The FIB-4 scores in the emergency department to predict the outcomes of COVID-19 patients in taiwan

Objective

We aimed to determine the reliability of using the Fibrosis-4 (FIB-4) index in COVID-19 patients without underlying liver illness.

Method

We employed multivariate logistic regression to identify variables that exhibited statistically significant influence on the ultimate outcome. Multilayer perceptron analysis was employed to develop a prediction model for the FIB-4 index concerning ICU admission and intubation rates. However, the scarcity of cases rendered the assessment of the mortality rate unfeasible. We plotted ROC curves to analyze the predictive strength of the FIB-4 index across various age groups.

Result

In univariate logistic regression, only the FIB-4 index and respiratory rate demonstrated statistical significance on all poor outcomes. The FIB-4 index for mortality prediction had an ROC and AUC of 0.863 (95% CI: 0.781-0.9444). It demonstrates predictive power across age groups, particularly for age ≥65 (AUC: 0.812, 95% CI: 0.6571-0.9673) and age <65 (AUC: 0.878, 95% CI: 0.8012-0.9558). Its sensitivity for intubation and ICU admission prediction is suboptimal.

Conclusion

FIB-4 index had promising power in prediction of mortality rate in all age groups.

Effect of the Timing of Hyperbaric Oxygen Therapy on the Prognosis of Patients with Idiopathic Sudden Sensorineural Hearing Loss

This study aimed to evaluate the effects of hyperbaric oxygen therapy (HBOT) on the hearing recovery of patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The clinical data of 79 patients diagnosed with ISSNHL and treated with HBOT between January 2017 and December 2019 were retrospectively reviewed. The pure tone audiometry (PTA) scores before and after HBOT were recorded. The associations of HBOT efficacy with demographic and clinical characteristics and the duration from disease onset to HBOT administration were determined. The average PTA score was 80.06 ± 25.94 dB before and 60.75 ± 21.26 dB after HBOT; the difference was significant. HBOT improved the hearing of 55.7% of the patients with ISSNHL (defined as an average PTA ≥ 11dB or a final average PTA score below 29 dB). There was a significant inverse relationship between the duration from symptom onset to HBOT administration and PTA score reduction after HBOT, which was adjusted for factors including age, sex, laterality of hearing loss, initial PTA score, reception of intratympanic steroid injections, tinnitus, dizziness, vertigo, diabetes, hypertension, and coronary artery disease. Commencing HBOT at an earlier stage is closely linked to greater improvements in hearing for patients with ISSNHL.

Newly-diagnosed immunoglobulin A nephropathy with increased plasma galactose-deficient-IgA1 antibody associated with mRNA COVID-19 vaccination: a case report

Newly-diagnosed or relapses of immunoglobulin A nephropathy (IgAN) have been associated with COVID-19 vaccination in the literature. Most reported cases were mild clinical diseases characterized by microscopic haematuria and do not require dialysis treatment. This current case report describes a 55-year-old male patient that presented to the emergency department with acute kidney injury after receiving the first dose of the mRNA-1273 COVID-19 vaccine. After admission, his renal function deteriorated rapidly, and then he developed uraemic encephalopathy. He underwent emergency haemodialysis with a rapid improvement in his mental status. Renal biopsy showed newly-diagnosed IgA nephropathy along with markedly elevated plasma level of galactose-deficient-IgA₁ (Gd-IgA₁) antibody. The patient did not receive immunosuppressive treatment and is now dialysis-free. Immune activation is considered an essential factor in developing or exacerbating IgAN following COVID-19 vaccination. This current case report demonstrates that elevated Gd-IgA₁ antibody may be the potential mechanistic link between COVID-19 vaccination and IgAN.

[Effect of a Simple Home-Based Oral Care Regimen on Oral Mucositis in Patients With Oral Cavity and Nasopharyngeal Cancer: A Quasi-Experimental Study]

BACKGROUND

The majority of patients with oral cavity and nasopharyngeal cancer experience severe oral mucositis during concurrent radiochemotherapy. The effectiveness of routine nursing education remains limited.

PURPOSE

To evaluate the effect of a simple home-based oral care regimen on oral mucositis.

