Intracranial stenosis in Chinese patients with acute stroke

We studied 100 consecutive acute stroke patients in a Chinese population with transcranial Doppler and CT. Twenty patients had intracerebral hemorrhage and 14 patients did not have adequate temporal windows for transcranial Doppler examination. Among the remaining 66 patients, 22 patients (33%) had intracranial occlusive diseases and 3 (6%) had extracranial carotid stenosis. Our data showed that intracranial occlusive disease is the most commonly found vascular lesion in our acute stroke patients.

In vitro percutaneous absorption enhancement of a lipophilic drug tamoxifen by terpenes

Tamoxifen is a highly lipophilic drug that is widely used in breast malignancies and also as a prophylactic therapy in women at high risk for the development of this disease. Recently, the terpenes have been reported to show an enhancement effect on percutaneous drug absorption. The effect of terpenes (e.g. carvone, 1,8-cineole, menthol, and thymol) was studied on the in vitro percutaneous absorption of tamoxifen through porcine epidermis. The above terpenes (5% w/v) in combination with 50% ethanol significantly (P < 0.01) increased the permeability coefficient of tamoxifen in comparison to the control (50% ethanol). The solubility of tamoxifen was determined in the control and enhancer solutions to correct the permeability enhancement by way of fractional solubility adjustment. Binding of tamoxifen to powdered stratum corneum from control and enhancer solutions was also determined. Binding studies reveal that the enhancement in the permeability coefficient of tamoxifen by menthol and thymol is due at least in part, to improvement in the partitioning of the drug to the stratum corneum. In conclusion, terpenes in combination with ethanol can be used to enhance the percutaneous absorption of the highly lipophilic drug tamoxifen.

[Preliminary studies on outer membrane protein (OMP) patterns of Escherichia coli O1, O2 and O78 isolates of chicken origin]

Omp patterns of twenty-five isolates of Escherichia coli serotype O1, O2 and O78 of chicken origin from Jiangsu area were determined. The outer membrane proteins of these isolates were isolated with the improved N-lauroylsarcosine method and analyzed by SDS-PAGE. Major outer membrane proteins bands contributed for OMP patterns were visualized with Coomassie brilliant blue staining. Two OMP patterns were divided in eight of O1 isolates and nine O2 isolates respectively. Among these OMP patterns, 1 OMP pattern was shared by these 2 different O serotypes isolates, and eight of O78 isolates also shared this OMP pattern. These results indicated that the OMP patterns of avian pathogenic Escherichia coli isolates of O1, O2 and O78 from this area were heterogeneous, and the same OMP patterns was presented in these 3 serotypes.

The association between Apo E genotype and depressive symptoms in elderly African-American subjects

In this study of 138 elderly subjects (112 without and 26 with dementia) obtained from a community sample of elderly African-American subjects, there were no significant differences in mean Geriatric Depression Scale scores by Apo E epsilon 4 status for dementia or nondementia subjects. Three subjects received a diagnosis of major depressive disorder. None of these subjects were Apo E epsilon 4-positive. These results do not support an association between depressive symptoms and Apo E allele status in this elderly African-American population.

Logistic regression models with missing covariate values for complex survey data

Maximum likelihood methods are used to incorporate partially observed covariate values in fitting logistic regression models. We extend these methods to data collected through complex surveys using the pseudo-likelihood approach. One can obtain parameter estimates of the logistic regression model using standard statistical software and their standard errors by Taylor series expansion or the jackknife method. We apply the approach to data from a two-phase survey screening for dementia in a community sample of African Americans age 65 and older living in Indianapolis. The binary response variable is dementia and the covariate with missing values is a daily functioning score collected from interviews with a relative of the study subject.

Clinical, pathologic and genetic studies on mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes

OBJECTIVE

To study the clinical, pathological and genetic characteristics of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS).

METHODS

Eight cases of MELAS (6 of them were from 2 families) underwent clinical study, muscle biopsy, autopsy on one patient, brain biopsy on one patient and genetic research.

