Although DBE enables endoscopic visualization of the SB, the available data of CD with SB lesions is limited. We performed a study to investigate changes between different time periods in the indications www.selleckchem.com/products/BAY-73-4506.html and clinical outcomes of enteroscopy. Methods: We retrospectively analyzed records in a prospectively collected database to identify CD patients with small bowel lesions who underwent enteroscopy (63 DBEs, 50 patients) from January 2004 to November 2012. We compared enteroscopic-related factors between the first stage (2004–2007, 38

DBEs, 28 patients) and second stage (2008–2012, 25 DBEs, 22 patients) of the study. Results: The most common indication was to make the initial diagnosis (52.6% vs. 20.0%, p = 0.017) in the first stage and obscure

gastrointestinal bleeding (31.6% vs. 40.0%, p = 0.592) in the second stage. Indication for evaluation and/or treatment of stricture increased significantly in the second stage compared with the first (2.6% vs. 20.0%, p = 0.032). Aphthous ulcer was the most common enteroscopic finding during the entire study period (35.1% vs. 33.3%), followed by longitudinal ulcer in the first stage (29.7% vs. 12.5%) and variable ulcer in the learn more second stage (10.8% vs. 29.2%). However, this difference was not statistically significant. The diagnostic yield of DBE was 89.5% in the first stage and 88.0% in the second stage, but there wasn’t statistically significant. More endoscopic interventions were performed in the second stage than in the first (2.6% vs. 20.0%, p = 0.017). No major complication was observed in both stages. Conclusion: During the entire study period, most clinical outcomes did not change, except for indication and increased frequency of endoscopic intervention. Key Word(s): 1. Enteroscopy; 2. Crohn’s disease; 3. small bowel; 4. time Presenting Author: CHANG HUN LEE Additional Authors: KYUNG BO YOO, BUM SU CHOUNG, SEUNG YOUNG SEO, SEONG HUN KIM, SEUNG

OK LEE, SOO TEIK LEE, IN HEE KIM, DAE GHON KIM, SANG WOOK KIM Corresponding medchemexpress Author: CHANG HUN LEE Affiliations: Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital, Chonbuk National University Hospital Objective: Parthenolide (PT) known as a NF-kB inhibitor has recently been demonstrated as a promising anticancer agent that promotes apoptosis of cancer cells. However, its role in the process of tumor development in colitis associated colon cancer (CAC) is not well established. We aimed to investigate the effects of PT on an experimental murine CAC model. Methods: Experimental CAC was induced by azoxymethane (AOM) and dextran sulfate sodium (DSS). Mice were divided into 3 groups: AOM+DSS, AOM+DSS+2 mg/kg PT and AOM+DSS+4 mg/kg PT, and we analyzed the results.

In most observational studies patients who underwent simultaneous hepatectomy or delayed hepatectomy was decided by the surgeon, and the allocation was based on surgeon preferences according to intraoperative findings and their own experience, which tended to increase the risk of bias for the results. In addition, universal definitions selleck inhibitor of postoperative complications were not available among the included studies. It is common sense that the best method to establish the selection criteria would be based on the individual patient data analysis (IPD meta-analysis); however, this is not

always available, and the diverse reporting forms from the included studies could reduce the reliability of the conclusion. In summary, this systematic review and meta-analysis was conducted at an appropriate time because enough data has accumulated for inspection by meta-analytical

methods when a simultaneous resection strategy for SCRLM patients is used more commonly. From the present pooled estimates, simultaneous resection is as efficient as a delayed procedure for long-term survival. There is evidence implying that in selected SCRLM patients less than 70 years old, without severe coexistent disease and undergoing colectomy combined with minor liver resection, simultaneous resection is a safe procedure. Future RCTs are awaited to confirm this conclusion. The authors thank Prof. Yuan-Tao Hao, Department of Medical Statistics, Sun Yat-sen University, Guangdong, find more China, for statistical advice; Yan Jia, Medical Library of North Campus, Sun Yat-sen University, Guangdong, China, for literature search. Author Contributions: Z.Y., C.L., Y.C., Y.B., and C.S.: data collection and elaboration, statistical analysis; Z.Y., C.L., Y.C., and R.Y.: writing of the article; D.Y. and J.W.: supervision of the study. Additional

