Search for mutations near the alternatively spliced 8-amino-acid exon in the GABAA receptor gamma 2 subunit gene and lack of allelic association with alcoholism among four aboriginal groups and Han Chinese in Taiwan

The alternatively spliced 8-amino-acid exon for the GABAA receptor gamma2 subunit gene (GABRC2) has been postulated to mediate behavioral actions of alcohol. A rapid search for splice-junction mutations near the 8-amino-acid exon using restriction enzymes which normally recognize sequences near or in the exon gave negative results among 217 alcoholics in four aboriginal groups (Ami, Atayal, Bunun and Paiwan) and Han Chinese in Taiwan. The role of the GABRC2 gene in alcoholism was further assessed by a comparison of allelic frequencies revealed by a NciI RFLP between case and control groups. No significant association of alcohol dependence with GABRC2 alleles was observed. These results suggest that the GABRC2 gene probably does not play an essential role in predisposition to alcoholism in the sample population.

Alcohol-related problems in Taiwan with particular emphasis on alcoholic liver diseases

Socioeconomic development has led to a progressive increase of alcohol consumption in Taiwan, with an accompanying increase in alcohol-related psychiatric problems, traffic accidents, and liver disease. The prevalent rates of alcohol dependence for Han Chinese and Fomosan aborigines were 0.1% and 1%, respectively in 1950. The rate of alcohol dependence increased to 23% for aborigines in 1995. The number of cases of death and serious injuries due to alcohol-related traffic accident has decreased, and the number of fatalities resulting from these accidents has decreased from third to eighth since the inception of a program of random traffic stops with alcohol breath test in 1997. Alcohol liver disease (ALD) was defined as daily alcohol consumption of 60 g, for a duration of longer than 5 years. We classified ALD patients into two groups: (1) those whose average daily consumption of alcohol exceeded 120 g for a duration longer than 15 years (group A); and (2) all other patients (group B). The case records of 33 cases of biopsy-confirmed ALD were obtained for study. The average of daily alcohol consumption in these cases was 160 g. All but one of these patients were male, age ranged from 26 to 69 years, with an average of 43.1. Clinically, ill-defined gastrointestinal symptoms were the most common presentation (61%), and hepatomegaly was the main physical sign (73%). The average mean corpuscular volume values of ALD and non-ALD patients were 102.3 +/- 10.94 and 94.5 +/- 8.1, respectively (p < 0.01). The mean corpuscular volume values of group A and group B were 102.9 +/- 9.7 vs. 96.5 +/- 9.11 (p < 0.05). Result from serum SGOT/SGPT and gamma-glutamyltransferase/alkaline phosphatase for ALD and non-ALD revealed statistically significant differences between these groups. Using the avidin-biotin complex technique, tissue IgA deposition for ALD patients was found to be different from that of non-ALD patients. Ten of 13 ALD patients vs. 2 of 13 non-ALD patients had continuous-form IgA deposition. Histologically, 45.5% of ALD patients had alcoholic cirrhosis, whereas alcoholic hepatitis was present in only 9.1% of patients. Overall, 88% of cases showed various severity of fatty metamorphosis.

A high-performance wide-range beamline for elliptically polarized undulator source

A high-performance wide-range beamline has been designed for monochromatizing circularly polarized photons with energies from 10 to 1400 eV. A grazing SGM-based beamline with two entrance slits has been employed to optimize the performance. The degree of the circular polarization affected by the beamline optics has been analysed. The horizontal and vertical refocusing mirrors have been specially arranged to improve greatly the polarization degree in the low-energy region. By connecting this beamline to a high-efficiency elliptically polarized undulator, this beamline should be able to provide, in the entire energy range, intensive and high-resolution photons of a high degree of circular polarization.

