Prophylactic anti-tumor effects in a B cell lymphoma model with DNA vaccines delivered on polyethylenimine (PEI) functionalized PLGA microparticles.

Idiotypic sequences, specific to the hypervariable regions of immunoglobulins expressed by malignant B cells offer a therapeutic target in B cell lymphoma. Efficient approaches have been described to clone a single chain fragment of the tumor immunoglobulin (Ig) comprising of heavy and light Ig chains (sFv) fused with proinflammatory chemokines. Tumor associated, poorly immunogenic self antigens encoded by plasmid DNA (pDNA) have been rendered immunogenic by chemokine fusion, thereby targeting to antigen presenting cells (APCs) which differentially express chemokine receptors. Here we present an injectable (parenteral) approach using synthetic polymer based cationic microparticle formulations for enhancing the potency of such chemokine/self antigen expressing plasmid construct. Branched and linear polyethyleneimine (PEI) were conjugated on poly (D, L lactide-co-glycolide) (PLGA) microparticles using carbodiimide chemistry followed by efficient loading of plasmid DNA. In addition to imparting significant buffering ability to these cationic microparticles, flow cytometry studies indicate that these DNA loaded microparticles significantly up regulate CD80 and MHC class II markers in phagocytic RAW264.7 cells, indicating intrinsic adjuvant effects. Intradermal injections in Balb/c mice with these formulations induced significant protection upon tumor challenge with 2.5 times the minimal lethal dose. Long term survival rates were significant (p < 0.05) in comparison with saline injected controls or blank microparticles. Further studies indicated that intramuscular delivery might provide better protection compared to intradermal injections and perform similar to gene gun mediated administration. We conclude, based on these promising in vivo results, that such surface-functionalized microparticles offer an attractive strategy to improve the potency of self antigen-based cancer DNA vaccines.     

Immunohistochemical study on the distribution of Bcl-2 and Bax in the central nervous system of the transgenic mice expressing a human Cu/Zn SOD mutation

In the present study, we performed immunohistochemical studies to investigate the changes of Bcl-2 and Bax in the central nervous system of the transgenic mice expressing a human Cu/Zn SOD mutation. In contrast to the controls, a high density of Bcl-2-IR astrocytes were detected all around the gray matter of the spinal cord of the mutant transgenic mice. Bcl-2-IR astrocytes were also detected in the cerebellum and brainstem of transgenic mice. Specific immunoreactivity for Bax was seen in the spinal cord and brainstem of transgenic mice. Immunostaining for Bax was identified only in neurons and not in glial cells. Our present study demonstrated the distribution of Bcl-2 and Bax in detail using immunohistochemical methods through the central nervous system of the transgenic mice, for the first time.     

PET/CT and MRI of intra-osseous haemangioma of the tibia

Intra-osseous haemangioma is a rare, benign neoplasm that usually involves the vertebrae and craniofacial bones. Furthermore, its occurrence in the long bones is extremely rare. We report the findings of fluorine-18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT and MRI in a patient with intra-osseous haemangioma in the proximal tibia, who was initially misdiagnosed as having a malignancy based on (18)F-FDG PET/CT. (18)F-FDG PET/CT showed a well-marginated osteolytic lesion with abnormal FDG uptake. The mass demonstrated low signal intensity on T(1) weighted MRI. On T(2) weighted images, the lesion appeared as a cluster of high signal intensity lobules and showed strong enhancement on contrast-enhanced T(1) weighted images. Surgical curettage was performed and histopathological examination of the excised tissue confirmed a cavernous haemangioma.     

Traumatic Axillary Artery Dissection with Radial Artery Embolism

This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram.     

The Processing Time for Recanalization and Size of Ischemic Lesions on DWI is Related With Complete Reperfusion After Mechanical Thrombectomy

Recent studies demonstrated that modified thrombolysis in cerebral infarction (TICI) 3 reperfusion have better functional outcomes than modified TICI 2b after mechanical thrombectomy in acute ischemic stroke with large vessel occlusion. The purpose of this study was to determine significant factors to forecast the presence of complete reperfusion after mechanical thrombectomy based on multimodal magnetic resonance imaging (MRI). We investigated 96 consecutive patients with acute large intracranial artery occlusion of anterior circulation who based on multimodal MRI. Also, we compared clinical and radiologic parameters between patients with modified TICI 3 and those with modified TICI 0-2b. Among 96 eligible subjects received mechanical thrombectomy, 39 patients (40.6%) showed complete reperfusion and 57 partial or nonreperfusion (mTICI 2b-26, mTICI 2a-9, mTICI 1-8, and mTICI 0-14) after mechanical thrombectomy. Patients with mTICI 3 had significantly smaller initial Diffusion weighted images (DWI) lesion volume (P < .01) and much shorter time interval from onset to reperfusion (P < .01) than those patients with mTICI (0-2b). In multivariate analysis, smaller initial DWI volume (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.23-2.57; P < .01) and faster reperfusion time (OR, 1.07; 95% CI 1.01-1.14; P = .015) had an independence significance for complete reperfusion after mechanical thrombectomy. In this study, the ischemic lesion volume on DWI and faster processing time are critical factor to predict the state of complete reperfusion after mechanical thrombectomy.     

