive dysfunction is a clinical syndrome associated with cognitive decline in patients after anesthesia. This study aimed to investigate the effect of VB12 (Vitamin B12), a kind of necessary micronutrients promoting the growth and development of the nervous system, on cognitive dysfunction induced by isoflurane anesthesia. MATERIALS AND METHODS: Eighteen-month-old rats were exposed to or were not exposed to 1.4% isoflurane for 2 h. Two hours before isoflurane exposure, rats in groups with VB12 were injected intramuscularly with VB12 at 10 or 20 µg. Two weeks later, rats were subjected to Barnes maze and Morris water maze. RESULTS: Rats exposed to isoflurane had significant impairments in long-term spatial memory assessed by Barnes maze. There was no statistical significance in the percentage of swimming time and path length in the Morris water maze tests among five groups, suggesting that isoflurane may not impair the recall of learned information in rats. Isoflurane increased the expression of interleukin 1ß (IL-1ß) and activated caspase 3 in the hippocampus, but not cortex of the rats. The increase of IL-1ß and activated caspase 3 was attenuated by VB12. However, isoflurane did not change the amount of tumor necrosis factor-α (TNF-α) and ß-amyloid peptide in the hippocampus and cerebral cortex. CONCLUSIONS: VB12 can attenuate cognitive dysfunction induced by isoflurane anesthesia. At the same time, IL-1ß may play an important role in this isoflurane effect.

Treatment for residual stones using flexible ureteroscopy and holmium laser lithotripsy after the management of complex calculi with single-tract percutaneous nephrolithotomy.

This study validated the effectiveness and safety of the treatment for residual stones using flexible ureteroscopy (fURS) and holmium laser (0.6-1.2 J, 20-30 Hz) lithotripsy via a fiber with a 200-µm core diameter and 0.22 numerical aperture (NA) after the management of complex calculi with single-tract percutaneous nephrolithotomy (PCNL). Between January 2014 and June 2016, 27 consecutive patients with complex calculi underwent fURS and holmium laser lithotripsy after a planned single-tract PCNL. Among the 27 patients with complex calculi, 9 had full staghorn calculi, 7 had partial staghorn calculi, and 11 had multiple calculi. After the first single-tract PCNL session, the mean stone size and mean stone surface area were 18.0 ± 10.7 mm and 181.9 ± 172.2 mm2, respectively. Treatment for residual stones with fURS and holmium laser lithotripsy was successfully completed and was performed without intraoperative complications. The mean operative time of the fURS procedure was 69.1 ± 23.6 min, and the mean hospital stay was 5.3 ± 2.4 days. The mean decrease in the hemoglobin level was 7.3 ± 6.5 g/l. After the fURS procedure, the overall stone-free rate was 88.9%. The overall postoperative complication rate was 14.8% (Clavien grade I 11.1%; Clavien grade II 3.7%). The current approach tested here combines the advantages of both PCNL and fURS and effectively manages complex calculi with a high stone-free rate (SFR) (88.9%). This approach also reduced the number of treatment sessions, the number of percutaneous access tracts, and the blood loss and potential morbidity associated with multiple tracts.

[Expression of miR-212 and miR-132 in serum of patients with primary liver cancer and their targeted regulation of GP73].