RESULTS

In clinical report the average age of onset was 10-22 years old. Four cases from one family were 3 brothers and their nephew (sister's son). The death age of the three brothers was 16-20 years. Two cases from another family were a brother and a sister. The six patients of the two families showed the typical inherited characters of MELAS. The symptoms were myoclonic epilepsy, stroke-like episodes, paralysis of limbs, progressive mental retardation and neurological deaf. CT showed calcification in globus pallidus and MRI demonstrated clearly the abnormal prolongation of T2-weighed signals that distributed in frontal, parietal, occipital and temporal cortex as multiple focal, cystic and laminar necrotic areas. Pathological studies on brain showed multi-focal, cystic, and laminar or spongy necrotic abnormality primarily in gray matter of frontal, parental, temporal and occipital cortex. Decrease and loss of nerve fibers of the sub-cortical white matters of the lesion areas of cortex and calcification of globus pallidus were also observed. Red ragged fibers (RRF) and abnormal mitochondron were found by muscle biopsies. A point mutation (A-G transition) at nt 4243 in the mitochondrial tRNA Leu (UUR) was confirmed by using PCR and Southern Blot.

CONCLUSION

Although great progress has been made in the clinical, pathological and genetic research of MELAS, the pathogenesis of the disease remains further research.

Apolipoprotein E-associated risk for Alzheimer's disease in the African-American population is genotype dependent

As a part of our ongoing study on Alzheimer's disease (AD) in elderly African Americans, we obtained clinical assessment and apolipoprotein E (ApoE) genotype data on 288 individuals (including 60 with AD). The ApoE epsilon4 allele frequency was significantly increased in AD patients compared with controls. The age-adjusted odds ratio (OR) for AD in epsilon4 homozygotes was 4.83 (95% confidence interval [CI], 1.71-13.64) compared with the epsilon3/epsilon3 genotype, but the OR for AD with the epsilon3/epsilon4 genotype did not reach significance (1.20; 95% CI, 0.58-2.45). These findings suggest that the association between ApoE epsilon4 and AD is weaker in African Americans than in whites.

An empirical comparison of two semi-parametric approaches for the estimation of covariate effects from multivariate failure time data

We conducted a simulation study to compare two semi-parametric approaches for the estimation of covariate effects from multivariate failure time data. The first approach was developed by Wei, Lin and Weissfeld (WLW) and the second by Liang, Self and Chang (LSC). Based on the simulation results we recommend Wei, Lin and Weissfeld's method for the situations with identical covariates and high correlations between the failure times. When the covariates are independent, LSC produces smaller mean squared errors than WLW, although at the expense of larger bias. We also compared four computer programs for implementing Wei, Lin and Weissfeld's approach: a FORTRAN program, MULCOX2; a SAS macro; the coxph function in S-plus, and a specialized software package for complex survey data (SUDAAN). Our comparison indicates that for large data sets, the speeds of the SAS macro and coxph are comparable, while MULCOX2- and SUDAAN took longer to run. However, MULCOX2 and coxph function in S-plus have the advantage of allowing time-dependent covariates, and SUDAAN has the advantage of handling complex survey data.

Effect of penetration enhancers and iontophoresis on the ultrastructure and cholecystokinin-8 permeability through porcine skin

The present study explores the effect of chemical penetration enhancers and iontophoresis on the in vitro permeability of cholecystokinin-8 (CCK-8) through porcine epidermis and on the ultrastructural changes in stratum corneum as observed by transmission electron microscopy (TEM). Enhancer [i.e., ethanol (EtOH), and 10% oleic acid in combination with ethanol (OA/EtOH)] pretreatment significantly increased (p < 0.01) the permeability coefficient of CCK-8 in comparison with the control (pretreated epidermis without enhancer). Iontophoresis further increased the permeability of CCK-8 (p < 0.01) through the enhancer-pretreated epidermis in comparison with the control. These results showed the synergistic effect of iontophoresis and enhancers such as OA/EtOH that provides an additional driving force to maintain and control the target flux of CCK-8. The ultrastructure of stratum corneum treated with ethanol demonstrated a loss of structural components in the superficial stratum corneum cell layers. OA/EtOH transformed the highly compact cells of stratum corneum into a looser network of filaments, creating an increased free volume and greater intracellular surface area. Treatment of stratum corneum with OA/EtOH followed by iontophoresis resulted in further swelling of stratum corneum cell layers. In conclusion, OA/EtOH in combination with iontophoresis increased the permeability of CCK-8 by loosening and swelling of stratum corneum cell layers.

Guillain-Barré syndrome: clinical analysis and pathological study on sural nerve biopsy of forty cases

OBJECTIVE

To make clinical analysis and pathological study on 40-case Gullain-Barré syndrome with sural nerve biopsy.

METHODS

A total of 90 cases of GBS were retrospectively analyzed of which sural nerve biopsies were performed in 40 cases. The type of GBS was determined according to Asbury and Ropper criteria, and its correlation with pathological findings was studied.