A unique high-performance wide-range (10-1500 eV) spherical grating monochromator beamline

A wide-spectral-range high-performance 6 m-spherical grating monochromator (6 m-SGM) beamline has been designed and is under construction at SRRC. Two different entrance slits, instead of additional mirrors, are used to optimize the overall performance. Six gratings are used to cover photon energies from 10 to 1500 eV. Movable entrance slits and bendable vertical focusing mirrors are used to enhance further the beamline performance. A bendable horizontal focusing mirror is used to improve the resolution and to focus the photon beam at the experimental station immediately after the exit slit. Several end-stations can be installed at the same time to utilize the beam time fully. The expected energy-resolving power, with both slit openings set at 10 micro m, is up to 15 000 and 40 000 for the high- and low-energy branches, respectively. A photon flux of 1 x 10(11) photons s(-1) can be obtained with an energy-resolving power of 20 000.

Spleen rupture in infectious mononucleosis: report of one case

Spleen rupture has been a rare but feared complication in patients with infectious mononucleosis. There have been many cases reported during the last decade. However, it has rarely been mentioned among the young infant group. Here, we present a case of an infant, two months of age, who suffered from spleen rupture due to infectious mononucleosis, and was latter cured by himself under conservative treatment.

Application of solid-phase microextraction and gas chromatography-mass spectrometry for the determination of chlorophenols in urine

This study investigated the feasibility of applying solid-phase microextraction (SPME) combined with gas chromatography-mass spectrometry to analyze chlorophenols in urine. The SPME experimental procedures to extract chlorophenols in urine were optimized with a polar polyacrylate coated fiber at pH 1, extraction time for 50 min and desorption in GC injector at 290 degrees C for 2 min. The linearity was obtained with a precision below 10% R.S.D. for the studied chlorophenols in a wide range from 0.1 to 100 microg/l. In addition, sample extraction by SPME was used to estimate the detection limits of chlorophenols in urine, with selected ion monitoring of GC-MS operated in the electron impact mode and negative chemical ionization mode. Detection limits were obtained at the low ng/l levels. The application of the methods to the determination of chlorophenols in real samples was tested by analyzing urine samples of sawmill workers. The chlorophenols were found in workers, the urinary concentration ranging from 0.02 microg/l (PCP) to 1.56 microg/l (2,4-DCP) depending on chlorophenols. The results show that trace chlorophenols have been detected with SPME-GC-MS in the workers of sawmill where chlorophenol-containing anti-stain agents had been previously used.

Characterization of the antiplatelet effects of (2S)-5-methoxy-6-methylflavan-7-ol from Draconis Resina

(2S)-5-methoxy-6-methylflavan-7-ol (MMF) was purified from Draconis Resina and its in vitro effects on various aspects of platelet reactivity were examined. Results indicated that MMF dose dependently inhibited aggregation of washed rabbit platelets induced by collagen, arachidonic acid, ADP, U46619 or platelet-activating factor (PAF), with IC50) values of 17.2, 49.8, 179.8, 109.6, and 189.2 microM, respectively. Concomitantly, MMF also dose dependently suppressed ATP release by platelets activated by these stimulants. The increase in intracellular free calcium ([Ca2+]i), elicited by these activating agents, was inhibited by MMF as reflected by fura-2 fluorescence measurements. However, MMF had no effects on the cyclic AMP level of platelets. In addition, MMF inhibited the arachidonic acid-induced thromboxane B2 and prostaglandin D2 formation in intact platelet suspensions or homogenized platelet lysates. This study provided evidence that MMF is an antiplatelet agent whose activity is likely related to cyclooxygenase inhibition and suppression of [Ca2+]i increase.

Prenatal and neonatal intussusception

Intussusception found in the 1st month of life is rare and usually discussed as one entity, neonatal intussusception, but in fact, includes the intussusceptions occurring both prenatally and neonatally, of which the clinical presentations and results are different. Four full-term babies with prenatal intussusception presenting as intestinal atresia (IA) and three premature babies with neonatal intussusception mimicking necrotizing enterocolitis (NEC) are presented. Prenatal intussusception, as one of the causes of IA produces prominent signs of intestinal obstruction immediately after birth. Preoperative evaluation usually fails to yield a definitive diagnosis, but surgery is usually performed in time and is successful. In neonatal intussusception, full-term infants usually have a pathological lead point and the colon is almost always involved. A barium enema is thus useful in diagnosis. Premature babies, on the other hand, rarely have a colonic component, and the clinical features are insidious and similar to NEC. This results in diagnostic confusion that may lead to a dangerous delay in appropriate surgical correction. A high level of suspicion about this condition in cases diagnosed presumptively with NEC is important. Serial abdominal sonograms may be helpful in the early diagnosis of neonatal intussusception.

