The Use of Impedance Index in the Surveillance of PTFE Femorodistal Grafts

BACKGROUND: Impedance is the equivalent in pulsatile flow of resistance in steady flow. The impedance index has been used successfully in the surveillance of vein grafts, but its use has not been reported in the context of PTFE femorodistal grafts. METHODS: Twenty-eight patients (median age 68 years (IQR 59-73 years) and 20 men) undergoing 28 PTFE femorodistal grafts with a vein cuff were evaluated prospectively comparing the impedance index with standard duplex graft surveillance. All grafts were performed for critical ischaemia. At risk grafts were identified and treated appropriately after angiography. RESULTS: The primary patencies at 1 and 2 years were 82% and 50% respectively. Duplex identified 11 at risk grafts of which 9 had an identifiable correctable lesion. Impedance analysis overpredicted at risk status when compared with duplex in the immediate postoperative phase and was unsuccessful in detecting inflow disease or low flow relating to cardiac failure. Using a threshold index of 0.5, impedance analysis has a sensitivity of 87%, specificity of 88%, with positive and negative predictive values of 76% and 94% respectively. CONCLUSIONS: Impedance index is a non-invasive method of graft surveillance which is applicable to PTFE femorodistal bypasses and may be a useful alternative to duplex although formal validation studies will be required.     

An association of aplastic anaemia in Thailand with low socioeconomic status

summary. The relationship of socioeconomic status to the risk of aplastic anaemia was evaluated in a case-control study conducted in Bangkok and two rural regions of Thailand (Khonkaen and Songkla). Among 152 cases and 921 controls there were significant trends of increasing risk with decreasing years of education (P = O01) and total household income (P = 0–0001), after control for confounding. The relative risk estimate for those with monthly incomes of >1500 baht (about 60 U.S.) was 3–9 (95% confidence interval 2–1–7–3) compared to those with monthly incomes of at least 5000 baht (about 200). The pattern of increasing risk with decreasing income was observed in all three regions, with significant trends in Bangkok (P= 0–004) and Khonkaen (P = 0–003). This finding may partly explain the high incidence of aplastic anaemia in Thailand. Low socioeconomic status may be a surrogate for one or more environmental factors that could cause aplastic anaemia, such as infectious pathogens or toxic exposures.     

ROS generation mediates the anti-cancer effects of WZ35 via activating JNK and ER stress apoptotic pathways in gastric cancer

Gastric cancer is one of the leading causes of cancer mortality in the world, and finding novel agents and strategies for the treatment of advanced gastric cancer is of urgent need. Curcumin is a well-known natural product with anti-cancer ability, but is limited by its poor chemical stability. In this study, an analog of curcumin with high chemical stability, WZ35, was designed and evaluated for its anti-cancer effects and underlying mechanisms against human gastric cancer. WZ35 showed much stronger anti-proliferative effects than curcumin, accompanied by dose-dependent induction of cell cycle arrest and apoptosis in gastric cancer cells. Mechanistically, our data showed that WZ35 induced reactive oxygen species (ROS) production, resulting in the activation of both JNK-mitochondrial and ER stress apoptotic pathways and eventually cell apoptosis in SGC-7901 cells. Blockage of ROS production totally reversed WZ35-induced JNK and ER stress activation as well as cancer cell apoptosis. In vivo, WZ35 showed a significant reduction in SGC-7901 xenograft tumor size in a dose-dependent manner. Taken together, this work provides a novel anticancer candidate for the treatment of gastric cancer, and importantly, reveals that increased ROS generation might be an effective strategy in human gastric cancer treatment.     