Objective: To investigate the expression of miR-212 and miR-132 in the serum of patients with primary liver cancer and their targeted regulation of GP73. Methods: The patients with liver cancer, chronic hepatitis B, or liver cirrhosis who were hospitalized in Taizhou People's Hospital from January 2015 to December 2016 were enrolled, and healthy volunteers were also enrolled as controls. Quantitative real-time PCR was used to measure the serum levels of miR-212 and miR-132, and the association between the expression of serum miR-212 and miR-132 and the clinicopathological features of patients with liver cancer was analyzed. A Spearman's rank correlation analysis was used to analyze the correlation between serum miR-212/miR-132 and GP73. Western blot was used to measure the protein expression of GP73, and MTT assay was used to measure the survival rate of cells. The Levene's homogeneity of variance test was used for data analysis. The independent samples t-test was used for comparison of means between two samples, and ANOVA was used for comparison of means between multiple samples. Results: A total of 90 patients with liver cancer, 60 with chronic hepatitis B, 68 with liver cirrhosis, and 100 healthy volunteers were enrolled. The relative expression levels of miR-212 and miR-132 in serum were 0.046 6 ± 0.024 7 and 0.005 9 ± 0.003 0 in the patients with liver cancer, 0.979 7 ± 0.259 5 and 1.001 8 ± 0.249 9 in the healthy volunteers, 0.588 2 ± 0.216 5 and 0.345 7 ± 0.233 8 in the patients with hepatitis, and 0.313 8 ± 0.153 3 and 0.080 1 ± 0.042 66 in the patients with liver cirrhosis. Compared with the normal controls, all patients had significant reductions in the expression of serum miR-212 (t = 10.26, 20.86, and 35.80, all P < 0.01) and miR-132 (t = 16.55, 36.09, and 39.85, all P < 0.01). In the patients with liver cancer, the relative expression of miR-212 and miR-132 was negatively correlated with alpha-fetoprotein (miR-212: t = -4.46, P < 0.01; miR-132: t = -4.83, P < 0.01), TNM stage (miR-212: t = 6.569, P < 0.01; miR-132: t = 7.31, P < 0.01), degree of tumor differentiation (miR-212: t = 5.268, P < 0.01; miR-132: t = 5.914, P < 0.01), and presence of portal vein tumor thrombus (miR-212: t = 5.16, P < 0.01; miR-132: t = 3.681, P < 0.01), while it was not correlated with tumor size (miR-212: t = 0.687, P > 0.05; miR-132: t = 0.887, P > 0.05). In addition, serum miR-212 and miR-132 were negatively correlated with GP73 in the patients with liver cancer (miR-212: r(s) = -0.709, P < 0.01; miR-132: r(s) = -0.877, P < 0.01). Overexpression of miR-212 or miR-132 in HepG2 cells significantly inhibited the activity and expression of 3'-UTR, and interference of miR-212 or miR-132 significantly increased the activity and expression of 3'-UTR in GP73. Overexpression of GP73 reversed the reduction in survival rate of hepatoma cells induced by the overexpression of miR-212 or miR-132. Conclusion: Patients with liver cancer have a significant reduction in the expression of miR-212 and miR-132 in serum, which is closely associated with the development, progression, and metastasis of liver cancer, and miR-212 and miR-132 in hepatoma cells inhibit the growth of liver cancer by targeted regulation of GP73 expression.

Efficacy evaluation of D-dimer and modified criteria in overt and nonovert disseminated intravascular coagulation diagnosis.

INTRODUCTION: D-dimer (D-D) was shown to be an important indicator for the diagnosis of overt disseminated intravascular coagulation (DIC) and nonovert DIC. However, its diagnostic cutoff value in the clinic is not clearly defined. METHODS: D-D, fibrinogen degradation products (FDP), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), antithrombin (AT), and blood platelet count (PLT) of 360 cases were used to assess the diagnostic efficacy of D-D (InnovanceR reagent) for the diagnosis of DIC and nonovert DIC, compared to, or combined with, other DIC coagulation indicators. RESULTS: When D-D > 3.0 µg/mL was used as the cutoff, the sum of diagnostic sensitivity and specificity reached maximum values for DIC and nonovert DIC, whereas the sum of misdiagnoses and missed diagnosis rate was minimal. Excluding D-D, AT, or Fg, but not TT, from the test combination reduced the diagnostic sensitivity of DIC or nonovert DIC by various degrees. The area under the receiver-operating characteristic curve of D-D for diagnosing DIC and nonovert DIC was 0.97 and 0.98, respectively. Combining two factors, D-D > 3.0 µg/mL and FDP > 10 mg/L, increased the sensitivity and specificity for the diagnosis of DIC and nonovert DIC. CONCLUSION: The cutoff value of D-D is >3.0 µg/mL; combined testing of D-D and FDP could be used as primary screening for diagnosing DIC and nonovert DIC in clinical practice.

Motivators and deterrents to blood donation among Black South Africans: a qualitative analysis of focus group data.

BACKGROUND AND OBJECTIVES: South Africa has a markedly skewed representation where the majority of blood (62%) is presently collected from an ethnically White minority. This study seeks to identify culturally specific factors affecting motivation of donors in South Africa. MATERIALS AND METHODS: We performed a qualitative study to evaluate motivators and deterrents to blood donation among Black South Africans. A total of 13 focus groups, comprising a total of 97 Black South Africans, stratified by age and geographic location were conducted. Transcripts of the interviews were analysed using a coding framework by Bednall & Bove. RESULTS: Participants made 463 unique comments about motivators focusing primarily on promotional communications (28%), incentives (20%) and prosocial motivation (16%). Participants made 376 comments about deterrents which focused primarily on fear (41%), negative attitudes (14%) and lack of knowledge (10%). CONCLUSION: Although prosocial motivation (altruism) was the most frequently mentioned individual motivator, promotional communication elicited more overall comments by participants. As reported by many authors, fear and lack of awareness were strong deterrents, but scepticism engendered by perceived racial discrimination in blood collection were unique to the South African environment.

