We evaluated the prognostic significance of excision repair cross-complementation group 1 protein (ERCC1) and thymidylate synthase (TS) in patients with nasopharyngeal cancer (NPC) treated with concurrent chemoradiotherapy (CCRT). Pre-treatment tumor biopsy specimens from 41 patients with locally advanced NPC (stage I: 1, II: 10, III: 9, IV: 21 patients) were analyzed for ERCC1 and TS expression by immunohistochemistry. All patients were treated with one cycle of induction chemotherapy (5-fluorouracil 1000mg/m(2)/day and cisplatin 20mg/m(2)/day, days 1-4) followed by CCRT starting on day 22. CCRT consisted of radiotherapy (70Gy/35 fractions for 7weeks) with cisplatin 20mg/m(2)/day for 4days on weeks 1, 4, and 7 of radiotherapy. High expression of ERCC1 and TS was observed in 25 (60%) and 21 (51%) patients, respectively. High expression of ERCC1 was associated with WHO type 1 or 2 histology (p=0.045). With a median follow-up duration of 106months (32-152months) in survivors, the 5-year overall survival (OS) of all patients was 53%. In univariate analysis, 5-year OS (73% versus 39%, p=0.005) was significantly inferior in patients with high expression of ERCC1, while high expression of TS was not correlated with patient outcome. In multivariate analysis, high expression of ERCC1 was a significant independent prognostic factor for poor OS (p=0.029) along with WHO type 1 or 2 histology. High expression of ERCC1 protein may be a useful prognostic factor for poor outcome in patients with locally advanced NPC treated with CCRT.

This study investigates the fate of nitrogen species during nitrate reduction by nanoscale zero valent iron (NZVI) as well as the related kinetics. The NZVI used for the experiments was prepared by chemical reduction without a stabilizing agent. The pseudo first order kinetic constant of nitrate reduction at 30 degrees C with an NZVI/nitrate ratio of 1.25:1, which were the reference conditions of this study, was 4.08 h(-1)(R(2)=0.955). A nitrogen mass balance was established by quantitative analysis of aqueous-phase and gas-phase nitrogen species. The results confirm that the nitrate was converted to ammonium ion, that ammonia stripping subsequently occurred under a strong alkaline condition, and that the total amount of aqueous nitrogen was consequently reduced. The nitrate reduction rate also increased with a lower pH and a higher temperature when microscale ZVI was used. However, in contrast to the reaction by microscale ZVI, the nitrate reduction rate by NZVI was higher for an unbuffered condition, possibly due to the abundance of surface atoms and the smaller size.

The objective of this study was to evaluate the pharmacokinetic profiles of toltrazuril (TZR), and its major metabolites toltrazuril sulfoxide (TZR.SO) and toltrazuril sulfone (TZR.SO(2)) in rabbits after oral administrations. Rabbits were dosed once with 10 and 20mg/kg TZR via stomach tube with manual restraint. The plasma concentrations of TZR, TZR.SO and TZR.SO(2) were determined by liquid chromatography/mass spectrometry. Plasma concentration-time data after single oral administration were analyzed by a non-compartmental analysis. Plasma peak concentrations of TZR, TZR.SO and TZR.SO(2) were 30.2+/-1.5mug/mL at 20.0+/-6.9h, 8.9+/-1.3mug/mL at 20.0+/-6.9h and 14.7+/-3.9mug/mL at 96.0+/-0.0h after oral administration of TZR with 10mg/kg bw, respectively. The terminal elimination half-lives for TZR, TZR.SO and TZR.SO(2) after oral dose of 10mg/kg were 52.7+/-3.6, 56.1+/-10.7 and 76.7+/-7.5h, respectively. Plasma peak concentrations of TZR, TZR.SO and TZR.SO(2) were 39.4+/-1.2mug/mL at 28.0+/-6.9h, 12.5+/-3.9mug/mL at 20.0+/-6.9h and 24.9+/-8.74mug/mL at 112.0+/-6.9h after oral administration of TZR with 20mg/kg bw, respectively. The terminal elimination half-lives for TZR, TZR.SO and TZR.SO(2) after oral dose of 20mg/kg were 56.7+/-1.9, 68.8+/-12.5 and 82.3+/-12.6h, respectively. In conclusion, TZR was very well-absorbed through the gastrointestinal tract and rapidly metabolized to TZR.SO and TZR.SO(2) in rabbits after oral administration. TZR.SO(2) was actually more slowly eliminated than TZR and TZR.SO.

BACKGROUND: Interleukin-6 (IL-6) is a key player in modulating inflammation. IL-6 and soluble IL-6 receptor (sIL-6R) complex induces the synthesis and secretion of various chemokines, adhesion molecules and angiogenic molecules. We hypothesized that the baseline peritoneal solute transport rate (PSTR) early after commencing peritoneal dialysis (PD) may depend largely on the IL-6/sIL-6R system. We also hypothesized that the dialysate concentrations of IL-6/sIL-6R could be closely related to local inflammation or angiogenesis in the peritoneal cavity. METHODS: Fifty incident patients with a modified peritoneal equilibration test result within 3 months after commencing PD and without a previous history of peritonitis were enrolled. Clinical parameters such as age, sex, comorbid disease, body mass index, residual renal function and C-reactive protein were assessed. Serum and dialysate markers including CA125, IL-6, sIL-6R, monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) were measured and correlated with PSTR. RESULTS: Dialysate concentrations of IL-6 (r = 0.576, P < 0.001), MCP-1 (r = 0.408, P = 0.003) and Ang-2 (r = 0.408, P = 0.003) correlated with mass transfer area coefficient for creatinine (MTAC(cr)), respectively. Dialysate appearance rate (AR) of albumin correlated with dialysate concentrations of CA125 (r = 0.751, P < 0.001), IL-6 (r = 0.303, P = 0.039), sIL-6R (r = 0.497, P < 0.001), MCP-1 (r = 0.488, P < 0.001), VEGF (r = 0.443, P = 0.004) and Ang-2 (r = 0.488, P < 0.001). Neither MTAC(cr) nor AR of albumin was associated with systemic markers. Multivariate analysis showed that MTAC(cr) is independently associated with dialysate IL-6 and serum albumin. It also showed that AR of albumin is independently predicted by dialysate sIL-6R. Dialysate IL-6 correlated with dialysate concentrations of CA125 MCP-1, VEGF and Ang-2. CONCLUSION: Our study from incident PD patients suggested that (i) dialysate the IL-6 system is a potent determinant of baseline PSTR and (ii) elevation of IL-6 in the dialysate is associated with up-regulation of intra-peritoneal inflammatory and angiogenic molecules.

