[Association between 23 urinary metals and mean platelet volume among a community-dwelling population in Wuhan, China]

OBJECTIVE

To investigate the potential association between 23 urinary metals and mean platelet volume (MPV) among a community population in Wuhan.

METHODS

A total of 3 053 community residents who lived in the sampling buildings for more than 5 years, aged from 18 to 80 years, were recruited using a stratified, cluster sampling approach in Wuhan city, China. Blood and urine samples were obtained from participants in the morning under fasting conditions. Urinary metals, including aluminum, titanium, vanadium, chromium, manganese, iron, cobalt, nickel, copper, zinc, arsenic, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, barium, tungsten, thallium, lead and uranium, were measured by inductively coupled plasma mass spectrometry. The MPV contents were determined using a fully automated clinical chemistry analyzer. Participants with missing data on covariates or cardiovascular disease were excluded. According to the reference intorvals of MPV for Chinese adults, the participants were classified into normal (7.0-11.0 fl) and high MPV (>11.0 fl) subgroups. Data from 2 203 participants were used to evaluate the associations between urinary metals and MPV levels using generalized linear regression models, and the risk of abnormal elevation of MPV using multivariable logistic regression models. The false discovery rate (FDR)-corrected P-value from 23 hypothesis tests was used to adjust for multiple testing.

RESULTS

After adjusting for potential confounders, urinary concentrations of arsenic (P50=2.431 μg/mmol creatinine) and molybdenum (P50=4.035 μg/mmol creatinine) were significantly associated with increased MPV levels and the risk of abnormal elevation of MPV. In contrast, urinary aluminum (P50=2.706 μg/mmol creatinine) and thallium (P50=0.046 μg/mmol creatinine) were associated with decreased MPV levels, but also the risk of abnormal elevation of MPV. The regression coefficients and 95% CIs were 0.119 (0.043-0.196) for arsenic (FDR-adjusted P=0.018), 0.119 (0.042-0.195) for molybdenum (FDR-adjusted P=0.018), -0.115 (-0.195--0.034) for aluminum (FDR-adjusted P=0.029), and -0.307 (-0.386- -0.228) for thallium (FDR-adjusted P<0.001), respectively. When comparing the extreme quartiles for arsenic, molybdenum, aluminum and thallium, adjusted OR and the 95%CIs were 1.830 (1.382-2.423), 1.496 (1.125-1.989), 0.566 (0.412-0.779) and 0.302 (0.219-0.416), respectively, and FDR-adjusted P-values were <0.001,<0.014,<0.008 and<0.001, respectively. Moreover, significant associations were found between an increased risk of abnormal MPV elevation with urinary iron (P50=6.716 μg/mmol creatinine) , antimony (P50=0.014 μg/mmol creatinine) and uranium (P50=0.003 μg/mmol creatinine) , and a decreased risk with urinary tungsten (P50=0.010 μg/mmol creatinine) and lead (P50=0.265 μg/mmol creatinine) . When comparing the extreme quartiles for iron, antimony and uranium, the respective adjusted OR (95%CI) were 1.866 (1.395-2.496), 1.507 (1.111-2.043) and 1.452 (1.063-1.984), and the respective FDR-adjusted P-values were <0.001,<0.022 and<0.012. The respective adjusted OR (95%CI) were 0.551 (0.417-0.726) and 0.534 (0.394-0.725), and the respective FDR-adjusted P-values were<0.001 and<0.001, when comparing the extreme quartiles for tungsten and lead. Based on multi-metal models, urinary chromium (P50=0.120 μg/mmol creatinine) and selenium (P50=0.646 μg/mmol creatinine) were associated with increased risk of abnormal MPV, while urinary nickel (P50=0.193 μg/mmol creatinine) was associated with decreased risk of abnormal MPV. When comparing the extreme quartiles for chromium, selenium and nickel, adjusted OR (95% CI) were 1.578 (1.054-2.363), 1.718 (1.159-2.549) and 0.535 (0.373-0.767), respectively, and the FDR-adjusted P-values were 0.017, 0.028 and 0.002, respectively.

CONCLUSION

In the general population of Wuhan city, exposure to aluminum, chromium, iron, nickel, arsenic, selenium, molybdenum, antimony, tungsten, thallium, lead and uranium were all associated with abnormal MPV elevation.

[Association of urinary metals and lung function in general Chinese population of Wuhan]

OBJECTIVE

To investigate the association between levels of 23 urinary metals and lung function, and explore their does-response relationships in the general population of Wuhan province, China.

METHODS

This was a cross-sectional study that enrolled volunteers from two communities of Wuhan between April and May 2011. All volunteers had resided in Wuhan for at least 5 years. Information from questionnaires and physical examinations were collected and lung function was assessed. Data from 2 540 volunteers were included. Urinary levels of 23 metals were measured by inductively coupled plasma mass spectrometry (ICP-MS). The relationship between urinary metals and lung function was analyzed with single and multiple regression models.

RESULTS

The mean age of the study population was 52.8 years. Mean levels of urinary metals, after adjustment for creatinine, including cobalt, copper, zinc, nickel, antimony and barium were 0.02, 0.68, 23.80, 0.20, 0.10, 0.34 and 0.26 μg/g creatinine, respectively. There were significant concentration-response relationships between increases in some urinary metals and reduced lung function. Single-metal regression models demonstrated that for each 1-unit increase in urinary levels of cobalt, lncopper, lnzinc, lnantimony, there was a reduction in forced vital capacity (FVC) of 0.091 L (95%CI: -0.155--0.027), 0.101 L (95%CI: -0.178--0.025), 0.094 L (95%CI: -0.172--0.027) and 0.118 L (95% CI: -0.203--0.033), respectively. Each 1-unit-increase in urinary lncobalt, lnnickel, lnstrontium, lnantimony, lnthallium, lnlead was associated with a reductions in forced expiratory volume in 1 sec (FEV1) of 0.070 L (95%CI: -0.124--0.016), 0.063 L (95%CI: -0.118--0.007), 0.063 L (95%CI: -0.124--0.002), 0.092 L (95%CI: -0.164--0.020), 0.055 L (95%CI: -0.105--0.005), 0.081 L (95%CI: -0.148--0.014), and 0.097 L (95% CI: -0.151--0.042), respectively. With respect to metal co-exposure, FVC was significantly associated with elevated urinary levels of cobalt, Cu and Sb, with reductions of 0.126 L (95%CI: 0.037-0.216) and 0.106 L (95% CI: 0.021-0.192), respectively, while FEV1 was significantly associated with elevated urinary Co, Sb, Ba and Pb, with reductions of 0.067 L (95% CI: -0.129--0.005), 0.142 L (95% CI: -0.247--0.037), 0.073 L (95% CI: -0.142--0.003) and 0.104 L (95% CI: -0.175--0.034), respectively.

CONCLUSIONS

Certain urinary metals were potentially associated, in a dose-dependent manner, with reduced lung function in the general population. Co-exposure to metals had stimulative and anti-stimulative effects on lung function.

