In silico analysis of gene content in tomato genomic regions mapped to the Ty-2 resistance gene

Tomato yellow leaf curl virus is one of the main diseases affecting tomato production worldwide. Previous studies have shown that Ty-2 is an important resistance gene located between molecular markers C2_At2g28250 (82.3 cM) and T0302 (89.0 cM), and exhibits strong resistance to tomato yellow leaf curl virus in Asia. In this study, Ty-2 candidate genes were subjected to bioinformatic analysis for the sequenced tomato genome. We identified 69 genes between molecular markers C2_At2g28250 and T0302, 22 of which were disease-related resistant genes, including nucleotide binding site-leucine-rich repeat disease resistance genes, protease genes (protein kinase, kinase receptor, and protein isomerase), cytochromes, and transcription factors. Expressed sequence tag analysis revealed that 77.3% (17/22) of candidate disease-resistance genes were expressed, involving 143 expressed sequence tags. Based on full-length cDNA sequence analysis, 7 candidate genes were found, 4 of which were involved in tomato responses to pathogens. Microarray expression analysis also showed that most candidate genes were involved in the tomato responses to multiple pathogens, including fungi, viruses, and bacteria. RNA-seq expression analysis revealed that all candidate genes participated in tomato growth and development.

Three branches of phospholipase C signaling pathway promote hepatocyte growth in rat liver regeneration

In general, the phospholipase C (PLC) signaling pathway is involved in many physiological activities, including cell growth. However, little is known regarding how the PLC signaling pathway participates in regulating hepatocyte (HC) growth during liver regeneration (LR). To further explore the influence of the PLC signaling pathway on HCs at the cellular level, HCs of high purity and vitality were isolated using Percoll density-gradient centrifugation after partial hepatectomy. The genes of the PLC signaling pathway and target genes of transcription factors in the pathway were obtained by searching the pathways and transcription factor databases, and changes in gene expression of isolated HCs were examined using the Rat Genome 230 2.0 Microarray. The results suggested that various genes involved in the pathway (including 151 known genes and 39 homologous genes) and cell growth (including 262 known genes and 37 homologous genes) were associated with LR. Subsequently, the synergetic effect of these genes in LR was analyzed using a mathematical model (Et) according to their expression profiles. The results showed that the Et values of G protein-coupled receptor/PLC, integrin/PLC, and growth factor receptor/PLC branches of the PLC pathway were all significantly strengthened during the progression and termination phases of LR. The synergetic effect of target genes, in parallel with target gene-related cell growth, was also enhanced during whole rat LR, suggesting the potential positive effect of PLC on HC growth. The present data indicate that the PLC signaling pathway may promote HC growth through 3 mechanisms during rat LR after partial hepatectomy.

Reliability and relative validity of three physical activity questionnaires in Taizhou population of China: the Taizhou Longitudinal Study

OBJECTIVE

To examine the test-retest reliabilities and relative validities of the Chinese version of short International Physical Activity Questionnaire (IPAQ-S-C), the Global Physical Activity Questionnaire (GPAQ-C), and the Total Energy Expenditure Questionnaire (TEEQ-C) in a population-based prospective study, the Taizhou Longitudinal Study (TZLS).

STUDY DESIGN

A longitudinal comparative study.

METHODS

A total of 205 participants (male: 38.54%) aged 30-70 years completed three questionnaires twice (day one and day nine) and physical activity log (PA-log) over seven consecutive days. The test-retest reliabilities were evaluated using intra-class correlation coefficients (ICCs) and the relative validities were estimated by comparing the data from physical activity questionnaires (PAQs) and PA-log.

RESULTS

Good reliabilities were observed between the repeated PAQs. The ICCs ranged from 0.51 to 0.80 for IPAQ-C, 0.67 to 0.85 for GPAQ-C, and 0.74 to 0.94 for TEEQ-C, respectively. Energy expenditure of most PA domains estimated by the three PAQs correlated moderately with the results recorded by PA-log except the walking domain of IPAQ-S-C. The partial correlation coefficients between the PAQs and PA-log ranged from 0.44 to 0.58 for IPAQ-S-C, 0.26 to 0.52 for GPAQ-C, and 0.41 to 0.72 for TEEQ-C, respectively. Bland-Altman plots showed acceptable agreement between the three PAQs and PA-log.

CONCLUSION

The three PAQs, especially TEEQ-C, were relatively reliable and valid for assessment of physical activity and could be used in TZLS.

Assessment of the genetic diversity of tomato yellow leaf curl virus

The objective of the present study was to analyze the genetic diversity of tomato yellow leaf curl virus (TYLCV). Representative TYLCV sequences were searched in the National Center for Biotechnology Information database. Comprehensive analysis of TYLCV was performed using bioinformatics by examining gene structure, sequence alignments, phylogeny, GC content, and homology. Forty-eight representative TYLCV sequences were selected from 48 regions in 29 countries. The results showed that all TYLCV sequences were 2752-2794 nucleotides in length, which encoded 6 open reading frames (AV1, AV2, AC1, AC2, AC3, and AC4). GC content ranged from 0.41-0.42. Sequence alignment showed a number of insertions and deletions within these TYLCV sequences. Phylogenetic tree results revealed that the sequences were divided into 10 classes; homology of the sequences ranged from 72.8 to 98.6%. All 48 sequences contained the typical structure of TYLCV, including open reading frames and intergenic regions. These results provide a theoretical basis for the identification and evolution of the virus in the future.

Performance enhancement using a non-uniform vertical electric field and polymer networks for in-plane switching of multi-pretilt, vertically aligned liquid crystal devices

A simple and reproducible alignment method for fabricating vertically aligned (VA) liquid crystal (LC) cells with a multi-pretilt structure is developed. A non-uniform vertical electric field is employed in the LC/monomer mixed cells during the photocuring process, and two pretilt domains with a functional small pretilt angle (∼1.6°) in the stabilized VA LC/polymer cells are achieved. The enhanced electro-optical performance of the cell driven by an in-plane switching field is demonstrated. Compared to the pure cell, the 2 wt.% pretilt angle cell shows 36%, 64%, and 76% improvement in the optical switch, the gray-level rise time, and the gray-level fall time responses, respectively, which are obtained at a low driving voltage (≤12  V). When applied to LC devices, the proposed method not only effectively benefits the LC molecular alignment, but it also significantly boosts the electro-optical performance.

Implication of polymorphisms in DNA repair genes with an increased risk of hepatocellular carcinoma

We explored the association between 4 XRCC1 (Arg194Trp and Arg399Gln) and XPD (Asp312Asn and Lys751Gln) polymorphisms with the development and prognosis of hepatocellular carcinoma (HCC). A total of 218 cases with HCC and 277 healthy controls were included in the study. Genotyping of the XRCC1 (Arg194Trp and Arg399Gln) and XPD (Asp312Asn and Lys751Gln) polymorphisms was performed in a 384-well plate format on the Sequenom MassARRAY platform. We found that individuals with the XRCC1 399AA genotype had a higher risk of HCC compared with the GG genotype (odds ratio, OR = 1.85, 95% confidence interval, CI = 1.03-3.23). Similarly, individuals carrying the XPD 751GG genotype showed a greatly increased risk of HCC (OR = 2.97, 95%CI = 126- 7.38). Cox regression analysis showed that individuals carrying XPD 751Gln/Gln genotypes had a 0.30-fold increased risk of death from HCC. These results suggest that polymorphisms in XRCC1 and XPD may have functional significance in HCC.

