An effective method for axillary bud culture and RAPD analysis of cloned plants in tetraploid black locust

An efficient micropropagation technique by axillary bud multiplication was established for cloning tetraploid black locust tree (Robinia pseudoacacia L.). The result showed that the optimal medium for shoot multiplication and elongation was Murashige and Skoog (MS) medium supplemented with 0.5 mg/l 6-benzylaminopurine in combination with 0.5 mg/l kinetin and 0.1 mg/l 1-naphthaleneacetic acid. The best medium for rooting was half-strength MS medium with 0.25 mg/l indole-3-butyric acid. In the present report, we examined the genetic fidelity of the micropropagated plants by the randomly amplified polymorphic DNA (RAPD) method with 25 primers. The cloned plants of tetraploid black locust showed complete stability.

Conservation of predatory arthropods in cotton: role of action thresholds for Bemisia tabaci (Homoptera: Aleyrodidae)

Studies were conducted in 1994 and 1995 to examine the effects of a range of action thresholds for managing Bemisia tabaci (Gennadius) Biotype B (= B. argentifolii Bellows & Perring) with insecticides in cotton on populations of arthropod predators in Imperial Valley, CA, and Maricopa, AZ. Application of insecticides significantly reduced population densities of spiders, Geocoris punctipes (Say), G. pallens (Stål), Orius tristicolor (White), Nabis alternatus Parshley, Zelus renardii Kolenati, Hippodamia convergens Guerin-Méneville, Spanogonicus albofasciatus (Reuter), Drapetis sp., and Chrysoperla carnea Stephens in one or both years and sites compared with untreated controls. Use of higher B. tabaci thresholds conserved some species and groups relative to lower thresholds. Stepwise regression analyses indicated that reductions in predator populations were generally influenced more strongly by the timing of the first insecticide application than by the total number of sprays necessary to maintain suppression of the pest below any given action threshold. A predation index, which weights the importance of each predator species based on their known frequency of predation on B. tabaci and another key pest, Pectinophora gossypiella (Saunders), was developed and analyzed. Patterns were similar to results based on changes in abundance alone, but the index generally revealed less severe effects of insecticides on overall predator function. The current action threshold for conventional insecticidal control of B. tabaci in Arizona and southern California is five adults per leaf. Results here suggest that predator conservation may be enhanced by raising the initial threshold to delay the first application or initially using more selective materials such as insect growth regulators.

Small cell carcinoma of the endometrium with concomitant pelvic inflammatory disease

BACKGROUND

Small cell carcinoma of the endometrium is a rare disease entity characterized by bulkiness and predisposition to necrosis. Clinical presentations include postmenopausal bleeding, lower abdominal mass, chronic abdominal pain and menorrhagia. We present a case of small cell carcinoma of the endometrium with concomitant pelvic inflammatory disease. The literature is also reviewed.

CASE

A 64 year old female presented was admitted with the principal complaints of fever, lower abdominal pain and malodorous vaginal discharge. Bimanual examination revealed cervical motion tenderness with a WBC of 9400 cells/microL and increased levels of neutrophils, band cells and C-reactive protein. Sonography revealed an adnexal echocomplex compatible with tubo-ovarian abscess. Culture of the vaginal discharge revealed the presence of E. coli. Symptoms persisted despite three days of antibiotics administration so a laparotomy was performed with a friable hemorrhagic uterus revealed and an area of necrosis evident in the left adnexa. Malignancy was confirmed from frozen section. Total abdominal hysterectomy, with bilateral salpingooophorectomy and optimal debulking, was performed. The final pathology report confirmed small cell carcinoma of the endometrium.

CONCLUSION

Malignancy and pelvic inflammatory disease have overlapping clinical characteristics. Once pelvic inflammatory disease is suspected in a postmenopausal patient, malignancy should also be suspected, and a thorough examination and a tumor-marker analysis performed.

[The factors of improving rice transformation efficiency]

The factors influencing the rice transformation frequency have been investigated by using 8 indica and japonica rice cultivars during the transformation procedures, such as induction of calli, selection, and regeneration. The following is the results: The immature embryos were pretreated in 4 degrees C for 4 or 7 days before inoculation, and the regeneration frequency of calli would be increased. High osmotic treatment may increase the possibility of transformation, especially for calli of 6 months or older. The transformation frequency was improved when selection pressure was removed during differentiation period. The V-type selection may be better than the normal selection. There is a difference of differentiation ability among the calli of three periods and it is found that the calli of two or three months are the best for transformation. Proline and DMSO can decrease browning rate of calli.

The use of genotyping to predict the phenotypes of human platelet antigens 1 through 5 and of neutrophil antigens in Taiwan

BACKGROUND

The human platelet antigen (HPA) 1 through 5 and the human neutrophil antigen (HNA-1) systems are relevant to immune-related thrombocytopenia and neutropenia. The alloantigen distribution profiles in the population will aid in estimating the risk of alloimmunization.

STUDY DESIGN AND METHODS

Genotyping of the genes that control the expression of the HPA-1 through -5 and HNA-1 systems in Taiwanese (n = 326) and Taiwan's indigenous peoples (n = 608) was performed by PCR with the sequence-specific primer (PCR-SSP) method.

RESULTS

In the HPA system, HPA-1b and HPA-4b were absent among Taiwan's indigenous tribes and detected among other Taiwanese only with frequencies of <0.2 percent and <0.5 percent, respectively. The GP1BA*2 (HPA-2b) and GP1A*2 (HPA-5b) allele frequencies range from 1 percent to 7 percent and 0.4 percent to 3.5 percent among the two ethnic groups, respectively. GP2B*1 (HPA-3a) and GP2B*2 (HPA-3b) showed similar allele frequencies. In the HNA-1 system, the FCGR3B*1 (HNA-1a) allele frequency was about twice that of FCGR3B*2 (HNA-1b) in Taiwanese and also in most of the indigenous tribes. Three FCGR3B (HNA-1) null persons were found in one indigenous tribe (Ami tribe), for an FCGR3B null frequency of 19.8 percent. However, no FCGR3B*3 (HNA-1c) allele was detected in Taiwan.

CONCLUSION

The frequencies of HPA-1b, -2b, and -5b in the Taiwanese population were much lower than those among whites. In Taiwan, all of the HNA-1 null found was due to the deletion of the FCGR3B gene, and this deletion may be widely distributed in the Ami tribe.

Polymorphism and distribution of the Secretor alpha(1,2)-fucosyltransferase gene in various Taiwanese populations

BACKGROUND

The Secretor gene (Se or FUT2), which produces alpha(1,2)-fucosyltransferase, exhibits extensive polymorphism. Six Se genes, including the weak Se (Se(w) or Se385) and three nonsecretor alleles (se571, se685, and se849) have been detected in various populations of Taiwan. The distribution of various Lewis phenotypes among the Taiwanese population groups has been shown to vary considerably.

STUDY DESIGN AND METHODS

A PCR-RFLP analysis system, which was based on the nucleotide polymorphism variation of the different Se alleles and which can reveal the Se genotype of an individual easily and accurately, was developed. The distribution of the Se alleles among Taiwanese population groups, including the two major populations, Minnan and Hakka Taiwanese, and 11 indigenous groups, was analyzed by the method.

RESULTS

Frequencies of the Se alleles among the Taiwanese populations were revealed. The distribution of the nonsecretor alleles, especially se849, showed a marked variation. A good correlation was observed between a person's Se genotype and Lewis phenotype.