[Association between personal exposure to metals in fine particulate matter and urinary metals: baseline results from a panel study]

OBJECTIVE

To investigate the associations between 21 metals in fine particulate matter (PM2.5) and their corresponding concentrations in urine in the general population.

METHODS

Between April and May 2011, this panel study enrolled 120 residents using random sampling approach in Wuhan communities which contained 3 035 subjects. Participants were aged 18 to 80 years and had lived in the sampling buildings for at least 5 years. Data from basic questionnaires, physical examinations, and morning blood and urine samples under fasting conditions were collected. Participants with missing data were excluded. Finally, 83 particpants included. Participants were instructed to use personal air samplers to continuously monitor PM2.5 for 24 h. The following 21 metals were measured in PM2.5 and urine by inductively coupled plasma mass spectrometry: aluminum, titanium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, barium, tungsten, thallium and lead. The associations between PM2.5 metals and urinary metals were investigated using generalized linear regression models.

RESULTS

The age of the study population was (51.5±6.3)years. After adjusting for age, sex, smoking status, BMI, education and income, elevated urinary chromium was significantly associated with increased chromium concentrations in personal PM2.5. The least square means (standard deviation) of urinary chromium in participants classified as having low exposure (<12.491 ng/m(3)), intermediate exposure (12.491-32.388 ng/m(3)) and high exposure (>32.388 ng/m(3)) were (-1.334±0.756), (-1.114±0.813) and (-0.718±0.645) μg/mmol creatinine, respectively (P=0.009). However, the association between urinary and personal PM chromium was not observed after additionally adjusting for false discovery rate (P>0.05). Furthermore, the results demonstrated that other metals in PM2.5 were not related to their corresponding concentrations in urine of subjects.

CONCLUSION

Urinary concentrations of metals did not reflect human exposure to metals in air, and may not be appropriate as an index to assess personal exposure to metals in particulate matter.

[Performance evaluation of two N95 filtering-facepiece respirators on decomposition products of sulfur hexafluoride]

OBJECTIVE

To assess the filtration efficiency of two N95 filtering-facepiece respirators (FFRs) for the decomposition products of sulfur hexafluoride (SF6).

METHODS

Two types of N95 FFRs (the particulate and the acid-proof respirators) were selected in this study. The decomposition products of SF6, including particles, hydrogen fluoride (HF) and sulfur dioxide (SO2) , were measured under experimental condition by using TSI PortaCount Plus, fluorine ion-selective electrodes and spectrophotometer separately. The filtration efficiency was then calculated and compared.

RESULTS

Both two models of N95 respirators had lowest filtration efficiency larger than 95% for particles under airflow ranged from 10 to 95 L/min. When exposed to different concentrations of HF (low: 0.00~1.99 mg/m(3), middle: 2.00~3.99 mg/m(3), high: >4 mg/m(3)) , the acid-proof N95 respirator was more effective than the particulate respirator (P<0.05) with a filtration efficiency of 98.83%, 99.08%, and 99.03% versus 48.44%, 45.71%, and 47.31%. For four SO2 concentration ranges (0.00~2.49 mg/m(3), 2.50~4.99 mg/m(3), 5.00~9.99 mg/m(3), and >10.00 mg/m(3)) , the acid-proof respirator showed a high filtration efficiency within exposure to 1.5 hours: 95.73%, 98.67%, 98.14%, and 97.78%, respectively, when exposure duration extended to 4 hours, the filtration efficiency of the acid-proof respirator decreased to 91.97%, 82.28%, 70.12%, and 58.56%, respectively.

CONCLUSION

Both the particulate and the acid-proof N95 FFRs met national standards on the particulate filtration efficiency. The acid-proof N95 respirator demonstrates to be more effective in filtering HF and SO2 than the particulate respirator. The filtration efficiency could decrease to an unsafe condition under longer exposure duration, timely replacement of respirator is recommended at the workplace.

Electron temperature and density probe for small aeronomy satellites

A compact and low power consumption instrument for measuring the electron density and temperature in the ionosphere has been developed by modifying the previously developed Electron Temperature Probe (ETP). A circuit block which controls frequency of the sinusoidal signal is added to the ETP so that the instrument can measure both T(e) in low frequency mode and N(e) in high frequency mode from the floating potential shift of the electrode. The floating potential shift shows a minimum at the upper hybrid resonance frequency (f(UHR)). The instrument which is named "TeNeP" can be used for tiny satellites which do not have enough conductive surface area for conventional DC Langmuir probe measurements. The instrument also eliminates the serious problems associated with the contamination of satellite surface as well as the sensor electrode.

Molecular cloning, characterisation and tissues expression analysis of the goose (Anser cygnoides) vasoactive intestinal peptide (VIP) gene

1. Vasoactive intestinal peptide (VIP) is involved in the control of prolactin (PRL) release and plays a pivotal role as a regulator of reproductive behaviour and neuroendocrine secretion in birds. 2. In this study, a 941-bp cDNA fragment covering the complete coding region (CDS) of goose VIP gene was identified. The cDNA contains a 32-bp 5'-untranslated region (UTR), a 603-bp CDS and a 306-bp 3'-UTR containing two ATTTA sequence elements, two polyadenylation signals (AATAAA) and a 25-bp poly (A) tail. 3. Seven exons and 6 introns were identified, and both the cDNA and genomic DNA sequences showed high identity with those of other species. 4. The sequence analysis indicated that there were two alternatively spliced transcripts the long transcript (VIP-1) encoded both VIP and peptide histidine isoleucine exons and the short one (VIP-2) only encoded VIP. 5. RT-PCR analysis indicates that the expression level of the VIP-1 is much lower than that of VIP-2, and that VIP-1 is negligible or absent in muscle, abdominal fat, ovary and spleen, whereas VIP-2 is widely distributed in all the examined tissues. 6. A total of 12 single nucleotide polymorphisms (SNPs), including 2 SNPs located in the coding region and 10 variations in intron regions, were identified in goose VIP gene.

Diet and exercise improve neutrophil to lymphocyte ratio in overweight adolescents

Neutrophil to lymphocyte ratio and levels of pro-inflammatory cytokines were evaluated in overweight, male Chinese adolescents upon completing a 4-week diet and physical exercise intervention. 43 recruited, non-randomized adolescents (body mass index >25 kg/m2) completed the controlled study. Anthropometric and biologic parameters were measured pre- and post-intervention. After the 4-week intervention, participants exhibited a significant decrease in body mass, body mass index, percentage body fat, basal heart rate, diastolic blood pressure, and all body shape indices tested. A significant decrease in serum lipids (except high-density lipoprotein cholesterol) and insulin levels was observed post-intervention. The neutrophil to lymphocyte ratio was significantly lower post-intervention. Bivariate correlation analyses showed that decrement in Δneutrophil to lymphocyte ratio significantly correlated with decrement in Δinterleukin-6 and Δwhite blood cell count. Thus, a 4-week diet and physical exercise intervention significantly reduces the neutrophil to lymphocyte ratio in a population of overweight, male adolescents. Weight loss caused by the intervention was associated with a significant decrease of pro-inflammatory cytokine levels.

