[The treatment strategy and outcome of pregnancy complicated with Stanford type A aortic dissection].

To summarize the clinical characteristics and surgical treatment experience of pregnant women with acute Stanford type A aortic dissection.We collected the clinical data of 12 cases with acute aortic dissection during pregnancy and puerperal period from June 2010 to July 2020 in Beijing Anzhen Hospital and analyzed retrospectively, and summarize the clinical characteristics, treatment and outcomes for both mother and fetus. The age of these patients was(29±5)years old, and the onset time was from 16 weeks of gestation and 1 month after delivery. All the 12 patients underwent surgical treatment. The patients in the puerperium received aortic surgery after delivery. Four of them received the aortic surgery and continued pregnancy. Five of them underwent aortic repair and cesarean section simultaneously. Surgical treatment should be actively considered in pregnancy complicated with acute Stanford type A aortic dissection. Multi-disciplinary team cooperation can effectively improve the safety of the patients and fetus.

Realization and manipulation of ZnO nanorod arrays on sapphire substrates using a catalyst-free metalorganic chemical vapor deposition technique.

Single-crystalline ZnO nanorod arrays (ZNRs) were grown by metalorganic chemical vapor deposition on ZnO buffer/sapphire substrate without using any metal catalyst. The density of vertically aligned ZNRs was found to govern by the morphology and thickness of buffer layer. That is to say, the ZnO buffer layer can be used as the nucleation template to control the growth direction and density of the ZNRs. In addition, by controlling the diethyl zinc flow rate, we can manipulate the size, crystal, and optical quality of ZNRs. Finally, the possible growth mechanism of ZNRs was discussed in detail.

Effects of Growth Conditions on Structural Properties of ZnO Nanostructures on Sapphire Substrate by Metal-Organic Chemical Vapor Deposition.

ZnO was grown on sapphire substrate by metal-organic chemical vapor deposition using the diethylzinc (DEZn) and oxygen (O(2)) as source chemicals at 500 degrees C. Influences of the chamber pressure and O(2)/DEZn ratio on the ZnO structural properties were discussed. It was found that the chamber pressure has significant effects on the morphology of ZnO and could result in various structures of ZnO including pyramid-like, worm-like, and columnar grain. When the chamber pressure was kept at 10 Torr, the lowest full width at half-maximum of ZnO (002) of 175 arc second can be obtained. On the other hand, by lowering the DEZn flow rate, the crystal quality of ZnO can be improved. Under high DEZn flow rate, the ZnO nanowall-network structures were found to grow vertically on the sapphire substrate without using any metal catalysts. It suggests that higher DEZn flow rate promotes three-dimensional growth mode resulting in increased surface roughness. Therefore, some tip on the ZnO surface could act as nucleation site. In this work, the growth process of our ZnO nanowall networks is said to follow the self-catalyzed growth mechanism under high-DEZn flow rate.

Characteristics of ZnO nanowall structures grown on GaN template using organometallic chemical vapor deposition.

Uniformly distributed ZnO nanowall network structures were grown at 550 degrees C by organometallic chemical vapor deposition technique on the GaN/sapphire substrate without using any catalysts. In this research, we discussed the nanostructures and optical properties of ZnO samples grown under the same conditions but on different underlying materials (GaN/sapphire and sapphire). By adjusting the growth parameters, ZnO nanowall networks with a honeycomb-like pattern without using any metal catalysts were successfully fabricated on the GaN/sapphire and sapphire substrates. Since the lattice mismatch between ZnO and GaN is only about 1.8% while the lattice mismatch between ZnO and sapphire is about 18.4%. Lattice mismatch may not be the decisive factor in the formation process of ZnO nanowall networks. The ZnO grown on GaN epilayer had smaller full width at half maximum value than that of ZnO grown under the same growth condition on the sapphire substrate, indicating a higher crystal quality in the sample of ZnO on GaN. The room temperature PL measurement of both ZnO nanostructures grown on GaN and sapphire show strong ultraviolet peak intensity and high intensity ratio of the near band emission to the deep-level emission in a PL spectrum.

Current status of human parasitic infections in Taiwan.

