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Aim The objectives of this laboratory‐based study were to investigate the effects of GH12 on Enterococcus faecalis biofilm and virulence. Methodology Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of GH12 against E. faecalis were first determined. A time‐kill assay was further conducted. The effects of GH12 on the expression of virulence and stress genes in E. faecalis were evaluated by RT‐qPCR. Crystal violet stain was used to investigate the effects of GH12 on E. faecalis biofilm formation and 1‐day‐old biofilm. Finally, an ex vivo tooth model contaminated with E. faecalis was used to evaluate the antimicrobial activity of GH12 as an irrigant by CFU counting, SEM and CLSM. One‐way anova and Tukey’s multiple comparisons test were used to compare the differences amongst groups (α = 0.05). Results The MICs and MBCs of GH12 against E. faecalis were 8.0 ± 0.0 and 16.0 ± 0.0 mg L−1, respectively, and GH12 at 32.0 mg L−1 reduced the bacterial numbers by more than 99.9% within 1 min. Various virulence genes (efaA, esp and gelE) and stress genes (dnaK, groEL, ctsR and clpPBCEX) in E. faecalis were significantly downregulated by GH12 at sub‐MIC levels (P < 0.05). Additionally, both E. faecalis biofilm formation and the biomass of 1‐day‐old E. faecalis biofilm were significantly reduced by GH12 (P < 0.05). Elimination of E. faecalis in biofilms from root canal walls was achieved through irrigation with 64.0 mg L−1 GH12 for 30 min. CLSM analysis revealed that GH12 at 64.0 mg L−1 was most effective in eliminating bacteria within dentinal tubules (P < 0.05). Conclusion In a laboratory setting, and when used as an irrigant, GH12 suppressed E. faecalis, downregulated specific virulence and stress‐associated genes, eliminated intracanal E. faecalis protected by biofilms and killed bacteria in dentinal tubules. These results emphasize the need for preclinical and clinical studies to explore the potential of GH12 as an antimicrobial agent during root canal treatment.

BACKGROUND AND PURPOSE: The contrast volume transfer coefficient (K trans), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation. MATERIALS AND METHODS: We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment. K trans maps were obtained with first-pass perfusion CT data. The K trans values at the region level, obtained with the Alberta Stroke Program Early CT Score system, were compared to determine the differences between the hemorrhagic transformation and nonhemorrhagic transformation regions. The K trans values of the whole ischemic region based on baseline perfusion CT were obtained as a variable to hemorrhagic transformation possibility at the global level. RESULTS: Forty-eight (45.3%) patients had hemorrhagic transformation, and 21 (19.8%) had symptomatic intracranial hemorrhage. At the region level, there were 82 ROIs with hemorrhagic transformation and parenchymal hemorrhage with a mean K trans , 0.5 Ϯ 0.5/min, which was significantly lower than that in the nonhemorrhagic transformation regions (P Ͻ .01). The mean K trans value of 615 nonhemorrhagic transformation ROIs was 0.7 Ϯ 0.6/min. At the global level, there was a significant difference (P ϭ .01) between the mean K trans values of patients with symptomatic intracranial hemorrhage (1.3 Ϯ 0.9) and those without symptomatic intracranial hemorrhage (0.8 Ϯ 0.4). Only a high K trans value at the global level could predict the occurrence of symptomatic intracranial hemorrhage (P Ͻ .01; OR ϭ 5.04; 95% CI, 2.01-12.65). CONCLUSIONS: Global high K trans values can predict the likelihood of hemorrhagic transformation or symptomatic intracranial hemorrhage at the patient level, whereas focal low K trans values can predict the spatial distributions of hemorrhagic transformation at the region level. ABBREVIATIONS: AIS ϭ acute ischemic stroke; HI ϭ hemorrhagic infarction; HT ϭ hemorrhagic transformation; IAT ϭ intra-arterial thrombolysis; K trans ϭ contrast volume transfer coefficient; PCT ϭ perfusion CT; PH ϭ parenchymal hemorrhage; sICH ϭ symptomatic intracranial hemorrhage

The inhibitor of apoptosis family member livin is expressed in several types of cancer but not in most benign tissues, and it has been considered to be a poor prognostic mark in various malignancies. However, livin expression and its prognostic relevance have not been evaluated in colorectal adenoma-carcinoma sequence. In this study, we analyzed the difference of livin expression among normal mucosa, adenoma, and adenocarcinoma and investigated the relationship of livin expression in carcinomas with clinicopathological variables using immunohistochemistry and real-time reverse transcription-PCR. We observed that the expression of livin protein was mainly present on base of colorectal crypts in adenoma and throughout the epithelium in carcinoma, whereas did not present in accompanying normal mucosa, and the expression of livin messenger RNA (mRNA) in adenocarcinomas was significantly higher than in adenomas and in normal mucosa (P = 0.001, respectively), whereas, compared with normal mucosa, the expression level of livin mRNA was up-regulated in adenomas but no significant difference (P = 0.196). We also found that the expression levels of livin mRNA in rectal cancer was significantly higher than those in colonic cancer, and livin mRNA expression was strongly related to colorectal cancer invasive depth but not to clinical tumor stage, differentiation, lymph node metastasis, tumor morphological category and pathological type, and patient's age and gender. These findings support the possibility that the livin gene may play a role in colorectal tumorigenesis, and increased expression of livin mRNA may serve as a new target for colorectal cancer treatment.