Abnormal gastric emptying and Helicobacter pylori infection in patients with cirrhosis of the liver

Thirty-seven patients aged 36-75 years with cirrhosis of the liver secondary to chronic hepatitis were included in the study. They were divided into three groups according to the modified Child's classification for cirrhotic severity, where A = good, B = fair and C = poor. In addition, the patients were divided according to the presence or absence of each of the following: ascites, splenomegaly and oesophageal varices. Radionuclide-labelled solid meals were used to evaluate gastric emptying and the 14C-urea breath test was used to detect Helicobacter pylori infection. Gastric emptying was represented by the gastric retention ratio of the solid meal at 90 min (RR90) and calculated using the following formula: the residual radioactivity within the region of interest (ROI) covering the whole stomach at 90 min divided by the initial radioactivity within the ROI at 0 min. We found that 75.7% (28/37) of the patients had abnormal gastric emptying and 45.9% (17/37) had H. pylori infection. No significant correlation was found between abnormal gastric emptying and H. pylori infection. There were no significant differences among the three groups regarding gastric emptying or H. pylori infection according to the modified Child's classification. However, the highest rates of abnormal gastric emptying and H. pylori infection were in patients in Child's class C. The differences in RR90 among patients with and without ascites, and patients with and without splenomegaly, were not significant (P > 0.05). However, there was a significant difference between the patients with and without oesophageal varices (P < 0.05). In addition, poor correlations (R2 < 0.01) were found between RR90 and serum levels of bilirubin and albumin.

Exposure to low-intensity ultrasound increases aggrecan gene expression in a rat femur fracture model

The effects of ultrasound stimulation on various parameters of bone repair after diaphyseal injury were assessed in a standard rat femur fracture model. Bilateral closed femoral fractures were made in 79 skeletally mature male Long-Evans rats. An ultrasound signal consisting of a 200 microsecond burst sine wave of 0.5 MHz repeating at 1 kHz, with an intensity of 50 or 100 mW/cm2 spatial and temporal average, was applied to one fracture in each animal. The contralateral fracture was not exposed to ultrasound and served as a control. Mechanical testing of the healing fracture was performed 3 weeks after injury. In fractures treated with a 50 mW/cm2 ultrasound signal, the average maximum torque (223.5 +/- 50.5 Nmm compared with 172.6 +/- 54.9 Nmm, p = 0.022, paired t test) and average torsional stiffness (13.0 +/- 3.4 Nmm/degree compared with 9.5 +/- 2.9 Nmm/degree, p = 0.017) were significantly greater in treated than in control fractures. In animals treated with a 100 mW/cm2 ultrasound signal, the average maximum torque and torsional stiffness were greater in treated than in control fractures, but this trend did not reach statistical significance. Biochemical analysis of callus in ultrasound-treated and control fractures failed to demonstrate significant differences in cell number, collagen content, or calcium content. Evaluation of gene expression in fractures treated with 50 mW/cm2 ultrasound demonstrated a shift in the expression of genes associated with cartilage formation; aggrecan gene expression was significantly higher on day 7 after fracture and significantly lower on day 21 (p = 0.033 and 0.035, respectively). alpha 1(II) procollagen gene expression was similarly modified, but this trend did not reach statistical significance. Expression of genes coding for bone-related proteins, including alpha 1(I) procollagen, bone gamma-carboxyglutamic acid protein, alkaline phosphatase, and transforming growth factor-beta 1, did not differ between ultrasound-treated and control fractures. These data suggest that ultrasound stimulation increased the mechanical properties of the healing fracture callus by stimulating earlier synthesis of extracellular matrix proteins in cartilage, possibly altering chondrocyte maturation and endochondral bone formation.

