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Biomedical subjects

David Wang

Publications and source records attributed to David Wang.

At least 37 records · Page 2Linked to original sources

Ameliorative effect of ozone on cytokine production in mice injected with human rheumatoid arthritis synovial fibroblast cells.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by invasion of hyperplastic synovial cells and progressive joint destruction. Ozone therapy has been proposed as an immunomodulator and cellular metabolic activator which shows long-term anti-inflammatory effects and serves to reduce further the proinflammatory factors. We purified RA synovial fibroblast cells (RA-SFc) from patients and avoided contaminating macrophages by flow cytometry, then treated them with ozone. Following the observable decreased production of proinflammatory factors TNF-alpha, IL-1beta, and IL-6 from RA-SFc, we infused the cultured RA-SFc into joints of severe combined immunodeficiency mice. The mRNA and protein levels of the RA-SFc exposed to 3% and 5% ozone were the same. As a result, 3% and 5% ozone applied externally ameliorated the inflammatory reaction of RA without toxicity or serious side effects. Therefore, ozone injected into the knees of RA patients could become a valuable treatment, and we confirm the interactive mechanism between ozone and RA-SFc.

Animals↗

Effects of various antioxidants on endotoxin-induced lung injury and gene expression: mRNA expressions of MnSOD, interleukin-1beta and iNOS.

Antioxidants have been shown to be effective in attenuating acute lung injury. In this study, we determine the effects of various antioxidants by different mechanisms on the lipopolysaccharide (LPS)-induced changes. LPS was administered intravenously at a dose of 10 mg/kg to anesthetized rats. LPS induced a significant decrease in blood pressure (P < 0.01) and increased exhaled nitric oxide (NO) from 3.60+/-0.18 to 35.53+/-3.23 ppb (P < 0.01) during an observation period of 4 h. Plasma nitrate concentrations also increased from 0.61+/-0.06 to 1.54+/-0.22 micromol/l (P < 0.05). LPS-induced oxygen radical release from white blood cells isolated from rat peripheral blood also increased significantly (P < 0.001). After the experiment, the lung weight was obtained and lung tissues were taken for the determination of mRNA expression of inducible nitric oxide synthase (iNOS), tumor necrosis factor alpha (TNF-alpha), interleukin-1beta (IL-1beta) and manganese superoxide dismutase (MnSOD). Histological examination of the lungs was also performed. In the control group injected with saline solution, mRNA expressions of iNOS, IL-1beta, TNF-alpha and MnSOD were absent. Four hours after LPS administration, mRNA expressions of iNOS, IL-1beta, and MnSOD were significantly enhanced, but TNF-alpha was not discernibly expressed. LPS also caused a twofold increase in lung weight. Pathological examination revealed endothelial cell damage and interstitial edema. Various antioxidants were given 1 h after LPS administration. These agents include SOD, catalase (CAT), SOD + CAT or vitamin C (ascorbic acid). These antioxidants effectively reversed the systemic hypotension, reduced the quantity of exhaled NO and plasma nitrate concentration, and prevented acute lung injury. Administration of various antioxidants also significantly attenuated LPS-induced oxygen radical release by rat white blood cells. LPS induced mRNA expressions of MnSOD and iNOS were significantly depressed by these antioxidants. However, only SOD + CAT and vitamin C inhibited the mRNA expression of IL-1beta. These results suggest that oxygen radicals are responsible for LPS-induced lung injury. Antioxidants can attenuate the lung injury by inhibiting mRNA expressions of iNOS and IL-1beta.

Animals↗

Ischemia and reperfusion of liver induces eNOS and iNOS expression: effects of a NO donor and NOS inhibitor.