The predictors of long-term care service utilization among older Americans

Long-term care for the elderly has recently become an area of great interest for practicing social workers because of the increasing number of aged persons and the important role of government in financing and regulating their care. Therefore, the purpose of this study was to provide a set of estimates on patterns in long-term care service use among older Americans over an eight-year period. This study applied multinomial logistic regression to analyzing the data from the National Long-Term Care Survey of 1982-1989 (NLTCS). The results of this study showed a number of differences from the results with cross-sectional studies. Of the 6,393 sample persons, more than half (56.5%) died over the eight years from 1982 to 1989. The rate of entering nursing homes (12.6%) was low. The rate of using community-based care services was fairly low. About 10.4 percent of the sample received care from helping professional personnel or paid helpers. As expected, the number receiving care from kin and other informal support was high. Long-term care services in the United States were distributed very unequally among various social groups. The indicator of need was not the only determinant of service utilization. Other variables such as number of household members, race, age and education were also important for service utilization. The predictors of deceased versus informal help were need, age, number of household member, gender and marital status. The predictors of nursing home care versus informal help were need, age, number of household members, education, attitude toward nursing home and race. The predictors of community-based help care versus informal help were need, number of household members, and education.

Anti-tumor effects of d-dicentrine from the root of Lindera megaphylla

d-Dicentrine, a naturally occurring aporphine type isoquinoline alkaloid, isolated from the root of Lindera megaphylla Hemsl. (Lauraceae), was evaluated for its potential anti-cancer activity. We found d-dicentrine significantly inhibited the growth of human hepatoma cell line HuH-7 by delaying its doubling time in tissue culture. An in vitro colony forming assay showed that d-dicentrine decreased the colony formation efficiency in both hepatoma cell lines, HuH-7 and MS-G2, used in our study. Biosyntheses of the macromolecules DNA and RNA were also strongly inhibited. An MTT assay in 21 tumor cell lines also revealed that d-dicentrine was most cytotoxic to esophageal carcinoma HCE-6, lymphoma cell lines Molt-4 and CESS, leukemia cell lines HL60 and K562, and hepatoma cell line MS-G2. An in vitro tumor growing assay in the Severe Combined immunodeficiency (SCID) mice showed that intraperitoneal injection of d-dicentrine at the dose of 100 micrograms twice a week for 4 weeks significantly inhibited the tumor incidence of leukemia cell line K562 in SCID mice. All these data indicated that d-dicentrine has potential anti-tumor applications.

The effects of particle charge on the performance of a filtering facepiece

This study quantitatively determined the effect of electrostatic charge on the performance of an electret filtering facepiece. Monodisperse challenge corn oil aerosols with uniform charges were generated using a modified vibrating orifice monodisperse aerosol generator. The aerosol size distributions and concentrations upstream and downstream of an electret filter were measured using an aerodynamic particle sizer, an Aerosizer, and a scanning mobility particle sizer. The aerosol charge was measured by using an aerosol electrometer. The tested electret filter had a packing density of about 0.08, fiber size of 3 microns, and thickness of 0.75 mm. As expected, the primary filtration mechanisms for the micrometer-sized particles are interception and impaction, especially at high face velocities, while electrostatic attraction and diffusion are the filtration mechanisms for submicrometer-sized aerosol particles. The fiber charge density was estimated to be 1.35 x 10(-5) coulomb per square meter. After treatment with isopropanol, most of fiber charges were removed, causing the 0.3-micron aerosol penetration to increase from 36 to 68%. The air resistance of the filter increased slightly after immersion in the isopropanol, probably due to the coating of impurities in isopropanol. The aerosol penetration decreased with increasing aerosol charge. The most penetrating aerosol size became larger as the aerosol charge increased, e.g., from 0.32 to 1.3 microns when the aerosol charge increased from 0 to 500 elementary charges.