Efficient photogeneration of charge carriers in silicon nanowires with a radial doping gradient

by performing electrodeless time-resolved microwave conductivity measurements, the efficiency of charge carrier generation, their mobility, and the decay kinetics on photoexcitation were studied in arrays of Si nanowires grown by the vapor-liquid-solid mechanism. Large enhancements in the magnitude of the photoconductance and charge carrier lifetime are found depending on the incorporation of impurities during the growth. They are explained by the internal electric field that builds up, due to higher doped sidewalls, as revealed by detailed analysis of the nanowire morphology and chemical composition.

Butanol production from the effluent of hydrogen fermentation

The purpose of the study was to recover butanol from the effluent of the hydrogen-producing bioreactor containing acetate, butyrate, and carbohydrate. The butanol production by Clostridium beijerinckii NRRL B592 was evaluated under both unsterilized and sterilized conditions for examining the potential of butanol production for the practical application. Sucrose of 10 g/L and butyrate of 2 g/L coupled with acetate buffer were used to mimic the effluent. Sucrose was completely consumed in the both unsterilized and sterilized conditions during acetone-butanol-ethanol (ABE) fermentation. However, the results illustrate that the carbohydrate consumption rate in the unsterilized condition was higher than that in the sterilized condition. The maximum butanol concentrations of 3,500 and 3,750 mg/L were achieved in the sterilized and unsterilized conditions, respectively. Meanwhile, it was found that the acetate and the butyrate concentrations of 600 and 1,500 mg/L, and 300 and 1,000 mg/L were ingested to yield butanol in the sterilized condition and in the unsterilized condition, respectively. The results concluded that high levels of acetate and butyrate could eliminate the interference of other microbial populations, resulting in the enrichment of C. beijerinckii NRRL B592 in the fermentor. The butanol production by C. beijerinckii NRRL B592 could be, therefore, produced from the effluent of the hydrogen-producing bioreactor. It promised that the microbial butanol production is one of attractive bioprocesses to recover energy from wastes.

Effect of daidzein on egg-laying performance in Shaoxing duck breeders during different stages of the egg production cycle

The effect of a phyto-oestrogen, daidzein, on the laying performance of Shaoxing female ducks was examined in three experiments performed at different stages of the egg production cycle. Egg-laying rate, egg weight, egg composition, feed conversion ratio, hatchability characteristics of eggs and body weight, ovary and oviduct weight, as well as changes in serum concentrations of T3, T4 and E2 were recorded as response criteria. In the first experiment, 68 young ducks, 100 d of age, were given a basal diet (maize-soybean meal) with or without 3 mg of daidzein/kg diet for 42 d. Daidzein did not affect the onset of lay but apparently decreased egg-laying rate and mean egg weight as well as the feed conversion ratio. In the second experiment, 240 breeding ducks, 402 d of age, were allotted at random to three groups and given the basal diet containing daidzein at 0 (control), 3 (Da1) and 5mg/kg (Da2) for 35d. Egg-laying rate, mean egg weight and feed conversion ratio increased in both Da1 and Da2 groups. However, an adverse effect of daidzein on fertility and hatchability was observed. In the third experiment, 320 breeding ducks, 415 d of age, were fed on the basal diet with or without 5mg of daidzein/kg diet for 63 d. Egg-laying rate increased by 7.7%, average egg weight tended to increase, whereas yolk/albumen ratio decreased. Daidzein-treated ducks had higher body weight and oviduct weight compared with their controls. Elevated plasma T4 and E2 concentrations accompanied these phenotypic changes, but serum T3 was not affected. It is suggested that daidzein exerts divergent effects on the egg-laying performance of Shaoxing ducks under different physiological conditions and this action is dose-dependent. The changes in circulating E2 imply possible participation of endogenous oestrogen in the mechanism of daidzein action.

Defect solitons in two-dimensional optical lattices

We report on the existence and stability of solitons in a defect embedded in a square optical lattice based on a photorefractive crystal with focusing saturable nonlinearity. These solitons exist in different bandgaps due to the change of defect intensity. For a positive defect, the solitons only exist in the semi-infinite gap and can be stable in the low power region but not the high power region. For a negative defect, the solitons can exist not only in the semi-infinite gap, but also in the first gap. With increasing the defect depth, these solitons are stable within a moderate power region in the first gap while unstable in the entire semi-infinite gap.

Removal of manganese ions from synthetic groundwater by oxidation using KMnO(4) and the characterization of produced MnO(2) particles

The aim of this study is to investigate the conditions for the removal of manganese ions from synthetic groundwater by oxidation using KMnO(4) to keep the concentration below the allowed level (0.05 mg/L). The process includes low-level aeration and addition of KMnO(4) in a Jar test system with Mn(2 + ) concentration of 0.50 mg/L, similar to that of natural groundwater in Taiwan. Different parameters such us aeration-pH, oxidant dose, and stirring speed were studied. Aeration alone was not sufficient to remove Mn(2 + ) ions completely even when the pH was increased. When a stoichiometric amount of KMnO(4) (0.96 mg/L) was used, a complete Mn(2 + ) removal was achieved within 15 min at an optimum pH of 8.0. As the amount of KMnO(4) was doubled, lower removal efficiency was obtained because the oxidant also generated manganese ions. The removal of Mn(2 + ) ions could be completed at pH 9.0 using an oxidant dose of 0.48 mg/L because Mn(2 + ) could be sorbed onto the MnO(2) particles. Finally, The MnO(2) particles were characterized using scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX).

Episodic pain syndrome restricted cheiro-oral region associated with pontine lesion

Other than from the thalamus and sensory cortex, episodic pain is an extremely rare neurological manifestation in the central compartment. This study reports a middle-aged man who experienced an acute onset of episodic oscillatory burning pain restricted to the cheiro-oral region, who was found to have a singular infarct at the left tegmental pons. A close relationship between his pain attack and an elevation of arterial blood pressure was clearly observed. Blood adenohypophyseal hormones and electroencephalogram did not reveal an abnormality in the ictus. Neuroimaging and clinical studies did not support involvement of the thalamus, periaqueductal gray matter, hypothalamus or regional structure. Therefore, episodic pain may be an isolated manifestation with a pontine lesion. A relapsing expansion of focal cerebral oedema with fluid retention may have corresponded to the oscillation of his sensory deficit. This accumulating, devastating calamity by a repetitive and paroxysmal offense after a blood-brain barrier breakdown should be cautiously reviewed.