Use of hyperbaric oxygen on flaps and grafts in China: analysis of studies in the past 20 years

In China, hyperbaric oxygen (HBO2) has been widely applied in the treatment of ischemia/hypoxia related diseases including decompression sickness, carbon monoxide poisoning, diabetic foot ulcer and others. Wounds after skin grafts are an indication for HBO2 therapy in the Chinese Guideline for Hyperbaric Oxygen Therapy. In this study, we retrospectively reviewed the available studies on the application of HBO2 in the management of skin flaps. The mechanisms underlying the therapeutic effects of HBO2 were summarized, and therapeutic aspects in the HBO2 therapy of skin flaps in China were also described. Finally, some important issues influencing the therapeutic efficacy and further systemic reviews are proposed. Our findings may help to improve the quality of future studies in this field and to more rationally apply HBO2 therapy in patients receiving skin grafting procedures.

The routine value of anogenital distance as an anthropometric measurement in newborns

OBJECTIVE

Anogenital distance (AGD) is a sexually dimorphic trait; AGD is an external marker of sexual differentiation at birth in animals.

STUDY DESIGN

The present study used a prospective, cross-sectional design. Data were collected from newborn infants that were delivered at hospital in Bucheon between March and September 2009. The mothers of the infants provided sociodemographic information and obstetric history. The relationships between AGD and other anthropometric measures (i.e., weight, height, and head circumference) were analyzed. Moreover adjusted AGD values were compared with obstetric characteristics, including number of deliveries, abortion history, preterm history, and duration of gestation.

RESULTS

Significant correlations were noted for all anthropometric measures in male and female newborns (p < 0.0001). The adjusted AGD values in males and females were also significantly associated with the duration of gestation (p = 0.0008 and p = 0.0148, respectively). Moreover, the adjusted AGD in female newborns, but not in males, was significantly associated with maternal abortion history (p = 0.0242).

CONCLUSION

The AGD is a valuable anthropometric marker in term infants.

Abstract B169: Hypoxia-inducible factor 1α (HIF-1α) correlates with epithelial-mesenchymal transition (EMT) and tumor growth in thyroid cancer cell lines

Hypoxia is essential for microenvironment to induce tumor metastasis. Intratumoural hypoxia, followed by stabilization and activation of the HIF-1α transcription complex, is one of the most important mechanisms that promotes metastasis and thereby, increases tumor aggressiveness. EMT (epithelial to mesenchymal transition), one of the central mechanisms that induces invasion and metastasis of tumors. The aim of this study was to investigate the possible role of HIF-1α as one of the microenvironmental influences driving metastatic progression by induction of epithelial to mesenchymal transition in thyroid cancer. In vitro studies revealed a functionally active HIF-1a pathway in several types of thyroid cells with transcriptional activation observed after hypoxia or overexpression. Knock-down of HIF-1α or overexpression of HIF-1α in thyroid cancer cells suggested that HIF-1α promotes epithelial-mesenchymal transition (EMT) and metastastic phenotypes in follicular thyroid cancer cell lines, especially. HIF-1α increases the expression of Vimentin, N-cadherin, Snail, Slug, Twist, MMP2, VEGF but not E-cadherin. Also, wound healing assay and in vitro migration assays showed that the cell migration ability was increased in a HIF1α- dependent manner. Furthermore, knock-down of HIF-1α leads to decreased tumor growth and regulates the expression of EMT marker genes in thyroid tumor xenograft mouse model. Taken together, these results suggest that the HIF-1 signaling induces EMT and metastasis through the regulation of various EMT regulators in vitro as well as in vivo study.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B169.

Citation Format: YJ Yang, HJ Na, Ws Kim, Jp Bong, Sj Baek, Jw Kim, Jh Park, Dy Shin, Hj Hong, Jh Kwon, Ej Lee, Yw Koh, Ec Choi. Hypoxia-inducible factor 1α (HIF-1α) correlates with epithelial-mesenchymal transition (EMT) and tumor growth in thyroid cancer cell lines. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B169.

Outcomes of overlapping heterogeneous drug-eluting stents versus homogeneous drug-eluting stents for diffuse lesions in small coronary arteries

OBJECTIVE

To investigate the outcomes of overlapping drug-eluting stenting (DES) in small and diffuse lesions.

BACKGROUND

Clinical outcomes of overlapping heterogeneous versus homogeneous DES of diffuse lesions (requiring ≥ 30 mm of length) in small coronary arteries (requiring ≤ 2.75 mm of diameter) are unknown.

METHODS

From January 2005 to December 2009, there were 99 patients with diffuse lesions in small coronary arteries receiving overlapping heterogeneous DES, and 558 patients receiving overlapping homogeneous DES at our institution. The clinical end-point of the study included in-hospital and 12-month major adverse cardiac events (death, nonfatal myocardial infarction, and target vessel revascularization (TVR).

RESULTS

There were no statistically significant differences between overlapping heterogeneous and homogeneous DES groups in-hospital (2.0% vs. 1.4%, respectively; P = 0.66) and 12-month (9.1% vs. 9.3%, respectively; P = 0.94) major adverse cardiac events. After adjustment, no significant differences for major adverse cardiac events were noted, but the rate of nonfatal myocardial infarction was lower in overlapping homogeneous DES group (odds ratio: 4.20, P = 0.03).

CONCLUSION

In this analysis, there were no significant differences in major adverse cardiac events between the 2 types of overlapping DES for diffuse lesions in small coronary arteries, except for higher nonfatal myocardial infarction in overlapping heterogeneous DES.

Using biochemical system to improve cinnabar dissolution

In order to evaluate the leaching of cinnabar, a chemobiological reactor system with Acidithiobacillus ferrooxidans for cinnabar dissolution was investigated. The results demonstrated cinnabar dissolution had relation to bioprocess of A. ferrooxidans and iron concentration tightly. The optimal dilution rate and iron concentration were 0.4/h and 2-3 g/L in chemobiological reactor. The process may be contributed to the indirect catalyzing of ferric iron generated with A. ferrooxidans and direct adherence oxidation function. This research shows the new microbiological technique may be a feasible and economical method in application.

Research progress of triptolide-loaded nanoparticles delivery systems

Triptolide is one of the major active components of traditional Chinese Medicine (TCM) - Tripterygium wilfordii Hook. f. (TWHf), which has been reported to be effective in the treatment of patients with a variety of inflammatory and autoimmune diseases, especially rheumatoid arthritis. However, its clinical use is restricted due to its scarce water solubility and some toxic effects. In order to find innovative ways for administering triptolide and alleviating its disadvantages, the novel types of delivery systems have been developed. This paper reviews the studies of triptolide- loaded nano drug delivery systems (NDDS) in our group during the past three years. The preparation, characterization, pharmacology and toxicity of triptolide-loaded solid lipid nanoparticles, microemulsions and polymeric nanoparticles were investigated. The results indicated that the NDDS presented more powerful activity and a lower toxicity in comparison with common drug carrier.