Blockade of isoproterenol-induced synaptic potentiation by tetra-9-aminoacridine in the rat amygdala

The effects of tetrahydro-9-aminoacridine (THA) on beta-adrenoceptor activation-induced synaptic potentiation were studied in brain slices of the rat amygdala using intracellular recording techniques. To exclude the involvement of N-methyl-D-aspartate (NMDA) receptors, all the experiments were performed in the presence of NMDA receptor antagonist, D-APV (50 microM). Bath application of isoproterenol (Iso; 15 microM) results in a long-lasting enhancement of the amplitude of excitatory postsynaptic potentials (EPSPs) to 200 +/- 6% of baseline. Forskolin, which directly activates adenyl cyclase, produces a similar effect suggesting that Iso may act through a cyclic AMP-dependent mechanism. Pretreatment of the slices with THA (300 microM) completely abolishes the Iso- and forskolin-induced synaptic potentiation. We hypothesize that the locus of THA/beta-adrenoceptor interaction is presynaptic; the underlying mechanism is likely due to THA's depression of transmitter release via a presynaptic blockade of voltage-dependent Ca2+ channels.

Prevalence of stroke in Kinmen

BACKGROUND AND PURPOSE

Stroke is the second most common cause of death in Taiwan. We studied its prevalence, risk factors, and mortality in a rural Chinese population.

METHODS

A door-to-door survey of stroke was conducted in two Kinmen Island townships with a total population of 26105 people. Our target population (n = 5061) consisted of all the registered residents in these townships who were aged > or = 50 years on August 1, 1993. All participants were given a standardized neurological examination and a questionnaire.

RESULTS

The participation rate was 77.4% (n = 3915). Ninety-six cases of completed stroke were identified. Eighty-nine patients had one, 6 patients had two, and 1 patient had three episodes of stroke. The prevalence of stroke in persons aged > or = 50 years was 24.5 per 1000 (95% confidence interval, 19.7 to 29.3 per 1000). Prevalence increased with age. Statistically significant risk factors associated with stroke included hypertension, diabetes mellitus, and irregular heartbeats. Of the stroke survivors, 59% were independent in activities of daily living and 71% could walk independently.

CONCLUSIONS

Compared with other countries, Taiwan has a moderately high prevalence of stroke. The risk factors for stroke in this rural region of a developing country are similar to those in developed countries. Most stroke survivors here perform their daily activities independently without outside assistance.

Myasthenia gravis complicated with hyperthyroidism, thymoma and serological evidence of systemic lupus erythematosus: a case report

A 55-year-old woman with a several-decade history of thyroid goiter is presented here as a case of myasthenia gravis complicated with hyperthyroidism and thymoma with serological evidence of systemic lupus erythematous (SLE). She had had right eyelid ptosis since July 1992, with a positive tensilon test. The acetylcholine receptor antibody titer was 4.01 nmol/L. A thyroid function test revealed T3: 162 ngidl, T4: 14.98 micrograms/dl, TSH:0.09 microIU/ml and positive anti-microsomal antibody (1:400). An MRI of the chest showed a thymoma in the left thymus. Other autoantibody screenings include ANA (1:320, speckled pattern) and anti-ds DNA (+) suggesting a serological association with SLE. After three courses of plasmapheresis, she received an extended maximal thymomectomy and a subtotal thyroidectomy. She was then treated with prednisolone, Mestinon, Eltroxin and discharged without complications. The coexistence of myasthenia gravis, hyperthyroidism, thymoma and a serological evidence of SLE have not previously been documented in the literature.

Preventive and therapeutic effects of nitrendipine on hypoxic right ventricular hypertrophy

AIM

To assess whether nitrendipine (Nit) can be used to prevent and treat the hypoxic right ventricular hypertrophy (RVH).

METHODS

Rats were exposed to a simulated altitude of 5000 m (barometric pressure = 54 kPa) for 30-60 d. Nit (10-20 mg.kg-1.d-1) was administered via gavage. The therapeutic efficacy was evaluated with right ventricular weight index (RVWI), right ventricular systolic pressure (RVSP), and myocardial ultrastructure.

