Effect of Korean red ginseng on blood pressure and nitric oxide production

AIM

To investigate the effect of crude saponin and nonsaponin fraction of Korean red ginseng (KRG) on the blood pressure and nitric oxide (NO) production in the conscious rats and cultured endothelial cell line, ECV 304 cells.

METHODS

Systolic blood pressure and heart rate were monitored in the conscious rats. Nitric oxide levels and the expression of nitric oxide synthase were measured by a spectrophotometric assay using Griess reagents and Western blotting, respectively. Nitric-oxide synthase activity was measured based on the conversion rate of [3H]arginine to [3H]citrulline.

RESULTS

Systolic blood pressure was decreased by crude saponin (100 mg/kg, i.v.) of KRG in the conscious control and one-kidney, one-clip Goldblatt hypertensive (1K, 1C-GBH) rats. The hypotensive effect induced by crude saponin of KRG reached maximum at 2-4 min and slowly recovered after 20 min to the initial level in both groups. Crude saponin of KRG induced tachycardia in the conscious rats but induced bradycardia in the anesthetized rats. In contrast to crude saponin of KRG, hypotensive effect induced by saponin-free fraction was minimal. Nitric oxide concentrations were increased by the treatment of crude saponin in conscious rats as well as in the cultured ECV 304 cells. The protein expression level of endothelial constitutive nitric-oxide synthase (eNOS) in the aorta of rats was not increased by crude saponin (100 mg/kg, i.p. for 3 d). However, nitric-oxide synthase activity was increased by crude saponin of KRG in the aortic homogenate of rats.

CONCLUSION

The hypotensive effect of red ginseng is mainly due to saponin fraction of KRG in the conscious rats, and this effect may be due to an increase in the nitric-oxide production by KRG.

Detection of human papillomavirus in cholesteatomas

The presence of human papillomavirus DNA in cholesteatoma may have some role in the development of middle ear cholesteatoma as well as in papilloma. In the present study, polymerase chain reaction and in situ hybridization with human papillomavirus (HPV)-6 and -11 DNA probes were used to detect the presence of HPV DNA in 32 human middle ear cholesteatomas. Only one specimen contained HPV-6 DNA. Although its occurrence may have been coincidental, it is also possible that the hyperproliferative epithelium of cholesteatomas might have some relationship with HPV infections.

Expression of TRAIL (TNF-related apoptosis-inducing ligand) receptors in cervical cancer

Apoptosis is an intrinsic and fundamental biologic process that plays a critical role in the normal development of multicellular organisms and in the maintainance of tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor (TNF) ligand family, such as Fas ligand (Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells. Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptors (-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL, and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in nine cases and immunohistochemical staining for TRAIL and TRAIL receptors (-R1, -R2, -R3) and TUNEL method for detection of apoptosis was performed in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-R1 and -R2 were more strongly expressed in tumor cells than normal epithelium (P < 0.05). Apoptosis correlated with expression of TRAIL-R1 and -R2 (P < 0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.

Effect of Korea red ginseng on the blood pressure in conscious hypertensive rats

The change of blood pressure and heart rate after intravenous injection of Korea red ginseng (KRG) were studied in the conscious normotensive and one-kidney, one-clip Goldblatt hypertensive (1K, 1C-GBH) rats. Crude saponin (CS) of KRG (50, 100 mg/kg i.v.) induced a hypotensive effect and bradycardia in a dose-dependent manner in the anesthetized rats. On the other hand, CS of KRG (100 mg/kg) induced a hypotensive effect and reflex tachycardia in the conscious rats. Saponin-free fraction (SFF) of KRG did not affect them in the anesthetized normotensive rats (P>.05). The maximal hypotensive effect by CS of KRG in the conscious 1K, 1C-GBH hypertensive rats and L-nitroarginine methyl ester (L-NAME, 40 mg/kg)-treated conscious hypertensive rats was not different from that of conscious normotensive rats (Delta 31.6+/-6.3, Delta 27.5+/-5.8 vs. Delta 26.7+/-4.3 mmHg, P>.05). However, pretreatment of L-NAME significantly inhibited the reflex tachycardia by CS of KRG (70.8+/-7.0 vs. 30.6+/-15.0 bpm, P<.05). Hemolysate-sensitive nitric oxide (NO) current by the CS of KRG was greater than that of the SFF of KRG (651.9+/-128.2 pA for CS and 164.9+/-92.5 pA for SFF, P<.001). These findings suggest that KRG has a hypotensive effect and its effect may be due to saponin fraction of KRG in the conscious rats. The releasing effect of NO of KRG, like NO donor, may be partly contributed to the hypotensive effect of KRG.