Aberrant activation of liver X receptors impairs pancreatic beta cell function through upregulation of sterol regulatory element-binding protein 1c in mouse islets and rodent cell lines.

AIMS/HYPOTHESIS: Liver X receptors (LXR) are important transcriptional regulators of lipid and glucose metabolism. Our previous report demonstrated that LXR activation inhibited pancreatic beta cell proliferation through cell cycle arrest. Here we explore the role of LXR activation in beta cell insulin secretion and the underlying mechanism that might be involved. METHODS: Mouse pancreatic islets or insulin-secreting MIN6 cells were exposed to the LXR agonist, T0901317, and insulin secretion, glucose and fatty acid oxidation, and lipogenic gene expression were assessed. The unsaturated fatty acid eicosapentaenoic acid and the dominant negative sterol regulatory element binding protein 1c (SREBP1c) were used to inhibit endogenous SREBP1c and evaluate the involvement of SREBP1c in beta cell dysfunction induced by LXR activation. RESULTS: Treatment with the LXR agonist decreased beta cell glucose sensitivity and impaired glucose-stimulated insulin secretion in vivo and in vitro. This was accompanied by derangements of beta cell glucose oxygen consumption, glucose oxidation, ATP production and intracellular voltage-gated calcium channel flux. LXR activation also regulated the expression of lipid metabolism-related genes such as Fas, Acc (also known as Acaca) and Cpt1a, and led to intracellular lipid accumulation. Further studies revealed that inhibition of SREBP1c abolished LXR activation-induced lipid accumulation and improved beta cell glucose metabolism, ATP production and insulin secretion. CONCLUSIONS/INTERPRETATION: Our data reveal that aberrant activation of LXR reproduced the phenomenon of beta cell dysfunction in the development of type 2 diabetes in vitro and in vivo. Upregulation of SREBP1c production and the lipotoxicity mediated by it played a central role in this process.

In vivo anticancer activity of vanillin semicarbazone.

OBJECTIVE: To evaluate the anticancer activity of vanillin semicarbazone (VSC) against Ehrlich ascites carcinoma (EAC) cells in Swiss albino mice. METHODS: The compound VSC at three doses (5, 7.5 and 10 mg/kg i.p.) was administered into the intraperitoneal cavity of the EAC inoculated mice to observe its efficiency by studying the cell growth inhibition, reduction of tumour weight, enhancement of survival time as well as the changes in depleted hematological parameters. All such parameters were also studied with a known standard drug bleomycin at the dose of 0.3 mg/kg (i.p.). RESULTS: Among the doses studied, 10 mg/kg (i.p.) was found to be quite comparable in potency to that of bleomycin at the dose of 0.3 mg/kg (i.p.). The host toxic effects of VSC was found to be negligible. CONCLUSIONS: It can be concluded that VSC can therefore be considered as potent anticancer agent.

Molecular dynamics simulation of the interfacial structure of [C(n)mim][PF6] adsorbed on a graphite surface: effects of temperature and alkyl chain length.

The structures and diffusion behaviors of a series of ionic liquids [C(n)mim][PF(6)] (n = 1, 4, 8 and 12) on a graphite surface have been investigated by means of molecular dynamics simulation. It was found that three or four ordering layers of ionic liquids were formed near the graphite surface, and this layering structure was stable over the temperature range investigated. At the liquid/vacuum interface, the ionic liquid with a butyl chain had a monolayer ordering surface, while [C(8)mim][PF(6)] and [C(12)mim][PF(6)] exhibited a bilayer ordering with a polar domain sandwiched between two orientational nonpolar domains. More impressively, the simulated results showed that for the ionic liquids with alkyl chains longer than C(4), the adjacent alkyl chains in the whole film tended to be parallel to each other, with the imidazolium rings packed closely together. This indicated that the ionic liquids have a better regulated short-range structure than was previously expected. It was also found that both in the bottom layer and in the bulk region, the diffusion of the alkyl chains was much faster than that of the polar groups. However, as the alkyl chain length increased, the charge delocalization in the cation and the enhanced van der Waals interaction between the nonpolar groups contributed by reducing this difference in the diffusivity of major groups.

