Vitamin D deficiency in Parkinson's disease patients with orthostatic hypotension.

OBJECTIVES: The purpose of our study was to investigate the associations between serum vitamin D3 levels and orthostatic hypotension (OH) in patients with Parkinson's disease (PD). MATERIALS AND METHODS: Fifty-five patients with PD were enrolled in this study. Blood pressure (BP) measurements were gathered while the patients were in the supine position and while standing up. Then, the patients were divided into two groups: PD patients with and without OH. We compared the levels of serum 25-hydroxyvitamin D3 and 1, 25-dihydroxyvitamin D3 (calcitriol) between the two groups. RESULTS: Serum 25-hydroxyvitamin D and calcitriol levels were significantly decreased in patients with OH compared with those without OH. The systolic and diastolic BPs and symptom severities significantly negatively correlated with the serum 25-hydroxyvitamin D and calcitriol levels. CONCLUSIONS: Although the underlying mechanism for this association is not fully understood, our results suggest that low vitamin D status is associated with OH in patients with PD.

Pleural cancer antigen-125 levels in benign and malignant pleural effusions.

OBJECTIVE: To examine the properties of mesothelial cells by measuring pleural cancer antigen 125 (CA-125) levels in different types of benign and malignant pleural effusions. DESIGN: In this retrospective study, pleural fluid was collected from 326 patients; pleural CA-125 levels were measured using radioimmunoassay. Patients were classified into five groups according to the aetiology of pleural effusions: I) tuberculosis, II) malignant, III) pyogenic, IV) congestive heart failure, and V) hepatic hydrothorax. RESULTS: CA-125 levels were significantly higher in the malignant group than in all benign groups. There was no difference in pleural CA-125 levels between transudate and exudate benign aetiologies. Although pleural CA-125 levels were significantly higher in malignant than benign effusions, about one third of malignant pleural effusions had levels of <600 U/ml. Among malignancies, there were no significant differences in pleural CA-125 levels between histological types. CONCLUSION: CA-125 levels in benign pleural effusions may not be influenced by pleural inflammation or hydrostatic or oncotic pressure changes. Pleural CA-125 levels may not be influenced by the histological type of tumour in malignant pleural effusions, suggesting that mesothelial cell properties may not be altered by these factors in the pleural space.

The susceptibility of magpies to a highly pathogenic avian influenza virus subtype H5N1.

Korean wild magpies (Pica pica sericea) were intranasally inoculated with highly pathogenic avian influenza (A/Chicken/Korea/ES/03 virus) (H5N1), which was classified as clade 2.5. We estimated viral replication, death after infection, and histology and immunohistochemistry. This species was highly susceptible to severe infection; 100% of birds died within 5 to 8 d. The virus was detected from oropharyngeal (1 to 5 d postinfection) and cloacal (3 to 5 d postinfection) swabs from infected magpies. At necropsy, the prominent lesions were coalescing necrosis of the pancreas with enlargement of livers and spleens. Microscopically, pancreas, brain, heart, adrenal gland, and kidney were most consistently affected with necrotic and inflammatory changes, and viral antigen was frequently demonstrated in the parenchyma of these organs. As a result, Korean wild magpies were very susceptible to avian influenza (H5N1) virus.

Atypical radiological manifestations of pulmonary Langerhans cell histiocytosis in a 12-year-old girl.

Pulmonary Langerhans cell histiocytosis is a rare pulmonary disease that typically affects cigarette smokers from 30-40 years of age onwards. It is very rare in children, especially for those under 15 years of age. We report an atypical radiological manifestation of isolated pulmonary Langerhans cell histiocytosis in a 12-year-old girl that showed multifocal consolidation and multiple small nodules on an initial chest radiograph, and gradual fibrotic change with multiple cysts on follow-up chest radiographs and CT scans.

Rectal carcinoid tumor in a renal transplant patient.

Malignancy represents a leading cause of morbidity and mortality in patients with a long-term surviving graft. Carcinoid tumor is a common primary endocrine tumor in the general population that is rare in transplant recipients. Our present report focused on a 48-year-old man who received immunosuppressive therapy based on cyclosporine and steroids. Twelve years after renal transplantation, he suffered watery diarrhea and abdominal discomfort. Colonoscopy showed a hard, sessile mass at 5 cm from the anal verge; endoscopic ultrasound showed a 13-mm homogenous hypoechoic mass. Upon endoscopic biopsy, the histological examination revealed a carcinoid tumor. Immunosuppresion was reduced and we performed endoscopic mucosal resection of the rectum. His clinical course has been good with no demonstrated recurrence.