METHODS

A double-group quasi-experimental design was adopted in this study. The participants were all newly diagnosed patients with oral cavity and nasopharyngeal cancer who were scheduled to receive concurrent radiochemotherapy in a northern medical center. A total of 31 patients in the experimental group and 32 patients in the control group were enrolled as participants. The control group received routine care, while the experimental group received an additional six- to seven-week two-way interactive home-based oral care regimen. The measurement tools included a plaque record and oral assessment guide (OAG) implemented twice during the study period. Study data were collected at 8 time points, including before treatment, at 1-5 weeks of treatment, at the end of treatment, and at one-month post-treatment. Data analysis was performed using two-way repeated measures ANCOVA.

RESULTS

After controlling for OAG score, nutrition, age, living habits, and oral hygiene, the development of mucositis was found to be significantly slower in the experimental group than in the control group during the traumatic phase (effect of group: F = 11.1, p < .01; effect of group x time: F = 3.5, p = .01). However, both groups reported a statistically similar rate of improvement during the repair phase (effect of group and group x time: F = 0.19, p = .67).

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

The simple home-based oral care regimen introduced in this study may be used to improve traumatic oral mucositis in patients with oral cavity and nasopharyngeal cancer. It is recommended that even after the completion of radiotherapy, medical staffs should continue to strengthen patients' execution of proper oral care to maintain the positive effect until the mucositis has abated.

Fermented Soy Paste Alleviates Lipid Accumulation in the Liver by Regulating the AMPK Pathway and Modulating Gut Microbiota in High-Fat-Diet-Fed Rats

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease due to lipid accumulation in the hepatocyte. Diet, especially a high-fat diet, is one risk factor that leads to NAFLD. Many natural compounds such as isoflavones have antiobesity effects. Therefore, intake of these functional compounds through daily dietary choices is a method of improving health. Miso is a kind of fermented soy paste, which is rich in isoflavones and has a different biological activity. In this study, we investigated the effects of different concentrations of fermented soy paste on NAFLD in high-fat-diet (HFD)-fed Sprague-Dawley (SD) rats. The results showed that 2% fermented soy paste decreased serum triacylglycerol (TG) and alanine aminotransferase (ALT) and reduced lipid accumulation in the liver through induced fatty acid oxidation by activating the adenosine 5'-monophosphate -activated protein kinase (AMPK) pathway and increasing PGC1α and CPT1α protein expression. Furthermore, we found that 2% fermented soy paste increased the abundance of Prevotellaceae NK3B31 and Desulfovibrio. Taken together, fermented soy paste improved HFD-induced lipid accumulation in the liver by activating fatty acid oxidation and modulating gut microbiota.

Helical tomotherapy with a complete-directional-complete block technique effectively reduces cardiac and lung dose for left-sided breast cancer

Objectives:

To evaluate the feasibility and optimal restricted angle of the complete-directional-complete block (CDCB) technique in helical tomotherapy (HT) by including regional nodal irradiation (RNI) with the internal mammary node (IMN) in left-sided breast cancer.

Methods:

Ten left-sided breast cancer patients treated with 50 Gy in 25 fractions were compared with five-field intensity-modulated radiation therapy (5F-IMRT) and six types of HT plans. In the HT plans, complete block (CB), organ-based directional block (OBDB) and CDCB with different restricted angles were used.

Results:

The conformity index (CI) between the CDCB_0,10,15,20 and 5F-IMRT groups was similar. Compared to CB, OBDB and 5F-IMRT, CDCB₂₀ resulted in a decreased ipsilateral mean lung dose. The low-dose region (V₅) of the ipsilateral lung in OBDB (84.0%) was the highest among all techniques (p < 0.001). The mean dose of the heart in CB was significantly reduced (by 11.5–22.4%) compared with other techniques. The V₃₀ of the heart in CDCB₂₀ (1.9%) was significantly lower than that of CB, OBDB and 5F-IMRT. Compared to the mean dose of the left anterior descending (LAD) artery of 5F-IMRT (27.0 Gy), CDCB₀, CDCB₁₀, CDCB₁₅, CDCB₂₀ and OBDB reduced the mean dose effectively by 31.7%, 38.3%, 39.6%, 42.0 and 56.2%, respectively. Considering the parameters of the organs-at-risk (OARs), CDCB_10,15,20 had higher expectative values than the other techniques (p = 0.01).

Conclusions:

HT with the CDCB technique is feasible for treating left-sided breast cancer patients. The CDCB_10-20 techniques not only achieved similar planning target volume coverage, homogeneity and dose conformity but also allowed better sparing of the heart and bilateral lungs.

