Dose-dependent toxicity of a commercially available demineralized bone matrix material

STUDY DESIGN

A relative risk assessment was performed to determine the safety of three commercially available Grafton demineralized bone matrix quantities used in athymic rats.

OBJECTIVE

To evaluate the possible dose-dependent adverse effects of a commercially available demineralized bone matrix containing glycerol.

SUMMARY OF BACKGROUND DATA

Commercially available Grafton demineralized bone matrix contains glycerol. The toxic effects of glycerol leading to acute renal failure have been documented. The toxicity of this glycerol-containing substance in higher doses has not been reported.

METHODS

Three doses of Grafton putty were implanted in the upper hind limb muscles of athymic nude rats. The rats were observed for adverse effects and early death. Histologic studies were performed.

RESULTS

All eight of the rats implanted with the highest dose of Grafton putty (0.008 mL/g) died, five of them within 12 hours of implantation and three in 48 to 72 hours. One rat with the intermediate dose (0.004 mL/g) died within 12 hours of implantation. By 72 hours after implantation, three of the six rats (50%) with the intermediate dose had died. All six of the rats receiving the lowest dose (0.002cc/g) survived. The median lethal dose of Grafton putty in athymic rats was estimated to be 0.00469 mL/g body weight. Histologic analysis of the animals that received the high dose showed acute tubular necrosis, probably secondary to rhabdomyolysis.

CONCLUSIONS

In athymic rats, large amounts of Grafton putty lead to death in a dose-dependent manner. Because the median lethal doses of Grafton putty (0.00469 mL/g) and glycerol (0.00442 mL/g) are comparable, a potential source of toxicity is the glycerol contained in the material. The results of this study suggest that high doses have the potential to cause acute renal failure. The authors suggest that clinical usage of Grafton putty in humans should be limited to no more than 2 mL/kg body weight of this material.

Bounds on the CP asymmetry in b --> sgamma decays

We have measured the CP asymmetry A(CP) identical with[gamma(b-->sgamma)-gammab-->sgamma)]/[gamma(b-->sgamma)+gamma(b-->sgamma)] to be A(CP) = (-0.079+/-0.108+/-0.022) (1.0+/-0.030), implying that, at 90% confidence level, A(CP) lies between -0.27 and +0.10. These limits rule out some extreme non-standard-model predictions, but are consistent with most, as well as with the standard model.

A comparison of fusion rates between single-level cervical corpectomy and two-level discectomy and fusion

A single corpectomy and strut grafting has been proposed as an alternative to performing two-level adjacent discectomies with multiple grafts to produce superior fusion rates. The purpose of this study was to compare the clinical and radiographic success of two-level discectomy and fusion with anterior cervical plate fixation compared with a single-level corpectomy. Fifty-two patients were treated with either a two-level adjacent anterior cervical discectomy and fusion with cervical plating, or by a single-level corpectomy and plate. Thirty-two patients had two-level discectomies, whereas 20 had a single corpectomy and a strut graft (average follow-up was 3.6 years). One patient had a pseudarthrosis from a single-level corpectomy and required subsequent surgery to obtain an osseous union. The fusion rates between the two groups was not statistically significant (p = 0.385). The clinical results of the surgeries were similar between the groups based on Odom's criteria. The addition of cervical plates to either two-level discectomies or single-level corpectomies yielded similar fusion and complication rates.

Bounds on the CP asymmetry in like-sign dileptons from B(0)B*(0) meson decays

We have measured the charge asymmetry in like-sign dilepton yields from B(0)B*(0) meson decays using the CLEO detector at the Cornell Electron Storage Ring. We find a(0)(ll) identical with[N(l(+)l(+))-N(l(-)l(-))]/[N(l(+)l(+))+N(l(-)l(-))] = +0.013+/-0.050+/-0.005. We combine this result with a previous, independent measurement and obtain Re(epsilon(B))/(1+ the absolute value of epsilon(B)(2)) = +0.0035+/-0.0103+/-0.0015 (uncertainties are statistical and systematic, respectively) for the CP impurity parameter, epsilon(B).

Study of tau decays to six pions and a neutrino

The tau decays to six-pion final states have been studied with the CLEO detector at the Cornell Electron Storage Ring. The measured branching fractions are B(tau(-)-->2pi(-)pi(+)3pi(0)nu(tau)) = (2.2+/-0.3+/-0.4)x10(-4) and B(tau(-)-->3pi(-)2pi(+)pi(0)nu(tau)) = (1.7+/-0.2+/-0.2)x10(-4). A search for substructure in these decays shows that they are saturated by intermediate states with eta or omega mesons. We present the first observation of the decay tau(-)-->2pi(-)pi(+)omega(nu)tau and the branching fraction is measured to be (1.2+/-0.2+/-0.1)x10(-4). The measured branching fractions are in good agreement with the isospin expectations but somewhat below the conserved-vector-current predictions.

Observation of new states decaying into Lambda+(c)pi(-)pi(+)

Using 13.7 fb(-1) of data recorded by the CLEO detector at the Cornell Electron Storage Ring, we investigate the spectrum of charmed baryons which decay into Lambda+(c)pi(-)pi(+) and are more massive than the Lambda+(c)(2625) baryon. We find evidence for two new states: one is broad and has an invariant mass roughly 480 MeV above that of the Lambda+(c) baryon; the other is narrow with an invariant mass of 596+/-1+/-2 MeV above the Lambda+(c) mass.

