Management of chest keloids

Keloid formation is one of the most challenging clinical problems in wound healing. With increasing frequency of open heart surgery, chest keloid formations are not infrequent in the clinical practice. The numerous treatment methods including surgical excision, intralesional steroid injection, radiation therapy, laser therapy, silicone gel sheeting, and pressure therapy underscore how little is understood about keloids. Keloids have a tendency to recur after surgical excision as a single treatment. Stretching tension is clearly associated with keloid generation, as keloids tend to occur on high tension sites such as chest region. The authors treated 58 chest keloid patients with surgical excision followed by intraoperative and postoperative intralesional steroid injection. Even with minor complications and recurrences, our protocol results in excellent outcomes in cases of chest keloids

Exponential ATP amplification through simultaneous regeneration from AMP and pyrophosphate for luminescence detection of bacteria

a b s t r a c t Bacteria monitoring is essential for many industrial manufacturing processes, particularly those involving in food, biopharmaceuticals, and semiconductor production. Firefly luciferase ATP luminescence assay is a rapid and simple bacteria detection method. However, the detection limit of this assay for Escherichia coli is approximately 10 4 colony-forming units (CFU), which is insufficient for many applications. This study aims to improve the assay sensitivity by simultaneous conversion of PP i and AMP, two products of the luciferase reaction, back to ATP to form two chain-reaction loops. Because each consumed ATP continuously produces two new ATP molecules, this approach can achieve exponential amplification of ATP. Two consecutive enzyme reactions were employed to regenerate AMP into ATP: adenylate kinase converting AMP into ADP using UTP as the energy source, and acetate kinase catalyzing acetyl phosphate and ADP into ATP. The PP i -recycling loop was completed using ATP sulfurylase and adenosine 5 0 phosphosulfate. The modification maintains good quantification linearity in the ATP luminescence assay and greatly increases its bacteria detection sensitivity. This improved method can detect bacteria concentrations of fewer than 10 CFU. This exponential ATP amplification assay will benefit bacteria monitoring in public health and manufacturing processes that require high-quality water. Ó 2011 Elsevier Inc. All rights reserved. Bacteria monitoring is essential for many industrial manufacturing processes, and particularly those involving food, semiconductors, and biopharmaceuticals. The presence of bacteria reduces production yield and may cause serious health problems in humans. Researchers have developed several rapid assays for detecting bacteria in water. These methods include polymerase chain reactions, fluorescence in situ hybridization [1], b-D-glucuronidase activity measurement The ATP luminescence assay is a rapid, sensitive, and easy-toperform method based on the detection of ATP, a molecule ubiquitously present in all living cells. The enzyme luciferase catalyzes the oxidation of the substrate luciferin while transforming the energy derived from ATP into light, which can be quantified by a luminometer. This assay has been widely used in bacteria monitoring for food hygiene [4] and surface cleanliness The current detection limit of the ATP luminescence method for Escherichia coli is approximately 10 4 colony-forming units (CFU) 1 [12,13], which is not sensitive enough for many industrial and medical applications. Several approaches have been adopted to improve the assay sensitivity. The first strategy involves the identification of chemical extractants that can effectively disrupt bacterial cells while not interfering with the luminescence assay. Both dimethyl sulfoxide (DMSO) 0003-2697/$ -see front matter

Optimization of high‐pressure processing in extraction of astaxanthin from Penaeus monodon carapace using response surface methodology

Penaeus monodon is a species of shrimp with astaxanthin content that prevents various diseases and enhances immune system. High‐pressure processing (HPP) is capable of achieving higher extraction astaxanthin yield within short processing time. The aim of this research was to optimize the extraction condition of astaxanthin from P. monodon using HPP using response surface methodology (RSM). The investigation was carried out using variables: pressure (150–250 MPa), holding time (10–20 min), and amount of acetone‐methanol mixture, 7:3, vol/vol (3–7 ml). The optimum condition was achieved at the pressure of 238.54 MPa, 16.29 min of holding time, and 6.59 ml of solvent mixture. The optimum yield of astaxanthin was 95.17 μg/gdw. The R2 value was 0.9836 and the adjusted‐R2 value was 0.9688. These values indicate that the application of RSM to optimize the yield of astaxanthin with HPP has a significant impact in enhancing the yield of astaxanthin