RESULTS

In the 40 biopsy cases, demyelination was the predominant pathological change in 38 cases. Mild axonal degeneration was also seen in 13 of the 38 cases. Prominent axonal degeneration was seen in only 2 of 13 cases. The increased monocyte infiltration and varied capillary permeability were observed in 19 of 25 cases. Onion-bulb like changes were seen in 6 cases.

CONCLUSION

We studied the correlation between paresthesia and the pathological findings of sural nerve biopsy and concluded that sural nerve biopsy is very useful in the diagnosis of GBS and its variant.

Universal standardization of bone density measurements: a method with optimal properties for calibration among several instruments

The International Dual-Photon X-Ray Absorptiometry (DXA) Standardization Committee (IDSC) conducted a cross-calibration study among three models of DXA machines from three different manufacturers. In that study, 100 subjects were scanned on all three machines. A set of equations were derived to convert bone mineral density (BMD) on each machine to a "standardized BMD" (sBMD) such that sBMD from the same subject derived from different machines would be approximately the same. In a reanalysis of the cross-calibration data, we showed that the conversion method used in the IDSC study did not achieve several optimal properties desirable in such conversions. We derived new conversion equations to sBMD based on minimizing differences among sBMD from the three machines. More important is that the new conversions have no residual bias that was present in the IDSC conversions. The performance of the methods were compared on the cross-calibration data as well as an external data set. We conclude that the IDSC conversions are adequate for clinical use on other machines worldwide, but that researchers should standardize their own machines in a laboratory using the new method.

Methods for comparing the means of two independent log-normal samples

Standard methods of using the t-test and the Wilcoxon test have deficiencies for comparing the means of two skewed log-normal samples. In this paper, we propose two new methods to overcome these deficiencies: (1) a likelihood-based approach and (2) a bootstrap-based approach. Our simulation study shows that the likelihood-based approach is the best in terms of the type I error rate and power when data follow a log-normal distribution.

[Surgical treatment of non-thoracotraumatic pneumomediastinum]

The experience of surgical treatment of non-thoracotraumatic pneumomediastinum in 48 cases was summarized. The etiology, classification, pathology, and surgical treatment of non-thoracotraumatic pneumomediastinum were discussed. We conclude that most non-thoracotraumatic pneumomediastinum was complicated by secondary diseases. Therefore, the effective treatments for primary diseases are important. A satisfactory effect must be based on different surgical techniques according to the different clinical symptoms and age of patients.

Implementation of a large-scale optical neural network by use of a coaxial lenslet array for interconnection

Optical implementation of a large-scale neural network with 32 x 32 neurons is reported. The experimental setup is described, error caused by limited precision of hardware is analyzed, and experimental results are presented.

[Determination of calcium, magnesium and potassium in nurtured cell by AAS with quick-pulsed nebulization technique and NaOH base digestion]

The sample is digested with 6% NaOH solution and an amount of 50 microl is used for protein content analysis by the method of Comassie Brilliant Blue G250, the residual is diluted with equal 0.4% Lathanurm-EDTA solution. Its Calcium magensium and potassium content are determined by AAS. With quick-pulsed nebulization technique. When a self-made micro-sampling device is used, 20microl of sample volume is needed and it is only the 1/10 approximately 1/20 of the sample volume required for conventional determination. Sensitivity, precision and rate of recovery agree well with those using regular wet ashing method.

Confidence intervals for the log-normal mean

In this paper we conduct a stimulation study to evaluate coverage error, interval width and relative bias of four main methods for the construction of confidence intervals of log-normal means: the naive method; Cox's method; a conservative method; and a parametric bootstrap method. The simulation study finds that the naive method is inappropriate, that Cox's method has the smallest coverage error for moderate and large sample sizes, and that the bootstrap method has the smallest coverage error for small sample sizes. In addition, Cox's method produces the smallest interval width among the three appropriate methods. We also apply the four methods to a real data set to contrast the differences.

[Pedicled omentum graft for improvement of late-blood supply after myocardial revascularization with Nd:YAG laser in the treatment of ischemic heart disease]

26 dogs were devided into 3 groups. Selected left coronary artery branches of all dogs were ligated to make the models of myocardial infarction. The control group of 10 dogs received ligation of selected coronary artery branches(L group) only. Eight dogs were revascularized by Nd:YAG laser (LL group), and 8 dogs were revascularized and covered with pedicled omentum. All dogs were monitored by ECG, cardiac output, fractional 86Rb uptake and histological examination. The results showed that laser channels can perfuse ischemic myocardium and recover myocardial circulation to improve cardiac function immediately. However, the laser channels were closed after 4 weeks by clot, fibrosis and scarring which caused by thermal damage of Nd:YAG laser. The late result of laser myocardial revascularization with pedicled omentum graft is more better in perfusing myocardium and improving cardiac function than sole laser myocardial revascularization.

