Despite wide spread use of the radial artery (RA) graft for coronary artery bypass grafting, the change of hand circulation after RA harvest has not been fully clarified. Severe hand ischemia such as resting pain or gangrene is a rare complication and has been reported in 4 patients. These cases resulted from occlusive artery disease in forearm, which should be carefully explored before RA harvest. Incidence of mild hand ischemia such as hand claudication or fatigue is unknown, but our study suggested that around 10% of the patients developed mild hand ischemia after RA harvest. The blood flow to the forearm territory was decreased by 20% after RA harvest despite the compensatory dilatation of ulnar artery. The presence of low perfusion in the affected hand has been pointed out in some studies. We reported the decreased tissue oxygenation of the affected hand during hand grip exercise. The Allen test is the most popular preoperative screening method, but is associated with considerable numbers of false-positive and falsenegative results. Full length scanning of ulnar artery by ultrasonography seems to have a lower false-positive rate. But further clinical experience is necessary to establish a more reliable screening method.

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This study compares temporomandibular joint dysfunction (TMD) symptoms before and after bilateral sagittal split ramus osteotomy, and identifies predictive factors for the postoperative TMD symptoms by assessing the adjusted odds ratio using multiple logistic regression analysis. A consecutive series of 37 cases treated only with bilateral sagittal split ramus osteotomy were evaluated. New postoperative TMD symptoms appeared in 9 cases, preoperative TMD symptoms disappeared in 6 cases, and TMD symptoms were unchanged in 5 cases. The median period until the interincisal opening range attained 40 mm was 5 months (range, from 2 to 15 months). Age was a positive factor in patients with postoperative TMD symptoms, with an odds ratio of 1.43 (95 percent confidence interval, from 1.05 to 1.93). In addition, the maximum value of the bilateral setback distance of more than 9 mm was a positive factor of 6.95 (95 percent confidence interval, from 1.06 to 45.42). We concluded that surgical correction in skeletal malocclusion may affect temporomandibular joint dysfunction symptoms.

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The ideal dressing material is bio-inert and keeps the wound site moist. It is equally important that no regenerative tissue is peeled off on the removal of the dressing. 2-Methacryloyloxyethyl phosphorylcholine (MPC) has a phospholipid polar group that mimics a biomembrane. We prepared poly [MPC-co-n-dodecyl methacrylate (DMA)] (PMD), using conventional radical polymerization with 2,2’-azobisisobutyronitrile as an initiator, and coated it on polyurethane (PU; Tecoflex^®
60 Thermedics Inc.) membrane. Fullthickness surgical wounds were made on the dorsal skin of rats and wound healing was compared under the following three conditions: air-exposed control (no dressing), PU dressing, and PMD dressing. At 3, 4 and 7 days after the operation, the wound sizes of the PMD dressings were smaller than the non-dressed wound, and at 6 and 7 days after the operation, the wound sizes of PU dressing were smaller than that of the air-exposed group. But there were no significant difference between the PMD dressing group and PU dressing group. Histologically, scab formation was not observed on the PU or PMD-dressed wounds. However, in the air-exposed control, a scab was formed and reepithelialization of the wound site was prevented. Additionally, no damage was observed in the histological section of PMD dressed wound after the wound was cured. These results indicate that PMD dressing (PMD-coated PU membrane) has the potential to provide an inert environment for wound healing as well as PU.

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Purpose: Aim of this study was to determine patients' preference to acrylic resin major connector analogues (MCA) that simulated strengthened major connector designs formulated for Ti-6Al- 7Nb alloy. Materials and methods: Four MCA namely wide design (Wide), design with 2 strengthening ridges (2SR), design with 1 strengthening ridge (1SR), and thick design (Thick) were fabricated using light-polymerizing acrylic resin for 10 patients with Kennedy Class I or II partially edentulous maxillary arches. They were asked to wear each MCA in the mouth for 30 seconds in 6 pairs, and to report their preference for each pair. Using these data the 4 MCA were ranked in a descending preference order for each patient. A within-subject comparison of preferences was performed with the Friedman test and multiple comparisons with Wilcoxon Signed Ranks test. Results: A statistically significant preference order was revealed: Wide, 1SR, 2SR, and Thick (P<0.008). The wide design (P<0.004) and the 1SR (P<0.01) were significantly preferred to the thick design. However, individual data showed that the first preference varied depending upon the subject. Conclusion: Thinner designs tended to be preferred to the thicker design by the subjects, while none of the designs tested were consistently selected as the best design.