Vitamin B6 antagonists alter the function and ultrastructure of mice endothelial cells

Vitamin B6, is necessary for normal membrane function and stability. Here we studied both the function and ultrastructure of aortic and arterial endothelial cells (ECs) in vitamin B6 deficient mice induced by vitamin B6 antagonists, 4-deoxypyridoxine x HCl (dPN x HCl), and isonicotinylhydrazide (INH). Mice were fed with normal laboratory chow and divided into three groups according to their drinking water. Mice in group I had distilled water and served as a control; group II had 0.1 mg dPN x HCl/mL H2O; and group III had 0.4 mg INH/mL H2O. After 5 mo, plasma concentrations of B6 vitamers pyridoxal-5'-phosphate (PLP) and pyridoxal (PL) were analyzed by HPLC. With the arachidonic acid (AA) as a precursor, prostacyclin (PGI2) production from ECs assayed by thin-layer chromatography (TLC) was used as an indicator of endothelial function. Aorta and arteriole from foot pad were removed, stained with osmium tetraoxide, and examined under transmission electron microscopy (TEM) to study the ultrastructure of ECs. The results showed that plasma concentrations of PLP, PL, and total B6 were the lowest for mice fed with INH. followed by that with dPN x HCl, compared with that of control. PGI2 production was paralleled with the plasma vitamin B6 status, with the lowest level for INH, followed by the dPN-treated group. Abnormalities in the ultrastructure of ECs were found in both dPN x HCl and INH groups, including cells detached from underlying elastic tissue, with prominent pinocytotic vesicles and swelling and/or indistinct cristae of mitochondria. These results suggest that vitamin B6 antagonists induce a deficient status that alters the function and the ultrastructure of ECs detrimental to vascular disease.

Pneumococcal and influenza immunization and human immunodeficiency virus load in children

OBJECTIVE

HIV-infected children receiving influenza vaccine, pneumococcal vaccine and both vaccines concurrently were studied to examine the effect of immunization on plasma HIV viral load.

METHODS

Thirteen children received immunizations: pneumococcal vaccine, 5; pneumococcal and influenza vaccines, 7; and influenza vaccine, 1. Most patients (12 of 13) were receiving combination reverse transcriptase inhibitor antiretroviral therapy without protease inhibitors at the time of immunization. Baseline plasma HIV RNA was determined 1 month prior (11 of 13), 2 weeks prior (12 of 13) and on the day of immunization (12 of 13). Plasma HIV RNA was assayed at 2 weeks (11 of 13), 4 weeks (12 of 13) and 3 months (5 of 13) after immunization. T cell activation markers (HLA-DR+, CD38+ and CD45RO+, CD28+) were examined for both CD4+ and CD8+ lymphocytes on the day of immunization and 2 weeks after immunization for 11 children.

RESULTS

Only one child developed a >0.5-log increase in viral load at any time after immunization. There was no correlation between an increase in viral load and antibody response to pneumococcal vaccine. At least one activation marker increased (> 10%) for two children receiving pneumococcal vaccine and two children receiving pneumococcal and influenza vaccines. One of these children experienced an increase in viral load.