Advances in knowledge:

For left-sided breast cancer patients whose RNI field includes the IMN, heart avoidance is an important issue. The CDCB technique achieved good PTV coverage, homogeneity and dose conformity and allowed better sparing of the mean dose of the lung, the LAD artery, and the heart and reduced the V₃₀ of the heart.

Targeting non-muscle myosin II promotes corneal endothelial migration through regulating lamellipodial dynamics

Corneal endothelial cell (CEC) dysfunction causes corneal edema that may lead to blindness. In addition to corneal transplantation, simple descemetorhexis has been proposed to treat centrally located disease with adequate peripheral cell reserve, but promoting the centripetal migration of CECs is pivotal to this strategy. Here, we show that targeting non-muscle myosin II (NMII) activity by Y27632, a ROCK inhibitor, or blebbistatin, a selective NMII inhibitor, promotes directional migration of CECs and accelerates in vitro wound healing. The lamellipodial protrusion persistence is increased, and actin retrograde flow is decreased after NMII inhibition. Counteracting lamellipodial protrusion by actin-related protein 2/3 (ARP2/3) inhibitor abolishes this migration-promoting effect. Although both Y27632 and blebbistatin accelerate wound healing, cell junctional integrity and barrier function are better preserved after blebbistatin treatment, leading to more rapid corneal deturgescence in rabbit corneal endothelial wounding model. Our findings indicate that NMII is a promising therapeutic target in the treatment of CEC dysfunction. KEY MESSAGES: NMII inhibition promotes directional migration and wound healing of CECs in vitro. Lamellipodial protrusion persistence is increased after NMII inhibition. Selective NMII inhibitor preserves junctional integrity better than ROCK inhibitor. Selective NMII inhibitor accelerates corneal deturgescence after wounding in vivo.

Prophylactic NS-21 maintains the skin moisture but does not reduce the severity of radiation dermatitis in patients with head and neck cancer: a randomized control trial

Background

To evaluate the practicality of NS-21 cream with regard to its skin-related toxicity in patients with head and neck cancer (HNC) who are undergoing concurrent chemoradiation therapy (CCRT) or radiotherapy (RT).

Methods

Between July 2015 and November 2017, 30 HNC patients who underwent RT or CCRT were randomly allocated to receive either NS-21 or control treatment on their irradiated skin three times per day, starting at the initiation of RT or CCRT and ending 2 weeks after the completion of RT or until the appearance of grade 3 acute radiation dermatitis (ARD). Dermatitis was recorded weekly according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Skin humidity was monitored by a digital moisture meter. The generalized estimating equation (GEE) and logit link function method were used for statistical analysis.

Results

No serious adverse events were observed in either group. Itching dermatitis occurred on the right lower neck in one patient of the NS-21 group during the 3rd week of CCRT, but the severity was mild. The median skin moisture value at the time of the final treatment was significantly different between the study and control groups (30.6 vs. 27.3, p = 0.013). Additionally, there was an inverse relationship between skin moisture and ARD grade (B = -0.04, p = 0.005). The incidence of ARD at the time of the last treatment was not significantly different between the study and control groups (6.7% vs 26.7%, p = 0.165). The risk of grade 3 ARD for skin that had received an irradiation dose of 47–70 Gy was higher than that of skin that had received an irradiation dose ≤46 Gy (OR = 31.06, 95% CI =5.95–162.21, p < 0.001). Nevertheless, the risk of ARD was not significantly different between the groups (OR = 0.38, 95% CI = 0.08–1.74, p = 0.212).

Conclusions

NS-21 was well tolerated and effective for the maintenance of skin moisture; however, there was no statistically significant reduction in the risk of ARD in HNC patients undergoing RT or CCRT when compared with HNC patients in the control group.

Trial registration

The study was approved by the Institutional Review Board of Far Eastern Memorial Hospital (FEMH-IRB, 104048-F), Registered 1st June 2015,

Esophageal Metal Stents with Concurrent Chemoradiation Therapy for Locally Advanced Esophageal Cancer: Safe or Not?

BACKGROUND

The purpose of this study was to review the risks and benefits of concurrent chemoradiation therapy (CCRT) with esophageal self-expandable metal stents (SEMS) for the treatment of locally advanced esophageal cancer.

MATERIALS AND METHODS

Between January 2014 and December 2016, the data from 46 locally advanced esophageal cancer patients who received CCRT at our institution were retrospectively reviewed. Eight patients who received CCRT concomitant with SEMS placement (SEMS plus CCRT group) and thirty-eight patients who received CCRT without SEMS placement (CCRT group) were identified. The risk of developing esophageal fistula and the overall survival of the two groups were analyzed.

