Lysophosphatidylcholine‐induced cytotoxicity and protection by heparin in mouse brain bEND.3 endothelial cells

A pathological feature in atherosclerosis is the dysfunction and death of vascular endothelial cells (EC). Oxidized low‐density lipoprotein (LDL), known to accumulate in the atherosclerotic arterial walls, impairs endothelium‐dependent relaxation and causes EC apoptosis. A major bioactive ingredient of the oxidized LDL is lysophosphatidylcholine (LPC), which at higher concentrations causes apoptosis and necrosis in various EC. There is hitherto no report on LPC‐induced cytotoxicity in brain EC. In this work, we found that LPC caused cytosolic Ca²⁺ overload, mitochondrial membrane potential decrease, p38 activation, caspase 3 activation and eventually apoptotic death in mouse cerebral bEND.3 EC. In contrast to reported reactive oxygen species (ROS) generation by LPC in other EC, LPC did not trigger ROS formation in bEND.3 cells. Pharmacological inhibition of p38 alleviated LPC‐inflicted cell death. We examined whether heparin could be cytoprotective: although it could not suppress LPC‐triggered Ca²⁺ signal, p38 activation and mitochondrial membrane potential drop, it did suppress LPC‐induced caspase 3 activation and alleviate LPC‐inflicted cytotoxicity. Our data suggest LPC apoptotic death mechanisms in bEND.3 might involve mitochondrial membrane potential decrease and p38 activation. Heparin is protective against LPC cytotoxicity and might intervene steps between mitochondrial membrane potential drop/p38 activation and caspase 3 activation.     

Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis.

Although surgical lung resection could improve prognosis in some patients with multidrug-resistant tuberculosis (MDR-TB), there are no reports on the optimal candidates for this surgery. The aim of the present study was to elucidate the prognostic factors for surgery in patients with MDR-TB. Patients who underwent lung resection for the treatment of MDR-TB between March 1993 and December 2004 were included in the present study. Treatment failure was defined as greater than or equal to two of the five cultures recorded in the final 12 months of treatment being positive, any one of the final three cultures being positive, or the patient having died during treatment. The variables that affected treatment outcomes were identified through univariate and multivariate logistic regression analysis. In total, 79 patients with MDR-TB were included in the present study. The treatment outcomes of 22 (27.8%) patients were classified as failure. A body mass index <18.5 kg x m(-2), primary resistance, resistance to ofloxacin and the presence of a cavitary lesion beyond the range of the surgical resection were associated with treatment failure. Low body mass index, primary resistance, resistance to ofloxacin and cavitary lesions beyond the range of resection are possible poor prognostic factors for surgical lung resection in multidrug-resistant tuberculosis patients.     

"Lysostrip" experiments with HLA class-II antigens. I. Independent surface mobility of DQ and DR molecules

We report on results of lysostrip experiments designated to analyse the molecular relations between DQ and DR antigens. The purpose of lysostrip application was to determine whether these antigens can independently be redistributed on B-cell surface by incubation with a specific antibody followed by incubation with F(ab')2 fragments of rabbit antihuman Ig. The obtained results have clearly shown that DQ antigens, and supertypic and narrow DR antigens, move independently, indicating that they are located on separate molecules, supporting the concept of different DQ and DR loci.     

Sonographic diagnosis of early recurrence after inguinal herniorrhaphy: Potential pitfalls

Three patients who presented with scrotal swelling within a few days of inguinal herniorrhaphy are reported. Ultrasonography scans performed in these patients all demonstrated features suspicious of recurrence of hernia. One patient underwent surgical exploration, which revealed only a scrotal haematoma without evidence of recurrent hernia. The other two patients were managed conservatively because clinically the swellings were regarded to be more compatible with haematoma. Both patients had subsequent resolution of the scrotal swelling with no clinical evidence of recurrence of hernia on follow‐up. It is concluded that sonographic diagnosis of recurrence of hernia shortly after inguinal herniorrhaphy can occasionally be misleading.     

Video-assisted thoracoscopic management of anterior mediastinal masses

The author reports his personal experience on the management of anterior mediastinal masses using video-assisted thoracoscopic surgery (VATS) at a single institution. From August 1993 to March 1995, 24 patients (14 males and 10 females ranging in age from 9 to 76 years old) with anterior mediastinal masses were diagnosed or treated by VATS. This consisted of 11 biopsies and 13 resections (11 thymectomies and 2 thymic cystectomies). Seven biopsies were performed for primary histological diagnosis (four non-Hodgkin's lymphoma, two metastatic carcinoma, one yolk sac tumor) and four biopsies were performed to detect residual tumors following chemotherapy. Complete thymectomy was accomplished in all 11 cases by examination of the thymic bed and resected specimen. We have reserved this approach for resection of benign masses only. Adequate biopsy for histological diagnosis was obtained in all 11 cases to guide further management. There was no surgical mortality or intraoperative complications. The median postoperative hospital stay for the entire group was 3 days. We conclude that VATS for resection or biopsy of an anterior mediastinal mass is technically feasible and provides an alternative to the conventional approaches in selected patients.     

Features of head injury in a developing country--Taiwan (1977-1987)

Certain features of head-injured patients admitted to the Chang Gung Memorial Hospital in Taiwan during the period 1977 to 1987 were reviewed. The most common causes of injury were motorcycle accidents (56.3%) and street accidents with pedestrian injury (29.47%). The age groups with the greatest incidence of injury were aged 16-20 years, 21-25 years, and 25-30 years. The pedestrian group involving the highest incidence of injury was less than 10 years of age. Overall mortality was 17.26%. The injured pedestrian group had the highest mortality (19.1%). Initial clinical assessment was recorded using the Glasgow Coma Scale. Head-injured patients with a GCS less than 8 had a mortality in the injured pedestrian group of 46%, whereas the mortality rate in the motorcycle accident group was 41%. Additional features studied were time of occurrence of injury and pattern of injury. Information gathered from this study would suggest the need to establish a Head Injury Prevention Program in Taiwan. This of course implies major cooperation among the providers of health care delivery, the medical profession, legislators, and the government at all levels.