CONCLUSION

The Se genes have a polymorphic distribution among various Taiwanese populations, and this agrees with previous results for Lewis phenotype distributions. The Se(w) allele and the three se alleles are responsible for the Le(a+b+) and Le(a+b-) phenotypes, respectively.

Carbon disulfide vasculopathy: a small vessel disease

We present the clinical manifestations of 4 male patients with acute stroke-like symptoms and polyneuropathy after long-term exposure to carbon disulfide (CS2) in a viscose rayon plant. The ages of onset of polyneuropathy ranged from 42 to 45 years with a duration of CS2 exposure between 6 and 21 years. The ages of onset of stroke were from 42 to 48 years. The risk factors for stroke including heart disease and diabetes were denied, except for smoking in 4, hyperlipidemia in 2 and hypertension in 1. At the initial visit in 1992, only 2 patients developed sudden onset of hemiparesis suggesting a lacunar stroke before the diagnosis of CS2 intoxication. Brain computed tomography (CT) scans showed low-density lesions in the basal ganglia in 2 patients, cortical atrophy in 1 and normal in 1. Brain magnetic resonance image (MRI) study disclosed multiple lesions in the corona radiata and basal ganglia on T(2)-weighted images in 3 patients and cortical atrophy in 1. After the diagnosis, they left their jobs for a CS2-free environment, and improvement of the working conditions was noted. During 5 years follow-up period, another 2 patients also developed an acute episode of stroke with hemiparesis. Brain CT and/or MRI follow-up studies in these 2 patients revealed new lesions in the basal ganglia and corona radiata. Intriguingly, a patient with previous stroke also developed new lesions in the bilateral thalami and brainstem. Carotid Doppler scan, transcranial Doppler scan and/or cerebral angiography did not show any prominent stenosis or occlusion in the major intracranial large arteries. We conclude that encephalopathy may occur in patients after long-term CS2 exposure, probably due to impaired cerebral perfusion. The lesions tend to occur in the basal ganglia, corona radiata and even brainstem, particularly involving the small-sized vessels. In addition, the cerebral lesions may progress even after cessation of CS2 exposure. Therefore, we suggest that CS2 exposure may be a risk factor for stroke.

Diversity of HLA among Taiwan's indigenous tribes and the Ivatans in the Philippines

Taiwan's indigenous tribes, especially the east coast tribes are not only closely related to Oceania but also with the Australian aborigines. The Ivatans of the Batan Islands in the Philippines are closely related to the Yami tribe of Taiwan as cultural and anthropological studies have shown. Many DRB1 alleles (*15021, *16021, *0404, *04051, *11011, *12021, *1401, *08032) have high allele frequencies (>20%) in certain tribes, suggesting Taiwan's indigenous tribes are homogeneous populations. These high frequency DRB1 alleles and also some HLA-A-B-DR haplotypes found in Taiwan's indigenous tribes are also found in Oceania, Australian aborigines, south and north east Asians and American Indians, lending further support to our previous findings that Taiwan's indigenous tribes are more or less genetically related to both northern and southern Asians, possibly as well as Amerindians. HLA-A*2402 with a remarkably high frequency among Taiwan's indigenous tribes (52.1% approximately 86.3%), especially the central mountain tribes, possibly represents not only founder effects and population bottlenecks, but also positive selection of the allele. Although the Ami tribe has the highest ever reported frequencies of the DRB1*0404 and DRB1*0405, these alleles have not been found to be associated with rheumatoid arthritis as previously described for Caucasians. In addition, DRB1*1401 has a high frequency in most tribes but is not associated with psoriasis as previously indicated in some studies, suggesting the involvement of some additional genetic and/or environmental factors mechanism in the development of these diseases.

Duodenojejunal intussusception secondary to hamartomatous polyps of duodenum surrounding the ampulla of Vater

Duodenojejunal intussusception is a rare pediatric emergency. A case of duodenojejunal intussusception secondary to hamartomatous polyps of the second portion of duodenum in a 10-month-old boy is reported. Surgical excision of the polyps and reduction of the intussusception were performed. Pathologic examination found hamartomatous polyps. This is the third case report of children in literature, but this is the first case of a child with intussusception surrounding the ampulla of Vater and a successful excision performed without damaging the ampulla of Vater.

[Improvement of transformation frequency of rice mediated by Agrobacterium]

The factors influencing the frequency of rice transformation mediated by Agrobacterium have been investigated by using 16 commercially important indica and japonica rice cultivars or lines. The main results were as following: For most rice CC medium was the best for both callus initiation and subculture. With supplement of 2.5-5 mg/L ABA the quality of calli can be improved. The concentration of selective agent for Indica rice callus was lower than that for japonica rice callus. Agrobacterium tumefaciens strain EHA105 was more efficient than LBA4404 and AGL1 for rice transformation. The inhibitive effect of cefotaxime to Agrobacterium was better than that of carbenicillin. The partial desiccation treatment after co-cultivation was beneficial to inhibit the growth of Agrobacterium and increase transformation efficiency. A stable and efficient Agrobacterium-mediated transformation system has been established in ten different rice cultivars and fertile transgenic plants have been obtained.

Juvenile papillomatosis of the breast in a 9-year-old girl

Juvenile papillomatosis (JP) is a rare benign, proliferative breast tumor in children. We observed a 9-year-old girl with a large soft-tissue mass at the lower outer quadrant of the left breast. Ultrasonography showed an ill-defined, inhomogeneous mass with numerous small, hypoechoic areas. The tumor was completely excised. Histopathology revealed JP of the breast. The case is presented and the literature is reviewed.

Ventilator-associated pneumonia with circuit changes every 2 days versus every week

BACKGROUND

Frequent ventilator circuit changes are expensive and sometimes unnecessary. Following the worldwide trend to lengthen the intervals for ventilator circuit change from 2 days to 1 week, this study aims to assure that low rate of ventilator-associated pneumonia (VAP) can be maintained with cost containment.

METHODS

Ventilator circuits were routinely changed every 7 days in the study period for 2 years and every 2 days during the historical control period of another 2 years. Pediatric patients (age less than 15 years) were not included. Nosocomial pneumonia was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC) of the United States (US). VAP was identified by combining and comparing 2 databases from the Respiratory Therapy Department and the Infection Control Unit of our hospital.

RESULTS

In the study group, 225 episodes of pneumonias were observed in 7,068 patients and 87,338 ventilator days. The rate of VAP was 2.58 per 1,000 ventilator days. There were 174 episodes of pneumonia in 6,213 patients and 65,467 ventilator days of the control group. The rate of VAP was 2.66 per 1,000 ventilator days. The difference between both groups was not significant (p = 0.803). Yet, the cost curbed was around 80,000 US dollars per year.

CONCLUSIONS

Extending ventilator circuit change interval from 2 days to 7 days do not increase the risk for VAP, but the cost savings for labor and supply are substantial.

The origin of Minnan and Hakka, the so-called "Taiwanese", inferred by HLA study

The Minnan and Hakka people groups, the so-called "Taiwanese", are the descendants of early settlers from the southeast coast of China during the last few centuries. Genetically they showed affinities to southern Asian populations, as determined by phylogenetic trees and correspondence analysis calculated from HLA allele frequencies. This corresponds historically with the fact that they are the descendants of the southeast coastal indigenous population (Yueh) of China and should therefore not be considered as descendants of "pure" northern Han Chinese. A33-B58-DRB1*03 (A33-Cw10-B58-DRB1*03-DQB1*02), the most common HLA haplotype among "Taiwanese", with a haplotype frequency of 6.3%, has also been found to be the most common haplotype among Thai-Chinese and Singapore Chinese, two other populations also originating from the southeast coast of China. These observations suggests that this haplotype is the most well-conserved ancient haplotype of the Yueh.