RESULTS

The rate of esophageal fistula formation during or after CCRT was 87.5% in the SEMS plus CCRT group and 2.6% in the CCRT group. The median doses of radiotherapy in the SEMS plus CCRT group and the CCRT group were 47.5 Gy and 50 Gy, respectively. SEMS combined with CCRT was associated with a greater risk of esophageal fistula formation than CCRT alone (hazard ratio [HR], 72.30; 95% confidence interval [CI], 8.62-606.12; p < .001). The median overall survival times in the SEMS plus CCRT and CCRT groups were 6 months and 16 months, respectively. Overall survival was significantly worse in the SEMS plus CCRT group than in the CCRT group (HR, 5.72; 95% CI, 2.15-15.21; p < .001).

CONCLUSION

CCRT concomitant with SEMS for locally advanced esophageal cancer results in earlier life-threatening morbidity and a higher mortality rate than treatment with CCRT alone. Further prospective and randomized studies are warranted to confirm these observations.

IMPLICATIONS FOR PRACTICE

Patients treated with SEMS placement followed by CCRT had higher risk of esophageal fistula formation and inferior overall survival rate compared with patients treated with CCRT alone. SEMS placement should be performed cautiously in patients who are scheduled to receive CCRT with curative intent.

Dexamethasone reduces mitomycin C-related inflammatory cytokine expression without inducing further cell death in corneal fibroblasts

The purpose of this study was to investigate the effect of dexamethasone (DEX) on mitomycin C (MMC)-induced inflammatory cytokine expression in corneal fibroblasts. Primary human corneal fibroblasts were treated with MMC, dexamethasone, or in combination. Morphological changes and cell growth were documented using phase-contrast microscopy and PicoGreen assay, respectively. Cell apoptosis was evaluated by annexin V/propidium iodide staining, whereas viability was tested by the live/dead assay and analyzed by flow cytometry. The relative expression of interleukin-8 and monocyte chemoattractant protein-1 was investigated with quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Mitogen-activated protein kinase activation and mitogen-activated protein kinase phosphatase-1 expression were documented by Western blot analysis. We found that MMC induced corneal fibroblast elongation, apoptosis, and retarded cell growth, whereas DEX did not significantly alter cell morphology or viability. The combination of DEX and MMC did not induce additional apoptosis and cell death. DEX dose dependently down-regulated basal and MMC-induced interleukin-8 and monocyte chemoattractant protein-1 mRNA expression and protein secretion. DEX attenuated MMC-induced p38 and Jun N-terminal kinases activation and up-regulated expression. These suggested that DEX may inhibit MMC-induced interleukin-8 and monocyte chemoattractant protein-1 by up-regulating MKP-1 expression, which subsequently deactivated p38 and Jun N-terminal kinases activation. Combined MMC and DEX treatment may facilitate corneal wound healing.

Mechanical corneal epithelium scraping and ethanol treatment up-regulate cytokine gene expression differently in rabbit cornea

PURPOSE

To explore inflammation and wound healing in the rabbit eye following topical ethanol treatment or mechanical debridement.

METHODS

Seventy-six pigmented rabbit corneas were divided into four groups: mechanical group (n = 33), which received mechanical epithelial debridement; ethanol-30 (n = 18) and ethanol-60 groups (n = 18), which were treated with 20% ethanol for 30 and 60 seconds, respectively; and control group (n = 7), which remained untreated. Corneal epithelial and stromal keratocyte changes were examined with hematoxylin-eosin and terminal deoxynucleotidyltransferase-mediated dUPT nick end labeling (TUNEL) staining at 3 hours (day 0) and days 1, 2, 3, 5, and 7. Interleukin (IL)-1alpha, IL-8, monocyte chemotactic protein (MCP-1), and transforming growth factor (TGF)-beta1 expression were examined using real-time polymerase chain reaction.

RESULTS

Stromal keratocyte cell death was higher in the mechanical group on day 0 (P = .002) and in the ethanol-60 group on days 3, 5, and 7 (P < .05). Keratocyte cell death was more pronounced in the ethanol-60 group than in the ethanol-30 group. In the mechanical group, IL-1alpha, IL-8, and MCP-1 expression was up-regulated starting on day 0 (P < .05) and returned to baseline on day 5 to 7. TGF-beta1 expression was up-regulated in the mechanical group throughout the experiment (P < .05). In the ethanol-30 and ethanol-60 groups, IL-1alpha expression was up-regulated on day 0, IL-8 expression was slightly up-regulated on day 0, and MCP-1 and TGF-beta1 expression were not up-regulated.