Occurrence and Molecular Characterization of Three Pineapple Mealybug Wilt-Associated Viruses in Pineapple in Taiwan

Pineapple (Ananas comosus) is one of the major fruit crops in Taiwan, accounting for 275 million U.S. dollars in 2006, following betel nut and citrus production in crop value. Tainung No. 17 is the most important cultivar, accounting for more than 70% of pineapples planted. Mealybug wilt of pineapple (MWP) is one of the most destructive diseases of pineapple. Pineapple mealybug wilt-associated virus-1 (PMWaV-1), PMWaV-2, and PMWaV-3 were identified as three distinct species in Ampelovirus from diseased Hawaiian pineapple (1,2). In November of 2007, pineapples (cv. Tainung No. 17) planted in Pingtung County of southern Taiwan showed symptoms similar to MWP. Mealybugs (Dysmicoccus brevipes) were also found. Three primer pairs, 225/226, 223/224, and 263/264 described previously specific for the HSP70h genes of PMWaV-1 (1), -2, and -3 (2), respectively, were used to detect the presence of these three viruses by reverse transcription (RT)-PCR. Expected DNA fragments of 590, 610, and 499 nt were obtained from the total RNA isolated from the leaves of diseased pineapples with primer pairs 225/226, 223/224, and 263/264, respectively. The RT-PCR amplified fragments were cloned, sequenced, and analyzed. The 590-nt fragment (Accession No. EU769113) shared 91.6 to 99.5% nucleotide and 96.8 to 99.5% amino acid identity to those of five isolates of PMWaV-1 available in the GenBank; one each from Hawaii (Accession No. AF414119) and Thailand (Accession No. EF620774) and three from Australia (Accession Nos. EF488752, EF467923, and EF467925). The 610-nt fragment (Accession No. EU769115) showed 98.7 and 99.7% nucleotide and 98% and 100% amino acid identity to those of PMWaV-2 from Hawaii (Accession No. AF283103) and Thailand (Accession No. EU016675), respectively. The 499-nt fragment (Accession No. FJ209047) shared 86.8 to 99.0% nucleotide and 94.0 to 100.0% amino acid identity to those of five PMWaV-3 isolates available in the GenBank; one from Hawaii (Accession No. DQ399259) and four from Australia (Accession Nos. EF467918, EF467919, EF488754, and EF488755). Using primer pairs FJ08-1 (5'-ATGGCTGATTCGAGC)/FJ08-2 (5'-TTATTTGCGTCCACC), FJ08-7 (5'-AGTGAGATTGATCGT)/FJ08-8 (5'-TGCAGGTATCCGCTG), and FJ08-35 (5'-AACGACCGAACTCGC)/FJ08-36 (5'-ATACTACAGATATTG) specific to the coat protein (CP) genes of PMWaV-1, -2, and -3, respectively, expected DNA fragments of 774, 909, and 789 nt were amplified by RT-PCR. The 774-nt CP gene of PMWaV-1 (Accession No. EU769114) shared 99% nucleotide and 98.4% amino acid identity to those of Hawaiian isolate (Accession No. AF414119). The 909-nt CP gene of PMWaV-2 (Accession No. EU769116) shared 99.0 and 99.1% nucleotide identity with isolates from Hawaii (Accession No. AF283103) and Cuba (Accession No. DQ225114), respectively, and 99.3% amino acid identity with both. The 789-nt CP gene of PMWaV-3 (Accession No. FJ209048) shared 99.1% nucleotide and 98.1% amino acid identity to those of the Hawaiian isolate (Accession No. DQ399259). One to two viruses among PMWaV-1, -2, and -3 were detected in all 40 samples collected from diseased pineapples. To our knowledge, this is the first report to identify three PMWaVs in the most important and widely planted pineapple cultivar in Taiwan, Tainung No. 17, by molecular characterization of the HSP70h and CP genes. References: (1) D. M. Sether et al. Plant Dis. 85:856, 2001. (2) D. M. Sether et al. Plant Dis. 89:450, 2005.

Serotonin transporter gene promoter polymorphism is associated with body mass index and obesity in non-elderly stroke patients

BACKGROUND

The serotonergic system is involved in the complex behavioral and physiological process in maintaining energy balance. Genetic factors regulating serotonergic function may have links with the development of obesity.

AIM

To investigate whether the 5-HTTLPR polymorphism of the serotonin transporter gene is associated with body mass index (BMI) and obesity in stroke patients.

SUBJECTS AND METHODS

The study included 376 patients (65.3+/-11.3 yr; male, 61.7%) with stroke. Associations between the 5-HTTLPR and BMI and obesity (BMI > or = 25 kg/m2) were examined in all subjects. In order to test age-dependent effects of the genetic variant, the association was also examined in the non-elderly subgroup (<65 yr) and the elderly subgroup (> or =65 yr) respectively.

RESULTS

For non-elderly subjects, the SS genotype was independently associated with increased BMI level (beta=1.84, p=0.037) and obesity (odds ratio 4.17, 95% CI 1.25-14.0, p=0.021) when the LL genotype was used as the reference. The association was not found for all patients or in the elderly subgroup. The LS genotype was not different from the LL genotype in BMI level or risk of obesity, either for all subjects or with regard to the non-elderly and elderly subgroups.

CONCLUSIONS

The SS genotype of 5-HTTLPR is an independent determinant of increased BMI level and obesity in non-elderly stroke patients but not in elderly patients. An age-dependent modification for the effect of the 5-HTTLPR on development of obesity is considered.

Heavy metal removal from wastewater using zero-valent iron nanoparticles

Because of having a high reduction potential, the zero-valent iron (ZVI) is often applied for the remediation of wastewater or groundwater with heavy metals. The purpose of this study was aimed to investigate the reaction behavior of heavy metals with ZVI nanoparticles in the wastewater. The affecting factors, such as initial pH, dosage of nanoscale ZVI and initial concentration of heavy metal, on the removal efficiency of heavy metals by ZVI in the wastewater were examined by the batch experiments in this study. It was found that the removal of heavy metals was affected by initial pH. The rate and efficiency of metal removal increased with decreasing initial pH. Greater than 90% of the heavy metals were removed when the initial pH was controlled at 2. In addition, the rate and efficiency of metal removal increased as the dosage of nanoscale ZVI increased. The removal efficiency of heavy metal was higher than 80% when 2.0 g/L of ZVI was added in the wastewater. On the other hand, the slow rate and low efficiency of metal removal from the wastewater treated by nanoscale ZVI was found in the wastewater with high concentration of heavy metal.

Defect superlattice solitons

We reveal theoretically that defect superlattice solitons (DSSs) exist at the defect site in one-dimensional optical superlattices with focusing saturable nonlinearity. Solitons with some unique properties exist in superlattices with defects. For a positive defect, solitons exist at the semi-infinite gap, and solitons are stable at low power but unstable at high power. For a negative defect, most solitons exist in the first finite gap and can propagate stably. In particular, it is found that the solitons can be divided into two equal parts upon propagation in a certain regime of parameters.

Normal neurulation in mammals

During mammalian neurulation regional differences are evident between the cranial region, in which neurulation is most complex, the trunk as far as the caudal neuropore and the secondary neurulation region of the caudal trunk plus tail. Differences among these three regions are characterized by specific patterns of morphogenesis and by specific patterns of gene expression. During cranial neurulation distinct regions develop in the brain and the presomitic hindbrain forms seven rhombomeric divisions. The first clear morphological boundary is the preotic sulcus (later transformed into the gyrus between rhombomeres 2 and 3), which may limit cell movement as neuroepithelial cells rostral to it flow towards and into the rapidly expanding forebrain region. The formation of rhombomeres as morphological entities and the development of a normal rhombomere-specific pattern of homeobox and other gene expression domains depend on relatively low levels of retinoic acid. Retinoic acid receptors, which are retinoic acid-activated transcription factors, and retinoid binding proteins, which control the availability of retinoic acid to the receptors, show regional patterns of expression in the cranial, trunk and caudal regions of the neuroepithelium during neurulation. These patterns suggest a possible mechanism for region-specific gene expression during neurulation.