Laser confocal microscopic study of pH profiles of synthetic absorbable fibers upon in vitro hydrolytic degradation

The objective of this study was to develop a new and non-destructive technique to measure the interior pH of synthetic absorbable biomaterials. Such a measurement would provide the required experimental evidence for validating the postulated theory that the accumulation of acidic hydrolytic degradation products within the interior of aliphatic polyesters is responsible for the observed accelerated degradation of this class of absorbable biomaterials. This new technique used a laser scanning confocal microscope coupled with pH sensitive fluorescent dyes like Texas Red sulfonyl chloride. The capability of optical thin sectioning of a laser confocal microscope would permit a non-destructive examination of the interior of biomaterials. Poly-p-dioxanone suture fibers (PDSII) of size 2/0 were used as the model compound for this new technique. The pH values of the unhydrolyzed and partially hydrolyzed PDSII fibers were found to decrease with increasing depth from the fiber surface and reached as low as about 3.5 at 70 microm depth. The largest depth that an interior pH could be measured within absorbable biomaterials was determined by the opacity of the biomaterials, i.e. a higher depth for a less opaque material. The observed interior pH profiles were correlated to the unique morphologic structure of PDSII fibers.

Repeated attacks of venous air embolism during craniotomy--a case report

Venous air embolism (VAE) is not uncommon during craniotomy, but repeated attacks of VAE during a single surgical procedure is rarely seen. We report a successful intraoperative management of repeated attacks of air embolism in a patient who sustained craniotomy for intracranial hemorrhage (ICH) in prone position. A 70-year-old male suffering from hemorrhage in the right cerebellar hemisphere with impending brainstem herniation was scheduled for craniotomy. He had history of hypertension but it was not well controlled with medical treatment. Emergent craniotomy for removal of blood clot resulting from ICH was performed. During the operation, sudden decrease of end-tidal CO2 (EtCO2) level, fall of blood pressure and increase of central venous pressure (CVP) were noted. Since air bubbles were retrieved from CVP catheter venous air embolism was highly suspected. With prompt diagnosis and proper management, we successfully improved the patient's hemodynamic status and he was discharged without any sequelae. Early detection together with aggressive treatment is the only way in the management of intraoperative venous air embolism.

Efficacy of CC traps and seasonal activity of adult Bemisia argentifolii (Homoptera: Aleyrodidae) in Imperial and Palo Verde Valleys, California

Adult whitefly Bemisia argentifolii Bellows & Perring trap (CC trap) catches were compared with suction type trap catches. CC trap catches were significantly correlated to the suction trap catches. Higher numbers of B. argentifolii adults were caught in CC traps oriented toward an untreated, B. argentifolii-infested, cotton field as compared with traps oriented toward Bermuda grass fields, farm roads, or fallow areas. CC trap catches at five heights above ground (from 0 to 120 cm) were significantly related to each other in choice and no-choice studies. CC trap catches were low in the Imperial and Palo Verde Valleys from late October to early June each of 1996, 1997, and 1998. Trap catches increased with increasing seasonal air temperatures and host availability. Trap catches were adversely affected by wind and rain. Abrupt trap catch increases of 40- to 50-fold for 1-2 d in late June to early July followed by abrupt decreases in adult catches suggest migrating activity of adults from other nearby crop sources.

Biodegradable dextran-polylactide hydrogel network and its controlled release of albumin

The objective of this paper was to study the release of bovine serum albumin (BSA) from a series of biodegradable hydrogels having a wide range of hydrophilicity to hydrophobicity, swelling, and biodegradation properties. BSA was incorporated into a series of biodegradable hydrogels made from a dextran derivative of allyl isocyanate (dex-AI, as the hydrophilic constituent) and poly(DL-lactic acid) diacrylate macromer (PDLLAM, as the hydrophobic constituent). The release kinetics of BSA from these dex-AI/PDLLAM hydrogels was studied. Laser confocal scanning microscopy was used to investigate the morphological change of the hydrogels, as well as BSA distribution in the hydrogels, as a function of dex-AI to PDLLAM composition ratio and incubation time. We found that the incorporation of PDLLAM into dex-AI reduced the initial burst release of BSA due to its more homogeneous distribution in the hydrogels. As the PDLLAM component increased, the rate of formation of a loose three-dimensional (3D) network structure increased; consequently, the sustained rate and extent of BSA release increased. Both release index and diffusion coefficient (from release kinetics data) increased as the PDLLAM component increased in the hydrogels. The data suggest that the release of BSA was controlled by both diffusion of BSA through swelling of the hydrophilic phase during an early stage, and degradation of the hydrophobic phase during a late stage, and also that the magnitude of diffusion versus degradation controlled release is dependent on composition ratio and immersion time.

Molecular cytogenetic analysis of intergeneric chromosomal translocations between wheat (Triticum aestivum L.) and Dasypyrum villosum arising from tissue culture

Fluorescence in situ hybridization (FISH) was applied with total genomic DNA extracted from Dasypyrum villosum (L.) Candargy as a probe to characterize chromosome translocations arising from tissue culture in hybrids of Triticum aestivum x (T. durum - D. villosum, amphiploid). Chromosome translocations between wheat and D. villosum occurred in callus cells at an average frequency of 1.9%. Translocations existed not only in callus cells but also in regenerants. Three plants with translocation chromosomes were characterized among 66 regenerants of T. aestivum 'Chinese Spring' x 'TH1W' and 'NPFP' x 'TH1'. One of them proved to be a reciprocal translocation with an exchange of about one third of a wheat chromosome arm with about one half of a chromosome arm of D. villosum. The breakpoints of the other two translocations were located at, or near centromeres. The results are similar for both callus cells and regenerants and provide further evidence that translocations take place in tissue culture. Other structural chromosomal changes, for example, fragments, telocentrics, dicentromeres, and deletions, as well as numerical alterations including aneuploidy and polyploidy were recorded both in callus cells and regenerants.

The study of fine and coarse particles, and metallic elements for the daytime and night-time in a suburban area of central Taiwan, Taichung

Daily average concentrations of fine and coarse particulates, and TSP samples have been measured simultaneously at daytime and night-time periods by using Universal and PS-1 sampler in a suburban area of central Taiwan from June to August 1998. The samples were analyzed by atomic absorption spectrometry to determine the fine and coarse particulate concentrations of metallic elements (Ca, Fe, Mn, Pb, Cu, Zn and Cr). The concentration of PM2.5 and TSP showed a decreased trend for the daytime period. The fine particle concentrations were about two times as that of coarse particulate concentrations. The averaged fine particulate concentrations at daytime are higher than at night-time. Ca and Fe were mostly in the coarse particulate mode. The correlation coefficients were 0.63 and 0.69 for elements Ca and Fe in the coarse particle mode for day and night periods. Pb showed a similar distribution ratio with Mn for the fine to coarse particle ratios at both day and night period. Pb and Mn are highly correlated for the day (R = 0.78) and night period (R = 0.61) at particle size <2.5 microm. Cu and Zn were mainly in fine particles at both day and night period. Fe and Ca consist of the major parts of all the elements. Elemental Mn is the lowest among the rest of the heavy metals.