Exploiting biological activities of brown seaweed Ecklonia cava for potential industrial applications: a review

Seaweeds are rich in vitamins, minerals, dietary fibres, proteins, polysaccharides and various functional polyphenols. Many researchers have focused on brown algae as a potential source of bioactive materials in the past few decades. Ecklonia cava is a brown seaweed that is abundant in the subtidal regions of Jeju Island in the Republic of Korea. This seaweed attracted extensive interest due to its multiple biological activities. E. cava has been identified as a potential producer of wide spectrum of natural substances such as carotenoids, fucoidans and phlorotannins showing different biological activities in vital industrial applications including pharmaceutical, nutraceutical, cosmeceutical and functional food. This review focuses on biological activities of the brown seaweed E. cava based on latest research results, including antioxidant, anticoagulative, antimicrobial, antihuman immunodeficiency virus, anti-inflammatory, immunomodulatory, antimutagenic, antitumour and anticancer effects. The facts summarized here may provide novel insights into the functions of E. cava and its derivatives and potentially enable their use as functional ingredients in potential industrial applications.     

A dipole model for Spreading Cortical Depression

Summary Spreading Cortical Depression (SCD) is the hyper-excitation, followed by extreme suppression of spontaneous electrical activity in the cortex. This work models SCD propagation using current dipoles to represent excitable pyramidal cells. An area of cortex, either gyrus or sulcus, supporting SCD is represented by surface dipoles oriented perpendicular to the surface. Magnetic fields created by these individual surface dipoles are calculated using the Biot-Savart law. We have assumed a plane volume conductor to represent the sulcus to simplify the mathematical derivation. The sources included in cortical surface area of 10^–4mm² is represented by a signal dipole. The magnetic field arising from the entire excited area of the cortex is obtained by summing the fields due to these individual dipoles. The simulated waveforms suggest that the shapes, amplitudes, and durations of the SCD signals depend on the size of the active area of cortex involved in SCD, as well as the location and orientation of the detector. Using this dipole model, we are able to simulate the Large Amplitude Waves (LAWs) similar to those observed by Barkley et al. (1990) while measuring spontaneous activity from migraine headache patients using the assumption that these LAWs arise from propagation of SCD across a sulcus. The shape of the simulated LAW waveform is strongly influenced by the relationships between the detector location and orientation, the propagation direction of the SCD wave, and the orientation of the sulcus.This research was supported by NIH/NINDS grant no. 1R01 NS30914. We gratefully acknowledge the cooperation of Dr. P.L. Nunez for his discussion and for providing the computer time for the simulations.     

Patterns of outpatient consultation: a survey of outpatients attending a metropolitan psychiatric hospital

A survey of all outpatients (n = 1135) attending a regional psychiatric hospital during a 3-month period. Psychoses constituted 72% and non-psychotic disorders 25%. Psychoses had a greater proportion of long-term attenders while non-psychotic disorders, though frequent (43%) among recent attenders, showed a high attrition rate. Demographic characteristics, patterns of attendance, selected clinical features, level of functioning and difficulties of management of the different diagnostic groups are presented and discussed. Reasons are adduced to explain why patients who were deemed suitable for transfer to other care had not been discharged from hospital. Steps taken to reduce the patient load and increase the efficiency of the services are described.     

A model for compound action potentials and currents in a nerve bundle I: The forward calculation

We describe a model for the Compound Action Currents (CACs) and Compound Action Potentials (CAPs) produced by a peripheral nerve bundlein vitro. The Single Fiber Action Currents (SFACs) and the extracellular Single Fiber Action Potentials (SFAPs) are calculated using a generalized volume conduction model. Frequency-dependent conductivities, variations in the intracellular action potentials with recording temperature and axon conduction velocity, and the effects of axonal myelination are incorporated into the volume conduction calculation. We demonstrate how the propagation distance and the recording radius affect the simulated Compound Action Signals (CASs) of various nerve bundles. We also demonstrate how the frequency-dependent and-independent conductivities affect the CASs simulated by our model. For this simulation, some of the parameters for the nerve bundles and Conduction Velocity Distributions (CVDs) were obtained from the literature. In accompanying papers, we use the simulated CASs to investigate the effects of variations in the model parameters on the CVDs predicted by our inverse model.