RESULTS

Chronic intermittent hypoxia for 30 d (8 h.d-1) resulted in an increase of RVSP and RVWI as well as in the changes of RV myocardial ultrastructure. As the hypoxic time was prolonged to 60 d, RVWI and RVSP were not further augmented. Nit (20 mg.kg-1.d-1, i.g.), when administered from the beginning of hypoxia, reduced RVSP (8.1 +/- 1.1 vs 6.0 +/- 1.0 kPa, P < 0.05) and RVWI (1.014 +/- 0.012 vs 0.915 +/- 0.049 mg/g body weight, P < 0.05). After development of hypoxic RVH, Nit (20 mg.kg-1) also decreased RVSP (7.9 +/- 1.0 vs 6.2 +/- 0.8 kPa, P < 0.05) and RVWI (1.02 +/- 0.13 vs 0.88 +/- 0.12 g/kg body weight, P < 0.05). Myocardial blood flow was increased and myocardial ultrastructure became nearly normal in rats treated with Nit.

CONCLUSION

Nit prevented and lessened the hypoxic right ventricular hypertrophy.

Epsilon 4 allele of apolipoprotein E increases risk of Alzheimer's disease in a Chinese population

We examined the apolipoprotein E genotype in 56 Chinese patients with late-onset sporadic Alzheimer's disease (AD) and 57 Chinese control subjects of similar age. The frequency of epsilon 4 in the AD group was significantly higher than that in the control group (23.2% versus 7.9%, p = 0.003). The odds ratio for AD in individuals with either one or two epsilon 4 was 2.96 (95% CI 1.11 to 8.03). The linear trend for AD in proportion to alleles of epsilon 4 was also significant (chi 2 = 8.2, p = 0.004). Our results support the association between epsilon 4 and AD in the Chinese.

Isolation and propagation of yolk-sac-derived endothelial cells from a hypervascular transgenic mouse expressing a gain-of-function fps/fes proto-oncogene

We report on the isolation and propagation of endothelial cells from the mouse embryonic yolk sac, the earliest site of blood vessel development, and on the advantages of a hypervascular transgenic mouse source of these cells. These transgenic mice express multiple copies of an activated allele of the human fps/fes proto-oncogene and display hypervascularity progressing to multifocal hemangiomas. This phenotype suggested a role of the fps/fes proto-oncogene in vasculogenesis and angiogenesis and led us to investigate the growth characteristics of yolk-sac-derived endothelial cells from transgenic fps/fes embryos. We have established eight independent cell clones from a mixture of transgenic and control yolk sacs from Day 12 embryos. Southern blot hybridization analysis showed all eight clones to be derived from transgenic cells, suggesting a growth advantage of cells carrying the activated fps/fes gene. A cell line, Clone 166 (C166), established from one of these clones, was more fully characterized. C166 exhibits normal endothelial characteristics, such as rearrangement into tubelike structures when placed on Matrigel, expression of angiotensin converting enzyme, retention of cobblestone morphology at confluence, and the presence of cell surface receptors for acetylated low density lipoprotein. The cells constitutively express murine endothelial cell adhesion molecule VCAM-1 and the vascular addressin identified by antibody MECA-99. As expected, the cell line expresses high levels of the cytoplasmic protein-tyrosine kinase encoded by the fps/fes proto-oncogene. The clone we have described as well as other endothelial cell lines that we have established from the mouse embryonic yolk sac should prove useful for the study of endothelial cell differentiation and for the determination of the mechanisms underlying the establishment of organ-specific endothelial cell heterogeneity.

