Survival impact of lymph node metastasis in TNM stage III carcinoma of the colon and rectum

BACKGROUND

Node-positive (TNM stage III) adenocarcinoma of the colon and rectum consists of tumors with a widely variable prognosis. To predict the outcome of patients with stage III carcinoma, we assessed the survival impact of the number and level of lymph node metastasis and other clinicopathological variables.

STUDY DESIGN

A retrospective study was performed on 538 patients with stage III carcinoma of the colon and rectum who underwent curative resection at Chang Gung Memorial Hospital between 1980 and 1989. Ten or more lymph nodes in each resected specimen were identified microscopically. Multivariate analysis was used to determine the independent variables.

RESULTS

The relative survival rates at five and ten years were 52 and 42 percent, respectively. Tumor morphology, depth or tumor penetration, histologic grade, and the status (number and level) of nodal involvement were significant in the univariate analyses. Only grade and nodal status remained significant in the multivariate analysis. Based on the nodal status, these patients were separated into three groups: stage IIIA (one to three positive nodes and absence of pN3 metastasis), IIIB (four to nine nodes and absence of pN3), and IIIC (ten or more nodes or presence of pN3). The five-year survival rates for patients with stages IIIA, IIIB, and IIIC disease were 69, 44, and 29 percent, respectively. Compared with patients with stage IIIA disease, the odds of death for patients with stages IIIB and IIIC carcinoma were 2.1 (95 percent confidence interval: 1.5 to 2.8, p = 0.0001) and 3.3 (95 percent confidence interval 2.4 to 4.5, p = 0.001), respectively.

CONCLUSIONS

We suggest that stage III adenocarcinoma of the colon and rectum be divided into three substages: IIIA (one to three positive nodes and absence of pN3 metastasis), IIIB (four to nine nodes and absence of pN3), and IIIC (ten or more positive nodes or presence of pN3.

Prevalence of permanent primary congenital hypothyroidism in Taiwan

The purpose of this study was to find the prevalence of permanent primary congenital hypothyroidism in Taiwan. From January 1988 to December 1990, there were 991,132 live births in Taiwan. Of these, 329,891 neonates were screened for primary congenital hypothyroidism. Fifty-seven cases of permanent primary congenital hypothyroidism were confirmed. Hence, the prevalence of permanent primary congenital hypothyroidism in that period in Taiwan was 1 in every 5,788 live births. There was a female preponderance with a female to male ratio of 1.7. Of 54 infants who had a thyroid scan, 36 were found to have an ectopic thyroid gland, while 11 were found to have dyshormonogenesis. Among the 57 infants, one case with a delayed rise in the serum thyrotropin level was missed on initial screening. When compared with other studies, these data suggest that the prevalence of permanent primary congenital hypothyroidism varies in different ethnic groups throughout the world.

Indirect control of yolk protein genes by 20-hydroxyecdysone in the fat body of the mosquito, Aedes aegypti

In response to a blood meal, the fat body of the female mosquito, Aedes aegypti, begins massive production of several yolk proteins which are subsequently stored in the developing oocytes. Although 20-hydroxyecdysone (20E) is important for initiation and maintenance of expression of the yolk protein genes encoding vitellogenin (Vg) and vitellogenic carboxypeptidase (VCP), the exact nature of 20E action has not been clearly defined. A primary question is whether this hormone directly stimulates expression of the genes for Vg and VCP or if it acts indirectly through a hormone response cascade. We have demonstrated that 10(-4) M cycloheximide (Chx) reversibly inhibits > 98% of protein synthesis in in vitro fat body culture. 10(-5) M 20E stimulates high levels of the mRNAs for Vg and VCP in previtellogenic fat bodies cultured in vitro, but initiation of this expression is eliminated by Chx. Thus, our results indicate that protein synthesis is required in response to 20E before increased levels of yolk protein mRNAs can be measured. We therefore conclude that the action of 20E is indirect.