A minimally invasive anterior approach to reduction and screw fixation of coronoid fractures.

We investigated a minimally invasive anterior approach to reduce and fix coronoid fractures with a screw in eight consecutive patients and evaluated seven patients at a minimum of 1 year (mean, 78 weeks; range, 61-89 weeks). It was only possible to repair seven of eight coronoid fractures. The average time to radiographic healing was 12 weeks and all healed without the screw loosening, migration or breakage. Endoscopy permitted an excellent view of coronoid fractures, allowing anatomic fixation, and as it avoided extensive soft tissue dissection, this method preserved soft tissue attachments of small coronoid fragments. This method was safe and minimally invasive.

Detection of human viral RNA via a combined fluorescence and SERS molecular beacon assay.

A dual-mode molecular beacon on a multiplexed substrate has been developed and applied to the measurement of unlabeled human viral RNA. The detection system is based on a combined surface-enhanced Raman scattering (SERS) and fluorescent molecular beacon assay that is assembled on Nanobarcodes™ particles. In this assay, a molecular beacon probe terminated with a fluorescent Raman label dye is conjugated to the metallic Nanobarcodes™ particles. The molecular beacon probe is a single-stranded oligonucleotide that has been designed with a hairpin structure that holds the dye at 3'-end close to the particle surface when the probe is attached through a 5'-thiol group. In this configuration, the SERS spectrum of the label was obtained and its fluorescence quenched because the dye is in very close proximity to a noble metal surface with nanoscale features (Nanobarcodes™ particles). The SERS signal decreased and the fluorescence signal increased when target viral RNA was captured by this molecular beacon probe. In addition, a hepatitis C virus reverse transcriptase-polymerase chain reaction (HCV RT-PCR) product was detected using this dual-mode beacon. The development of a multiplexed, label-free assay system with the reassurance offered by detection of two distinctly separate signals offers significant benefits for rapid molecular diagnostics.

Toward proteomics in uroscopy: urinary protein profiles after radiocontrast medium administration.

Previous attempts to use urinary protein profiles for diagnostic purposes have been rather disappointing with respect to their clinical validity, in part because of the insufficient reproducibility, sensitivity, and rapidity of available techniques. Therefore, a newly developed, high-throughput technique, namely surface-enhanced laser desorption/ionization (SELDI) ProteinChip array-time of flight mass spectrometry, was studied, to assess its applicability for protein profiling of urine and to exemplify its use for a group of patients receiving radiocontrast medium. Assessment of the accuracy, sensitivity, and reproducibility of SELDI in test urinary protein profiling was performed. Renal function was studied in 20 male Sprague-Dawley rats before and after intravenous administration of either 1.25 g/kg ioxilan (n = 10) or hypertonic saline solution (n = 10) as a control. Urine samples from 25 patients undergoing cardiac catheterization were obtained before, immediately after, and 6 to 12 h after the procedure. Administration of ioxilan to rats resulted in changes in the abundance of proteins of 9.9, 18.7, 21.0, and 66.3 kD. For patients, even in uncomplicated cases of radiocontrast medium infusion during cardiac catheterization, perturbations in the protein composition occurred but returned to baseline values after 6 to 12 h. Proteins with molecular masses of 9.75, 11.75, 23.5, and 66.4 kD changed in abundance. For patients with impaired renal function, these changes were not reversible within 6 to 12 h. As a proof of principle, one of the peaks, i.e., that at 11.75 kD, was identified as beta(2)-microglobulin. SELDI is a promising tool for the detection, identification, and characterization of trace amounts of proteins in urine. Even for patients without renal complications, proteins with a broad range of molecular masses either appear in or disappear from the urine. Some of these might represent markers of impending nephropathy.

The 100-kda U5 snRNP protein (hPrp28p) contacts the 5' splice site through its ATPase site.

To identify splicing factors in proximity of the 5' splice site (5'SS), we followed a crosslinking profile of site-specifically modified, photoreactive RNA substrates. Upon U4/U5/U6 snRNP addition, the 5'SS RNA crosslinks in an ATP-dependent manner to U6 snRNA, an unidentified protein p27, and the 100-kDa U5 snRNP protein, a human ortholog of an ATPase/RNA helicase yPrp28p. The 5'SS:hPrp28p crosslink maps to the highly conserved TAT motif in proximity of the ATP-binding site in hPrp28p. We propose that hPrp28p acts as a helicase to unwind the 5'SS:U1 snRNA duplex, and at the same time as a 5'SS translocase, which, upon NTP-dependent conformational change, positions the 5'SS for pairing with U6 snRNA within the spliceosome. This repositioning of the 5'SS takes place regardless of whether the 5'SS is originally duplexed with U1 snRNA.

