Malignant peripheral neuroectodermal tumor in an infant with neurofibromatosis type 1

A case of multifocal malignant peripheral neuroectodermal tumor (PNET) arising from a plexiform neurofibroma in a 4-month-old Chinese boy with neurofibromatosis type 1 (NF-1) is described. Cytogenetic culture demonstrated hypotriploid karyotype with an abnormal clone characterized by 59–60, XY, +2, +3, +6, +8, +8, +12, +i(13)(q10), +der(14)t(1;14)(q21;q32), +16, +19, +20, +mar[cp3] with no apparent abnormality of chromosome 17. The child was treated with combination chemotherapy comprising ifosphamide, vincristine and doxorubicin. Despite initial partial response the child finally died of tumor progression and pulmonary metastases 8 months after diagnosis. We believe this is the first reported case of PNET in a child with NF-1 and may support an association between these two disorders of neural crest origin. © 1996 Wiley-Liss, Inc.     

Palladium nanoparticles immobilized on polyethylenimine-derivatized gold surfaces for catalysis of Suzuki reactions: development and application in a lab-on-a-chip context

Gold surface-bound hyperbranched polyethyleneimine (PEI) films decorated with palladium nanoparticles have been used as efficient catalysts for a series of Suzuki reactions. This thin film-format demonstrated good catalytic efficiency (TON up to 3.4 × 10³) and stability. Incorporation into a quartz crystal microbalance (QCM) instrument illustrated the potential for using this approach in lab-on-a-chip-based synthesis applications.

Gold surface-bound hyperbranched polyethyleneimine (PEI) films decorated with palladium nanoparticles have been used as efficient catalysts for a series of Suzuki reactions in a lab-on-a-chip format.

