Congenitally missing maxillary primary canines: report of three cases

BACKGROUND

Hypodontia is uncommon in the primary dentition and lateral incisors are the most commonly missing primary teeth in the patients affected. Studies have found that hypodontia in the primary dentition involving only maxillary canine is rare.

CASE REPORTS

Three cases of hypodontia in the primary dentition involving only maxillary canine are presented. Two of them were affected by hypodontia and hyperdontia in the permanent dentitions respectively, yet all the permanent canines developed normally in these three cases.

CONCLUSION

In children with congenitally missing maxillary canines, the permanent dentitions may show diverse anomalies in tooth numbers, ranging from hypodontia to hyperdontia.

[A field epidemiological study on the risk factors of injury caused by typhoon]

OBJECTIVE

To determine the risk factors involved in the typhoon episodes and to put forward and evaluate the intervention measures.

METHODS

We defined a confirmed injury case as: 'a person with fall,scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am,August 12 to 6 pm, August 14 2004' and a death case as: 'a person with fall, scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am, August 12 to 12 am, August 18 2004'. We investigated all hospitalized injured cases in ten hospitals and telephoned to those who were not hospitalized and the cases of death. We did case-control study with 1 pair versus 2 cases. 74 cases were selected in ten hospitals. The controls were neighbors of the controls matched by occupation, sex, village, and within 5 years of age without injury in this typhoon. We asked the cases and the controls on their alertness regarding typhoon and what actions taken when typhoon arrived.

RESULTS

There were 392 injury cases in all ten hospitals and 50 death cases. The attack rate of injury was 27.3 per 100 000. The fatal rate was 11.3% with the death rate 3.1 per 100 000. We investigated 209 injury cases and 31 death cases. The number of cases who were injured from 1 to 6 hours before typhoon landing accounted for 64.6% (155) of all cases. The peak of epidemic curve was 4 hours before the landing of typhoon. Data on the analysis of 74 cases and 148 controls revealed that 42% (31) of the cases were outside their homes before and during typhoon compared to 15% (22) of the controls (OR = 3.9, 95% CI: 1.9-7.7). Compared with 20% (30) control persons (OR = 17,95% CI: 4.2-68). 28% (21) cases did not receive the alert of typhoon before it arrived compared with 18% (27) control persons (OR = 3.3, 95% CI:1.3-8.6). 53% (39) of the cases did not pay attention to the alert of typhoon before typhoon arrived.

CONCLUSION

Staying outdoor, not receiving or did not take seriously about the alert of typhoon seemed to be the risk factors of injury by the typhoon episode, suggesting that the government should increase the emergency preparedness and to raise the awareness on risks associated with typhoon.

Similarities and differences for light-induced surface plasmons in one- and two-dimensional symmetrical metallic nanostructures

Two types of double-sided nanostructure, one possessing a slit aperture with parallel grooves and the other possessing a circular aperture with concentric grooves, were fabricated to examine the similarities and differences of their diffraction behavior in one-dimensional (1-D) and two-dimensional (2-D) nanostructures. Based on the projection-slice theory, we conjecture that the surface plasmons in these two different nano-scale grooves possess similar modes. A localized surface plasmon (LSP) was used to examine the transmission characteristics induced by the apertures. The transmission characteristics of the slitted nanostructure and the circular nanostructure aperture were then measured. We coupled the transmission spectra measured from these two apertures with a 1-D parallel groove transmission curve simulated by a 1-D rigorous coupled wave analysis. Measured spectra results show reasonable agreement with the simulated data. We propose that the apparent blueshift observed in the peak frequency of a 2-D nanostructure is due to the difference in the shape of the aperture and the spot transmission characteristics of 1-D and 2-D systems as induced by a LSP.

Association of melanocortin 4 receptor (MC4R) and high mobility group AT-hook 1 (HMGA1) polymorphisms with pig growth and fat deposition traits

The aim of this study was to analyse the combined effect of melanocortin 4 receptor (MC4R) and high mobility group AT-hook 1 (HMGA1) polymorphisms on growth and fatness traits in Duroc pigs. No significant interaction was observed between MC4R and HMGA1 for back-fat traits. An additive mode of inheritance of both gene effects was found for average daily gain and lean meat content. Maximum mean differences from combined genotypic effects were over 2 mm for back fat, 70 g/day for average daily gain and 2% for lean meat content. Therefore, utilization of polymorphisms in both MC4R and HMGA1 for marker-assisted selection could result in an economic benefit to the pig industry.

Oxidative Metabolism in Pediococcus pentosaceus III. Glucose Dehydrogenase System

Lee, Chin K. (North Carolina State of the University of North Carolina, Raleigh), and Walter J. Dobrogosz. Oxidative metabolism in Pediococcus pentosaceus. III. Glucose dehydrogenase system. J. Bacteriol. 90:653-660. 1965.-A method was developed for the purification of glucose dehydrogenase from Pediococcus pentosaceus Az-25-5. The procedures included treatments with protamine sulfate, ammonium sulfate, and heat in addition to acid precipitation, calcium phosphate adsorption and elution, and diethylaminoethyl-Sephadex column chromatography. The final preparation thus obtained was purified 255-fold and exhibited both similarities and dissimilarities to the same enzyme isolated from other sources. The enzyme is absolutely specific for nicotinamide adenine dinucleotide phosphate (NADP) as a cofactor, and oxidizes only glucose or its analogue 2-deoxyglucose via the following reversible reaction: beta-d-glucose + NADP right harpoon over left harpoon d-glucono-delta-lactone + NADPH(2) + H(+). K(m) values were 2.3 x 10(-2) for glucose and 2 x 10(-4) for NADP. Monovalent cations were required for stability of the enzyme and stimulated activity. The pH optimum was 7.0, and the equilibrium constant was determined to be 13.4 x 10(-7) at pH 6.4. Among the Lactobacillaceae, glucose dehydrogenase activity was found to be essentially limited to members of the genus Pediococcus. Studies on the enzymatic composition of P. pentosaceus viewed in conjunction with other available data led to the conclusion that this enzyme is not involved to any significant extent in the energy metabolism of this organism.

Beaming light from a subwavelength metal slit surrounded by dielectric surface gratings

In this article, we demonstrate that a subwavelength metal slit surrounded by dielectric surface gratings possesses a directional beaming effect. We propose a surface plasmon diffraction scheme to explain the three kinds of beaming conditions. The numerical simulations of the illustrative structures undertaken used a Finite Difference Time Domain (FDTD) Method and a Rigorous Coupled Wave Analysis (RCWA) Method. Our simulations were found to be consistent and in agreement with the experimental results. In comparison with other metal structures, we find that dielectric metal structures offer better performance as well as the advantage of being able to be efficiently mass produced for large volume industrial applications.