Mice lacking DNA topoisomerase IIIbeta develop to maturity but show a reduced mean lifespan

Targeted gene disruption in the murine TOP3beta gene-encoding DNA topoisomerase IIIbeta was carried out. In contrast to the embryonic lethality of mutant mice lacking DNA topoisomerase IIIalpha, top3beta(-/-) nulls are viable and grow to maturity with no apparent defects. Mice lacking DNA topoisomerase IIIbeta have a shorter life expectancy than their wild-type littermates, however. The mean lifespan of the top3beta(-/-) mice is about 15 months, whereas that of their wild-type littermates is longer than 2 years. Mortality of the top3beta(-/-) nulls appears to correlate with lesions in multiple organs, including hypertrophy of the spleen and submandibular lymph nodes, glomerulonephritis, and perivascular infiltrates in various organs. Because the DNA topoisomerase III isozymes are likely to interact with helicases of the RecQ family, enzymes that include the determinants of human Bloom, Werner, and Rothmund-Thomson syndromes, the shortened lifespan of top3beta(-/-) mice points to the possibility that the DNA topoisomerase III isozymes might be involved in the pathogenesis of progeroid syndromes caused by defective RecQ helicases.

Evidence of New States Decaying into Xi(*)(c)pi

Using 13.7 fb(-1) of data recorded by the CLEO detector at Cornell Electron Storage Ring, we report evidence of two new charmed baryons: one decaying into Xi(0')(c)pi(+) with the subsequent decay Xi(0')(c)-->Xi(0)(c)gamma, and its isospin partner decaying into Xi(+')(c)pi(-) followed by Xi(+')(c)-->Xi(+)(c)gamma. We measure the following mass differences for the two states: M(Xi(0)(c)gammapi(+))-M(Xi(0)(c)) = 318.2+/-1.3+/-2.9 MeV and M(Xi(+)(c)gammapi(-))-M(Xi(+)(c)) = 324.0+/-1.3+/-3.0 MeV. We interpret these new states as the J(P) = 1 / 2(-) Xi(c1) particles, the charmed-strange analogs of the Lambda(+)(c1)(2593).

A biological phosphorus removal potential test for wastewaters

A simple test was proposed to assess whether phosphorus in a wastewater can be removed using a biological phosphorus removal (BPR) process. The test includes the measurement of phosphorus release during 2 hours of the anaerobic stage in a batch reactor containing phosphorus-accumulating organisms (PAOs) and estimation of the effluent phosphorus concentration using biochemical relationships. The BPR potential test developed allowed for the successful evaluation of BPR feasibility for five wastewater samples. The BPR potential test was validated by comparing the test results with the effluent phosphorus concentrations measured in a sequencing batch reactor (SBR). An effluent phosphorus concentration of 1.9 mg P/L predicted for the BPR potential test performed was close to the effluent phosphorus concentration of 1.8 mg P/L obtained from an SBR on the same day. During the anaerobic stage, phosphorus release was significantly affected by the sludge concentration initially, but became insignificant after 2 hours. The initial sludge concentration affected the phosphorus release rate; thus, it is recommended that the BPR potential test be conducted at a target mixed liquor volatile suspended solids concentration. It is also recommended that the BPR potential test be conducted at the site where the PAO-containing sludge is available and the wastewater sample can be delivered at 4 degrees C in less than 24 hours. The PAOs in different sludges had almost identical phosphorus release after 2 hours; however, the characteristics of facultative bacteria in sludges affected the phosphorus release. If the wastewater is prefermented for at least 3 days before the BPR potential test, the amount of phosphorus released by various PAO-containing sludges is expected to be identical.

Antimutagenicity of extracts of Hericium erinaceus

Hericium erinaceus is valuable in the diet and in medical treatment. It contains water-soluble polysaccharides that have been found to enhance immunity and which show anti-artificial pulmonary metastatic tumor effects. In this study, water and ethanol extracts of the mycelium and fruiting body of Hericium erinaceus were examined by the Ames test using Salmonella typhimurium TA98 to screen for antimutagenic effects against 5 mutagens: AFB1, B[a]P, Glu-P-1, NQNO, and Trp-P-1. We found that both extracts have the strongest antimutagenic activity against Trp-P-1, followed by Glu-P-1, B[a]P-1, AFB1, and finally NQNO. In addition, the antimutagenicity of the extracts was produced in a concentration-dependent manner. At a concentration of 200 ppm, both extracts showed the highest inhibitory action. However, the linear correlation indicated that concentration-activity relationship was not significant (p > 0.05). In addition, extracts showed less antimutagenicity after heat treatment (p < 0.05). This suggests that the antimutagenicity of the extracts is heat-labile. The ethanol extract from mycelium or fruiting body had better antimutagenic effects than did the water extract (p < 0.05). Also, the extract from the fruiting body had better antimutagenic effects than did that from the mycelium.

Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features

We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers.

Observation of B --> phiK and B --> phiK*

We have studied two-body charmless hadronic decays of B mesons into the final states straight phiK and phiK(*). Using 9.7 million B&Bmacr; pairs collected with the CLEO II detector, we observe the decays B- --> phiK- and B0--> phiK(*0) with the following branching fractions: B(B--->phiK-) = (5.5(+2.1)(-1.8)+/-0.6)x10(-6) and B(B0--> phiK(*0)) = (11.5(+4.5+1.8)(-3.7-1.7))x10(-6). We also see evidence for the decays B0-->phiK0 and B---> phiK(*-). However, since the statistical significance is not overwhelming for these modes, we determine upper limits of <12.3x10(-6) and <22.5x10(-6) ( 90% confidence level), respectively.

Observation of the Omega(0)(c) Charmed Baryon at CLEO

The CLEO experiment at the CESR collider has used 13.7 fb(-1) of data to search for the production of the Omega(0)(c) (css ground state) in e(+)e(-) collisions at square root of (s) approximately 10.6 GeV. The modes used to study the Omega(0)(c) are Omega(-)pi(+), Omega(-)pi(+)pi(0), Xi-K-pi(+)pi(+), Xi0K-pi(+), and Omega(-)pi(+)pi(+)pi(-). We observe a signal of 40.4+/-9.0(stat) events at a mass of 2694.6+/-2.6(stat)+/-1.9(syst) MeV/c(2), for all modes combined.