Supporting Information may be found in the online version of this article. “
“Increased basal release of nitric oxide (NO) in the splanchnic circulation contributes to elevated plasma levels of NO observed in decompensated cirrhosis. We evaluated in rat mesenteric arteries whether the differences in basal release of NO, revealed by asymmetric dimethylarginine (ADMA)- and NG-nitro-L-arginine methyl ester (L-NAME)-induced contractions, were associated with changes in messenger RNA (mRNA) expression of endothelial NO synthase (eNOS) and dimethylarginine dimethylaminohydrolases 上海皓元医药股份有限公司 (DDAHs). Rat small mesenteric arteries from 14 Sham-control, from 14 with partial portal vein ligation (PPVL), and from 14 with bile duct excision (BDE)-induced cirrhosis were precontracted under isometric conditions with norepinephrine, and additional contractions were induced with ADMA and L-NAME. mRNA expression of eNOS, DDAH-1, and DDAH-2 in mesenteric arteries were evaluated by real-time polymerase chain reaction. ADMA and L-NAME caused concentration- and endothelium-dependent contractions. pD2 values to L-NAME were similar in all groups.

, 2007; Wroe et al., 2007; Bourke et al., 2008; Wroe, 2008; Wroe et al., 2008;

Slater & van Valkenburgh, 2009; Chamoli & Wroe, 2011). The extant species modelled are as follows, including estimates of the percentage of vertebrate food comprising the diets of each [see Figueirido et al. (2010) and Mattson (1998)]: A. melanoleuca (giant panda) (0%); U. arctos (brown bear) (36%), Ursus americanus (black bear) (2%), Ursus maritimus (polar bear) (100%) and Ursus thibetanus (Asian bear) (2%). In addition to finite element models (FEMs) of these extant taxa, we further reconstruct the skull of the fossil Agriotherium africanum (tribe Ursavini). Traditionally, it has been argued that the extinct giant short-faced bears, Agriotherium and Arctodus (tribe Tremarctini), were hypercarnivorous and more active predators on large terrestrial prey than any living bear, largely on the basis of craniodental morphology (Hendey, 1980). This Selleck Poziotinib is because both genera exhibit a range of independently evolved traits, including a short, broad skull, premasseteric fossa on the mandible and well-developed carnassial blades (Kurtén, 1967; Hendey, 1980; Sorkin, 2006). The relative importance of vertical shearing in the dentition is widely considered an important

indicator of carnivory selleck compound (Van Valkenburgh, 1989; Wroe, Brammal & Cooke, 1998) and a predaceous, 上海皓元 felid-like feeding ecology for A. africanum has been hypothesized (Hendey, 1980). More recently, however, it has been argued that Agriotherium and Arctodus were probably neither active predators of large prey nor hypercarnivores, although both likely consumed larger quantities of vertebrate prey than most living ursids in the form of carrion (Sorkin, 2006). A niche as scavengers of large vertebrate carcasses and predators of small prey supplemented with plant material has been proposed (Sorkin, 2006). Sorkin drew analogy with the living brown and striped hyaenas (Parahyaena brunnea and Hyaena

hyaena) as opposed to large felids. The argument was based on a range of observations, including the high degree of wear on the carnassial teeth of a North American specimen of Agriotherium. Wear is far less pronounced in the specimen of A. africanum included in our analysis (Fig. 1), and it may be that proportions of killed to scavenged vertebrates varied considerably within the genus, or that our specimen is a younger individual. While recent studies by Figueirido & Palmqvist (2009) and Figueirido et al. (2010) support Sorkin’s (2006) conclusion that Arctodus was more of an omnivore than a hypercarnivorous active predator, no further work in this regard had been carried out on Agriotherium. Based on analyses of our FEMs, we ask a range of questions and test a number of predictions, some of which would not be possible with smaller datasets.