'Reverse redistribution pattern' during myocardial perfusion imaging with 99Tcm-MIBI

We retrospectively studied 540 consecutive patients with coronary artery disease (CAD) undergoing 99Tcm-methoxy-isobutyl-isonitrile (99Tcm-MIBI) myocardial single photon emission tomography (SPET) to determine the incidence of the 'reverse redistribution pattern' (RRP). RRP is similar to reverse redistribution (RR) in 201Tl myocardial SPET and is defined as the presence of a perfusion defect on the resting cardiac image, rather than on the exercise image. Our results confirmed 30 (5.6%) patients to have RRP, all of whom underwent diagnostic coronary angiography. None of the 30 patients showed RRP in the territory of the left circumflex coronary artery. RRP occurred in the territory of the left anterior descending coronary artery (LAD) in 16 patients, 12 of whom had a normal LAD. Fourteen patients presented with RRP in the territory of the right coronary artery, all of whom had normal coronary arteries. RRP in 99Tcm-MIBI myocardial SPET is less common than RR in 201Tl myocardial SPET and is frequently associated with normal coronary arteries. RRP with 99Tc(m)-MIBI seems to be of little value in the diagnosis of CAD.

Abnormal gastric emptying in patients with liver cirrhosis

Twenty-eight patients (aged: 44-76 years) with liver cirrhosis secondary to chronic hepatitis were included in this study. None of the patients had a history of gastric surgery, diabetes, hypothyroidism, or neurological or collagen vascular disease. The patients were divided into groups based on the presence or absence of the following conditions: (1) ascites, (2) splenomegaly, (3) esophageal varices. Radionuclide labelled solid meals were used to evaluate gastric emptying (GE). GE was represented by the gastric retention ratio of the solid meal at 90 min (RR90), and calculated by the following formula: RR90 = residual radioactivity within the region of interest (ROI) covered the whole stomach at 90 min divided by the initial radioactivity within the ROI at 0 min. The RR90 values of the patients were compared with the RR90 values of 25 normal control volunteers. If the RR90 was more than two standard deviations (SD) above the mean of the control group (> 0.687), GE was defined as abnormal. The results showed 71% (20/ 28) of the cirrhotic patients had abnormal GE. Patients with ascites, splenomegaly, or esophageal varices had higher RR90 values than patients without ascites, splenomegaly or esophageal varices. The differences in RR90 among patients with and without ascites, and patients with and without splenomegaly, were not significant (P values > 0.05). However, there were significant differences among the 2 patient groups separated according to the presence or absence of esophageal varices (P values < 0.05). In addition, poor correlations (R square values < 0.01) were found for RR90 and serum values of bilirubin and albumin.

Tc-99m sestamibi myocardial SPECT in syndrome X

The authors reviewed the stress Tc-99m MIBI SPECT results and clinical data of 15 patients with syndrome X. The results of exercise EKG and resting left ventricular ejection fraction (LVEF) were compared with the results of Tc-99m MIBI SPECT. Of the 15 patients, 9 (60%) had a normal Tc-99m MIBI SPECT study and 6 (40%) had an abnormal Tc-99m MIBI SPECT. The authors found that 1) an abnormal Tc-99m MIBI SPECT was common in syndrome X, 2) the results of the exercise EKG were not related to perfusion defects on Tc-99m MIBI SPECT, and 3) for patients with an abnormal Tc-99m MIBI SPECT, the incidence of an abnormal resting LVEF and cardiac abnormalities were not higher than in patients with normal Tc-99m MIBI SPECT studies.

Positive regulation of cdc2 gene activity by protein phosphatase type 2A

Several lines of evidence indicate that serine/threonine protein phosphatases may act as negative regulators of cellular growth. For example, treatment of cells with the tumor-promoter okadaic acid, an inhibitor of certain types of these phosphatases, resulted in the increased expression of several proto-oncogenes, indicating a negative role of the respective phosphatases in gene regulation. However, it was puzzling to find that okadaic acid-treated cells, even in the presence of highly expressed proto-oncogenes, did not proliferate, but were arrested at certain points of the cell cycle. To further analyze this discrepancy, we investigated the involvement of protein phosphatases in the control of other cell cycle regulatory genes, such as cdc2 which encodes an essential cell cycle regulatory kinase. We found that cdc2 gene expression was blocked by okadaic acid, but stimulated by protein phosphatase 2A. Protein phosphatase 2A is shown to be a positive regulator of cdc2 gene activity and to be required for cdc2 expression. Thus, our findings identify protein phosphatase 2A as a positive regulator of a major cell cycle regulatory gene and therefore suggest a stimulatory role of this enzyme in this aspect of cellular growth control.