Accumulation of chromium (VI) from aqueous solutions using water lilies (Nymphaea spontanea)

This study describes an investigation using tropical water lilies (Nymphaea spontanea) to remove hexavalent chromium from aqueous solutions and electroplating waste. The results show that water lilies are capable of accumulating substantial amount of Cr(VI), up to 2.119 mg g(-1) from a 10 mg l(-1) solution. The roots of the plant accumulated the highest amount of Cr(VI) followed by leaves and petioles, indicating that roots play an important role in the bioremediation process. The maturity of the plant exerts a great effect on the removal and accumulation of Cr(VI). Plants of 9 weeks old accumulated the most Cr(VI) followed by those of 6 and 3 weeks old. The results also show that removal of Cr(VI) by water lilies is more efficient when the metal is present singly than in the presence of Cu(II) or in waste solution. This may be largely associated with more pronounced phytotoxicity effect on the biochemical changes in the plants and saturation of binding sites. Significant toxicity effect on the plant was evident as shown in the reduction of chlorophyll, protein and sugar contents in plants exposed to Cr(VI) in this investigation.

Implications of increased tumor blood flow and oxygenation caused by mild temperature hyperthermia in tumor treatment

In many past clinical studies in which hyperthermia enhanced the efficacy of radiotherapy, the tumor temperatures could be raised only to 40-42 degrees C range in most cases. The heat-induced cell death, cellular radiosensitization, and vascular damage induced by such mild temperature hyperthermia (MTH) are likely to be insignificant despite the increased response of tumors to radiotherapy. Heating rodent tumors at 40-42 degrees C was found to cause an enduring increase in blood flow and oxygenation in the tumors. Recent studies with canine soft tissue sarcoma and human tumor clinical studies also demonstrated that MTH improves tumor oxygenation, and enhances response of the tumors to radiotherapy or chemoradiotherapy. The increased blood flow and vascular permeability caused by MTH may also improve the delivery of various therapeutic agents such as chemotherapy drugs, immunotherapeutic agents and genetic constructs for gene therapy to tumor cells. MTH as a means to potentiate the efficacy of radiotherapy and others warrants further investigation.

Effects of growth factors and feeder cells on porcine primordial germ cells in vitro

As embryonic stem (ES) cells are not available in swine, embryonic germ (EG) cells derived from primordial germ cells (PGCs) are an alternate source of pluripotent embryonic cells for genetic modification through homologous recombination. Although morphological and biochemical characteristics are similar between ES and EG cells, culture conditions are quite different. To optimize the culture condition for the establishment of porcine EG cells, porcine PGCs were cultured in vitro with various combinations of growth factors (leukemia inhibitory factor [LIF], stem cell factor [SCF], and basic fibroblast growth factor [bFGF]) and on different kinds of feeder cells (STO, TM(4), Sl/Sl(4) m220, porcine embryonic fibroblasts, and COS-7 cells). Optimal results were obtained when all three growth factors (LIF, SCF, and bFGF) were present in the media. Also, feeder cells expressing membrane-bound SCF are required for survival and establishment of porcine EG cells. Therefore, a combination of growth factors and proper feeder cells are critical for the establishment of undifferentiated porcine EG cells.

Inhibition of histone deacetylase 2 increases apoptosis and p21Cip1/WAF1 expression, independent of histone deacetylase 1

Histone deacetylases (HDACs) 1 and 2 share a high degree of homology and coexist within the same protein complexes. Despite their close association, each possesses unique functions. We show that the upregulation of HDAC2 in colorectal cancer occurred early at the polyp stage, was more robust and occurred more frequently than HDAC1. Similarly, while the expression of HDACs1 and 2 were increased in cervical dysplasia and invasive carcinoma, HDAC2 expression showed a clear demarcation of high-intensity staining at the transition region of dysplasia compared to HDAC1. Upon HDAC2 knockdown, cells displayed an increased number of cellular extensions reminiscent of cell differentiation. There was also an increase in apoptosis, associated with increased p21Cip1/WAF1 expression that was independent of p53. These results suggest that HDACs, especially HDAC2, are important enzymes involved in the early events of carcinogenesis, making them candidate markers for tumor progression and targets for cancer therapy.

Prevention of transfusion-transmitted hepatitis E by donor-initiated self exclusion

Safety in blood transfusion has all along been focused on blood borne viruses like HIV, hepatitis B and C. However, infective agents that are not usually transmitted through blood may also pose risk to transfusion if the donor gives blood in the early-viraemic phase. A case report of potential transfusion-transmitted hepatitis E (HEV) is described. It shows the virus can be transmissible via blood because of the presence of HEV RNA in the blood donated. Pre-donation health screening was unable to exclude this asymptomatic donor. But donor-initiated call back system which acts as an additional safety net prevented the release of the potential infective blood products.

Use of convalescent plasma therapy in SARS patients in Hong Kong

In order to evaluate the efficacy of convalescent plasma therapy in the treatment of patients with severe acute respiratory syndrome (SARS), 80 SARS patients were given convalescent plasma at Prince of Wales Hospital, Hong Kong, between 20 March and 26 May 2003. Good outcome was defined as discharge by day 22 following the onset of SARS symptoms. Poor outcome was defined as death or hospitalization beyond 22 days. A higher day-22 discharge rate was observed among patients who were given convalescent plasma before day 14 of illness (58.3% vs 15.6%; P<0.001) and among those who were PCR positive and seronegative for coronavirus at the time of plasma infusion (66.7% vs 20%; P=0.001).

Polysaccharide vaccines for preventing serogroup A meningococcal meningitis

BACKGROUND

Randomised trials carried out over two decades ago showed that the polysaccharide vaccine prevented serogroup A meningococcal meningitis. Subsequent non-randomised studies, however, suggested significant variations in the age-specific duration of protection among young children.

OBJECTIVES

The aim of the review was to determine the effect of polysaccharide serogroup A vaccine for preventing serogroup A meningococcal meningitis. The specific objectives were to assess the age-specific effects of the vaccine, the effect of booster doses in children under five years of age, and the duration of protection in children and adults.

SEARCH STRATEGY

In 2004, the review was updated. The following databases were searched for records of new trials: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2004); MEDLINE (January 1966 to November Week 1 2004); and EMBASE (January 1990 to September 2004).

SELECTION CRITERIA

The first stage of the review included randomised trials. The second stage included non- randomised studies that addressed specific outcomes not answered by the randomised trials.

DATA COLLECTION AND ANALYSIS

One reviewer assessed the methodological quality of the randomised trials and two reviewers independently identified and assessed the non-randomised studies. Of the twelve eligible Randomized trials, four were excluded because of the high risk of bias in assessing vaccine efficacy. Data from the trials were pooled using the Exact method to assess vaccine efficacy at one, two and three years post vaccination. Of the 15 non-randomised studies, only two addressed the specific objectives not answered by the randomised trials but were assessed to be at high risk of bias.

