Effect of chewing gum on anxiety in women undergoing elective cesarean section: a randomized controlled study.

BACKGROUND: Preoperative anxiety is a common problem in pregnant women undergoing elective cesarean section. We aimed to determine the anxiolytic effects of chewing gum in pregnant women undergoing elective cesarean section under regional anesthesia. METHODS: This was a single-center, prospective, randomized controlled trial. Sixty-six women were randomly assigned to either the control group (n=33) or gum group (n=33) in a 1:1 ratio. In the gum group, the participants chewed xylitol gum for at least 10 min/h, regardless of fasting. Gum chewing was started at 5 pm a day before surgery and continued till the participant entered the operation room. In the control group, participants were requested to follow fasting guidelines without further instruction. The primary outcome was preoperative anxiety measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) immediately before surgery. RESULTS: The APAIS score immediately before surgery showed no significant difference between the control and the gum group (19.2±5.8 vs. 19.1±4.1, P>0.99). There were no statistically significant differences in the eight items related to anxiety: unfitness, concentration difficulty, hunger, thirst, dry mouth, fatigue, headache, and nausea. However, the pain score during the procedure of combined spinal epidural anesthesia was significantly lower in the chewing gum group [4 (IQR, 3-5.5)] than in the control group [5 (IQR, 3-7), P=0.045]. CONCLUSIONS: Preoperative gum chewing did not reduce anxiety levels measured immediately before entering the operating room in the participants undergoing elective cesarean section. TRIAL REGISTRATION: Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp and identifier: KCT0006602; date of registration: September 27, 2021; principal investigator's name: RyungA Kang.

Comparison of two doses of intrathecal morphine in laparoscopic donor hepatectomy: A randomized double-blinded non-inferiority trial.

BACKGROUND: Intrathecal morphine (ITM) injection is an effective postoperative analgesic strategy in open or laparoscopic donor hepatectomy; however, the optimal dose has not been determined. In this trial, we compared the post-operative analgesic effects of two doses (300 vs. 400 µg) of ITM injections. METHODS: In this prospective randomized non-inferiority trial, 56 donors were divided into either the 300 µg or 400 µg ITM group (n = 28, each). The primary outcome was the resting pain score at 24 h postoperatively. Pain scores, cumulative opioid consumption, and side effects (postoperative nausea and vomiting [PONV]) were compared up to 48 h postoperatively. RESULTS: Fifty-five donors participated in the entire study. The mean resting pain scores at 24 h after surgery were 1.7 ± 1.6 and 1.7 ± 1.1 in the ITM 300 and ITM 400 groups, respectively (mean difference, 0 [95% CI, -.8 to .7], p = .978). The upper limit of the 95% CI was lower than the prespecified non-inferiority margin (δ = 1), indicating that non-inferiority had been established. The incidence of PONV was lower in the ITM 300 group than in the ITM 400 group at 18 (p = .035) and 24 h postoperatively (p = .015). There were no significant differences in the resting and coughing pain scores and cumulative opioid consumption at any time point. CONCLUSION: For laparoscopic donor hepatectomy, preoperative ITM 300 µg exhibited non-inferior postoperative analgesic effects compared to ITM 400 µg, with a lower incidence of PONV.

Tetrabromobisphenol A-Induced Apoptosis in Neural Stem Cells Through Oxidative Stress and Mitochondrial Dysfunction.

Tetrabromobisphenol A (TBBPA) is widely used in materials like plastics and textiles as a fire retardant. In a previous study, we reported TBBPA might disrupt hippocampal neurogenesis and neurocognitive function in mice. However, the mechanism responsible for these effects has not been established. The present study was undertaken to investigate the potential involvement of oxidative stress and mitochondrial dysfunction in TBBPA-mediated neurotoxicity in neural stem cells. We confirmed TBBPA was more cytotoxic to neural stem cells than to neurons, astrocytes, or fibroblasts, and found that TBBPA-induced neural stem cell apoptosis was accompanied by increased reactive oxygen species generation and mitochondrial dysfunction. At a molecular level, TBBPA-induced apoptosis was determined to be mediated by c-Jun N-terminal kinase-p53 pathway activation. Taken together, these findings suggest that the adverse effects of TBBPA on hippocampal neurogenesis are due to the inhibition of neural stem cell expansion.