Electric-field control of nonvolatile magnetization in Co40Fe40B20/Pb(Mg(1/3)Nb(2/3))(0.7)Ti(0.3)O3 structure at room temperature

We report a large and nonvolatile bipolar-electric-field-controlled magnetization at room temperature in a Co(40)Fe(40)B(20)/Pb(Mg(1/3)Nb(2/3))(0.7)Ti(0.3)O(3) structure, which exhibits an electric-field-controlled looplike magnetization. Investigations on the ferroelectric domains and crystal structures with in situ electric fields reveal that the effect is related to the combined action of 109° ferroelastic domain switching and the absence of magnetocrystalline anisotropy in Co(40)Fe(40)B(20). This work provides a route to realize large and nonvolatile magnetoelectric coupling at room temperature and is significant for applications.

Photoconduction mechanism of oxygen sensitization in InN nanowires

The photoconduction (PC) mechanism in indium nitride (InN) nanowires (NWs) has been investigated via environment-, temperature-, and power-dependent measurements. The adsorbed oxygen-induced modulation of the surface state is proposed to be the leading factor in the long lifetime or high gain transport and in sensitizing photocurrent generation in the InN NWs. The electron trapping effect by adsorbed oxygen can be verified by the increased activation energy from 33 ± 4 (in vacuum) to 58 ± 2 meV (in oxygen). The observed supralinear power dependence of photocurrent also suggests the presence of acceptor states that influence the carrier recombination behavior and compensate the thermal carriers in the InN NWs. The potential influence of native oxide on the molecule-sensitive PC in this nitride nanomaterial is also inferred.

Trends in in-hospital outcome after percutaneous coronary intervention in the drug-eluting stents era

BACKGROUND

The introduction of drug-eluting stents (DES) dramatically changed the practice of percutaneous coronary intervention (PCI) in the 2000s. Little is known about trends in in-hospital outcome after PCI in the DES era.

HYPOTHESIS

The in-hospital outcomes after PCI might be continuously improved over time.

METHODS

We analyzed in-hospital outcomes of 21,667 patients who underwent PCI at Fu Wai Hospital in the past 5 years. The patients were divided into 5 groups according to the time of their intervention: group 1 (June 2004 to May 2005), group 2 (June 2005 to May 2006), group 3 (June 2006 to May 2007), group 4 (June 2007 to May 2008), and group 5 (June 2008 to May 2009).

RESULTS

Procedural success rates for the 5 groups were 93.6%, 95%, 94.4%, 94.2%, and 94.3%, respectively (P = 0.39). Significant reduction in in-hospital major adverse cardiac events (3.1%, 3.4%, 2.8%, 1.6%, and 1.0%, P < 0.001) and need for target-vessel revascularization (2.0%, 2.2%, 1.5%, 0.4%, and 0.2%, P < 0.001) was noted over time, which was associated with a significant increase in use of DES (from 56.6% to 97.0%, P < 0.001). On multivariate analysis, use of DES, dissection during procedure, left main lesion, prior myocardial infarction, and age > or = 65 years were independent predictors of major adverse cardiovascular events.

CONCLUSIONS

There were substantial reductions in in-hospital major adverse cardiac events and target-vessel revascularization over the past 5 years. This reduction was associated with the concurrent increased use of DES.

Mechanisms of L-DOPA-induced cytotoxicity in rat adrenal pheochromocytoma cells: implication of oxidative stress-related kinases and cyclic AMP

L-DOPA therapy for Parkinson's disease has a double-edge effect on nigrostriatal dopaminergic neurons: L-DOPA increases the intracellular level of dopamine, but it induces neuron cytotoxicity in a concentration-dependent manner. To investigate the molecular signaling mechanisms that underlie the concentration-dependent effects of L-DOPA on cell viability, the activities of mitogen-activated protein kinases (MAPKs) and apoptotic enzymes were measured in rat adrenal pheochromocytoma (PC12) cells in the presence of a low concentration (20 muM) and high concentrations (100-200 muM) of L-DOPA. At the low concentration, L-DOPA was not cytotoxic and its presence increased the activities of extracellular signal-regulated kinase (ERK)1/2, p38 MAPK, BadSer112, Bcl-2, and caspase-12. At the high concentrations, L-DOPA was cytotoxic and stimulated the activities of ERK1/2, p38 MAPK, c-Jun N-terminal kinase (JNK)1/2, BadSer155, caspase-12 and caspase-3. The increased levels of ERK1/2 and BadSer155 in the presence of high concentrations of L-DOPA did not protect against L-DOPA-mediated cytotoxicity. In addition, the levels of L-type Ca(2+) channel-sensitive intracellular cyclic AMP (cAMP) and Ca(2+) were elevated in the presence of L-DOPA, and the increase in the levels of intracellular cAMP may also play a role in cellular viability, since cAMP levels and cytotoxicity increased in parallel with L-DOPA concentrations and the addition of forskolin in the medium increased cytotoxicity in a concentration-dependent manner. These results suggest that, at a low and non-toxic concentration, L-DOPA may promote cell survival by increasing the activities of ERK1/2, BadSer112 and Bcl-2, while, at high concentrations, L-DOPA activates the caspase-3 cell death enzyme through the JNK1/2 and p38 MAPK signaling pathways as well as endoplasmic reticulum stress that activates caspase-12. Intracellular cAMP levels may also play a role here. The results may lead to an effective therapy for Parkinson's disease.

Single crystalline film on glass for thin film solar cells

A simple Ge-on-glass metal-oxide-semiconductor solar cell has been demonstrated by wafer bonding and smart-cut. Since single crystalline Ge is directly bonded on glass, the crystalline substrate is not necessary. The metal-oxide-semiconductor structure can be easily fabricated without n and p dopant diffusion or implantation. The reason for low efficiency is discussed, and then the optimized structures are designed by simulation. An outstanding enhancement on efficiency can be achieved with the Si/Ge/Si structure. The best performance can be achieved by optimization of the position of the Ge layer, the thickness of the Ge layer, and the number of the Ge layers. The efficiency of the thin film Si/Ge/Si solar cell with single layer of 30-nm-thick Ge outside the depletion region reaches 15.9%, as compared to the control Si sample of 11.8%. Based on the simulation and technologies, high efficiency thin film solar cells can be demonstrated in the future.

Comparative study of simple versus complex stenting of coronary artery bifurcation lesions in daily practice in Chinese patients

BACKGROUND

Recently, several randomized and controlled trials have demonstrated great advantages of a drug-eluting stent (DES) with respect to significant reduction in restenosis and recurrence of symptoms, and improvement in clinical outcomes after percutaneous coronary intervention (PCI). Little is known about the comparative effects of the 1-DES plus the kissing balloon technique with the 2-DES for bifurcation angioplasty in a Chinese population.