Diagnostic value of brain MRI and 18F-FDG PET in the differentiation of Parkinsonian-type multiple system atrophy from Parkinson's disease.

BACKGROUND AND PURPOSE: Differentiation between parkinsonian type multiple system atrophy (MSA-P) and Parkinson's disease (PD) is important but often difficult. We investigated the diagnostic value of brain magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) in differentiating MSA-P from PD. METHODS: Twenty-four patients with MSA-P (16 probable and 8 possible) and eight patients with PD were included in this study. RESULTS: For analysis using the putaminal findings, the sensitivities were 58.3% by visual analysis of brain MRI, 95.8% by visual analysis of (18)F-FDG PET, and 79.2% by statistical parametric mapping (SPM) analysis of (18)F-FDG PET in differentiating MSA-P from PD; the specificity was 100% for each analysis. Using the putaminal findings, visual analysis of (18)F-FDG PET had a higher sensitivity compared with brain MRI (P = 0.004) and SPM analysis of (18)F-FDG PET revealed a tendency towards higher sensitivity compared with brain MRI (P = 0.063). For analysis using both putaminal and infratentorial findings, the sensitivities were 79.2% by visual analysis of brain MRI, 95.8% by visual analysis of (18)F-FDG PET, 95.8% by SPM analysis of (18)F-FDG PET in differentiating MSA-P from PD; the specificity was 100% for each analysis. CONCLUSION: Both brain MRI and (18)F-FDG PET showed diagnostic usefulness in differentiating MSA-P from PD, with (18)F-FDG PET being more sensitive than brain MRI.

A model of the effect of temperature on the growth of pathogenic and nonpathogenic Vibrio parahaemolyticus isolated from oysters in Korea.

Vibrio parahaemolyticus is recognized as the leading cause of human gastroenteritis associated with the consumption of seafood. The objective of this study was to model the growth kinetics of pathogenic and nonpathogenic V. parahaemolyticus in broth and oyster slurry. Primary growth models of V. parahaemolyticus in broth and oyster slurry fit well to a modified Gomperz equation (broth R(2)=0.99; oyster slurry R(2)=0.96). The lag time (LT), specific growth rate (SGR), and maximum population density (MPD) of each primary model were compared. The growth of nonpathogenic V. parahaemolyticus was found to be more rapid than that of pathogenic V. parahaemolyticus, regardless of the model medium. In addition, significant (P<0.05) differences in the growth kinetics between pathogenic and nonpathogenic V. parahaemolyticus in broth were observed at 10 degrees C. When compared to growth in broth, the growth of V. parahaemolyticus was delayed in oyster slurry, and growth was not observed at 10 or 15 degrees C. The Davey and square root models were identified as appropriate secondary models for predicting the LT and SGR, respectively. For the broth model, the average B(f) and A(f) values for LT were found to be 0.97 and 1.3, respectively, whereas the average B(f) and A(f) values for SGR were 1.05 and 1.11, respectively. The model generated in this study predicted an LT that was shorter and an SGR that was similar to those that were actually observed, which indicates that these models provide a reliable and safe prediction of V. parahaemolyticus growth.

Multicenter phase II study of docetaxel plus oxaliplatin combination chemotherapy in patients with advanced gastric cancer: Daegu Gyeongbuk Oncology Group.

The present study was conducted to evaluate the efficacy and safety of a combination regimen of docetaxel plus oxaliplatin in patients with advanced gastric cancer. Patients with previously untreated metastatic or recurrent, measurable gastric cancer received intravenous docetaxel 65 mg m(-2) plus oxaliplatin 120 mg m(-2) on day 1 based on a 3-week cycle. Forty-two patients were enrolled in the current study, among whom 39 were assessable for efficacy and all assessable for toxicity. One complete response and 18 partial responses were confirmed, giving an overall response rate of 45.2% (95% confidence interval (CI); 31.7-59.7%). At a median follow-up of 7.7 months, the median time to progression and median overall survival was 5.7 (95% CI; 4.3-7.2) months and 9.9 (95% CI; 7.8-12.0) months, respectively. Grade 3/4 neutropenia occurred in 11 patients (26.1%) and febrile neutropenia was observed in four patients (9.5%). The common non-haematologic toxicity was fatigue (grade 1/2, 61.9%) and nausea (grade 1/2, 47.7%). The combination of docetaxel and oxaliplatin was found to be well tolerated and effective in patients with advanced gastric cancer.

A molecule carrier.