Sensitive neurotoxicity assessment of bisphenol A using double immunocytochemistry of DCX and MAP2.

Bisphenol A (BPA) is an environmental toxin widely used in manufacturing industries. Studies conducted on the neurotoxicity of BPA demonstrated that at excessive, high concentrations (≥ 200 µM) adverse responses occurred which were not detectable using traditional toxicity tests at lower chemical quantities than 200 µM. Thus, a method capable of effectively detecting neurotoxicity at low concentrations (≤ 100 µM) was devised. Bisphenol A-mediated neurotoxicity was examined in primary cultured neurons using various methods, including Western blot, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cytotoxicity and reactive oxygen species assays. These methods confirmed BPA-induced toxicity at 200 µM, but no marked effect was observed at concentrations below 200 µM. However, when immunocytochemistry (ICC) was performed using a co-immunofluorescence assay of doublecortin (DCX) and microtubule-associated protein 2 (MAP2), BPA adversely affected neuronal maturation in neural progenitor cells at concentrations as low as 100 µM, at which the three traditional methods failed to detect any neurotoxic effect. Our DCX/MAP2 ICC findings indicate that low concentrations of BPA are toxic to developing neurons, and suggest that the devised double ICC technique might provide an effective means of assessing neurotoxic effects of environmental toxins at low concentrations.

Learning, memory deficits, and impaired neuronal maturation attributed to acrylamide.

Acrylamide (ACR) is a neurotoxin known to produce neurotoxicity characterized by ataxia, skeletal muscle weakness, cognitive impairment, and numbness of the extremities. Previously, investigators reported that high-dose (50 mg/kg) ACR impaired hippocampal neurogenesis and increased neural progenitor cell death; however, the influence of subchronic environmentally relevant low dose-(2, 20, or 200 µg/kg) ACRs have not been examined in adult neurogenesis or cognitive function in mice. Accordingly, the aim of the present study was to investigate whether low-dose ACR adversely affected mouse hippocampal neurogenesis and neurocognitive functions. Male C57BL/6 mice were orally administered vehicle or ACR at 2, 20, or 200 µg/kg/day for 4 weeks. ACR did not significantly alter the number of newly generated cells or produce neuroinflammation or neuronal loss in hippocampi. However, behavioral studies revealed that 200 µg/kg ACR produced learning and memory impairment. Furthermore, incubation of ACR with primary cultured neurons during the developmental stage was found to delay neuronal maturation without affecting cell viability indicating the presence of developmental neurotoxicity. These findings indicate that although exposure to in vivo low-dose ACR daily for 4 weeks exerted no apparent marked effect on hippocampal neurogenesis, in vitro observations in primary cultured neurons noted adverse effects on learning and memory impairment suggestive of neurotoxic actions.

High dose tetrabromobisphenol A impairs hippocampal neurogenesis and memory retention.

Tetrabromobisphenol A (TBBPA) is a brominated flame retardant that is commonly used in commercial and household products, such as, computers, televisions, mobile phones, and electronic boards. TBBPA can accumulate in human body fluids, and it has been reported that TBBPA possesses endocrine disruptive activity. However, the neurotoxic effect of TBBPA on hippocampal neurogenesis has not yet been investigated. Accordingly, the present study was undertaken to evaluate the effect of TBBPA on adult hippocampal neurogenesis and cognitive function. Male C57BL/6 mice were orally administrated vehicle or TBBPA (20 mg/kg, 100 mg/kg, or 500 mg/kg daily) for two weeks. TBBPA was observed to significantly and dose-dependently reduce the survival of newly generated cells in the hippocampus but not to affect the proliferation of newly generated cells. Numbers of hippocampal BrdU and NeuN positive cells were dose-dependently reduced by TBBPA, indicating impaired neurogenesis in the hippocampus. Interestingly, glial activation without neuronal death was observed in hippocampi exposed to TBBPA. Furthermore, memory retention was found to be adversely affected by TBBPA exposure by a mechanism involving suppression of the BDNF-CREB signaling pathway. The study suggests high dose TBBPA disrupts hippocampal neurogenesis and induces associated memory deficits.