The eradication of the 2 mosquito-borne parasitic diseases, malaria and lymphatic filariasis, is one of the greatest achievements of the parasite control campaigns in Taiwan. Most of the soil-transmitted nematode infections, with the exception of pinworm infection, are currently well controlled and limited to some aboriginal areas. Food-borne parasitic zoonosis such as infections with Angiostrongylus cantonensis, Clonorchis sinensis, and Taenia saginata asiatica are not rare, but the former is seasonal and the latter 2 are ethnically and geographically associated. Intestinal protozoal infections with Giardia lamblia and Cryptosporidium parvum are at low levels but may be widely distributed. Opportunistic protozoal infections among patients with acquired immunodeficiency syndrome, which included amebic colitis, Pneumocystis carinii pneumonia, and cerebral toxoplasmosis, are becoming increasingly important. The rapid increase in international travel and the introduction of large numbers of foreign workers from other countries in Southeast Asia may change the epidemiological patterns of parasitic infections in Taiwan.

Retrovirus-mediated transfer of prothymosin gene inhibits tumor growth and prolongs survival in murine bladder cancer.

To explore the potential use of prothymosin alpha(ProT), a putative thymic hormone, in gene therapy for bladder cancer, we generated a replication-defective recombinant retroviral vector encoding ProT and tested its antitumor effect on the MBT-2 murine bladder cancer. C3H/HeN mice injected with MBT-2 cells in conjunction with retroviruses encoding ProT exhibited smaller tumor mass, lower tumor incidence and higher survival rate, as well as higher antitumor cytotoxic activities compared with those injected with control viruses. However, such effects were not observed in severe combined immunodeficiency mice, suggesting that ProT exerts antitumor effects through its immunomodulatory activities. Cell growth in monolayer culture and colony formation in soft agar were enhanced in ProT gene-modified MBT-2 clones, and such growth-promoting activities of ProT could be reversed if its nuclear localization signal (NLS) was deleted. To circumvent the proliferation-promoting effect of ProT on tumor cells, a retroviral vector encoding ProT lacking NLS was constructed. Our results showed that retroviruses encoding NLS-deleted ProT was more efficacious than those encoding wild-type ProT in prolonging survival of tumor-bearing mice. This is the first report indicating that ProT, in particular NLS-deleted ProT, delivered by retroviral vectors may be further explored for the treatment of bladder cancer.

A case study of cytokine profiles in acute human babesiosis.

The immune response in a patient with acute babesiosis was determined by measurements of lymphocyte subpopulations, serum levels of cytokines, and adhesion molecules. The ratio of CD4+:CD8+ lymphocytes was reduced early in the infection, but returned to a normal value after treatment with azithromycin and quinine. Natural killer (NK) cells markedly increased in the acute phase but progressively decreased and to the normal range in the convalescent phase. Serum levels of tumor necrosis factor-alpha, interferon-gamma, interleukin-2 (IL-2), IL-6, E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 were highly elevated in the acute phase while normal levels of these mediators were observed one month after treatment. These results suggest that CD8+ T cells and NK cells may be involved in the host defense mechanisms against acute babesiosis.

One-tube, nested-PCR assay for the detection of Trichomonas vaginalis in vaginal discharges.

To shorten the time and improve the accuracy of diagnosis of vaginal trichomoniasis, a novel, one-tube, nested PCR, which targets a family of 650-bp specific DNA repeats from the Trichomonas vaginalis genome, has been developed. Samples were prepared by a rapid boiling method and the PCR products analysed by gel electrophoresis. A 290-bp DNA fragment was observed in all positive cases. No cross-reaction with any other pathogens, including the Pentatrichomonas hominis and Giardia lamblia used as controls, was found. Using the assay, one genome-equivalent of T. vaginalis in 20 microliters vaginal discharge can be detected and diagnosis can be made within 6 h. When 165 clinical specimens were examined by wet amount, culture and the PCR assay, 16 were found positive for T. vaginalis by both culture and PCR, whereas only nine of these 16 cases were found to be positive by examination of wet mounts. No PCR-negative cases were positive by wet mount or culture. This new assay appears to be a simple, rapid, accurate and sensitive method for the diagnosis of vaginal trichomoniasis.

Colorimetric one-tube nested PCR for detection of Trichomonas vaginalis in vaginal discharge.

