Circulating Tumor DNA as a Predictive Marker of Recurrence for Patients With Stage II-III Breast Cancer Treated With Neoadjuvant Therapy

Background

Patients with stage II to III breast cancer have a high recurrence rate. The early detection of recurrent breast cancer remains a major unmet need. Circulating tumor DNA (ctDNA) has been proven to be a marker of disease progression in metastatic breast cancer. We aimed to evaluate the prognostic value of ctDNA in the setting of neoadjuvant therapy (NAT).

Methods

Plasma was sampled at the initial diagnosis (defined as before NAT) and after breast surgery and neoadjuvant therapy(defined as after NAT). We extracted ctDNA from the plasma and performed deep sequencing of a target gene panel. ctDNA positivity was marked by the detection of alterations, such as mutations and copy number variations.

Results

A total of 95 patients were enrolled in this study; 60 patients exhibited ctDNA positivity before NAT, and 31 patients exhibited ctDNA positivity after NAT. A pathologic complete response (pCR) was observed in 13 patients, including one ER(+)Her2(-) patient, six Her2(+) patients and six triple-negative breast cancer (TNBC) patients. Among the entire cohort, multivariate analysis showed that N3 classification and ctDNA positivity after NAT were independent risk factors that predicted recurrence (N3, hazard ratio (HR) 3.34, 95% confidence interval (CI) 1.26 – 8.87, p = 0.016; ctDNA, HR 4.29, 95% CI 2.06 – 8.92, p < 0.0001). The presence of ctDNA before NAT did not affect the rate of recurrence-free survival. For patients with Her2(+) or TNBC, patients who did not achieve pCR were associated with a trend of higher recurrence (p = 0.105). Advanced nodal status and ctDNA positivity after NAT were significant risk factors for recurrence (N2 – 3, HR 3.753, 95% CI 1.146 – 12.297, p = 0.029; ctDNA, HR 3.123, 95% CI 1.139 – 8.564, p = 0.027). Two patients who achieved pCR had ctDNA positivity after NAT; one TNBC patient had hepatic metastases six months after surgery, and one Her2(+) breast cancer patient had brain metastasis 13 months after surgery.

Conclusions

This study suggested that the presence of ctDNA after NAT is a robust marker for predicting relapse in stage II to III breast cancer patients.

Using next-generation sequencing to redefine BRCAness in triple-negative breast cancer

BRCAness is considered a predictive biomarker to platinum and poly(ADP‐ribose) polymerase (PARP) inhibitors. However, recent trials showed that its predictive value was limited in triple‐negative breast cancer (TNBC) treated with platinum. Moreover, tumors with mutations of DNA damage response (DDR) genes, such as homologous recombination (HR) genes, could be sensitive to platinum and PARP inhibitors. Thus, we aim to explore the relationship between mutation status of DDR genes and BRCAness in TNBC. We sequenced 56 DDR genes in 120 TNBC and identified BRCAness by array comparative genomic hybridization. The sequencing results showed that 13, 14, and 14 patients had BRCA, non‐BRCA HR, and non‐HR DDR gene mutations, respectively. Array comparative genomic hybridization revealed that BRCA‐mutated and HR gene‐mutated TNBC shared similar BRCAness features, both having higher numbers and longer length of large‐scale structural aberration (LSA, >10 Mb) and similar altered chromosomal regions of LSA. These suggested non‐BRCA HR gene‐mutated TNBC shared similar characteristics with BRCA‐mutated TNBC, indicating non‐BRCA HR gene‐mutated TNBC sensitive to platinum and PARP inhibitors. Among tumors with mutation of non‐HR DDR genes, 3 PTEN and 1 MSH6 mutation also contained significant LSAs (BRCAness); however, they had different regions of genomic alteration to BRCA and HR gene‐mutated tumors, might explain prior findings that PTEN‐ and MSH6‐mutated cancer cells not sensitive to PARP inhibitors. Therefore, we hypothesize that the heterogeneous genomic background of BRCAness indicates different responsiveness to platinum and PARP inhibitors. Direct sequencing DDR genes in TNBC should be applied to predict their sensitivity toward platinum and PARP inhibitors.