Presacral tumor: a review of forty-five cases

Forty-five patients with primary presacral tumors underwent their treatment at Division of Colon Rectal Surgery, Chang Gung Memorial Hospital, from 1978 to 1992. These 45 patients, 20 male and 25 female, ranged from 15 to 76 years of age (mean, 41.1 years). Congenital tumors (47 per cent) were the most frequent histologic type, followed by miscellaneous tumors (36 per cent). Forty-eight per cent of patients had malignant tumors. All benign congenital cysts were in females. These tumors presented a variety of symptoms and signs. Diagnosis could be made by digital examination in 43 (96 per cent) of the patients. Computed tomographic scan was the most important diagnostic tool in determining the extent and degree of tumor invasion. The positive rate was 100 per cent in 21 patients. As for operative methods, abdominal approach was selected in 24 patients, transacral in 13 patients, abdominal/sacral combined in 6 patients, and biopsy only in two patients. Postoperative complications occurred in 16 patients (36 per cent), but there were no operative deaths. Of the tumors that underwent resection, 23 had total resection (18 benign and 5 malignant) and 22 incomplete (5 benign and 17 malignant). Benign tumors had a good chance with resection of the lesion (P < 0.05). For patients with malignant tumors, the 5-year survival rate was 40.7 per cent. Whenever possible, total resection could offer better results for presacral tumor, whether the lesions were benign or malignant.

Renal effects and urinary excretion of prostaglandin following indomethacin therapy in premature infants with patent ductus arteriosus

Renal side effects and urinary prostaglandin were evaluated in 10 premature infants (Mean +/- SD: BW 1245 +/- 290 gm, GA 32 +/- 2.2 wks, Postnatal age 7.7 +/- 3.8 days) with significant PDA who were given one dose of indomethacin (0.3 mg/kg intravenously). There was a significant decrease in urinary output, osmolal and free water clearance after therapy. The fractional excretion of sodium, chloride, potassium, glomerular filtration rate and urinary prostaglandin E2 also decreased but were not statistically different from the baseline values. In infants who responded to indomethacin with ductus closure, their renal functions appeared to be preserved even though they had higher plasma indomethacin levels than the non-responders in whom significant changes in renal function were observed following indomethacin therapy. This observation suggested that the improved renal hemodynamics following the closure of the ductus may minimize or attenuate the renal side effects of indomethacin.

Use of a low profile Doppler angioplasty guidewire to evaluate the effect of percutaneous coronary angioplasty on coronary artery flow velocity

BACKGROUND

The intracoronary Doppler flow velocity measurement is widely used. The Doppler flow catheter, used in many studies, still cannot always measure distal portions of coronary artery stenosis. However, three years ago, a low profile Doppler angioplasty guide wire (0.018-inch) was started by apply for measurement of changes in proximal and distal flow velocity during coronary angioplasty.

METHODS

Blood flow velocity and diastolic/systolic velocity ratio (DSVR) on both proximal and distal portions of the coronary artery were measured with a low profile Doppler angioplasty guide wire in 13 patients with stenosis of the left anterior descending artery (LAD) during coronary angioplasty.

RESULTS

Non-significant improvement in maximal peak velocity was noted in the distal portion of the coronary artery immediately after angioplasty (before, 36 +/- 12 cm/s; after, 41 +/- 12 cm/s; p > 0.05); but significant improvement was found after removal of the balloon (from 41 +/- 12 cm/s to 49.5 +/- 15 cm/s, p < 0.01). Increases in proximal maximal peak velocity after angioplasty were less remarkable (before, 38.5 +/- 15 cm/s; after, 45 +/- 13 cm/s; p > 0.05), and there was a significant increase of DSVR on the distal portion of the left anterior descending artery after angioplasty (before, 2.18 +/- 0.51; after, 2.98 +/- 0.44; p < 0.05). However, there was no significant increase of DSVR on the proximal portion of LAD (before, 2.19 +/- 0.16; after, 2.44 +/- 0.1; p > 0.05). The coronary flow reserve ratio showed no significant increase on the distal portion of the LAD (before, 1.03 +/- 0.3; after, 1.02 +/- 0.3) and proximal portion of LAD (before, 1.05 +/- 0.2; after, 1.03 +/- 0.3).