The aim of this study was to investigate the role of nitric oxide (NO) in hepatic ischemia-reperfusion (I/R) injury in rats. Immunohistochemistry was used to examine the protein expression of endothelial and inducible nitric oxide synthases (eNOS, iNOS) and nitrotyrosine after I/R challenges to the liver, and blood levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactic dehydrogenase (LDH), hydroxyl radical and NO were measured before ischemia and after reperfusion. Ischemia was induced by occlusion of the common hepatic artery and portal vein for 40 min, followed by reperfusion for 90 min. Reperfusion of the liver induced a significant increase in the blood concentrations of AST, ALT, LDH (n = 8; P < 0.001), hydroxyl radical (n = 8; P < 0.001) and NO (n = 8; P < 0.01). The eNOS, iNOS, nitrotyrosine, SOD1 and SOD2 protein expression was also found to increase significantly after reperfusion (n = 3). Administration of the NOS inhibitor N(omega)-nitro-L-arginine methyl ester (L-NAME) (n = 8) had a protective effect on the I/R-related injury, but the NO donor L-arginine (L-Arg) (n = 8) potentiated the damage caused by I/R. These results suggest that reperfusion of the liver induces expression of NOS, which is related to the elevation of blood NO. The increase in hydroxyl radical concentration was accompanied by an increase in antioxidant enzyme expression (SOD1 and SOD2), and an increase in nitrotyrosine expression was also observed, reflecting the increased production of NO and oxygen radicals. We concluded from the protective effect of L-NAME and the potentiation by L-Arg that NOS expression and increases in NO and hydroxyl radical production have deleterious effects on the response to I/R in the liver.

Alanine Transaminase↗

Inhaled nitric oxide exacerbated phorbol-induced acute lung injury in rats.

In this study, we determined the effect of inhaled nitric oxide (NO) on the acute lung injury induced by phorbol myristate acetate (PMA) in isolated rat lung. Typical acute lung injury was induced successfully by PMA during 60 min of observation. PMA (2 microg/kg) elicited a significant increase in microvascular permeability, (measured using the capillary filtration coefficient Kfc), lung weight gain, lung weight/body weight ratio, pulmonary arterial pressure (PAP) and protein concentration of the bronchoalveolar lavage fluid. Pretreatment with inhaled NO (30 ppm) significantly exacerbated acute lung injury. All of the parameters reflective of lung injury increased significantly except PAP (P<0.05). Coadministration of Nomega-nitro-L-arginine methyl ester (L-NAME) (5 mM) attenuated the detrimental effect of inhaled NO in PMA-induced lung injury, except for PAP. In addition, L-NAME (5 mM) significantly attenuated PMA-induced acute lung injury except for PAP. These experimental data suggest that inhaled NO significantly exacerbated acute lung injury induced by PMA in rats. L-NAME attenuated the detrimental effect of inhaled NO.

Administration, Inhalation↗

Protective effect of U74500A on phorbol myristate acetate-induced acute lung injury.

1. The present study was designed to determine whether U74500A could ameliorate acute lung injury (ALI) induced by phorbol myristate acetate (PMA) in our rat isolated lung model compared with any amelioration induced by dimethylthiourea (DMTU), superoxide dismutase (SOD) and catalase. 2. Acute lung injury was induced successfully by PMA during 60 min of observation. At 2 microg/kg, PMA elicited a significant increase in microvascular permeability (measured using the capillary filtration coefficient Kfc), lung weight gain, the lung weight/bodyweight ratio, pulmonary arterial pressure and protein concentration of the bronchoalveolar lavage fluid. 3. Pretreatment with 1.5 mg/kg U74500A significantly attenuated ALI; there was no significant increase in any parameters measured, except for pulmonary arterial pressure. The protective effect of U74500A was approximately the same as that of 600 mg/kg DMTU. However, 6000 U/kg SOD, 50,000 U/kg catalase and 6000 U/kg SOD + 50,000 U/kg catalase had no protective effect. 4. These experimental data suggest that U74500A significantly ameliorates ALI induced by PMA in rats.

Animals↗

A new algorithm for determining collimator angles that favor efficiency in MLC based IMRT delivery.

A new algorithm to determine collimator angles that favor delivery efficiency of intensity modulated radiotherapy plans was developed. It was found that the number of segments and monitor units (MUs) were largely reduced with the set of collimator angles determined with the new algorithm without compromising plan quality. The improvement of delivery efficiency using the new algorithm depends on the size and shape of the target(s), the number of modulation levels, and the type of leaf-sequencing algorithm. In a typical prostate case, when a sweeping leaf-sequencer is used for Varian 120 leaf (0.5 x 0.5 cm2 beamlet), 80 leaf (1 x 1 cm2 beamlet) and Elekta 40 leaf (1 x 1 cm2 beamlet), the number of segments was reduced by 42%, 29%, and 5%, respectively. The number of MUs was reduced by 41%, 35%, and 10%. For the Siemens MLC (IMFAST leaf sequencer, 1 x 1 cm2 beamlet) the segment reduction was 32% and the MU reduction was 14%. Comparison of the plans using the new and Brahme algorithms, in terms of target conformity index and dose volume histogram of the organs at risk, showed that the quality of the plans using the new algorithm was uncompromised. Similar results were obtained for a set of head and neck treatment plans.