Surface superlattice gap solitons

We demonstrate that specific surface superlattice gap solitons can be supported at an interface between a one-dimensional photonic superlattice and a uniform medium with saturable nonlinearity. The solitons are stable in the semi-infinite gap but do not exist in the first gap. With the decrease of the power, the solitons jump from the surface site to the next one, and they may continue the motion into the lattices, which offers potential applications for the routing of optical signals.

Approximate entropy analysis of electroencephalogram in vasovagal syncope on tilt table test

Thirty vasovagal attacks on sublingual nitroglycerin stressed tilting test were selected. By the method of shifting window along the continuous EEG signals the linear (spectral power and coherence) and nonlinear (approximate entropy) EEG features of the whole course in the tilt table test were demonstrated. Of all the EEG parameters approximate entropy is a more sensitive index in clarifying stages of various degree of tilting stress and in identifying the syncopal transient.

Surface defect gap solitons

We report on the existence of surface defect gap solitons. Such new type of solitons can be well supported by an interface between the defect of optical lattice and the uniform media with focusing saturable nonlinearity. The surface defect of optical lattice can profoundly affect the properties of solitons. It is shown that for the positive defect, stable solitons exist at the first bandgap and their powers decrease with defect depth; while for negative defect, stable solitons exist at the second bandgap and their powers increase with defect depth. Such solitons with moderate power between lower and higher ones cannot stably existent at the first bandgap.

Sudden cardiac death associates with a large right atrium thrombus in a late survivor of heart transplantation

A fatal circulatory collapse developed acutely in a patient six years after orthotopic heart transplantation. Autopsy revealed a large, fresh thrombus inside the right atrium which obstructed the orifice of the vena cava completely. The grafted coronary artery and pulmonary vessels were patent. There was no rejection or acute infarct in myocardium. Mildly immature organization was seen on the thrombus-adhered wall. Four chamber enlargement and a rapid decline of right ventricular hypokinesia were detected shortly before death although he did not show active cardiopulmonary symptom. Intracardiac thrombus formation is rather uncommon in late survivor. A synergic effect of atrial turbulence and ventricular hypokinesia in the right heart, superimposed by tissue organization, was proposed for thrombus formation. An empty cardiac output was favored for his mortality. These findings provide a strong evidence to suggest anticoagulation in case of complicated or highly risk of embolization such as turbulence or hypokinesia despite of an absence of active cardiopulmonary symptom.

Hypercalcemia and status epilepticus relates to salmon calcitonin administration in breast cancer

Calcitonin is currently used to treat hypercalcemia of many clinical types. However, we encountered a woman who suffered severe hypercalcemia and status epilepticus, both of which developed 8 days after the administration of salmon calcitonin for the treatment of breast cancer. When the patient first presented her serum calcium level was 15.5mg/dl, intact parathyroid hormone level 118 pg/ml, calcitonin <2 pg/ml, magnesium 1.2mg/dl, and phosphate 1mg/dl. Her serum calcium level returned to the reference range within 48 h after correction. At follow-up no hypercalcemia had developed, although the patient had received no further treatment for her breast cancer and multiple metastases were subsequently detected. Her hypercalcemia is ascribed to exogenous calcitonin supplementation. These conflicting events may be due to functionally heterogeneous calcitonin receptors or to activation of 1 alpha-hydroxylase by exogenous calcitonin.

Type I and II collagen regulation of chondrogenic differentiation by mesenchymal progenitor cells

Chondrogenic differentiation by mesenchymal progenitor cells (MPCs) is associated with cytokines such as transforming growth factor-beta 1 (TGF-beta1) and dexamethasone. Extracellular matrix (ECM) also regulates the differentiation by MPCs. To define whether ECM plays a functional role in regulation of the chondrogenic differentiation by MPCs, an in vitro model was used. That model exposed to dexamethasone, recombinant human TGF-beta1(rhTGF-beta1) and collagens. The results showed that MPCs incorporated with dexamethasone and rhTGF-beta1 increased proliferation and expression of glycosaminoglycan (GAG) after 14 days. Type II collagen enhanced the GAG synthesis, but did not increase alkaline phosphatase (ALP) activity. When adding dexamethasone and rhTGF-beta1 MPCs increased mRNA expression of Sox9. Incorporation with type II collagen, dexamethasone and rhTGF-beta1, MPCs induced mRNA expression of aggrecan and enhanced levels of type II collagen, and Sox9 mRNA. In contrast, incorporation with type I collagen, dexamethasone and rhTGF-beta1 MPCs reduced levels of aggrecan, and Sox9 mRNA, and showed no type II collagen mRNA. Altogether, these results indicate that type I and II collagen, in addition to the cytokine effect, may play a functional role in regulating of chondrogenic differentiation by MPCs.

High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease

BACKGROUND

In average-risk patients, the new anti-platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high-risk patients.

AIM

To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study.

METHODS

During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non-aspirin-related peptic ulcer disease or a history of aspirin-related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end-point.

RESULTS

After a median follow-up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel-associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007; odds ratio, 1.3; 95% confidence interval, 1.1-1.5).

CONCLUSIONS

Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high-risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.

Prevalence and predictors of renal artery stenosis in Chinese patients with coronary artery disease

BACKGROUND

Ischaemic nephropathy is currently a major public health issue in atherosclerotic populations. Although atherosclerotic cardiovascular disease in Asia has reached epidemic proportions over the last two decades, there is little published data on the prevalence of atherosclerotic renal artery stenosis (ARAS) in Oriental subjects. Because ARAS may be clinically silent until end-stage renal failure sets in, it is important to identify patients with significant but clinically unsuspected ARAS. ARAS and coronary artery disease (CAD) often coexist.

AIMS

The purpose of the present study was to evaluate the prevalence and predictors of ARAS among Chinese patients with CAD.

METHODS

A total of 230 consecutive Chinese patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for ARAS. Patient demographics and comorbidities were analysed for any association with ARAS.

RESULTS

A total of 34 (14.8%) patients was found to have significant ARAS. Age and multivessel CAD were independent predictors of ARAS. Hypertension, renal insufficiency, extracranial cerebrovascular disease and female gender were also associated with a higher risk of ARAS but did not independently predict ARAS.

CONCLUSION

Clinically silent yet angiographically significant ARAS is common among CAD patients. The prevalence and predictors of ARAS among Chinese patients with CAD are similar to those reported for Caucasian subjects. Underlying ARAS should be suspected in CAD patients with such comorbidities as hypertension, renal insufficiency, extracranial cerebrovascular disease, and more so in the elderly and those with multivessel disease.

The validity of eye blink rate in Chinese adults for the diagnosis of Parkinson's disease

We evaluated the eye blink rate (EBR) in healthy Chinese adults and Parkinson's disease (PD) patients. In healthy subjects, the EBR declined with age, was lower in women than men younger than 50 years of age, and did not differ from male PD patients older than 60 years or female PD patients older than 50 years. Accordingly, EBR is not a good indicator for bradykinesia in Chinese individual older than 50 years that is prevalent for PD onset also.

Symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain

AIM

To determine whether symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain.

METHODS

Patients who complained of chest pain, but had normal coronary angiography, were asked to undergo upper endoscopy. Those without gastric and oesophageal lesions were recruited for 24-h ambulatory oesophageal pH monitoring, and were randomly given lansoprazole 30 mg or placebo, both daily for 4 weeks. Chest pain symptoms were recorded before and 1 month after treatment on a locally validated questionnaire. The symptom score was calculated by multiplying the severity and frequency of the symptom, and symptom improvement was defined as > 50% reduction in symptom score.

RESULTS

Overall, 68 patients, 36 on lansoprazole and 32 on placebo, completed the trial. The symptom score was reduced significantly in both groups (P < 0.001). In the lansoprazole group, more patients with than without abnormal reflux showed symptom improvement (92% vs. 33%; odds ratio = 22; 95% confidence interval, 2.3-201.8; chi2 = 10.9; P = 0.001), giving a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 92%, 67%, 58%, 94% and 75%, respectively. In the placebo group, the rates of symptom improvement were similar between those with and without abnormal reflux (33% vs. 35%, P = N.S.).

CONCLUSIONS

Treatment with lansoprazole is a useful test in diagnosing endoscopy-negative gastro-oesophageal reflux disease in Chinese patients with non-cardiac chest pain.

Hemodynamic effects of the different vascular accesses used for double-filtration plasmapheresis

Systematic investigations of hemodynamic status during double filtration plasmapheresis (DFP) are rare in the literature. To investigate the hemodynamic effects of the vascular access chosen for DFP, variations in blood pressure (BP) and pulse rate (PR) induced acutely by DFP were prospectively analyzed in 46 myasthenia gravis (MG) patients a standard DFP protocol with isovolumetric saline fluid replacement. BP and PR were monitored at 30-min intervals (baseline, M30, M60, M90, and M120) during the procedures. The patients were randomized into central vein (CV) and peripheral vein (PV) groups based on the vascular access used. Systolic BP (SBP) dropped significantly at M60 (P < 0.05), M90 (P < 0.001), and M120 (P < 0.001) when compared to the baseline level. Symptomatic hypotension was not observed in any of the 46 sessions. SBP values during DFP in the CV group were significantly lower than the PV group's at M60 (93.1 vs. 101.0%, P < 0.05) and marginally lower at M90 (91.2 vs. 97.2%, P = 0.06). There was no significant difference in diastolic BP changes between the two groups. In the CV and PV groups, PR changes during plasmapheresis also differed at M90 (103.4 vs. 94.5%, P < 0.001) and M120 (101.3 vs. 95.0%, P < 0.05). The significantly lower SBP during DFP in the CV group at M60 may be due to the high central vein flow rate and resultant delay in volume replacement. In conclusion, the vascular access selected for DFP plays a role in the pathogenesis of plasmapheresis-related hypotension. Controlling flow rates may help to prevent hypotension.

A perturbation of antithrombin-III and protein C coupling associates with an increase of anti-beta2-glycoprotein I antibody in non-antiphospholipid antibody syndrome cerebral ischemia

Anti-beta -glycoprotein I antibody (abetaGPI) has been recognized in raising the risk of cerebral ischemia in patients with antiphospholipid antibody syndrome (APS), especially by protein C (PC) axis perturbation. Although a high potential is also seen in non-APS patients, the mechanism is substantially unknown. In the present study, we examined the effect of abetaGPI on PC and antithrombin-III (AT-III) activity in non-APS patients with non-cardiac cerebral ischemia (NCCI). A total of 111 NCCI patients and 30 healthy controls were enrolled. They were free of APS manifestation, and their anticardiolipin antibody and lupus anticoagulant tests were within normal range. There were 14.4% patients found to have an abnormal increase of blood abetaGPI. The PC, AT-III, albumin, aminotransferases, creatinine, prothrombin time and activated partial thromboplastin time did not differ between our patients and controls, or patients with or without increased abetaGPI. However, a marked decrease of the PC/AT-III ratio was found in patients with increased abetaGPI. The correlation between PC and AT-III activity was highly significant in patients with an increase of abetaGPI (P = 0.001), only marginal in controls (P = 0.042), and was insignificant in patients with a normal abetaGPI (P = 0.277). The abetaGPI did not correlate to PC or AT-III activity in either patients or controls. These findings suggest that high PC/AT-III coupling may relate to NCCI in non-APS patients associated with an increase of abetaGPI. This coupling effect seems not to be caused by abetaGPI directly.

Upper gastrointestinal evaluation of Chinese patients with non-cardiac chest pain

AIMS

To test the usefulness of upper gastrointestinal investigations and quality of life assessment in Chinese patients with non-cardiac chest pain.

METHODS

Seventy-eight consecutive patients with non-cardiac chest pain underwent upper endoscopy. Eight patients had upper gastrointestinal pathology (10%). The remaining 70 patients received acid perfusion test, oesophageal manometry and 24-h ambulatory oesophageal pH (n=65)/manometry (n=61), and the results were compared with those of healthy controls (n=20). Symptoms and quality of life (SF-36) were assessed by standard validated questionnaire.

RESULTS

Significant acid reflux symptoms were present in five (5/70, 7%) patients. Abnormal 24-h oesophageal pH, indicating gastro-oesophageal reflux, was found in 19 (19/65, 29%) patients. The percentage of simultaneous contractions was higher and the percentage peristalsis was lower in patients with non-cardiac chest pain when compared with normal subjects by 24-h ambulatory manometry. Patients with non-cardiac chest pain had a lower SF-36 score when compared to controls.

CONCLUSIONS

Typical acid reflux symptoms are uncommon in Chinese patients with non-cardiac chest pain, but abnormal 24-h pH results, indicating gastro-oesophageal reflux, were found in 29% of patients. Ineffective contractions were more frequently found in patients with non-cardiac chest pain by 24-h ambulatory manometry, which may have a bearing on the impaired quality of life in such patients. Upper gastrointestinal investigations are useful for the evaluation of Chinese patients with non-cardiac chest pain.