MAIN RESULTS

The protective effect within the first year of vaccination was consistent across the randomised trials, and the summary vaccine efficacy was 95% (95% confidence interval (CI) 87% to 99%). Protection extended into the second and third year after vaccination but the results did not attain statistical significance. The vaccine was protective in Finnish children aged 3 months to five years. The latter was also the only trial that assessed the effect of a booster dose in children under two years of age but lacked power to yield statistically significant results. The vaccine was protective in one- to five-year old children in developing countries (Nigeria and Sudan) but the age-specific efficacy in strata between one and five years of age could not be determined.

AUTHORS' CONCLUSIONS

For the first year after vaccination, the polysaccharide serogroup A vaccine was strongly protective against serogroup A meningococcal meningitis in participants over five years of age. It was also protective beyond the first year after vaccination in this age group but the level of vaccine efficacy could not be determined with precision. Children aged one to five years in developing countries were also protected but the level of efficacy in this age group could not be determined. While the vaccine was strongly protective among children aged three months to five years in developed countries the level of efficacy across age strata within this age group could not be determined. The number of children aged under two years was too small to draw conclusions on the protective effect of a booster dose of vaccine.

Congenitally missing maxillary permanent canines: report of 32 cases from an ethnic Chinese population

Cases of congenitally missing permanent teeth involving only maxillary canines are uncommon. Prevalence studies have revealed that it is a rare finding in Caucasian populations, but it may be relatively more common in Asian groups. This report describes radiographic findings in 32 Chinese children with congenitally missing maxillary permanent canines. The aetiology of such an anomaly is obscure, but the racial difference in prevalence suggests that genetic factors may be more influential than environmental ones.

Association of the oestrogen receptor alpha gene polymorphisms with disease onset in systemic lupus erythematosus

OBJECTIVE

To evaluate the genetic influence of PvuII and XbaI polymorphisms of oestrogen receptor alpha (ORalpha) in patients with systemic lupus erythematosus (SLE) in Korea.

METHODS

Genomic DNA from 268 female controls and 137 female SLE patients (41 childhood onset and 96 adult onset) were analysed using PvuII and XbaI restriction fragment length polymorphism. Comparison of the frequencies of alleles and genotypes was made in control and patient groups and in childhood onset and adult onset SLE subgroups.

RESULTS

Although the Pp genotype occurred more often in SLE patients than in controls (p(c) = 0.017), ORalpha genotype distributions of adult onset SLE did not differ significantly from controls. The PP, Pp, and xx genotypes occurred less often in childhood onset SLE (p(c) = 0.0045, 0.0498, and 0.0255, respectively) than in controls. Additionally, the PP genotype was less common in childhood onset than in adult onset SLE (p(c) = 0.016). SLE patients with the PP genotypes were older at disease onset than those with the other genotypes (p = 0.001). Patients with the Xx genotype had an earlier onset of SLE than those with the xx genotype (p = 0.025). The frequency of the combined ppXx genotype was greater in childhood onset SLE than in controls (p(c) = 0.0009) or adult onset SLE (p(c) = 0.027). The same trend was supported by subgroup analyses according to age at menarche and logistic multivariate analyses.

CONCLUSIONS

ORalpha polymorphisms are significantly associated with the age at disease onset in Koreans with SLE.

The system design of UV-assisted catalytic oxidation process--degradation of 2,4-D

Unlike the conventional first- or second-order model, a novel approach to design for the removal of 2,4-dichlorophenoxy (2,4-D) by the UV-catalytic oxidation process (UVCOP) was investigated. Two distinctive parameters, initial decay rate and maximum oxidative capacity, were characterized. By using these parameters, the performance of the degradation of 2,4-D by UVCOP regarding to the reagent dosages could be successfully predicted. Low concentrations of ferrous ion was found to be a rate-limiting factor for the process while the dosage of hydrogen peroxide was concluded as a dominant species in determining the maximum oxidation capacities. This information can be used to optimize the treatment process and achieve the expected performance target; an "optimal-dose model" was developed accordingly. The model is an intelligent and useful tool to evaluate the optimal doses of hydrogen peroxide with the minimum dose of ferrous ion, which leads to a better design of the treatment process.

Impact of severe respiratory syndrome on anxiety levels of front-line health care workers

OBJECTIVE

To identify anxiety levels among front-line health care workers during the 2003 severe acute respiratory syndrome outbreak.

DESIGN

Questionnaire survey.

SETTING

Regional hospital, Hong Kong.

PARTICIPANTS

All hospital staff were given a questionnaire; administrative staff who had not had any patient contact served as controls.

MAIN OUTCOME MEASURES

Levels of contact with patients who had severe acute respiratory syndrome were measured and correlated with anxiety levels as determined by the State-Trait Anxiety Inventory.

RESULTS

Of 4252 questionnaires distributed between May and June 2003, 2040 (48.0%) were returned and 1926 (45.3%) were valid for analysis. Overall, 534 (27.7%) respondents had had contact with patients with severe acute respiratory syndrome. Anxiety scores ranged from 20 to 80, and mean (standard deviation) scores were higher among staff who had had contact with patients with severe acute respiratory syndrome than among those who had not (52.6 [10.5] versus 49.8 [10.1], respectively; P<0.01). Mean anxiety levels were higher among workmen, health care assistants, and nurses than among administrative staff controls or doctors (P<0.01). Anxiety scores were correlated with burnout scores (Pearson's correlation coefficient, 0.52-0.59) and with discomfort from wearing protective gear (0.21-0.32).

CONCLUSION

Severe acute respiratory syndrome has likely stressed the public health care system. Prediction and early identification of adverse factors in a crisis situation would allow early implementation of interventions to reduce and counteract the impact of this stress.

Simulation and fabrication of subwavelength structures for a nanometer feature enabling lens-less laser writers

A set-up was proposed to propagate submicrometer light beams without resorting to the conventional approach of using a lens. The main target was to develop a method of either by passing or circumventing the diffraction limit to develop a new optical head for a laser writer system with submicrometer resolution. Starting from using surface plasma theory to explain the mechanism of extraordinary transmission phenomenon, we move to discuss the fabrication processes for free-standing metal films and the corresponding transmission light beam images in the far field. A finite difference time domain (FDTD) method was adopted to simulate the electromagnetic field distribution of transmission light beams from the near field to the far field. The experimental results confirm that surface structures on the incident side of incoming light beams can excite surface plasma and enhance the throughput energy of transmission light beams. In addition, we also established that surface structures on the exit side can suppress the diffraction effect and make transmission light beams directional. The experimental and simulation results were found to agree well with each other, which validates the effectiveness of the FDTD simulation approach. As a free-standing film was too fragile to be of practical use, a proposition to develop a substrate-based nanostructured film to ease the construction of an optical head for a laser writer was developed.

Challenge model for Helicobacter pylori infection in human volunteers

BACKGROUND

A reliable challenge model is needed to evaluate Helicobacter pylori vaccine candidates.