Moreover, up-regulation of Smad6 and Smad7, inhibitors of BMP signaling, occurs in HFE-HH, identifying these molecules as potential aggravators of disease pathogenesis which may act by preventing appropriate induction

of hepcidin in the setting of hepatic iron overload. ALT, alanine aminotransferase; BMP, bone morphogenic protein; HAMP, selleck chemical hepcidin antimicrobial peptide; HH, hereditary hemochromatosis; Id1, inhibitor of differentiation 1; pSmad, phosphorylated Smad; RT-PCR, reverse transcription polymerase chain reaction; Smad, small mothers of decapentaplegic; SNP, single-nucleotide polymorphism; TfR, transferrin receptor; TGFβ, transforming growth factor β. Ethical approval for this study was obtained from the Research Ethics Committee of the Mater Misericordiae University Hospital, Dublin, Ireland. Informed written consent was obtained from all patients involved. Liver tissue was collected from 20 male C282Y selleck screening library homozygotes with HH prior to venesection therapy. Control liver tissue was obtained from four donor livers at time of transplant and three biopsies were from patients undergoing liver biopsy for investigation of abnormal liver function tests that demonstrated no inflammation or fibrosis, and were negative for iron staining. The immunohistochemical component of this study was extended with the

addition of a further 10 untreated C282Y homozygotes and three individuals with medchemexpress non-HFE hepatic hemosiderosis associated with chronic viral hepatitis, all of whom had hepatic iron concentrations measured. All study subjects were male and had no cirrhosis. Controls were negative for the HFE mutations C282Y and His63Asp (H63D). Following an overnight fast, blood samples were obtained from all patients with HH for serum ferritin, transferrin saturation,

iron, total iron binding capacity, full blood count, and liver function tests (including alanine aminotransferase [ALT]). HFE genetic analysis for C282Y and H63D mutations was performed using LightCycler technology (Roche Diagnostics) with Genes-4U ToolSets. Hepatic iron concentration was measured as described.34 Liver biopsies were independently evaluated by a single histopathologist (A.F.) for grading of hepatocellular iron staining (Perl’s Prussian blue stain) and fibrosis (METAVIR score).35 Liver samples were snap-frozen or placed in RNAlater and stored at −80°C prior to use. Total RNA was extracted using the RNAeasy kit (Qiagen, UK). Reverse transcription was performed using the high-capacity complementary DNA reverse transcription kit (Applied Biosystems [AB], Carlsbad, CA). Gene expression analysis for hamp(hepcidin antimicrobial peptide), bmp6, smad4, smad6, smad7, and Id1 was performed using AB gene expression assay systems, using AB 7000 sequence detector.

nov. It possesses the cytoplasmic kerotimization and reddish-brown coloration of several species in the genus. Phylogenetic analysis based on 16S rRNA gene sequence shows B. angustatum within a highly supported clade containing all sequenced Brasilonema species. We compared the secondary structure of the 16S–23S ITS regions for B. octagenarum and B. angustatum.

The structurally conservative D1–D1′ and V3 helices show similar motifs between the two taxa, but differ structurally and in sequence, providing additional justification for erection of the new species. The Box-B helix has identical secondary structure. The existence of tapering in a Brasilonema species is unique in this genus, and requires modification of the current concept of the genus Brasilonema, which was described as being unattenuated. Our Y 27632 phylogenetic evidence supports the hypothesis that tapering

has developed repeatedly in separate cyanobacterial lineages and lacks the taxonomic significance once assumed by early workers. “
“The delineation of species boundaries in the potentially harmful cyanobacterium Planktothrix Anagnostidis et Komárek 1988 is particularly tangled. Genetic recombination has been invoked to explain the occurrence of overlapping biological traits among recognized species. Although horizontal gene transfer is shown as a driver of diversification in this genus, clear evidence for homologous recombination at the single gene level is still selleck compound lacking. Several Planktothrix strains (n = 244) sampled in eight fresh water lakes in north Italy were characterized by sequencing the rpoC1 gene, a molecular marker previously proposed to discriminate between species. Six haplotypes were detected, four of which are newly described. A relevant number of rpoC1 sequences (n = 54) showed evidence of homologous recombination. By comparing

上海皓元 the sequences produced in the work presented here to those available on GenBank for the genus, multiple recombination events were tracked between haplotypes associated to P. rubescens, P. suspensa and P. agardhii, the latter being a species not found in our survey. Recombination signals were in form of (i) a vast mosaic structure present in the alignment of rpoC1 haplotypes, (ii) multiple and statistically significant paths in the split decomposition network connecting these haplotypes and (iii) many individual crossing-over events detected by means of recombination detection tests. Data suggest that the molecular evolution of the rpoC1 gene in the genus Planktothrix appears as strongly influenced by homologous recombination. In addition, rpoC1 diversity effectively tracks recombinational processes among species in the complex made up by P. rubescens, P. agardhii and P. suspensa, which are not isolated in terms of gene-flow. “
“The effect of temperature and oxygen on nitrogenase activity in two heterocystous cyanobacteria, Anabaena variabilis Kütz.

