Optical Coherence Tomography for the Diagnosis and Evaluation of Human Otitis Media

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.

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Pathological Substratum for a Case of Fulminant Myocarditis Treated with Extracorporeal Membrane Oxygenation and Subsequent Heart Transplantation

Fulminant myocarditis has been defined as the clinical manifestation of cardiac inflammation with rapid-onset heart failure and cardiogenic shock. We report on the case of a 23-yr-old woman with pathology-proven fulminant lymphocytic myocarditis presenting shock with elevated cardiac troponin I and ST segments in V_1-2, following sustained ventricular tachycardia and a complete atrioventricular block. About 55 min of intensive cardio-pulmonary resuscitation, with extracorporeal membrane oxygenation support, bridged the patient to orthotopic heart transplantation. The explanted heart revealed diffuse lymphocytic infiltration and myocyte necrosis in all four cardiac chamber walls. Aggressive mechanical circulatory support may be an essential bridge for recovery or even transplantation in patients with fulminant myocarditis with shock.

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Effects of Ethanol on Intestinal Absorption of Drugs.

The effect of chronic alcohol intake on the intestinal absorption of seven compounds belonging to a homologous series (ciprofloxacin derivatives) was evaluated using an in situ rat gut technique that measures the intrinsic absorption rates of the compounds both in control and chronic alcohol-fed rats. For chronic alcohol treatment, the animals were fed a liquid diet containing ethanol (36% of calories), whereas an isocaloric diet was given to the pair-fed control animals. The biophysical absorption model, relating the intestinal absorption rate constants and partition indexes of the tested compounds, was then established either for control or alcohol-fed animals. Differences were analyzed and tentatively interpreted on the basis of general diffusion principles. Results revealed that, in chronic alcohol-fed animals, hydrophilic homologs are absorbed at a significantly faster rate than in control ones, whereas lipophilic homologs do not change their absorption rate relative to controls. Results demonstrate that the bulk polarity of the microvillous lipoidal membrane is enhanced by chronic ethanol intake, whereas basic features of the aqueous boundary layer are not altered. These observations suggest that the physicochemical properties of the compounds are an important factor in explaining the influence of chronic alcohol intake on passive intestinal absorption of xenobiotics. The possible practical implications of our results are discussed from a speculative viewpoint     

Anti-tumor effect of the alphavirus-based virus-like particle vector expressing prostate-specific antigen in a HLA–DR transgenic mouse model of prostate cancer

The goal of this study was to determine if an alphavirus-based vaccine encoding human Prostate-Specific Antigen (PSA) could generate an effective anti-tumor immune response in a stringent mouse model of prostate cancer. DR2bxPSA F₁ male mice expressing human PSA and HLA-DRB1^*1501 transgenes were vaccinated with virus-like particle vector encoding PSA (VLPV–PSA) followed by the challenge with Transgenic Adenocarcinoma of Mouse Prostate cells engineered to express PSA (TRAMP–PSA). PSA-specific cellular and humoral immune responses were measured before and after tumor challenge. PSA and CD8 reactivity in the tumors was detected by immunohistochemistry. Tumor growth was compared in vaccinated and control groups. We found that VLPV–PSA could infect mouse dendritic cells in vitro and induce a robust PSA-specific immune response in vivo. A substantial proportion of splenic CD8 T cells (19.6 ± 7.4%) produced IFNγ in response to the immunodominant peptide PSA_65–73. In the blood of vaccinated mice, 18.4 ± 4.1% of CD8 T cells were PSA-specific as determined by the staining with H-2D^b/PSA_65–73 dextramers. VLPV–PSA vaccination also strongly stimulated production of IgG2a/b anti-PSA antibodies. Tumors in vaccinated mice showed low levels of PSA expression and significant CD8+ T cell infiltration. Tumor growth in VLPV–PSA vaccinated mice was significantly delayed at early time points (p = 0.002, Gehan–Breslow test). Our data suggest that TC-83-based VLPV–PSA vaccine can efficiently overcome immune tolerance to PSA, mediate rapid clearance of PSA-expressing tumor cells and delay tumor growth. The VLPV–PSA vaccine will undergo further testing for the immunotherapy of prostate cancer.     

不同压力对巨噬细胞ATP结合盒转运子A1表达的影响

目的观察不同压力对巨噬细胞ABCA1 mRNA及蛋白表达的影响。方法将THP—1源巨噬细胞依照不同压力分为对照组、60组、80组、100组、120组、140组、160组和180组，分别在大气压下，60mmHg、80mmHg、100mmHg、120mmHg、140mmHg、160mmHg和180mmHg压力下继续培养48h。观察巨噬细胞ABCA1 mRNA及蛋白表达。结果60组、80组、100组、120组ABCA1 mRNA分别为1．11±0．08、1．31±0．04、1．53±0．11和1．15±0．07，较对照组（0．91±0．10）明显增加（P〈0．05或P〈0．01），以100组增加最显著；140组、160组和180组ABCA1mRNA分别为0．75±0．06，0．46±0．08及0．35±0．05，较对照组明显减少（P〈0．01）。ABCA1蛋白表达与mRNA情况相似：60组（1．09±0．06），80组（1．12±0．09），100组（1．41±0．06），120组（1．11±0．06）较对照组（1．00±0．00）明显增加（P〈0．05或P〈0．01），而140组（0．78±0．07）、160组（0．49±0．09）和180组（0．47±0．10）较对照组明显减少（P〈0．01）。结论压力在80---120mmHg范围时，压力升高促进了巨噬细胞ABCA1 mRNA及蛋白表达，压力〉120mmHg后，随着压力的增高，巨噬细胞ABCA1 mRNA及蛋白表达反而减少。     