Pore structure analysis of swollen dextran-methacrylate hydrogels by SEM and mercury intrusion porosimetry

The objectives of this study were to visually examine the surface and interior morphology of a new class of biodegradable hydrogels based on dextran-methacrylate and to quantify the porous structure of these hydrogels in swollen state. Two techniques (scanning electron microscopy and mercury intrusion porosimetry) were used to analyze pore structure of dextran-methacrylate hydrogels as a function of the degree of methacrylate substitution. SEM was used to observe 3-dimensional network structure of cryofixed and fractured swollen dextran-methacrylate hydrogels. Image analysis of the SEM data revealed different pore shapes and sizes, depending on the degree of substitution and the location within the hydrogel. A higher methacrylate-substituted dextran hydrogel showed a compact and rigid pore structure, while a lower substituted hydrogel showed a delicate and fragile pore structure. Mercury intrusion porosimetry analysis of the pore structure of dextran-methacrylate hydrogels provided useful and more reliable quantitative data of pore characteristics, such as total pore area, average pore diameter, their distribution, and bulk density. The total pore area and average pore diameter of swollen dextran-methacrylate hydrogels decreased with an increase in degree of methacrylate substitution, while bulk density increased with an increase in degree of substitution.

Use of CC traps with different trap base colors for silverleaf whiteflies (Homoptera: Aleyrodidae), thrips (Thysanoptera: Thripidae), and leafhoppers (Homoptera: Cicadellidae)

During 1996, 1997, and 1999, studies were conducted in cotton, sugar beets, alfalfa, yardlong bean, and peanut fields to compare insect catches in CC traps equipped with different trap base colors. The studies were conducted in southwestern United States, China, and India. The nine colors, white, rum, red, yellow, lime green, spring green, woodland green (dark green), true blue, and black, varied in spectral reflectance in the visible (400-700 nm) and near-infrared (700-1050 nm) portions of spectrum. Lime green, yellow, and spring green were the three most attractive trap base colors for silverleaf whitefly, Bemisia argentifolii Bellows & Perring, and leafhopper, Empoasca spp. adults. The three trap base colors were moderately high in the green, yellow, and orange spectral regions (490-600 nm), resembling the spectral reflectance curve of the abaxial (underleaf) surfaces of green cotton leaves. True blue and white were the most attractive trap base colors for western flower thrips, Frankliniella occidentalis (Pergande), adults. The true blue and white trap bases were moderately high in the blue spectral region (400-480 nm).

In vitro release behavior of dextran-methacrylate hydrogels using doxorubicin and other model compounds

In vitro drug release behavior of doxorubicin, Alizarin Red S, FITC-dextran from photocross-linked dextran-methacrylate hydrogel was studied. The effects of pH of media, degree of substitution (DS) of dextran-methacrylate hydrogel, and molecular weight of model compounds on their release profiles were investigated. Each model compound was successfully incorporated into dextran-methacrylate hydrogel matrix through photopolymerization of the hydrogel precursor. Delayed release of model compounds was observed with these hydrogels having a higher DS. Doxorubicin and Alizarin Red S showed pH-dependent release behavior because of the presence of ionizable groups in their structure. Different types of ionization of doxorubicin and Alizarin Red S resulted in more release into an acidic or alkaline media. As molecular weights of drugs increased, the total amount of released drug at the end of 240 hrs decreased significantly and reached a minimum level as the MW of drugs reached about 10,000. Release of these three model compounds followed simple Fickian diffusion at an early stage of release, i.e., cumulative release of model compounds was proportional to the square root of time. Dextran-methacrylate hydrogel effectively delayed and controlled the release of anticancer antibiotics, doxorubicin.

Effects of glucose-free maintenance solution on plasma glucose during anesthesia in patients undergoing long neurologic surgery

BACKGROUND

Using glucose-free solution as fluid maintenance is widely advocated during neurosurgery because of concerns about hyperglycemia aggravating cerebral ischemia. This study evaluated the alterations in plasma glucose concentrations in both adult and pediatric patients undergoing lengthy neurologic surgery, during which they were given glucose-free solutions.

METHODS

This study included 154 patients (ASA class II, aged 3 months-75 years) undergoing elective neurosurgical procedures. They were divided into two groups: group A (15-75 years-of-age) and group P (3 months-14 years-of-age). Groups A (n = 126) and P (n = 28) were further divided into five subgroups, respectively, based on the duration of surgery: 5, 6, 7, 8 and 9 hours. Anesthesia was maintained with isoflurane, fentanyl and vecuronium. Blood sampling was undertaken every hour throughout surgery.

RESULTS

Adult patients differed significantly in body weight (61.5 +/- 10.9 vs 25.6 +/- 14.9 kg), age (58.9 +/- 15.7 vs 7.5 +/- 4.3 years), use of preoperative beta-blocking agents (33/126 vs 1/28) and the need for blood transfusion (58/126 vs 24/28). Neither group had elevated glucose levels. Compared with pediatric patients, the incidence of intraoperative hypoglycemia was statistically higher in adult patients, with a rate that peaked in the eighth (25.9%, group A vs 0% group P) and ninth hours (27.3%, group A vs 0% group P) of surgery. There were no differences in glucose concentrations at other points in time.

CONCLUSIONS

In contrast to pediatric patients, intraoperative hypoglycemia occurred more often in adult patients during prolonged neurosurgical procedures when glucose-free solution was used for fluid maintenance. Therefore, frequent determination of plasma glucose concentrations is mandatory, especially in patients undergoing long-lasting neurosurgical anesthesia.

Effect of milrinone on postbypass pulmonary hypertension in children after tetralogy of Fallot repair

BACKGROUND

Postbypass pulmonary hypertension in surgical correction of tetralogy of Fallot (TOF) is a risk for right ventricular failure. Effective management remains a major challenge. Milrinone is a new drug with a unique mechanism of "inodilation", which offers both inotropic and vasodilatory effects. We attempted to determine if application of milrinone could improve cardiopulmonary dysfunction in children after TOF repair.

METHODS

We studied 10 children with postbypass pulmonary hypertension after TOF repair within six months. Heart rate, systolic pulmonary arterial pressure (PAP), systolic arterial blood pressure (SBP), pulmonary capillary wedge pressure and PAP/SBP ratio were recorded. Standard cardiopulmonary bypass (CPB) was performed. After CPB, if PAP/SBP was more than 0.5, pulmonary hypertension was suspected and milrinone was administered with a loading dose of 20 micrograms/kg followed by continuous infusion of 0.2 microgram/kg/minute. Hemodynamics were compared before and after administration of milrinone to evaluate its effect.

RESULTS

significant reduction in PAP/SBP ratio within 15 minutes was found after administration of milrinone. The effect persisted for 24 hours during continuous infusion of milrinone. No remarkable adverse effect was noted in the study.

CONCLUSIONS

We conclude that milrinone is effective in the management of pulmonary hypertension following CPB in children who underwent TOF repair.