We found that anthraquinone diffuses along a straight line across a flat, highly symmetric Cu111 surface. It can also reversibly attach one or two CO2 molecules as "cargo" and act as a "molecule carrier," thereby transforming the diffusive behavior of the CO2 molecules from isotropic to linear. Density functional theory calculations indicated a substrate-mediated attraction of approximately 0.12 electron volt (eV). Scanning tunneling microscopy revealed individual steps of the molecular complex on its diffusion pathway, with increases of approximately 0.03 and approximately 0.02 eV in the diffusion barrier upon attachment of the first and second CO2 molecule, respectively.

Measurement of a linear free energy relationship one molecule at a time.

A systematic study of the dehydrogenation of substituted thiophenols by controlled charge injection from the tip of a scanning tunneling microscope (STM) reveals a pronounced dependence of the reaction yield on the position and the chemical nature of the substituent. We evaluate the dehydrogenation rate of para-halo-substituted species within a linear free energy relationship, namely the Hammett equation. The resultant rho value of 1.4 can faithfully predict the reaction rates of molecules that are meta-halo-substituted or para-methyl-substituted. The positive sign of rho suggests a negatively charged transition state at the core of the STM-induced process, and the magnitude of the rho value indicates that the presence of the substrate does not preclude substantial substituent effects. The applicability of the Hammett equation to single-molecule chemistry offers facile prediction of the rate of STM-based single-molecule chemistry in a field, which so far has been addressed by focusing on involved quantum-mechanical modeling of its underlying processes.

Halogen-substituted thiophenol molecules on Cu(111).

Para-halosubstituted thiophenols (X-TPs, where X is Br, Cl, or F) form ordered islands and monolayers on Cu(111) at temperatures as low as 81 K. At incomplete coverages, all X-TPs adsorb with the dehydrogenated thiol group attached to the substrate and the substituted ring inclined toward the surface, as verified experimentally and theoretically. The structure of ordered islands has a pronounced dependence on the nature of the halogen substituent: while unsubstituted TP and pentafluoro-TP molecules do not self-assemble into extended ordered patterns at 81 K, X-TP molecules form a range of different structures which depend both on the size and electronegativity of the substituent, as well as on the coverage.

Comparison of canine single and sequential bilateral lung transplant model for lung preservation study.

The purpose of this study was to compare canine sequential bilateral lung transplantation (SBLT) with left single lung transplant (LSLT) models. After 24 hours of lung preservation with low potassium/dextran glucose (LPDG) solution, seven SBLT procedures were performed using mongrel dogs. The comparative group including nine cases of LSLT. After completion of each transplant, the dogs were maintained on a ventilator for 3 hours. Thereafter serial hemodynamics were evaluated with recipients with chest X-ray, computed tomography, and lung perfusion scan checked at 2 hours after transplantation. Pathological evaluations were also performed. Five of seven SBLT successfully completed the whole assessment, all LSLT survived. In SBLT, pulmonary arterial pressure and pulmonary vascular resistance were significantly elevated, but recovered 3 hours after reperfusion. The ultrastructural aspects of alveolae and pulmonary artery endothelium showed a reversible mild injury 24 hours after lung preservation and reperfusion. The present study suggests that the canine SBLT model using LPDG solution provides an excellent preservation effect and is more physiological as the dog is completely dependent on the function of the transplanted lung.

Pulmonary preservation effect of nitroglycerine in isolated rat lung reperfusion model.

PURPOSE: Though nitric oxide has many favorable protective effects on donor lungs, it may also have cytotoxic side effects. In this regard, we investigated whether administration of nitroglycerine, a nitric oxide donor, could minimize ischemia-reperfusion injury in an isolated rat lung reperfusion model. MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats were used for this experiment. The nitroglycerine (NTG) group (n = 18) received the drug intravenously and the 17 control group hosts were treated with the same amount of normal saline. The heart-lung block was retrieved, weighed, and maintained in University of Wisconsin solution for 24 hours at 10 degrees C. Reperfusion was performed using human blood diluted in Krebs-Hensleit solution for 60 minutes. Peak inspiratory pressure, pulmonary artery pressure, and blood gas analysis were performed. After 60 minutes of reperfusion, the amount of protein in bronchoalveolar lavage (BAL) fluid and the myeloperoxidase (MPO) activity in the lung were measured. RESULTS: There were no major statistical differences between the two groups in peak inspiratory pressure and pulmonary artery pressure, but the NTG group maintained lower pulmonary artery pressure during the whole period of reperfusion. Oxygen tension in the NTG group was significantly higher, whereas there were no differences in carbon dioxide tension, BAL fluid, protein, or MPO activity. CONCLUSION: Administration of NTG before donor lung preservation resulted in better lung protection, a possible strategy for clinical application.

Ultrastructural evaluation of the protective effect of nitroglycerin in preservation-reperfusion injury of rat lungs.