METHODS

A cag pathogenicity island negative, OipA positive, multiple antibiotic susceptible strain of H pylori obtained from an individual with mild gastritis (Baylor strain 100) was used to challenge volunteers. Volunteers received 40 mg of famotidine at bedtime and 10(4)-10(10) cfu of H pylori in beef broth the next morning. Infection was confirmed by (13)C urea breath test ((13)C-UBT), culture, and histology. Eradication therapy was given four or 12 weeks post challenge and eradication was confirmed by at least two separate UBTs, as well as culture and histology.

RESULTS

Twenty subjects (nine women and 11 men; aged 23-33 years) received a H pylori challenge. Eighteen (90%) became infected. Mild to moderate dyspeptic symptoms occurred, peaked between days 9 and 12, and resolved. Vomitus from one subject contained >10(3) viable/ml H pylori. By two weeks post challenge gastric histology showed typical chronic H pylori gastritis with intense acute and chronic inflammation. The density of H pylori (as assessed by cfu/biopsy) was similarly independent of the challenge dose. A minimal infectious dose was not found. Gastric mucosal interleukin 8 levels increased more than 20-fold by two weeks after the challenge.

CONCLUSION

Challenge reliably resulted in H pylori infection. Infection was associated with typical H pylori gastritis with intense polymorphonuclear cell infiltration and interleukin 8 induction in gastric mucosa, despite absence of the cag pathogenicity island. Experimental H pylori infection is one of the viable approaches to evaluate vaccine candidates.

Thick aluminium nitride films deposited by room-temperature sputtering for ultrasonic applications

Materials in film form for electromechanical transduction have a number of potential applications in ultrasound. They are presently under investigation in flexural transducers for air-coupled ultrasound and underwater sonar operating at frequencies up to a few megahertz. At higher frequencies, they have the potential to be integrated with electronics for applications of ultrasound requiring high spatial resolution. However, a number of fabrication difficulties have arisen in studies of such films. These include the high temperatures required in many thick and thin film deposition processes, making them incompatible with other stages in transducer fabrication, and difficulties maintaining film quality when thin film--typically sub-1 microm--processes are extended to higher thicknesses. In this paper, we first outline a process which has allowed us to deposit aluminium nitride (AlN) films capable of electromechanical transduction at thicknesses up to more than 5 microm without substrate heating. As an ultrasonic transduction material, AlN has functional disadvantages, particularly a high acoustic velocity and weak electromechanical transduction. However, it also has a number of advantages relating to practicality of fabrication and functionality. These include the ability to be deposited on a variety of amorphous substrates, a very high Curie temperature, low permittivity, and low electrical and mechanical losses. Here, we present experimental results highlighting the transduction capabilities of AlN deposited on aluminium electrodes on glass and lithium niobate. We compare the results with those from standard simulation processes, highlighting the reasons for discrepancies and discussing the implications for incorporation of AlN into standard ultrasonic transducer design processes.

Surviving male with incontinentia pigmenti: a case report

Incontinentia pigmenti, or Block-Sulzberger Syndrome, is an X-linked dominant disorder with characteristic skin, hair, eye and tooth abnormalities. It is classically considered a male-lethal disorder with recurrent miscarriages of male foetuses. A few cases of surviving males with incontinentia pigmenti have been reported in the medical literature. This article reports the medical and dental findings of a boy diagnosed with incontinentia pigmenti.

Sorption of Cr(VI) and Cu(II) in aqueous solution by ethylenediamine modified rice hull

The sorption characteristics of Cr(VI) and Cu(II) by ethylenediamine modified rice hull from single and binary metal ion solutions were evaluated under various experimental conditions. Optimal Cr(VI) and Cu(II) removal from single metal ion solutions occurred at pH 2.0 and 5.5, respectively. Simultaneous removal of Cr(VI) and Cu(II) occurred at pH greater than 3.0. The sorption kinetics of Cr(VI) and Cu(II) from single and binary metal ion solutions were studied with reference to metal concentration, agitation rate and particle size. Sorption of Cr(VI) was more rapid than Cu(II). The kinetics of metal ion sorption fitted a pseudo-second order expression. The variation in the initial uptake rates was very small at an agitation rate beyond 150 rpm and sorption was generally independent of particle size. Equilibrium sorption data could be fitted into the Langmuir isotherm equation. Maximum sorption capacities of ethylenediamine modified rice hull for Cr(VI) at pH 2 and Cu(II) at pH 4 in single metal solutions were 0.45 and 0.06 mmol g(-1), respectively. This corresponds to an enhancement factor of 2.6 and 3 fold for Cr(VI) and Cu(II), respectively, compared to natural rice hull. A synergistic effect was observed for sorption of these ions in binary metal solutions.

Monitoring PAH-contaminated soil using laser-induced fluorescence (LIF)

The heterogeneity and opacity of soil matrices pose considerable challenges for the quantification of soil contaminants. In order to investigate the feasibility of applying the Laser-Induced Fluorescence technique to measure contamination levels of soils, statistical analyses of contaminant levels and intensity of fluorescence were investigated in relation to soil properties. A significant correlation (R2 > 0.97) between contaminant levels and intensity of fluorescence was shown under different matrix conditions, such as moisture content and particle size distribution. Higher fluorescence intensities were obtained from soils with higher sand and moisture content. The statistical results in relation to the interaction between fluorescence intensity and matrix properties rejected the hypothesis that all properties of the matrices and contaminants had an equal influence on fluorescence. This implied that the concentrations of contaminants had the greatest contribution to the fluorescence intensity, but other variables also showed a considerable influence.

Prevalence and specificity of clinically significant red cell alloantibodies in Chinese women during pregnancy--a review of cases from 1997 to 2001

Guidelines for the prevention and management of red cell alloantibodies during pregnancy, related to anti-D in particular, are well established in Caucasian populations. However, because of the racial difference of the blood group distribution, applicability to Chinese is unknown as a result of insufficient data on the prevalence and their outcome. In a retrospective review of 28,303 (21,327 Chinese) antenatal attendances from 1997 to 2001, 213 (0.79%) women were found to have a total of 230 irregular antibodies. About 137 (0.64%) were ethnic Chinese, and a total of 160 irregular antibodies were identified in their blood samples. About 58 of these Chinese women (0.27%) were found to have 66 clinically significant antibodies. There was only one case of anti-D detected in an Rh(D)-negative subject. Our study shows the overall prevalence of clinically significant antibodies in Chinese women, which was not different from that of the Western population. However, the specificities of the antibodies differ with the commonest antibodies encountered; these being anti-Mi (57.6%), anti-E (19.7%), anti-S (10.6%) and anti-c (7.6%). Neonatal jaundice was observed in 37 babies and 10 of them required phototherapy. The findings support the previous recommendation that routine antenatal antibody screening for Chinese women may not be worthwhile except in Rh(D)-negative subjects or those with an antecedent history of haemolytic disease of the newborn (HDN). The relative high incidence of anti-Mi in the present study and the local population, in general, may warrant a large-scale prospective study of pregnancy outcome in these subjects, especially in the light of the previous case reports of HDN because of anti-Mi.

