New taxoids from the seeds of taxus chinensis

Two new taxoids, 2alpha-acetoxy-2',7-dideacetoxyaustrospicatine (1) and decinnamoyltaxinine E (2), have been isolated from the extracts of the seeds of the Chinese yew Taxus chinensis (Pilg.) Rehd. in addition to taxuspine Z (3), taxin B (4), taxezopidine G (5), 7, 2'-bisdeacetoxyaustropicatine (6), 5alpha-cinnamoyl-9alpha,10beta, 13alpha-triacetoxytaxa-4(20),11-diene (7), taxachitriene A, 20-deacetyltaxachitriene A, 13-O-acetylbrevifoliol, taxinines A and J, and taxacin. The structures of these compounds were elucidated on the basis of spectral analysis and chemical derivatizations.

Study of environmental biomonitoring of the Jiaozhou Bay

The content of 34 elements was determined in tissue samples of several marine bivalve species collected from various sites in the Jiaozhou Bay. The scope of the study was to determine the most suitable bivalve species to be used for environmental biomonitoring and to evaluate the environmental status of the bay. Clams exhibited higher elemental contents than oysters and they are the major marine bivalve species in the Jiaozhou Bay; therefore, we consider clams to be more suitable than oysters as bioindicators for evaluating the environmental status of the area. Increased elemental levels in clam tissues indicate polluted sites. Also, increased elemental levels in mussels point to possible pollution from tourism development at one selected site.

Outpatient thoracoscopic limited sympathectomy for hyperhidrosis palmaris

Thoracoscopic sympathectomy is considered the most effective treatment for hyperhidrosis palmaris. We have treated 1,043 cases of this disease by this method. We have developed an outpatient technique of thoracoscopic sympathectomy using electrocautery. This procedure has been used in 47 patients with hyperhidrosis palmaris. The early results have been favorable. We describe this fast, safe, economic, and effective method for the treatment of hyperhidrosis palmaris.

p53 codon 72 polymorphism in Taiwanese lung cancer patients: association with lung cancer susceptibility and prognosis

An association between the BstUI (Pro/Pro) genotype of the p53 codon 72 polymorphism and lung cancer has been reported previously (X. Jin et al., Carcinogenesis (Lond.), 16: 2205-2208, 1995). However, the genotype distribution of p53 codon 72 polymorphism as well as the association of this polymorphism with lung cancer risk and prognosis remain undefined in the Taiwanese population. Therefore, we investigated the genotype distribution of p53 codon 72 polymorphism in 194 lung cancer patients and 152 noncancer controls. The genotype frequencies in Taiwanese noncancer controls were 0.56 (Arg) and 0.44 (Pro). Chi2 analysis indicated significant differences in genotype distribution of p53 from other reports in Swedish (P < 0.001), Spanish (P < 0.001), Caucasians in the United States (P = 0.002), and African-Americans (P = 0.027). In addition, our data suggest that the Pro allele of the p53 codon 72 polymorphism increased the risk of lung cancer among female Taiwanese. The female patients with genotype Pro/Pro showed a significantly increased odds ratio (3.14; confidence interval, 1.48-6.64; P = 0.003) of having lung adenocarcinoma, compared with normal controls with the other genotypes. Patients with the Pro/Pro genotype had an odds ratio of 2.63 (confidence interval, 1.22-5.68; P = 0.01) higher than those with the other genotypes to be diagnosed with lung cancer at the early ages. We further investigated the association of p53 codon 72 polymorphism with prognosis in 133 lung cancer patients. Patients with the Pro/Pro genotype tended to have poorer prognosis than those with the Arg/Pro genotype (P = 0.05, by the log-rank test). Our data suggested that p53 codon 72 polymorphism may play a role in cancer susceptibility and prognosis in specific classes of lung cancer patients in Taiwan.