A colorimetric one-tube nested PCR was developed for the detection of Trichomonas vaginalis in clinical vaginal discharge specimens. A family of 650-bp specific DNA repeats from the T. vaginalis genome was targeted. There was no cross-reaction with human DNA or other infectious agents, including Pentatrichomonas hominis and Giardia lamblia. The colorimetric assay was applied as an adjunct to nested PCR for semiquantitative determination of T. vaginalis DNA at levels corresponding to 1 to 1,000 parasites. PCR of samples prepared by a rapid boiling method was as sensitive and specific as PCR of samples prepared by the standard DNA extraction method: the equivalent of one T. vaginalis organism in 20 microliters of vaginal discharge could be detected. The colorimetric nested PCR was compared with wet mount and culture for the detection of T. vaginalis. A total of 378 clinical vaginal discharge specimens from symptomatic patients were examined; 31 patients were positive for T. vaginalis both by culture and by nested PCR. However, only 17 of these 31 patients were positive by wet mount examination. In addition, of 113 asymptomatic patients, 9 were positive for T. vaginalis by nested PCR. Of these nine PCR-positive patients, only two were also positive both by wet mount and by culture, four patients were positive by culture but negative by wet mount, and three patients were negative both by wet mount and by culture. No specimens negative by nested PCR were positive by wet mount or by culture. The three asymptomatic patients with PCR-positive but wet mount- and culture-negative samples were subsequently found to have T. vaginalis infection after repeated and prolonged culture was performed. This colorimetric nested PCR was very sensitive compared with culture for the diagnosis of vaginal trichomoniasis, especially asymptomatic T. vaginalis infection. It is also simple, specific, rapid, and semiquantitative.

Silicone intubation with tissue glue anastomosis in the treatment of congenital nasolacrimal duct obstruction.

BACKGROUND AND OBJECTIVE: To evaluate the advantages of tissue glue application for the anastomosis of silicone intubation in congenital nasolacrimal duct obstruction. PATIENTS AND METHODS: Patients with congenital nasolacrimal duct obstruction were treated with silicone intubation with the aid of tissue glue for end-to-end anastomosis. The recurrence rate, complications, and the need for general anesthesia at tube removal were recorded. RESULTS: The silicone tubes for all 18 eyes studied were removed smoothly on an outpatient basis. Early extrusion was noted in 3 eyes. No recurrence of epiphora was noted in any eye after more than 6 months of follow-up. CONCLUSION: Tissue glue anastomosis is a beneficial modification that avoids the need for general anesthesia during stent removal in children and allows removal to be easily performed in an outpatient clinic.

Generation of interleukin-8 from human monocytes in response to Trichomonas vaginalis stimulation.

Neutrophils are the predominant inflammatory cells found in the vaginal discharges of patients with Trichomonas vaginalis infection. We have investigated the possible role of interleukin-8 (IL-8) in the inflammatory response elicited by T. vaginalis infection. This study has shown that T. vaginalis induces blood monocytes to produce large amounts of bioactive IL-8, mainly by membrane components of T. vaginalis (MTV). Monocyte-derived IL-8 induced by MTV was dose and time dependent. The peak level of IL-8 was 102 +/- 11 ng/ml of conditioned media (mean +/- standard error; n = 5) obtained from MTV-stimulated monocytes (MTVCM) at 36 h of cultivation. With a multichamber chemotactic assay, we found an optimal neutrophil chemotaxis (177 +/- 14 migrated cells) induced by MTVCM collected at 16 h of cultivation when the level of IL-8 was 42 +/- 8 ng/ml. A neutralizing monoclonal antibody directed against IL-8, but not the irrelevant antibodies, significantly blocked the neutrophil chemotactic activity (decreased from 153 +/- 6 to 23 +/- 3 migrated cells; n = 3 [P < 0.001]) induced by MTVCM. Moreover, the maximum increase of the IL-8 mRNA level from MTV-treated monocytes was observed after a 5-h cultivation and decreased thereafter. Monocytes cocultured with MTV in the presence of a neutralizing monoclonal antibody directed against tumor necrosis factor alpha, but not against IL-1 beta, decreased IL-8 production by 25% (P < 0.05), indicating that the release of IL-8 in MTV-stimulated monocytes is partially dependent on tumor necrosis factor alpha. The capacity of MTV-induced monocytes to synthesize IL-8 suggests that these cells can contribute to the induction of the acute inflammatory response seen in T. vaginalis infection.