The evaluation of intra- and extra-cranial circulation in subclavian steal syndrome

OBJECTIVE

To compare the efficacy of transcranial Doppler ultrasound (TCD) and digital subtraction angiography (DSA) in identifying the clinical and hemodynamic relationship between intra- and extra-cranial circulation and subclavian steal syndrome.

METHODS

Sixteen patients were collected. The intra- and extra-cranial arteries were insonated with Doppler ultrasound. DSA and brain CT were performed in all patients. The relationship between the grade of arterial stenosis showing in DSA and the flow direction showing in TCD was studied.

RESULTS

TCD showed reversal flow of the vertebrobasilar artery in 13 patients, normal flow in 3, which was influenced obviously by fist-clenching. In the hyperemia test, the flow velocity and the direction changed significantly in all patients. The steal phenomenon of the middle cerebral artery (MCA) was coincident with that of the arterial cerebral artery (ACA) in 2 cases. Stenosis of MCA or ACA was found in 5 cases (31%). Nine patients were treated with arterial bypass or angioplasty. TCD was performed during the follow-up.

CONCLUSIONS

Reversal flow of the vertebral artery may occur in rest or only in exercise, depending on the grade of subclavian arterial stenosis. Hyperemia test is the most sensitive index. It is necessary to monitor blood flow in the MCA and basilar artery in hyperemia test. The coexistence of intra- and extra-cranial arterial stenosis is common.

[An experimental study on effect of atrial natriuretic peptide on intraocular pressure of white rabbits]

OBJECTIVE

To study the therapeutic effect of atrial natriuretic peptide (ANP) on glaucoma.

METHODS

Various doses of ANP were injected subconjunctivally in albino rabbits, and their effects on intraocular pressures (IOPs) were observed.

RESULTS

The IOPs were significantly decreased by the subconjunctival injection of 20, 30, 40 micrograms of ANP, and with a dose of 40 micrograms, the maximum effect of IOP lowering of 0.88-0.15 kPa maintaining for the longest time 7.5 hours was obtained. Generally, one hour after the injection, the maximum effect could be seen. A dose-effect relationship that is the degree of the reduction of IOP increasing with the dose increase of ANP could be observed.

CONCLUSION

This study indicates that ANP might play an effective therapeutic role in glaucoma.

Somatic mutation theory, DNA repair rates, and the molecular epidemiology of p53 mutations

The theory of somatic mutagenesis predicts that the frequency pattern of induced selectable mutations along a gene is the product of the probability patterns of the several sequential steps of mutagenesis, e.g., damage, repair, polymerase misreading, and selection. Together, the variance of these component steps is propagated to generate a mutagen's induced mutational spectrum along a gene. The step with the greatest component of variance will drive most of the variability of the mutation frequency along a gene. This most variable step, for UV-induced mutations, is the cyclobutyl pyrimidine dimer repair rate. The repair rate of cyclopyrimidine dimers is quite variable from nucleotide position to nucleotide position and we show that this variation along the p53 gene drives the C-->T transition frequency of non-melanocytic skin tumors. On showing that the kinetics of cyclopyrimidine dimer repair at any one nucleotide position are first order, we use this kinetic and the somatic mutation theory to derive Leq, the adduct frequency along a gene as presented to a DNA polymerase after a cell population reaches damage-repair equilibrium from a chronic dose of mutagen. Leq is the product of the first two sequential steps of mutagenesis, damage and repair, and the frequency of this product is experimentally mapped using ligation-mediated PCR. The concept of Leq is applied to mutagenesis theory, chronic dose genetic toxicology, genome evolution, and the practical problems of molecular epidemiology.

Vascular lesions in Chinese patients with transient ischemic attacks

We studied 96 Chinese patients with TIAs using transcranial Doppler and duplex ultrasonography. We found intracranial stenosis or occlusion in 51% of cases and extracranial disease in 19% of cases. The most common intracranial lesion was stenosis of the terminal internal carotid artery or proximal middle cerebral artery, whereas the most common extracranial lesion was stenosis of the carotid bifurcation.