CONCLUSION

Immunization with pneumococcal and influenza vaccines, alone or in combination, is rarely associated with a significant increase in HIV plasma RNA in children receiving combination antiretroviral therapy.

[High-level expression of BYDV GAV coat protein gene in Escherichia coli]

The IPTG-inducible expression vector containing the BYDV GAV coat protein gene was constructed and transferred into E. coli BL21(DE3). High-level expression of the specific protein was achieved by IPTG induction. The results of SDS-PAGE and Western blotting show that the expression product which accumulates 19.5% of the total cellular proteins estimated by scanning is 24 kD BYDV GAV coat protein plus eleven amino acids of pET-5a.

A protein kinase activity associated with Epstein-Barr virus BGLF4 phosphorylates the viral early antigen EA-D in vitro

The Epstein-Barr virus (EBV) open reading frame BGLF4 was identified as a potential Ser/Thr protein kinase gene through the recognition of amino acid sequence motifs characteristic of conserved regions within the catalytic domains of protein kinases. In order to investigate this potential kinase activity, BGLF4 was expressed in Escherichia coli and the purified protein was used to generate a specific antiserum. Recombinant vaccinia virus vTF7-3, which expresses the T7 RNA polymerase, was used to infect 293 and 293T cells after transient transfection with a plasmid containing BGLF4 under the control of the T7 promoter. Autophosphorylation of the BGLF4 protein was demonstrated using the specific antiserum in an immune complex kinase assay. In addition, EBNA-1-tagged BGLF4 and EBNA-1 monoclonal antibody 5C11 were used to demonstrate the specificity of the kinase activity and to locate BGLF4 in the cytoplasm of transfected cells. Manganese ions were found to be essential for autophosphorylation of BGLF4, and magnesium can stimulate the activity. BGLF4 can utilize GTP, in addition to ATP, as a phosphate donor in this assay. BGLF4 can phosphorylate histone and casein in vitro. Among the potential viral protein substrates we examined, the EBV early antigen (EA-D, BMRF1), a DNA polymerase accessory factor and an important transactivator during lytic infection, was found to be phosphorylated by BGLF4 in vitro. Amino acids 1 to 26 of BGLF4, but not the predicted conserved catalytic domain, were found to be essential for autophosphorylation of BGLF4.

Alpha-tocopherol downregulates the expression of GPIIb promoter in HEL cells

Alpha-tocopherol is known to inhibit platelet aggregation but the mechanism responsible for this has not been elucidated. Glycoprotein IIb (GPIIb) is the alpha-subunit of the platelet membrane protein GPIIb/IIIa, which functions as a specific receptor for platelet aggregation. Human erythroleukemia (HEL) cells are megakaryocytelike and express the megakaryocyte-specific GPIIb gene. To understand the molecular mechanism of alpha-tocopherol on antiaggregation, we analyzed the effect of physiologically relevant concentrations of alpha-tocopherol on the expression of human GPIIb promoter in HEL cells. The enhancement of tetradecanoylphoerbol-12,13-acetate (TPA)-mediated transient and optimal expression of plasmids was achieved by adding 10(-7)-M TPA in the medium 24 h before lipofection. Transient expression of GPIIb promoter was determined in transfected cells pretreated with various concentrations of alpha-tocopherol. Our data shows that the GPIIb promoter activity was downregulated to 55, 23, 27, 20, and 15% in the presence of 10, 20, 40, 80, and 120 microg/ml of alpha-tocopherol, respectively, as compared with that in the absence of alpha-tocopherol. The downregulation of alpha-tocopherol on the TPA-mediated GPIIb promoter activity may result in a reduction of GPIIb protein expression and thus contribute to antiplatelet aggregation.