ASB6 Promotes the Stemness Properties and Sustains Metastatic Potential of Oral Squamous Cell Carcinoma Cells by Attenuating ER Stress

Up-regulation of ASB6 has been previously associated with late-stage and poor prognosis of oral squamous cell carcinoma (OSCC) patients. To explore the cellular and molecular basis of how ASB6 enhances the malignancy of OSCC, we employed the clonogenicity and migration assays, murine pulmonary metastasis model, Western blot, and immunofluorescence microscopy to characterize the phenotypes of OSCC cells with lentiviral-based stable overexpression or knockdown of ASB6. We found that ASB6 overexpression increases, whereas ASB6 knockdown decreases, the potential of tumor-sphere formation, colony formation, and expression of Oct-4 and Nanog. While knockdown of ASB6 decreases cell migration in vitro and lung metastasis in mice, the migratory potential was however not promoted by ASB6 overexpression. ASB6 knockdown down-regulates the level of vimentin, and the loss of filopodia formation became more prominent following CRISPR/Cas9-directed knockout of ASB6. Moreover, ASB6 was up-regulated when cells were grown in selective condition featured with a collateral effect of enhancing intracellular stress, and the level of endoplasmic reticulum (ER) stress was further increased by knockdown of ASB6. Thus, ASB6 may attenuate ER stress that would otherwise accumulate and subsequently impede the potential of cells to acquire or sustain the stemness properties and metastatic capacity, thereby enhancing the malignancy of OSCC by increasing the population of cancer stem or stem-like cells.

Psychiatrists' Attitude and Use of Second-generation Antipsychotics for the Treatment of Schizophrenia in Taiwan

OBJECTIVES

This survey aimed to understand the attitude of psychiatrists and their use of commonly prescribed second-generation antipsychotics (SGAs) for the treatment of schizophrenia in Taiwan. It also attempted to identify the factors that might influence their preference for selecting SGAs.

METHODS

Psychiatrists were interviewed face-to-face using a structured questionnaire. The questionnaire addressed various issues involved in the treatment of patients with schizophrenia, including the reasons for selecting SGAs, psychiatrists' level of satisfaction with commonly prescribed SGAs, and their current use of SGAs in clinical practice.

RESULTS

Gender and age of the psychiatrists, and practice setting were not related to SGA selection. The selection of a SGA might be influenced by characteristics of the psychiatrist, properties of the drugs, and the healthcare insurance system. Most psychiatrists agreed that the performance of brand-name drugs was superior to that of generic drugs. Better symptom control, improvement in cognition, and higher tolerability were among the major factors considered by psychiatrists in Taiwan when prescribing antipsychotics.

CONCLUSION

Selection of a SGA in Taiwan is potentially influenced by the characteristics of the psychiatrist, properties of the drug, and the healthcare insurance system. Efficacy and tolerability were among the major determining factors when prescribing antipsychotics for the treatment of patients with schizophrenia.

N-Glycosylation of Human R-Spondin 1 Is Required for Efficient Secretion and Stability but Not for Its Heparin Binding Ability

R-spondin 1 (Rspo1) plays an essential role in stem cell biology by potentiating Wnt signaling activity. Despite the fact that Rspo1 holds therapeutic potential for a number of diseases, its biogenesis is not fully elucidated. All Rspo proteins feature two amino-terminal furin-like repeats, which are responsible for Wnt signal potentiation, and a thrombospondin type 1 (TSR1) domain that can provide affinity towards heparan sulfate proteoglycans. Using chemical inhibitors, deglycosylase and site-directed mutagenesis, we found that human Rspo1 and Rspo3 are both N-glycosylated at N137, a site near the C-terminus of the furin repeat 2 domain, and Rspo2 is N-glycosylated at N160, a position near the N-terminus of TSR1 domain. Elimination of N-glycosylation at these sites affects their accumulation in media but have no effect on the ability towards heparin. Introduction of the N-glycosylation site to Rspo2 mutant at the position homologous to N137 in Rspo1 restored full glycosylation and rescued the accumulation defect of nonglycosylated Rspo2 mutant in media. Similar effect can be observed in the N137 Rspo1 or Rspo3 mutant engineered with Rspo2 N-glycosylation site. The results highlight the importance of N-glycosylation at these two positions in efficient folding and secretion of Rspo family. Finally, we further showed that human Rspo1 is subjected to endoplasmic reticulum (ER) quality control in N-glycan-dependent manner. While N-glycan of Rspo1 plays a role in its intracellular stability, it had little effect on secreted Rspo1. Our findings provide evidence for the critical role of N-glycosylation in the biogenesis of Rspo1.