METHODS

From April 2004 to June 2006, 566 consecutive Chinese patients underwent DES implantation for true bifurcation lesions, including 346 1-DES with the kissing balloon technique (300 male, 57.7 +/- 11.5 y old) and 220 2-DES (183 male, 58.1 +/- 10.7 y old) were analyzed. Clinical and angiographic follow-up was performed after 7 mo.

RESULTS

The major adverse cardiac event (MACE) rates were higher in the 2-DES group than in the 1-DES group (5.5% versus 2.0%; p = 0.032), which was mainly contributed to by acute myocardial infarction (AMI) (4.5% versus 1.4%; p = 0.032), rather than death and target lesion revascularization (TLR) (0% versus 0.5%; p = 0.389, 1.4% versus 2.7%; p = 0.352). Stent thrombosis rates were higher in the 2-DES group than in the 1-DES group (0.6% versus 2.7%; p = 0.042), except for 1 late-stent thrombosis in the 2-DES group, and all of them were subacute stent thrombosis (2 in the 1-DES group and 5 in the 2-DES group). The 7 mo angiographic follow-up rate was 36.4%. In the main branch there was no difference in restenosis rate in the 1-DES group compared with the 2-DES group (9.8% versus 11.9%; p = 0.652), but in the side branch the restenosis rate was higher in the 1-DES group (33.6% versus 15.5%; p = 0.004). However, there was no difference in in-segment late loss between the 2 groups, either in the main or side branch.

CONCLUSION

Compared with the 2-DES strategy, if a final kissing balloon could be achieved, the 1-DES strategy may be more efficient and safe.

Carvedilol reduces myocardial no-reflow by decreasing endothelin-1 via activation of the ATP-sensitive K+ channel

It has been verified that carvedilol can attenuate myocardial no-reflow. However, the effects of carvedilol on adenosine triphosphate-sensitive K+ (KATP) channel and endothelin-1 (ET-1) are unknown. Forty mini-swines were randomized into 5 study groups: 8 control, 8 carvedilol pretreatment, 8 glibenclamide (KATP channel blocker)-treated, 8 carvedilol and glibenclamide-pre-treated and 8 sham-operated. An acute myocardial infarction(AMI) and reperfusion model was created with a three-hour occlusion of the left anterior descending coronary artery followed by one-hour reperfusion. Compared with the control group, carvedilol significantly decreased the area of no-reflow (myocardial contrast echocardiography: from 78.5±4.5% to 24.9±4.1%, pathological means: from 82.3±1.9% to 25.8±4.3% of ligation area, respectively; all p < 0.01) and reduced necrosis size from 98.5±1.3% to 74.4±4.7% of ligation area, p < 0.05). It also decreased plasma ET-1 and myocardial tissue ET-1. However, glibenclamide abrogated the protective effect of carvedilol. The beneficial effect of carvedilol on myocardial no-reflow could be due to its effect on ET-1 via the activation of the KATP channel.

Sirolimus-based immunosuppressive therapy in liver transplant recipient with tacrolimus-related chronic renal insufficiency

BACKGROUND

While providing potent immunosuppression for liver transplant recipients, calcineurin inhibitors (CNI) exhibit nephrotoxicity as a major side effect. The purpose of this study was to evaluate the safety and efficacy of conversion from CNI to sirolimus (SRL) among liver transplant recipients with CNI-induced chronic nephrotoxicity.

METHODS

Between January 2004 and June 2005, we performed conversion in 16 recipients after a median period of 8.5 months after liver transplantation. The indication for conversion was CNI-related nephrotoxicity with a serum creatinine (sCr) value >132.6 umol/L. Renal function was measured before and after conversion to SRL. Clinical and laboratory data related to the clinical course of the patients were recorded to investigate the safety and efficacy of conversion.

RESULTS

Sixteen patients were converted to SRL after developing nephrotoxicity. Their renal function improved gradually after conversion. The levels of sCr decreased significantly within the first 30 days (164.1 +/- 12.48 micromol/L to 130.1 +/- 5.573 micromol/L), and over the next 60 days after conversion (97.86 +/- 11.69 micromol/L to 90.7 +/- 8.95 micromol/L) (P < .01). Similarly, the mean glomerular filtration rate (GFR) increased significantly during the same period. Four recipients experienced hypercholesterolemia, 1 with ankle edema, and 1 with acute rejection. The median follow-up was 2.4 years. No patient discontinued SRL due to side effects. No patient needed dialysis or kidney transplantation during the study period.

CONCLUSIONS

SRL is a safe, effective replacement agent as primary immunosuppressive therapy following withdrawal of CNIs in liver transplant recipients with CNI-induced chronic nephrotoxicity.

Preliminary research on abating rat testicle toxicity due to triptolide after oral polymer nanoparticle delivery

This study was undertaken to investigate the effect of triptolide (TP) on male rats after oral polymer nanoparticle delivery (TP-loaded poly(D,L-lactic acid) nanoparticles, TP-PLA-NPs). Free TP and TP-PLA-NPs were administered orally at doses of 0.2 and 0.6 mg/kg for 15 days and rats were sacrified at end of the dosage period. All rat testes were weighed, fructose content and activity of acid phosphatase (ACP) were assayed, and testis tissues were observed histopathologically. Testis weight, testis index, ACP activity, and fructose content of the treated animals were lower than those of the control group. Moreover, ACP activity and fructose content were markedly decreased for free TP of 0.6 mg/kg in comparison to the same dose of TP-PLA-NPs. Obvious pathological changes were not observed for a dose of 0.2 mg/kg free TP and TPPLA-NPs at the end of 15 days. At a dose of 0.6 mg/kg, however, free TP caused more serious damage to the testes than TP-PLA-NPs. These results revealed that TP-PLA-NPs might decrease the testis toxicity of TP because TP was slowly released from polymer nanoparticles. Further research on this mechanism of abated toxicity is in progress.

Hyperbaric oxygen induces endogenous neural stem cells to proliferate and differentiate in hypoxic-ischemic brain damage in neonatal rats

BACKGROUND AND PURPOSE

Studies suggest that after brain injury, hyperbaric oxygen (HBO2) is neuroprotective by stimulating cell proliferation. We examine whether HBO2 promotes neural stem cells (NSC) to proliferate and differentiate in neonatal hypoxic-ischemic (HI) rats.

METHODS

Seven-day-old rat pups were subjected to unilateral carotid artery ligation followed by 2 hours of hypoxia (8% O2). HBO2 was administered (2 ATA (atmospheres absolutes), once daily for 7 days) within 3 hours after HI. The proliferating neural stem cells in the subventricular zone (SVZ) and dentate gyrus (DG) were dynamically examined by 5-bromo-2-deoxyuridine (BrdU)/nestin immunofluorescence. Nestin protein was detected by western blot analysis at various time points (from 6 hours to 14 days) after HI. The migrating NSC were examined by BrdU/doublecortin (DCX) immunofluorescence 7 and 14 days after HI. The phenotype of the newborn cells was identified by BrdU/beta-tubulin, BrdU/ glial fibrillary acidic protein (GFAP) and BrdU/O4 (oligodendrocyte marker) immunofluorescence. Myelin basic protein (MBP) was examined by immunohistochemistry and pathological changes of the brain tissue were detected 28 days after HI.