CONCLUSIONS

Mechanical epithelial removal initially induces more keratocyte cell death, but deep stromal keratocyte death persists longer with ethanol treatment. In this rabbit model, mechanical epithelial removal upregulated inflammatory cytokines and TGF-beta1 gene expression more than ethanol treatment.

Mitomycin C Upregulates IL-8 and MCP-1 Chemokine Expression via Mitogen-Activated Protein Kinases in Corneal Fibroblasts

PURPOSE

To investigate the expression of chemokines and their signaling pathways after application of mitomycin C (MMC) to corneal fibroblasts.

METHODS

Primary porcine and human corneal fibroblasts from passages 3 to 6 were treated with MMC at concentrations of 0.05, 0.1, or 0.2 mg/mL for 1, 2, 5, or 10 minutes. The relative expression of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) were investigated with reverse transcription, and quantitative real-time polymerase chain reaction (qRT-PCR), and enzyme-linked immunosorbent assay (ELISA). The effects of MMC on the activation of kinases were analyzed by Western blot analysis with specific antiphosphokinase antibodies. The signaling pathways by which MMC regulates the expression of IL-8 and MCP-1 were evaluated by pharmacological kinase-specific inhibitors.

RESULTS

The expression of IL-8 and MCP-1 were upregulated after MMC treatment in a time- and concentration-dependent manner. Furthermore, the upregulated expression of IL-8 and MCP-1 increased with longer incubation time. MMC treatment enhanced the phosphorylation of p38, JNK, and ERK at different time points. The MMC-related IL-8 and MCP-1 expression was inhibited by both a p38 inhibitor (SB203580) and an ERK inhibitor (PD98059). A JNK inhibitor (SP600125) reduced the expression of MMC-induced MCP-1 but not of IL-8.

CONCLUSIONS

MMC treatment upregulated the expression of IL-8 and MCP-1 mRNA and protein secretion by the activation of mitogen-activated protein kinases (MAPKs) in corneal fibroblasts.

Ethanol Treatment Induces Significant Cell Death in Porcine Corneal Fibroblasts

PURPOSE

To explore the effect of ethanol treatment on corneal stromal cells.

METHODS

Primary porcine corneal fibroblasts from passages 3 to 5 were treated with ethanol at concentrations of 10%, 15%, 20%, and 50% for 30 seconds. A control group was treated with phosphate-buffered saline (PBS) for 30 seconds. Morphologic changes were documented with phase-contrast microscopy, and the growth curves were examined with a PicoGreen assay. Cellular viability was examined with an ethidium homodimer and calcein-AM stain, whereas cellular apoptosis and/or necrosis were analyzed by a YO-PRO-1 dye/propidium iodide apoptosis assay coupled with flow cytometry and further confirmed with a genomic DNA pattern assay. Cellular toxicity was examined with a lactate dehydrogenase (LDH) assay.

RESULTS

Significant cell rounding and detachment from the culture dish were noticed after 20% ethanol treatment of 30 seconds, despite that the cell morphology remained unchanged in the PBS and 10% and 15% ethanol groups. Twenty percent ethanol induced significant cellular toxicity, causing cell death as shown by ethidium homodimer and calcein-AM stain, YO-PRO-1 dye/propidium iodide apoptosis assay, and LDH assay, although 10% and 15% ethanol caused minimal changes to corneal fibroblasts. Cellular death was most significant 6 hours after the 20% ethanol treatment. The genomic DNA pattern revealed intact DNA in the control, 10% ethanol, and 15% ethanol groups at all times, whereas DNA smearing was noticed at 48 hours after the 20% ethanol treatment. However, none of the DNA examined revealed significant DNA laddering patterns of apoptosis. Fifty percent ethanol treatment of 30 seconds resulted in cell fixation and cell death.

CONCLUSION

Treatment with 20% ethanol for 30 seconds induced significant porcine corneal fibroblast cell death, whereas 10% and 15% ethanol treatment of 30 seconds caused minimal changes. We propose that, when applied for 30 seconds, 20% ethanol is the threshold level that causes cell death in cultured porcine corneal fibroblasts.