Algorithms↗

Static inflation attenuates ischemia/reperfusion injury in an isolated rat lung in situ.

STUDY OBJECTIVES: Ischemia (I)/reperfusion (R) lung injury is an important clinical issue in lung transplantation. In the present study, we observed the effects of lung static inflation, different perfusates, and ventilatory gas with nitrogen or oxygen on the I/R-induced pulmonary damage. DESIGN AND SETTING: A total of 96 male Sprague-Dawley rats were used. The lung was isolated in situ. METHODS: In an isolated lung, the capillary filtration coefficient (Kfc), lung weight gain (LWG), lung weight (LW)/body weight (BW) ratio, and protein concentration in BAL fluid (PCBAL) were measured or calculated to evaluate the degree of lung injury. Histologic examinations with hematoxylin-eosin staining were performed. RESULTS: I/R caused lung injury, as reflected by increases in Kfc, LWG, LW/BW, and PCBAL. The histopathologic picture revealed the presence of hyaline membrane formation and the infiltration of inflammatory cells. These values were significantly attenuated by static lung inflation. The I/R lung damage appeared to be less in the lung perfused with whole blood than in the lung perfused with an isotonic solution. Therapy with ventilatory air (ie, nitrogen or oxygen) did not alter the I/R lung damage. CONCLUSIONS: The data suggest that lung inflation is protective to I/R injury, irrespective of the type of ventilatory air used for treatment. The preservation of the lung for transplantation is better kept at a static inflation state and perfused with whole blood instead of an isotonic physiologic solution.

Animals↗

Rapid and selective cerebral hypothermia achieved using a cooling helmet.

OBJECT: Hypothermia is by far the most potent neuroprotectant. Nevertheless, timely and safe delivery of hypothermia remains a clinical challenge. To maximize neuroprotection yet minimize systemic complications, ultra-early delivery of selective cerebral hypothermia by Emergency Medical Service (EMS) personnel in the field would be advantageous. The authors (W.E. and H.W.) have developed a cooling helmet by using National Aeronautics and Space Administration spinoff technology. In this study its effectiveness in lowering brain temperature in patients with severe stroke or head injury is examined. METHODS: Patients were randomly assigned to groups receiving either the cooling helmet or no cooling, and brain temperatures (0.8 cm below the cortical surface) were continuously monitored for a mean of 48 to 72 hours with a Neurotrend sensor and then compared with the patients' core temperatures. There were eight patients in the study group and six in the control group. The mean change in temperature (brain-body temperature) calculated from 277 data hours in the study group was -1.6 degrees C compared with a mean change in temperature of +0.22 degrees C calculated from 309 data hours in the control group. This was statistically significant (p < 0.0001). On average, 1.84 degrees C of brain temperature reduction (range 0.9-2.4 degrees C) was observed within 1 hour of helmet application. It took a mean of 3.4 hours (range 2-6 hours) to achieve a brain temperature lower than 34 degrees C and 6.67 hours (range 1-12 hours) before systemic hypothermia (< 36 degrees C) occurred. Use of the helmet resulted in no significant complications. There was, however, one episode of asymptomatic bradycardia (heart rate < 40) that responded to a 0.5 degrees C body temperature increase. CONCLUSIONS: This helmet delivers initial rapid and selective brain cooling and maintains a significant temperature gradient between the core and brain temperatures throughout the hypothermic period to provide sufficient regional hypothermia yet minimize systemic complications. It results in delayed systemic hypothermia, creating a safe window for possible ultra-early delivery of regional hypothermia by EMS personnel in the field.

Adolescent↗

Pharmacological modulation of TNF production in macrophages.