Effect of left ventricular outflow on flow convergence region on the left septal surface in ventricular septal defect

The corrected shunt flow rate (Fc) and corrected defect orifice area (Ac) were calculated by modified equation F = 2 pi R2 (NL-VLVOT x Sin theta) in 23 patients with single membranous ventricular septal defect, in order to correct the effect of left ventricular outflow on flow convergence region on the left septal surface. The results indicated that Fc was closely correlated with Qp-Qs, and Qp/Qs measured by pulsed wave Doppler (r = 0.95 and r = 0.81 respectively, P < 0.001). And the correlation between Ac and the diameter of defect (Dd) measured directly in two-dimensional views was better than that between uncorrected defect orifice area (A) and the Dd (r = 0.98 and 0.69, respectively, P < 0.001). The shunt flow rate calculated by ideal equation F = 2 pi R2 x NL overestimated the actual shunt flow rate in ventricular septal defect, especially in membranous type. Our study concluded that Fc can be used for a more accurate evaluation of the shunt severity of ventricular septal defect.

Color Doppler monitoring of changes of utero-placental-fetal circulation in normal pregnancy and intrauterine growth retardation

The utero-placental-fetal circulation (UPFC) of 150 subjects during second and third trimester was examined by using color Doppler. Of them 89 were normal woman and 58 were patients with intrauterine growth retardation IUGR). Our results showed that UPFC was increased gradually during normal pregnant period. In IUGR patients it was revealed that TAV and Q of UmA, UmV and UtA decreased at 20th week of gestation, especially after 30th week. PI, RI and S/D ratio of UmA were increased, but TAV, Q of UmA and UmV were markly reduced, so was UtA. PI were increased, but the changes of RI, S/D ratio in UtA were not significant. Hemodynamical findings of UmA, UmV and UtA were abnormal in 92.53% of IUGR patients. Only 81.03% present abnormal S/D ratio of UmA (P < 0.01) and the difference was statistically significant. Maternal serum E3, HPL level in IUGR were significantly lower than that of the normal. 6KP level was reduced, TXB2/6KP ratio was significantly increased. TXB2/6KP ratio was markedly related with TAV, Q of UmA, UmV and UtA. Our results suggested that using color doppler ultrasound for examination of hemodynamical changes of UmA, UmV and UtA could revealed UPFC function directly. It is one of the best methods for monitoring IUGR and might be used for early diagnosis of IUGR. The main pathophysiological changes of IUGR were UPFC obstruction and placental disfunction.

[Diagnostic value of endometrial assessment by transvaginal ultrasonography in patients with postmenopausal bleeding]

OBJECTIVE

To assess the value of endometrial transvaginal sonography in diagnosis of patients with postmenopausal bleeding.

METHODS

High resolution transvaginal ultrasonographic examination was performed in 192 patients with postmenopausal bleeding before fractional uterine curettage. The results of endometrial sonogram were compared with endometrial histological findings.

RESULTS

Seventy-seven cases had endometrial thickness < or = 4mm. 74 of them (96.1%) showed physiological changes by pathological examination. Only 3 were endometrial cancer. In contrast, in 115 patients who had endometrial thickness > or = 5mm, 59 (51.3%) had endometrial cancer.

CONCLUSION

Transvaginal ultrasonography may be used as a screening procedure in patients with postmenopausal bleeding. Diagnostic uterine curettage may be avoided in patients who had endometrial thickness < or = 4mm.

[Reconstruction of lacrimal passage in repair of oblique facial cleft]

For the reconstruction of lacrimal passage in obligue facial cleft, three methods were performed in 4 cases. According to the difference in local pathology canaliculorhinestomy, transfer of vein or oral mucosa, or modified dacryocystorhinostomy was performed. The patients were followed for 6 to 12 months with satisfacting results.

Distinct roles for two G protein alpha subunits in fungal virulence, morphology, and reproduction revealed by targeted gene disruption

Reduced accumulation of the GTP-binding protein G(i)alpha subunit CPG-1, due either to hypovirus infection or transgenic cosuppression, correlates with virulence attenuation of the chestnut blight fungus, Cryphonectria parasitica. The role of G protein-mediated signal transduction in fungal virulence was further examined by targeted disruption of the gene cpg-1, encoding CPG-1, and a second Galpha gene, cpg-2, encoding the subunit CPG-2. Disruption of cpg-1 resulted in a set of phenotypic changes similar to, but more severe than, those associated with hypovirus infection. Changes included a marked reduction in fungal growth rate and loss of virulence, asexual sporulation, female fertility, and transcriptional induction of the gene lac-1, encoding the enzyme laccase. In contrast, cpg-2 disruption resulted in only slight reductions in growth rate and asexual sporulation and no significant reduction in virulence, female fertility, or lac-1 mRNA inducibility. These results provide definitive confirmation of previous correlative evidence that suggested a requirement of CPG-1-linked signaling for a number of fungal processes, including virulence and reproduction, while demonstrating that a second Galpha, CPG-2, is dispensable for these processes. They also significantly strengthen support for the apparent linkage between hypovirus-mediated disruption of G protein signal transduction and attenuation of fungal virulence.