Estimation of bacterial risk in extending the shelf life of PLT concentrates from 5 to 7 days

BACKGROUND

The use of bacterial culture to prevent bacterial contamination of blood components has renewed interest for extending the shelf life of PLT concentrates to 7 days after collection.

STUDY DESIGN AND METHODS

This study was therefore conducted to determine the residual risk of bacterial contamination in PLT concentrates at the end of 5 and 7 days after collection in a center where all PLT concentrates are routinely screened by taking samples on Day 2 for culture. PLT units with no growth after 48 hours were sampled a second time on Day 5 or Day 7 after collection, followed by inoculation into aerobic culture bottles. The inoculated bottles were then monitored for up to 7 days at 35 degrees C in an automatic monitoring and detection system.

RESULTS

During a 16-month study period, a total of 6020 PLT concentrates were tested 5 days (Group A, n=3010) and 7 days (Group B, n=3010) after collection. Four units in each group (0.133%) were found to be contaminated. In 6 units, bacteria were seen on direct Gram stain. In addition, 5 of the associated RBC units grew the same organisms on culture. The organisms include three coagulase-negative staphylococci and five Propionibacterium acnes. The positive rate of routine short-term bacterial culture was 0.035 percent during the same study period.

CONCLUSION

Despite routine short-term bacterial culture, a significant risk of bacterial contamination remains at 5 and 7 days after collection. For now, the shelf life of PLT concentrates should remain 5 days.

Copper vapour laser ID labelling on metal dentures and restorations

Denture marking is accepted as a means of identifying dentures and persons in geriatric institutions, or post-mortem during war, crimes, civil unrest, natural and mass disasters. Labelling on the acrylic resin component of the denture can easily be damaged or destroyed by fire but on cobalt-chromium components it would be more resistant. A copper vapour laser (CVL) can be used to label the cobalt-chromium components of dentures and metal restorations easily, and legibly, and miniaturised for the incorporation of more personal particulars necessary for the identification of the deceased person. The CVL beam is focussed by its optics and delivered to the material surface by the two-axis scanner mounted with mirrors. A personal computer controls the movement of the scanner and the firing of the CVL. The high peak power of the pulsed CVL is focussed to very high energy density producing plasma ablation of the alloy surface. Very fine markings of a few microns width can be produced enabling the storage of detailed information of the deceased person on a metal surface for the purpose of rapid identification.

Acid-activated spent bleaching earth as a sorbent for chromium (VI) in aqueous solution

Spent bleaching earth, an industrial waste produced after the bleaching of crude palm oil, was investigated for its potential in removing Cr(VI) from aqueous solution. The earth was treated with different amounts of sulfuric acid and under different activation temperatures. Results show that the optimum treatment process involved 10% sulfuric acid at 350 degrees C. The effects of contact time, pH, initial concentration, sorbent dosage, temperature, sorption isotherms and the presence of other anions on its sorption capacity were studied. Isotherm data could be fitted into a modified Langmuir isotherm model implying monolayer coverage of Cr(VI) on acid activated spent bleaching earth. The maximum sorption capacity derived from the Langmuir isotherm was 21.2 mg g(-1). This value was compared with those of some other low cost sorbents. Studies of anion effect on the uptake of Cr(VI) on acid activated spent bleaching earth provided the following order of suppression: EDTA >PO4(3-)>SO4(2-)>NO3(-)>Cl(-).

Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures

e analysed the CT scans and radiographs of 76 vertebrae in 49 patients who underwent vertebroplasty for painful osteoporotic compression fractures. Leaks of cement were classified into three types: those via the basivertebral vein (type B), via the segmental vein (type S), and through a cortical defect (type C). More leaks were identified on CT scans than on radiographs by a factor of 1.5 (74/49). Most type-B (93%) and type-S (86%) leaks were missed or underestimated on a lateral radiograph which is usually the only view used during the injection of cement. Of the leaks into the spinal canal, only 7% (2/28) were correctly identified on radiographs. The areas on lateral radiographs where this type of leak may be observed were divided into four zones, and their diagnostic value in predicting a leak into the spinal canal was evaluated. The results showed that cement in the neural foramina had the highest positive predictive value (86%).

Removal of Cu and Pb by tartaric acid modified rice husk from aqueous solutions

A study on the modification of rice husk by various carboxylic acids showed that tartaric acid modified rice husk (TARH) had the highest binding capacities for Cu and Pb. The carboxyl groups on the surface of the modified rice husk were primarily responsible for the sorption of metal ions. A series of batch experiments using TARH as the sorbent for the removal of Cu and Pb showed that the sorption process was pH dependent, rapid and exothermic. The sorption process conformed to the Langmuir isotherm with maximum sorption capacities of 29 and 108 mg/g at 27 +/- 2 degrees C for Cu and Pb, respectively. The uptake increased with agitation rate. Decrease in sorbent particle size led to an increase in the sorption of metal ions and this could be explained by an increase in surface area and hence binding sites. Metal uptake was reduced in the presence of competitive cations and chelators. The affinity of TARH for Pb is greater than Cu.

Impact of donor arm skin disinfection on the bacterial contamination rate of platelet concentrates

BACKGROUND AND OBJECTIVES

Despite improved methods for detecting bacterial contamination of blood products, bacterial sepsis remains a significant risk in blood transfusion. This study was undertaken to investigate whether adopting a different skin disinfection protocol could reduce the rate of bacterial contamination of platelet concentrates.

MATERIALS AND METHODS

Two skin disinfection protocols were consecutively used in the routine blood collection setting during two 10-month periods: 0.5% cetrimide/0.05% chlorhexidine solution followed by 70% isopropyl alcohol (first 10-month time-period); and 10% povidone-iodine followed by 70% isopropyl alcohol (second 10-month time-period). The rates of bacterial contamination of platelet concentrates were monitored by using a surveillance programme described previously.

RESULTS

The overall bacterial contamination rate in the first time-period was 0.072%. After introduction of the povidone-iodine and isopropyl alcohol protocol, the bacterial contamination rate decreased to 0.042% (relative risk reduction: -0.42; 95% confidence interval, -0.12 to -0.61, P= 0.009). There were no differences in the types of micro-organisms identified (P = 0.7).

CONCLUSIONS

Skin disinfection by povidone-iodine and isopropyl alcohol is more effective than that by cetrimide/chorhexidine and isopropyl alcohol in reducing venepuncture-associated contamination of platelet concentrates by skin flora. Our data indicate that the disinfection protocol should be used on a routine basis and such implementation should translate into a significant improvement in blood safety to patients receiving platelet transfusion.