Neuroprotective effects of 2,4-dinitrophenol in an acute model of Parkinson's disease.

Neurons depend on mitochondria for homeostasis and survival, and thus, mitochondrial dysfunction has been implicated in neurodegenerative diseases, including Parkinson's disease (PD). Increasing evidence indicates the mitochondrial uncoupler, 2,4-dinitrophenol (DNP), protects neurons against neurodegeneration and enhances neural plasticity. Here, the authors evaluated the protective effects of intraperitoneally (i.p.) administered low dose DNP in an acute mouse model of PD. Mice were administered DNP (1 or 5mg/kg) for 12 consecutive days, and then on day 13, MPTP (20mg/kg, i.p.) was administered four times (with 2h intervals between injections) to induce PD. It was found that MPTP-induced motor dysfunction was ameliorated in the DNP-treated mice versus vehicle-treated controls. Additionally, DNP effectively attenuated dopaminergic neuronal loss observed in MPTP treated mice. Moreover, in primary cultured neurons, DNP at 10µM, but not at 100µM, prevented MPP+-induced cell death and mitochondrial membrane potential (MMP) reduction. In addition, DNP was observed to cause the nuclear translocation of Nrf2 in primary neurons. Taken together, these findings of the present study suggest that DNP protects dopaminergic neurons against neurodegeneration and maintains MMP integrity in PD by activating adaptive stress responses.

Neuroprotective and anti-inflammatory effects of morin in a murine model of Parkinson's disease.

Parkinson's disease (PD) is one of the most common neurodegenerative disorders and is characterized by loss of dopaminergic neurons in the substantia nigra (SN). Although the causes of PD are not understood, evidence suggests that oxidative stress, mitochondrial dysfunction, and inflammation are associated with its pathogenesis. Morin (3,5,7,2',4'-pentahydroxyflavone) is a flavonol found in wine and many herbs and fruits. Previous studies have suggested that morin prevents oxidative damage and inflammation and ameliorates mitochondrial dysfunction. The present study describes the neuroprotective effects of morin in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of PD, and we report the results of our investigation into its neuroprotective mechanism in primary neurons and astrocytes. In the mouse model, morin pretreatment ameliorated motor dysfunction, protected against dopaminergic neuronal losses in SN and striatum, and alleviated MPTP-induced astrocyte activation. In vitro studies revealed that morin protected primary cultured neurons against 1-methyl-4-phenylpyridine (MPP(+) )-mediated reactive oxygen species production and mitochondrial membrane potential (MMP) disruption. In addition, morin effectively reduced MPP(+) -induced astroglial activation and nuclear translocation of nuclear factor-κB in primary cultured astrocytes. These results indicate that morin acts via multiple neuroprotective mechanisms in our mouse model and suggest that morin be viewed as a potential treatment and preventative for PD. © 2016 Wiley Periodicals, Inc.

Methylglyoxal Causes Cell Death in Neural Progenitor Cells and Impairs Adult Hippocampal Neurogenesis.

Methylglyoxal (MG) is formed during normal metabolism by processes like glycolysis, lipid peroxidation, and threonine catabolism, and its accumulation is associated with various degenerative diseases, such as diabetes and arterial atherogenesis. Furthermore, MG has also been reported to have toxic effects on hippocampal neurons. However, these effects have not been studied in the context of neurogenesis. Here, we report that MG adversely affects hippocampal neurogenesis and induces neural progenitor cell (NPC) death. MG significantly reduced C17.2 NPC proliferation, and high concentration of MG (500 µM) induced cell death and elevated oxidative stress. Further, MG was found to activate the ERK signaling pathway, indicating elevated stress response. To determine the effects of MG in vivo, mice were administrated with vehicle or MG (0.5 or 1 % in drinking water) for 4 weeks. The numbers of BrdU-positive cells in hippocampi were significantly lower in MG-treated mice, indicating impaired neurogenesis, but MG did not induce neuronal damage or glial activations. Interestingly, MG reduced memory retention when administered to mice at 1 % but not at 0.5 %. In addition, the levels of hippocampal BDNF and synaptophysin were significantly lower in the hippocampi of mice treated with MG at 1 %. Collectively, our findings suggest MG could be harmful to NPCs and to hippocampal neurogenesis.