The quantity and duration of production of tumor necrosis factor (TNF) is tightly controlled due to its potential to cause serious harm. For example, TNF release in response to overwhelming bacterial infection has been implicated as the first step in potentially lethal septic shock. Prostaglandins and leukotrienes are thought to play opposing roles in regulating TNF production by monocytes and macrophages. We investigated the effects of 5 drugs on the production of TNF by cells of the murine macrophage line RAW264 after stimulation with bacterial lipopolysaccharide endotoxin (LPS). These drugs were of the following 3 classes: cyclooxygenase inhibitors indomethacin (indo) and ibuprofen (ibu); 5-lipoxygenase inhibitors VZ 65 and AA-861; and methylxanthine pentoxyfilline (PTX). While indo and ibu treatment resulted in increased TNF production, PTX, VZ 65, and AA-861 significantly inhibited TNF production, whether administered simultaneously with LPS or 30 min after LPS treatment. VZ 65 and AA-861 also inhibited prostaglandin E2 (PGE2) production, coupled with an absence of any rise in intracellular cAMP. Leukotriene B4 (LTB4) levels peaked at 15 min and approached background level at 30 min after LPS treatment. Taken together, these data suggest that VZ 65 and AA-861 may inhibit TNF production through mechanism(s) independent of LTB4 production. VZ 65, AA-861, and PTX all diminished the rate of TNF mRNA transcription, yet VZ 65 and AA-861 appeared to enhance message stability. We conclude that while PTX reduced TNF protein levels by inhibiting TNF mRNA transcription, both VZ 65 and AA-861 exerted opposing effects on TNF transcription and increased mRNA stability.

Animals↗

Viral discovery and sequence recovery using DNA microarrays.

Because of the constant threat posed by emerging infectious diseases and the limitations of existing approaches used to identify new pathogens, there is a great demand for new technological methods for viral discovery. We describe herein a DNA microarray-based platform for novel virus identification and characterization. Central to this approach was a DNA microarray designed to detect a wide range of known viruses as well as novel members of existing viral families; this microarray contained the most highly conserved 70mer sequences from every fully sequenced reference viral genome in GenBank. During an outbreak of severe acute respiratory syndrome (SARS) in March 2003, hybridization to this microarray revealed the presence of a previously uncharacterized coronavirus in a viral isolate cultivated from a SARS patient. To further characterize this new virus, approximately 1 kb of the unknown virus genome was cloned by physically recovering viral sequences hybridized to individual array elements. Sequencing of these fragments confirmed that the virus was indeed a new member of the coronavirus family. This combination of array hybridization followed by direct viral sequence recovery should prove to be a general strategy for the rapid identification and characterization of novel viruses and emerging infectious disease.

Base Sequence↗

Characterization of a novel coronavirus associated with severe acute respiratory syndrome.

In March 2003, a novel coronavirus (SARS-CoV) was discovered in association with cases of severe acute respiratory syndrome (SARS). The sequence of the complete genome of SARS-CoV was determined, and the initial characterization of the viral genome is presented in this report. The genome of SARS-CoV is 29,727 nucleotides in length and has 11 open reading frames, and its genome organization is similar to that of other coronaviruses. Phylogenetic analyses and sequence comparisons showed that SARS-CoV is not closely related to any of the previously characterized coronaviruses.

Amino Acid Sequence↗

NOS inhibition accelerates atherogenesis: reversal by exercise.

In this study, we assessed the effects of chronic exercise training (12 wk) on atherosclerotic lesion formation in hypercholesterolemic apolipoprotein E-deficient mice (n = 31). At the age of 9 wk, mice were assigned to the following groups: sedentary (Sed; n = 9); exercise (Ex; n = 12); sedentary and oral NG-nitro-L-arginine (L-NNA, Sed-NA; n = 4), or exercise and oral L-NNA (Ex-NA; n = 6). Chronic exercise training was performed on a treadmill for 12 wk (6 times/wk and twice for 1 h/day) at a final speed of 22 m/min, and an 8 degrees grade. L-NNA was discontinued 5 days before final treadmill testing. The farthest distance run to exhaustion was observed in Ex-NA mice (Sed: 306 +/- 32 m; Ex: 640 +/- 87; Sed-NA: 451 +/- 109 m; Ex-NA: 820 +/- 49 m; all P < 0.05). Lesion formation was assessed in the proximal ascending aorta by dissection microscopy after oil red O staining. The aortas of Sed-NA mice manifested a threefold increase in lesion formation compared with the other groups. This L-NNA-induced lesion formation was reduced by chronic exercise training (Sed, 786 +/- 144; Ex, 780 +/- 206; Sed-NA, 2,147 +/- 522; Ex-NA, 851 +/- 253; Sed-NA vs. all other groups: P < 0.001). In conclusion, treatment with oral L-NNA (an nitric oxide synthase antagonist) leads to accelerated atherogenesis in genetically determined hypercholesterolemic mice. This adverse effect can be overcome by chronic exercise training.

Animals↗

Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary disease.