RESULTS

In neonatal HI rats treated with HBO2, the proliferation of endogenous NSC was observed in the SVZ and DG. Cell numbers peaked 7 days after HI and proliferating NSC migrated to the cerebral cortex at 14 d after HI. Twenty-eight days after HI, an increase in newly generated neurons, oligodendrocytes and MBP was observed in the HBO2 group compared to the untreated and HI-treated rats.

CONCLUSIONS

This study suggests that HBO2 treatment may promote neurogenesis of the endogenous NSC in neonatal HI rats, contributing to repair of the injured brain.

Post-marketing surveillance study of the efficacy and safety of vardenafil among patients with erectile dysfunction in primary care

To evaluate the safety and efficacy of vardenafil in primary care, we undertook a post-marketing surveillance study in 384 men with erectile dysfunction (ED), enrolled by 22 family physicians in Korea, from July 2004 to August 2005. Of the 384 patients enrolled, 343 (89.3%) returned for efficacy assessment and safety evaluation. Among the latter, 279 patients (81.3%) reported that their erectile function improved, 292 (92.1%) showed enhanced IIEF (International Index of Erectile Function)-5 scores and 265 (77.9%) responded that they were 'very satisfied' or 'satisfied' with vardenafil treatment. The most frequent reason for patient satisfaction with vardenafil was erectile potency (62.4%), followed by safety (42.4%), rapid onset (35.3%), adequate duration of efficacy (28.5%) and easy administration (25.9%). A total of 23 adverse events were observed in 18 patients, with the most frequent being hot flushes (3.2%), followed by headache (1.2%), nasal congestion (0.6%), color vision disturbance (0.3%), dizziness (0.3%), dry mouth (0.3%), dyspepsia (0.3%), nausea (0.3%) and diarrhea (0.3%). Only one patient discontinued vardenafil as a direct result of an adverse event. These results suggest that vardenafil prescribed by primary care physicians improved erectile function and was well tolerated by patients with ED.

[Preparation of monoclonal antibodies against West Nile virus envelope protein domain.]

BACKGROUND

To prepare monoclonal antibodies against West Nile virus (WNV) envelope protein domain.

METHODS

BALB/c mice were immunized with recombinant antigen of West Nile virus envelope protein domain, and the spleen cells of the mice were used to prepare the monoclonal antibodies (McAb) by hybridoma technique.

RESULTS

Three hybridoma cell strains secreting McAbs against WNV envelope protein domain, designated as 4F7, 6H3 and 8E4, respectively, were obtained and were identified by indirect enzyme linked immunosorbent assay (ELISA), they belonged to IgG1, IgG1 and Ig2a, respectively. Two epitopes of envelope protein domain were determined, among them, 4F7 and 6H3 were against the same epitope and 8E4 to another one.

CONCLUSIONS

The results of indirect ELISA, Western blot and indirect immunofluorescence experiment indicated that these three McAbs were specific for West Nile virus envelope protein domain and did not cross-react with Japanese encephalitis virus and other viruses, so they can be used for specific detection of West Nile virus.

Tetraspanin CD9 regulates invasion during mouse embryo implantation

The expression of tetraspanin CD9 was found on blastocysts in mice and endometrium epithelial cells in human and bovine. However, it remains unknown how CD9 is involved in the precise dialogue between embryo and uterus during early pregnancy. This study was designed to investigate the functional roles of CD9 in the embryo implantation with monoclonal antibody against CD9 protein (anti-CD9 mAb) and antisense oligonucleotide against CD9 gene (AS-CD9). Our results showed that intrauterine injection of anti-CD9 mAb on day 4 of pregnancy significantly increased the number of embryos implanted (7.24+/-0.39 versus 4.04+/-0.38). In vitro, anti-CD9 mAb or AS-CD9 significantly enhanced embryo-outgrowth ability on the monolayer of uterus epithelial cells in a dose-dependent manner. However, the attachment of blastocysts to epithelial cells was unaffected. Furthermore, we found that anti-CD9 mAb or AS-CD9 stimulated matrix metalloproteinase 2 (MMP-2) production of blastocysts on Fibronectin. LY294002, a specific inhibitor of phosphoinositide 3-kinase, was able to counteract the effect of anti-CD9 mAb and AS-CD9 on outgrowth ability and production of MMP-2. Our results indicated that CD9 played a role of inhibiting embryo implantation. CD9 was able to impair embryo invasion and the production of MMP-2 through the phosphoinositide 3-kinase signaling pathway.

Impact of an outbreak of severe acute respiratory syndrome on a hospital in Taiwan, ROC

STUDY OBJECTIVE

To estimate the impact of the severe acute respiratory syndrome (SARS) outbreak in early 2003 on a tertiary care hospital in Taiwan, ROC.

METHODS

The study estimated the utilisation of resources related to infection control, SARS related medical services, and routine medical services, and SARS related medical outcomes at National Cheng Kung University Hospital (NCKUH) from 25 March to 16 June 2003 through a cross sectional survey of hospital records.

RESULTS

A mean of 5100 persons per day (95%CI 4580 to 5610) underwent fever screening at the outpatient and emergency department (ED) entrances to the hospital, of which 35 per day (95% CI 30 to 40) were referred for further evaluation for suspected or probable SARS. ED isolation surge capacity was created via 12 new beds outside the ED: eight for SARS assessment, three for patients awaiting in hospital bed assignment, and one for resuscitation. A total of 382 patients were fully evaluated for suspected or probable SARS outside the ED, of which 27 were admitted. The mean numbers of outpatient clinic patient visits, ED visits, ED trauma patient visits, ED admissions, hospital admissions, and operative procedures decreased during the outbreak. Thirty eight patients were hospitalised with suspected SARS, of which three received the final diagnosis of probable SARS. Two patients with probable SARS died. No cases of nosocomial SARS transmission occurred.

CONCLUSIONS

This SARS outbreak was associated with substantial use of hospital and ED resources aimed at infection control, comparatively less use of resources related to the medical care of patients with suspected or probable SARS, and decreased use of routine medical services.

Serum lysophosphatidic acid concentrations measured by dot immunogold filtration assay in patients with acute myocardial infarction

In this study the relation between lysophosphatidic acid (LPA) and myocardial infarction was investigated, the typical and simplified methods for measuring serum LPA concentration by dot immunogold filtration assay (DIFA) based on a polyclonal antibody to LPA were developed, and serum LPA concentrations were measured in 31 patients with acute myocardial infarction (AMI) and 12 controls (blood donors) by DIFA. Serum LPA levels were raised more than twofold 8 h after the onset of AMI. Maximal elevation (10.43 mg/L) was found at 48-72 h following onset and remained higher than the control concentration (1.66 mg/L) 7 days after AMI. The rise in serum LPA concentration in AMI patients suggests that LPA might be involved in AMI-related pathophysiology in the cardiovascular system. The simplified DIFA developed in the present study for measuring serum LPA concentration is convenient and highly sensitive.