Metal and metal-oxide nanostructures and nanoparticles are often key features in materials used in separation technology, biomedical devices, and catalysis.^1,2 Poor mechanical strength and a tendency to aggregate, thus reducing the surface to volume ratio, both limit their use in real-time applications.^3,4 To overcome these shortcomings, nanoparticles are often dispersed in a matrix, such as sol–gel, biopolymers, and carbon-based materials without disturbing their innate properties at nano-scale level.^5,6 Functionalized polymers have been explored extensively in this regard due to their robustness, low cost, ease of handling, and their amenability for chemical modification.^7–9Recently, we have demonstrated the immobilization of hyperbranched polyethyleneimine (PEI) hydrogels on metallic surfaces for use as antifouling surfaces.¹⁰ Owing to their hydrogelation properties, polymers of this type have proven useful in therapeutic applications, for e.g. bio-mineralization, and the formation of nanostructures.^11,12 PEI is a hyperbranched polymer containing very high densities of primary, secondary and tertiary amines, in a 1 : 2 : 1 ratio, and are capable of coordination with transition metals to form nanostructures.^13,14 Recent reports on amine functionalized polymer-supported heterogeneous catalysts for C–C coupling reactions (Table 1-SI^†) prompted us to deploy PEI as a matrix for synthesizing surface-bound palladium nanoparticles for use as catalysts of C–C coupling reactions. For catalytic applications, a miniaturized microfluidic setup, such as a lab-on-a-chip device, can significantly reduce the consumption of chemicals, catalysts, process time and be beneficial for on-site analysis.^15,16In this study, we demonstrate the use of the PEI surface-supported nanoparticles for as a support for catalysis of the Suzuki reaction the possibility for using of these Pd-nanoparticle immobilized PEI-derivatized gold surfaces for performing Suzuki reactions in a microfluidics device. Catalytic surface fabrication (Scheme 1) was performed using gold sputtered quartz surfaces (Au/quartz) that were functionalized with 11-mercaptoundecanoic acid (MuDA), and then activated and derivatization with PEI. The polymer attachment was carried out at high ionic strength (150 mM NaCl), which has been found to enhance the thickness and growth of PEI brush-like structures.¹⁰ Optimization of the Pd nanoparticle synthesis procedure was performed by varying incubation times and Pd(OAc)₂ concentrations (Table 1-SI^†). A quartz crystal microbalance (QCM) was used to monitor the amount of Pd deposited on the PEI coated Au/quartz resonators.Open in a separate windowScheme 1Palladium immobilization on polyethyleneimine coated Au/quartz surfaces.The energy dispersive X-ray (EDX) spectrum confirmed the presence of Pd in the PEI film with a distinct band at 2.8 keV (Fig. 1A). XPS spectra of the Pd-bound PEI surfaces revealed the presence of the anticipated proleptic elements (C_1s, N_1s, O_1s, Pd_3d and Au_4f) (Fig. 1A-SI^†). Deconvoluted peaks differentiated the amine N of PEI (399.8 eV) from that of the amide N (–*N–C O–, 400.8 eV) (Fig. 1B-SI^†).^17,18 Bands around 335 and 340 eV in the survey spectra correspond to the 3d_5/2 and 3d_3/2 states of the surface bound Pd.¹⁹ The deconvoluted bands at 335.3 and 338.2 demonstrated the presence of Pd(0) and Pd(ii), respectively (Fig. 1B). Importantly, peak integration showed the immobilized Pd to be predominantly in the Pd(0) state, with less than 5% present as Pd(ii).¹⁹Open in a separate windowFig. 1(A) Energy dispersive X-ray (EDX) analysis and (B) X-ray photoelectron spectra (XPS) of the palladium nanoparticle immobilized PEI coated Au/quartz surface.RAIR spectra confirmed the presence of the PEI on the gold surface based on the discernible vibrational bands of the –N–H–, –CH– and –CN– bending modes of the adsorbed PEI film (Fig. 2). Subtle differences can be observed in the RAIR spectra of the PEI before and after Pd immobilization. The band corresponding to –N–H– bending mode has been significantly red shifted emphasizing the interaction of the Pd particles with the amine moieties of the PEI film (Fig. 2, inset). This, together with the XPS data, provides evidence for the reduction of Pd(ii) to Pd(0) and its incorporation as nanoparticles into the PEI brush layer.Open in a separate windowFig. 2RAIR spectra of PEI coated Au/quartz surface before and after Pd immobilization.SEM images (Fig. 3) showed uniform long-range coating of the palladium nanoparticles on the PEI immobilized surface (PEI/Pd). The crystallinity of the Pd coated PEI surface was evaluated with powder diffraction measurements which showed characteristic peaks for Pd(111), Pd(200) and Pd(220) with Miller indices of 40, 47.2 and 68.3° (JCPDS No. 98-004-7386), respectively, again confirming the presence of Pd nanoparticles in the (0) oxidation state (curve a, Fig. 2-SI^†).Open in a separate windowFig. 3Scanning electron micrographs of (A) gold surface, (B) polyethyleneimine (PEI) film and (C) PEI-supported palladium particles fabricated on Au/quartz surfaces.The possibility of using these surfaces for catalysis of the Suzuki reaction was explored using a series of phenylboronic acids and substituted aryl halides (†). The amount of catalytic nanopalladium loaded was determined by QCM. Au/quartz surfaces coated with PEI/Pd were immersed in the reaction mixtures at 55 °C for 12 h (Section 1.7-SI^†). Reactions of aryl halides with a series of arylboronic acids offered the corresponding products in good to excellent yield (†). This negligible effect on Pd catalyst poisoning confirms the nature of the catalytic Pd exists predominantly in the (0) oxidation state.²⁰ No biphenyl product has been observed when the Suzuki reaction was performed in presence of unmodified Au/quartz surface (without PEI and Pd).Suzuki cross-coupling reactions of aryl halides with arylboronic acids using PEI/Pd as catalysts^a

Recipient FK506 pretreatment regimens in rat small bowel transplantation: allograft survival, function, and systemic infection