CONCLUSIONS

Increase in peak velocity and DSVR of the distal portion of the coronary artery after angioplasty was more significant after removal of the balloon catheter than as if it were assessed immediately, without removing the balloon catheter. No significant increase in flow velocity of the proximal portion of the coronary artery after angioplasty was observed. No significant increase of the coronary flow reserve of the distal and proximal portion of the coronary artery occurred after successful angioplasty.

Cisplatin and 5-fluorouracil as neoadjuvant chemotherapy: predicting response in head and neck squamous cell cancer

In order to prospectively evaluate the efficacy, toxicity and predictive factors of response to neoadjuvant chemotherapy, a total of 120 patients with head and neck squamous cell cancer diagnosed from January 1992 to November 1993 were enrolled in this study. There were 118 male and 2 female patients, with a median age of 51 years (range 30-74 years). The primary sites were the oral cavity (77), oropharynx (15), hypopharynx (25) and larynx (3). Betel quid chewing was habitual in 91% of patients. All patients were previously untreated, and 94% had stage III or IV disease. Chemotherapy was given in two or three courses to 96 patients who were then assessed for response rate and predictive factors. The chemotherapy regimen consisted of cisplatin 100 mg/m2/day on day 1 and 5-fluorouracil (5-FU) 1 g/m2/day intravenous infusion continuously for 4 to 5 days for 4 weeks. The overall chemotherapy response rate was 56%, with a 3% complete response. By univariate analysis, both the T-stage and tumor volume were significant for predicting the response of the primary site. The age, histologic differentiation, tumor location and N-stage were unpredictive for response. The nodal response (43%) was less than that of the primary site (68%). By multivariate analysis, only the tumor volume (> or = 50 cm3) and the presence of nodal metastases were predictive for the combined TN response. Based on the World Health Organization toxicity criteria, 49 patients experienced grade 3 to 4 mucositis, and 24 patients had grade 3 to 4 vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential effects of 4'-chlorodiazepam on expressed human GABAA receptors

The interactions of the atypical benzodiazepine 4'-chlorodiazepam (Ro 5-4864) with functionally expressed human GABAA receptor cDNAs were determined. Cotransfection of human alpha 2, beta 1, and gamma 2 subunits was capable of reconstituting a 4'-chlorodiazepam recognition site as revealed by a dose-dependent potentiation of t-[35S]butylbicyclophosphorothionate ([35S]-TBPS) binding to the GABA-activated chloride channel. This site is found on GABAA receptor complexes containing sites for GABA agonist-like benzodiazepines and neuroactive steroids. The importance of the alpha subunit was further demonstrated as substitution of either alpha 1 or alpha 3 for the alpha 2 subunit did not reconstitute a 4'-chlorodiazepam recognition site that was capable of modulating [35S]TBPS binding under the same experimental conditions. The 4'-chlorodiazepam modulatory site was shown to be distinct from the benzodiazepine site, but the phenylquinolines PK 8165 and PK 9084 produced effects similar to 4'-chlorodiazepam, consistent with the previous analysis of the 4'-chlorodiazepam site in brain homogenates. Further analysis of the subunit requirements revealed that coexpression of alpha 2 and beta 1 alone reconstituted a 4'-chlorodiazepam recognition site. It is interesting, however, that the 4'-chlorodiazepam site was found to inhibit [35S]TBPS binding to the GABA-activated chloride channel. Thus, the 4'-chlorodiazepam site may be reconstituted with only the alpha and beta polypeptides.

Acquired genital smooth-muscle hamartoma. A case report

Smooth-muscle hamartoma is an uncommon, usually congenital malformation of smooth-muscle origin. When it is acquired, it may be confused with Becker's nevus with a prominent smooth-muscle component. Over the past 3 decades, only two cases of acquired smooth-muscle hamartoma without the concomitant appearance of hairy-pigmented lesions have been reported. We describe a third case. To the best of our knowledge, this is the first case of smooth-muscle hamartoma to occur in the scrotum.