Magnetic resonance visualization of surgical classification of rotator cuff tear: comparison with three-dimensional shoulder magnetic resonance arthrography at 3.0 T.

The purpose was to evaluate the diagnostic feasibility of magnetic resonance arthrography (MRA) for surgical classification of rotator cuff tear (RCT). Two-dimensional (2D)/three-dimensional (3D) MRAs of 45 patients who underwent and subsequent arthroscopy were evaluated. Full-thickness tears of supraspinatus-infraspinatus tendon were classified based on surgical categories: crescentic, U-shaped, and L-shaped. Signal-to-noise ratios showed no significant difference (P>.05); however contrast-to-noise ratios were significantly higher on 2D MRA (P=.02). Diagnoses of RCTs using 3D MRA were similar to diagnoses using 2D MRA, but had a shorter imaging time. MR visualization for surgical classification was feasible. However, diagnosis of L-shaped tears was limited.

White blood cell differential counts in severely leukopenic samples: a comparative analysis of different solutions available in modern laboratory hematology.

BACKGROUND: We evaluated the efficacy of white blood cell (WBC) differential counts in severely leukopenic samples by the Hematoflow method and by automated hematology analyzers and compared the results with manual counts. METHODS: EDTA-anticoagulated blood samples (175 samples) with WBC counts of 40-990/µL were selected. Hematoflow differential counts were performed in duplicates employing flow cytometry using the CytoDiff reagent and analysis software. Differential counts were also performed using the DxH 800 (Beckman Coulter) and XE-2100 (Sysmex) automated hematology analyzers. The sum of the manual counts by a hematology technician and a resident were used as the manual counts. RESULTS: The total analysis time and hands-on time required by the Hematoflow method were shorter than those required by manual counting. Hematoflow counts were reproducible, showed a good correlation with automated analyzers, and also showed strong correlation with manual counts (r > 0.8) in neutrophils, lymphocytes, and monocytes. None of the cases containing less than 4% blasts as analyzed by the Hematoflow method had blasts in the manual counts, but 8 cases of 21 cases (38.1%) with over 4% blasts by Hematoflow had blasts in manual counts. CONCLUSION: Hematoflow counts of severely leukopenic samples were reproducible and showed a good correlation with manual counts in terms of neutrophil, lymphocyte, and monocyte counts. The Hematoflow method also detected the presence of blasts. Manual slide review is recommended when over 4% blasts are found by Hematoflow.

Positive predictive value of additional synchronous breast lesions in whole-breast ultrasonography at the diagnosis of breast cancer: clinical and imaging factors.

PURPOSE: To evaluate the positive predictive value (PPV) of bilateral whole-breast ultrasonography (BWBU) for detection of synchronous breast lesions on initial diagnosis of breast cancer and evaluate factors affecting the PPV of BWBU according to varying clinicoimaging factors. METHODS: A total of 75 patients who had synchronous lesions with pathologic confirmation at the initial diagnosis of breast cancer during January 2007 and December 2007 were included. The clinical factors of the patients were evaluated. One observer retrospectively reviewed the imaging studies of the index breast cancer lesion and the synchronous lesion. The PPV for additional biopsy was calculated for BWBU and various clinical and imaging factors affecting the PPV for BWBU were evaluated. RESULTS: The overall PPV for additional biopsy was 25.7% (18 of 70). The PPV for synchronous lesions detected both on mammography and BWBU, and detected only on BWBU, was 76.9% (10 of 13) and 14.3% (7 of 49), respectively. There was no clinical factor affecting the PPV for BWBU. Among the imaging factors, ipsilateral location of the synchronous lesion to the index lesion (P=0.06) showed a marginal statistically significant correlation with malignancy in the synchronous breast lesion. A mass with calcification on mammography presentation (P<0.01), presence of calcification among the ultrasonography findings (P<0.01), and high Breast Imaging Reporting and Data System final assessment (P<0.01) were imaging factors that were associated with malignancy in the additional synchronous lesion. CONCLUSION: BWBU can detect additional synchronous malignancy at the diagnosis of breast cancer with a relatively high PPV, especially when mammography findings are correlated with ultrasonographic findings.