OBJECTIVES: To investigate the feasibility of an outdoor 6-minute walk test (6MWT) as a measure of functional status among individuals with chronic obstructive pulmonary disease (COPD), and to examine the relationship between performance on an indoor and an outdoor 6MWT. DESIGN: An experimental, repeated-measures crossover design. Subjects were studied on 2 separate days in the same week. Two 6MWTs-one indoors and the other outdoors-were performed on each study day, with a rest in between. The test order was randomly selected on the first day and reversed on the second day. Outdoor tests were performed on days of moderate weather conditions (mean temperature +/- standard deviation, 21 degrees +/-3 degrees C; mean wind speed, 15+/-7km/h; no precipitation) and on a flat surface (sidewalk). SETTING: Outpatient rehabilitation program in Ontario. PARTICIPANTS: Eighteen subjects with COPD (10 men, 8 women; age, 70+/-8y), 5 using supplemental oxygen at rest (forced expiratory volume in 1s, 1.0+/-0.3L; 42%+/-8% of predicted). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Distance walked in 6 minutes (in meters), duration of rest (in seconds), and change in rate of perceived dyspnea. RESULTS: There was no significant effect of setting (indoors vs outdoors) on distance walked (394+/-86m vs 398+/-84m, P=0.4), duration of rest (13+/-28s vs 9+/-20s, P=0.4), or change in rate of perceived dyspnea (2.3+/-1.7 vs 2.3+/-2.0, P=0.8). Testing day had no significant effect on walk test performance (all P>0.1). CONCLUSIONS: The results indicate that the 6MWT performed outdoors within reasonable climatic parameters may be reflective of 6MWT performance indoors.

Aged↗

Scoring polysomnography respiratory events: the utility of nasal pressure and oro-nasal thermal sensor recordings.

OBJECTIVE: To evaluate the clinical utility of nasal cannula/pressure (NP) and oro-nasal thermal sensor (Th) recordings, alone and in combination for scoring respiratory events during routine diagnostic polysomnography (PSG). BACKGROUND: The use of Th devices to measure airflow during PSG is not recommended because Th are insensitive to airflow changes other then complete airflow cessation. It has been suggested that NP recording is a better measure of airflow and can also detect increased upper airway resistance during PSG. METHODS: Thirty consecutive PSG's were examined using 13 standard channels including Th and NP recordings. Respiratory events were scored separately utilizing NP+Th, Th alone and NP alone in a blinded fashion using modified AASM criteria. Respiratory events were time matched to within 5 s for each of the recording methods. RESULTS: NP+Th detected more events than Th alone (P<0.0001); NP+Th detected more events than NP alone (P<0.0001) and NP alone detected more events than Th alone (P<0.0001). For AHI >50, NP alone and Th alone each detected 90% of matched NP+Th events. However, for AHI <50, NP alone detects 54% and Th alone detects 42% (P<0.005) of matched NP+Th events. For AHI >50, NP alone scored 97% of matched Th alone scored respiratory events, and Th alone scored 94% of NP alone scored respiratory events (P>0.05). However, for AHI<50, NP alone scored 90% of matched Th alone scored respiratory events, whereas Th alone scored 62% of matched NP alone scored events (P<0.0001). CONCLUSIONS: In severe sleep disordered breathing (AHI >50), NP+Th, NP alone and Th alone have similar ability to detect respiratory events. When AHI <50, NP+Th appears better for detecting respiratory events than NP or Th alone. If only one measure of airflow is used, NP detects more events than Th.

Adult↗

Airway management after maxillectomy: routine tracheostomy is unnecessary.

OBJECTIVES/HYPOTHESIS: There is a paucity of data to guide the optimal management of the airway in patients after maxillectomy. The decision on whether a concomitant tracheostomy is needed is often dictated by the surgeon's training and experience. We reviewed our experience with maxillectomy to assess the need for tracheostomy in postoperative airway management. STUDY DESIGN: Retrospective analysis at a university hospital. METHODS: We identified 121 patients who underwent 130 maxillectomies between October 1990 and September 2001. Twenty-four of these were total (all six walls removed), 45 were subtotal (two or more walls removed), and 61 were limited (only one wall removed). Reconstruction ranged from none to microvascular free flap, with split-thickness skin graft being the most common reconstructive option. RESULTS: Only 10 tracheostomies (7.7%) were performed at the time of maxillectomy. These included four tracheostomies in patients who underwent bulky flap reconstruction, two tracheostomies in patients who underwent both flap reconstruction and mandibulectomy, one tracheostomy in a patient who underwent mandibulectomy, one tracheostomy in a patient with mucormycosis in anticipation of prolonged ventilatory support postoperatively, and two tracheostomies at the surgeons' discretion because of concern for upper airway edema. Among the 111 patients who underwent 120 maxillectomies without concomitant tracheostomy, 1 patient (0.9%), a 74 year-old man with oxygen-dependent chronic obstructive pulmonary disease, required repeat intubation on day 3 and again on day 10 after the surgery, because of respiratory failure; fiberoptic examination confirmed the absence of upper airway compromise. CONCLUSIONS: The routine performance of tracheostomy in patients undergoing maxillectomy is unnecessary. Selective use of tracheostomy may be indicated in situations in which mandibulectomy or bulky flap reconstruction is performed or a concern for postoperative oropharyngeal airway obstruction because of edema or packing exists.