Mutations in the genes responsible for clarithromycin- (23s rRNA), levofloxacin- (gyrA and gyrB), and metronidazole-resistant (rdxA and frxA) were investigated by direct sequencing. Results: Seventeen H. pylori groups from separate patients harbored antibiotic-heteroresistance: amoxicillin (0%), levofloxacin (23.5%), clarithromycin (5.9%) and metronidazole (82.4%). Among them, two showed heteroresistance to more than one antibiotic. DNA-RAPD genotype analysis showed that only 1 (5.9%) patient had mixed-infected with different H. pylori strains while the other pairs of isolates

showed identical or similar fingerprinting patterns. Mutations in gyrA at N87 or D91 had an impact on levofloxacin resistance. Interestingly, check details Hp1528B showed high level of levofloxacin resistance (MIC > 32 μg/ml) with neither gyrA nor gryB mutation. RdxA protein variants and 23s rRNA mutation were responsible for metronidazole and clarithromycin resistance, respectively. Conclusion: These results suggest that the failure treatment of heteroresistance-H. pylori mostly develop from pre-existing susceptible strain rather than mixed-infected with different strains. Key Word(s): 1. H. pylori; 2. Antibiotic; http://www.selleckchem.com/products/LY294002.html 3. Heteroresistance; 4. Mixed-infection; Presenting Author: PEDROBOAL CARVALHO Additional

Authors: MARIAJOÃO MOREIRA, JOSÉ COTTER Corresponding Author: PEDROBOAL CARVALHO, MARIAJOÃO MOREIRA, JOSÉ COTTER Affiliations: Centro Hospitalar do Alto Ave Objective: Almost half the world population is infected with Helicobacter pylori, and over 40% of the adults suffer from dyspepsia; nevertheless, their interaction is not yet completely understood. We aimed to assess the correlation between Helicobacter pylori infection and both inflammatory and carcinogenic gastric lesions in dyspeptic patients. Methods: Unicentric retrospective study including 199 consecutive patients undergoing upper gastrointestinal endoscopy with stomach biopsies

(both body and antrum) between January and December of 2012. Exclusion 上海皓元 criteria: previous upper gastrointestinal endoscopy or gastric surgery as well as both antibiotics and proton-pump inhibitors on the month before the procedure. Gastric inflammation was classified according to the Updated Sidney System, from 0 to 4. The program SPSS 17.0 was used to perform statistical analysis of the data. Results: The patients’ age ranged from 15 to 87 years, with an average of 52; 49% were women. Helicobacter pylori infection was significantly more prevalent in patients under 40 years (75% vs 44%, p < 0,0001). Chronic nonatrophic gastritis was the most frequently observed lesion in the biopsies (52% of the patients); of those, 76% were infected by Helicobacter pylori.

, Redwood City, CA; www.ingenuity.com) was used to analyze statistically

significant protein abundance differences identified within the context of known biological responses and regulatory networks. For all analyses, the 4,324 total proteins identified in this study provided the background for determination of functional enrichment using a Fisher’s exact test, a standard method for determining statistical enrichment of molecules within biological pathways or functions in the IPA knowledge base. A right-tailed Fisher’s exact test reflects the likelihood that pathways or functions have more molecules represented within them from the total list of significant proteins than would be expected by random chance alone. IPA analysis was applied to statistically significant protein abundance changes before application of filtering criteria (397 proteins total) and after background correction and filtering

for MI-503 manufacturer missing data (i.e., the 250 proteins total presented in Fig. 2). The enrichment of differentially regulated proteins linked to the various biological functions described was well conserved (data not shown), thus facilitating efforts to focus biological interpretation on the most uniform responses. Global comparative proteome selleckchem analyses aimed at identifying molecular signatures representative of the processes influencing early progression to fibrosis were performed as described in Fig. 1. Using a label-free LC-MS strategy incorporating the AMT tag approach, we identified a total of 13,016 peptides corresponding to 4,324 proteins in the entire study (Supporting Tables 3 and 4, respectively). Proteins exhibiting statistically significant differences between patient groups were first analyzed via 2D complete-linkage hierarchical clustering using Pearson’s correlation coefficients (Supporting Fig. 1A). Relative abundance patterns of these selected proteins tend to cluster together, separating progressors from nonprogressors with few exceptions. Moreover, consecutive MCE biopsies coming from the same patient tend to cluster together, and simultaneously, progressors display a correlation in their protein abundance to a greater extent than nonprogressors (Supporting Fig. 1B).