Search for B --> tau(nu) and B --> K(nu)nu

We report results of a search for B-->tau(nu) in a sample of 9.7 x 10(6) charged B meson decays. We exclusively reconstruct the companion B decay to suppress background. We set an upper limit on the branching fraction B(B-->tau(nu))<8.4 x 10(-4) at 90% confidence level. We also establish B(B+/--->K+/-nu(nu))<2.4 x 10(-4) at 90% confidence level.

Measurement of the relative branching fraction of upsilon(4S) to charged and neutral B-meson pairs

We analyze 9.7x10(6) B_B pairs recorded with the CLEO detector to determine the production ratio of charged to neutral B-meson pairs produced at the Upsilon(4S) resonance. We measure the rates for B0-->J/psiK((*)0) and B+-->J/psiK((*)+) decays and use the world-average B-meson lifetime ratio to extract the relative widths f(+-) / f(00) = gamma(Upsilon(4S)-->B+B-) / gamma(Upsilon(4S)-->B0 B-0)) = 1.04+/-0.07(stat)+/-0.04(syst). With the assumption that f(+-)+f(00) = 1, we obtain f(00) = 0.49+/-0.02(stat)+/-0.01(syst) and f(+-) = 0.51+/-0.02(stat)+/-0.01(syst). This production ratio and its uncertainty apply to all exclusive B-meson branching fractions measured at the Upsilon(4S) resonance.

First observation of the decays B(0) --> D(*-)p_p pi+ and B(0) --> D(*-)p_n

We report the first observation of exclusive decays of the type B-->D(*)N_NX, where N is a nucleon. Using a sample of 9.7x10(6)B_B pairs collected with the CLEO detector operating at the Cornell Electron Storage Ring, we measure the branching fractions B(B0-->D(*-)p_p pi(+)) = (6.5(+1.3)(-1.2)+/-1.0)x10(-4) and B(B0-->D(*-)p_n) = (14.5(+3.4)(-3.0)+/-2.7)x10(-4). Antineutrons are identified by their annihilation in the CsI electromagnetic calorimeter.

Increased fusion rates with cervical plating for three-level anterior cervical discectomy and fusion

STUDY DESIGN

A retrospective review of all patients surgically treated by a single surgeon with a three-level anterior cervical discectomy and fusion with and without anterior plate fixation.

OBJECTIVES

To compare the clinical and radiographic success of anterior three-level discectomy and fusion performed with and without anterior cervical plate fixation.

SUMMARY OF BACKGROUND DATA

Previous studies of multilevel cervical discectomies and fusions have shown fusion rates to decrease as the number of surgical levels increases. Anterior cervical plate stabilization can provide more stability and may increase fusion rates for multilevel fusions.

METHODS

Over a 7-year period, 59 patients were treated surgically with a three-level anterior cervical discectomy and fusion by the senior author. Forty patients had cervical plates, whereas 19 had fusions with no plates. These patients were observed for an average of 3.2 years. Clinical and radiographic follow-up data were obtained.

RESULTS

Of the 59 patients, 14 had a pseudarthrosis (7 in each group). The pseudarthrosis rates were 18% (7 of 40) for patients with plating and 37% (7 of 19) for patients with no plating. Although the nonunion rate for unplated fusions was double that of plated fusions, this difference was not statistically significant. There was no statistically significant correlation between pseudarthrosis and gender, age, level of surgery, history of tobacco use, or previous anterior surgery. The fusion rates were improved with the use of a cervical plate. Inferior clinical results were demonstrated in patients with a pseudarthrosis, regardless of the use of a cervical plate.

CONCLUSIONS

The addition of plate fixation for three-level anterior cervical discectomy and fusion is a safe procedure and does not result in higher complication rates. In this study, the pseudarthrosis rate was lower for patients with a cervical plate. However, this difference was not statistically significant. Patients treated with cervical plating had overall better results when compared with those of patients treated without cervical plates. Although the use of cervical plates decreased the pseudarthrosis rate, a three-level procedure is still associated with a high nonunion rate, and other strategies to increase fusion rates should be explored.

Measurement of the lambda(+)(c) lifetime

The Lambda+c lifetime is measured using 9.0 fb(-1) of e+e- annihilation data collected on or just below the Upsilon(4S) resonance with the CLEO II.V detector at CESR. Using an unbinned maximum likelihood fit, the Lambda+c lifetime is measured to be 179.6+/-6.9(stat)+/-4.4(syst) fs. The precision of this colliding beam measurement is comparable to other measurements, which are based on fixed-target experiments, with different systematic uncertainties.

Carotid Stump Syndrome: Outcome from Surgical Management

OBJECTIVES

in patients with occluded internal carotid arteries the carotid stump is a potential source of microemboli resulting in the persistence of retinal or cerebral ischaemic symptoms. We report 25 patients who had persistent cerebral and retinal ischaemic symptoms with an occluded ipsilateral ICA and a carotid stump who underwent surgical exclusion of the stump.

METHODS

between January 1988 and January 1998, 332 patients underwent carotid endarterectomy. Twenty-five patients (20 males: five females; mean age 58.9 (range 44-78 years)) had carotid stump exclusion. Indications for surgery were transient ischaemic attack (22), amaurosis fugax (eight) and cerebrovascular accident (13). Three patients had undergone contralateral carotid endarterectomy and 12 had significant contralateral stenosis. Twenty patients were being treated with aspirin and four with warfarin at the time of presentation.

