Neonates, although deficient in cell immunity, frequently reveal sepsis with augmented proinflammatory reactions. Here, we found that neonatal monocytes produced significantly higher TNF-α mRNA and protein than adult monocytes. Assessment of the transcriptional factor found no significant difference of NF-κB p65 level between neonatal and adult monocytes. Addition of Act D to access the half-life of TNF-α mRNA revealed no significant difference of the LPS-induced TNF-α mRNA half-life between them, whereas CHX increased neonatal TNF-α mRNA significantly. This suggests that a post-transcriptional mechanism involves the augmentation of TNF-α production by neonatal monocytes. To examine whether miRNA was involved in the post-transcriptional regulation, differential displays of miRNA array between neonatal and adult MNCs were performed, along with the discovery of hsa-miR-103, hsa-miR-125b, hsa-miR-130a, hsa-miR-454-3p, and hsa-miR-542-3p, which were greater than a twofold decrease or increase after LPS treatment for 4 h. The functional validation identified that miR-125b decreased significantly in association with higher TNF-α expression by neonatal monocytes after LPS stimulation. Transfection of the miR-125b precursor into neonatal monocytes significantly repressed the TNF-α mRNA and protein expression, suggesting that miR-125b negatively regulates TNF-α expression in neonatal monocytes. Modulation of miRNA expression may be used to regulate TNF-α production in newborns with altered proinflammatory reactions.

ObjectiveSmall-bore pigtail catheters have been found to be effective in the treatment of primary spontaneous pneumothorax (PSP) in adults. The aim of this study was to compare the effectiveness of small-bore pigtail and large-bore catheters in the treatment of PSP in young adolescents.Materials and methodsYoung adolescents (<18 years) with initial PSP were treated with aspiration (control group), small-bore pigtail catheters or large-bore catheters. Treatment was determined on a case-by-case basis with parental consultation. Success rate, recurrence rate (within 12 months), duration of hospital stay, duration of catheter insertion, and complications were analysed.Main resultsThere were 41 patients treated: aspiration, n=8; small-bore pigtail catheters, n=10; large-bore catheters, n=23. Demographic and baseline clinical characteristics were similar between groups. The success rates were 50.0% and 65.2% in the small-bore pigtail and large-bore catheter groups, respectively. Corresponding recurrence rates were 20.0% and 56.5%. There was no difference between the small-bore pigtail and large-bore catheter groups in the duration of hospital stay in patients for whom treatment was successful; however, the duration of catheter insertion was significantly shorter in the small-bore pigtail catheter group compared with the large-bore catheter group in patients for whom treatment was successful (p<0.05). There were no major complications in either catheter treatment group and few minor complications (small-bore pigtail catheter, n=2; large-bore catheter, n=4).ConclusionsThe findings suggest that small-bore pigtail catheters may be as effective as large-bore catheters for the initial treatment of PSP in young adolescents.

A patient with peripheral polyneuropathy after bariatric surgery for morbid obesity is reported. She suffered from frequent episodes of vomiting and abdominal pain after surgery. Muscle weakness in her lower limbs developed 5 months later and she experienced difficulty in walking and standing. Wrist drop, foot drop, and marked distal limb muscle atrophy were found bilaterally. Electromyography showed the presence of sensorimotor axonal polyneuropathy. Nutritional deficiencies may play an important role in pathogenesis. This uncommon neurological complication might be due to rapid weight loss and vitamin deficiency. Physicians who take care for patients after bariatric surgery should have a high index of awareness for the neurologic complications, and routine vitamin supplementation might be useful for these patients.