Serial changes in regional blood flow in the cerebrum and cerebellum of stroke patients imaged by 99Tcm-HMPAO SPET

Luxury perfusion is a well-known phenomenon that can mask ischaemic lesions in patients with cerebral infarction, thus making diagnosis difficult. In this study, we evaluated the incidence of luxury perfusion over a 3-week period following a stroke episode. The usefulness of crossed cerebellar diaschisis (CCD) as a complementary feature in the diagnosis of cerebral infarction was also evaluated using 99Tcm-hexamethylpropyleneamine oxime (99TcmHMPAO) brain single photon emission tomography (SPET). Twelve patients diagnosed as having a hemispheric ischaemic stroke of the middle cerebral arterial territory were enrolled in the study. Each patient underwent a total of four 99Tcm-HMPAO brain SPET examinations, 1 day, 1 week, 2 weeks and 3 weeks following the stroke episode. Our results show that the incidence of luxury perfusion was 67% (8/12) after 1 week, 75% (9/12) after 2 weeks and 83% (10/12) after 3 weeks. The incidence of CCD was 33% (4/12) after 1 day, 50% (6/12) after 1 week, 42% (5/12) after 2 weeks and 33% (4/12) after 3 weeks. We conclude that the detection of cerebral infarction is difficult 2 weeks or more after a stroke episode. The interval between the stroke episode and examination must be considered when reading the 99Tcm-HMPAO image. In addition, CCD may be helpful for the diagnosis of cerebral infarction within the first week after a stroke episode, especially in cases of an unidentified ischaemic region on the 99Tcm-HMPAO hemispheric image. However, the value of CCD is limited 2 weeks or more following the stroke episode.

Evaluation of lung ventilation and alveolar permeability in cirrhosis

This study sought to evaluate lung ventilation and alveolar permeability (AP) in patients with cirrhosis of the liver.

METHODS

Pulmonary function in 29 patients with cirrhosis was measured by 99mTc-DTPA aerosol inhalation lung scintigraphy, using commercial lung radio-aerosol delivery units. Equilibrium lung ventilation images were visually interpreted according to the presence or absence of inhomogeneous distribution, inverted base-to-apex gradient and segmental defects. Degree of AP damage to the upper, middle, lower and total right lung was expressed as the slopes of the time-activity curves from dynamic lung images. The patients were classified into three groups, according to cirrhotic severity, using the modified Child's classification (A = good; B = fair; C = poor). Twelve healthy nonsmokers (2 women, 10 men; 42-75 yr old) formed the control group, and all had normal chest radiographic and pulmonary function test results.

RESULTS

None of the 29 patients had significantly abnormal lung ventilation findings, but 13 had reduced lung ventilation in the basilar lung zone. The incidence of lung ventilation abnormalities was 20% (3 of 15), 50% (3 of 6) and 88% (7 of 8) in patients with nil, slight-to-moderate and moderate-to-severe ascites, respectively (p < 0.05 for nil versus moderate-to-severe ascites). The AP studies showed higher time-activity curve slopes for patients with cirrhosis than for normal control subjects. The slopes for the right total lung showed no significant differences among the three groups; however, those for right upper and right lower lung showed significant differences between some subgroups. In addition, albumin and bilirubin levels showed no significant correlation with slope values in cirrhotic patients.

CONCLUSION

Although lung ventilation is normal in most patients with cirrhosis of the liver (16 [55%] of 29 in the present study), the disease can predispose patients to AP damage; however, the degree of damage is not related to cirrhotic severity.