Hierarchical order of critical residues on the immunity-determining region of the Im7 protein which confer specific immunity to its cognate colicin

The directed mutagenesis study of the Im7 protein of colicin E7 revealed that three residues, D31, D35, and E39, located in the loop 1 and helix 2 regions of the protein were critical for initiating the complex formation with its cognate colicin E7. Interestingly, the importance of these three critical residues in conferring specific immunity to its own colicin was exhibited in a hierarchical order, respectively. Moreover, we found that existence of the three critical residues was common among the DNase-type Im proteins. Most likely the three residues of the DNase-type immunity proteins are critical for initiating the unique protein-protein interactions with their cognate colicin. In addition, replacement of the helix 2 of Im7 by the corresponding region of Im8 produced a phenotype of the mutant protein very similar to that of Im8. This result suggests that the DNase-type Im proteins indeed share a "homologous-structural framework" and evolution of the Im proteins may be engendered by minor amino acid changes in this specific immunity-determining region without causing structural alteration of the proteins.

Ventilation tube in adults with middle-ear effusion

OBJECTIVE

This study was conducted to analyze the data concerning otitis media with effusion (OME) to configure its etiology, symptomatology, and outcome in adults.

METHOD

A retrospective study of 198 consecutive cases (260 ears) of OME was conducted between July 1988 and June 1996. All of the patients were older than 16 years and were diagnosed for the first time. Tympanograms, initial symptoms, underlying diseases, extrusion of the ventilation tube, and recurrence rate of effusion were analyzed.

RESULTS

Sinusitis was usually seen in patients 16 to 29 and over 60 years old, whereas nasopharyngeal carcinoma was prevalent in patients 30 to 59 years old. Ear stuffiness (75.3%) was the most prevalent initial symptom, followed by hearing impairment (74.2%). One hundred seventy-five ears from 132 patients had been followed up for more than 2 years. In four ears, ventilation tubes were removed by instrument; the ventilation tubes in the remaining 171 ears of 128 patients extruded spontaneously within 20 months (8.6 months on average). Recurrence of effusion within 2 years was noted in 78.8% (78/99 ears) of patients with head and neck tumours and in 27.3% (12/44 ears) of patients with sinusitis.

CONCLUSION

Nasopharyngeal carcinoma and sinusitis were the main etiologies of OME in adults. In addition to treatment of sinusitis, nasopharyngeal check-up is mandatory in adults with OME.

Effect of heavy metal stressors and salinity shock on the susceptibility of grouper (Epinephelus sp.) to infectious pancreatic necrosis virus

In the present study, attempts were made to clarify the effect of heavy metal stressors and salinity shock on the disease susceptibility of grouper fry (Epinephelus sp.) to infectious pancreatic necrosis virus (IPNV) infection. Zinc, cadmium and copper (5 ppm ZnCl2, 3 ppm CdCl2 and 1 ppm CuCl2) were used to treat groupers before and after virus infection. Cumulative mortalities in the experimental groups were 96-100% within 42 days. Only 5-15% mortalities were observed in most of the groups that were exposed to either heavy metals or virus infection alone. Subsequently, virus was re-isolated from the experimentally infected groupers, and copper concentration was measured in fish that had been exposed to CuCl2. We also investigated the effect of salinity shock (i.e. an abrupt change of salinity level from 33 ppt to either 40 ppt or 20 ppt) on susceptibility of grouper to IPNV. Similar results were obtained, mortalities of groupers in the experimental groups reached 80-100%. The results of the present study suggest that an IPN virus with only low pathogenicity could cause high mortality in groupers when combined with environmental stress.

Identification of a new single nucleotide substitution on the hypoxanthine-guanine phosphoribosyltransferase gene (HPRT(Tsou) from a Taiwanese aboriginal family with severe gout

OBJECTIVE

A new single nucleotide change of the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene on coding region has been identified from a Taiwanese aboriginal family with gout. The mutation was used to screen 27 members of the family, 22 Tsou, 70 Atayal, and 76 Bunun children, the elders for whom had been found to have a high prevalence of gout.