Synthesis and characterization of dextran-methacrylate hydrogels and structural study by SEM

The objectives of this study were to develop a simple and reproducible method for the preparation of the hydrogel precursor dextran-methacrylate and to conduct a visual observation of the interior structure of the swollen dextran-methacrylate hydrogel with minimum artifacts. A dextran-methacrylate hydrogel precursor was synthesized by reacting dextran with methacrylic anhydride in the presence of triethylamine as a catalyst. The effects of reaction time, temperature, concentration, and catalyst amount were studied to obtain a wide range of degree of substitution (DS) in dextran by methacrylate. The dextran-methacrylate synthesized showed an enhanced solubility in water and common organic solvents. UV irradiation of dextran-methacrylate by a long-wave UV lamp (365 nm) generated a photocrosslinked hydrogel. This dextran-methacrylate hydrogel showed a range of swelling ratio from 67 to 227% and exhibited an increase in swelling ratio with a decrease in methacrylate substitution. The pH of the swelling media did not affect the swelling behavior of the dextran-methacrylate hydrogels at all the degrees of substitution used. Special cryofixation and cryofracturing techniques were used to prepare aqueous swollen dextran-methacrylate hydrogel samples for SEM observation of their surface and interior structures. A unique three-dimensional porous structure was observed in the swollen hydrogel but was absent in the unswollen hydrogel. Different pore sizes and morphologies between the surface and the interior of swollen hydrogels also were observed.

Orbitofrontal cortex pathology in Alzheimer's disease

The orbitofrontal cortex has been examined in Alzheimer's disease (AD) from the viewpoint of neurofibrillary tangle (NFT) pathology, its laminar distribution and topography. NFT pathology in the orbitofrontal cortex is extensive in AD. In cases with extensive cortical pathology, NFTs extend from the pole of the frontal lobe to the orbitoinsular junction. In lesser affected cases, the anterior granular part of the orbital cortex is less invested by NFTs. Layers III and V contain the greatest density of NFTs and these are most dense in the dysgranular areas, posterior to the transverse orbital sulcus. Posterior and medial orbitofrontal areas, forming area 13 and the posterior tip of the paraolfactory gyrus, are the most severely damaged, as are the smaller agranular fields that surround the olfactory tract and cortex. The widespread orbitofrontal damage in AD affecting projection neurons suggests that this pathology may contribute heavily to the many non-memory-related behavior changes observed in this disorder.

Transverse testicular ectopia: preoperative diagnosis by ultrasonography

Transverse testicular ectopia (TTE) is a rare anomaly. We report the first case of TTE described in Taiwan. The physical examination, ultrasonography (US), and laparoscopy revealed both testes in the left hemiscrotum, and surgical correction was performed. This case was diagnosed preoperatively by US, which can offer an easy, safe, and convenient alternative in the preoperative diagnosis of TTE. The possible mechanism for this anomaly and the literature are reviewed.

Combined spinal-epidural anesthesia for cesarean section in a patient with Takayasu's disease

We describe a successful episode of anesthesia management in a parturient affected with Takayasu's disease who underwent elective cesarean section under combined spinal-epidural anesthesia. Takayasu's disease is characterized by chronic occlusive inflammation of the arteries (panarteritis) of unknown origin that usually involves the aorta and its main branches. Progression of the disease may be marked by aneurysmal dilation of the affected arteries and may lead to a fatal outcome, usually from cerebral ischemia or heart failure. The impact of pregnancy on Takayasu's disease is unclear, but worsening of ischemic symptoms, cardiac failure, aggravation of hypertension and cerebral hemorrhage have been reported in sufferers who are in the later stages of pregnancy. Nonetheless, anesthesia management of a parturient with advanced Takayasu's disease presents a challenge to anesthetists.

Heterogeneity of Taiwan's indigenous population: possible relation to prehistoric Mongoloid dispersals

Taiwan's 9 indigenous tribes (Tsou, Bunun, Paiwan, Rukai, Atayal, Saisiat, Ami, Puyuma, Yami) are highly homogeneous within each tribe, but diversified among the different tribes due to long-term isolation, most probably since Taiwan became an island about 12,000 years ago. Homogeneity of each tribe is evidenced by many HLA-A,B,C alleles having the world's highest ever reported frequencies, e.g. A24 (86.3%), A26 (18.8%), Cw10 (36.8%), Cw7 (66%), Cw8 (32.1%), B13 (27.9%), B62 (37.4%), B75 (18%), B39 (53.5%), B60 (33.3%), and B48 (24%). Also, all of these tribes have HLA class I haplotype frequencies greater than 10%, with A24-Cw7-B39 in Saisiat (44.5%) being the highest, suggesting Taiwan's indigenous tribes are probably the most homogeneous ( the "purest") population in the world. A24-Cw8-B48, A24-Cw10-B60 and A24-Cw9-B61 found common to many Taiwan indigenous tribes, have also been observed in Maori, Papua New Guinea Highlanders, Orochons, Mongolians, Inuit, Japanese, Man, Buryat, Yakut, Tlingit, Tibetans and Thais. These findings suggest Taiwan's indigenous groups are more or less genetically related to both northern and southern Asians. Principal component analysis and the phylogenetic tree (using the neighbor-joining method) showed close relationship between the indigenous groups and Oceanians. This relationship supports the hypothesis that Taiwan was probably on the route of prehistoric Mongoloid dispersals that most likely took place along the coastal lowland of the Asian continent (which is under the sea today). Cultural anthropology also suggests a relationship between Taiwan's indigenous tribes and southern Asians and to a lesser extent, northern Asians. However, the indigenous groups show little genetic relationship to current southern and northern Han Chinese.

The role of superoxide ions in the degradation of synthetic absorbable sutures

The objective of this study was to examine the effect of superoxide ion-induced degradation on synthetic absorbable biomaterials. Synthetic absorbable sutures were used as the model compounds. Inflammatory cells, particularly leukocytes and macrophages, are able to produce highly reactive oxygen species, such as superoxide (. O(2)(-)), during inflammatory reactions to foreign materials. Superoxide ions may act as oxygen nucleophile agents to attack biomaterials. In this study, the changes in tensile breaking force, thermal properties, and the surface morphology of five commercial (2/0 in size) synthetic absorbable sutures (Dexon, Vicryl, PDS II, Maxon, and Monocryl) as a function of superoxide ion concentration at 25 degrees C for 24 h were studied. Among the five absorbable sutures and over the concentration range of this study, the monofilament Monocryl suture was the most sensitive toward superoxide ion-induced degradation, followed by Maxon, Vicryl, Dexon, and PDS II sutures. The amount of tensile breaking force loss over a 24 h period ranged from as low as 3% to as high as 80%, depending on the type of absorbable sutures, the reaction time, and the superoxide ion concentration. All five absorbable sutures showed significant reductions in both the T(m) and T(g). Unlike the surface morphological changes of absorbable sutures in conventional buffer solutions, the effect of superoxide ion-induced degradation on the surface morphologies of these five absorbable sutures was unique, particularly the moon-crater-shaped impressions of various sizes and depths found in Monocryl and Maxon sutures, which defied the anisotropic characteristics of fibers.

Acute fatal vasoplegia and asystole induced by intravenous amiodarone after cardiopulmonary bypass in a patient with preoperative cardiogenic shock

Single dose intravenous amiodarone has been widely used and shown to be effective to treat supraventricular and ventricular arrhythemias in cardiac surgery. We, herein, report a 60-year-old female patient, sustaining cardiogenic shock in the course of percutaneous transluminal coronary angioplasty (PTCA) for unstable angina unrelieved by medication including nitroglycerin, succumbed to a life-saving emergent coronary artery bypass grafting (CABG) operation at the end of cardiopulmonary bypass (CPB) following a 180 mg bolus dose of amiodarone (3 mg/kg) directed at the ventricular arrhythmias, triggered by protamine and unresponsive to lidocaine treatment. Amiodaroneinduced asystole and vasoplegia were thought to be the causation of the failure of resuscitation. The causes of the development of these complications, the potential hazards of its use and the management relative to the consequential complications are reviewed and discussed.