Preparation and identification of an antiserum against recombinant UL31 protein of pseudorabies virus

Pseudorabies virus (PRV) early protein UL31 is a homologue of herpes simplex virus 1 (HSV-1) UL31, which is a multifunctional protein important for HSV-1 infection. However, the precise roles of PRV UL31 in virus life cycle are still poorly understood. A relatively crucial tool for uncovering the function of UL31 is an antiserum that specifically detects UL31 in the PRV-infected cells. For this purpose, a recombinant UL31 protein consisting of N-terminal 27 aa of UL31 fused to EYFP and His-tag was expressed, purified and used for the preparation of antiserum in BALB/c mice. Our results show that Western blot analysis and immunofluorescence assay showed that this antiserum could specifically detect the purified recombinant UL31 as well as full-length UL31 in the PRV infected cells. These results demonstrate that the prepared antiserum could serve as a valuable tool for further studies of UL31 functions in PRV infection.

A genome-wide association study of growth trait-related single nucleotide polymorphisms in Chinese Yancheng chickens

Chicken (Gallus gallus) growth traits are important economic traits, and many studies have been conducted on genetic selection for body weight. However, most of these studies have detected functional chromosome mutations or regions by conventional molecular markers or gene chips. In this study, we performed a new genome-wide association study using specific-locus amplified fragment sequencing (SLAF-seq) technology in purebred Yancheng chickens. Single nucleotide polymorphisms (SNPs) that were significantly associated with phenotypic traits were identified by GAPIT-compressed mixed linear models. Eighteen SNP markers reached 5% Bonferroni genome-wide significance. A region spanning 72.3 to 82.1 Mb on GGA4 had a strong influence on growth traits. Four genes (FAM184B, KCNIP4, MIR15A, and GLI3) were closely associated with body weight. Some SNPs were coincident with previously reported quantitative trait locus regions. Our results would promote the researches of Chinese chickens and accelerate the utilization of Chinese chicken, specially Yancheng chicken.

Development and Impact of De Novo Anti-HLA Antibodies in Pediatric Heart Transplant Recipients

There is increasing evidence that de novo anti-HLA antibodies, more specifically de novo donor-specific antibodies (DSA) following solid organ transplantation may be associated with negative outcomes including rejection in the first year and graft loss. Limited data are available in pediatric heart transplant recipients. We sought to prospectively determine the incidence, class and early impact of de novo anti-HLA antibodies in a cohort of pediatric heart transplant recipients. Serial panel reactive antibody testing posttransplant was performed in 25 patients (14 males) transplanted between January 2008 and June 2010. Five patients were sensitized pretransplant; all patients had negative direct crossmatch. Seventy-two percent developed de novo anti-HLA antibodies at a median of 2.6 weeks (IQR 1.2 weeks to 6.2 months) posttransplant; 67% of these were DSA. The majority of recipients in our cohort developed de novo anti-HLA antibodies within the first year posttransplant, with two-thirds being donor-specific. Acute cellular rejection, though frequent, was not different in patients with antibody development regardless of class or specificity, and there was no antibody-mediated rejection, graft loss or early cardiac allograft vasculopathy.

ZnO nanorod optical disk photocatalytic reactor for photodegradation of methyl orange

A low-cost and efficient photocatalytic reactor for environmental treatment and green technology was presented. ZnO nanorods firmly growing on polycarbonate optical disk substrate are generally perpendicular to the substrate as the immobilized photocatalyst of the spinning disk reactor. The photocatalytic efficiency and durability of the ZnO nanorods are effectively demonstrated.

The effect of surface coating on energy migration-mediated upconversion

Lanthanide-doped upconversion nanoparticles have been the focus of a growing body of investigation because of their promising applications ranging from data storage to biological imaging and drug delivery. Here we present the rational design, synthesis, and characterization of a new class of core-shell upconversion nanoparticles displaying unprecedented optical properties. Specifically, we show that the epitaxial growth of an optically inert NaYF(4) layer around a lanthanide-doped NaGdF(4)@NaGdF(4) core-shell nanoparticle effectively prevents surface quenching of excitation energy. At room temperature, the energy migrates over Gd sublattices and is adequately trapped by the activator ions embedded in host lattices. Importantly, the NaYF(4) shell-coating strategy gives access to tunable upconversion emissions from a variety of activators (Dy(3+), Sm(3+), Tb(3+), and Eu(3+)) doped at very low concentrations (down to 1 mol %). Our mechanistic investigations make possible, for the first time, the realization of efficient emissions from Tb(3+) and Eu(3+) activators that are doped homogeneously with Yb(3+)/Tm(3+) ions. The advances on these luminescent nanomaterials offer exciting opportunities for important biological and energy applications.