PURPOSE: Successful small bowel transplantation requires effective immunosuppression that preserves intestinal function but avoids opportunistic infection. This study aims to evaluate FK506 as a single immunosuppressant in different pretreatment regimens in a rat high responder strain combination. METHODS: Lewis --> DA rat heterotopic small bowel transplantation was performed. Studied groups were (1) untreated control, n = 12; (2) FK-1, n = 8; (3) FK-3, n = 8. FK506 (2 mg/kg/d, intramuscularly) was given to the recipients for 1 day (FK-1) and 3 days (FK-3) before small bowel transplantation, followed by 2 weeks of subtherapeutic treatment (0.3 mg/kg/d, intramuscularly) after small bowel transplantation. Syngeneic small bowel transplantation also was performed (n = 8). FK blood levels, maltose absorption test, histology, and bacteriology were performed at different postoperative days. RESULTS: Allograft survival was prolonged significantly with FK pretreatment, being more so in FK-3 group (FK-1, 22.2 +/- 1.5 d; FK-3, 40.7 +/- 14.1 d; control, 6.6 +/- 0.8 d; P< .01). In the first postoperative week, FK blood level was significantly higher in FK-3 group (19.8 +/- 1.5 ng/mL) than in FK-1 group (5.0 +/- 0.4 ng/mL; P < .05). There was no evidence of systemic infection in either FK-treated group. For maltose absorption, control allograft was abnormal on day 7 correlating to severely damaged intestinal architecture. In contrast, FK-treated allografts showed well-protected intestinal structure and normal absorption on days 7 and 21. CONCLUSION: High FK506 blood levels in the first postoperative week, achieved with FK pretreatment, prolonged intestinal allograft survival and preserved intestinal structure and function without allowing systemic infection.     

Peripheral nerve compression syndromes of the upper limb

Nerve compression syndromes are commonly encountered in the elective out-patient setting and therefore core and specialist trainees should understand the aetiology, pathophysiology, investigation and treatment. A knowledge of nerve physiology and clinical assessment of upper limb neurology may be encountered in the MRCS exam.     

The Elag-Koln automatic blood pressure recorder. A clinical appraisal.

The performance of an Elag-Koln semiautomatic blood pressure recorder was compared with the London School of Hygiene mercury sphygmomanometer in 24 subjects providing a wide range of blood pressure measurements. Readings with the two instruments correlated highly (for systole, r=0-99; for diastole phase 4, r=0-97; for diastole phase 5,r=0-98), and the slopes of the regressions did not differ significantly from unity. Elag-Koln measurements were higher for systole (mean difference 3-7 mmHg,P less than 0-001) and diastole phase 5 (mean difference 7-4 mmHg,P less than 0-001), but agreed closely with diastole phase 4 readings with the London School of Hygiene instrument. The Elag-Koln recorder tested was compact, easy to use, and had acceptable accuracy. This type of instrument deserves further testing to examine its suitability for general use.     

Comparison of nasopharyngeal flocked swabs and aspirates for rapid diagnosis of respiratory viruses in children.

BACKGROUND: The quality of clinical specimens is a crucial determinant for virological diagnosis. OBJECTIVES: We compared the viral diagnostic yield for influenza A and respiratory syncytial virus (RSV) from the recently developed nasopharyngeal flocked swabs (NPFS) with nasopharyngeal aspirates (NPA) collected in parallel from 196 hospitalized children with acute respiratory infection during the peak period of influenza A and RSV activity in Hong Kong. Specimens were tested by RT-PCR for influenza A and RSV and viral load determined. They were also tested by direct immunofluorescence (DIF) for influenza A and B, RSV, parainfluenza types 1-3 and adenovirus. RESULTS: Both NPA and NPFS had excellent sensitivity (100%) for detecting influenza A by RT-PCR but NPA was slightly more sensitive than NPFS for detecting RSV by both RT-PCR (100% vs. 92.3%) and DIF (87.2% vs. 84.6%) and for detecting influenza A by DIF (90.2% vs. 82.9%). Viral load for influenza A in NPA and NPFS was not significantly different but that for RSV was higher in NPA. CONCLUSION: NPA remains the optimal specimen for diagnosis of respiratory infections by RT-PCR and DIF. However, collection of NPFS is easier to perform in an out-patient setting, was more acceptable to parents and less likely to generate aerosols than NPA engendering potentially less infection control hazard.