Lipoprotein-X reduces LDL atherogenicity in primary biliary cirrhosis by preventing LDL oxidation

Hypercholesterolemic human LDL contains oxidized subfractions that have atherogenic properties. Paradoxically, atherosclerosis incidence is low in patients with primary biliary cirrhosis (PBC), a disease characterized by marked increases in plasma LDL, including the LDL subfraction lipoprotein-X (Lp-X). To investigate the mechanisms underlying this paradox, we first examined the propensity to oxidation of unfractionated LDL isolated from PBC patients. After prolonged incubation with copper, PBC-LDL failed to increase the oxidation index or electrophoretic mobility noted in control LDL. An admixture of PBC-LDL or Lp-X with control LDL prevented oxidation of the latter in a dose-dependent manner. PBC-LDL was also noncompetitive against copper-oxidized LDL (oxLDL) for binding with a murine monoclonal anti-oxLDL antibody in a competitive ELISA. OxLDL exerts its proapoptotic and antiangiogenic effects in part by inhibiting fibroblast growth factor 2 (FGF2) expression. Preincubation of oxLDL with PBC-LDL, but not control LDL, attenuated the inhibitory effects of oxLDL on FGF2 expression in cultured bovine aortic endothelial cells (ECs). The antioxidant and prosurvival properties of PBC-LDL diminished after the patients underwent orthotopic liver transplantation. These results suggest that Lp-X reduces LDL atherogenicity by preventing LDL oxidation to protect EC integrity in the presence of hypercholesterolemia. They also suggest that altering LDL composition may be as important as reducing LDL concentration in preventing or treating atherosclerosis.

Sp1 and Sp3 are involved in up-regulation of human deoxyribonuclease II transcription during differentiation of HL-60 cells

Expression of DNase II in macrophages is potentially crucially important in the removal of unwanted DNA. We have previously shown that DNase II expression is up-regulated at the transcriptional level during the phorbol 12-myristate-13-acetate (PMA)-induced differentiation of HL-60 and THP-1 cells. In this study, we investigated the cis-regulatory elements and transcription factors involved in this process in HL-60 cells. cis-Regulatory elements in the DNase II promoter were located by 5' deletion and site-directed mutagenesis of promoter-luciferase constructs and transient transfection of HL-60 cells. Furthermore, the binding proteins were identified by electrophoretic mobility shift assay (EMSA) in the presence of specific antibodies. In the DNase II promoter, 249 base pairs upstream of the transcription start site were essential for maximal promoter activity in both untreated and PMA-treated HL-60 cells and, within this region, three Sp1 and Sp3 binding sites were identified as essential for transcriptional regulation and PMA induction. Western blot analysis showed that PMA treatment resulted in increased levels of Sp1 and Sp3 proteins. Furthermore, cotransfection analysis in Drosophila SL2 cells showed that Sp1 was more potent than Sp3 in activating the DNase II promoter. We therefore conclude that Sp1 and/or Sp3 are involved in the up-regulation of DNase II expression during the differentiation of HL-60 cells.

Pesticide storage and release in unsaturated soil in Illinois, USA

The chemical fate and movement of pesticides may be subject to transient storage in unsaturated soils during periods of light rainfall, and subsequent release into shallow groundwater by increased rainfall. The objective of this study was to conduct field-scale experiments to determine the relative importance of transient storage and subsequent release of agrichemicals from the vadose zone into potential aquifers. Two field-scale experiments were conducted under a rain exclusion shelter. In the 1x experiment, atrazine and chlorpyrifos were applied at application-rate equivalents (1.6 kg ha(-1) and 1.3 kg ha(-1), respectively). In the 4x experiment, atrazine was applied in an amount that was four times greater than that usually applied to fields (6.7 kg ha(-1)). Water was either applied to simulate rain or withheld to simulate dry periods. In the 1x experiment, atrazine was detected in the water samples whereas chlorpyrifos was not detected in the majority of the samples. The dry period imposed on the treatment plot did not appear to result in storage of the chemicals, whereas the wet period resulted in greater leaching of atrazine, although the concentrations remained less than the Maximum Contaminant Level of 3 microg L(-1). Both chemicals were detected in soil samples collected from a 20- to 30-cm depth, but it appeared that both chemicals dissipated before the field experiment was concluded. It appeared that the one-time application of atrazine and chlorpyrifos at the label rates did not result in a sufficient mass to be stored and flushed in significant concentrations to the saturated zone. When atrazine was applied at 4x and a longer drought period was imposed on the treatment plot, the resulting concentrations of dissolved atrazine were still less than 3 microg L(-1) . Atrazine was detected in only the near-surface (0 to 15 cm) soil samples and the herbicide dissipated before the onset of the dry period in the treatment plot. The results of this field study demonstrated that atrazine and chlorpyrifos were not sufficiently persistent to be stored and then released in significantly large concentrations to the saturated zone. The dissipation half-life of atrazine in the 4x application was about 44 days. This study, in addition to others, suggested that atrazine may be less persistent in surface soil than has been generally reported.