Using the SVD-MDS dimensionality reduction technique, we demonstrated that this protein signature can completely segregate progressor from nonprogressor patients in three-dimensional space (Fig. 2A), capturing the critical information with respect to progressors and nonprogressors, as well as biologic variability in these groups when compared with initial, unfiltered SVD-MDS analysis (Supporting Fig. 2). Using SVD-MDS, the loss of information during the dimensionality reduction process was quantified as only 24%, indicating that the signature captures the main characteristics of the difference between progressors and nonprogressors. Note that the convex hulls over the two patient groups do not intersect, thus complete separation is achieved.

333, P = 0.0471). Conclusions:  Liver stiffness measurement by transient elastography is valuable for evaluating fibrotic progression in NAFLD.

“
“Background Temozolomide ic50 and Aims:  Head and neck cancers, especially pharyngeal cancers, as well as esophageal cancers frequently coexist either synchronously or metachronously, but most cases of pharyngeal cancer are detected at an advanced stage resulting in poor prognosis. The aim of this study is to evaluate the effectiveness of using narrow-band imaging (NBI) endoscopy with magnification for early detection of pharyngeal cancer on patients following their treatment for esophageal squamous cell carcinoma (SCC). Methods:  This case series was conducted at the National Cancer Center Hospital in Tokyo between April and October 2005 and included 424 consecutive patients for surveillance endoscopy who had previously undergone chemoradiotherapy (CRT) and/or surgery for esophageal SCC. Observation of the pharyngeal region was randomly conducted on 91 patients using NBI endoscopy with magnification (NBI group) and 333 patients using conventional white light endoscopy (control group). Results:  The detection rate for pharyngeal cancer was significantly higher using NBI endoscopy with magnification (10.9%; 10/91) compared with conventional

endoscopy (1.2%; 4/333) (P < 0.0001). In particular, the detection rate in CRT patients was significantly higher in the NBI group (12.9%; 7/54) than

the control group Bioactive Compound Library mouse (0.5%; 1/191) (P < 0.0001). In addition, diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the NBI group were 100% (10/10), 97.5% (79/81), 97.8% (89/91), 83.3% (10/12) and 100% (79/79), respectively. Conclusion:  NBI endoscopy with magnification is a promising technique for detecting superficial pharyngeal cancer at an early stage in patients previously treated for 上海皓元 esophageal SCC. “
“Successful treatment with antiviral therapy could potentially reduce morbidity and mortality in patients with hepatitis C virus (HCV) infection. However, at the population level, these benefits may be offset by a limited number of patients who have access to antiviral treatment. Using data from the National Health and Nutrition Examination Survey conducted in 2005-2008, we analyzed the health insurance status and treatment candidacy of HCV-positive (HCV+) individuals. A total of 10,582 subjects were examined; of those, 1.16% had detectable HCV RNA and were defined as HCV+. The HCV+ patients were less likely to be insured than HCV-negative individuals (61.2% versus 81.2%; P = 0.004). Among those with health insurance, HCV+ patients were less likely to have private insurance, whereas the coverage by Medicare/Medicaid and other government-sponsored plans was similar to the rest of the population.