Plasma endothelin and atrial natriuretic peptide in normal and hypertensive pregnancy

OBJECTIVE

To investigate the possible role of endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) in the pathogenesis of pregnancy-induced hypertension (PIH).

MATERIAL AND METHODS

A total of 110 normal pregnant women (in three trimesters, labour or postpartum) and 30 patients with PIH were studied by measuring plasma ET-1 and ANP levels by radioimmunoassay; 23 normal non-pregnant women were selected as controls.

RESULTS

Compared with normal non-pregnant women, plasma ET-1 levels were significantly decreased in normal pregnant women during all three trimesters. Plasma ET-1 level was significantly increased in the 2nd stage of labour, compared with that in the 3rd trimester. There were significant positive correlation between plasma ET-1 level and mean arterial pressure in normal non-pregnant women and normal pregnant women in all three trimesters. Compared with matched normal pregnant women, plasma ET-1 and ANP levels were significantly increased, while plasma ANP/ET-1 ratio was significantly decreased in PIH patients. Significant positive correlations existed between plasma ET-1 level and mean arterial pressure or the score index of the severity of PIH. After the treatment with magnesium sulfate infusion, plasma ET-1 and ANP levels were significantly decreased, but plasma ANP/ET-1 ratio was significantly increased in PIH patients.

CONCLUSIONS

Augmentation of ET-1 secretion and attenuation of ANP function may be responsible for the development of PIH. ET-1 secretion may be indirectly influenced by magnesium in PIH.

The relationship between alcohol consumption, cognitive performance, and daily functioning in an urban sample of older black Americans

OBJECTIVE

To report on moderate alcohol consumption and measurements of cognitive function and activities of daily living in an older, urban, community-dwelling sample of black Americans.

DESIGN

As part of a community prevalence study of dementia, information on alcohol consumption and cognitive performance was collected on 2040 randomly selected black subjects living in Indianapolis.

MEASUREMENTS

From questions in the screening interview, alcohol consumption was grouped into four categories: lifetime abstainers, regular drinkers less than 4 drinks per week, 4 to 10 drinks per week, and more than 10 drinks per week. Current and past drinkers were analyzed separately. Three measurements were used: (1) a total cognitive score; (2) the delayed recall score from the East Boston Memory Test; (3) a score for daily functioning based upon information from the informant. Multiple regression models were fitted with drinking variables as the major predictor, including covariates of age, gender, education, history of stroke, hypertension, being treated for depression, and a family history of dementia.

MAIN RESULTS

In all analyses, there was a very consistent pattern for both current and past drinkers. There was a small but significant dose effect of drinking for the drinkers, with subjects in the heaviest drinking category scoring poorest, i.e., lowest scores in cognitive tests and highest scores in scales of daily functioning indicating more impairment. The scores of abstainers were worse than those of subjects in the lightest drinking category. The pattern of scores for cognitive performance and daily functioning was similar between current and past drinkers. These patterns remained the same even after potential confounders were included.

CONCLUSIONS

Previous research on effects of alcohol on health indices have suggested a J-shaped relationship between amounts of alcohol consumption and measurements of heart disease, stroke, and mortality rates. Our study provides some support for the concept of a similar J-shaped relationship between cognitive performance and alcohol consumption, but the differences between drinking categories were modest and the clinical significance of these findings uncertain.

Association of the epsilon 4 allele of apolipoprotein E with poor performance on a dementia screen in African Americans

In a community-based study of Alzheimer's disease in African Americans age 65 and over, subjects were classified into three levels of performance based on their scores as measured by the Community Screening Instrument for Dementia (CSI"D"), consisting of cognitive and functioning components. In a subset of 268 subjects with apolipoprotein E (APOE) genotype data, we found that the epsilon 4 allele of APOE was associated with intermediate/poor performance (single copy epsilon 4 odds ratio 1.51, 95% CI 1.18 to 1.92; double copy epsilon 4 odds ratio 3.42, 95% CI 2.18 to 5.43). From these data, we believe it would be possible to conduct population screening for the effects of possession of the APOE-epsilon 4 allele using information derived from the CSI"D".