Monoclonal and polyclonal antibodies against human ferritin, a nonspecific tumor marker

The aim of this study was to produce monoclonal and polyclonal antibodies against a nonspecific tumor marker, human ferritin. Hyperimmune ICR mice produced polyclonal antibodies after injection with 0.5 mL pristane, and were injected with NS-1 myeloma cells 2 weeks later. Hyperimmune Balb/c mice were used for the production of monoclonal antibodies (MAbs). Mice were immunized four times, given a final boost, and their spleen cells were collected and fused with NS-1 myeloma cells under the presence of PEG 1500. The fused cells were then selected in the HAT-RPMIX medium. Anti-ferritin antibody-secreting hybridoma cell lines with high titer were cloned by enzyme-linked immunoadsorbent assay (ELISA) and then subcloned by limiting dilution in 15% fetal bovine serum (FBS) HT-RPMIX medium. Five murine hybridoma-producing antiferritin MAbs were obtained and designated 1AD11F9, 1AD11E11, 2AD11D2, 2AD11A5, and 3AD11G8. Isotypes of these MAbs were identified as IgM heavy chain and kappa light chain. Hitrap Protein A and Hitrap IgM purification column were used for the purification of polyclonal and monoclonal antibodies, respectively.

Microbiologic assay for detection of antimicrobial agents in urine

Antimicrobial therapy can be a confounding factor in the diagnosis of urinary tract infection and is not always reported to laboratories by physicians. We developed a microbiologic assay for screening urine specimens for antimicrobial agents. Bacillus stearothermophilus was used as the indicator bacteria. A total of 1,921 urine specimens from three hospitals in Taiwan were screened using this assay. Of the samples assayed, 1,293 were positive for antimicrobial agents. Agreement between information provided by physicians and laboratory findings was 68.5% (419/612). In the presence of antimicrobial agents in the urine samples, the isolation of yeasts and Pseudomonas aeruginosa increased dramatically, from 4.5 to 19.5% and 4.2 to 13.2%, respectively. Additionally, Escherichia coli was more resistant to gentamicin (75.3% vs 48.7%, p < 0.0001), norfloxacin (85.2% vs 64.6%, p = 0.0006) and co-trimoxazole (58.5% vs 35.5%, p = 0.0018). In view of the high rate of occurrence of antimicrobial agents in urine specimens and the lack of information provided by most physicians to laboratories, a screening method to detect the presence (or absence) of antimicrobials in urine specimens may be a useful tool particularly in areas such as Taiwan where antimicrobial agents are commonly abused.

[The ratios and kinds of clinical bacteria isolated in Taiwan's large-size hospitals]