Topical steroid treatment of phimosis in boys

PURPOSE

We evaluate whether steroid application alone or retraction and hygiene are responsible for successful results in boys treated with topical steroids for phimosis.

MATERIALS AND METHODS

A prospective study was performed, which included a control group of 42 patients with phimosis seen at our outpatient department from January to June 1997. During that time we trained the parent to retract and clean the foreskin only. From July 1997 to June 1998 topical steroid cream was prescribed in addition to retraction and hygiene in 276 boys with phimosis. All cases were divided into 3 subgroups of asymptomatic, symptomatic and buried penis.

RESULTS

The response rate was greater than 95% in patients who received topical steroid treatment in addition to improved hygiene. Only 13 boys (less than 5%) had no response to steroid treatment. Of the control patients 23 (55%) had no response to gentle retraction and personal hygiene. There was a significant difference (p<0.001) in response rate between the study and control groups. However, the subgroup with a buried penis responded poorly to steroid, retraction and hygiene treatment. There was significant difference (p<0.001) in response rate between the buried penis and other steroid groups but no significant difference (p>0.05) in the control group.

CONCLUSIONS

Phimosis is a physiological condition in neonates due to natural adhesion between the foreskin and the glans. Chronic infection due to poor hygiene is responsible for most cases of childhood phimosis. Circumcision is the traditional treatment of choice for phimosis or unretractable foreskin, although it is not always desired by parents or surgeons. Topical steroid cream is an easy, safe and nonsurgical alternative for phimosis. However, boys with a buried penis are not good candidates for steroid treatment.

Characterization of chemical species in PM2.5 and PM10 aerosols in suburban and rural sites of central Taiwan

Aerosol samples for PM2.5 (particulate matter with aerodynamic diameters less than 2.5 microns), PM2.5-10 (particulate matter with aerodynamic diameters between 2.5 and 10 microns) and TSP were collected from June to September 1998 at THU (suburban) and HKIT (rural) sites in central Taiwan. The ratios of PM2.5/PM10 averaged 0.70 for the daytime and 0.63 for the nighttime at THU, respectively. At HKIT, the PM2.5/PM10 ratios averaged 0.56 for the daytime and 0.72 in the nighttime, respectively. These results indicated that the PM2.5 concentrations contribute the majority of the PM10 concentration and PM10 concentrations contribute the majority of the TSP at both sites. The averaged PM2.5 concentrations at THU are higher than those measured at HKIT during the daytime period. However, the average PM2.5-10 concentrations in THU are lower than those measured at HKIT during nighttime. The samples collected were also analyzed by atomic absorption spectrophotometry for the elemental analysis of Ca, Fe, Pb, Zn, Cu, Mn and Cr. Meanwhile ion chromatography was used to analyze for the water-soluble ions: sulphate, nitrate and chloride in the Universal samples. The concentrations of heavy metals in PM10 during daytime were all higher than nighttime at THU. However, the averaged concentrations of metal elements in PM10 during day and night period were distributed irregularly at HKIT. The results indicated that for metal elements collected at HKIT have different emission sources. The concentrations of metal elements during daytime in PM10 at THU were generally higher than HKIT. The phenomena owing to the averaged PM2.5 particle concentrations at THU (suburban) were higher than those measured at HKIT (rural) and PM2.5 occupied the major portions of PM10 for both sites during the day period. For anion species, there are no significant differences between day and night period in PM10 concentrations at both suburban and rural sites.

A role for the polymorphism at position 247 of the beta2-glycoprotein I gene in the generation of anti-beta2-glycoprotein I antibodies in the antiphospholipid syndrome

OBJECTIVE

To determine the frequencies at which either a valine or leucine occurs at position 247 in the beta2-glycoprotein I (beta2GPI) gene of normal individuals of the Caucasian, African American, and Asian ethnic groups and to compare these data with those in patients with the antiphospholipid syndrome (APS), with and without anti-beta2GPI antibodies.

METHODS

The DNA segment containing the position-247 polymorphism was amplified by seminested polymerase chain reaction, and the polymorphism was detected by restriction endonuclease digestion. DNA samples from 370 healthy controls of different racial backgrounds were analyzed, and the results were compared with those from 149 APS patients (66 primary; 83 secondary). Allele and genotype frequencies were compared using Fisher's exact test. When significant differences were detected, pairwise comparisons were made using Fisher's exact test with a Bonferroni adjustment.

RESULTS

Allele and genotype expression was significantly different (P < 0.0001 for both) among the 3 races, with the V allele and the VV genotype occurring most often among Caucasians, less among African Americans, and least among Asians. Conversely, the V allele and the VV genotype were found more frequently among Asian APS patients than among controls (P = 0.0028 and P = 0.0023, respectively). No significant differences in allele or genotype frequencies were seen in comparisons of the Caucasian or the African American patients with appropriate controls. The differences in allele and genotype frequencies seen in the Asian APS patients were restricted to the anti-beta2GPI-positive patients (P = 0.0018 and P = 0.0005, respectively).

CONCLUSION

In Asian patients with APS, expression of a V at position 247, especially in the homozygous state, is significantly associated with the presence of anti-beta2GPI antibodies and, therefore, can be viewed as a major risk factor in this ethnic group (odds ratio 9.19 and 16.33, respectively).

Synthesis and characterization of dextran-maleic acid based hydrogel

A new class of hydrogel precursor, dextran-maleic acid (Dex-MA), was synthesized by the reaction of dextran with maleic anhydride in the presence of the catalyst triethylamine. The effects of temperature, time, catalyst amount, and reactant concentration on the degree of substitution (DS) by MA was studied to establish an optimum reaction condition. The new hydrogel precursor had excellent solubility in various common organic solvents. The hydrogels based on Dex-MA precursor were made by the irradiation of Dex-MA with a long wave UV lamp. The Dex-MA hydrogels showed a very high swelling ratio in water, and the magnitude of swelling depended on the pH of the medium and the DS by MA. The Dex-MA hydrogels exhibited the highest swelling ratio in neutral pH, followed by acidic (pH 3) and alkaline pH (10). The most distinctive characteristic of Dex-MA hydrogels was that a carboxylic acid group was generated by the reaction of dextran with maleic anhydride. As a result, the swelling ratio increased with an increase of the DS of the MA segment (ionizable moiety that affects swelling ratio) in the Dex-MA hydrogel.

[Hypothyroid myopathy: a case report]

Though proximal muscle weakness is characteristic of polymyositis, other agents may also lead to proximal muscle weakness, such as drugs, endocrine diseases, or infections. Here, we report a thirty year-old female suffering from proximal weakness which initially was thought to be a case of polymyositis with high serum creatine phosphokinase level. Very low thyroid hormone levels were found as the history inquiry revealed constipation, hoarseness and cold intolerance. The muscle biopsy showed no obvious inflammation. After thyroxine therapy, her muscle weakness recovered. Up to now, hypothyroid myopathy with muscle mitochondrial abnormalities shown by electron microscopic examination has not been reported in the medical literature in Taiwan. Hypothyroid myopathy, though it is rare, may be misdiagnosed as polymyositis clinically. Therefore, it is recommended that hypothyroid myopathy should be considered in the differential diagnosis of proximal muscle weakness.