RESULTS

the diagnosis of carotid stump was made in 22 patients by angiography. In the remaining three patients duplex alone was diagnostic in two patients. In the third case duplex was combined with magnetic resonance angiography (MRA) to confirm the diagnosis. Stump exclusion was carried out by oversewing the ICA origin. All but one patient remained symptom free at follow-up.

CONCLUSION

carotid stump syndrome should be considered as a likely clinical entity in patients with an occluded ICA and persisting cerebral and retinal microembolic symptoms. Surgical exclusion of the carotid stump is a safe and effective method of treatment.

Unusual appearance of an en plaque meningioma of the cervical spinal canal. A case report and literature review

STUDY DESIGN

A case report of a patient with cervical spinal cord and nerve root compression caused by a meningioma en plaque together with calcification of the posterior longitudinal ligament is presented,with a review of the literature.

OBJECTIVE

To present the diagnosis of a calcified dural meningioma en plaque, with extradural extension into the ligamentum flavum, in a woman with cervical myelopathy and neuropathy.

SUMMARY OF BACKGROUND DATA

This case demonstrates that the cervical spine can be involved in dural meningioma en plaque with calcifications, in a manner mimicking ossification of the ligamentum flavum, which has never been previously reported.

METHODS

A patient presenting with cervical cord and nerve root compression caused by ossification of the posterior longitudinal ligament and a concurrent calcified dural meningioma en plaque was treated surgically and has made a gradual recovery. Imaging studies,surgical findings, and histopathologic evaluation were analyzed to support the diagnosis.

RESULTS

At surgery, ossification of the posterior longitudinal ligament was noted, along with a calcified lesion involving the posterior cervical dura and the adjacent ligamentum flavum. A calcified meningioma was diagnosed by histopathologic examination of the dural-based lesion.

CONCLUSION

Although previously not described, the diagnosis of calcified dural meningioma en plaque should be considered in all patients presenting with spinal cord and/or nerve root compression,even at cervical levels. Although ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum are more common etiologies of partially circumferential spinal calcification, dural-based meningiomas with extension into the surrounding ligaments demand early recognition because they can be associated with a poorer prognosis.

First observation of the sigma(*+)(c) baryon and a new measurement of the sigma(*+)(c) mass

Using data recorded with the CLEO II and CLEO II.V detector configurations at the Cornell Electron Storage Rings, we report the first observation and mass measurement of the Sigma(*+)(c) charmed baryon, and an updated measurement of the mass of the Sigma(+)(c) baryon. We find M(Sigma(*+)(c))-M(Lambda(+)(c)) = (231.0+/-1.1+/-2.0) MeV, and M(Sigma(+)(c))-M(Lambda(+)(c)) = (166.4+/-0.2+/-0.3) MeV, where the errors are statistical and systematic, respectively.

Study of B Decays to Charmonium States: B-->eta(c)K and B --> chi(c0)K

In a sample of 9.66x10(6)B&Bmacr; pairs collected with the CLEO detector we make the first observation of B decays to an eta(c) and a kaon. We measure branching fractions B(B+-->eta(c)K+) = (0.69(+0.26)(-0.21)+/-0.08+/-0.20)x10(-3) and B(B degrees -->eta(c)K degrees ) = (1.09(+0.55)(-0.42)+/-0.12+/-0.31)x10(-3), where the first error is statistical, the second is systematic, and the third is from the eta(c) branching fraction uncertainty. From these we extract the eta(c) decay constant in the factorization approximation, f(eta(c)) = 335+/-75 MeV. We also search for B decays to a chi(c0) and a kaon. No evidence for a signal is found and we set 90% C.L. upper limits: B(B+-->chi(c0)K+)<4.8x10(-4) and B(B degrees -->chi(c0)K degrees )<5.0x10(-4).

Physical heights of children with prolonged low dose-rate gamma-radiation exposure in radiocontaminated buildings

PURPOSE

To evaluate low dose-rate radiation effects on the physical heights of children staying in apartments with 60Co-contaminated steel construction.

MATERIALS AND METHODS

Children who once resided in radiocontaminated apartments since early 1983 were examined for height and body weight status from age 1 month to 18 years and before they moved out of the apartments. The physical heights and body weights of 21 898 age- and sex-matched non-exposed children from a nationwide school surveillance in 1997-98 were taken as controls. The physical height data were shown as height percentiles (HP) compared with reference children and age-specific relative height differences (RHD).

RESULTS

HP and RHD in 48 exposed boys and 37 girls were analysed using generalized estimating equations (GEE), which accounted for multiple measurements and correlation between these measurements in the same individuals during this period. After adjusting for effects from parental heights and body mass index (BMI), clear dose-related decreases in HP and RHD were observed in the exposed boys with a cumulative exposure > 60 mSv.

CONCLUSIONS

Prolonged low dose-rate y-radiation exposure was associated with adverse effects on the physical heights of growing boys, but were less apparent in the exposed girls.

Correlation between a positive Hoffmann's reflex and cervical pathology in asymptomatic individuals

STUDY DESIGN

Asymptomatic patients with a positive Hoffmann's reflex were prospectively studied with cervical radiographs and magnetic resonance imaging.

OBJECTIVES

To determine a relationship between a positive Hoffmann's reflex and cervical pathology in asymptomatic patients and to evaluate if further work-up was necessary in this patient population.

SUMMARY OF BACKGROUND DATA

A positive Hoffmann's reflex usually implies an upper motor neuron lesion from spinal cord compression. Although this reflex is commonly tested, the significance of this reflex in asymptomatic patients is not known.

METHODS

Sixteen patients without cervical pain or radiculopathy and a positive Hoffmann's reflex were prospectively studied with cervical radiographs and magnetic resonance imaging. Positive findings were correlated with a detailed neurologic examination.