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Glomerular visceral epithelial cells or podocytes are located on the outer surface of the glomerular basement membrane and play an indispensable role as a filtration barrier. The core cytoskeleton of the foot processes is actin filaments, which play an important role in maintaining the unique structure of podocytes. We previously established a transgenic mouse line (NEP25), which expresses human (h)CD25 selectively on podocytes. By injecting an hCD25-targeted recombinant immunotoxin (LMB2), podocyte injury can be induced on demand. After LMB2 injection, NEP25 mice develop nephrotic syndrome with downregulation of podocyte-specific proteins. In the present study, we genetically labeled podocytes with lacZ linked with β-actin-based CAG promoter. Utilizing the Cre-loxP system, this labeling was confined to the podocyte lineage. Without LMB2, all podocytes were positive for lacZ. After LMB2 injection, lacZ expression was rapidly downregulated, before podocytes showed any discernible morphological changes. Confocal imaging of filamentous (F)- actin-binding Alexa 488-phalloidin revealed that the normal continuous pattern of F-actin distribution in podocytes was punctuated after LMB2 injection. These collectively suggest that disturbance of actin filaments may be one of the key initial events leading to subsequent podocyte damage.

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Human herpesvirus-6B (HHV-6B), a causative agent of exanthem subitum, infects human adult T cell leukemia (ATL) cell lines. We established a persistent HHV-6B infection in an ATL cell line, TaY, in the presence of 20 units/ml interleukin-2 (IL-2). The HHV-6B infected culture proliferated with a constant ratio of infected (1%) to the uninfected (99%) cells. When the IL-2 concentration was reduced to 5 units/ml, the number of infected cells in the culture increased transiently by 60% in 11 days, a new balance of 25% infected cells and 75% uninfected cells was established thereafter. PCR analysis confirmed a 125-fold increase in the amount of viral genome in the culture, while the treatment with ganciclovir reduced the proportion of infected cells, indicating that an efficient replication of virus was induced in the culture. Both of these cultures were maintained in the presence of 20 or 5 units/ml IL-2 over one year without loss of infected cells. Interestingly, we found that cultures containing the infected cells grew significantly faster than the parental uninfected cells at the same concentration of IL-2. The infected culture continued to grow for 7 days even in the absence of IL-2. Because the infection induces cell cycle arrest, these results indicate that the HHV-6B-infected ATL cells stimulate the growth of the uninfected cells during persistent infection in culture.

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Background: It is unknown whether insurance status influences care provided and patients' prognosis, in China. Methods: This retrospective cohort study included medical records of 4,714 patients with acute myocardial infarction aged 20 and older, discharged consecutively from 14 Chinese hospitals between January 2000 and February 2003. Uni-variate analysis, multivariate logistic regression and linear regression were used to compare differences in patients’ characteristics, care provided and prognosis between insured patients and the uninsured. Results: The uninsured were more likely to be older, female, have transfer admissions, and less likely to be hospitalized to institutions with cardiac interventional facilities, intensive care units or coronary care units. The uninsured were also less likely to undergo diagnostic procedures, interventions and to receive medications, and stayed shorter in hospital and consumed less health care resources. In-hospital mortality in the uninsured, the non-government insured and the government insured was 10.5%, 12.2% and 8.4% respectively. After adjusting for potential confounders, odd ratio in hospital mortality was 1.079 (95% CI, 0.836–1.392) and 0.763 (95% CI, 0.559–1.041) for the non-government insured and the government insured, compared to the uninsured. At significant level of 0.05, we could not assert insurance status is a significant factor to in-hospital mortality.

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