Influence of humoral immunity on leukotriene B4 production by neutrophils in response to Trichomonas vaginalis stimulation.

Neutrophils are the predominant inflammatory cells found in vaginal discharges from patients with Trichomonas vaginalis infection. In this study, we investigated the effect of humoral immunity on leukotriene B4 (LTB4) generation by neutrophils in the inflammatory response of vaginal trichomoniasis. As quantitated by a radioimmunoassay, no release of LTB4 was detected from neutrophils (5 x 10(6)/ml) interacted with trichomonads (1 x 10(6)/ml). However, specific immunoglobulin G(IgG) but not F(ab')2, at a titre of 1:256 directed against T. vaginalis, augmented LTB4 production (1.4 +/- 0.4 ng/ml, n = 5) by neutrophils, suggesting that this enhancement is Fc gamma receptor-mediated. Moreover, addition of the specific IgG (1 mg/ml) to C2-deficient serum or Factor B-deficient serum, but not C5-deficient serum, significantly increased LTB4 production by neutrophils in response to trichomonad stimulation. This indicates that the complement common pathway activation is crucial for the amplification of host defence mechanisms against T. vaginalis. An LTB4 receptor antagonist, SC-41930, completely abolished neutrophil chemotactic activity induced by LTB4. Taken together, these results indicate that humoral immunity could promote the interaction of neutrophils with T. vaginalis and augment the inflammatory response through the amplification of LTB4 production.

A study on the in vitro susceptibility of Trichomonas vaginalis to metronidazole.

The susceptibility of 32 clinical isolates of Trichomonas vaginalis to metronidazole has been studied under aerobic and anaerobic conditions. Of 32 patients with vaginal trichomoniasis, 27 (84%) were cured by a standard metronidazole treatment regimen (200 mg thrice daily for seven days). The geometric means of minimum inhibitory concentration (MIC) under aerobic and anaerobic conditions for these isolates were 2.0 and 0.4 micrograms/ml, respectively; the geometric means of minimum lethal concentration (MLC) under aerobic and anaerobic conditions were 7.4 and 2.0 micrograms/ml, respectively. However, for those five patients with treatment failure, the geometric means of MIC for these isolates under aerobic and anaerobic conditions were 6.8 and 1.1 micrograms/ml, respectively; the geometric means of MLC under aerobic and anaerobic conditions were 18 and 5.5 micrograms/ml, respectively. Trichomonads reisolated from patients after treatment failure had similar susceptibility to metronidazole as before treatment. However, all five women were cured by a second course of metronidazole treatment. Although primary treatment failure was common when isolates of T. vaginalis had aerobic MLC values of > 18 micrograms/ml or anaerobic MLC values > 5.5 micrograms/ml, two cases with isolates having high MLC values (aerobic: 20 micrograms/ml, anaerobic: 5 micrograms/ml) responded well to the standard treatment. It was evident that no metronidazole-resistant trichomonads were found in this study.

Killing of Trichomonas vaginalis by complement-mediated lysis is not associated with the presence of Trichomonas vaginalis virus.

We have examined the possible relationship between trichomonad killing by human serum and the presence of virus-encoded double-stranded ribonucleic acid in T. vaginalis (TVV). Indirect immunofluorescence assay revealed that non-immune serum (NIS) and T. vaginalis-immune serum (TVIS) had immunoglobulin G (IgG) antibody titres of 1:8 and 1:256, respectively, against T. vaginalis. Among the 12 isolates of T. vaginalis examined, 9 were infected with TVV. Upon long-term (> 9 months) culture, of the 9 infected isolates, 3 isolates lost the virus during the passage process. Five of 9 TVV-infected isolates were completely killed by 10% NIS while the other 4 TVV-infected isolates had viability over the range 22-81%. Three fresh non-TVV-infected isolates had viability over the range 12-89%. On the other hand, no trichomonads survived in the presence of 10% TVIS. Viability of the virus-lost isolates during long-term culture was not altered when compared with that of their corresponding fresh isolates. Heat-inactivated-NIS and -TVIS had no killing effect on trichomonads while absorbed-NIS and -TVIS (ATVIS) had a similar killing effect to NIS. Further studies on the role of antibody and complement in the killing of trichomonads by serum revealed no significant difference in trichomonad viability between treatments of Mg2+-ethylene glycol-bis-(beta-aminoethyl ether)- N,N,N1,N1- tetraacetic acid (Mg(2+)-EGTA)-TVIS and of Mg(2+)-EGTA-ATVIS. Zymosan-treated ATVIS did not kill trichomonads but zymosan-treated TVIS had a marked killing effect.(ABSTRACT TRUNCATED AT 250 WORDS)