A SPECT study of patients with gait apraxia without evidence of frontal lobe dysfunction

BACKGROUND

The pathogenesis of gait apraxia (GA) is unknown. Even though imaging studies provide excellent assessment of brain morphology, there is still a lack of congruous results. Single photon emission computed tomography (SPECT) using Tc-99m hexamethylpropyleneamine oxime (HMPAO) may show alterations in regional cerebral blood flow (rCBF) and provide indirect information about brain metabolism.

METHODS

We conducted a SPECT study of GA patients and evaluated the related cortical function. rCBF was assessed in 16 GA patients (15 male, one female; age range 65-79 years, mean 70.5 years) by SPECT using HMPAO. Mean HMPAO cortical or basal ganglia/cerebellum activity ratios were calculated. The regions of interest included the frontal lobe, parietal lobe and basal ganglia. A battery of GA tests and magnetic resonance imaging (MRI) of the brain were also performed in these 16 patients.

RESULTS

Nine of the patients had equilibrium disorder, and all 16 patients had locomotion disorder. The MRI findings were lacunar infarct (16/16 in basal ganglia, or 6/16 in thalamus), leukoaraiosis (4/16), enlarged ventricle (3/16), frontal lesion (3/16) and parietal lesion (1/16). Lower rCBF was noted in the frontal lobe (3/16), occipital lobe (1/16, thalamus (7/16) and basal ganglia (9/16). Though SPECT showed decreased rCBF in nine patients (9/16), mean cortical and basal ganglia regional uptake ratios in the patient group were not significantly different from values in the control group (cortical p = 0.0613; basal ganglia p = 0.0576, by Student's t-test).

CONCLUSIONS

Though only a small number of patients were studied, it was clear that brain SPECT and MRI did not show any significant abnormalities in the frontal or parietal lobes of patients with GA. Thus, the pathogenesis of GA and its related anatomic lesion should be further investigated.

Successful arterial switch operation in a low-birth-weight neonate who had transposition of the great arteries and advanced necrotizing enterocolitis

A low-birth-weight (LBW; 1,940 g) girl was born at the gestational age of 36 weeks without any perinatal insult. Transposition of the great arteries (TGA) with a large patent ductus arteriosus (PDA) and interatrial shunt was detected. Stage IIIB necrotizing enterocolitis (NEC) developed 46 hours after birth. She received ileostomy and drainage. Arterial switch operation was successfully performed at 23 days of age when her weight was 1,900 g. The enterostomy was successfully repaired at 104 days of age.

ATP-induced arachidonic acid release in cultured astrocytes is mediated by Gi protein coupled P2Y1 and P2Y2 receptors

ATP-induced arachidonic acid (AA) release was studied in [3H]AA-prelabeled cultured astrocytes. To characterize the P2 purinoceptor-mediated effect of ATP, the subtype-specific agonists 2-methylthio ATP (2-MeSATP) and UTP were compared. ATP, UTP, or 2-MeSATP induced a dose-dependent increase of [3H]AA release, with EC50 values of 22.7 microM, 29.4 microM, and 1.68 microM, respectively; alpha,beta-methyleneATP and adenosine had no effect. The order of potency was ATP = UTP > or = 2-MeSATP, indicating that ATP interacted with both P2Y1 and P2Y2 receptors to mediate AA release in astrocytes. The effect of ATP, UTP, or 2-MeSATP was markedly inhibited by pretreatment of cells with pertussis toxin. Ca2+ ionophore-A23187 and PKC activator-TPA mimicked the effects of these three agonists to stimulate AA release. ATP, UTP, and 2-MeSATP induced a rapidly initial rise of [Ca2+]i and a sustained [Ca2+]i increase. The AA release was blocked in the external Ca2+ free in condition the sustained [Ca2+]i increase was abolished. Both A23187- and TPA-induced AA release were also blocked in this condition. Furthermore, inorganic Ca2+ channel blocker Co2+ inhibited ATP, UTP, or 2-MeSATP induced AA release as well. Long-term (24 h) treatment of cells with TPA resulted in an attenuation of three agonists, TPA or A23187 response. Similarly, ATP or TPA promoted AA release was inhibited by the mitogen-activated protein kinase (MAPK) cascade inhibitor PD 98059. ATP, TPA, or A23187 induced an increase in the activity and tyrosine phosphorylation of p42 MAPK, as well as a molecular weight shift, consistent with phosphorylation, of cytosolic phospholipase A2 (cPLA2). ATP- and TPA-stimulated activation of p42 MAPK activity and tyrosine phosphorylation were inhibited by long-term TPA treatment, while A23187-stimulated effects were completely blocked. Furthermore, tyrosine phosphorylation and activation of p42 MAPK and mobility shift of cPLA2 induced by A23187 were reversed in the absence of external Ca2+, suggesting the involvement of PKCalpha in MAPK activation and mobility shift of cPLA2. Taken together, ATP-stimulated AA release was secondary to the activation of P2Y1 and P2Y2 receptors/PLC pathway. Ca2+ and PKC interact to regulate this response. Elevation of intracellular Ca2+, the mechanism involving extracellular Ca2+ influx, might act partly through PKCalpha activation and in turn MAPK might be activated, leading to cPLA2 phosphorylation and AA release.