Arachidonic acid-induced H+ and Ca2+ increases in both the cytoplasm and nucleoplasm of rat cerebellar granule cells

1. Arachidonic acid (AA) exerts multiple physiological and pathophysiological effects in the brain. By continuously measuring the intracellular pH (pH(i)) and Ca2+ levels ([Ca2+]i) in primary cultured rat cerebellar granule cells, we have found, for the first time, that 20 min treatment with 10 microM AA resulted in marked increases in Ca2+ and H+ levels in both the cytosol and nucleus. 2. A much higher concentration (40 mM) of another weak acid, propionic acid, was needed to induce a similar change in pH(i). The [Ca2+]i increase was probably caused by AA-induced activation of Ni2+-sensitive cationic channels, but did not involve NMDA channels or the Na+-Ca2+ exchanger. 3. AA-induced acidosis occurs by a different mechanism involving predominantly the passive diffusion of the un-ionized form of AA, rather than a protein carrier, as proposed by Kamp & Hamilton for fatty acids (FAs) in artificial phospholipid bilayers (the 'flip-flop' model). The following results, which are similar to those observed in lipid bilayers, support this conclusion: (1) FAs containing a -COOH group (AA, linoleic acid, alpha-linolenic acid, and docosahexaenoic acid) induced intracellular acidosis, whereas a FA with a -COOCH3 group (AA methyl ester) had little effect on pH(i), (2) a FA amine, tetradecylamine, induced intracellular alkalosis, and (3) the AA-/FA-induced pH(i) changes were reversed by bovine serum albumin. 4. Further evidence in support of a passive diffusion model, rather than a membrane protein carrier, is that: (1) there was a linear relationship between the initial rate of acid flux and the concentration of AA (2-100 microM), (2) acidosis was not inhibited by 4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid, a potent inhibitor of the plasma membrane FA carrier protein, and (3) the involvement of most known H+-related membrane carriers and H+ conductance has been ruled out. 5. Since AA can be released under both physiological and pathophysiological conditions, the possible significance of the AA-evoked increases in H+ and Ca2+ in both the cytoplasm and nucleoplasm is discussed.

Comparison of transcranial color-coded sonography and magnetic resonance angiography in acute ischemic stroke

BACKGROUND AND PURPOSE

This study was designed to assess the accuracy of transcranial color-coded sonography (TCCS) as compared to magnetic resonance angiography (MRA) for detecting intracranial arterial stenosis in patients with acute cerebral ischemia.

METHODS

The authors prospectively identified 120 consecutive patients admitted with acute ischemic stroke and performed both TCCS and MRA with a mean interval of 1 day. TCCS data (sampling depth, peak systolic and end diastolic angle-corrected velocity, mean angle-corrected velocity, and pulsatility index) for middle cerebral arteries (MCAs) were compared to MRA data and classified into 4 grades: normal (grade 1): normal caliber and signal; mild stenosis (grade 2): irregular lumen with reduced signal; severe stenosis (grade 3): absent signal in the stenotic segment (flow gap) and reconstituted distal signal; and possible occlusion (grade 4): absent signal. The cutoffs were chosen to maximize diagnostic accuracy.

RESULTS

Interobserver agreement for MRA grading resulted in a weighted-kappa value of 0.776. The rate of poor temporal window was 37% (89/240). Doppler signals were obtained in 135 vessels, and the angle-corrected velocities (peak systolic, end diastolic, mean) were significantly different (P = .001, P = .006, and P < .001) among the MRA grades: grade 1 (100, 47, 68 cm/s), grade 2 (171, 72, 110 cm/s), grade 3 (226, 79, 134 cm/s), grade 4 (61, 26, 39 cm/s). Additionally, an angle-corrected MCA peak systolic velocity > or = 120 cm/s correlates with intracranial stenosis on MRA (grade 2 or worse) with high specificity (90.5%; 95% confidence interval = 78.5%-96.8%) and positive predictive value (93.9%) but relatively low sensitivity (66.7%; 95% confidence interval = 61.2%-69.5%) and negative predictive value (55.1%).

CONCLUSION

Elevated MCA velocities on TCCS correlate with intracranial stenosis detected on MRA. An angle-corrected peak systolic velocity > or = 120 cm/s is highly specific for detecting intracranial stenosis as defined by significant MRA abnormality.

Double filtration plasmapheresis in the treatment of myasthenic crisis--analysis of prognostic factors and efficacy

OBJECTIVES

To examine the prognostic factors and outcome of myasthenia gravis (MG) patients in crisis with double filtration plasmapheresis (DFP) treatment.

MATERIAL AND METHODS

A total of 15 patients experienced 20 episodes of crisis during the study period. Plasmapheresis was carried out using a double filtration

METHOD

Demographic information, clinical features of crisis, and associated complications were analyzed.

RESULTS

The median duration of crisis was 9 days. Chest infection was the most common precipitant of crisis. Twelve out of the 20 episodes (60%) responded well to DFP and mechanical ventilation was discontinued after the third session of DFP in 8 of them. Three significant predictors for prolonged crisis were shorter intervals between the onset of MG and the first crisis (P=0.04), higher serum bicarbonate levels at baseline (P=0.03) and the thymic pathology of thymoma (P=0.03).

CONCLUSION

DFP can ameliorate the profound weakness in crisis and seems to be a rational therapy for patients with myasthenic crisis.

Minilaparotomy for internal drainage of a symptomatic lymphocele after renal transplantation

Development of a lymphocele after renal transplantation is a well-described complication that occurs with relative frequency. Management options include simple aspiration with sclerotherapy and operative marsupialization of the lymphoceles into the peritoneal cavity. Laparoscopic internal drainage has been favored in recent reports. Still, the laparoscopic procedure is associated with a number of potential problems, including difficulty in localizing lymphoceles if laparoscopic ultrasound is unavailable. In addition, lobulated lymphoceles are more difficult to completely dissect with laparoscopy, and lymphoceles always occur on the anterior and medial aspects of the graft which are easily approached directly from the anterior skin. We tried to resolve these complications by modifying traditional laparotomy and proved that laparoscopy is a progressive, popular procedure, and that fenestration with finger dissection of the lobulated lymphoceles through minilaparotomy is still a reliable, effective procedure.

Plasmapheresis in the treatment of ataxic sensory neuropathy associated with Sjögren's syndrome

Sjögren's syndrome (SS) is an important but poorly recognized cause of peripheral neuropathy. Several forms of peripheral nerve dysfunction occur, including trigeminal sensory neuropathy, mononeuropathy multiplex, distal sensorimotor polyneuropathy and pure sensory neuronopathy. The pathological findings vary and the definite treatment is not known. Here we present 4 cases of acute ataxic sensory polyneuropathy with SS, and the experience of treatment with plasmapheresis (PP). The 4 patients were all females; ages ranged from 30 to 58 years. All had prominent loss of kinesthetic and proprioceptive sensation. The course ranged from acute to subacute onset. Patients were treated with 5-9 sessions of PP. Two patients with initiation of treatment within 2 weeks of onset showed dramatic and sustained responses after PP, while the other 2 had no detectable effects. Our experience showed that PP should be considered in patients who present with sensory neuropathy associated with SS, and the treatment should be given as early as possible.

Bethlem myopathy in a Taiwanese family

We report three cases of Bethlem myopathy from three consecutive generations of a Taiwanese family, including one woman aged 70, one man aged 40, and a boy aged 8. The clinical features of the patients included autosomal dominant inheritance, childhood or adolescent onset, mainly proximal and extensor involvement, early diffuse joint contractures, and absence of cardiac involvement. These features fulfilled the diagnostic criteria for Bethlem myopathy. Though the clinical course of the disease was once thought to be benign, our female patient became wheelchair-bound at the age of 53. This suggests that the disease process in Bethlem myopathy is slow but ongoing.