Intelligence quotient in childhood acute lymphoblastic leukemia after prophylactic treatment in central nervous system with 18 Gy cranial irradiation and intrathecal methotrexate

The purpose of this study is to evaluate whether central nervous system prophylactic treatment (CNSP) with cranial irradiation therapy (CrRT) 18 Gy and intrathecal methotrexate would decline the intelligence quotient (IQ) scores of children with acute lymphoblastic leukemia (ALL). In protocol TCL 842, children with ALL received CrRT 18 Gy in 12 fractions, and 5 concomitant doses of intrathecal methotrexate 15 mg/m2/dose with 15 mg as the maximum, for CNSP after remission achieved. The first IQ test was performed immediately after CNSP. Those who had no CNS relapse for more than 5 years after CNSP had a second IQ test. For children between 3 and 6 years old, the Stanford-Binet (S-B) IV test was used, and for older children, the Wechsler Intelligence Scale for Children-Revised (WISC-R) was used. Fourteen consecutive children at our hospital were enrolled. There were 7 boys and 7 girls. The age at diagnosis ranged from 3 to 9 years old. Two of them were in the high-risk group, eight in the intermediate-risk group, and four in the standard-risk group. The IQ scores of all patients fell within the average range. In the first IQ tests, the mean IQ score was 104.29 (range 83-124, S.D. 14.55). In the second IQ tests, the mean IQ score was 100.93 (range 85-128, S.D. 11.57). Statistically, there was no significant difference between the first and second IQ scores (paired t-test, two-tailed P = 0.4232; one-tailed P = 0.2116). Our findings suggested that CNSP used in protocol TCL 842 did not reduce IQ scores of children with ALL 5 years after CNSP.

Radiolabelling of Lipiodol with generator-produced 188Re for hepatic tumor therapy

In this study we prepared and analyzed the biodistribution of 188Re-labelled Lipiodol ([188Re]-Lipiodol) in rats after intrahepatic arterial injection. EDTB was synthesized by condensation of 1,2-benzenediamine and ethylenediaminetetraacetic acid (EDTA). The labelling efficiency of [188Re] Lipiodol was determined to be greater than 97% by ITLC developed with n-hexane. Following incubation of the [188Re] Lipiodol with an equal volume of serum at 37 degrees C for 48 h, ITLC indicated good in vitro stability. Approximately 7.4 MBq [188Re] Lipiodol was injected in each rat via the hepatic artery and samples of liver, spleen, muscle, lung, kidney, bone, whole blood and testis were obtained. [188Re] Lipiodol tissue concentrations showed that after 1 h intrahepatic injection most of the radiotracer was retained in the liver, and was eliminated slowly with a biological half-life of 33.5 h. Radioactvity levels in the lung, kidney and blood were moderate at 1 h, and declined rapidly over time. In the spleen, muscle, testis and bone, radiation levels were insignificant. These initial results indicate that -188Re- Lipiodol may be a potential radiopharmaceutical agent for the treatment of liver tumors.

The effect of Helicobacter pylori infection on gastric emptying of digestible and indigestible solids in patients with nonulcer dyspepsia

OBJECTIVE

There is no general agreement with regard to the effect of Helicobacter pylori infection on gastric emptying in patients with nonulcer dyspepsia.

METHODS

We performed the 14C urea breath test as well as simultaneous recordings of scintigraphic gastic emptying and gastric clearance of radiopaque markers to determine the effect of Helicobacter pylori infection on gastric emptying of digestible and indigestible solids in nonulcer dyspepsia patients.