The paired Ig-like receptor PIR-B is an inhibitory receptor that recruits the protein-tyrosine phosphatase SHP-1

An emerging family of cell surface inhibitory receptors is characterized by the presence of intracytoplasmic immunoreceptor tyrosine-based inhibition motifs (ITIM). These ITIM-bearing inhibitory receptors, which are typically paired with activating isoforms, associate with Src homology domain 2-containing phosphatases following ITIM tyrosine phosphorylation. Two categories of phosphatases are recruited by the ITIM-bearing receptors: the protein-tyrosine phosphatases, SHP-1 and SHP-2, and the polyphosphate inositol 5-phosphatase, SHIP. The dynamic equilibrium of B cell activation is partially controlled by two well known ITIM-bearing receptors, CD22 and FcgammaRIIB, a low affinity receptor for IgG. We describe here that a murine ITIM-bearing molecule, PIR-B, can also negatively regulate B cell activation. Tyrosine-phosphorylated ITIMs allow PIR-B to associate with SHP-1 but not with SHIP. Engagement of PIR-B thereby initiates a SHP-1-dependent inhibitory pathway that may play an important role in regulating B lymphocyte activation.

Measurement of prostaglandin E2 and leukotriene B4 in the gingival crevicular fluid

The arachidonic acid metabolites prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) are inflammatory mediators which are likely to be involved in the pathogenesis of periodontal disease. PGE2 mediates vasodilatation, increases vascular permeability, enhances pain perception by bradykinin and histamine, alters connective tissue metabolism and enhances osteoclastic bone resorption. LTB4 causes the accumulation of inflammatory cells in the inflamed sites, and degranulation of polymorphonuclear leukocytes.

OBJECTIVE

To measure gingival crevicular fluid (GCF) levels of PGE2, LTB4 and periodontal health.

METHODS

The periodontal condition of 24 subjects was evaluated on the basis of plaque index, gingival index, probing depth, and attachment level. GCF samples were collected from one or two site(s) of each sextant per subject and the volume was measured using Periotron 6000. Samples were then assayed for PGE2 and LTB4 using a competitive enzyme immunoassay. Mean PGE2 and LTB4 levels were determined for each subject and group means compared.

RESULTS

Significant differences in the levels of PGE2 and LTB4 were found between patients with periodontitis, and non-periodontitis individuals (P < 0.001). The PGE2/LTB4 levels were positively correlated with the clinical parameters (P < 0.01) and reduced markedly after phase 1 of the periodontal treatment (P < 0.01). The total amount and concentration (ng ml-1) of LTB4 was positively correlated with the gingival index (P < 0.01).

CONCLUSIONS

These results indicate that the levels of PGE2 correlated with the severity of the periodontal status, and the levels of LTB4 correlated with gingival inflammation. Thus, our data suggest that the total amounts of PGE2/LTB4 may be good indicators for periodontal inflammation.