The optimal effective concentration of lidocaine to reduce pain on injection of propofol

STUDY OBJECTIVE

To determine the optimal concentration of lidocaine that reduces pain on injection of a propofol-lidocaine mixture.

DESIGN

Prospective, randomized, double-blinded, clinical investigation.

SETTING

Medical center, university teaching hospital.

PATIENTS

240 ASA physical status I and II female outpatients, aged 21 to 65 years, undergoing dilation and curettage with propofol for anesthesia induction.

INTERVENTIONS

Patients were randomized to one of four groups in double-blinded fashion. In Group A (control), patients were given propofol containing normal saline; in Group B, Group C, and Group D, patients received propofol containing 0.05% lidocaine (Group B), propofol containing 0.1% lidocaine (Group C), and propofol containing 0.2% lidocaine (Group D) for induction.

MEASUREMENTS AND MAIN RESULTS

The incidence of pain on injection of propofol was significantly decreased in Group C and Group D (8.3% and 10.0%, respectively) in comparison to the control group (91.7%) (p < 0.001). Although the result in Group B (76.7%) was better than that in the control group, the difference was not statistically significant. No significant difference was seen between Group C and Group D.

CONCLUSIONS

The optimal effective concentration of lidocaine, which decreased the incidence of pain caused by propofol injection, was 0.1% in the currently studied population.

Plasma surface modification of synthetic absorbable sutures

The aim of the study was to examine the feasibility of using plasma surface modification technology to alter the hydrolytic degradation rate of commercial synthetic absorbable sutures. Size 2-0 Dexon, Vicryl, PDSII, and Maxon sutures were tested. They were treated by two different surface modification techniques: parylene deposition and plasma gases (Methane, trimethylsilane, and tetrafluoroethene). The thickness of surface treatment ranged from 200 to 1000 A. The treated sutures were subject to in vitro hydrolytic degradation in phosphate buffer of pH = 7.4 at 37 degrees C for up to 120 days. The tensile breaking strength, weight loss, surface wettability, bending stiffness, and surface morphology were evaluated. The results indicated that the concept of plasma surface treatment for altering the hydrolytic degradation of synthetic absorbable sutures was feasible, and the level of improvement depended on the type of sutures, the treatment conditions, and the duration of hydrolysis. Vicryl and PDSII sutures showed overall the best improvement in tensile strength retention among the four commercial sutures. Dexon and Maxon sutures, however, exhibited only marginal improvement. The observed improvement in tensile strength retention appeared to be related to the increasing hydrophobicity of the sutures. The surface treatments did not adversely affect the bending stiffness of the sutures and no visible surface morphological changes were observed. Refinements and optimization of the surface treatment conditions are needed for achieving the maximum advantage of the proposed concept, particularly shielding the harmful effect of uv during plasma treatment.

A comparison of a new polypropylene suture with Prolene

The purpose of this paper is to examine the performance of the newly available monofilament polypropylene suture (Surgipro) manufactured by U.S. Surgical and compare it with commercial Prolene sutures for determining the merit of this new suture. Two different sizes of Surgipro sutures were used. They were 4/0 and 0 sizes and were tested in terms of their fundamental properties: level of crystallinity, melting temperature, fiber morphology, and mechanical properties including knot strength and knot security. The effect of three different sterilization methods on the mechanical and fundamental properties of the new polypropylene (PP) sutures was also examined. In general, the new Surgipro sutures performed as good as Prolene sutures in terms of mechanical properties; but there were some differences in fundamental properties between these two types of PP sutures, particularly in finer size PP sutures. The major differences were in interior fiber morphology, level of crystallinity, and melting temperature. Surgipro suture fibers showed homogeneous interior morphology, while Prolene fibers exhibited two distinctive fiber morphologies. These two types of PP suture fibers also responded differently to the three sterilization methods tested. Surgipro sutures are less affected by different sterilization methods than the same size Prolene control. Except for the Co 60 gamma sterilization, Surgipro suture fibers did not exhibit statistically significant differences in tensile breaking strength between sterilized and control. Ethylene oxide and autoclave sterilized Prolene suture fibers, however, showed statistically (p less than 0.05) consistently lower tensile breaking strength than their unsterilized controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Tissue mosaicism in the skeletal muscle and sural nerve biopsies in the MELAS syndrome

We describe a clinically full-blown MELAS patient, who had an A3243G point mutation of mitochondrial DNA (mtDNA) in muscle and blood cells, and his family members. From the proband two muscle biopsies from the vastus lateralis muscle were analysed; one had typical ragged red fibers and focal cytochrome c oxidase deficiency and the other was completely normal. He also had a peripheral neuropathy confirmed by nerve conduction velocity and sural nerve biopsy studies. Axonal degeneration, relative loss of large myelinated fibers and paracrystalline inclusion bodies in the Schwann cells were noted. Intriguingly, the A3243G mutation of mtDNA was not found in the sural nerve biopsy. Therefore, we conclude that tissue mosaicism is present in the muscle fibers and that the mtDNA mutation may not be detected in the nerve involved as proved by pathology. We also suggest that the involvement of specific tissues in patients with mitochondrial diseases should be further determined by single fiber mtDNA analysis.

A newly identified nonsecretor allele of the human histo-blood group alpha(1,2)fucosyltransferase gene (FUT2)

BACKGROUND AND OBJECTIVES

The human Secretor alpha(1, 2)fucosyltransferase gene determines the ABH secretor status and influences the Lewis phenotype of an individual. Studies were carried out on the Lewis (a+b-) nonsecretors of different groups indigenous to Taiwan to demonstrate their se genotypes.

METHODS

The Lewis phenotype of the blood samples was determined by a microplate method. The se genotypes of the individuals with the Lewis (a+b-) phenotype were analyzed by a polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method designed for the se alleles reported previously. PCR and cloning techniques were used to determine the coding sequence of the novel se gene.

RESULTS

A new se allele, se685, with a three-nucleotide deletion of GTGGT to GT in the coding region of nucleotides 685 through 689 was identified in a Le (a+b-) nonsecretor from the Ami tribe indigenous to Taiwan. The deletion predicts the loss of the amino acid Val230 in the corresponding secretor enzyme's C-terminal segment. The distribution of the se685 allele in the Ami tribe was further verified by PCR-RFLP analysis.

CONCLUSION

The Se gene exhibits heterogeneity with some Se alleles being common but others displaying a unique distribution in different ethnic populations. The newly identified se685 allele seems to exist only in the Ami tribe indigenous to Taiwan.

Chronic inorganic mercury induced peripheral neuropathy

We report the clinical features, electrophysiological studies, and morphometric analysis of sural nerve pathology in a patient with polyneuropathy due to inorganic mercury intoxication. He developed slowly progressive generalized paralysis of all limbs after 3 months ingestion of herb drugs which contained mercuric sulfate. Electrophysiologic studies revealed axonal polyneuropathy involving both motor and sensory fibers. Sural nerve biopsy demonstrated axonal degeneration with demyelination and a predominant loss of large myelinated fibers. His muscle strength showed only mild improvement after 2 years' follow-up. We concluded that inorganic mercury exposure may induce severe axonal sensorimotor polyneuropathy in humans and that neurological deficits may persist in severe cases.