The prevalence of clinical bacteria, as isolated from Linko Chang-Gung Memorial Hospital (2,300 beds) in the period January 1985 to December 1986 and from Taipei Veterans General Hospital (2,300 beds) during the period January 1986 to December 1986, was analyzed with the following findings: (i) The isolation ratio of anaerobic and aerobic or facultative bactria during the period of investigation were 7.8% (5,513/70,799) and 92.2% (65,286/70,799), respectively. (ii) Of the total aerobic or facultative isolates from the two hospitals, 32.9% (21,510/65,286) were Gram positive cocci and bacilli, 67.1% (43,776/65,286) were Gram negative cocci and bacilli. (iii) Of these Gram-negative bacilli, 65.2% (28,490/43,675) were Enterobacteriaceae were Enterobacteriaceae and glucose fermentative Gram negative bacilli, 32.0% (13,984/43,675) were glucose nonfermentative Gram negative bacilli, and 2.7% (1,200/43,675) were fastidious Gram negative bacilli. (iv) The more common species among the members of Enterobacteriaceae were Escherichia coli 35.7% (10,163/28,490), and Klebsiella pneumoniae 18.2% (5,186/28,490). The other common species included Enterobacter cloacae, Proteus mirabilis, Serratia marcescens, Morganella morganii, Citrobacter freundii and Proteus vulgaris. The frequencies of Salmonella species and Shigella species in these two large hospitals were up to 1.6% (456/28,490) and 0.5% (149/28,490), respectively. The most common isolate among other glucose fermentative Gram negative bacilli was Aeromonas hydrophila 3.0% (843/28,490). The finding of 0.1% (11/28,490) Vibrio alginolyticus was considered as clinically significant in Taiwan. (v) Of these glucose nonfermentative Gram negative bacilli, 69.4% (9,704/13,984) were Pseudomonas aeruginosa, 18.9% (2,637/13,984) Acinetobacter species, 10.8% (1,516/13,984) Pseudomonas species. (vi) The most common bacteria among fastidious Gram negative bacilli was Haemophilus influenzae, 96.2% (1,154/1,200). (vii) Of these Gram negative cocci, 59.4% (60/101) was Neisseria gonorrhoeae and 6.9% (7/101) N. meningitidis. (viii) The more common isolates of Gram positive bacilli included Bacillus species and Corynebacterium species (diphtheroids). (ix) Of these Gram positive cocci, the isolation rates of Staphylococcus species and Streptococcus species were 54.6% (10,838/19,827) and 45.4% (9,002/19,847), respectively. The most common isolate among Gram positive cocci was Staphylococcus aureus, 30.2% (5,994/19,847); the next, enterococcus, 24.9% (4,936/19,847); then S. epidermidis, 22.2% (4,390/19,847). The less common isolates were Streptococcus pyogenes 1.1% (212/19,847) and S. pneumoniae, 1.7% (329/19,847).(ABSTRACT TRUNCATED AT 400 WORDS)

Absence of plant uptake and translocation of polybrominated biphenyls (PBBs)

Studies of polybrominated biphenyl (PBB) uptake by plants have been conducted in hydroponic solutions and in greenhouse experiments with soil. Autoradiograms of corn and soybean seedlings grown in hydroponic solutions showed no translocation of 14C-PBB from 14C-PBB-treated solutions to plant tops or within the leaf from 14C-PBB-treated spots on the upper leaf surface. A significant portion of the 14C-PBB associated with the roots was removed when the roots were dipped in acetone. Three root crops (radishes, carrots, and onions) were grown in two soils, each treated with a mixture of FireMaster BP-6 (PBB) and 14C-PBB to achieve final concentrations of 100 ppm and 100 ppb. All roots showed more PBB when grown in the soil with the lower clay and organic matter content than they did when grown in the soil with more clay and organic matter. In the latter soil (clay loam) no PBB was detected in any roots from the 100 ppb treatment. More PBB was associated with roots of carrot than of radish or onion. Corn leaf whorls containing dust from a PBB contamination soil and washed radishes from a heavily contaminated garden showed no PBB.

Field concentrations and persistence of polybrominated biphenyls in soils and solubility of PBB in natural waters

Soil samples were collected from 28 fields which had received manure from Michigan's most highly contaminated dairy herds. The number of fields in each concentration range of PBB in soil were: 2, not detectable; 15, 0.0 to 8.0 ppb; 6, 14-102 ppb, and 5, 153 to 371 ppb. Plant tissue sampled from the 10 most highly contaminated fields contained no detectable PBB. No evidence of significant degradation of PBB was noted after 1 year incubation in soil. When 14C hexabromobiphenyl and heptabromobiphenyl isomers were incubated in soil less than 0.2% of the 14C was volatilized. Also gas chromatographic analysis of soil extracts showed no difference in recovery of the six major PBB isomers between sterilized and nonsterilized soil. Analysis of these extracts by thin layer chromatography and autoradiography showed no 14C-PBB intermediates. Photodegradation products of the major hexa- and heptabromobiphenyl isomers showed more but still minor (approximately 3%) biodegradation in soil. Much of the photodegradation products appeared bound to soil, since these products could not be extracted from soil. Photodegradation does not appear to be a significant fate of PBB in manures spread on fields since no change was noted in the relative concentrations of isomers in soil samples from our field survey. Studies with distilled, tap, river, and soil waters showed that PBB solubility was markedly influenced by water composition.

Concentric nuclear inclusions

Membrane bound concentric lamellar inclusions were found in the nuclei of pancreatic acinar cells of a patient with multiple primary neoplasms and in the parotid acinar cells of a patient with systemic lupus erythematosus. It is proposed that these inclusions form from rough cisternae sequestered in the nucleus.