Selective actions of certain neuroactive pregnanediols at the gamma-aminobutyric acid type A receptor complex in rat brain

Certain endogenous pregnanediols (5 alpha-pregnan-3 alpha,20 alpha-diol and 5 beta-pregnan-3 alpha,20 beta-diol) were observed to have limited efficacy as allosteric modulators of t-[35S]butylbicyclophosphorothionate ([35S]TBPS) and [3H]flunitrazepam binding to sites on the gamma-aminobutyric acid (GABA)A receptor complex in rat brain. In contrast, 3 alpha-hydroxy-5 alpha-pregnan-20-one (3 alpha,5 alpha-P) and 3 alpha-hydroxy-5 beta-pregnan-20-one (3 alpha,5 beta-P) have full efficacy. Moreover, 3 alpha,5 beta-P but not 3 alpha,5 alpha-P recognizes high (nanomolar) and low (micromolar) affinity neuroactive steroid sites in these allosteric modulatory assays. The concentration-response curve for 3 alpha,5 alpha-P modulation of [35S]TBPS binding was shifted rightward in the presence of these pregnanediols and GABA. The maximum shift produced by these pregnanediols never exceeded the concentration-response curve obtained with 3 alpha,5 alpha-P alone in the absence of GABA. Additionally, neither 5 alpha-pregnan-3 alpha,20 alpha-diol nor 5 beta-pregnan-3 alpha,20 beta-diol had any effect on the site recognized by 3 alpha,5 alpha-P in the absence of GABA. The difference in the affinities of the two apparent sites (29 nM versus 152 nM in the presence and absence of GABA, respectively) recognized by 3 alpha,5 alpha-P is only approximately 5-fold. In contrast, the difference between the high (30 nM) and low (7 microM) affinity sites discriminated by 3 alpha,5 beta-P is > 200-fold. Thus, the selective interaction between the high affinity site recognized by 3 alpha,5 beta-P and these pregnanediols can be clearly observed. A saturating concentration of 5 beta-pregnan-3 alpha,20 beta-diol selectively eliminated the high affinity component recognized by 3 alpha,5 beta-P, whereas 5 alpha-pregnan-3 alpha,20 alpha-diol did not completely abolish the high affinity site. 5 alpha-Pregnan-3 alpha,20 alpha-diol recognized only a portion of the high affinity sites discriminated by 3 alpha,5 beta-P, relative to 5 beta-pregnan-3 alpha,20 beta-diol, whereas the two pregnanediols recognized a similar population of sites mediating 3 alpha,5 alpha-P inhibition of [35S]TBPS binding. Collectively, these studies provide evidence that the limited efficacy of certain pregnanediols as allosteric modulators of [35S]TBPS binding may be explained in part by selectivity for the high affinity site recognized by 3 alpha,5 beta-P.(ABSTRACT TRUNCATED AT 400 WORDS)

Regression of left ventricular aneurysm after delayed percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction

Two weeks after acute myocardial infarction (AMI), 23 patients received delayed percutaneous transluminal coronary angioplasty (PTCA) and 14 consecutive randomized selected patients received conservative treatment as a control group. Follow up intravenous and/or intraventricular left cine-ventriculography, as well as radionuclide ejection fraction were performed 6-24 months (mean 11.2 months) after the acute phase. The results showed no significant statistical differences between the two groups for age, sex, Killip class, left ventricular end-diastolic pressure, and medication. The PTCA group showed a significant increase in radionuclide left ventricular ejection fraction, when compared to the control group (20.4 +/- 0.3 vs. 2.05 +/- 1.2; P < 0.05), as well as in the cine-global ejection fraction (32.1 +/- 0.4 vs. 3.44 +/- 1.1; P < 0.05). The dyskinetic area and volume were found also to have greater reduction in the PTCA group than in the control group (-84.7 +/- 1.2 vs. -10.5 +/- 1.1 and -86.1 +/- 1.1 vs. -15.4 +/- 0.9; P < 0.05). There were no significant changes in diastolic or systolic circumferences for both group. In conclusion, delayed PTCA after AMI can reduce the left ventricular dyskinetic area, and improve cine-global ejection fraction. Intravenous first pass left ventriculography is a safe, simple, and reproducible method for evaluating left ventricular remodeling after acute myocardial infarction.