The different transport pathways of 5-nm polymer-coated gold nanoparticles (Au NPs) crossing epithelial Caco-2 cell monolayers were explored. We found that the majority of cationic and neutral Au NPs depended heavily on endocytosis for cellular uptake and transport, and the anionic charged nanoparticles trafficked preferentially through the tight junctions (i.e., a paracellular pathway). The current study demonstrates that the surface chemistry of neutral polymer coatings dictate the trafficking through Caco-2 cell monolayers; poly(ethylene glycol)-coated Au NPs traffic via an endocytosis pathway assisted by microtubules; poly(2,3-hydroxy-propylacrylamide)-coated Au NPs traffic via endocytosis but assisted by other nonmicrotubular pathways. The Au NPs coated with poly(N-isopropylacrylamide)(hydrophobic above the lower critical solution temperature of 32°C) traffic via either the microtubule-assisted endocytosis pathway or the paracellular pathway depending on the temperature. This knowledge will aid in the future of the design of nanoparticles as potential oral drug carriers. FROM THE CLINICAL EDITOR: The authors examined different transport pathways of polymer-coated gold nanoparticles to cross epithelial Caco-2 cells, concluding that surface chemistry of neutral polymer coatings dictates the trafficking through monolayers.

Purpose: The present study was performed to evaluate the 5-year status of immediately placed implants subjected to maxillary sinus elevation without grafting. Materials and Methods: Implants were placed in 2004 and 2005. A minimum of 3 mm of residual bone height (RBH) was required. All implants were placed with a sinus elevation performed through a lateral approach by the trap-door, open-window method without placement of any grafting material. Regular follow-up included oral hygiene instruction, periodontal charting, panoramic radiographs, and cone beam computed tomographic scans. The gained bone height (GBH) in the sinus, peri-implant sulcus depth, and marginal bone loss were analyzed statistically. Results: Forty-four patients (26 men, 18 women) with an average age of 58 years received 80 implants, which were followed for 5 years after prosthesis delivery. No patients developed sinusitis or other complications leading to implant loss. The average RBH was 5.06 ± 1.51 mm and the average intrasinus implant length was 7.77 ± 1.69 mm. Survival rates for the implants were 100% after 2 and 5 years. Average GBH was 7.24 ± 1.83 mm at 2 years (range, 3 to 12 mm) and 7.44 ± 1.94 mm at 5 years (P >.05). The average peri-implant sulcus depths were 2.5 ± 0.4 mm at 2 years and 3.1 ± 0.5 mm at 5 years (P <.05). The mean peri-implant marginal bone loss was 1.3 ± 0.3 mm at 2 years and 2.1 ± 0.5 mm at 5 years (P <.05). Conclusions: New bone formation in the sinus was confirmed, and good survival of implants with maxillary sinus elevation by the lateral approach without grafting was observed after 5 years. Attention should be focused on oral hygiene maintenance to ensure peri-implant gingival health. Int J Oral Maxillofac Implants 2011;26:1079-1086.

Effects of UV irradiation on humic acid (HA) removal by Fe(0)/air, ozonation and Fenton oxidation were investigated. The trihalomethane forming potential (THMFP) and toxicity of treated solutions were also evaluated. The experimental conditions were ozone of 21mgmin(-1), H(2)O(2) of 8×10(-4)M, Fe(0) of 20gL(-1), air flow of 5Lmin(-1), and UVC of 9W. Results indicated that Fe(0)/air rapidly removed HA color (>99%) and COD (90%) within 9min. 51-81% of color and 43-50% of COD were removed by ozonation and Fenton oxidation after 60min. Both UV enhanced ozone and Fenton oxidation removed HA, but the Fe(0)/air process did not. Spectrum results showed all processes effectively diminished UV-vis spectra, except for ozonation. The THMFP of Fe(0)/air-treated solution (114μgL(-1)) was much lower than those of Fenton-(226μgL(-1)) and ozonation-treated solutions (499μgL(-1)). Fe(0)/air with UV irradiation obviously increased the THMFP of treated solution (502μgL(-1)). The toxicity results obtained from Vibrio fischeri light inhibition test indicated that the toxicity of Fe(0)/air-treated solution (5%) was much lower than that of ozonation-(33%) and Fenton-treated solutions (31%). Chlorination increased the solution toxicity. The correlation between biotoxicity and chloroform in the chlorinated solution was insignificant.