Extensive alteration of fungal gene transcript accumulation and elevation of G-protein-regulated cAMP levels by a virulence-attenuating hypovirus

Persistent infection of the chestnut blight fungus Cryphonectria parasitica with the prototypic hypovirus CHVI-713 results in attenuation of fungal virulence (hypo-virulence) and reduced accumulation of the GTP-binding (G) protein a subunit CPG-1. Transgenic cosuppression of CPG-1 accumulation in the absence of virus infection also confers hypovirulence. We now report the use of mRNA differential display to examine the extent to which virus infection alters fungal gene transcript accumulation and to assess the degree to which modification of CPG-1 signal transduction contributes to this alteration. More than 400 PCR products were identified that either increased (296 products) or decreased (127 products) in abundance as a result of virus infection. Significantly, 65% of these products exhibited similar changes as a result of CPG-1 cosuppression in the absence of virus infection. We also report that both virus infection and CPG-1 cosuppression elevate cAMP levels 3- to 5-fold. Additionally, it was possible to mimic the effect of virus infection and CPG-1 cosuppression on transcript accumulation for representative fungal genes by drug-induced elevation of cAMP levels. These results strengthen and extend previous indications that hypovirus infection causes a significant and persistent alteration of fungal gene expression/transcript accumulation. They further show that this alteration is primarily mediated through modification of the CPG-1 signaling pathway and suggest that, similar to mammalian Gi alpha subunits, CPG-1 functions as a negative modulator of adenylyl cyclase. Finally, these results suggest a role for G-protein-regulated cAMP accumulation in hypovirus-mediated alteration of fungal gene expression.

[Loss of heterozygosity involving DCC gene in human colorectal cancers is correlated with the metastatic potential]

DCC gene located at chromosome 18q21.3 is an important tumor-supressor gene associated with tumorigenesis and progression, especially in colorectal carcinomas. Adopting Southern blot technique and RFLP analysis, 33 primary Chinese colorectal cancer patients were examined for loss of heterozygosity (LOH) of DCC gene. Among 16 informative cases, 6 (38%) showed allelic deletion. 18q LOH was correlated with lymph node and hepatic metastases (P < 0.05). The results indicate that application of molecular genetics is of value in ascertaining the metastatic potential of colorectal carcinomas.

Cloning and targeted disruption of enpg-1, encoding the major in vitro extracellular endopolygalacturonase of the chestnut blight fungus, Cryphonectria parasitica

The gene enpg-1, encoding the major extracellular endopolygalacturonase (endoPG) purified from culture filtrates of the chestnut blight fungus, Cryphonectria parasitica, was cloned and characterized. The deduced mature enpg-1 protein product, ENPG-1, had a calculated molecular mass of 34.5 kDa and a pI of 7.2, consistent with empirically derived values for the purified enzyme, and had 66% identity with an endoPG from the maize pathogen Cochliobolus carbonum. Targeted disruption of enpg-1 was accomplished by homologous recombination with a cloned copy of the gene that contained the Escherichia coli hygromycin B phosphotransferase gene (hph) inserted into exon 1. enpg-1 disruption resulted in no reduction in canker formation on dormant American chestnut stems. Unexpectedly, the level of polygalacturonase (PG) activity measured in cankered bark tissue infected with enpg-1 disruptants was indistinguishable from that found in canker tissue infected with virulent strain EP155. Isoelectric focusing and activity gel analysis of PG activity extracted from canker bark tissue revealed ENPG-1 to be a minor (less than 5%) activity component in tissue infected with the virulent strain and to be absent in tissue infected with the disruption mutants. The predominant activity in both canker samples consisted of two previously undetected acidic PG forms that appear absent in C. parasitica culture filtrates. We conclude from these results that the major C. parasitica extracellular endoPG produced in culture, ENPG-1, does not play a significant role in fungal virulence. However, the identification of two acidic PG activities expressed predominantly, if not exclusively, in planta provides new opportunities for examining the importance of PGs in C. parasitica pathogenesis.

Psychiatric disorders in African American nursing home residents

OBJECTIVE

High prevalence rates of psychiatric illness and high levels of behavioral disturbance have been reported in studies of nursing home residents; however, the populations evaluated have been predominantly Caucasian. The aims of the present study were to identify prevalence rates of psychiatric disorders and behavioral disturbances in a sample of African American nursing home residents.

METHODS

The authors evaluated 106 African American nursing home residents, aged 65 and over, from a representative sample of nursing homes. The evaluation included informant interview with nursing home staff, cognitive assessment, and a psychiatric interview that included a physical and neurological examination. Consensus diagnoses were reached by using DSM-III-R criteria.