Expression of mannose-binding sites on human spermatozoa and their role in sperm-zona pellucida binding

A D-mannosylated albumin (DMA) neoglycoprotein was assessed to validate experimentally a probe capable of detecting mannose-binding sperm receptors involved in human sperm-egg interaction. DMA specifically blocked zona binding of swim-up human spermatozoa in a concentration-dependent manner. While no considerable effect was observed on sperm-zona initial contact, almost 50% of spermatozoa bound to the zona during a 2-hour period detached from it when DMA was introduced in the incubation medium. DNA inhibition was evident when 10% fetal bovine serum, but not 3.5% human serum albumin (HSA), was used as Ham's F10 medium supplementation. This may be due to the amount of free calcium in the medium since addition of 40 mM CaCl2 to F10-HSA restored DMA inhibition. Furthermore, the higher the calcium concentration in the incubation buffer, the greater the DMA blockage of sperm-zona binding. Unfixed sperm presented fluorescent DMA label over the entire acrosomal area (cap pattern), or concentrated at the equatorial segment (bar pattern). These patterns increased during capacitation, appearing on an average of 20% of the sperm after overnight incubation. They also increased, especially the bar pattern, following calcium ionophore treatment. Nearly all of methanol-fixed spermatozoa displayed the fluorescent label at the head level. Concomitant assessment of sperm membrane integrity and DMA fluorescent patterns revealed that DMA fluorescence coincided mostly with permeabilized or altered sperm plasma membrane. In conclusion, DMA is a suitable probe to identify human sperm mannose-binding sites crucially involved in sperm-zona interaction. These sites appear to require free calcium concentrations to operate, and their expression changes with capacitation and acrosome reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

The development of a broad-spectrum toxicology screening program in Taiwan

Our institute serves as a centralized clinical laboratory for municipal and private hospitals in Taipei, a major international metropolis in the Asian region. Two key considerations leading to the development of our toxicology program are: a large number of foreign visitors and local residents returning from overseas trips may bring in chemicals which are less commonly seen in this region; and the lack of readily available assays for a large percentage of commonly used medicines, including prescription and over-the-counter drugs. Our toxicology screening program addresses the needs of both the Emergency Department Drug Screening and Drug of Abuse Screening. In Emergency Department Drug Screening, REMEDi HS is used as the general screening method. In Drug of Abuse Screening, the TDx is used for the initial screening of amphetamine-like substances and opiates, followed by REMEDi HS for the confirmation of positive samples. Emergency Department data collected at our institute over one year (September 1992 to August 1993) identified 57 different drugs in 713 samples. Opiates, narcotics and central stimulants accounted for 24% of the encountered drugs. Presently, there is no extensive reporting of misuse of benzodiazepines in this region. The detection of herbal ingredients like ephedrine and methylephedrine (from the Ma-Huang plant) in patient samples illustrates a large area often overlooked by western toxicology.

Correlation of cervical cancer mortality with reproductive and dietary factors, and serum markers in China

BACKGROUND

Cervical cancer is the second leading cause of cancer death among Chinese women. Within China, a considerable geographical variation in mortality rates has been observed, but the reasons are not well understood.

METHODS

Cervical cancer rates were examined in relation to indices of reproductive factors, dietary habits, and selected serum biomedical markers in 65 rural Chinese counties.

RESULTS

Cervical cancer mortality rates correlated positively and significantly with antibodies to herpes simplex virus type 2 (HSV-2) (r = 0.40, P < 0.01), serum levels of ferritin (r = 0.33, P < 0.01), body mass index (BMI) (r = 0.42, P < 0.01) and cigarette smoking (r = 0.51, P < 0.05) and negatively and significantly with age at first birth (r = -0.51, P < 0.01), consumption of green vegetables (r = -0.40, P < 0.01) and animal foods (r = -0.40, P < 0.01), and serum levels of selenium (r = -0.26, P < 0.05). When these variables were considered in the multiple regression analysis, early age at first birth and higher BMI were positively associated with cervical cancer mortality, while consumption of green vegetables and animal foods were negatively correlated. In the serum model, infection with HSV-2 and low levels of sex hormone binding globulin (SHBG) were positively related to cervical cancer mortality. No relation was found for consumption of fruits.