Confirmation and refinement of a genetic locus for disseminated superficial actinic porokeratosis (DSAP1) at 12q23.2-24.1

BACKGROUND

Our previous study has identified two loci for disseminated superficial actinic porokeratosis (DSAP), but the genes responsible are still unknown.

OBJECTIVES

To narrow down the candidate regions and to assess candidate genes.

METHODS

A genome-wide scan and linkage analysis were carried out in a newly collected five-generation Chinese family with DSAP. In addition, six candidate genes were screened for possible DSAP-associated mutations.

RESULTS

DSAP in this family was associated with chromosome 12q. Fine mapping and haplotype construction refined the DSAP1 locus to a 4.4-cM interval. No disease-associated mutation was detected in CRY1, C4ST1, TXNRD1, HCF2, CMKLR1 or KIAA0789 genes.

CONCLUSIONS

The DSAP1 locus was localized to a 4.4-cM interval at chromosome 12q23.2-24.1. CRY1, C4ST1, TXNRD1, HCF2, CMKLR1 and KIAA0789 genes were not associated with DSAP1.

Potential of adenoviral p53 gene therapy and irradiation for the treatment of malignant gliomas

We investigated the combined effects of p53 gene transfer and irradiation and its still unclear interaction mechanism in human gliomas. Four human glioma cell lines expressing mutant type p53 (U373 and A172) and wild-type p53 (D54MG and EFC-2) were transfected by adenoviral vectors bearing p53 gene at 50 multiplicity of infection. Two days after transfection, cells were irradiated (3, 6, and 9 Gy). The cytotoxicity was evaluated by clonogenic assay. The quantitative analysis of apoptosis and cell cycle analysis were performed using flow cytometry. Irradiation combined with adenoviral p53 transfection significantly increased cytotoxicity, which was additive in cell lines with wild-type p53 and more than additive in cell lines with mutant p53. The combination of two modalities increased the apoptotic population by 14% in A172 cells and 20% in D54 MG cells, which were the sum of apoptosis from each modality. Adenoviral p53 transfection increased the G1 phase fraction and concomitant decrease of radioresistant S phase fraction in A172 and D54MG cells. Our study demonstrated that p53 gene transfer combined with irradiation increased absolute cytotoxicity in human glioma cells used in this experiment. The interaction mechanism for increased cytotoxicity involved, in part, increased apoptosis and change of cell cycle profile.

Diagnosis of high-grade pulmonary neuroendocrine carcinoma by fine-needle aspiration biopsy: nonsmall-cell or small-cell type?

A consensus optimal therapy for large-cell neuroendocrine carcinoma of the lung has not been achieved since this entity was proposed in 1991. Accumulation of clinical data and investigation, however, can be greatly impeded by erroneous cytological diagnosis, based on which treatment may be initiated. To avoid erroneous diagnoses, cytological criteria need to be defined. Twenty cases of fine-needle aspiration specimens with a diagnosis of neuroendocrine tumor by either cytology or follow-up histology were retrospectively reviewed for cytomorphologic features. Patients' clinical data were also reviewed. Three cytomorphologic patterns were identified for large-cell neuroendocrine carcinoma, i.e., nonsmall-cell-like, small-cell-like and, mixed nonsmall-cell-small-cell-like. Small-cell-like large-cell neuroendocrine carcinoma can be mistaken for small-cell carcinoma. The most important differential features between these two entities are nuclear size and perceptibility of nucleoli of tumor cells.

Distinction of well-differentiated liposarcoma from lipoma in two patients with multiple well-differentiated fatty masses

This case report describes the features of gadolinium-enhanced MRI in well-differentiated liposarcoma with histologic correlation and addresses the usefulness of this imaging technique in distinguishing well-differentiated liposarcoma from lipoma. Gadolinium-enhanced MRI revealed significantly enhanced signal in well-differentiated liposarcoma in a background of multiple well-differentiated benign fatty masses by showing the increased vascularity in the septa of well-differentiated liposarcoma. Although such signal enhancement can be seen in some types of benign lipomatous tumors with increased blood vessels, this technique is helpful in selection of biopsy site, especially in a clinical setting of multiple fatty masses.

[Comparative effects of carvedilol and metoprolol in preventing from left ventricular remodeling after acute myocardial infarction in rats]

OBJECTIVE

To compare the effects of carvedilol and metoprolol in preventing from left ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in rats.

METHODS

Twenty-four hours after ligating left coronary artery, 105 surviving female SD rats were randomly assigned to AMI control, carvedilol 1 mg/(kg.d) and metoprolol 2 mg/(kg.d) groups. Sham-operated rats (n = 16) were selected randomly as non-infarction control. After four weeks of drugs therapy, hemodynamic studies and pathologic analysis were performed. Exclusive of MI size < 35% or > 55%, complete experimental variables were obtained in 46 rats, which were comprised of AMI (n = 11), carvedilol (n = 12), metoprolol (n = 11), and Sham-operated (n = 12) groups.

RESULTS

Compared with sham-operated group, left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV) and weight (LVW), were all significantly increased (P < 0.05-0.001), while maximal rate of rise and fall (+/- dp/dt) of LV pressure as well as their corrected values (+/- dp/dt/LVSP) were all significantly decreased (P < 0.01-0.001) in AMI group. In comparison with AMI group, the LVEDP and LVV were all significantly decreased (all P < 0.001), while +/- dp/dt and +/- dp/dt/LVSP were significantly increased (P < 0.05-0.001) in both carvedilol and metoprolol group, with LVW and RVW only decreased in carvedilol group (P < 0.05-0.01).

CONCLUSIONS

1. Carvedilol can effectively attenuate LVRM, and improve hemodynamics and LV function after AMI in rats, 2. Metoprolol has equivalent beneficial effects as carvedilol on hemodynamics, LV dilatation and function, but not LV hypertrophy.

[Inhibition of PKC and ERK1/2 in cultured rat vascular smooth muscle cells by angiotensin-(1-7)]

The present study was undertaken to investigate the effects of angiotensin-(1-7)[Ang-(1-7)] on the proliferation and expression of protein kinase C (PKC) and extracellular regulated protein kinases (ERK1/2) of vascular smooth muscle cells (VSMCs) by techniques of Western blot, 3H-thymidine (3H-TdR) and 3H-leucine (3H-Leu) incorporation. Ang II increased VSMC DNA and protein synthesis, and promoted protein expression of PKC-zeta and ERK1/2. In contrast, Ang-(1-7) not only inhibited PKC-zeta and ERK1/2 protein content, but also decreased Ang II mediated VSMC hyperplasia, as compared with the controls (P < 0.01 or P < 0.05). These results suggest that Ang-(1-7) may inhibit VSMC proliferation by influencing protein expression of PKC-zeta and ERK1/2.

Diagnosis of chondroid lipoma by fine-needle aspiration biopsy

Chondroid lipoma is a rare, recently described soft tissue tumor that mimics extraskeletal chondrosarcoma and myxoid liposarcoma. Reports regarding its cytologic and radiological features are sparse. In this report, we describe the cytologic features of this unusual tumor, which include mixed mature lipocytes and lipoblast-like cells embedded in chondromyxoid matrix. We also describe the "target sign appearance" of this tumor in magnetic resonance imaging studies, resembling a neurogenic tumor. More importantly, we demonstrate that a definitive diagnosis of this unusual tumor can be made by fine-needle aspiration biopsy. The usefulness of cell block in fine-needle aspiration biopsy diagnosis of soft tissue tumors is emphasized.