RESULTS

Sixty patients, 30 males and 30 females, were enrolled in the study. There were 22 patients (36.7%) without and 38 patients (63.3%) with H. pylori infection. Twenty-four of the 60 patients (40%) showed normal and 36 patients (60%) showed delayed gastric emptying of digestible solids. In addition, 21 patients (35%) showed normal and 39 patients (63%) showed delayed gastric emptying of indigestible solids. There was no correlation between delayed gastric emptying of digestible and indigestible solids (p > 0.05, difference not significant). Although not statistically significant, the incidence of delayed indigestible solid emptying was higher than that of delayed digestible solid emptying (65% vs. 60%). Among different patterns of gastric emptying, no difference was noted between the patients with and without H. pylori infection.

CONCLUSION

Delayed gastric emptying of indigestible solids is as common as delayed gastric emptying of digestible solids in nonulcer dyspepsia patients. The status of H. Pylori infection appeared not to influence the incidence of delayed gastric emptying of digestible and indigestible solids.

The relationships between the radionuclide alveolar integrity study and the pulmonary function test

This study evaluated the relationships between the alveolar integrity and the pulmonary function in 33 male subjects, including 18 COPD patients, 10 normal volunteers and 5 NIDDM patients. Alveolar integrity was evaluated by dynamic Tc-99m DTPA/HMPAO radioaerosol lung scintigraphies. The speed of radioaerosol clearance is represented as a slope from the lungs to the blood stream. Comprehensive pulmonary function tests included forced expiratory volume, flow-volume loop, and diffusion capacity of a single breath CO method. The results showed the following: that (1) there are no correlations between the slopes and the parameters of pulmonary function tests, and (2) that the clearance of DTPA aerosols is faster than the clearance of HMPAO, and that these differences are significant. In conclusion, the radionuclide alveolar integrity study should be considered as a new method for evaluating lung function, and should be differentiated from traditional pulmonary function tests, and, secondly, lipophilic HMPAO aerosols are slower to clear than those of hydrophilic DTPA, which suggests at least two different clearance mechanisms for radioaerosols.

Delayed gastric emptying in patients with chronic renal failure

Forty patients with chronic renal failure (CRF) were enrolled into the study, none of whom had peptic ulcer disease, amyloidosis, a previous abdominal operation, diabetes mellitus or other factors that could influence gastric emptying. Twenty of the 40 patients had been receiving regular haemodialysis (HD) for at least 1 year prior to the study. Twelve of the 40 patients had upper gastrointestinal symptoms/signs (GI Sx). Radionuclide-labelled solid meals were used to calculate gastric emptying time (GET). Twenty-five normal volunteers comprised the control group. Of the 40 patients, 35 (88%) had an abnormal GET. The incidence of an abnormal GET in HD and non-HD patients was 95 and 80%, respectively; the incidence of an abnormal GET in patients with and without upper GI Sx was 83 and 89%, respectively. These differences in the incidence of an abnormal GET among the HD and non-HD patients, as well as in the patients with and without upper GI Sx, were not statistically significant. There were no significant differences between the normal and abnormal GET patients for any of the following clinical parameters and conditions: dialyser-specific proportionality constant x time/urea distribution volume (KT/V), protein catabolic rate (PCR), ferritin, serum blood urea nitrogen, creatinine, calcium ion, phosphate, intact parathyroid hormone, albumin, uric acid, haemoglobin, triglyceride and cholesterol, total dialysis time, creatinine clearance and daily urine protein. We conclude that in Chinese patients with CRF, both dialysed and undialysed, an abnormal GET is common. The pathogenesis seems to be multifactorial. The presence of abdominal symptoms cannot foretell an abnormal GET.

Hepatic artery injection of Yttrium-90-lipiodol: biodistribution in rats with hepatoma

In this study, we analyzed the biodistribution of 90Y-lipiodol in rats with liver tumors (hepatoma) following hepatic arterial injection.

METHODS

Sixteen male Sprague-Dawley rats with liver tumors were killed at 1, 24, 48 and 72 hr (four rats at each time) after injection of approximately 0.1 mCi 90Y-lipiodol through the hepatic artery, respectively. Samples of tumor, liver, spleen, skeletal muscle, lung, kidney, bone, whole blood and testis were obtained and counted to calculate the tissue concentrations (%ID/g).