Effects of spiked metals on the MSW anaerobic digestion

This study aimed to investigate the effects of eight metals on the anaerobic digestion of the organic fraction of municipal solid waste (OFMSW) in bioreactors. Anaerobic bioreactors containing 200 mL MSW mixed completely with 200 m L sludge seeding. Ca and K (0, 1000, 2000 and 6,000 mg L(-1)) and Cr, Ni, Zn, Co, Mo and W (0, 5, 50 and 100 mg  L(-1)) of various dose were added to anaerobic bioreactors to examine their anaerobic digestion performance. Results showed that except K and Zn, Ca (~728 to ~1,461 mg  L(-1)), Cr (~0.0022 to ~0.0212 mg  L(-1)), Ni (~0.801 to ~5.362 mg  L(-1)), Co (~0.148 to ~0.580 mg  L(-1)), Mo (~0.044 to ~52.94 mg  L(-1)) and W (~0.658 to ~40.39 mg  L(-1)) had the potential to enhance the biogas production. On the other hand, except Mo and W, inhibitory concentrations IC(50) of Ca, K, Cr, Ni, Zn and Co were found to be ~3252, ~2097, ~0.124, ~7.239, ~0.482, ~8.625 mg  L(-1), respectively. Eight spiked metals showed that they were adsorbed by MSW to a different extent resulting in different liquid metals levels and potential stimulation and inhibition on MSW anaerobic digestion. These results were discussed and compared to results from literature.

Model-based segmentation of flexor tendons from magnetic resonance images of finger joints

Trigger finger is a common hand disease, causing swelling, painful popping and clicking in moving the affected finger joint. To better evaluate patients with trigger finger, segmentation of flexor tendons from magnetic resonance (MR) images of finger joints, which can offer detailed structural information of tendons to clinicians, is essential. This paper presents a novel model-based method with three stages for automatically segmenting the flexor tendons. In the first stage, a set of tendon contour models (TCMs) is initialized from the most proximal cross-sectional image via two-step ellipse estimation. Each of the TCMs is then propagated to its distally adjacent image by affine registration. The propagation is sequentially performed along the proximal-distal direction until the most distal image is reached, as the second stage of segmentation. The TCMs on each cross-sectional image are refined in the last stage with the snake deformation. MR volumes of three subjects were used to validate the segmentation accuracy. Compared with the manual results, our method showed good accuracy with small average margins of errors (within 0.5 mm) and large overlapping ratio (dice similarity coefficient above 0.8). Overall, the proposed method has great potential for morphological change assessment of flexor tendons and pulley-tendon system modeling for image guided surgery.

Modeling biogas production from organic fraction of MSW co-digested with MSWI ashes in anaerobic bioreactors

This study aims at investigating the effects of MSW incinerator fly ash (FA) and bottom ash (BA) on the anaerobic co-digestion of OFMSW with FA or BA. It also simulates the biogas production from various dosed and control bioreactors. Results showed that suitable ashes addition (FA/MSW 10 and 20 g L(-1) and BA/MSW 100 g L(-1)) could improve the MSW anaerobic digestion and enhance the biogas production rates. FA/MSW 20 g L(-1) bioreactor had the higher biogas production and rate implying the potential option for MSW anaerobic co-digestion. Modeling studies showed that exponential plot simulated better for FA/MSW 10 g L(-1) and control bioreactors while Gaussian plot was applicable for FA/MSW 20 g L(-1) one. Linear and exponential plot of descending limb both simulated better for BA/MSW 100 g L(-1) bioreactor. Modified Gompertz plot showed higher correlation of biogas accumulation than exponential rise to maximum plot for all bioreactors.

A rare cutaneous fungal infection complicating bacterial necrotising fasciitis

We report a case of bacterial necrotising fasciitis complicated by the rare fungus Absidia corymbifera. Although this fungal infection is rare, the prognosis is poor and it therefore requires attention. Only 30 cases have been reported since 1874, and we are the first group to report this clinical scenario in our locality. Using a comprehensive journal review, we discuss the expected clinical course and optimal management.