AIM OF STUDY: Nitric oxide (NO) has been reported as a favorable protective supplement in donor lung preservation, but related ultrastructural studies are rare in the literature. This study was performed to assess the ultrastructural changes and to evaluate the protective effect of NO as donor nitroglycerin (NTG) treatment of ischemia-reperfusion injury in rat lungs. MATERIALS AND METHODS: Fifteen Sprague-Dawley rats weighing 300 to 350 g were used in this study. The NTG group (n = 5) used intravenous administration followed by mixture in the University of Wisconsin (UW) solution. For the non-NTG group (n = 5), we injected the same amount of normal saline intravenously followed by admixture in the UW solution. The heart-lung blocks were removed, weighed, and kept in UW solution for 24 hours at 10 degrees C. Reperfusion using human blood diluted in Krebs-Hensleit solution was done for 60 minutes. For the control group (n = 5), we injected the same amount of normal saline intravenously, and removed the lungs with no preservation and reperfusion procedures. RESULTS: The non-NTG group showed multiple patchy areas of alveolar collapse with marked swelling and destruction of type I epithelial cells, loss of type II cell surfactant granules, endothelial swelling and papillary projection, interstitial edema, and alveolar macrophages with active phagocytosis of the destroyed materials. The NTG group showed similar ultrastructural changes, but in a lesser severity compared with the non-NTG group. CONCLUSION: Administration of the NTG reduced the ischemia-reperfusion injury in the rat donor lungs. Ultrastructural examination was an effective tool to evaluate the protective effect of NTG in ischemia-reperfusion procedures of donor lungs.

Low-temperature mobility and structure formation of a prochiral aromatic thiol (2,5-dichlorothiophenol) on Cu(111).

We present a low-temperature scanning tunneling microscopy study of increasing coverages of 2,5-dichlorothiophenol, an asymmetrically halo-substituted aromatic thiol, on Cu(111). At low coverage, deprotonation of the thiol occurs spontaneously upon adsorption at 80 K. Albeit the low deposition temperature, we find the formation of adsorbate islands at low coverage, which coalesce into a well-ordered film of horizontally adsorbed molecules at increasing coverage. This behavior indicates (i) significant mobility of the thiols on Cu(111) even at low temperatures and (ii) attractive adsorbate-adsorbate interactions. At higher coverages intermolecular interactions prevent long-range diffusion of adsorbates and thermal activation of the S-H bond becomes necessary. A close analysis of the molecular films reveals chiral recognition between neighboring molecules, which leads to the formation of enantiopure areas on the surface. Upright orientation of individual molecules starts at the boundaries between such phases and can be induced by scanning tunneling microscopy.

Cytokine levels in cerebrospinal fluid and delayed ischemic deficits in patients with aneurysmal subarachnoid hemorrhage.

Subarachnoid hemorrhage (SAH) induces an inflammatory reaction and may lead to ischemic brain damage. The pathogenesis of brain dysfunction and delayed ischemic symptoms remain difficult to understand despite extensive surveys of such reactions. Cytokine production in the central nervous system following SAH and its relation with clinical outcome have hardly been studied. This study was aimed to determine whether the levels of IL-1 beta, IL-6 and TNF-alpha in the initial cerebrospinal fluid would increase following aneurysmal SAH, and be related with development of delayed ischemic deficit and clinical outcome. Nineteen patients suffering from aneurysmal SAH and 12 control volunteers were the subjects in this study. Cerebrospinal fluid samples were obtained on admission and the levels of each cytokine were determined with enzyme-linked immunosorbent assay. Patients with aneurysmal subarachnoid hemorrhage showed elevated levels of IL-1 beta, and TNF-alpha on admission. The patients with poor neurological status showed high levels of IL-1 beta, and IL-6. The patients who developed delayed ischemic deficit had high level of IL-6. We suggest that elevated level of IL-6 in cerebrospinal fluid of patients with aneurysmal SAH on admission can predict the high risk of delayed ischemic deficit.

Prefrontal cortical sulcal widening associated with poor treatment response to clozapine.

Increased sulcal widening in the prefrontal cortex of patients with schizophrenia may be associated with a poor treatment response to clozapine. To further evaluate this, we examined data from patients treated with clozapine in our center. Patients with the greatest degree of improvement (n=26) and those with no improvement (n=10) were compared. Computerized tomography (CT) scans were rated blindly on a visual scale of prefrontal sulcal widening. Patients with the greatest degree of functional improvement had significantly less prefrontal sulcal widening than those whose symptoms remained unchanged. There was no relationship between clozapine response and general sulcal widening. These data support the link between the superior therapeutic efficacy of clozapine and the integrity of the prefrontal cortex.