15 In this context, Hou and colleages identified the network of low miR-199a/b-3p expression, high PAK expression and consecutive

activation see more of the Raf/MEK/ERK cascade as a new key player in development and progression of HCC. Notably, most of the patients analyzed in their study suffered from hepatitis B virus–associated HCC, and further studies are needed to clarify whether these data can be transferred one-to-one to HCC caused by other etiologies. Interestingly, the authors further verified an increase of miR-199a/b-3p in nontumorous but fibrotic tissues, which is in line with previous array-based data from mouse models of liver fibrosis and from patients with liver cirrhosis6, 16, 17 and suggests that this specific miRNA might functionally be

involved in the processes driving the transition from fibrosis to HCC. Finally, in this elegant article, the authors provided evidence that genetic delivery of miR-199a/b-3p might represent a promising option for pharmacological manipulation of tumor progression in patients with HCC. However, major obstacles have to be overcome on the way to a successful miRNA-based therapy. First, Maraviroc the optimal way for an effective and safe delivery of miRNA into cancer cells or the tumor microenvironment still remains unclear. They can be delivered by retroviruses, adenoviruses, or adeno-associated viruses or injected in cholesterol-modified form to the tissue of interest.18 The authors and other groups demonstrated the feasibility of both approaches in rodents and nonhuman primates. Second, the high number of potential targets for each individual miRNA may give rise to unexpected and

fatal toxicity. If these concerns can be addressed, the promise of an miR-based anticancer therapy might become reality. “
“Intestinal failure (IF) occurs where absorption of nutrients and water from the gut is inadequate to provide sufficient nutrition for maintenance and growth, resulting in the need for parenteral nutrition (PN). PN should be administered when the gut is unable to provide nutrition for a period of at least a week. The nutrition support team (NST) provides support in the nutritional management of any child with complex nutritional needs, 上海皓元 especially where there are complicating factors. Short bowel syndrome (SBS) in children is most common in infancy and is defined as a bowel length of <80 cm, with very short bowel defined as <40 cm and extreme as <15 cm. Most congenital enteropathies present in the first 6 months of life, often in the first weeks. Primary chronic intestinal pseudo-obstruction syndrome (CIPOS) may be familial or sporadic, due to abnormalities in enteric smooth muscle or the enteric nervous system. "
“We read with interest the article by Kamiyama et al.

Preliminary results from these animal models suggest development of gene transfer techniques, which represent a potentially attractive novel approach to haemostasis in click here patients with haemophilia and other platelet disorders. In this supplement, we discuss current prophylaxis treatment strategies for patients with haemophilia and highlight future directions for continued research. Through an improved understanding of prophylaxis in patients with haemophilia, including the potential use of bypassing agents as primary prophylaxis in those who have developed inhibitors, we aim to develop more optimal treatment

strategies that further improve the quality of life of patients. The author states that he has no interests that might be perceived as posing a conflict or bias. “
“Summary.  Combined factor V (FV) and factor VIII

(FVIII) deficiency (F5F8D) is a rare autosomal recessive disorder caused by mutations in LMAN1 or MCFD2 genes which encode proteins that Antiinfection Compound Library cell assay form a complex involved in the transport of FV and FVIII from the endoplasmic reticulum to Golgi apparatus. We report two novel mutations in MCFD2 gene and one recurrent mutation in LMAN1 gene that caused combined FV and FVIII deficiency in two unrelated Tunisian Muslim families. For the first family two patients were homozygous for a new missense mutation Asp81His in exon 3 of MCFD2 and heterozygous for a second new missense mutation Val100Asp in the same exon. Replacement respectively of the hydrophilic Asp residue with hydrophobic positively charged His and of the hydrophobic neutral Val residue with the Asp residue most likely 上海皓元 disrupts the MCFD2–LMAN1 interaction, thus leading to the disease phenotype. For the second family

a reported Arg202X mutation in exon 5 in the LMAN1 gene was identified in the homozygous state. “
“LB01 Haemophilia B gene therapy study in the UK AMIT NATHWANI UCL Cancer Institute, Paul O’Gorman Building, University College London, 72 Huntley Street, London WC1E 6BT Correspondence: Amit Nathwani, UCL Cancer Institute, Paul O’Gorman Building, University College London, 72 Huntley Street, London WC1E 6BT. Tel.: +44 (0)20 7679 6225; fax: +44 (0)20 7679 6222; e-mail: [email protected] Our study differs from previous HB clinical trials with AAV vectors in three important aspects. Firstly, AAV8 pseudotyped vectors will be used instead of AAV2 primarily because of the substantially lower prevalence of pre-existing humoral immunity to this AAV serotype in humans. The second difference relates to the use of a vector containing a self complementary genome which, is more potent than concentional single stranded AAV vectors and offers a unique opportunity to mediate efficient therapeutic gene transfer potentially at a low dose of vector.