RESULTS

Of the 106 subjects, 90% received at least one primary psychiatric diagnosis, and 71% had at least one behavioral problem; dementia was the most common psychiatric diagnosis (68%). Thirty -one percent of the patients were treated with neuroleptic medication; most of these patients received diagnoses of dementia or schizophrenia. Fifteen percent of the patients had been in physical restraints, which correlated with physical disability.

CONCLUSIONS

The prevalence of psychiatric illness in this sample of African American nursing home residents is similar to that reported in previous studies with predominantly Caucasian populations. Behavioral disturbances, while commonly reported, were somewhat less frequent than reported in previous studies.

[Preparation of huichun zhibao oral liquid (HZOL)]

The formulation, preparing method, quality standards, pharmacodynamic experinents and toxicological experiments of HZOL are described. The content of icariin, which is and effective component of epimedium herb as well as one of the main ingredients in HZOL, was successfully determined through HPLC, with an average recovery of 98.98% and RSD = 1.53%.

[Changes in hematoporphyrin in patients with gastric and hepatic carcinoma and their clinical significance]

The fluorescence spectroscopy of porphyrin molecule in blood was determined with photoluminescence fluorescence spectroscope in 139 patients with gastric carcinoma, 76 with hepatic carcinoma, 110 with gastric ulcer and chronic gastritis, 168 with liver cirrhosis and 33 normals as controls. The results showed that the peaks of Zinc porphyrin and protoporphyrin in patients with cancer were significantly higher than those in patients with benign disease, the peak of protoporphyrin being two to three times higher in the former groups of patients than that in the latter (P < 0.01). Protoporphyrin could be used as a marker to screen and diagnose gastric and hepatic carcinoma.

[Technological studies of effects of inclusion on pericarpium Citri reticulatae volatile oil-beta-cyclodextrin]

The effects of inclusion on Pericarpium Citri Reticulatae volatile oil-beta-cyclodextrin were studied by comparing four methods saturation, grinding, liquid to liquid and liquid to gas. The utilization ratio of oil, the ratio of oil in inclusion complex and the recovery of inclusion complex were used as the criteria in evaluating the inclusion effectiveness. The results showed that the saturation method was the best.

Pharmacokinetics of ceftizoxime in renal failure patients without dialysis

AIM

To investigate the pharmacokinetics of ceftizoxime (Cef) in renal failure patients without any dialysis and supply the basis for a suitable clinical regimen.

METHODS

Cef in plasma and urine was assayed by HPLC.

RESULTS

After injecting Cef 16.7 mg kg-1, Cef concentration in blood was described as a 2-compartment open model. The main pharmacokinetic parameters were Vd 0.55 +/- 0.17 L kg-1; AUC 879 +/- 460 mg L-1 h; Cl 27 +/- 11 mL kg-1 h-1. T1/2 beta was 15 +/- 4 h.

CONCLUSION

T1/2 beta in renal failure patients was about 10 times longer than that in normal volunteers. The clinical regimen should be adjusted in renal failure patients with infection, either prolonging the interval between Cef administration, or decreasing Cef dosage.

A factor in lymph node and spleen induced by restraint stress in mice and rats suppresses lymphocyte proliferation

Extracts from lymph node and spleen in mice and rats subjected to restraint stress significantly suppressed lymphocyte proliferation, but extracts from brain, skeletal muscle, and thymus gland had no effect on lymphocyte proliferation, suggesting that a suppressive factor for lymphocyte proliferation might selectively be induced in lymph node and spleen. Further experiments showed that biochemical properties, molecular weight, correlation between suppressive factors in serum and in extract of the lymph tissue from stressed animals, and control of the generation, all indicated that under the conditions of restraint stress and under the control of central nervous system a suppressive factor was generated in peripheral lymph tissue and then released into the blood-stream, which acted as a strong suppressor of lymphocyte proliferation.

[Copper needle puncturing for the treatment of cavernous hemangioma]

From the beginning of 1990 to Oct. 1993, we have treated 31 patients with cavernous hemangioma using copper needle puncturing. Three months' to one and half years' follow-up showed positive effects in all cases. The paper describes general and local reaction of the treatment, the changes in blood copper concentration and echocardiography and complications.

[Effects of copper needling therapy on cavernous hemangioma assessed by echogram]

Thirty-one patients with subcutaneous cavernous hemangioma were observed by echogram before and after treatment with copper needling. Different characteristics of echogram were found in hemangioma before and after treatment. Color Doppler imaging gave great help in the diagnosis and treatment of this disease and follow-up.