To improve the existing trial-and-error process in designing a microfluidic T-junction, a systematic study of the geometrical (mainly the channel length) effects on the generated bubbly/slug flow was conducted to figure out basic design guidelines based on experimental and theoretical analyses. A driving system with dual constant pressure sources, instead of the commonly used dual constant volume-rate sources (such as two syringe pumps), was chosen in this study. The newly proposed effective pressure ratio (P(e)*) has revealed its advantages in excluding the surface tension effect of fluids. All the data of generated bubbly/slug flow for a given geometry collapse excellently into the same relationship of void fraction and effective pressure ratio. This relationship is insensitive to the liquid viscosity and the operation range is strongly affected by the geometrical effect, i.e., the channel length ratio of downstream to total equivalent length of the main channel in a T-junction chip. As to the theoretical design and analysis of gas-liquid-flow characteristics in a microfluidic T-junction, which is still sporadic in the literature, the proposed semi-empirical model has successfully predicted the operation boundaries and the output flow rate of bubbly/slug flow of different investigated cases and demonstrated its usability.

Human newborns are known to be susceptible to microbial infection. This susceptibility is generally attributed to immaturity of the newborn immune system. However, the mechanisms for impaired immunity in newborns are still incompletely defined. In this study, we sought to elucidate the protein differential display between adult and neonatal mononuclear cells (MNC) using a proteomic approach. MNC samples from cord blood and adult peripheral blood were subjected to 2-D PAGE analysis. Differential protein displays between cord blood and adult MNC were determined and validated. There were 34 differentially expressed proteins between cord blood and adult MNC identified by 2-D PAGE. The differentially displayed proteins were clustered into two major signal pathways, cellular processing and purine metabolism. After validation by Western blot, we found more abundant arginase-1 (ARG1) and Rho GDP-dissociation inhibitor 2 (RhoGDI2), while less adenosine deaminase (ADA) and β-actin in cord blood MNC. In functional validation, we found that lower ADA was proven to enhance the TNF-α production by cord blood monocytes. The results from this study discovered the proteomic displays for altered immunity between adult and neonatal MNC that support a understanding of the correction of impaired immune response in newborns.

BACKGROUND/PURPOSE Pediatric patients with atrial septal defect (ASD) may have failure to thrive. This study aimed to investigate body weight changes in pediatric patients after transcatheter closure of ASD. METHODS From June 2003 to September 2008, we enrolled 60 pediatric patients who underwent transcatheter closure of ASD. Changes in body weight percentile, heart rate, and resolution of right ventricular hypertrophy were compared before and after ASD closure. Patients were divided into two groups according to initial weight percentile: group A,<50(th) percentile (n = 39) and group B, ≥50(th) percentile (n = 21). Echocardiography and routine weight measurements were performed before the procedure and at 3, 6, and 12 months during follow-up. Clinical presentations, laboratory data, and outcomes were measured. RESULTS Increased body weight percentile (41±4 vs. 48±4, p<0.01), lower heart rate (100±2 beats/min vs. 89±2beats/min, p<0.01), and resolution of right ventricular hypertrophy (59/60 vs. 1/60, p<0.01) were achieved after ASD closure at the 12-month follow-up. Patients in group A were significantly younger (4.6±0.5 years vs. 7.0±0.9 years, p = 0.016), had a higher pulmonary/systemic blood flow ratio (2.2±0.1 vs. 1.8±0.l, p = 0.044), a largerratio of ASD diameter/body surface area (25.0±1.4 vs. 16.4±1.9, p<0.01), and higher percentage of weight gain increase ≥ 5 percentile compared with patients in group B (22/39 vs. 6/21, p = 0.039). CONCLUSION Transcatheter closure of ASD positively affects weight gain. An increase of 7 percentile weight was observed at 1 year of follow-up. Patients with a younger age, higher pulmonary/systemic blood flow ratio, and a larger ratio of ASD diameter/body surface area may have better weight gain after ASD closure.