Efficacy of enzyme immunoassay for the detection of Helicobacter pylori antigens in frozen stool specimens: local validation

AIM

To investigate the efficacy of measurement of Helicobacter pylori stool antigen (HpSA) using stored frozen stool specimens, and to assess whether there were factors affecting efficacy in Hong Kong.

METHODS

Patients undergoing upper endoscopy at Tuen Mun Hospital were recruited. Stool samples were saved for HpSA testing and questionnaires were completed. Stool samples were frozen immediately upon receipt and stored at -70 degrees C until tested. HpSA results were compared with rapid urease test and histology.

RESULTS

One hundred and eighty-one patients were recruited. One hundred and seventy-eight patients were suitable for analysis. Eighty-three were H. pylori positive and 95 were H. pylori negative. The mean duration of storage of the stool samples was 120 days (range, 40-225 days). The sensitivity, specificity and positive and negative predictive values were 84.3%, 97.9%, 97.2% and 88.6%, respectively. In patients with a false negative HpSA test, there was a significant delay in collecting the stool specimen after endoscopy when compared with those with a true positive HpSA test (4.2 vs. 2.3 days; P < 0.05). However, the duration of storage of the specimens was not longer, and consumption of coffee or tea and smoking habits were similar.

CONCLUSIONS

HpSA testing showed good sensitivity and specificity, even with frozen stool samples stored for up to 225 days. The efficacy was not affected by coffee, tea or smoking.

Does the extent of surgery have an impact on the survival of patients who receive postoperative radiation therapy for supratentorial low-grade gliomas?

We evaluate the impact of extent of surgery (EOS) on survival of patients with supratentorial nonpilocytic low-grade gliomas (LGG) treated with postoperative radiation therapy (PORT). Sixty-five patients with pathologically confirmed supratentorial nonpilocytic LGG (36 astrocytomas and 29 oligodendrogliomas) were treated with PORT after different extents of surgery: 12 gross total resections (GTR), 27 minimal or subtotal resections (MR/SR), and 26 biopsies (B). EOS was confirmed with postoperative imaging. The median radiation dose delivered was 5,940 cGy (range, 4,950-6,620 cGy). One of 12 patients (8%) in the GTR group and 12 of 53 patients (23%) in the less than GTR group demonstrated contrast enhancement. The median follow-up was 61 months (range 5-194 month). The 10-year overall survival (OS) was 82.5% and 32% for the GTR and the less than GTR groups, respectively (P = 0.0008). The corresponding 10-year disease-specific survival (DSS) was 90% and 41.4%%, respectively (P = 0.001). Multivariate analysis showed that only contrast enhancement and EOS were predictors for OS and DSS. Our data suggest that EOS correlates with OS and DSS in patients who have PORT. GTR should be the goal if technically achievable without causing significant morbidity, and its combination with PORT is compatible with long-term survival.

Application of narrow band laser ultrasonics to the nondestructive evaluation of thin bonding layers

In this paper, a modified laser induced grating technique (LIG) has been utilized to generate narrow band surface waves in an epoxy-bonded copper-aluminum layered structure. A high performance optical interferometer system was utilized to detect the laser-generated surface waves. The dispersion of surface wave in an epoxy-bonded copper-aluminum specimen was measured and compared with the theoretical solution. An inverse algorithm based on the simplex method was then introduced to determine the bonding thickness as well as the elastic properties of the bonding layer. The inversion results demonstrated that the thickness in the microm range or the elastic properties of the bonding layer could be successfully determined.

A dose escalation study for salvage chemotherapy in patients with refractory lymphoma prior to high-dose myeloablative therapy with stem cell transplantation

Chemosensitive response prior to transplantation has been shown to be most significant for survival post transplant. To estimate toxicity of a dose-intensive regimen that was to improve chemosensitive response rate, 15 patients with primary refractory lymphoma were enrolled in dose escalation of pre-transplant salvage chemotherapy. The first cycle had a fixed dose of ifosfamide 6 g/m2 and mitoxantrone 12 mg/m2, with arabinosyl cytosine (Ara-C) 2 g/m2, and methylprednisolone 2.0 g. Each cycle of the second and third had cisplatin 90 mg/m2, Ara-C 6 g/m2, methylprednisolone 2.0 g, and escalated doses of ifosfamide from 7.5 g/m2 to 15 g/m2 and mitoxantrone from 16 to 28 mg/m2. Blood stem cells were collected before the second cycle and > or = 3 x 10(6) CD34 cells/kg were infused 2 days after the second and third cycles, respectively. The maximum tolerated doses of ifosfamide and mitoxantrone were 11.25 g/m2 and 16 mg/m2, respectively. Acute renal failure and bacterial infection occurred as non-hematologic dose limiting toxicities. Eleven patients completed therapy. Five patients achieved complete remission and five had partial remission. Nine patients received autologous and four received allogeneic transplants. Currently, six are alive without evidence of disease, with a 3-year survival of 40%. Although preliminary, the regimen suggests acceptable toxicity and significant activity that warrants further study.

Streptococcus pneumoniae bacteremia in southern Taiwan

Streptococcus pneumoniae bacteremia was diagnosed in 33 patients between June 1999 and November 2000 at the Chang Gung Memorial Hospital-Kaohsiung in southern Taiwan. Antimicrobial susceptibility and serotyping of the clinical isolates were performed. Pneumonia was diagnosed in 19 patients, primary bacteremia in 13, and meningitis in one. The most common serotypes were types 14, 3, and 23F. Fourteen (42.4%) isolates of S. pneumoniae were non-susceptible to penicillin. High antimicrobial resistance rates were found to erythromycin (81.9%), tetracycline (69.7%), clindamycin (69.7%), trimethoprim-sulfamethoxazole (33.1%), and chloramphenicol (12.1%). The mortality was 42.4% and liver cirrhosis was an independent risk factor for mortality (odds ratio = 9.998; 95% confidence interval, 1.011-98.85; p=0.049). All isolated strains were covered by 23-valent the pneumococcal vaccine. Given the increasing prevalence of penicillin non-susceptible S. pneumoniae infection in the community, ongoing periodic monitoring of the evolutionary clinical situation is needed. Results of this study suggest that patients with liver cirrhosis should be inoculated with pneumococcal vaccine.

Acute thoracolumbar burst fractures: a new view of loading mechanisms

STUDY DESIGN

An in vitro investigation of loading mechanisms in acute thoracolumbar burst fractures.

OBJECTIVES

To assess the validity of the authors' hypothesis that anterior shear forces transmitted by the facet joints are responsible for causing the severe canal compromise associated with acute thoracolumbar burst fractures.

SUMMARY OF BACKGROUND DATA

Thoracolumbar burst fractures created in the laboratory rarely match the severity of clinical cases. To date, no studies have examined in great detail the role of facet joint loading in the burst-fracture mechanism. An incomplete understanding of loading mechanisms may contribute to the controversies regarding management.

METHODS

Nine human cadaveric motion segments were instrumented with strain gages and subjected to axial compression or axial impact coupled with an extension moment. Failure loads, strain information, and radiographs were collected.