Causes of airway obstruction during cuffed oropharyngeal airway use.

This study investigated the cause for needing airway maneuvers to maintain a patent airway during the use of cuffed oropharyngeal airway (COPA). Twenty adult patients (29.4+/-6.8 years-old, ASA 1-2) scheduled for minor gynecological surgery who required brief manipulations of the airway despite COPA use following the manufacture's guidelines, were enrolled in this study. To obtain airway patency, 15 patients required only the head-tilt maneuver. In eight of the 15 patients, the laryngeal inlet was opened partially (n=4) or completely (n=4). Despite lifting the epiglottis, the laryngeal inlet was incomplete at the level of pharyngeal view. The patency of the laryngeal inlet was decided by the extent of the distance between the posterior pharyngeal wall and the lateral glossoepiglottic fold, which was made by hyoid bone. In the other seven patients, the head-tilt maneuver elevated the epiglottis and completely opened the laryngeal inlet. Five patients required both the jaw-thrust and head-tilt maneuver. Of these patients lifting the epiglottis was incomplete in three and the laryngeal inlet was partially collapsed in one even after the airway manipulations. The airways in these three patients, however, became patent after manipulations despite the persisting partial obstruction.

[Resolution of overlapping chromatographic peaks by radial basis function neural network].

A new algorithm-resolution of overlapping chromatographic peaks by radial basis function neural network(RBFNN) is presented. A two-phase genetic algorithm(GA) which has robustness and random globe optimization is used to train RBFNN so that it has the ability on the resolution of overlapping chromatographic peaks. The two-phase genetic algorithm involves two procedures: training structure and optimizing parameter. The first procedure uses GA to train the architectures of RBFNN, the second procedure uses gradient descent to train the center(tR) and the width(sigma) of RBFNN. The alternate use of these two procedures makes the network having the ability to learn structure, therefore makes itself adaptable to resolution of the chromatographic peaks with unknown number of components. The method proposed here needs no artificial interference, not only has it robustness and globalism, but also the ability of accurate resolution to completely overlapped chromatographic peaks. The simulation experiments show that this method is more accurate than other methods.

[Pulmonary complications following laparoscopic cholecystectomy in patients with abnormal spirometry].

The purpose of this study was to determine the incidence of postoperative pulmonary complications (PPC) and the value of preoperative spirometry to predict PPC after laparoscopic cholecystectomy. Sixty-four of 1372 patients (8%) showed abnormal spirometry data. One out of 1372 patients developed aspiration pneumonia. The patient had high risk factors for serious PPC such as ASA physical status 4.84 y/o, longer anesthesia duration (230 min), multiple brain infarction and low albuminemia. Thirty to 39% of patients with abnormal spirometry showed less severe PPC such as atelectasis, lung collapse and pleural effusion, and incidence was the similar with normal lung function patients. Postoperative blood gas analysis showed a slight increase in arterial carbon dioxide tension during oxygen therapy. However, none of the patients with abnormal spirometry and less severe PPC developed manifest PPC (pneumonia, respiratory failure). Less severe PPC disappeared within second to third postoperative days. We conclude that laparoscopic intervention significantly reduced the incidence of severe PPC and the preoperative spirometry was not recommended in patients with no pulmonary symptoms.

Cardiac arrest associated with use of an argon beam coagulator during laparoscopic cholecystectomy.

We describe a cardiac arrest during use of an argon beam coagulation (ABC) system in an 82-yr-old woman having laparoscopic cholecystectomy under general and epidural anaesthesia. Intra-abdominal pressure (IAP) was controlled to less than 12 mm Hg during a carbon dioxide gas pneumoperitoneum and at first the operation was uneventful. When the ABC system (gas flow 6 litre min(-1)) was used to control local bleeding in the liver bed abdominal pressure increased rapidly to over 20 mm Hg and, 1 min later, the end-tidal carbon dioxide decreased to zero, followed by bradycardia and cardiac arrest. At once, an emergency laparotomy was performed and resuscitation begun. A mill-wheel murmur was heard on auscultation, leading to suspicion of argon gas embolism. Fortunately, recovery was completed with no neurological deficit. Anaesthesiologists should consider showed that argon gas embolism can occur with the ABC system during laparoscopic surgery.