CTLA-4 gene and susceptibility to human papillomavirus-16-associated cervical squamous cell carcinoma in Taiwanese women

Human papillomavirus (HPV) is considered to be a necessary but not sufficient cause for cervical cancer. The host immunogenetic background plays an important role in the persistence of HPV infection and subsequent development of cervical cancer. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a molecule expressed mainly on activated T cells and is important in the down-regulation of T-cell activation. The aim of this study was to determine if polymorphisms of the CTLA-4 gene are associated with HPV-induced cervical cancer in Taiwanese women. Polymerase chain reaction-restriction fragment length polymorphism was used to genotype -318 C/T, +49 A/G and CT60 A/G polymorphisms in 144 women with cervical squamous cell carcinoma (CSCC) and 378 ethnicity-matched healthy control women. The presence and genotypes of HPV in CSCC were determined by E6-, E7-based nested polymerase chain reaction. The frequency of C/T genotype of -318 C/T polymorphism was significantly higher in patients with HPV-16-positive CSCC compared with controls (odds ratio = 1.99, 95% confidence interval = 1.16-3.42, P(c) = 0.03). No significant associations were found for +49 A/G and CT60 A/G polymorphisms. Analysis of haplotypes, computationally inferred from genotype data, also revealed no significant differences in distribution among all subjects with CSCC, those with HPV-16-positive CSCC and controls. Our results suggest that the -318 C/T variant in the promoter region of the CTLA-4 gene is associated with HPV-16-associated CSCC in Taiwanese women.

Dissociation dynamics of positive-ion and negative-ion fragments of gaseous and condensed Si(CH(3))(2)Cl(2) via Si 2p, Cl 2p, and Cl 1s core-level excitations

The state-selective positive-ion and negative-ion dissociation pathways of gaseous and condensed Si(CH(3))(2)Cl(2) following Cl 2p, Cl 1s, and Si 2p core-level excitations have been characterized. The excitations to a specific antibonding state (15a(1) (*) state) of gaseous Si(CH(3))(2)Cl(2) at the Cl 2p, Cl 1s, and Si 2p edges produce significant enhancement of fragment ions. This ion enhancement at specific core-excited states correlates closely with the ion kinetic energy distribution. The results deduced from ion kinetic energy distribution are consistent with results of quantum-chemical calculations on Si(CH(3))(2)Cl(2) using the ADF package. The Cl(-) desorption yields for Si(CH(3))(2)Cl(2)Si(100) at approximately 90 K are notably enhanced at the 15a(1) (*) resonance at both Cl 2p and Si 2p edges. The resonant enhancement of Cl(-) yield occurs through the formation of highly excited states of the adsorbed molecules. These results provide insight into the state-selective ionic fragmentation of molecules via core-level excitation.

The lead content of currently available new residential paint in several Asian countries

Worldwide prohibitions on lead gasoline additives were a major international public health accomplishment, the results of which are still being documented in parts of the world. Although the need to remove lead from paints has been recognized for over a century, evidence reported in this article indicates that lead-based paints for household use, some containing more than 10% lead, are readily available for purchase in some of the largest countries in the world. Sixty-six percent of new paint samples from China, India, and Malaysia were found to contain 5000 ppm (0.5%) or more of lead, the US definition of lead-based paint in existing housing, and 78% contained 600 ppm (0.06%) or more, the limit for new paints. In contrast, the comparable levels in a nearby developed country, Singapore, were 0% and 9%. In examining lead levels in paints of the same brands purchased in different countries, it was found that some brands had lead-based paints in one of the countries and paints meeting US limits in another; another had lead-free paint available in all countries where samples were obtained. Lead-based paints have already poisoned millions of children and likely will cause similar damage in the future as paint use increases as countries in Asia and elsewhere continue their rapid development. The ready availability of lead-based paints documented in this article provides stark evidence of the urgent need for efforts to accomplish an effective worldwide ban on the use of lead in paint.

The vertebrate phototransduction cascade: amplification and termination mechanisms

The biochemical cascade which transduces light into a neuronal signal in retinal photoreceptors is a heterotrimeric GTP-binding protein (G protein) signaling pathway called phototransduction. Works from psychophysicists, electrophysiologists, biochemists, and geneticists over several decades have come together to shape our understanding of how photon absorption leads to photoreceptor membrane hyperpolarization. The insights of phototransduction provide the foundation for a mechanistic account of signaling from many other G protein-coupled receptors (GPCR) found throughout nature. The application of reverse genetic techniques has strengthened many historic findings and helped to describe this pathway at greater molecular details. However, many important questions remain to be answered.

Implications of the changing pattern of bacterial infections following total joint replacements

PURPOSE

To retrospectively review the causative organisms isolated from infected hip and knee replacements requiring revision.