Transcriptional pulsing approaches for analysis of mRNA turnover in mammalian cells

Modulation of mRNA stability provides a powerful means for controlling gene expression during the cell cycle, cell differentiation, the immune response, as well as many other physiological transitions. Through the years, many different methods have been developed for measuring mRNA stability. Frequently mRNA stability is studied indirectly by analyzing the steady-state level of mRNA. Therefore by inference, changes in mRNA abundance are thought to affect only the stability of the mRNA, an assumption that is not always correct. Alternatively, direct measurements of mRNA decay are performed in a number of ways, including kinetic labeling techniques and administration of transcriptional inhibitors. Due to the nature of these techniques, they either are technically demanding or introduce a significant change in cell physiology. In addition, many critical mechanistic issues as to deadenylation kinetics, decay intermediates, and precursor-product relationships cannot be readily addressed by these methods. Here, we describe and discuss in detail two different transcriptional pulsing methods based on the c-fos serum-inducible promoter and the tetracycline-regulated promoter systems as an effort to better elucidate the mechanistic steps and regulation underlying differential and selective mRNA turnover in mammalian cells. Both systems allow unequivocal monitoring of deadenylation and decay kinetics as well as determination of precursor-product relationship. In addition, decay rate constants and half-lives are determined and used in both methods to quantitatively denote the mRNA stability. Thus, they provide a reliable way to determine subtle yet physiologically meaningful changes in mRNA stability. Application of one method or the other covers the study of mRNA turnover in most mammalian cell types under a wide range of physiological conditions.

The immune response to Haemophilus ducreyi resembles a delayed-type hypersensitivity reaction throughout experimental infection of human subjects

Previous work in 3 subjects infected for 2 weeks indicated that experimental infection with Haemophilus ducreyi recruits CD4 cells to the skin at the pustular stage of disease. In order to describe the kinetics of the host response, 23 subjects were infected at 2 sites with a standardized dose of H. ducreyi. Subjects were biopsied 1 or 4 days after inoculation or when they developed a painful pustular lesion (days 7-14). Papules and pustules contained a predominant T cell infiltrate that consisted of CD45RO and CD4 cells of the alpha beta lineage. Both papules and pustules contained mixed or T helper 1 type cytokine mRNA and interleukin-8 and tumor necrosis factor-alpha mRNA. Although the subjects had no history of chancroid, their immune responses resembled delayed-type hypersensitivity reactions that occurred within 24 h of inoculation and persisted throughout the course of experimental infection.

Closed management and percutaneous fixation of unstable proximal humerus fractures

BACKGROUND

In dealing with displaced proximal humerus fractures, there is still much controversy in treatment modalities. The latest investigations emphasize the concept of minimal exposure and rigid fixation.

METHODS

The technique of closed reduction and percutaneous fixation with cannulated screws and k-pins was performed on 19 patients with two- and three-part proximal humerus fractures. The outcomes were evaluated with a mean follow-up of 21 months.

RESULTS

All except one case had a solid union of the fracture. Sixteen of 19 patients (84%) acquired good or excellent results according to Neer's classification. No further collapse or avascular necrosis was found.

CONCLUSION

The method of closed reduction and percutaneous fixation, although technically demanding, yields satisfactory results in displaced proximal humerus fracture. Cannulated screws provided rigid fixation that was the underlying tenet for early functional retrieval.

Analysis of K-ras gene mutations in lung carcinomas: correlation with gender, histological subtypes, and clinical outcome

PURPOSE

Lung cancer is respectively the leading and second-leading cause of cancer deaths among women and men in Taiwan. The commonest pathological type of lung carcinoma found in Taiwan is adenocarcinoma. and it has been documented that K-ras oncogene mutation occurs in a subset of lung adenocarcinoma. We therefore investigated the mutation spectrum and clinicopathological significance of K-ras oncogene mutations in lung cancer patients in Taiwan.

METHODS

The lung tumors were surgically resected from 84 lung cancer patients. DNA was isolated and the mutation spectrum was examined by direct sequencing. These data were also correlated with the clinicopathological characteristics of patients.

RESULTS

K-ras gene mutations were detected in 5 cases among the 84 patients investigated (6.0%). The majority of mutations occurred in exon 1 (80%, 4 of 5) and were located mainly in codons 12 and 13. Two patients had G x C --> T x A transversions and 2 patients had G x C --> A x T transitions. Notably, 1 patient had a G x C base-pair deletion from the contiguous G x C base pairs located between codons 68 and 69. All mutations occurred in male patients who were smokers. The incidences of K-ras gene mutation among male and female patients with adenocarcinoma were 13% and 0% respectively. Patients with K-ras gene mutation survived for shorter periods than those without mutations (P = 0.08, by the log-rank test).