Intra and extra pelvic multidisciplinary surgical approach of retroperitoneal sarcoma: Case series report

BACKGROUNDRetroperitoneal sarcoma (RPS) is a rare malignancy arising from mesenchymal cells that most commonly presents as an abdominal mass and is associated with poor prognosis. Although several studies have assessed the survival benefits of wide excision, few have reported detailed methods for achieving wide excision in patients with RPS.AIMTo describe our experience with multidisciplinary surgical resection of RPS using intra- and extra-pelvic approaches.METHODSMultidisciplinary surgery is an anatomical approach that combines intra- and extra-peritoneal access within the same surgery to achieve complete RPS removal. This retrospective review of the records of patients who underwent multidisciplinary surgery for RPS analyzed surgical and survival outcomes.RESULTSEight patients underwent 10 intra- and extra-pelvic surgical resections, and their median mass size was 12.75 cm (range, 6-45.5 cm). Using an intrapelvic approach, laparoscopy-assisted surgery was performed in four cases and laparotomy surgery in six. Using an extrapelvic approach, ilioinguinal and posterior approaches were used in four cases each, and the prone position and midline skin incision were shared in one. All patients’ RPS masses were removed completely, and four achieved R0 resection through intra- and extra-pelvic surgery. The median estimated blood loss was 2000 mL (range, 300-20000 mL) and the median hospitalization was 12.6 d (range, 9-69 d). Reoperation was needed in two patients (one for wound necrosis and the other for bowel perforation and wound necrosis). The median overall survival rate and median progression-free survival were 64.6 and 13.7 mo, respectively.CONCLUSIONRPS is therapeutically challenging because of its location and high risk of recurrence. Therefore, intra- and extra-pelvic surgical approaches can improve the macroscopic security of the surgical margin.     

中药活血化瘀片对于实验性肝损伤的效果研究

应用活血化瘀片对大白鼠的实验性肝损伤进行了研究,以死亡率、体重变化、肝/体重和脾/体重比值、~(14)C 氨基比林呼吸试验、肝脏蛋白结合羟脯氨酸和病理检查作为对比指标。实验结果显示:活血化瘀片无毒性作用,可使正常大白鼠肝脏蛋白结合羟脯氨酸减少,在减少病死率和减轻肝硬变的形成上,有一定的保护作用。     

蒙医陶拉布日疗法简介

被称之为蒙医传统五种疗法之首的陶拉布日（下泻）疗法在临床应用有越来越少的趋势。这主要是因为陶拉布日疗法的服药方法略繁琐所致。陶拉布日疗法服药方法有三个步骤：即下泻施治前的准备，泻药的使用和善后调理。服药前的准备又有远近之分。泻药的使用包括配方、服法、洗肠、下泻程度和辅助疗法等五个部分。陶拉布日疗法又分为峻泻剂与缓泻剂两种。缓泻剂可无需实施施治前的准备和善后调理，直接用药，不会影响患者的工作学习，所以被广泛应用于临床。     

Effect of drug-loaded TiO<Subscript>2</Subscript> nanotube arrays on osseointegration in an orthodontic miniscrew: an <Emphasis Type="Italic">in-vivo</Emphasis> pilot study

Osseointegration was evaluated for the surface of miniscrews with TiO₂ nanotube arrays containing drugs in this in-vivo study. The diameter and length of the TiO₂ nanotube arrays were about 70 nm and 5 μm, respectively. Recombinant human bone morphogenetic protein-2 (rhBMP-2) or ibuprofen was loaded in the TiO₂ nanotube arrays with 12 miniscrews. The 12 drug-loaded miniscrews, 6 miniscrews with no drug-loaded TiO₂ nanotube arrays and 6 conventional miniscrews, were placed on the tibias of New Zealand white rabbits. Histological osseointegration was assessed 8 weeks after implantation by measuring the bone-to-implant contact (BIC) ratio. Ibuprofen-loaded miniscrews showed a significantly higher BIC of 71.6% over conventional miniscrews of 44.3% on average. The mean BIC ratios of rhBMP-2-loaded miniscrews and no drug-loaded miniscrews was 24.6% and 60.1%, respectively. Our results suggest that TiO₂ nanotube arrays on the surface of miniscrews could be used as carriers of drugs, and loading ibuprofen in TiO₂ nanotube arrays may improve osseointegration of miniscrews. However, the effect of rhBMP-2 loaded in TiO₂ nanotube arrays on osseointegration of miniscrews was questionable in this pilot study.     

Venous Thromboembolism in Korean Patients Undergoing Major Orthopedic Surgery: A Prospective Observational Study using Computed Tomographic (CT) Pulmonary Angiography and Indirect CT Venography

In patients undergoing major orthopedic surgery, data of deep venous thrombosis (DVT) and pulmonary embolism (PE) are lacking as studied by computed tomographic (CT) pulmonary angiography and indirect CT venography (CTPA-CTV). A prospective observational study was performed for 363 Korean patients undergoing major orthopedic surgery to determine the incidence of venous thromboembolism (VTE), especially proximal DVT and PE. The incidence of VTE was 16.3% (n=59). Of them, 8 patients (2.2%) were symptomatic. The rate of VTE was the highest in patients who underwent total knee replacement (40.4%), followed by hip fracture surgery (16.4%), and total hip replacement (8.7%; P<0.001). The incidence of PE was 6.6% (n=24). Of them, 4 patients (1.1%) were symptomatic. Forty-one patients (11.3%) were in the proximal DVT or PE group. Based on multivariate analysis, total knee replacement and age ≥65 yr were significant risk factors for proximal DVT or PE in patients undergoing major orthopedic surgery (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.1-5.1; P=0.025; and OR, 2.1; 95% CI, 1.0-4.4; P=0.046, respectively). Taken together, the overall incidence of PE was 6.6% and rate of symptomatic PE rate was 1.1%. Knee joint replacement and age ≥65 yr were significant risk factors for proximal DVT or PE.