METHODS

We reviewed a consecutive series of 36 patients who underwent revision hip or knee arthroplasties due to bacterial infection at Pamela Youde Nethersole Eastern Hospital in Hong Kong between 1995 and 2003. The male to female ratio was 1:2, and the mean age of patients was 70 years (range, 54-82 years). The mean duration of follow-up was 3.8 years (range, 1.1-8.3 years). No patient was lost to follow-up. All 14 revision knee patients had previously undergone cemented and patella-resurfacing total knee arthroplasties. Of the 22 revision hip patients, 9 had cementless, 6 had cemented, and 7 had hybrid total hip arthroplasties previously.

RESULTS

None of the bacteria isolated from 1995 to 1996 were multiple-drug resistant. Subsequently, however, most of the isolates were multiple-drug resistant, with methicillin-resistant Staphylococcus aureus (MRSA) being the most common. Half of the isolates of Staphylococcus epidermidis and Escherichia coli demonstrated multiple-drug resistance. The incidence of positive culture in revision hip patients was 59%, 46% of which were MRSA. All 13 revision hips with positive cultures showed chronic sepsis: 4 occurred within one year and 10 occurred 2 or more years after the index arthroplasty. The incidence of positive culture in revision knee patients was 57%, 46% of which were MRSA. All 8 revision knees with positive cultures showed chronic sepsis: 3 occurred within one year, 5 occurred 2 or more years after the index arthroplasty. Only one patient, who was infected with gram-negative bacilli, required a second revision for residual sepsis. Harris hip scores for the revision hip patients improved from a mean of 65 (range, 55-75) to 85 (range, 75-90). Knee Society knee scores of the revision knee patients improved from a mean of 68 (range, 55-75) to 80 (range, 70-85). There were no radiological signs suggestive of loosening in the 2 groups at the latest follow-up.

CONCLUSION

This study found a definite increase in multiple-drug-resistant bacteria isolated from periprosthetic infections around total hip and knee prostheses.

Raising and controlling study of dissolved oxygen concentration in closed-type aeration tank

This study investigated the promotion and control of dissolved oxygen (DO) concentration of the closed-type aeration tank via practical experiments in the wastewater treatment system of a 5-star hotel in Taipei. As with limited and treasured space in Taiwan, before the completion of the sewer system construction in cities, to utilize the mat foundation under large buildings as the space of sewage treatment plant still has been one of the alternatives of those sewage treatments. However, aeration tanks constructed in the mat foundation of buildings have smaller effective water depth, which will cause a lower total transfer amount of DO. Controlling the total exhaust gas flow rate can increase the pressure on such closed-type aeration tanks. The DO concentration thus may increase according to Henry's Law. Furthermore, it may enable operators to adjust the DO concentration of the aeration tank more precisely and thus sustain optimal operating conditions in these treatment facilities. Practical experiments indicated that the DO concentration of aeration tank maintains an average of 3.8 mg l(-1), obtaining the optimum operating conditions. The efficiency of the biological treatment facilities in the mat foundation could be markedly improved.

Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis

BACKGROUND

The long-term use of methamphetamine (MAMP) can result in psychosis but it is not clear why some individuals develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We set out to characterize MAMP users and to examine the relationship of pre-morbid personality, pre-morbid social function and other psychiatric disorders to MAMP psychosis.

METHOD

Four hundred and forty-five amphetamine users were recruited from a psychiatric hospital and a detention centre in Taipei, and were assessed with the Diagnostic Interview for Genetic Studies (DIGS). Their parents were interviewed with the Premorbid Schizoid and Schizotypal Traits (PSST) and the Premorbid Social Adjustment (PSA) schedules. Pre-morbid characteristics and psychiatric co-morbidity were compared between the MAMP users with a lifetime diagnosis of MAMP psychosis and those without.

RESULTS

The MAMP users with psychosis presented a clinical picture which mimicked the positive symptoms of schizophrenia: 85% had auditory hallucinations; 71% persecutory delusions; 63% delusions of reference. Compared with their non-psychotic counterparts, these MAMP users were younger at first MAMP use, used larger amounts of MAMP, had a significantly higher mean PSST score, and higher rates of major depressive disorder, alcohol dependence and antisocial personality disorder.

CONCLUSIONS

Earlier and larger use of MAMP was associated with increased risk of psychosis. Our data are also compatible with the view that pre-morbid schizoid/schizotypal personality predisposes MAMP users to develop psychosis, and that the greater the personality vulnerability, the longer the psychosis will persist.