A follow-up study of annular pancreas in infants and children

Fifteen pediatric patients undergoing surgery for annular pancreas from 1984 to 1996 were analyzed. Vomiting was the most common presenting symptom. Twelve patients (80%) had associated anomalies including malrotation (40%), intrinsic duodenal obstruction (33%), Down syndrome (27%) and duodenal bands (27%). Their ages at operation were between 5 hours and 8.5 years, with a median of 4 days. Surgical treatment included duodenojejunostomy in nine, duodenoduodenostomy in five and duodenotomy with duodenoplasty in one. The mean duration for reestablishment of bowel transit was 17.9 days, with 22.8 days for duodenojejunostomy and 12.3 days for duodenoduodenostomy. All cases received postoperative follow-up, but only 11 of them were long-term followed until April 1997, with a duration ranging from 1 year and 2 months to 11 years, with a median of 7 years and 5 months. The survival was 100%, but 12 cases (80%) developed postoperative complications including cholestatic jaundice (53%), upper gastrointestinal motility disorder (47%), failure to thrive (40%) and chronic diarrhea (33%). Annular pancreas divisum was noted in one case with chronic relapsing pancreatitis. At the end of follow-up (April 1997), when final ages ranged from 1 year and 2 months to 18 years and 9 months with a median of 7 years and 5 months, there were still problems: steatorrhea in 1, diarrhea after fatty diet in 3, malnutrition in 4, failure to thrive in 3 and lower concentration of stool trypsin in 3 cases. In conclusion, close long-term follow-up is essential for infants treated for annular pancreas because many of them can be expected to develop complications, even if the initial postoperative period is uncomplicated and survival is excellent.

Factors affecting postoperative fecal soiling in Hirschsprung's disease

We retrospectively assessed the factors that may contribute to fecal soiling after surgery for Hirschsprung's disease. Fifty-eight patients underwent surgery for Hirschsprung's disease and returned for follow up. The patients were divided into two groups based on the presence or absence of fecal soiling. The postoperative period, level of bowel pulled through, stool frequency, stool character, presence or absence of anorectal surgical complications, and manometric findings of the two groups were compared. Forty-three patients (40 boys, 3 girls, mean age 9.5 yr) had soiling and 15 (10 boys, 5 girls, mean age 10.2 yr) did not. Patients with soiling had significantly higher rates of anorectal surgical complications (60% vs 7%), abnormal stool character (75% vs 7%), stool frequency greater than three times per day (63% vs 20%), absence of rectoanal inhibitory reflex (33% vs 2%), and narrow anorectal pressure gradient (60% vs 13%) than those without. The results of manometric study suggested that a damaged internal sphincter or irritable neorectum might have contributed to fecal soiling. In conclusion, although anorectal surgical complications might result in both irritable neorectum and damaged internal sphincter, their effect on the neorectum (significantly increased rate of high resting rectal pressure) seemed to outweigh that on the internal sphincter. A competent anal sphincter and a less irritable neorectum after operation may therefore lower the likelihood of fecal soiling.

Bone metastases in patients with gastrinomas: a prospective study of bone scanning, somatostatin receptor scanning, and magnetic resonance image in their detection, frequency, location, and effect of their detection on management

PURPOSE

To determine whether bone scan, magnetic resonance imaging (MRI), or somatostatin receptor scintigraphy (SRS) is best for identifying bone metastases in patients with gastrinomas, as well as their frequency and location, whether their detection affects management, and what patient subgroups should be examined.

MATERIALS AND METHODS

One hundred fifteen patients with gastrinoma were prospectively studied. Patients were examined yearly and those with liver metastases were reexamined every 3 months. Based on clinical history, histology, growth pattern, and development of new bone lesions, possible bone metastases were classified as to whether they were or were not bone metastases. Imaging results were correlated at different times in the disease course and with disease extent.