Analysis of immunoglobulin and T cell receptor gene rearrangement in the bone marrow of lymphoid neoplasia using BIOMED-2 multiplex polymerase chain reaction.

The evaluation of bone marrow (BM) involvement is important for diagnosis and staging in patients with lymphoid neoplasia. We evaluated of immunoglobulin (Ig) and/or T-cell receptor (TCR) gene rearrangements in the BM using the standardized BIOMED-2 multiplex PCR clonality assays and compared the results with microscopic findings such as histology and CD10, CD20, CD79a, CD3 and CD5 immunohistochemistry. A total of 151 samples were enrolled; 119 B cell neoplasia, 29 T cell neoplasia, and 3 Hodgkin's lymphoma. The molecular clonality assay and microscopic diagnosis were concordant in 66.9% (n=101) and discordant in 33.1 % (n=50). Ig/TCR gene clonality assay detected 43 cases of BM involvement which was not presented in the morphology. Two cases among them turned into microscopic BM involvement during a close follow up. Clonal TCR gene rearrangements were detected in 12.6% of B cell neoplasia and Ig gene rearrangement were found in 3.4% of T cell neoplasia. This molecular clonality assay is valuable particularly in diagnosing BM involvement of lymphoid neoplasia if it is morphologically uncertain. But it should be carefully interpreted because molecular clonality may be present in the reactive lymphoproliferation. Therefore, comprehensive analysis with morphologic analysis should be important to reach a final diagnosis.

Mean corpuscular volume (MCV) values reflect therapeutic effectiveness in zidovudine-receiving HIV patients.

BACKGROUND: An increase of the mean corpuscular volume (MCV) of erythrocytes and alterations in the lipid profiles have been described in HIV-infected patients under combination of anti-retroviral treatment (cART), particularly zidovudine (AZT). METHODS: In 687 sera from 179 HIV-positive patients, MCV levels were correlated with the clinical outcome or therapeutic effectiveness. The sera were classified into three groups according to AZT treatment; cART with AZT (n = 317), cART without AZT (n = 262), and no anti-retroviral therapy (n = 108). RESULTS: The MCV and lipid profile values were increased after cART. The AZT-based cART group had higher MCV levels (111.6 ± 7.0 vs. 97.8 ± 7.0 fl, P < 0.001) and a higher incidence of macrocytosis (>99 fl; 95.3% vs. 38.2%, P < 0.001) than the non-AZT-based cART group. The receiver operating characteristic curve analysis showed that the area under the curve was 0.835 and the cut-off of MCV (>102 fl) had a sensitivity of 96.1% and specificity of 66.7% for detecting HIV-RNA (-) sera in AZT-based cART group. In the multivariate regression analysis, HIV-viral load and HDL-cholesterol were the only significant correlates to the MCV values in the AZT-base cART group (P < 0.05). CONCLUSION: The MCV values could be used as a surrogate marker to monitor the clinical outcome of HIV-infected patients receiving AZT-based cART.

Glioma grading capability: comparisons among parameters from dynamic contrast-enhanced MRI and ADC value on DWI.