A novel neutrophil-activating factor released by Trichomonas vaginalis.

We have investigated the effects of a novel neutrophil-activating factor released by Trichomonas vaginalis (TV-NAF) on neutrophil chemotaxis. TV-NAF was present in the supernatant from 10(7) T. vaginalis (STV) cultured in 1 ml of serum-free Hanks' balanced salt solution (HBSS) at 37 degrees C for 30 min. With a multichamber chemotactic assay, we found that there were 112 +/- 15 migrated neutrophils (mean +/- standard deviation, n = 7) for STV and 11 +/- 4 for HBSS per high-power field (x 400). STV was also able to induce neutrophil actin assembly (increased 1.5-fold), enhance expression of complement receptor type 3 (increased 5-fold), and promote intracellular calcium mobilization (increased 2.5-fold). There was no chemotactic activity in the preparation of STV from killed trichomonads. The fact that heating up to 100 degrees C or deproteinization by treatment with proteinase K at 65 degrees C for 1 h did not abolish its chemotactic activity suggests that the TV-NAF involved was not a protein. The chemotactic activity of TV-NAF was associated with the fraction containing small molecules of less than 3,000 Da. Therefore, the possibility that eicosanoid production by trichomonads is responsible for neutrophil activation was investigated. Leukotriene B4 (LTB4; 500 pg/ml) but not thromboxane B2 (< 20 pg/ml) or prostaglandin E2 (< 8 pg/ml) was found in the STV by radioimmunoassay. Production of LTB4 by trichomonads was time dependent and increased twofold when arachidonic acid (100 microM) was added but was not decreased when eicosanoid inhibitors were present. Evidence for the presence of LTB4 in STV was further provided by the fact that rabbit anti-LTB4 antiserum could abolish the chemotactic activity of STV. These studies suggest that the spontaneous release of TV-NAF, which is most likely LTB4, may activate neutrophils, presumably through a different arachidonate metabolic pathway than that in mammalian cells.

The role of immunoglobulin and complement in enhancing the respiratory burst of neutrophils against Trichomonas vaginalis.

Human neutrophils, alone, did not kill Trichomonas vaginalis. More than 90% of T. vaginalis (10(5)/ml) survived in the presence of 10% normal human serum (NHS) while 90% of these organisms were killed in the presence of a combination of neutrophils (10(6)/ml) and 10% NHS. Mechanisms responsible for this serum-mediated neutrophil killing of T. vaginalis were demonstrated through a process of lucigenin-amplified neutrophil chemiluminescence. As evidenced by indirect immunofluorescence, NHS showed specific immunoglobulin G (IgG) titre of 1:8 for T. vaginalis. Purified IgG, at 1.6 mg/ml, showed no direct opsonizing or lytic effect on this organism. Formalin-fixed trichomonads opsonized by C2 deficient human serum promote 4 times more neutrophil chemiluminescence than those opsonized by Factor B deficient human serum. With the addition of purified IgG (5 mg/ml) neutrophil chemiluminescence was increased by 4 times and further improved trichomonal killing by neutrophils (from 5 +/- 4% to 78 +/- 16%) via activation of the classical complement pathway, but did not alter that due to activation of the alternative complement pathway. These studies indicate that both an IgG-enhanced classical complement pathway activation and an antibody-independent alternative complement pathway activation provide opsonin (C3) for T. vaginalis to facilitate the neutrophil killing mechanism.