Holographic equations of state and astrophysical compact objects

We solve the Tolman-Oppenheimer-Volkoff equation using an equation of state (EoS) calculated in holographic QCD. The aim is to use compact astrophysical objects like neutron stars as an indicator to test holographic equations of state. We first try an EoS from a dense D4/D8/\textoverline {D8} model. In this case, however, we could not find a stable compact star, a star satisfying pressure-zero condition with a radius $R$, $p(R)=0$, within a reasonable value of the radius. This means that the EoS from the D4/D8/\textoverline {D8} model may not support any stable compact stars or may support one whose radius is very large. This might be due to a deficit of attractive force from a scalar field or two-pion exchange in the D4/D8/\textoverline {D8} model. Then, we consider D4/D6 type models with different number of quark flavors, $N_f=1,2,3$. Though the mass and radius of a holographic star is larger than those of normal neutron stars, the D4/D6 type EoS renders a stable compact star.Comment: 12 pages, 9 figure

Highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis

<p>Abstract</p> <p>Purpose</p> <p>To evaluate the characteristics of highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis.</p> <p>Materials and methods</p> <p>The clinical and radiological characteristics of 18 cases of highly malignant soft tissue sarcomas of the extremity with a delayed diagnosis were determined.</p> <p>Results</p> <p>Ten men and eight women of mean age 44.8 years (range, 15-79 years) were included in this study. Seven cases of synovial sarcoma, three cases each of alveolar soft part sarcoma and malignant fibrous histiocytoma, two cases each of highly malignant leiomyosarcoma and myxofibrosarcoma, and one case of clear cell sarcoma were enrolled. Times from tumor detection to diagnosis ranged from 1 to 3 years in most cases; three of the seven synovial sarcoma cases took more than 10 years to diagnose. Of the seven cases of synovial sarcoma, five cases of small, superficial located masses were simply excised without a pre-surgical biopsy. Three cases of alveolar soft part sarcoma showed characteristic T1- and T2-weighted high signal intensities with signal voids in MR images. In addition, one synovial sarcoma patient and one alveolar soft part sarcoma patient showed evidence of calcification on plain radiographs. However, no general characteristic clinical findings were found to be common to the 18 cases.</p> <p>Conclusions</p> <p>Contrary to general expectations, some soft tissue tumors that grow slowly are painless, and those that occur in superficial limbs may be highly malignant. Thus, even when a slow growing, painless superficial mass is encountered in a limb, physicians should keep the possibility of highly malignant soft tissue sarcoma in mind.</p

Coronary Computed Tomographic Angiography at 80 kVp and Knowledge-Based Iterative Model Reconstruction Is Non-Inferior to that at 100 kVp with Iterative Reconstruction

The aims of this study were to compare the image noise and quality of coronary computed tomographic angiography (CCTA) at 80 kVp with knowledge-based iterative model reconstruction (IMR) to those of CCTA at 100 kVp with hybrid iterative reconstruction (IR), and to evaluate the feasibility of a low-dose radiation protocol with IMR. Thirty subjects who underwent prospective electrocardiogram-gating CCTA at 80 kVp, 150 mAs, and IMR (Group A), and 30 subjects with 100 kVp, 150 mAs, and hybrid IR (Group B) were retrospectively enrolled after sample-size calculation. A BMI of less than 25 kg/m2 was required for inclusion. The attenuation value and image noise of CCTA were measured and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated at the proximal right coronary artery and left main coronary artery. The image noise was analyzed using a non-inferiority test. The CCTA images were qualitatively evaluated using a four-point scale. The radiation dose was significantly lower in Group A than Group B (0.69 ± 0.08 mSv vs. 1.39 ± 0.15 mSv, p < 0.001). The attenuation values were higher in Group A than Group B (p < 0.001). The SNR and CNR in Group A were higher than those of Group B. The image noise of Group A was non-inferior to that of Group B. Qualitative image quality of Group A was better than that of Group B (3.6 vs. 3.4, p = 0.017). CCTA at 80 kVp with IMR could reduce the radiation dose by about 50%, with non-inferior image noise and image quality than those of CCTA at 100 kVp with hybrid IR

The role of primary tumor resection in colorectal cancer patients with asymptomatic, synchronous unresectable metastasis: Study protocol for a randomized controlled trial