CONCLUSIONS

Although limitations of these ecologic data preclude causal inferences, findings in this study, including associations with HSV-2 infection, early age at first birth, consumption of green vegetables and animal foods, may provide clues to cervical cancer aetiology.

Bone density and lifestyle characteristics in premenopausal and postmenopausal Chinese women

The relationships between bone health and various lifestyle factors were examined in a cross-sectional study in 775 Chinese women aged 35-75 years. Bone mass was significantly positively associated with body weight, height, body mass index (BMI) and duration of breastfeeding, but was not significantly associated with other lifestyle variables, including alcohol consumption, parity, age at menarche and age at menopause after adjusting for age and body weight. A positive association was observed in premenopausal women (but not in postmenopausal women) for bone density with current cigarette smoking and plasma and urinary cotinine (the major metabolite of smoking). However, the confounding effects of other unknown factors present in this cross-sectional study may not be excluded. Daily physical activity, as indicated by time spent working in the fields, was found consistently to be positively associated with bone mass (p < 0.0001). When these women were grouped into three physical activity levels on the basis of occupation and daily work intensity, those undertaking heavy labor also had significantly higher radial bone mass than women undertaking light or medium labor. These results suggest a protective effect of daily physical activity on bone health in both pre- and postmenopausal women.

Tuberous sclerosis associated with neurofibromatosis: report of a case

Neurofibromatosis and tuberous sclerosis are phakomatous syndrome diseases. They are both inherited as autosomal dominant diseases. Neurofibromatosis type 1 and tuberous sclerosis very seldom occur together. We report a 16-year-old male who had characteristics of these two diseases. This patient had all the criteria for a definitive diagnosis of tuberous sclerosis such as: classical shagreen patches, periungual fibroma, retinal hamartomata, facial angiofibroma, renal angiomyolipomata, and subependymal glial nodules on computed tomography. He also had the three presumptive diagnostic criteria: cardiac rhabdomyoma, seizure history and first degree relatives with tuberous sclerosis. The patient had more than six café-au-lait spots, the greatest diameter of which exceeded 15 mm in diameter. Multiple neurofibromas, one plexiform neurofibroma, axillary freckling and optic gliomas were also found on his body. These criteria are sufficient for a diagnosis of neurofibromatosis type 1 to be made. The skin biopsies were also consistent with the disease. Apart from the patient's mother and younger sister, who had tuberous sclerosis, there was no other person with neurofibromatosis type 1 in his immediate family. We believe that tuberous sclerosis was inherited from his mother and that neurofibromatosis type 1 may have resulted from mutation.

Elevated serum CA-125 in tuberculous peritonitis: report of a case

A 37-year-old female presented with a 2-month history of abdominal distention. Omentum masses with massive ascites were found and ovarian cancer with peritoneal carcinomatosis was suspected. Her serum CA-125 level was over 500 U/ml before therapy. Tuberculous peritonitis was diagnosed via peritoneal biopsy. The serum CA-125 level returned to normal after antituberculous therapy. Elevated serum CA-125 does not always indicate ovarian malignancy. This tumor marker may be used to monitor the disease activity in non-neoplastic ascitic states.

[Effects of lowering perilymph calcium concentration on various cochlear potentials]

In the present experiment, changes in compound action potentials of auditory nerve (CAP), cochlear microphonics (CM) and endocochlear potentials were observed when the calcium concentration of perilymph was reduced by means of perilymph perfusion, with the aim of analyzing how calcium was involved. Perfusion with Ca(2+)-free artificial perilymph reversibly suppressed both CAP and CM amplitudes, but did not alter the basic nonlinear properties of CAP I/O curve. Furthermore, the perfusion did not alter the EP and negative EP (n-EP) induced by anoxia but eliminated the fast change of EP with respect to turning on and off of intense sound. The mechanisms underlying the effects of calcium are discussed.