CONCLUSIONS

The incidence of K-ras gene mutations for male and female patients with adenocarcinoma was 13% and 0% respectively. Thus, the role of K-ras in the development of lung adenocarcinoma among Chinese men who are predominantly smokers is not significantly different from that in other populations worldwide. However, K-ras mutations may not be associated with adenocarcinoma among women in Taiwan, who are virtually all nonsmokers.

Prognosis-predicting system based on factors related to survival of cervical carcinoma

OBJECTIVE

To establish a different category system based on grouping of the risk factors in patients with cervical smear.

METHODS

Univariate and multivariate analyses of factors associated with survival time were performed in 443 patients with stage Ib-IIa squamous cell carcinoma (SCC) from 1985 to 1989.

RESULTS

Univariate analysis showed that parametrial extension, bulky tumor size (> or = 4 cm), uterine body involvement, poor differentiation and pelvic lymph node (LN) metastasis were prognostically significant. However, by multiple regression method, only LN metastasis, deep stromal invasion (DSI), and poor differentiation (PD) were significantly related to the patient's survival time with risk ratios of 2.78, 2.61 and 1.52, respectively. A prognosis-predicting system was established on the basis of these simplified factors: groups of high, intermediate, low and very low-risks, obtained survival rates of 93-96%, 77%, 51% and 25-37%, respectively.

CONCLUSIONS

Using this simple model, cervical carcinomas can be classified prognostically for predicting 5-year-survival rates, and for risk-guided therapy in the future.

Correlation of genetic instability and apoptosis in the presence of oncogenic Ki-Ras

The product of the ras proto-oncogene has been implicated as an essential signal transducer, involved in a variety of biological or pathological activities, including apoptosis. The aim of this investigation was to further explore the mechanisms of apoptosis triggered by Ras. Stable expression of constitutively-activated (v)-Ki-Ras in Balb/c-3T3 mouse fibroblasts resulted in a loss of G1 arrest in response to treatments which induced cell cycle arrest in the parental Balb/c-3T3 cells, accompanied by decreased expression of the p53 tumor suppressor protein and the GADD45 gene, the product of which is involved in DNA repair, and deregulated expression of the MDM-2 gene, the product of which can regulate p53 expression. Ki-Ras expression also increased the frequency of PALA-selectable CAD gene amplification, and paradoxically the susceptibility to PALA-induced apoptosis. After persistent serum-starvation, cells expressing the activated ras gene lost clonogenic potential, indicating impaired capability for genetic repair in the cells. Taken together, these data suggest that activated Ki-ras may confer genetic instabilty upon cells, possibly through interference with tumor suppressors, such as p53. While this instability may facilitate adaptation to environmental stresses, this instability in the genome also renders cells containing activated ras genes intrinsically more susceptible to programmed cell death, possibly by accumulation of undesirable or lethal genetic events during the process of tumor development.

Metabotropic glutamate receptors depress vagal and aortic baroreceptor signal transmission in the NTS

We sought to determine whether metabotropic glutamate receptors contribute to frequency-dependent depression of vagal and aortic baroreceptor signal transmission in the nucleus of the solitary tract (NTS) in vivo. In alpha-chloralose-anesthetized rabbits, we determined the number of extracellular action potentials synaptically evoked by low (1 Hz)- or high-frequency vagal (3-20 Hz) or aortic depressor nerve (ADN) (6-80 Hz) stimulation and postsynaptically evoked by the ionotropic glutamate receptor agonist alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA). The metabotropic glutamate receptor agonist (2S,1'S, 2'S)-2-(carboxycyclopropyl)glycine (L-CCG-I) attenuated NTS responses monosynaptically evoked by 1-Hz vagus stimulation by 34% (n = 25; P = 0.011), while augmenting AMPA-evoked responses by 64% (n = 17; P = 0.026). The metabotropic glutamate receptor antagonist alpha-methyl-4-phosphonophenylglycine (MPPG) did not affect NTS responses to low-frequency vagal stimulation (n = 11) or AMPA (n = 10) but augmented responses to high-frequency stimulation by 50% (n = 25; P = 0.0001). MPPG also augmented NTS responses to high-frequency ADN stimulation by 35% (n = 9; P = 0.048) but did not affect responses to low-frequency stimulation (n = 9) or AMPA (n = 7). The results suggest that metabotropic glutamate receptors, presumably at presynaptic sites, contribute to frequency-dependent depression of vagal and aortic baroreceptor signal transmission in NTS.