RESULTS

Fracture patterns characteristic of acute thoracolumbar burst fractures were observed in the three specimens tested with an extension moment. In this group, high strains were also recorded at the bases of the pedicles, indicating a probable site of fracture initiation. Specimens tested in a neutral orientation experienced crush fractures without an increase in interpedicular distance. Strain patterns were more uniform in this group.

CONCLUSIONS

The severity and clinical relevance of the injuries sustained by the specimens tested in extension suggest that facet joint loading plays a critical role in the acute thoracolumbar burst-fracture loading mechanism. Fracture patterns and strain concentrations are in agreement with clinical observations as well as past experimental studies.

A comparison of the supra-alveolar pulp size of impeded and unimpeded mandibular rat incisors using micro-computed tomography

The pulp space is almost totally obliterated in the incisal end of a mandibular rat incisor. Repeated shortening of the incisor has been shown to increase the pulp space below the alveolar bone level; however, little is known about that above the alveolar bone level. This study investigated the changes in the pulp space superior to the bone level after rendering the incisor unimpeded for a period of three weeks. A desktop micro-computed tomography scanning unit, which is non-invasive, non-destructive, accurate, less technique sensitive and less time consuming than conventional methods, was used to calculate the volume of the pulp space. The results showed that the pulp size increased 140% at a level 3 mm below the alveolar bone margin and more than 700% at a level 2.5 mm above the alveolar bone. Moreover, the bone level of the unimpeded incisor was found to move incisally 0.4-0.5 mm; while deposition of dentine on the mesial and distal aspects of the pulp space were affected differently to that on the buccal and lingual sides.

Comparison of the efficacy and safety of naproxen CR and nabumetone in the treatment of patients with osteoarthritis of the knee

OBJECTIVE

To comparre the safety and efficacy of naproxen CR (1,000 mg once daily) with that of nabumetone (1,000 mg once daily) in the treatment of patients with symptomatic knee osteoarthritis(OA).

METHODS

A total of 159 Korean patients (80 in the naproxen CR group and 79 in the nabumetone group) were enrolled in this 4-week, single-blind, controlled, randomized, parallel study and an intention-to-treat model was used for data analysis. Six efficacy parameters were measured: Lequesne index, visual analogue pain scale at rest and atactivity, patient's and physician's global assessment, and time to walk 50 feet.

RESULTS

Significant improvement in all efficacy parameters except time to walk 50 feet occurred at Week 2 and Week 4 in both groups. Themean improvement from baseline at Week 2 and Week 4 for the efficacy variables was not different between naproxen CR and nabumetone group. Twenty-four patients (30%) in the naproxen CR group and 18 patients (22.8%) in the nabumetone group withdrew from the study. Among them, only 1patient in the naproxen CR group terminated the study prematurely due to an adverse event of dyspepsia. No statistically significant difference in the frequency of adverse events, including gastrointestinal symptoms, was observed between these 2 groups during the treatment period. Significant laboratory abnormalities also did not occur during the study period in both groups.

CONCLUSIONS

Naproxen CR is an effective and tolerable drug in the treatment of knee OA. Efficacy and safety profiles are comparable to those of nabumetone.

Two ethyl 2-deoxy-alpha-D-hexo-3,7-pyranoso-3-octulosonate derivatives

In each of the two pyranoid sugars, ethyl 2-deoxy-4,5,6,8-tetra-O-acetyl-alpha-D-gluco-3,7-pyranoso-3-octulosonate, C18H26O12, and ethyl 2-deoxy-4,5,6,8-tetra-O-benzyl-alpha-D-galacto-3,7-pyranoso-3-octulosonate, C38H42O8, the anomeric configuration is alpha. The acetoxymethyl substituent on the hexopyranose ring of the former compound and the ethoxycarbonylmethyl substituents in both sugars all have the gauche-trans conformation, while the benzyloxymethyl substituent of the galactopyranose sugar has the trans-gauche conformation. In each structure, the anomeric hydroxy group forms an intramolecular hydrogen bond with the carbonyl O atom of the ethoxycarbonylmethyl substituent.

Two halodeoxy sucrose analogues

At 160 K, the structure of 4-bromo-4-deoxysucrose, C(12)H(21)BrO(10), is very similar to that of sucrose, particularly with respect to the conformation of the glycosidic linkage. As in sucrose, an intramolecular hydrogen bond exists between the glucopyranosyl and the fructofuranosyl rings. Conversely, the structure of 1',6'-dibromo-4-fluoro-4,1',6'-trideoxysucrose monohydrate, C(12)H(19)Br(2)FO(8) x H(2)O, shows large conformational differences when compared with the structures of both sucrose and sucralose. This compound does not exhibit any intramolecular hydrogen bonds. In each compound, a complex series of intermolecular hydrogen bonds link the molecules into an infinite three-dimensional framework. The absolute configuration of each molecule has been determined.

Spinal deformities in Noonan syndrome: a clinical review of sixty cases

BACKGROUND

Skeletal abnormalities, including spinal deformities, in Noonan syndrome have been described, but no detailed and systematic study of such spinal deformities has been presented in the literature.

METHODS

The cases of sixty patients with Noonan syndrome were reviewed retrospectively, and the general appearance, growth disturbance, and mental status of the patients were documented. Spinal deformities were evaluated radiographically, and the frequency, pattern, and severity of the curves were documented.

RESULTS

Spinal deformity was present in eighteen (30%) of the sixty patients. Two patients had congenital spinal deformity. Of the remaining sixteen patients with scoliosis, nine had a single thoracic curve, four had a single thoracolumbar curve, and three had a double major curve. Thoracic lordosis was also present in three of these sixteen patients. No patient had only increased kyphosis or lordosis. The mean age when the spinal deformities were detected was nine years; seven deformities were detected before the age of seven years. Overall, surgery was recommended to eleven of the eighteen patients; it was recommended for the treatment of scoliosis (mean, 68.5 degrees; range, 45 degrees to 125 degrees ) in eight patients and for the treatment of an associated thoracic lordosis (8 degrees, 15 degrees, and 18 degrees ) in three. Seven of the eleven patients underwent spinal arthrodesis. The operation was deferred in one patient because malignant hyperthermia developed during the induction of anesthesia.

CONCLUSIONS

Scoliosis with an associated thoracic lordosis occurs more frequently in Noonan syndrome than has been reported previously. Since the deformities tend to develop early and are relatively severe, a clinical and, if necessary, radiographic assessment of the spine with careful follow-up should be performed for early detection and treatment of spinal deformity. Although malignant hyperthermia is rare, all patients with Noonan syndrome should be considered to be at risk for the development of this complication before operative treatment.

Dynamic sagittal imbalance of the spine in degenerative flat back: significance of pelvic tilt in surgical treatment

STUDY DESIGN

A retrospective study of 26 patients with degenerative flat back treated with corrective osteotomy.