Heroin-induced rhabdomyolysis as a cause of reflex sympathetic dystrophy

Reflex sympathetic dystrophy is an excessive or abnormal response of the sympathetic nervous system in an extremity to an injury or other condition. The authors describe a 37-year-old man who experienced constant pain and vasomotor instability in both feet after nontraumatic rhabdomyolysis secondary to smoking heroin. Three-phase bone scintigraphy was performed and revealed significantly increased blood-flow, blood-pool, and delayed-phase radioactivity. The follow-up three-phase bone scinitigram showed less radiotracer uptake that was consistent with a good response to calcitonin therapy. Heroin-induced rhabdomyolysis should be added to the list of precipitating conditions that can induce this syndrome.

An unusual increase of blood anti-beta 2-glycoprotein-I antibody but not antiphospholipid antibody in cerebral ischemia--a case report

An abnormal increase in anti-beta2-glycoprotein I antibodies (abeta2GPI) is capable of producing thrombosis and the vasculopathy-simulating antiphospholipid antibody (aPL). However, it is rarely described in cerebral ischemia without an association with aPL. The authors report a middle-aged man who experienced recurrent cerebral ischemia and diffuse cerebral stenosis without the apparent traditional cardiovascular risk factor. He was free of antiphospholipid/cofactor syndrome (APCS) and systemic lupus erythematosus (SLE). An increase of blood abeta2GPI was detected in serial measurements. The aPL, Venereal Disease Research Laboratory (VDRL) test, Coombs' test, and antinuclear factor were negative. Activated partial thromboplastin time was normal. This patient is a reminder to consider abeta2GPI in an unexplained recurrent cerebral thrombosis and cerebral artery stenosis even when the typical clinical manifestation or laboratory data of APCS is absent.

Differential in vitro suppressive effects of steroids on leukocyte phagocytosis in two teleosts, tilapia and common carp

The objectives of this study were to investigate the potential roles of cortisol and gonadal steroids in the phagocytic activity of peripheral blood leukocytes in two teleosts, tilapia (Oreochromis niloticus x O. aureus) and common carp (Cyprinus carpio). An in vitro microtiter plate assay, measuring incorporation of FITC-latex beads into peripheral blood leukocytes, was developed for the first time in teleosts. Peripheral blood leukocytes were cultured in AL medium with tested compounds in a microfluor black plate at 25 degrees C. FITC-latex beads were further incubated for phagocytosis and engulfed fluorescent intensity in phagocytes was detected fluorometrically. Cortisol suppressed leukocyte phagocytosis in a dose (10(-14) to 10(-4) M)- and time (0.5 to 8 h)-dependent manner in tilapia. The glucocorticoid agonist dexamethasone had a suppressive effect similar to that of cortisol, while cortisone and the mineralocorticoid aldosterone had only a weak effect in tilapia. High doses of estradiol and ethynylestradiol, but not of estrone, suppressed phagocytosis in tilapia. No suppressive effect on phagocytosis was observed with various concentrations of progesterone, testosterone, and 11-ketotestosterone. Triiodothyronine was also inactive on phagocytosis. A combination of estradiol and cortisol potentiatingly suppressed phagocytosis. Actinomycin D and cycloheximide blocked the suppressive effects of cortisol and estradiol. Cortisol had weaker suppressive effects on the phagocytosis of leukocytes in common carp than tilapia. Other steroids had no suppressive action on phagocytosis in common carp. It is concluded that the suppressive effects of cortisol and estradiol on phagocytosis in tilapia are mediated by specific glucocorticoid receptors and estrogen receptors, respectively. Cortisol would play a main and important role on the down-regulation of phagocytic activity. Sexual steroids, such as estradiol, also could interact with cortisol to further suppress immunity in tilapia. Differential responsiveness of the immune system to suppressive effects of steroids, among teleosts species, has been demonstrated.

Two-Dimensional Electric-Field Vector Measurement by a LiTaO(3) electro-optic probe tip

An electro-optic probe tip that is made from LiTaO crystal to make tangentially two-dimensional electric-field (E-field) vector measurements is presented. We combine a new electro-optic modulation technique and a conventional one to resolve the two E-field components. The new modulation effect on the optical probing beam is caused by rotation of the principal axis the electro-optic crystal, which is proportional to the E-field. Inasmuch as there is no free charge involved in the axis rotation, rotation modulation of the axis can be as fast as conventional modulation. The principles are carefully derived, and an experimental system constructed, to measure two-dimensional E-field vectors on a test pattern. The results are in good agreement with those obtained with commercial software for electromagnetic simulation. The sensitivities of two tangential E-field components are 76 (mV/cm)/ radicalHz and 0.8 (V/cm)/ radicalHz, respectively. The root-mean-square error of an E-field directional measurement is 1.5 degrees .

Traceless solid-phase synthesis of heterosteroid framework

[reaction: see text]A traceless solid-phase synthesis of cyclopenta[c]-4H-chromen-8-ol, benzo[d]cyclopenta[e]-3H-3-azin-8-ol, and other 11-heterosteroids via the fulvene hetero [6 + 3] cycloaddition is described.

The six year experience of plasmapheresis in patients with myasthenia gravis

Plasmapheresis (PP) effectively removes autoantibodies in various autoimmune diseases. The use of PP in the treatment of myasthenia gravis (MG) has been widely accepted since the 1970s. The treatment protocol, however, has not been standardized. For the last 6 years, we collected a total of 94 MG patients, 38 males and 56 females aged 14-80 years, who received 175 courses of PP treatment for a total of 823 sessions. The methods we used were double filtration plasmapheresis (DF), immunoadsorption plasmapheresis (IA), and plasma exchange (PE). There were 167 courses of DF, 6 courses of IA, and 2 courses of PE. Each course of treatment consists of 4 to 5 sessions of apheresis. The processed volume of plasma is 1 calculated plasma volume. All patients tolerated PP well although 2.3% of them experienced hypotension. Our experiences are summarized as follows. Both DF and IA effectively ameliorate symptoms and signs of MG. IA removes acetylcholine receptor antibody more effectively than DF does, but clinical effects between these 2 methods are similar. A daily schedule seems more effective than an alternate daily schedule. The optimal number of PP sessions for each course is 4. The factors correlating with better clinical response are high MG score, nonthymoma patients, younger age at onset, and higher removal rate for immunoglobulin G.

Transtentorial cerebellar c-jun expression after focal cerebral cortical injury in mice

Delayed and remote effect of focal cerebral cortical lesion on cerebellum remains unclear. The c-Jun, an inducible transcription factor of cellular immediate early gene, is the predominant transcription factor and consistent marker for neurons that respond to stress or injury. We use a mouse cryogenic injury model to study the spatial and temporal changes of c-jun in the cerebellum after focal neocortical lesion. A transient and moderate expression of c-jun mRNA was found in the cerebellum with central dominance since 3 day postinjury and gradually subsided within 2 weeks. A distinct increment of c-Jun protein expression in Purkinje cells of the bilateral cerebellar hemispheres with focal connotation in the vermis was detected since 1 week postinjury. These findings suggest that the delayed and remote c-jun expression of the cerebellum, functionally connected with the cerebral cortex, indicate transneuronal gene activation.