Adult↗

Acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) can be associated with various disorders. Among these, coronavirus infection may cause life-threatening severe acute respiratory syndrome (SARS). In this review, we present animal models and techniques for the study of ARDS, and discuss the roles and possible mechanisms of various chemical factors, including nitric oxide (NO). Our early work revealed that cerebral compression elicits severe hemorrhagic pulmonary edema (PE), leading to central sympathetic activation that results in systemic vasoconstriction. The consequence of systemic vasoconstriction is volume and pressure loading in the pulmonary circulation. Vasodilators, but not oxidant radical scavengers, are effective in the prevention of centrogenic PE. In isolated perfused lung, exogenous and endogenous NO enhances lung injury following air embolism and ischemia/reperfusion. In contrast, NO synthase (NOS) inhibitors reverse such lung injury. Although NO is important in maintaining vasodilator tone, hypoxia-induced pulmonary vasoconstriction is accompanied by an increase instead of a decrease in NO release. In animal and isolated lung studies, endotoxin produces acute lung injury that is associated with increases in cytokines and inducible NOS mRNA expression, suggesting that NO is toxic to the lung in endotoxin shock. Recently, we reported several rare cases that indicate that ARDS in patients with Japanese B encephalitis, lymphangitis with breast cancer and fat embolism is caused by different mechanisms. Our early and recent studies on ARDS and PE may provide information for clinical practice and the understanding of the pathogenesis of SARS.

Animals↗

Urgent endovascular treatment of acute symptomatic occlusion of the cervical internal carotid artery.

OBJECT: The prognosis of patients with acute symptomatic cervical internal carotid artery (ICA) occlusion is generally considered to be poor. Traditionally, such patients are not considered eligible for urgent thrombolytic/endovascular treatment. Since 1998, an aggressive therapeutic approach with endovascular treatment has been adopted at the authors' institution. In this report they assess whether aggressive treatment of ICA occlusion is appropriate. METHODS: The clinical characteristics and outcome of six consecutive patients treated urgently with an endovascular approach between 1998 and 2001 are reviewed and summarized. Recanalization was accomplished in all patients. At a mean follow-up period of 8 months (range 2-14 months), five of six patients had good or excellent outcomes (modified Rankin Scale [mRS] Score 0-1) and one had a poor outcome (mRS Score 4). CONCLUSIONS: With recent advancements in thrombolytic and endovascular treatments, an aggressive endovascular approach in patients with acute symptomatic cervical ICA occlusion may be successful. Further clinical data are required to determine the optimal endovascular approach in these patients.

Acute Disease↗

Microarray-based detection and genotyping of viral pathogens.

The detection of viral pathogens is of critical importance in biology, medicine, and agriculture. Unfortunately, existing techniques to screen for a broad spectrum of viruses suffer from severe limitations. To facilitate the comprehensive and unbiased analysis of viral prevalence in a given biological setting, we have developed a genomic strategy for highly parallel viral screening. The cornerstone of this approach is a long oligonucleotide (70-mer) DNA microarray capable of simultaneously detecting hundreds of viruses. Using virally infected cell cultures, we were able to efficiently detect and identify many diverse viruses. Related viral serotypes could be distinguished by the unique pattern of hybridization generated by each virus. Furthermore, by selecting microarray elements derived from highly conserved regions within viral families, individual viruses that were not explicitly represented on the microarray were still detected, raising the possibility that this approach could be used for virus discovery. Finally, by using a random PCR amplification strategy in conjunction with the microarray, we were able to detect multiple viruses in human respiratory specimens without the use of sequence-specific or degenerate primers. This method is versatile and greatly expands the spectrum of detectable viruses in a single assay while simultaneously providing the capability to discriminate among viral subtypes.

DNA Viruses↗