Non-NMDA and NMDA receptors transmit area postrema input to aortic baroreceptor neurons in NTS

We sought to determine whether glutamate acting at both N-methyl-D-aspartate (NMDA) and non-NMDA receptors transmits area postrema (AP) excitatory inputs to nucleus tractus solitarii (NTS) neurons in the aortic baroreceptor or vagal afferent pathways in vivo. In alpha-chloralose-anesthetized rabbits, we recorded extracellular NTS neuronal responses to low-frequency aortic depressor nerve (ADN), vagus nerve, and AP stimulation and to iontophoresis of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid and NMDA during control, iontophoresis of 2, 3-dihdroxy-6-nitro-7-sulfamoylbenzo(f)quinoxaline (NBQX), DL-2-amino-5-phosphonovaleric acid (AP5), or both, and recovery conditions. In neurons receiving AP and ADN inputs, NBQX attenuated AP- and ADN-evoked responses by 46 (P = 0.0206) and 49% (P = 0.0042). AP5 attenuated AP- and ADN-evoked responses by 39 (P = 0.0270) and 40% (P = 0.0157). NBQX + AP5 attenuated AP- and ADN-evoked responses by 74 (P = 0.0040) and 75% (P = 0.0028). In neurons receiving AP and vagal inputs, AP transmission was attenuated by 58, 60, and 98%; vagal transmission was attenuated by 62, 35, and 83% during NBQX, AP5, and both antagonists, respectively. These data suggest that both non-NMDA and NMDA receptors transmit AP input to NTS neurons in aortic baroreceptor or vagal afferent pathways.

Resympathectomy for palmar and axillary hyperhidrosis

BACKGROUND

The aim was to analyse patterns of failure or symptom recurrence after primary sympathectomy for palmar or axillary hyperhidrosis, and to carry out tactical problem-solving for resympathectomy and review the operative findings.

METHODS

Over a 2-year period, 20 patients (six men and 14 women) underwent resympathectomy for palmar hyperhidrosis (13 patients, 20 sides) or axillary hyperhidrosis (seven patients, ten sides). T2-3 sympathectomy for palmar hyperhidrosis or T4-5 sympathectomy for axillary hyperhidrosis was performed during the repeat procedure. Criteria for evaluation by means of patient questionnaire included good (more than 80 per cent), fair (50-80 per cent) and poor (less than 50 per cent) improvement.

RESULTS

Operative findings included inadequate sympathectomy on 19 sides, nerve regeneration on eight sides and no evidence of previous sympathectomy on three sides. One patient had Kuntz fibre in addition to inadequate sympathectomy. In the palmar hyperhidrosis group, good results were obtained in all 13 patients on all 20 sides after resympathectomy. In the axillary hyperhidrosis group, six of seven patients, or eight of ten sides, showed good results after resympathectomy.

CONCLUSION

The main cause of primary sympathectomy failure was inadequate surgery, and recurrence of palmar or axillary hyperhidrosis was seldom caused by nerve regeneration. The key factor for preventing failed sympathectomy or recurrent palmar or axillary hyperhidrosis is a first-time sympathectomy that is both accurate and adequate. Most patients with recurrent symptoms can be cured by resympathectomy.