RESULTS

All 16 patients were asymptomatic. Fourteen patients (87.5%) demonstrated spondylosis on cervical radiographs. The magnetic resonance imaging studies showed pathologic findings in all 16 patients. Fifteen patients (94%) had cervical involvement with cord compression from a herniated nucleus pulposus. The remaining patient had a T5-T6 thoracic disc with resultant compression. No treatment was instituted, and the clinical course of each patient was not affected.

CONCLUSIONS

Although the presence of cervical cord impingement is extremely high in these patients, no treatment was rendered specifically to address the cervical pathology. Therefore, the presence of a positive Hoffmann's reflex in asymptomatic patients strongly suggests underlying cervical pathology, but it does not warrant further evaluation with either cervical radiographs or magnetic resonance imaging since the management and clinical course are not affected by positive studies.

Selective diphosphine ligand chelation and pi bond coordination in CoRu(CO)7(mu-PPh2): kinetics and X-ray structure of CoRu(CO)4(mu-bma)(mu-PPh2)

Thermolysis of CoRu(CO)7(mu-PPh2) (1) in refluxing 1,2-dichloroethane in the presence of the diphosphine ligands 2,3-bis(diphenylphosphino)maleic anhydride (bma) and 4,5-bis(diphenylphosphino)-4-cyclopenten-1,3-dione (bpcd) furnishes the new mixed-metal complexes CoRu(CO)4(mu-P-P)(mu-PPh2) [where P-P = bma (3a), bpcd (3b)] along with trace amounts of the known complex CoRu(CO)6(PPh3)(mu-PPh2) (4). The requisite pentacarbonyl intermediates CoRu(CO)5(mu-P-P)(mu-PPh2) [where P-P = bma (2a), bpcd (2b)] have been prepared by separate routes (mild thermolysis and Me3NO activation) and studied for their conversion to CoRu(CO)4(mu-P-P)(mu-PPh2). The penta- and tetracarbonyl complexes have been isolated and fully characterized in solution by IR and NMR spectroscopy. The kinetics for the conversion of 2a-->3a and of 2b-->3b were measured by IR spectroscopy in chlorobenzene solvent. On the basis of the first-order rate constants, CO inhibition, and the activation parameters (2a-->3a, delta H++ = 29.2 +/- 1.4 kcal mol-1 and delta S++ = 8.2 +/- 3.8 eu; 2b-->3b, delta H++ = 27.7 +/- 0.6 kcal mol-1 and delta S++ = 1.4 +/- 1.6 eu), a mechanism involving dissociative CO loss as the rate-limiting step is proposed. The solid-state structure of CoRu(CO)4(mu-bma)(mu-PPh2) (3a), as determined by X-ray crystallography, reveals that the two PPh2 groups are bound to the ruthenium center while the maleic anhydride pi bond is coordinated to the cobalt atom.

Effect of APOE genotype and promoter polymorphism on risk of Alzheimer's disease

OBJECTIVE

To verify the association between APOE gene promoter polymorphisms and the development of AD and to determine whether the effect of promoter polymorphisms on AD is independent of the APOE epsilon4 allele.

BACKGROUND

Three polymorphisms in the APOE promoter have been shown to modify APOE expression in vitro. Several studies have suggested that these polymorphisms may also modulate risk for AD, either independently or by modifying the effect of the APOE coding polymorphism.

METHODS

The authors analyzed allele and genotype distributions for APOE and all three known APOE promoter polymorphisms (-491 A/T, -427 T/C, and -219 G/T) in a study group consisting of 237 subjects with AD and 274 age-matched controls. They then used log-linear and logistic regression analyses to test for possible interactions between APOE genotype and the promoter polymorphisms on risk of AD.

CONCLUSION

A strong association between the APOE epsilon 4 allele and AD was detected regardless of promoter polymorphism status. In addition, the -491 AA genotype appears to be an independent genetic risk factor for AD. The -427 T/C polymorphism and the -219 T/G polymorphism were not directly associated with AD.

Comparison of MRI and radiographs in the evaluation of acromial morphology

This study compared the accuracy of magnetic resonance imaging (MRI) grading of acromions using supraspinatus outlet view radiographs. Thirty-two consecutive patients (17 men and 15 women) treated for shoulder disorders were included in the study. Average patient age was 58.5 years. All patients had both a supraspinatus outlet radiograph and an MRI of the shoulder. Each acromion was graded by three independent observers at separate intervals by radiographs and MRI and the results were compared. The incidence of the three acromial types determined by radiographs was: type I = 6%, type II = 66%, and type III = 28%. The incidence of the three acromial types determined by MRI was: type I = 6%, type II = 69%, and type III = 25%. There was essentially no difference in the incidence of acromial morphology between the two groups. Magnetic resonance imaging demonstrated the same shape as shown on the plain radiographs in 97% of the patients (95% confidence interval, 0.84-0.99). Magnetic resonance imaging is similar to supraspinatus outlet radiographs in determining acromial type. Acromial grading by MRI is a valid method of determining acromial morphology.

Role of Bacillus subtilis SpoIIIE in DNA transport across the mother cell-prespore division septum

The SpoIIIE protein of Bacillus subtilis is required for chromosome segregation during spore formation. The COOH-terminal cytoplasmic part of SpoIIIE was shown to be a DNA-dependent adenosine triphosphatase (ATPase) capable of tracking along DNA in the presence of ATP, and the NH(2)-terminal part of the protein was found to mediate its localization to the division septum. Thus, during sporulation, SpoIIIE appears to act as a DNA pump that actively moves one of the replicated pair of chromosomes into the prespore. The presence of SpoIIIE homologs in a broad range of bacteria suggests that this mechanism for active transport of DNA may be widespread.