Ultrasonography for inguinal hernias in boys

BACKGROUND/PURPOSE

History taking and physical examination alone no longer meet the surgeon's need in the diagnosis of inguinal hernia. Ultrasonography (US) provides a good and safe diagnostic tool for inguinal hernias in boys.

METHODS

From 1995 to 1997, 244 boys with inguinal hernias (41 bilateral and 203 unilateral), received preoperative US on both groins to confirm the diagnosis. Those with positive US findings, such as viscera or fluid in inguinal canal or widening of the internal inguinal ring, underwent surgery.

RESULTS

The accuracy of diagnosis with US and clinical assessment were 97.9% and 84%, respectively. More than 95% of widening of internal inguinal rings (>4 mm) proved to be hernias. There were two direct inguinal hernias and two femoral hernias, which were misdiagnosed by clinical examination, but proved to be diagnosed correctly by US.

CONCLUSIONS

US serves as a noninvasive and highly accurate diagnostic tool for inguinal hernias in boys. Using 4 mm as the upper limit of the normal diameter of the internal inguinal ring, an occult inguinal hernia can be easily detected before surgery.

Anesthetic management of a parturient with Eisenmenger's syndrome and preeclampsia during cesarean section--a case report

It has been recommended that women with Eisenmenger's syndrome (ES) are better not to become pregnant and pregnancy may justifiably be terminated by artificial abortion to avoid high maternal mortality and coherent fetal mortality. We present a case report about a parturient with ventricular septal defect (VSD) and ES who received general anesthesia for Cesarean section (C/S) because of preeclampsia, as a result of which she finally succumbed to an episode of intraoperative hypotension in spite of vigorous cardiopulmonary resuscitation. The death was thought to be precipitated by continuous deterioration of maternal health during the 3rd trimester of gestation. The anesthetic management of pregnant ES patients in confinement was reviewed and discussed, and the possible etiological factors relevant to the tragic outcome were also explored.

Migratory leptomeningeal inflammation with relapsing polychondritis

We report a case of relapsing polychondritis with focal sensorimotor seizures, aseptic meningitis, and migratory leptomeningeal enhancement on contrast MRI. These abnormalities on imaging studies correlated accurately with laterality of the patient's seizures, facilitating early aggressive management of his neurologic symptoms.

Expressed genes in interleukin-4 treated B cells identified by cDNA representational difference analysis

Interleukin-4 (IL-4) stimulates B cell growth and differentiation, such as inducing mature B cells to switch to IgG1 and IgE production. To further characterize IL-4 effects on B cells, we used a sensitive PCR-based subtraction approach to isolate genes expressed in IL-4 treated cells. Our approach combined an adaptation of the genomic representational difference analysis (RDA) method to cDNA analysis with a physical separation method (magnetic bead depletion). This cDNA RDA technique allowed us to perform subtraction on the relatively small number of highly, characterized, purified B cells that can be conveniently prepared. In the hopes of removing genes responsible for general cell growth, we subtracted cDNA made from lipopolysaccharide (LPS)-stimulated B cells from cDNA from LPS+IL-4 stimulated B cells. Two rounds of subtraction resulted in greater than 100-fold enhancement of expected IL-4-induced Cgamma1 cDNA. At that point, we cloned this subtraction library and analysed 154 randomly picked clones for sequence similarities. From these clones, 37 individual genes were obtained. Most of these genes (30) could be functionally identified by sequence similarity. These included genes encoding Cgamma1 (1), cytoskeletal components (4) and products involved in DNA replication (3), metabolism (5), signal transduction (4), transcription (4), translation (6) and transport (3). Only 7 genes had no similarity to known sequences in the GenBank, EMBL or Swiss Prot databases. One unknown gene (designated Fig1 for IL-Four Induced Gene 1) and one gene with homology to the human transcription factor E4BP4 were confirmed by Northern blot analysis to be induced 10-20-fold by IL-4 treatment. This list of expressed genes in LPS + IL-4 treated B cells may shed further insight on the action and mechanism of IL-4 stimulation of cells.

Isoorientin-6"-O-glucoside, a water-soluble antioxidant isolated from Gentiana arisanensis

The antioxidant activities of isoorientin-6"-O-glucoside were studied using various models. Isoorientin-6"-O-glucoside was more potent than Trolox, probucol and butylated hydroxytoluene (BHT) in reducing the stable free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH). It also scavenged superoxide anion, peroxyl and hydroxyl radicals that were generated by xanthine/xanthine oxidase, 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH) and Fe3+-ascorbate-EDTA-H2O2 system, respectively. The IC50 value, stoichiometry factor and second-order rate constant were 9.0+/-0.8 microM, 1.8+/-0.1 and 2.6 X 10(10) M(-1) s(-1) for superoxide generation, peroxyl and hydroxyl radicals. However, isoorientin-6"-O-glucoside did not inhibit xanthine oxidase activity or scavenge hydrogen peroxide (H2O2), carbon radical or 2,2'-azobis(2,4-dimethyl-valeronitrile) (AMVN)-derived peroxyl radical in hexane. Isoorientin-6"-O-glucoside inhibited Cu2+-induced oxidation of human low-density lipoprotein (LDL) as measured by fluorescence intensity, thiobarbituric acid-reactive substance formation and electrophoretic mobility. Since isoorientin-6"-O-glucoside did not possess pro-oxidant activity, it may be an effective water-soluble antioxidant that can prevent LDL against oxidation.

Fiber-matrix interface studies on bioabsorbable composite materials for internal fixation of bone fractures. II. A new method using laser scanning confocal microscopy

In this study, a new visual characterization method was developed using laser scanning confocal microscopy (LSCM) to study morphologic properties, particularly at the fiber-matrix interface, by optical sectioning of bioabsorbable single-fiber composites. The interface gap width (IGW) between the fiber and matrix, and the changes in IGW after in vitro hydrolysis, named the gap rate (Rg), were measured from images obtained using the LSCM. Higher values for IGW and Rg showed faster degradation of the fiber-matrix interface. These parameters were used to investigate the effects of strain, wicking, different reinforcing fibers, and gamma-irradiation on the fiber-matrix interface morphology. The component materials used were nonbioabsorbable AS4 carbon (C) fibers, bioabsorbable calcium phosphate (CaP), poly(glycolic acid) (PGA), and chitin fibers, and bioabsorbable poly(L-lactic acid) (PLLA) matrix. The application of strain on CaP/PLLA composites increased the IGW up to about 15%, after which there was no change up to 25%. The Rg for CaP/PLLA composites with the fiber ends exposed in vitro (permitting wicking) was greater than for CaP/PLLA with the fiber ends embedded completely within the matrix (preventing wicking). Open-end C/PLLA composites had the slowest rate of interface degradation in vitro, followed by chitin/PLLA, PGA/PLLA, and CaP/PLLA. The exposure of closed-end CaP/PLLA composites to 4 Mrad of gamma-irradiation, in air at room temperature or in vaccuum at 77K, accelerated the rate of interface degradation in vitro. In conclusion, an effective new visual characterization method was developed using LSCM, and it was used to show that (a) moderate strain could accelerate the degradation of the interface, (b) fiber-matrix interface wicking could accelerate the rate of degradation of the interface, (c) the rate of interface degradation depends on the type of fiber used, and (d) gamma-irradiation could accelerate the rate of interface degradation. Furthermore, the results of LSCM analysis of different reinforcing fibers with a PLLA matrix agree with measurements of interfacial shear strength (IFSS) and single-fiber tensile strength reported in Part I of this study.