Treatment of slaughterhouse wastewater using an activated sludge/contact aeration process

This study combines a two-phase biological treatment system of activated sludge/contact aeration process by adding biological contact filters into the rear sector of the activated sludge aeration tank of the slaughterhouse wastewater treatment plant. This system keeps the advantages of complete mixing of substrates and microorganisms and flexible operation of the activated sludge process, and increased biological phase, less sludge, process stability and good settleability of sludge of the contact aeration process. This system could avoid the defects of sludge bulking, increased sludge production and difficult operation of the activated sludge process, and system clogging and rigid operation of the contact aeration process. Because suspended microorganisms are flowing into the contact aeration system, which then degrade or suspend within the biological contact filters after being adsorbed by the fixed biological film, on which partial bio-solids will act as seeding microorganisms. Suspended microorganisms and the dropped biological film will settled in the secondary settling tank, then reflux into the activated sludge aeration tank. The partial dropped biological film will decompose in the activated sludge aeration tank to achieve the function of decreasing sludge. Large specific gravity and good settling ability of biofilm sludge will provide better effluent quality. It has been proven through a practical experiment at a slaughterhouse wastewater treatment plant in Taiwan, that the activated sludge process effluent COD value of 150-200 mg/L and SS value of 80-100 mg/L were decreased to around 40 mg/L and 22 mg/L, respectively, after changing its system to the two-phase biological treatment system of activated sludge/contact aeration process.

Anti-HBc IgG subclasses in different populations by comparing a variety of ELISA plates

The number of IgG subclasses for hepatitis B virus (HBV) core antigen (anti-HBc), demonstrated for HBV-infected individuals, was measured by enzyme-linked immunosorbent assay (ELISA). Four commercially available hepatitis B core antigen (HBcAg) plates and one prepared plate were tested for ELISA sensitivity by the detection of 14 serum samples drawn from HBV chronic carriers, cured patients, vaccinees, and non-infected individuals. Differences in optical density (OD) values were obtained by comparing data gathered from the five plate types, suggesting that different plates may have different binding capabilities for each anti-HBc IgG subclass and, thus, contribute to the different ELISA sensitivities. Of these plates, the GB plate showed the most obvious absorbance changes for anti-HBc subclasses in different populations. These data also indicated different patterns for IgG-specific subclasses for various populations. For HBsAg+ carriers, the OD for IgG1 was greater than for IgG3. By contrast, the OD for IgG3 was higher than that for IgG1 in those subjects who were negative for HBsAg.

Characterization of human GRK7 as a potential cone opsin kinase

PURPOSE

Homozygous inactivation of the mouse gene for GRK1 (G protein-coupled receptor kinase 1, or rhodopsin kinase) causes severe defects in the recovery of cone phototransduction. However, electroretinographic (ERG) analyses of human oguchi patients with defective GRK1 alleles showed normal or slightly abnormal photopic responses. It remains unclear why the loss of GRK1 yields such different phenotypes in the recovery of mouse and human cones. We examined the localization and enzyme activity of GRK7, the human ortholog of the seventh member of the GRK family, in an attempt to understand its potential role in photopic vision.

METHODS

Bioinformatic approaches were used to identify the human GRK7 gene. Human and bovine GRK7 cDNAs were isolated by RT-PCR. Recombinant GRK7, expressed in insect cells, was used to phosphorylate activated rhodopsin. Antibodies raised against GRK7 peptides were used to examine the retina specific expression of GRK7 by immunoblotting and its subcellular localization by immunocytochemistry.

RESULTS

The human GRK7 gene is located on chromosome 3q21, spans at least 10 Kb and consists of 4 exons. In human, GRK7 is expressed exclusively in the retina and is found in all retinal neurons, and specifically, in cone outer segments. Recombinant human GRK7 catalyzes rhodopsin phosphorylation in a light dependent manner. We provide evidence that GRK1 and GRK7 are co-expressed in human cones. In contrast, mouse GRK7 is expressed in many tissues including retina where photoreceptors apparently do not express GRK7.

CONCLUSIONS

The presence of GRK7 in human, but not in mouse, cone outer segments suggests that GRK7 may function to provide the normal photopic vision reported by oguchi patients with a defective GRK1 gene. The absence of GRK7 expression in cone outer segments of mice is consistent with the notion that mouse cones rely solely on GRK1 to shutoff cone visual pigments.