Effects of baicalein and esculetin on transduction signals and growth factors expression in T-lymphoid leukemia cells

The possible mechanisms of antiproliferative effect of baicalein were studied in human T-lymphoid leukemia cells (CEM cells) and compared with those of esculetin. Baicalein, esculetin and related compounds, baicalein, wogonin, esculin and scoparone, inhibited CEM cell proliferation. Baicalein exhibited the greatest antiproliferative activity with an IC50 of 4.7 +/- 0.5 microM and the maximal suppression of 91.5 +/- 1.4% in CEM cells. The protein tyrosine kinase activity in the CEM cells was significantly reduced by baicalein (10(-6)-10(-4) M) and esculetin (10(-4) M). Baicalein exhibited a greater inhibitory activity on the protein tyrosine kinase than did esculetin (74.1 +/- 3.3% vs. 64.6 +/- 2.8% inhibition at 10(-4) M). On the other hand, the protein kinase C activity stimulated by phorbol-12-myristate 13-acetate was reduced by directly incubating with baicalein (10(-6)-10(-4) M) and esculetin (10(-4) M). However, the inhibitory activities on protein kinase C did not show a dose-dependency. The reverse transcription-polymerase chain reaction analysis of platelet-derived growth factor-A (PDGF-A) and transforming growth factor-beta 1 (TGF-beta 1) messenger RNA levels demonstrates that baicalein and esculetin reduced the PDGF-A mRNA level, but less affected the TGF-beta 1 mRNA. Baicalein exhibited the greater reduction on the expression of PDGF-A mRNA than did esculetin. It is suggested that baicalein and esculetin may affect cell proliferation by direct inhibition of growth-related signal, protein tyrosine kinase, as well as reduction of mRNA expression of growth factor, platelet-derived growth factor.

Comparison of the effects of nifedipine and nitroglycerin on coronary blood flow using intracoronary Doppler catheter

Different effects of nifedipine and nitroglycerin on large coronary arteries measured by the Xenon washout method are well documented in early reports, but results of direct measurements of the flow velocity of the large vessels were inconsistent. The goal of this investigation was to compare the effects of nifedipine and nitroglycerin on coronary blood flow using an intracoronary Doppler catheter. Fourteen patients with normal coronary arteries (group 1) and eight (group 2) with coronary artery diseases (more than 75% concentric stenosis over the left anterior descending artery in the middle portion) were presented on diagnostic procedure for evaluation of chest pain or abnormal exercise tests after written informed consents. We compared the effects of nitroglycerin (0.6 mg) and nifedipine (10 mg) given sublingually on coronary blood flow velocity using a Doppler coronary catheter. The results indicated that the maximal increase in large coronary arterial diameter induced by nifedipine was similar to that induced by nitroglycerin. Nifedipine increased diastolic and systolic velocity area indices (DVAI and SVAI), and reduced diastolic and systolic coronary vascular resistance (DCVRI and SCVRI). In contrast, nitroglycerin reduced DVAI and SVAI and minimally increased DCVRI and decreased SCVRI in group 2 patients. The increased heart rate and decreased blood pressure induced by both drugs were similar. The differences in the rate-pressure product between the two drugs were not significant. Nifedipine increased flow velocity and decreased coronary vascular resistance, but nitroglycerin achieved the opposite effect, especially in patients with coronary artery disease.

Assessment of a modified household food weighing method in a study of bone health in China

OBJECTIVE

A 'modified' household dietary method to estimate individual intakes from total household intakes was evaluated in comparison to the individual food weighing method, i.e. direct weighing of foods consumed by individuals.

DESIGN

Foods consumed by the household were weighed and recorded over a 3 day period and were proportionally allocated to a specific person in the household by using energy conversion factors based on age, gender and physical activity. The individual dietary intakes were standardized by body weight (ratio of individual body weight to reference body weight from Chinese Recommended Daily Allowances (Acta Nutr. Sin. 12, 1-9), and were compared with the estimates from the individual food weighing method for both accuracy and associations with bone density.