RESULTS

We found that the radioactivity in the liver tumor was high at 1 and 24 hr and then declined slowly. The biological half-time was 84.1 hr. The radioactivity in normal liver tissue was also high at 1 hr but was significantly lower than that in the tumor. The biological half-time was 38.5 hr. The ratio of tissue concentration between liver tumor and normal liver tissue (T/N ratio) was 3.03 at 1 hr and rose to 6.45 at 72 hr. The radioactivity in the lung was almost as high as in normal liver tissue at 1 hr and declined rapidly with a biological half-time of 25.6 hr. The activity levels of the kidney were moderate at 1 hr and remained at almost the same level throughout the study. A moderate concentration of radioactivity in bone was noted within the first 24 hr. The concentration, however, rose over the ensuing time. The concentration of radioactivity in skeletal muscle, spleen, testis and whole blood was quite low.

CONCLUSION

Following hepatic arterial injection of 90Y-lipiodol, tracer uptake in liver tumor was high and tumor retention was lengthy. Consequently, large radiation doses could be delivered to the tumor. We suggest that 90Y-lipiodol is a potential agent in the treatment of liver malignancy.

Gastric clearance of radiopaque markers in non-ulcer dyspepsia patients

BACKGROUND

The use of radiopaque markers has been proposed as an easy, non-invasive method for measuring gastric emptying. In this study we intended to evaluate the effectiveness of this test in determining the gastric motor function in patients with non-ulcer dyspepsia.

METHODS

Simultaneous recording of scintigraphic solid gastric emptying and gastric clearance of radiopaque markers were conducted in 65 non-ulcer dyspepsia patients.

RESULTS

Forty-two patients (64.4%) showed abnormal gastric clearance of radiopaque markers, and 38 patients (58.5%) showed delayed solid gastric emptying. There was no correlation between delayed solid gastric emptying and abnormal gastric clearance of radiopaque markers (p > 0.05). Although the frequency of abnormal gastric clearance of radiopaque markers was higher than that of delayed solid gastric emptying (64.6% versus 58.5%), it was not statistically significant.

CONCLUSIONS

On the basis of the results of our study, gastric clearance of radiopaque markers may be used as an easy, non-invasive screening test for the purpose of detecting gastric motor dysfunction. However, this test is not superior to scintigraphic gastric emptying studies.

A door-to-door survey of Parkinson's disease in a Chinese population in Kinmen

BACKGROUND

Most published studies have shown lower prevalence rates of Parkinson's disease (PD) in Asian and black African than in Western countries, leading to the hypothesis that Asians and blacks might be protected from PD.

OBJECTIVE

To investigate the prevalence of PD in a Chinese population.

DESIGN

Community-based survey.

SETTING

Registered residents 50 years of age or older (N = 5061) on the islet of Kinmen located off the southeastern coast of China [corrected].

METHOD

Single-phase door-to-door survey by neurologists. All participants were administered a questionnaire and received motor examinations of the Unified Parkinson's Disease Rating Scale.

RESULTS

The participation rate was 96% (N = 3915) among 4158 contacted individuals. Twenty-three cases of PD were identified, including three cases with dementia. The crude prevalence rate of PD was 587 (95% confidence interval (CI), 373 to 884) per 100,000 persons 50 years of age or older. Assuming no case of PD among individuals under 50 years of age, the prevalence rate was 119 (95% CI, 80 to 169) per 100,000 for the total population.

CONCLUSIONS

The prevalence rates of PD in Kinmen were much higher than those reported from mainland China, but slightly lower than those reported from more developed countries. The present findings suggest that, instead of genetic factors, differences in case-ascertainment, life expectancy, and the length of survival with PD may be more important contributors to the variations in observed PD prevalence rates.