Measurements of the mass, total width, and two-photon partial width of the eta(c) meson

Using 13.4 fb(-1) of data collected with the CLEO detector at the Cornell Electron Storage Ring, we have observed 300 events for the two-photon production of ground-state pseudoscalar charmonium in the decay eta(c)-->K(0)(S)K-/+pi(+/-). We have measured the eta(c) mass to be [2980.4+/-2.3 (stat)+/-0.6 (syst)] MeV and its full width as [27.0+/-5.8 (stat)+/-1.4 (syst)] MeV. We have determined the two-photon partial width of the eta(c) meson to be [7.6+/-0.8 (stat)+/-0.4 (syst)+/-2.3 (br)] keV, with the last uncertainty associated with the decay branching fraction.

Study of charmless hadronic B meson decays to pseudoscalar-vector final states

We report results of searches for charmless hadronic B meson decays to pseudoscalar( pi(+/-), K+/-, pi(0), or K(0)(S))-vector( rho, K(*), or omega) final states. By using 9.7x10(6) BB pairs collected with the CLEO detector, we report the first observation of B(-)--->pi(-)rho(0), B(0)-->pi(+/-)rho(-/+), and B(-)-->pi(-)omega, which are expected to be dominated by hadronic b-->u transitions. The measured branching fractions are (10.4(+3.3)(-3.4)+/-2.1)x10(-6), (27.6(+8.4)(-7.4)+/-4.2)x10(-6), and (11.3(+3.3)(-2.9)+/-1. 4)x10(-6), respectively. Branching fraction upper limits are set for all of the other decay modes investigated.

Rapidly growing small peripheral lung cancers detected by screening CT: correlation between radiological appearance and pathological features

12 peripheral small lung cancers (< 20 mm) of rapid growth (volume doubling time < 150 days), detected by repeated low dose CT screening, were evaluated to examine their CT features and to correlate such features with histopathological findings. Each patient's CT images, including follow-up and thin section CT images, were studied retrospectively to determine tumour growth rate and CT morphological features. Nine of the tumours exhibited a solid tumour growth pattern: seven of these showed a well defined, homogeneous, soft tissue density with spicular or lobulated margin. These seven tumours included small cell lung cancer (n = 3), moderately differentiated adenocarcinoma (n = 2), poorly differentiated adenocarcinoma (n = 1) and squamous cell carcinoma (n = 1). The other two tumours, a moderately differentiated adenocarcinoma and a well differentiated adenocarcinoma, appeared as irregular, soft tissue density nodules with poorly defined margins. The latter exhibited an air bronchogram pattern and a small cavity. The remaining three tumours exhibited a lepidic tumour growth pattern. They showed ground glass opacity or ground glass opacity with a higher density central zone on CT images and were well differentiated adenocarcinomas. In conclusion, most peripheral small lung cancers of rapid growth were adenocarcinomas. They also included small cell lung cancer and squamous cell carcinoma. The majority showed solid tumour growth pattern and lacked an air bronchogram and/or small air spaces in the nodule. Some well differentiated adenocarcinomas with lepidic tumour growth pattern also showed rapid growth.

Interaction between yeast sgs1 helicase and DNA topoisomerase III

The Saccharomyces cerevisiae Sgs1 protein is a member of the RecQ family of DNA helicases that includes the human Bloom's syndrome and Werner's syndrome proteins. In this work, we report studies on the interaction between Sgs1 and DNA topoisomerase III in vitro and in vivo. Affinity chromatography experiments with various fragments of Sgs1, a 1447-amino acid polypeptide, suggested that its N-terminal one-fifth was sufficient for interaction with DNA topoisomerase III. Gel electrophoretic mobility shift assays also indicated that a fragment Sgs1(1-283), containing residues 1-283, inhibited the binding of DNA topoisomerase III to single-stranded DNA. A shorter protein fragment containing residues 1-107 also showed partial inhibition in these assays. Studies of a sgs1 top1 double mutant lacking both Sgs1 and DNA topoisomerase I showed that the slow growth phenotype of this double mutant is suppressed by expressing full-length Sgs1, but not Sgs1 without the N-terminal 107 amino acid residues. In sgs1 top3 cells devoid of DNA topoisomerase III, however, expression of full-length Sgs1 or Sgs1 lacking the N-terminal 107 amino acid residues has the same effect of reducing the growth rate of the double mutant. These in vitro and in vivo data indicate that Sgs1 and DNA topoisomerase III physically interact and that this interaction is physiologically significant.

Observation of B --> K(+/-) pi(0) and B --> (K)0 pi(0), and evidence for B --> pi(+)pi(-)

We have studied charmless hadronic decays of B mesons into two-body final states with kaons and pions and observe three new processes with the following branching fractions: beta(B-->pi(+)pi(-)) = (4.3(+1. 6)(-1.4)+/-0.5)x10(-6), beta(B-->K(0)pi(0)) = (14.6(+5.9+2.4)(-5.1-3. 3))x10(-6), and beta(B-->K(+)/-pi(0)) = (11.6(+3.0+1.4)(-2.7-1.3))x10(-6). We also update our previous measurements for the decays B-->K(+)/-pi(-/+) and B+/--->K(0)pi(+/-).

Two-body B meson decays to eta and eta('): observation of B --> eta K*

In a sample of 19 x 10(6) produced B mesons, we have observed the decays B-->eta K(*) and improved our previous measurements of B-->eta'K. The branching fractions we measure for these decay modes are B(B+-->eta K(*+)) = (26.4(+9.6)(-8.2)+/-3.3)x10(-6), B(B(0)-->eta K(*0)) = (13.8(+5.5)(-4.6)+/-1.6)x10(-6), B(B(+)-->eta'K(+) = (80(+10)(-9)+/-7)x10(-6), and B(B(0)-->eta'K0) = (89(+18)(-16)+/-9)x10(-6). We have searched with comparable sensitivity for related decays and report upper limits for these branching fractions.