OBJECTIVE: Permeability parameters from dynamic contrast-enhanced MRI (DCE-MRI) and apparent diffusion coefficient (ADC) value on diffusion-weighted imaging (DWI) can be quantitative physiologic metrics for gliomas. The transfer constant (K(trans)) has shown efficacy in grading gliomas. Volume fraction of extravascular extracellular space (ve) has been underutilized to grade gliomas. The purpose of this study was to evaluate ve in its ability to grade gliomas and to assess the correlation with other permeability parameters and ADC values. MATERIALS AND METHODS: A total of 33 patients diagnosed with pathologically-confirmed gliomas were examined by 3 T MRI including DCE-MRI and ADC map. A region of interest analyses for permeability parameters from DCE-MRI and ADC were performed on the enhancing solid portion of the tumors. Permeability parameters form DCE-MRI and ADC between low- and high-grade gliomas; the diagnostic performances of presumptive metrics and correlation among those metrics were statistically analyzed. RESULTS: High-grade gliomas showed higher K(trans) (0.050 vs. 0.010 in median value, p = 0.002) and higher ve (0.170 vs. 0.015 in median value, p = 0.001) than low-grade gliomas. Receiver operating characteristic curve analysis showed significance in both K(trans) and ve for glioma grading. However, there was no significant difference in diagnostic performance between K(trans) and ve. ADC value did not correlate with any of the permeability parameters from DCE-MRI. CONCLUSION: Extravascular extracellular space (ve) appears to be comparable with transfer constant (K(trans)) in differentiating high-grade gliomas from low-grade gliomas. ADC value does not show correlation with any permeability parameters from DCE-MRI.

Experience at 1 year with the moving tip technique of radiofrequency ablation for the treatment of symptomatic venous malformations in the head and neck.

PURPOSE: To evaluate the effectiveness and safety of performing radiofrequency ablation (RFA) using the moving tip technique to treat venous malformations (VMs) in the head and neck. METHODS: Ten patients (male:female ratio, 2:8; median age, 38 years; age range, 27-59 years) prospectively underwent RFA using the moving tip technique as the first treatment. Improvement of their clinical symptoms, volume reduction of the treated VMs as determined by ultrasound (US) or magnetic resonance imaging (MRI), and any patient complications were evaluated at 1, 3, 6, and 12 months after RFA. RESULTS: All patients underwent follow-up examinations 12 months after RFA. The following criteria were used to evaluate these patients: (1) symptomatic VMs were diagnosed by US, MRI, and the patients' clinical history; (2) superficially located VMs were evaluated using a linear 12-MHz US probe to determine the tumor volume; and (3) localized and limited VMs were evaluated using the Hamburg classification. The mean symptom score of the 10-cm visual analog scale and the mean volume reduction of the VMs as measured by MRI at the 6-month follow-up examination were significantly decreased from 8.0 (range, 7.0-9.0) to 2.0 (range, 1.0-3.0) and from 18.8 (range, 8.3-28.2) cm(3) to 8.5 (range, 4.2-14.1) cm(3), respectively (P < .05). No major patient complications were noted. CONCLUSIONS: RFA using the moving tip technique is an effective and safe method for treating localized VMs in the head and neck.

Determination of optimal imaging mode for ultrasonographic detection of subdermal contraceptive rods: comparison of spatial compound, conventional, and tissue harmonic imaging methods.

OBJECTIVE: To determine which mode of ultrasonography (US), among the conventional, spatial compound, and tissue-harmonic methods, exhibits the best performance for the detection of Implanon® with respect to generation of posterior acoustic shadowing (PAS). MATERIALS AND METHODS: A total of 21 patients, referred for localization of impalpable Implanon®, underwent US, using the three modes with default settings (i.e., wide focal zone). Representative transverse images of the rods, according to each mode for all patients, were obtained. The resulting 63 images were reviewed by four observers. The observers provided a confidence score for the presence of PAS, using a five-point scale ranging from 1 (definitely absent) to 5 (definitely present), with scores of 4 or 5 for PAS being considered as detection. The average scores of PAS, obtained from the three different modes for each observer, were compared using one-way repeated measure ANOVA. The detection rates were compared using a weighted least square method. RESULTS: Statistically, the tissue harmonic mode was significantly superior to the other two modes, when comparing the average scores of PAS for all observers (p < 0.00-1). The detection rate was also highest for the tissue harmonic mode (p < 0.001). CONCLUSION: Tissue harmonic mode in uS appears to be the most suitable in detecting subdermal contraceptive implant rods.

Diffuse interstitial infiltrative lung metastasis of malignant melanoma: a case report.