RESULTS

Bone scan was positive in 52 patients, MRI in seven, and SRS in six. Eight patients (7%) were determined to have bone metastases and MRI was correctly positive in seven, SRS in six, and bone scan in five. SRS or MRI was positive in all patients with bone metastases. Bone scan had significantly lower specificity and sensitivity, and a higher rate (P < .02) of false-negative results than MRI or SRS. Bone metastases occurred in 31% of patients with liver metastases and 0% with only lymph node metastases. The initial bone metastases were in the spine or sacrum (75%) followed in descending order by the pelvis or sacroiliac joints (38%), scapula or shoulder, and ribs. In all cases, detection of bone metastases changed the management.

CONCLUSION

SRS and MRI, because of high sensitivity and specificity, are recommended over bone scanning to screen for bone metastases in patients with gastrinomas. However, because bone metastases can occur initially outside the axial skeleton, SRS is the recommended initial localization method of choice. Bone metastases occur in 7% of all patients and 31% of patients with liver metastases, only occur in patients with liver metastases, are usually in the axial skeleton initially, and their detection changes management in all cases. Patients with pancreatic endocrine tumors with liver metastases should undergo SRS every 6 months to 1 year to detect bone metastases.

Anorectal function and endopelvic dissection in patients with repaired imperforate anus

Fifty-eight patients with anorectal malformations were closely followed up for postoperative anorectal function. Constipation was noted shortly after anorectoplasty in 10 of 28 low anomalies (35.7%) treated with limited sagittal anorectoplasty (LSARP), in 18 of 25 high or intermediate anomalies (72.0%) treated with posterior sagittal anorectoplasty (PSARP), but in none of 5 high or intermediate anomalies treated with Rehbein's mucosa-stripping endorectal pull-through and anterior sagittal perineal anorectoplasty (R-ASAP). The constipation resolved mostly within 1-2 years after repair under conservative management, but persisted beyond 2 years after repair in 3/25 children with LSARP and 10/25 with PSARP. Anal soiling was noted in 1/23 (4.3%) LSARP and 6/22 (27.3%) PSARP patients, but normal anorectal function was attained in 20/23 LSARP (86.9%) and 11/12 PSARP patients (50.0%) by the time of toilet training. Manometric studies disclosed that the resting rectal pressure (RRP) was lower and the anorectal pressure gradient (ARPG) higher in the constipated than the non-constipated children, while the RRP was higher and the ARPG lower in the soiled than the non-soiled patients. The ARPG after R-ASPA was close to that of non-constipated and in between that of the constipated and soiled patients. The rectoanal sphincter inhibitory reflex was not related to defecation status or surgical procedures, but showed a tendency toward positive conversion with time or after exclusion of esctatic terminal bowel in the severely constipated. It is concluded that anorectal function in patients with repaired imperforate anus seems to be more affected by the extent of endopelvic dissection than by preservation of the terminal bowel or sphincter muscles.

Six New Diarylbutane Lignans from Justicia procumbens

Six new diarylbutane lignans, namely, justin A (1), (-)-dihydroclusin diacetate (2), secoisolariciresinol dimethyl ether diacetate (3), 5-methoxy-4,4'-di-O-methylsecolariciresinol diacetate (4), justin B (5), and justin C (6), together with three known diarylbutane lignans [2,3-demethoxysecisolintetralin acetate (7), secoisolariciresinol dimethyl ether (8), and 5-methoxy-4,4'-di-O-methylsecolariciresinol (9)], were isolated from the whole plant of Justicia procumbens. Their structures were established by spectral analysis.

In situ detection of Epstein-Barr virus in breast cancer

Epstein-Barr virus (EBV) is strongly associated with nasopharyngeal carcinoma and some lymphoepithelioma-like carcinomas from other anatomic sites. This study investigates the presence of EBV in breast cancer. Immunohistochemistry for EBV proteins (EBV nuclear antigen-2 and latent membrane protein-1) and in situ hybridization for EBV-encoded small nuclear RNAs (EBER-1 and -2) were performed in 60 invasive breast cancers. None of the 60 breast cancer samples showed detectable EBV. These results suggest that EBV may not play a significant role in the etiology of breast cancers in Taiwan.