A 69-year-old male presented with obstructive hypertrophic cardiomyopathy, mitral valve regurgitation, and myxomatous mitral valve prolapse. A spontaneous chordal rupture and acute severe mitral regurgitation resulted in abrupt clinical deterioration despite complete relief of severe left ventricular outflow tract obstruction and systolic anterior motion of the anterior mitral leaflet. The patient underwent extensive cardiac surgery due to intractable heart failure. Surgical procedures included a mitral valve replacement, a septal myectomy, and the Maze procedure.

OBJECTIVE: Although an intra-arterial mechanical embolectomy extends the therapeutic time window for restoration of the cerebral blood flow, its suboptimal recanalization rate also necessitates a salvage procedure if the patient is still within the therapeutic time window. As such, a surgical embolectomy can be performed in a rapid and less invasive manner for an acute middle cerebral artery (MCA) occlusion. The technical details of this procedure are discussed and demonstrated. METHODS: Four patients with an acute MCA occlusion were treated using a novel surgical embolectomy technique after unsuccessful intra-arterial mechanical recanalization therapy. Unique to the proposed surgical technique are a laterally extended superciliary approach, small (3-mm) arteriotomy, and closure of the arteriotomy using an aneurysm clip after removal of the intravascular embolus. RESULTS: Occluded MCAs were successfully recanalized using the present technique, and the operative time from skin incision to recanalization was 1 to 1.5 hours in each patient. One to 3 arteriotomies were made in each patient. Six of the 8 arteriotomies in the present series were closed using an aneurysm clip, whereas the other 2 arteriotomies were repaired using microsutures. Postoperative angiograms demonstrated patent MCAs without remarkable clip-induced stenosis. The successful recanalization provided considerable neurological improvement in all patients without procedural complications, except for 1 patient with a fatal putaminal hemorrhage resulting from a reperfusion injury. CONCLUSION: A laterally extended superciliary approach and clip application for arteriotomy closure enable a surgical embolectomy to become a rapid and less invasive procedure.

TiO2 mesoporous films with a thickness more than 2 microm were synthesized through the evaporation-induced self-assembly approach. In order to prevent the formation of cracks due to the strain during the calcination, we employed the ZnO nanorod arrays as a pre-embedded support, which were obtained from an aqueous solution method. The spaces between ZnO nanorods were filled with TiO2 sol-gel by a dip-coater. Then ZnO nanorods embedded in the thick film were eliminated by a wet chemical etching method and the left spaces were refilled by the TiO2 sol-gel. As a result, a dense and thick TiO2 mesoporous film was obtained. The resultant materials were characterized in detail by using small angle X-ray diffraction (SAXRD), field-emission scanning electron microscopy (FESEM) and transmission electron microscopy methods (TEM).

We fabricated Volmer-Weber type ZnO nanorods by using a hydrothermal method combing with an RF sputtering system. Volmer-Weber type ZnO seed nanocrystals were formed on Pt(111)/TiO2/SiO2/Si(100) substrates by using RF sputtering method and then the seeded substrates were soaked in an aqueous chemical solution, which was mixed with Zn(NO3)2 x 6H2O and NaOH. We found that ZnO nanorods were perpendicularly grown along the [002] direction by using X-ray diffraction (XRD) and scanning electron microscopy (SEM) methods. We also confirmed that fabricated ZnO nanorods were Volmer-Weber type by using an energy dispersive X-ray spectrometer (EDX) method.

Venous thrombosis and thromboembolism appear to occur more often in patient with inflammatory bowel disease (IBD). The cause of thrombotic complications in IBD is generally considered to be associated with hypercoagulable conditions. Its prevalence rate ranges from 1% to 8% in clinical studies and rises to 39% in autopsy, but the renal vein thrombosis is very rare complication in ulcerative colitis patient. A 24-year-old man presented with intermittent abdominal pain and hematochezia for 6 months and recently developed pitting edema for few weeks. He was diagnosed as severe ulcerative colitis involving whole colon combined with thrombosis in both renal veins by colonoscopy and computed tomography scan of abdomen. We used steroid for the treatment of ulcerative colitis and both intravenous lower molecular weight heparin and warfarin for renal vein thrombosis. His symptoms were improved after treatment and maintained with mesalazine and warfarin. Follow-up abdominal CT scan showed complete resolution of both renal vein thrombosis. Currently he has been followed up for 2 years with oral mesalazine.

As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p<0.05 to p<0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7mug/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000Hz with odds ratios raging from 3.06 to 6.26 (p<0.05~p<0.005). We concluded that elevated blood lead at level below 10mug/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.