The gut. A key metabolic organ protected by lactoferrin during experimental systemic inflammation in mice

The gastrointestinal tract may be viewed as an ecologic system in which a balance between the host and bacterial flora exists. Two major host components appear to be involved in maintaining this balance. The first is a non-specific structural barrier provided by the epithelial layer of the gastrointestinal mucosae. The second component involves functional immunological elements found in the mucosal and submucosal compartments, e.g., gut associated lymphoid tissue. When gut integrity is disrupted by invasive pathogens or by trauma, a myriad of pro-inflammatory mediators are released from cells in the gut wall that exert actions in the tissue or gut lumen. One of these mediators is lactoferrin, and iron binding protein found in high concentration in most human exocrine secretions. Despite controversies on its physiological role, evidence is emerging that lactoferrin plays an important role in host defense against toxic metabolites and antigenic components of potential pathogens2-4. This manuscript is intended to provide an overview of work related to lactoferrin's modulatory roles in inflammation, and to present observations from experimental studies on the preservation of intestinal structure and function by lactoferrin during intestinal inflammation. The possibility that lactoferrin limits the autodestructive inflammatory responses presents a new alternative for the future management of systemic inflammation.

Central nervous system candidiasis in very low-birth-weight premature neonates and infants: US characteristics and histopathologic and MR imaging correlates in five patients

PURPOSE

To analyze the high-resolution (i.e., 5.0- or 7.5-MHz) ultrasonographic (US) imaging characteristics of central nervous system (CNS) candidiasis and their histopathologic and magnetic resonance (MR) imaging correlates in very low-birth-weight (VLBW) premature neonates and infants with systemic candidiasis.

MATERIALS AND METHODS

The US images obtained in one VLBW neonate (age, 24 days; weight, 846 g) and four VLBW infants (age range, 36-161 days; weight range, 800-1, 360 g) with proved CNS candidiasis complicating systemic candidiasis and the clinical (n = 5), histopathologic (n = 3), and MR imaging (n = 2) correlates were retrospectively reviewed.

RESULTS

The cranial US findings consisted of parenchymal abnormalities in four and ventricular lesions in three patients. The most common findings were multiple echogenic, rim-like microabscesses (four patients) scattered in the subcortical, periventricular, and basal ganglial areas. Confluent macroabscess formation, seen as echogenic mass-like lesions with hypoechoic centers in the periventricular regions and/or thalami, was noted on the US images obtained in two patients. The ventricles showed dilatation in two, increased ependymal echogenicity in three, the presence of intraventricular echogenic septa in two, and a lumpy choroid plexus or the presence of debris in two patients. US findings correlated well with MR imaging and autopsy findings. The histopathologic changes in the posterior fossa were well demonstrated on MR images but not demonstrated on 5.0- or 7.5-MHz US images.

CONCLUSION

CNS candidiasis in VLBW neonates and infants has characteristic US features that may help in the early diagnosis of CNS involvement in systemic candidiasis.

An arf1Delta synthetic lethal screen identifies a new clathrin heavy chain conditional allele that perturbs vacuolar protein transport in Saccharomyces cerevisiae

ADP-ribosylation factor (ARF) is a small GTP-binding protein that is thought to regulate the assembly of coat proteins on transport vesicles. To identify factors that functionally interact with ARF, we have performed a genetic screen in Saccharomyces cerevisiae for mutations that exhibit synthetic lethality with an arf1Delta allele and defined seven genes by complementation tests (SWA1-7 for synthetically lethal with arf1Delta). Most of the swa mutants exhibit phenotypes comparable to arf1Delta mutants such as temperature-conditional growth, hypersensitivity to fluoride ions, and partial protein transport and glycosylation defects. Here, we report that swa5-1 is a new temperature-sensitive allele of the clathrin heavy chain gene (chc1-5), which carries a frameshift mutation near the 3' end of the CHC1 open reading frame. This genetic interaction between arf1 and chc1 provides in vivo evidence for a role for ARF in clathrin coat assembly. Surprisingly, strains harboring chc1-5 exhibited a significant defect in transport of carboxypeptidase Y or carboxypeptidase S to the vacuole that was not observed in other chc1 ts mutants. The kinetics of invertase secretion or transport of alkaline phosphatase to the vacuole were not significantly affected in the chc1-5 mutant, further implicating clathrin specifically in the Golgi to vacuole transport pathway for carboxypeptidase Y.