A diffuse interstitial infiltrative pattern of lung metastasis in a patient with malignant melanoma is rare and can be confused with benign conditions such as pulmonary edema or drug-induced pneumonitis. We experienced a case of diffuse interstitial infiltrative lung metastasis in malignant melanoma in a 37-year-old man. This case was confirmed by a transbronchial lung biopsy. We herein describe the findings on CT and positron emission tomography scan.

Characterization of antigenic determinants in ApxIIA exotoxin capable of inducing protective immunity to Actinobacillus pleuropneumoniae challenge.

Actinobacillus pleuropneumoniae is the causative agent of porcine pleuropneumonia. Among the virulence factors of the pathogen, ApxIIA, a bacterial exotoxin, is expressed by many serotypes and presents a plausible target for vaccine development. We characterized the region within ApxIIA that induces a protective immune response against bacterial infection using mouse challenge model. Recombinant proteins spanning the length of ApxIIA were produced and antiserum to the full-length ApxIIA was induced in mice. This antiserum recognized fragments #2, #3 and #5 with high binding specificity, but showed poor recognition for fragments #1 and #4. Of the antisera induced in mice by injection of each fragments, only the antiserum to fragment #4 failed to efficiently recognize the full-length antigen, although the individual antisera recognized their cognate antigens with almost equal efficiency. The protective potency of the immunogenic proteins against a challenge injection of bacteria in vivo correlated well with the antibody titer. Fragment #5 induced the highest level of protective activity, comparable to that by the full-length protein. These results support the use of fragment #5 to produce a vaccine against A. pleuropneumoniae challenge, since the small antigen peptide is easier to handle than is the full-length protein and can be expressed efficiently in heterologous expression systems.

Newly designed flexible electrode for laparoscopic radiofrequency ablation: ex vivo and in vivo comparative studies with needle electrode in a porcine liver as technical study.

BACKGROUND: To compare the efficiency of radiofrequency ablation (RFA) using the newly designed flexible laparoscopic radiofrequency electrode and the internally cooled needle electrode for creating an ablation zone in ex vivo and in vivo porcine livers. MATERIALS AND METHODS: In the ex vivo ablation zone, 40 ablation areas were created using the flexible electrode (group A, n=5) and the needle electrode of the Cool-tip RF system (group B, n=5). These were done in an excised porcine liver with a 200 W generator. In each group, ablation durations were 3, 6, 9, and 12 min, respectively. The volume was compared in each group. In the in vivo ablation zone, under laparoscopy, we divided the surface of the porcine liver into four areas: anterior, cranial, right lateral, and caudal. At each area, a couple of RFA using the flexible and needle electrodes with 6 min ablation duration was performed, respectively, in line with 3 cm intervals in five porcine livers. A flexible electrode was administered in the peritoneal cavity via a laparoscopic cannula, and a needle electrode was administered via a transcutaneous route, which avoided a pulmonary injury. The volumes and shapes of the ablation zones in each group and area were compared in the excised liver. RESULTS: In the ex vivo experiments, the ablation volumes using the flexible and needle electrodes with 3, 6, 9, and 12 min ablation duration were 3.19±0.41 cm(3), 6.36±0.48 cm(3), 7.66±0.51 cm(3), 8.72±0.78 cm(3) (Group A) and 3.40±0.35 cm(3), 6.83±0.66 cm(3), 7.79±0.56 cm(3), 8.85±0.54 cm(3) (Group B). There was no statistical significance among all the ablated volumes in each group at the same duration. In the in vivo experiment, the differences in the short diameter and the volume of ablated zones in the caudal and right lateral areas were statistically significant (P<0.05). In the cranial, right lateral, and caudal areas, the shape of the ablated zone using the needle electrode was elliptical. However, the ablated zone using the flexible electrode was spherical. The difference of the long and short diameter ratio in the cranial and right lateral areas was statistically significant (P<0.05). CONCLUSION: The newly designed flexible laparoscopic RF electrode shows similar efficacies compared with the needle electrode in the ex vivo study. However, it shows superiority in efficacy and predictability with the increased volume and predictable shape of coagulation necrosis at the laparoscopic RFA in the porcine liver.