Measurement of charge asymmetries in charmless hadronic B meson decays

We search for CP-violating charge asymmetries (alpha(CP)) in the B meson decays to K(+/-)pi(-/+), K(+/-)pi(0), K(0)(S)pi(+/-), K(+/-)eta('), and omega pi(+/-). Using 9.66 million upsilon(4S) decays collected with the CLEO detector, the statistical precision on alpha(CP) is in the range of +/-0.12 to +/-0.25 depending on decay mode. While CP-violating asymmetries of up to +/-0.5 are possible within the standard model, the measured asymmetries are consistent with zero in all five decay modes studied.

Radiologic assessment of metastases to the thyroid gland

PURPOSE

We reviewed the radiologic and clinical data in patients with metastatic disease to the thyroid gland and assessed the role of radiologic techniques in this disorder.

METHOD

The findings on US (n = 11), CT (n = 7), MRI (n = 6), palpation or US-guided fine needle aspiration (FNA) biopsy, and clinical records were reviewed in 11 cases of pathologically verified metastatic tumors of the thyroid gland.

RESULTS

Five patients had palpable thyroid nodules and six had nonpalpable nodules discovered incidentally with imaging procedures. Three patients had no known malignancies at the time of diagnosis of thyroid tumors. Correct diagnosis was obtained in 10 of the 11 cases with FNA biopsy. Thyroid metastases were detected in all of the cases with US and MRI and six of the seven cases with CT. Thyroid metastases were solitary (n = 5) or multiple (n = 6), and about half of them measured <2 cm in diameter. These tumors typically had well defined margins and no calcification and sometimes had cystic portions. Multiple nodules within the same patient were radiologically quite similar to each other. On US, metastases appeared as hypoechoic or markedly hypoechoic areas without halo, on CT as low density areas, and on MRI as areas of varying signal intensities. Half of the metastases showed hypointensity on either T2-weighted images or gadolinium-enhanced T1-weighted images. The tumors involved lymph nodes in 10 cases and other remote organs in 5. Level I or II or parotid nodes were involved in six cases.

CONCLUSION

These radiologic features may alert clinicians to a possibility of metastatic thyroid cancer. US combined with US-guided FNA biopsy is suitable for early diagnosis of metastases to the thyroid gland.

Transducin-like enhancer of split proteins, the human homologs of Drosophila groucho, interact with hepatic nuclear factor 3beta

Members of the hepatic nuclear factor 3 (HNF3) family, including HNF3alpha, HNF3beta, and HNF3gamma, play important roles in embryonic development, the establishment of tissue-specific gene expression, and the regulation of gene expression in differentiated tissues. We found, using the glutathione S-transferase pull-down method, that the transducin-like Enhancer of split (TLE) proteins, which are the human homologs of Drosophila Groucho, directly associate with HNF3beta. Conserved region II of HNF3beta (amino acids 361-388) is responsible for the interaction with TLE1. A mammalian two-hybrid assay was used to confirm that this interaction occurs in vivo. Overexpression of TLE1 in HepG2 and HeLa cells decreases transactivation mediated through the C-terminal domain of HNF3beta, and Grg5, a naturally occurring dominant negative form of Groucho/TLE, also increases the transcriptional activity of this region of HNF3. These results lead us to suggest that TLE proteins could influence the expression of mammalian genes regulated by HNF3.

Effects of JTV-519, a novel anti-ischaemic drug, on the delayed rectifier K+ current in guinea-pig ventricular myocytes

We studied the effects of a newly synthesized anti-ischaemic agent, 4-[3-(4-benzylpiperidin-1-yl) propionyl]-7-methoxy-2, 3, 4, 5-tetrahydro-1, 4-benzothiazepine monohydrochloride (JTV-519) on the delayed rectifier potassium current (IK), using guinea-pig ventricular myocytes and whole-cell voltage-clamp techniques, under blockade of the L-type calcium current (ICa,L) by D600 (1 microM) or nitrendipine (5 microM). The IK in guinea-pig ventricular cells consists of two different components; the rapidly activating, E4031-sensitive component (IKr) and the slowly activating E4031-resistant component (IKs). Under steady-state conditions, JTV-519 (1 and 5 microM) did not change the amplitude of IKs remaining after blockade of IKr with 5 microM E4031. The effect of JTV-519 on IKr was assessed using short (50 ms) pulses which evoked a tail current that was sensitive to E4031 but not to chromanol 293B, a specific blocker of IKs. JTV-519 suppressed the IKr with a half-maximal inhibitory concentration of 1.2 microM. Selective inhibition of IKr by this agent was confirmed by using the "envelope of tails" test. These results suggest that the blockade of IKr may underlie the prolongation of action potential duration in ventricular muscle and QT-intervals alleged to occur in animal as well as human hearts.

The relationship between acromial morphology and conservative treatment of patients with impingement syndrome

This study assessed the predictive value of acromial morphology in the treatment outcome of patients with impingement syndrome. Sixty-five patients with impingement syndrome were treated by a single orthopedic surgeon according to the same protocol and initially received the same conservative modalities. The incidence of acromial types in the nonoperative group was significantly different from those in the operative group (P=.008). A large proportion (88.9%) of the patients with type I acromions responded to conservative measures, while fewer (73.1%) patients with type II acromions responded to conservative measures. The majority (58.3%) of patients with type III acromions required surgical intervention. Acromial morphology appears to have a predictive value in determining the success of conservative measures and the need for surgery in patients with impingement syndrome.