The effects of starch and protein degradation rates, hay sources, and feeding frequency on rumen microbial fermentation in a continuous culture system

Six continuous culture fermenters were used in three experiments to study the effects of dietary starch and protein degradability combination, hay sources, and feeding frequency on fermentation by rumen microorganisms. Experiments 1 and 2 used a 3 x 2 factorial design in which six diets were formulated to contain low (LS), medium (MS), or high starch degradability (HS) in combination with low (LP) or high protein degradability (HP). The dietary combinations were (1) LS + HP, (2) LS + LP, (3) MS + HP, (4) MS + LP, (5) HS + HP, and (6) HS + LP. In experiment 1, pangola was used as the hay source, and in experiment 2, alfalfa hay was used. In experiment 3, two starch degradabilities (LS, MS) and two hay sources (alfalfa, A; pangola, P) were combined with two feeding frequencies (2 X/d, 12 X/d). The dietary combinations were (1) LS + A + 12 X/d, (2) MS + A + 12 X/d, (3) LS + A + 2 X/d, (4) MS + A + 2 X/d, (5) LS + P + 12 X/d, and (6) MS + P + 12 X/d. A CRD design was used for experiment 3. Two rumen-cannulated Holstein cows fed alfalfa hay ad lib were used as donors of rumen fluid for all experiments. Each period was 6 d in length, with 5 d for adaptation and 1 d for sampling. In experiments 1 and 2, the effects of starch degradability on the composition of rumen microorganisms were significant. The MS or HS with HP had the highest total bacterial and protozoal density (P < 0.05). As for VFA, pH and nitrogen products, the effects of starch and protein degradability were not significant. There was no interaction between starch and protein degradability on most of microbial composition (ammonia-N, microbial nitrogen). In experiment 3, 12 X/d feeding frequency (MS + A + 12 X/d vs. MS + A + 12 X/d) resulted in higher pH, which tended to increase bacterial and protozoal density and starch and protein digestibilities. Different hay sources altered the starch and protein synchronization effect on the ammonia-N concentration (mg/dl) and non-ammonia N content (% DM) in the continuous culture system.

Sonographic characteristics of the cavum velum interpositum

BACKGROUND AND PURPOSE

Differential considerations for pineal region CSF collections include both true cysts and normal cystlike anatomic variations. Our purpose was to determine the sonographic characteristics of pineal region fluid spaces that reflect the presence of a normal persistent cavum velum interpositum (CVI).

METHODS

Eighteen neonates and infants who had sonographic findings of "cysts" in the pineal region were examined prospectively with conventional sonography and color Doppler sonography to evaluate the shape of the fluid collection and its anatomic relationship with the color-coded internal cerebral veins. Subsequent MR images were obtained in eight of these infants to determine the exact nature of the cystlike collections.

RESULTS

The cystlike spaces in the pineal region were of an inverted helmet shape in 14 subjects and roundish in four. All were situated inferior or slightly anteroinferior to the splenium of the corpus callosum and 2.5 to 4 mm away from the quadrigeminal plate. The internal cerebral veins were either inferior (n = 12) or inferolateral (n = 6) to the cystlike spaces at sonography. Subsequent MR studies confirmed eight of these cystlike spaces to be the posterior portion of the CVI.

CONCLUSION

The CVI may appear as a cyst in the pineal region on neonatal sonograms. Usually, it has a characteristic inverted helmet shape and is situated beneath the fornices and above the internal cerebral veins.

Neuroimaging findings in late infantile GM1 gangliosidosis

Late infantile GM1 gangliosidosis is an extremely rare metabolic disorder with clinical features of seizure and progressive motor and mental retardation without facial dysmorphism or visceral organomegaly. We report the CT and MR imaging findings in one infant, which included abnormalities of the cerebral cortex, white matter, and deep nuclei.

Color Doppler ultrasound pulsatile flow signals of thoracic lesions: comparison of lung cancers and benign lesions