[Calcineurin signaling pathway is involved in cardiomyocyte hypertrophy mediated by calcium activators]

AIM

To investigate the effects of intracellular free calcium ([Ca2+]i) from different resources on calcineurin (CaN) dependent signaling pathway and cardiomyocyte hypertrophy.

METHODS

Angiotensin II (Ang II,10(-7) mol/L), ryanodine (RY, 10(-7) mol/L), inositol (1,4,5)-trisphosphate (IP3, 10(-7) mol/L) were applied to stimulate the [Ca2+]i, CaN activity and protein expression were measured in primary cultured cardiomyocytes from Wistar rat. [Ca2+]i was measured using Fura-2/AM fluorescent technique. The incorporation of 3H-Leucine (3H-Leu) determined the synthesis rates of protein.

RESULTS

Ang II, RY and IP3 increased [Ca2+]i, promoted CaN activity and protein expression, and 3H-Leu incorporation in cultured cardiomyocytes compared with control (P < 0.05 or P < 0.01).

CONCLUSION

Cardiomyocyte hypertrophy is associated with the changes of cellular [Ca2+]i, but not with its resources. Indicating that CaN signaling pathway play an important role in the hypertrophy of cardiomyocytes.

Diagnostic utility of intracytoplasmic lumen and transgressing vessels in evaluation of Hürthle cell lesions by fine-needle aspiration

INTRODUCTION

Recent abstracts have emphasized the importance of recognizing intracytoplasmic lumen and transgressing vessels as useful criteria enabling distinction between Hürthle cells encountered in neoplastic and nonneoplastic thyroid aspirates. The purpose of this retrospective study was to evaluate if application of these criteria improves specificity and sensitivity of cytologic diagnosis of true Hürthle cell neoplasms.

MATERIALS AND METHODS

We retrospectively reviewed 30 fine-needle aspirates of thyroid with cytologic diagnosis of Hürthle cell neoplasms (13 cases) and nonneoplastic thyroid with prominent Hürthle cells (17 cases). All cases were evaluated for the presence of intracytoplasmic lumen and transgressing vessels and were reclassified as neoplastic or nonneoplastic based on the presence or absence of 1 or both of these criteria. Surgical follow-up was available in all cases.

RESULTS

Surgical follow-up in 13 cases of Hürthle cell neoplasms revealed Hürthle cell carcinoma (3 cases), Hürthle cell adenoma (6 cases), and Hashimoto's thyroiditis (4 cases). Seventeen cases with nonneoplastic diagnosis revealed Hürthle cell carcinoma (1 case), Hashimoto's thyroiditis (12 cases), and nodular goiter (4 cases). After application of the previously mentioned cytologic criteria, the cytologic diagnoses were reclassified as Hürthle cell neoplasms (13 cases) and nonneoplastic thyroid (17 cases). The true sensitivity of the test before and after the application of the criteria was 90% and 100%, respectively. The true specificity before and after the application of the cytologic criteria was 65% and 85%, respectively.

CONCLUSIONS

Intracytoplasmic lumen and transgressing vessels are helpful features in distinguishing neoplastic and nonneoplastic Hürthle cell thyroid lesions. Use of these criteria may improve the specificity and sensitivity of the cytologic diagnosis.

The small blue cell dilemma associated with tamoxifen therapy

CONTEXT

Several endometrial diseases, such as endometrial hyperplasia, endometrial carcinoma, and endometrial polyps, have been reported to be associated with tamoxifen administration. We recently observed a high incidence of distinctive small blue cells in Papanicolaou tests of women who had received tamoxifen treatment for breast carcinoma.

OBJECTIVES

To define the characteristics of these small blue cells, to identify the patient population in which they are found, and to determine the clinical significance and possible etiology of these findings.

DESIGN

A total of 154 Papanicolaou tests from 60 patients with a clinical history of tamoxifen therapy were reviewed retrospectively.

RESULTS

Small blue cells were found in 40% of Papanicolaou tests from patients who received tamoxifen therapy. Patients with small blue cells in their Papanicolaou tests were an average of 9 years older at the time tamoxifen therapy was initiated than those without. Among the available follow-up surgical biopsies, no malignant diagnoses were made.

CONCLUSIONS

We conclude that these distinctive small blue cells are found more frequently in older patients and most probably represent proliferative reserve cells of cervical/vaginal epithelium resulting from the estrogenic agonist effect of tamoxifen. More importantly, they are nonneoplastic in nature.

Prevalence and rapid identification of clarithromycin-resistant Helicobacter pylori isolates in children

BACKGROUND

Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals.

OBJECTIVE

To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant H. pylori isolates.

METHODS

Enrolled were 245 children investigated for H. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system.

RESULTS

H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin-resistant and 6 (9%) were metronidazole-resistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations.

CONCLUSIONS

The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.

Application of pusher in mini-invasive patent ductus arteriosus ligation

The possibility of a residual shunt is a major drawback to current minimally invasive procedures for the treatment of patent ductus arteriosus (PDA). From April 1997 to October 1999, 30 patients (10 males, 20 females) underwent PDA ligation by a modified technique that uses a pusher for securing the ligate of PDA via posterolateral minithoracotomy at our hospital. No complication or mortality occurred. Postoperative echocardiography also revealed no residual shunt. In this article, we introduce this simple, safe procedure for PDA ligation.

Sigmoid volvulus in children: report of two cases

Volvulus of the sigmoid colon is rare in children. An early, accurate diagnosis can avoid unnecessary surgery and reduce the risk of complications. This condition is mainly due to a redundant sigmoid colon with a narrow mesosigmoid attachment. We describe two cases of sigmoid volvulus, which showed different clinical severities and were treated with different methods. Patient 1, a 9-year-old boy, presented with acute abdominal pain and vomiting. Patient 2, an 11-year-old boy, presented with abdominal pain, abdominal distention, and bloody mucoid stool. Plain abdominal radiographs revealed a distended colonic loop extending upward from the pelvis in patient 1 and a typical "coffee bean" sign in patient 2. Barium enema examination was used to confirm the diagnosis in both cases. The volvulus was reduced by insertion of a rectal tube in patient 1 and surgically in patient 2. Sigmoid colon volvulus should be included in the differential diagnosis of childhood abdominal pain or distention. This report suggests that nonsurgical reduction should be attempted first for uncompromised sigmoid volvulus in children, unless bowel ischemia or perforation develops.

Quantitation of lipid-laden macrophages in evaluation of lower airway cytology specimens from pediatric patients

Quantitation of lipid-laden macrophages has been used as a tool in the diagnosis of aspiration-related respiratory disorders. Fifty-six respiratory specimens from pediatric patients with lung diseases were retrospectively reviewed, and lipid-laden macrophage indices were evaluated according to modified published grading methods. The indices from patients at high risk for aspiration were significantly different from those at low risk. A simpler and more reproducible grading method was introduced. An important issue regarding sample adequacy was also addressed.