Gene expression profiles of light-induced apoptosis in arrestin/rhodopsin kinase-deficient mouse retinas

To examine the molecular processes that lead to light-induced retinal degeneration, mutant mice deficient in arrestin and rhodopsin kinase were raised in the dark and then subjected to relatively low doses of white light. The kinetics of the subsequent induction of apoptosis, change in mRNA transcript level, and photoreceptor cell death were monitored. Analysis of transcript profiles identified clusters of genes that responded differently to illumination, including a cluster of photoreceptor-specific genes that showed marked decreases in levels long before morphological damage could be readily ascertained. The behaviors of other gene clusters demonstrate the coordinate induction of stress gene responses early in the course of irradiation. There was little, if any, change in transcript levels corresponding to genes associated with the initiation of apoptosis or antiapoptotic effects. Transcript analysis provides insight into the patterns of gene expression that are associated with the different stages of retinal degeneration in this model system.

Long-lived immune response to early secretory antigenic target 6 in individuals who had recovered from tuberculosis

We sought to understand the persistence and relevance of the long-lived immune response to early secretory antigenic target (ESAT-6) of Mycobacterium tuberculosis in humans. ESAT-6 is recognized by memory cells involved in protection of animals against tuberculosis (TB). Recent reports also showed that ESAT-6 response can be recovered in patients with TB and in those soon after anti-TB therapy. We chose 18 individuals who had recovered from pulmonary TB (some in remission for >5 years), and 14 bacille Calmette-Guérin-vaccinated healthy individuals for this study. The results showed that peripheral blood mononuclear cells of 10 (55.6%) of 18 patients with TB remission responded to ESAT-6 with stimulation indices >3.0, whereas none of the healthy controls responded. Functional analysis showed that 13 (72.2%) of 18 patients with TB remission produced significant amounts of IFN-gamma in response to ESAT-6, whereas only 1 (7.1%) of the 14 healthy control subjects did so. It appears that responses to ESAT-6 can persist in individuals who had recovered from pulmonary TB.

Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: an electromyographic study

OBJECTIVES

To evaluate the electromyographic activities of vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles in open and closed kinetic chain exercises in subjects with patellofemoral pain syndrome (PFPS).

DESIGN

Case-controlled study.

SETTING

Rehabilitation science center in a tertiary medical center.

PARTICIPANTS

Ten patients with bilateral knee pain diagnosed with PFPS and 10 healthy volunteers.

INTERVENTIONS

Subjects performed open kinetic chain exercise on an isokinetic dynamometer and closed kinetic chain exercise by squat-to-stand and stand-to-squat tasks. Surface electromyography was done for the VMO and VL muscles.

MAIN OUTCOME MEASURES

VMO/VL ratios were calculated after normalization of muscle activities.

RESULTS

The VMO/VL ratios of PFPS subjects were significantly lower than were those of unimpaired subjects during knee isokinetic closed kinetic chain exercises (p = .047). However, there was no statistical difference in VMO/VL ratio between subjects with and without PFPS during closed kinetic chain exercises (p = .623). Maximum VMO/VL ratio was obtained at 60 degrees knee flexion in closed kinetic chain exercise.

CONCLUSION

In closed kinetic chain exercises, more selective VMO activation can be obtained at 60 degrees knee flexion. Maximal VMO/VL ratio was observed at this knee flexion angle, and muscle contraction intensity was also greatest.

Lipoma arborescens of the knee: a case report

Lipoma arborescens is a rare intraarticular lesion of unknown etiology. We describe the radiographic, computerized tomographic, and magnetic resonance (MR) imaging characteristics of lipoma arborescens in a 17-year-old boy presenting with chronic painful swollen knee. Histologic examination after surgical synovectomy confirmed the diagnosis of lipoma arborescens. The fatty nature and frond-like appearance of this lesion can be demonstrated on imaging studies, especially MR imaging. Open synovectomy is curative in most cases. Although lipoma arborescens is rare, it is important to recognize and differentiate it from other synovial lesions by MR imaging.

Chemical constituents from Drypetes littoralis

Chemical investigation of Drypetes littoralis yielded three new tricyclic diterpenes, drypetenones A, B, and C (1--3), and one new xanthone (4). Spectral analyses and chemical correlations established the structures as 10S-12-hydroxy-11-methoxy-13-methylpodocarpa-1,5,8,11,13-pentaene-3,7-dione, (1), 10S-12-hydroxy-11-methoxy-13-methylpodocarpa-5,8,11,13-tetraene-3,7-dione (2), 10S-12-hydroxy-6,11-dimethoxy-13-methylpodocarpa-1,5,8,11,13-pentaene-3,7-dione (3), and 1-hydroxy-7-hydroxymethyl-6-methoxyxanthone (4). Complete (13)C NMR assignment of boehmenan D (5) is also made.