Color Doppler ultrasound (US) was performed in 153 patients (including 102 with lung cancer and 51 with benign lesions) to assess pulsatile flow signals in thoracic lesions. The values of resistive index (RI) and pulsatility index (PI) of color Doppler US pulsatile flow signals in lung cancers and benign lesions were measured, analyzed, and compared. In the enrolled 153 patients with thoracic lesions, 61 lung cancers and 34 benign lesions had detectable color Doppler US pulsatile flow signals, and lung cancers had lower RI and PI values than benign lesions (RI: 0.70+/-0.03 vs. 0.79+/-0.04, p < 0.05; PI: 1.61+/-0.15 vs. 2.44+/-0.25, p < 0.005). However, overlapping RI and PI values in lung cancers and benign lesions somewhat limited color Doppler US pulsatile flow signals to differentiate lung cancers from benign lesions. Further analysis of RI and PI values in subgroups of lung cancers [squamous cell carcinoma (SCC, n = 34), adenocarcinoma (AC, n = 18), and small-cell lung cancer (SCLC, n = 6)] and benign lesions [cavitary benign lesions (CBL, n = 8), and noncavitary benign lesions (NCBL, n = 26)] revealed that all different cell types of lung cancers (SCC, AC, and SCLC), indeed, had lower RI and PI values than NCBL (for RI, all p < 0.01; for PI, all p< or =0.001). Moreover, the mean RI and PI values showed a significant incremental decrease from NCBL (mean RI, PI = 0.88, 2.94) toward SCC and AC (for SCC, mean RI, PI = 0.71, 1.68; for AC, mean RI, PI = 0.68, 1.67) and, finally, to SCLC (mean RI, PI = 0.62, 1.05). In contrast, CBL had relatively lower RI and PI values than AC and SCLC (for CBL, mean RI, PI = 0.53, 0.80; both p > 0.05 for RI and PI), and even a significant difference from SCC (p < 0.05 for RI and PI). We conclude that color Doppler US pulsatile flow signal is somewhat limited to differentiate lung cancers from benign lesions, but provides a noninvasive in vivo model to assess the neovascularity intensity of lung cancers.

Molecular subtyping of Treponema pallidum subspecies pallidum

BACKGROUND AND OBJECTIVES

Epidemiologic studies on syphilis have been hampered by the fact that strains of Treponema pallidum subspecies pallidum (T. pallidum), the causative agent of this disease, cannot be differentiated by either protein-based or deoxyribonucleic acid-based methods. Syphilis is endemic in many developing countries and is common in some industrialized nations. In addition, the disease has been shown to increase the risk of infection with the human immunodeficiency virus.

GOAL

To develop a molecular subtyping method for T. pallidum.

STUDY DESIGN

Two genes exhibiting intrastrain variability were identified as potential targets for strain differentiation: the acidic repeat protein (arp) gene, which contains a variable number of 60 base pair repeats, and a member of the treponema pallidum repeat (tpr) gene family. Polymerase chain reaction amplification and restriction endonuclease digestion of polymerase chain reaction products from laboratory strains and clinical specimens were used to develop a molecular subtyping scheme for T. pallidum.

RESULTS

Determining the number of repeats in the arp gene by polymerase chain reaction resulted in 12 different subtypes among the 63 isolates that were studied. Among those, most (54.2%) had arp genes with 14 repeats. The other 11 subtypes had arp genes with 7 to 21 repeats, each accounting for 2% to 14% of the isolates. Polymerase chain reaction amplification of a member of the tpr gene family from a subset of 46 isolates followed by digestion of the polymerase chain reaction product with MseI resulted in seven restriction fragment length polymorphism patterns designated a to g. Strains with 14 repeats could be grouped into five restriction fragment length polymorphism subtypes. By combining the two systems we observed 16 subtypes among 46 isolates examined. This typing system is stable, reproducible, and easy to perform. In addition, the use of the ABI Genetic Analyzer for the determination of fragment size and banding patterns makes the results unbiased.

CONCLUSION

This is the first molecular subtyping system that distinguishes among clinical isolates of T. pallidum.

The economic costs associated with body mass index in a workplace

This study was undertaken to determine if a progressive correlation exists between body mass index (BMI), health care costs, and absenteeism and to identify an economically optimal BMI. We studied 3,066 First Chicago NBD employees by using health risk appraisals and personnel data. Analysis was completed for those employees with and without a risk for BMI. People at risk for BMI are more likely to have additional health risks, short-term disability and illness absence, and higher health care costs than those not at risk for BMI. A "J-shaped" curve between health care costs and BMI exists, with the low point occurring at about 25 to 27 kg/m2. We concluded that indirect and direct costs to an employer increase with increasing BMI. Employers may benefit from helping employees achieve a healthy weight. The initial target population should be those who are at highest risk of complications from obesity.