The molecular physiology of hepatic nuclear factor 3 in the regulation of gluconeogenesis

Glucocorticoids stimulate gluconeogenesis by increasing the rate of transcription of genes that encode gluconeogenic enzymes such as phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase. Previous studies have shown that hepatic nuclear factor 3 (HNF3) is required as an accessory factor for several glucocorticoid-stimulated genes, including PEPCK. Here, we show that adenovirus-mediated expression of an HNF3beta protein with a deleted C-terminal transactivation domain (HNF3betaDeltaC) reduces the glucocorticoid-induced expression of the PEPCK and glucose-6-phosphatase genes in H4IIE hepatoma cells. Furthermore, expression of this truncated HNF3 protein results in a proportionate reduction of glucocorticoid-stimulated glucose production from lactate and pyruvate in these cells. The expression of HNF3betaDeltaN, in which the N-terminal transactivation domain is deleted, does not exhibit any of these effects. These results provide direct evidence that members of the HNF3 family are required for proper regulation of hepatic gluconeogenesis. Modulation of the function of the HNF3 family of proteins might be used to reduce the excessive hepatic production of glucose that is an important pathophysiologic feature of diabetes mellitus.

Hemolytic uremic syndrome associated with clopidogrel: a case report

Clopidogrel and ticlopidine are antiplatelet agents used in the treatment of patients with cerebrovascular and peripheral vascular disease and to reduce the risk for thrombosis in patients undergoing coronary artery stenting. Ticlopidine has been reported to have major hematologic adverse effects, including neutropenia and thrombotic thrombocytopenic purpura or hemolytic uremic syndrome (HUS). Clopidogrel, an analogue of ticlopidine, was developed because it did not show bone marrow toxic effects in either tissue culture or animal models. In human studies, to date, clopidogrel has been associated with a low incidence of severe neutropenia and no reported cases of thrombotic thrombocytopenic purpura or HUS. For these reasons, clopidogrel has been increasingly used in place of ticlopidine after coronary artery stenting. We report a case of clopidogrel-associated HUS. This observation implicates clopidogrel as a possible causative agent in HUS.

The feasibility of using photographs to estimate historical heights of children

In studying the growth and development of children, records of body heights are often unavailable for certain periods of time. To evaluate the feasibility of using photographs to estimate body heights in the past, we obtained 23 photographs taken within two months of a documented measurement of height from a cohort of an on-going study. From each photograph, an object was selected as the reference, and the historical height of the child was estimated by proportional projection according to the height of the reference. Two independent sets of estimates were made, and both correlated well with measured heights (correlation coefficient = 0.99, p < 0.0001). The mean differences between the measured and estimated heights were 1.4 cm and 1.5 cm respectively, and both were not statistically significant (Wilcoxon signed rank test, p > 0.05). The average differences between the two sets of estimates was only 0.1 cm (p > 0.05 for Wilcoxon signed rank test), which indicates a high reproducibility. Photographs taken in the "landscape" style tended to provide better estimates than those taken in the "portrait" style. Without any high technology equipment, this simple approach can be readily applied to obtain satisfactory estimates for epidemiological studies.

Review of trophoblastic disease at Taipei Veterans General Hospital

BACKGROUND

Trophoblastic diseases are well known and encountered frequently within most oriental populations except the Japanese. In recent decades, fewer cases have been reported in Taiwan. The purpose of this study was to review and discuss all patients diagnosed with trophoblastic disease at one particular Taiwanese medical center.

METHODS

Sixty-four patients with malignant gestational trophoblastic disease (GTD) were treated at the Taipei Veterans General Hospital from 1977 to 1995. All cases, except those of placental-site trophoblastic disease, were included in this study.

RESULTS

Of the 64 cases of GTD identified, 36 were nonmetastatic and 28 were metastatic. The common metastatic sites were the lungs, followed by the brain and/or liver. Six patients died of the disease. The majority of these patients (5/6) suffered from liver and/or brain metastases.

CONCLUSIONS

GTD was found to be a highly chemosensitive and curable disease. However, a significant proportion of patients die of the disease. More effective therapeutic protocols may be required in such patients to improve the survival rate.

G protein beta3 subunit variant and essential hypertension in Taiwan - a case-control study

Recent studies have shown that a C825T polymorphism of the gene encoding the G protein beta3 subunit contributes to the genesis of essential hypertension. However, the link between the gene and blood pressure is not consistently found in different populations. The aim of the present study is to investigate this issue in Taiwan. We analyzed the allelic status in 302 hypertensive (age, 60+/-11 years; male/female, 136/166) and 199 normotensive subjects (62+/-15 years; male/female, 90/109). Our result showed that the T allelic was more frequently seen in the hypertensive group than the normotensive, but the difference did not reach statistic significance (56.5 vs. 54.3%, P>0.1). Subsequent analysis demonstrated a similar trend in the female (58.7 vs. 53.7%, P>0.1) but a reverse trend in the male (53.7 vs. 55%, P>0.1). Another finding was that the T allele frequency in all the groups was over 50%, markedly higher than those reported in whites. In conclusion, the observation suggests that the polymorphism in the G protein gene is not likely to play an important role in the manifestation of high blood pressure in Taiwan.

Beta-catenin, a novel prognostic marker for breast cancer: its roles in cyclin D1 expression and cancer progression

Beta-catenin can function as an oncogene when it is translocated to the nucleus, binds to T cell factor or lymphoid enhancer factor family members, and transactivates its target genes. In this study, we demonstrate that cyclin D1 is one of the targets of beta-catenin in breast cancer cells. Transactivation of beta-catenin correlated significantly with cyclin D1 expression both in eight breast cell lines in vitro and in 123 patient samples. More importantly, we found that high beta-catenin activity significantly correlated with poor prognosis of the patients and was a strong and independent prognostic factor in breast cancer. Our studies, therefore, indicated that beta-catenin can be involved in breast cancer formation and/or progression and may serve as a target for breast cancer therapy.