Change in hepatitis A virus seroepidemiology in southern Taiwan: a large percentage of the population lack protective antibody

Hepatitis A, the predominant reported etiologic form of viral hepatitis in Taiwan, continues to be a disease primarily of children and young adults. A seroepidemiologic study was performed to assess the seroprevalence of hepatitis A (HAV) antibodies in the southern Taiwan general population in 1998 and is compared with results of a similar study in 1992. A total of 948 subjects (477 male and 471 female) with ages ranging from 0.3 to 63 years were stratified into 14 age-specific groups. The presence of anti-HAV antibodies was detected using a commercially available radioimmunoassay. Fifteen percent of the subjects were positive for anti-HAV antibodies, which is lower than that in 1992 (P < 0.001). Seroprevalences were 14.1% for males and 22.6% for females (P = 0.006). The pattern of anti-HAV seroprevalence was distinguishable from that found in 1992; minimum seroconversion occurred at ages ranging from 1 to 30 years. Prevalence of seropositive subjects decreased markedly for the < 1, 13-15, 16-19, 20-24, 25-29, and 30-39 year age groups in comparing 1998 with 1992. The current study demonstrates a continuing decline in the prevalence of HAV among children, adolescents, and young adults. The findings can be ascribed to the improvement of socioeconomic status and modernization of environmental sanitation. As a consequence of this changing trend of endemicity and the resulting lack hepatitis A antibodies among the general population in Taiwan, the risk of sudden major outbreaks is increased because of increasing international travel and immigration, particularly during and after natural disasters. HAV vaccination will be important for the prevention and control of HAV outbreaks in the community.

[Effect of baicalin and dexamethasone on cytokines in brain tissue of infectious brain edema]

OBJECTIVE

To explore the effect of baicalin(BC) and dexamethasone(DXM) on interleukin-1 beta (IL-1 beta) and tumor necrosis factor alpha(TNF-alpha) in brain tissues of infectious brain edema.

METHODS

The infectious brain edema model induced by pertussis bacilli(PB) was used. Brain water content(WC), content of Na+ and the levels of IL-1 beta, TNF-alpha were determined, and the morphological changes were observed under the light microscope.

RESULTS

The results showed that the levels of WC, Na+, IL-1 beta and TNF-alpha in group PB were higher than those in group of normal saline(NS) (P < 0.01). And they were lower in groups BC and DXM than those in group PB(P < 0.05). In groups BC and DXM, there were no significant difference in the contents of water, Na+, IL-1 beta and TNF-alpha(P > 0.05). The water contents were positive linar correlated with IL-1 beta or TNF-alpha(P > 0.05). The water contents were positive linear correlated with IL-1 beta or TNF-alpha contents(r = 0.9381, 0.8349, P < 0.01). The structure of brain tissues in group NS was normal. In group PB, there were severe edema in brain tissues. In groups BC and DXM, the edema of brain tissues was reduced.

CONCLUSIONS

The results suggest that the protective effect of BC and DXM against infectious brain edema were similar, the mechanism may be associated with the reduction of TNF-alpha and IL-1 beta.

[Comparison of infectious brain edema models induced by different kinds of pertussis bacilli in rats]

OBJECTIVE

To understand the difference of infectious brain edema models induced by varied kinds of pertussis bacilli in rats and to look for a new infectious brain edema model.

METHODS

Sprague-Dawley rats were randomly divided into 3 groups: normal saline group(NS); rude pertussis bacilli(PBR); purified pertussis bacilli(PBP). After infectious brain edema model was induced by rude pertussis bacilli or purified pertussis bacilli, the water content(WC), Evan's blue content(EB), Na+ and K+ content in brain tissues were measured.

RESULTS

The WC, EB and Na+ contents in brain tissues in PBR and PBP groups were significantly increased than those in NS group; K+ content was significantly decreased in PBR and PBP groups than that in NS group(P < 0.01). Evan's blue discoloration was demonstrated in all rats of PBR group, but 6 rats of PBP group showed bluish discoloration. EB content in brain tissues was significantly increased in PBR group than that in PBP group.

CONCLUSIONS

The infectious brain edema model can be induced by rude pertussis bacilli or purified pertussis bacilli in rats, the former gives priority to mixed brain edema, and the latter mainly avails cytotoxin brain edema.

Brachial plexus injury following coronary artery bypass surgery: a case report

Postoperative brachial plexus injury, often manifesting as a variety of upper extremity neuropathies, is a recognized and not uncommon complication following cardiac surgery that requires a median sternotomy. In general, the vast majority of its neurological symptoms are transient and need no treatment. Nevertheless, in very rare cases, the peripheral neuropathies will persist and cause disability. We treated a 67-year-old male patient complicated by permanent paresthesia and paralysis of the left upper extremity after an eventful coronary artery bypass surgery. The nerve conduction measurements and electromyography all revealed a C5 to T1 lesion. After carefully reviewing the surgical course and referring to the published literature, we tentatively concluded that compression or overstretching produced by wide and prolonged sternal separation of the brachial plexus was the most likely etiology. Asymmetrical traction of the sternal halves during internal mammary artery harvesting might also have contributed to this nerve injury. We surmised, therefore, that brachial plexus injury could be minimized by an exact median sternotomy, a lower position and the smallest possible opening for the sternal retractor, and the avoidance of constant and asymmetrical traction on the sternal halves.

Complications of varicella in children: emphasis on skin and central nervous system disorders

A review of medical records at a tertiary hospital in southern Taiwan from June 1988 through May 1998 identified 136 children who had been hospitalized for varicella-related complications. Of the children, 83% (113/136) were healthy before the onset of varicella and 17% (23/136) had underlying illnesses. The mean age was 4.7 years (ranged from 1 day to 18 years) with a male predominance (1.7:1). The mean hospital stay was 5.5 days (ranged from 1 to 22 days). Secondary bacterial skin or soft tissue infections were the most common complications (44%), followed by central nervous system (CNS) involvement (23%), pneumonia (18%), thrombocytopenia (12%), and liver function impairment (10%). Among the 60 patients with secondary bacterial cutaneous infection, 16 (27%) had positive isolates, including 12 isolates of Staphylococcus aureus and four Streptococcus pyogenes. Age above 8 years was significantly associated with the development of varicella-associated CNS complications (p = 0.019). Of the 23 immunocompromised hosts, the most common underlying conditions were hematological diseases (11 patients, 48%), followed by neonatal varicella (7 patients, 30%) and chronic illness with steroid treatment (5 patients, 22%). All of the subjects in this study had a favorable outcome except for three lethal cases, resulting in a case-fatality rate of 2.2%. The cause of death was S. aureus septicemia in one patient, streptococcal toxic shock syndrome in one patient, and encephalitis with brain herniation in one patient. Our results demonstrate that varicella continues to be a serious disease that occasionally results in life-threatening complications in healthy and immunocompromised children. Routine immunization of all healthy children against varicella is recommended.