SETTING

The subjects were randomly selected from five rural countries in China, characterized by different dietary patterns.

SUBJECTS

A total of 712 women aged 35-75 years participated in the dietary and bone measurements.

RESULTS

Nutrient intakes estimated by the modified household method (adjusting for body weight were very similar to those obtained by the individual method (r = 0.53-0.78, P < 0.001), except for sodium which had the largest deviation from the individual methods (r = 0.23, P < 0.001). Calcium intakes were 405 +/- 271 and 409 +/- 323 mg/day, respectively, as estimated by the individual and modified household methods. A very similar degree of correlation with radial bone density also was obtained for both calcium estimates.

CONCLUSION

The results indicate that the modified household method is appropriate for assessing food intakes of individuals in large nutritional studies.

Analysis of mosquito vitellogenin cDNA. Similarity with vertebrate phosvitins and arthropod serum proteins

The cDNA coding for vitellogenin of the mosquito Aedes aegypti was cloned and sequenced. An immunological analysis of expressed deletions from the 5'-end of the vitellogenin cDNA clones using vitellogenin subunit-specific antibodies showed that the small vitellogenin subunit is located at the N terminus and the large one at the carboxy-portion of the pre-provitellogenin. The position of the cleavage between the vitellogenin subunits in the pre-provitellogenin was identified by locating the N terminus of the large subunit. The cleavage site has a consensus RXRR for the subtilisin-processing endoprotease. Mosquito vitellogenin is highly hydrophilic with 17 putative N-linked glycosylation sites and 13 potential tyrosine sulfation sites. In contrast to known invertebrate vitellogenins, mosquito vitellogenin contains three polyserine domains that are similar to those of phosvitins in vertebrate vitellogenins. These polyserine domains, originally presumed to be vertebrate-specific, have several phosphorylation consensus sites in their sequences. Unlike other known vitellogenins, mosquito vitellogenin is rich in aromatic amino acid residues, tyrosine and phenylalanine, and in this respect is similar to insect serum proteins, arylphorins. This similarity suggests that mosquito vitellogenin may supply aromatic amino acids to the cuticle of rapidly developing embryos.

Evaluation of choledochojejunostomy with subcutaneous jejunostomy for treatment of intrahepatic stones

Twenty-nine patients, 16 males and 13 females, with intrahepatic stones were treated by choledochojejunostomy with subcutaneous jejunostomy after choledocholithotomy in cases where the common bile duct was dilated more than 2 cm in diameter. This surgical technique consists of putting a segment of jejunum in the subcutaneous area with a jejunostomy after finishing the choledochojejunostomy. If the stone recurs years later, this loop of jejunum will offer a route for inserting the scope while producing the fistulotomy under local anesthesia. These patients became symptomless soon after removal of the residual stone by postoperative choledochoscope. After more than five years of follow-up study, seven cases (24.1%) had reflux cholangitis and among them, four patients had recurrent stones. Reopening of the fistulotomy was carried out under local anesthesia, and the choledochoscope was inserted into the bile duct through the jejunum for removal of those recurrent stones. We believe that this surgical technique is very effective for the treatment of patients with recurrent intrahepatic stones without the necessity of major laparotomy.

(4aR,8R,SR)-8-(p-tolylsulfinyl)-2,3,4,4a,5,6,7,8-octahydro-4a-quinolinol

The title compound, C16H21NO2S, isolated from the reaction of lithiated racemic 2,3,4,4a,5,6,7,8-octahydroquinoline with 0.5 equivalents of (-)-(1R,2S,5R)-menthyl (SS)-p-toluenesulfinate, possesses the unusual conformation in which the OH and bulky p-toluenesulfinyl groups are in axial positions. The S=O bond distance of 1.519 (3) A is longer than expected because of intramolecular hydrogen bonding between the hydroxyl group and the sulfinyl O atom.