BACKGROUND: Approximately 20 % of all patients with colorectal cancer are diagnosed as having Stage IV cancer; 80 % of these present with unresectable metastatic lesions. It is controversial whether chemotherapy with or without primary tumor resection (PTR) is effective for the treatment of patients with colorectal cancer with unresectable metastasis. Primary tumor resection could prevent tumor-related complications such as intestinal obstruction, perforation, bleeding, or fistula. Moreover, it may be associated with an increase in overall survival. However, surgery delays the use of systemic chemotherapy and affects the systemic spread of malignancy. METHODS/DESIGN: Patients with colon and upper rectal cancer patients with asymptomatic, synchronous, unresectable metastasis will be included after screening. They will be randomized and assigned to receive chemotherapy with or without PTR. The primary endpoint measure is 2-year overall survival rate and the secondary endpoint measures are primary tumor-related complications, quality of life, surgery-related morbidity and mortality, interventions with curative intent, chemotherapy-related toxicity, and total cost until death or study closing day. The authors hypothesize that the group receiving PTR following chemotherapy would show a 10 % improvement in 2-year overall survival, compared with the group receiving chemotherapy alone. The accrual period is 3 years and the follow-up period is 2 years. Based on the inequality design, a two-sided log-rank test with α-error of 0.05 and a power of 80 % was conducted. Allowing for a drop-out rate of 10 %, 480 patients (240 per group) will need to be recruited. Patients will be followed up at every 3 months for 3 years and then every 6 months for 2 years after the last patient has been randomized. DISCUSSION: This randomized controlled trial aims to investigate whether PTR with chemotherapy shows better overall survival than chemotherapy alone for patients with asymptomatic, synchronous unresectable metastasis. This trial is expected to provide evidence so support clear treatment guidelines for patients with colorectal cancer with asymptomatic, synchronous unresectable metastasis. TRIAL REGISTRATION: Clinicaltrials.gov NCT01978249

Directed Induction of Functional Motor Neuron-Like Cells from Genetically Engineered Human Mesenchymal Stem Cells

Cell replacement using stem cells is a promising therapeutic approach to treat degenerative motor neuron (MN) disorders, such as amyotrophic lateral sclerosis and spinal cord injury. Human bone marrow-derived mesenchymal stem cells (hMSCs) are a desirable cell source for autologous cell replacement therapy to treat nervous system injury due to their plasticity, low immunogenicity, and a lower risk of tumor formation than embryonic stem cells. However, hMSCs are inefficient with regards to differentiating into MN-like cells. To solve this limitation, we genetically engineered hMSCs to express MN-associated transcription factors, Olig2 and Hb9, and then treat the hMSCs expressing Olig2 and Hb9 with optimal MN induction medium (MNIM). This method of induction led to higher expression (>30% of total cells) of MN markers. Electrophysiological data revealed that the induced hMSCs had the excitable properties of neurons and were able to form functional connections with muscle fibers in vitro. Furthermore, when the induced hMSCs were transplanted into an injured organotypic rat spinal cord slice culture, an ex vivo model of spinal cord injury, they exhibited characteristics of MNs. The data strongly suggest that induced Olig2/Hb9-expressing hMSCs were clearly reprogrammed and directed toward a MN-like lineage. We propose that methods to induce Olig2 and Hb9, followed by further induction with MNIM have therapeutic potential for autologous cell replacement therapy to treat degenerative MN disorders

Analysis of Imprinted Gene Expression in Normal Fertilized and Uniparental Preimplantation Porcine Embryos

In the present study quantitative real-time PCR was used to determine the expression status of eight imprinted genes (GRB10, H19, IGF2R, XIST, IGF2, NNAT, PEG1 and PEG10) during preimplantation development, in normal fertilized and uniparental porcine embryos. The results demonstrated that, in all observed embryo samples, a non imprinted gene expression pattern up to the 16-cell stage of development was common for most genes. This was true for all classes of embryo, regardless of parental-origins and the direction of imprint. However, several differentially expressed genes (H19, IGF2, XIST and PEG10) were detected amongst the classes at the blastocyst stage of development. Most interestingly and despite the fact that maternally and paternally expressed genes should not be expressed in androgenones and parthenogenones, respectively, both uniparental embryos expressed these genes when tested for in this study. In order to account for this phenomenon, we compared the expression patterns of eight imprinted genes along with the methylation status of the IGF2/H19 DMR3 in haploid and diploid parthenogenetic embryos. Our findings revealed that IGF2, NNAT and PEG10 were silenced in haploid but not diploid parthenogenetic blastocysts and differential methylation of the IGF2/H19 DMR3 was consistently observed between haploid and diploid parthenogenetic blastocysts. These results appear to suggest that there exists a process to adjust the expression status of imprinted genes in diploid parthenogenetic embryos and that this phenomenon may be associated with altered methylation at an imprinting control region. In addition we believe that imprinted expression occurs in at least four genes, namely H19, IGF2, XIST and PEG10 in porcine blastocyst stage embryos