OBJECTIVE

To analyze dynamic sagittal imbalance and to elucidate the cause of postoperative persistent stooping in degenerative flat back.

SUMMARY OF BACKGROUND DATA

Sagittal spinal imbalance in degenerative flat back was more evident on walking, suggesting its dynamic nature. The most puzzling complication in its surgical treatment was postoperative persistent stooping.

METHODS

This study analyzed 26 surgically treated patients with preoperative gait analysis. Patients were divided into two groups according to postoperative improvement in stooping: Group 1 with marked improvement in stooping and Group 2 with persistent stooping. Various radiographic and gait parameters were compared between the two groups.

RESULTS

Comparison of radiographic parameters, representing the static status of the spine, did not indicate any clue to the mechanism for persistent stooping. However, comparison of gait parameters, representing the dynamic status of the spine, revealed meaningful differences between the two groups. Among various gait parameters compared, pelvic tilt seemed to be the most important clue. Patients in Group 1 showed posterior pelvic tilt, whereas those in Group 2 showed marked anterior pelvic tilt.

CONCLUSION

Degenerative flat back could be classified into two types based on pelvic position during walking: one with posterior pelvic tilt and the other with marked anterior pelvic tilt. In the former type, corrective surgery improved the stooping. In the latter, corrective surgery was ineffective, resulting in postoperative persistent stooping.

Sterilizing immunity against experimental Helicobacter pylori infection is challenge-strain dependent

The development of a murine model of Helicobacter pylori infection through serial in vivo passage of candidate strains has enabled a quantitative assessment of vaccine efficacy. In this study we compare infection with and protection against challenge from both CagA(+) type I, and CagA(-) type II in vivo adapted isolates. In vivo passage of a type II H. pylori isolate resulted in a highly infectious strain (X47-2AL), capable of reproducibly infecting mice to high density (10(7) CFU/g of gastric tissue). Similarly adapted type I strains were found to colonize mice at a significantly lower level (10(4)-10(5) CFU/g tissue). Mucosal immunization with recombinant urease (rUre) significantly protected animals against both types. Protection against X47-2AL was characterized by a > or =100-fold (or 2 log) reduction in bacterial density. However, the presence of a residual infection highlighted the inability to achieve sterilizing immunity against this strain. The level of protection appeared independent of challenge dose, and was stable for up to 6 months, all animals exhibiting a low-level residual infection that did not recrudesce with time. Similarly immunized mice challenged with isolates representing the residual infection were also protected, confirming that they did not represent a sub-population of H. pylori that could escape immunity. Immunization and challenge studies with type I adapted-isolates, demonstrated a similar 2-3 log reduction in the bacterial burden, but that in this instance resulted in sterilizing immunity. These results suggest varied specificity for the murine host by different Helicobacter strains that can influence the outcome of both infection and immunity.

3-O-acetyl-4-deoxy-4-iodo-beta-D-fructofuranosyl 2,3,6-tri-o-acetyl-4-chloro-4-deoxy-alpha-D-glucopyranoside

At 160 K, the glucopyranosyl ring of the title compound, C(20)H(28)ClIO(13), has a near-ideal (4)C(1) conformation and the fructofuranosyl ring has a twist (4)T(3) conformation. The two hydroxy groups are involved in intra- and intermolecular hydrogen bonds, with the latter interactions linking the molecules into infinite one-dimensional chains. The absolute configuration of the molecule has been determined.

Late onset post-transplantation lymphoproliferative disease of recipient origin following cytogenetic relapse and occult autologous haematopoietic regeneration after allogeneic bone marrow transplantation for acute myeloid leukaemia

A post-transplantation lymphoproliferative disease (PTLD) of recipient origin was identified in one of 376 consecutive cases of allogeneic bone marrow transplantation (BMT). This occurred in a 36-year-old woman who received an allogeneic BMT for acute myeloid leukaemia in relapse. At 15 months after BMT, recipient haematopietic and leukaemic cells were found in the bone marrow, which disappeared on withdrawal of immunosuppression. However, severe graft-versus-host disease (GVHD) necessitated the continuation of immunosuppression, leading to the occurrence of PTLD in the liver and lung 12 months afterwards. Fluorescence in situ hybridisation showed that the neoplastic cells were of recipient origin. Although the PTLD also responded completely to withdrawal of immunosuppression, the patient finally died from the complications of GVHD. This case of late onset PTLD post-BMT showed features similar to those in solid organ transplantation, in that the tumour was of recipient origin and responded well to the withdrawal of immunosuppression. Of further interest is that recipient lymphoid regeneration had accompanied autologous haematopoietic regeneration and become a target for subsequent neoplastic transformation.

Emergence of YMDD motif mutant of hepatitis B virus during short-term lamivudine therapy in South Korea

BACKGROUND/AIMS

The emergence of a YMDD mutant resistant to lamivudine therapy has been reported in patients with hepatitis B treated with long-term lamivudine therapy. However, it is not well known whether the YMDD mutant could be detected early in lamivudine therapy in hepatitis B virus (HBV) endemic areas. The aim of this study was to investigate the emergence of the YMDD mutant during short-term lamivudine therapy in South Korea.

METHODS

We prospectively investigated the emergence of the YMDD mutant by the nested PCR assay using restriction fragment length polymorphism in 28 patients with chronic hepatitis B who were treated with 100 mg of lamivudine daily for 12 weeks.

RESULTS

The YMDD mutant was detected in 17 (60.7%) out of 28 patients at week 12, and the only type of mutation found was the YIDD mutation. When we carried out the nested PCR serially in five patients, YIDD mutants were detected as early as 2 weeks by the nested PCR assay. The nested PCR results were in concordance with DNA sequencing in one patient's serial samples.

CONCLUSIONS

YMDD mutants in HBV were detected within a few weeks during lamivudine therapy in South Korea, which suggests that the YMDD mutant may exist even before lamivudine therapy in HBV endemic areas.

Inhibitory effects of ethaverine, a homologue of papaverine, on monoamine oxidase activity in mouse brain

The effects of benzylisoquinoline compounds such as ethaverine, laudanosine, and tetrahydropapaverine on monoamine oxidase (MAO, EC 1.4.3.4) activity in mouse brain were investigated. Ethaverine showed an inhibition of MAO activity in a concentration-dependent manner (57.6% inhibition at 40 microm). Papaverine also inhibited MAO activity (38.1% inhibition at 40 microM). However, laudanosine and tetrahydropapaverine did not inhibit MAO activity. The IC50 value of ethaverine for MAO was 25.5 microm. Ethaverine non-competitively inhibited MAO activity with a substrate kynuramine. The Ki value for ethaverine was 11.9 microM. In addition, ethaverine proved to preferentially inhibit type B MAO activity in a concentration-dependent manner, with an IC50 value of 32.8 microm. These results suggest that ethaverine partially contributes to the regulation of catecholamine content.