汉坦病毒汉城型浙37株G1、G2包膜糖蛋白基因重组体的构建及在真核细胞中的表达

目的：构建汉坦病毒浙37（Z37）株包膜糖蛋白基因G1、G2真核表达质粒，并在真核细胞中表达。方法：根据Z37M基因序列设计6条引物，分别以质粒pGEMZ37,pCUMZ37为模板，通过聚合酶链反应（PCR）获得G1及G2片段。将G1、G2片段经BamHⅠ、XhoⅠ双酶切片插入至真核表达载体pcDNA3.1( ），经酶切鉴定，并测序证实。以磷酸钙沉淀法分别将重组质粒转染COS－7细胞，用间接免疫荧光法（IFA）检测瞬时表达的蛋白。结果：获得分别含有编码汉坦病毒（HV）Z37株包膜糖蛋白G1、G2基因的重组质粒pcDNA3.1-g1,pcDNA3.1-G2；在转染的COS－7细胞内，用IFA可检测到细胞内有特异性荧光。结论：成功地构建了HV Z37株包膜糖蛋白G1、G2基因真核表达载体，并可在COS－7细胞中瞬时表达。     

叠氮钠对SH—SYT6人神经母细胞瘤细胞膜电位和胞内β—淀粉样蛋白表达的影响

目的：观察线粒体呼吸链复合体Ⅳ抑制剂叠氮钠对SH－SY5Y细胞的细胞膜电位及胞内β－淀粉样蛋白（Aβ）表达水平的影响，以探讨用叠氮钠建立模拟Alzheimer病（AD）脑中神经细胞能量代谢障碍的细胞模型的可能性。方法：不同浓度的叠氮钠损伤细胞后，用激光共聚焦显微镜观察细胞膜膜电位；用免疫细胞化学法检测细胞内β－淀粉样蛋白前体蛋白（APP）和Aβ的表达水平。结果：叠氮钠在浓度25－100mmol/L时，与细胞共孵育，可使细胞膜电位去极化程度明显增高，并引起胞内Aβ表达显著增高，但对胞内APP表达水平影响不明显。结论：叠氮钠致神经细胞损伤模型可能是模拟AD患者及脑中与线粒体复合体Ⅳ损伤相关的病理改变的较好模型。     

Membranes for Therapeutic Apheresis

Abstract: Kuraray has developed many kinds of apheresis devices, such as plasma separators, plasma fractionators, and apheresis monitors. In this article, apheresis membranes, especially double filtration plasmapheresis (DFPP) and plasma fractionators used in DFPP are introduced. DFPP is both clinically and cost effective apheresis therapy, and it has been used widely for the treatment of many kinds of diseases. Several types of plasma separators with various pore sizes are available. It is important to select the proper plasma separator with suitable pore size, determined by the size of the pathogenic substances to be removed. The Evaflux 5A ethylene‐vinyl alcohol copolymer plasma fractionator efficiently separates low‐density lipoprotein from high‐density lipoprotein. DFPP with the Evaflux 5A is effective for the treatment of familiar hyperlipidemia.     

Acute and chronic cough

Individuals are generally content to self-medicate for acute cough. It is only when the cough becomes persistent that they seek medical assistance. It is not known why patients cough in association with an acute upper respiratory tract infection (URTI), although interest has focused on how viruses may influence airway sensory nerve function and contribute to heightened cough reflex sensitivity. Why some patients develop a persistent cough following a viral URTI is also unclear. Much more is known about the causes and aggravants of chronic cough although there is no broad agreement as to the best way to manage such patients. Asthma, upper gastrointestinal dysfunction and rhinitis are frequently associated with chronic cough, although the impact of cough in suppurative lung disease and interstitial lung fibrosis is rarely considered. The development of effective treatments for cough remains a challenge and will require co-operation between clinicians, scientists and the pharmaceutical industry.     

左心室辅助装置与体外膜肺氧合治疗1例心力衰竭患者的护理

总结左心室辅助装置与体外膜肺氧合治疗1例心力衰竭患者的护理经验。护理要点包括：血栓预防与出血控制、超声引导下心功能监测的护理配合、预防感染、早期运动康复护理、针对性心理护理。该患者经过精心治疗与护理,25 d后由ICU转入普通病房。