METHODS

An entire peptide of HPRT coding region was directly sequenced from the cDNA of a patient with severe gout, and by using polymerase chain reaction and restriction fragment length polymorphism to screen the other participants.

RESULTS

A new nucleotide change located at nucleotide 152 (G to A transition) was found that predicted an arginine to glutamine substitution at amino acid 51. This variant was named HPRT(Tsou), and was found in 3 women and 3 men among the patient's 7 siblings, 2 boys and 2 girls among the 8 children of the siblings, and one female Tsou (4.5%, 1/22) and one female Atayal (1.4%, 1/70). The serum uric acid concentration among male HPRT(Tsou) carriers in the patient's family was significantly higher than among those who had at least one HPRT gene that did not have HPRT(Tsou).

CONCLUSION

We found that the HPRT(Tsou) gene variant is partially responsible for the hyperuricemia in an aboriginal population in Taiwan known for a high incidence of gout.

Hepatitis C virus infection among short-term intravenous drug users in southern Taiwan

The purpose of this study was to determine the correlation between the prevalence of hepatitis C virus (HCV) infection with duration of drug use and other risk factors among drug users. This survey covered 899 male drug users from Kaohsiung Narcotic Abstention Institute and Kaohsiung prison. The prevalence of positive anti-HCV was 67.2% among intravenous drug users (IVDU) and 14.7% among non-intravenous drug users (non-IVDU). Among intravenous (IV) drug users, age and duration of drug use were independently related to HCV seropositivity. Seroprevalence rate for HCV in the IVDU group increased with increasing duration of injection use within the first seven years of drug use. However, the steepest trajectory in seroprevalence of HCV infection occurred within the first four months. Due to the high rate of HCV infection among drug users, investigation of risk behaviors should be routine in such a group. A high frequency of HCV infection was also found among short-term injectors, which indicated that early risk reduction intervention was an important measure in moderating HCV infection.

Adequacy of maternal pyridoxine supplementation during pregnancy in relation to the vitamin B6 status and growth of neonates at birth

To evaluate the adequacy of maternal pyridoxine supplementation during pregnancy for both maternal and neonatal status at birth, vitamin B6 status, assessed by plasma pyridoxal phosphate (PLP), pyridoxal (PL) and total aldehyde vitamer (PLP + PL) concentrations, and the growth of neonates, including weight, length, head and chest circumferences, were examined for 209 neonates whose mothers were supplemented with 0, 1, 2 or 3 mg pyridoxine.HCl (PN.HCl)/d during pregnancy. Maternal PN.HCl supplementations were positively correlated to both maternal (r = 0.62) and cord (r = 0.78) plasma PLP concentrations (p < 0.0001). Mothers supplemented with 2 or 3 mg/d PN.HCl had significantly higher plasma concentrations of PLP and total B6 aldehyde vitamer in maternal and cord blood compared with those receiving 0 or 1 mg PN.HCl/d. A growth benefit for neonates whose mothers had maternal and cord plasma PLP concentrations > or = 40 nM was revealed by the maternal supplementation of 2 mg PN.HCl/d during pregnancy. Thus, in healthy pregnant women, according to our study, a daily supplement of 2 mg PN.HCl provides the adequacy of maternal and neonatal vitamin B6 status and the satisfactory growth of neonates at birth.

Vitamin B6 down-regulates the expression of human GPIIb gene

Glycoprotein IIb (GPIIb) is the alpha-subunit of the platelet membrane receptor GPIIb/IIIa, which plays a major role in platelet aggregation. Vitamin B6 has been reported to be an antiaggregative agent, although its mechanism is not well known. To understand the molecular mechanism of vitamin B6 on antiaggregation, we analyzed the effects of various forms of vitamin B6 on the expression of human GPIIb promoter using chloramphenicol acetyl transferase (CAT) as the reporter gene. The GPIIb promoter region was amplified by polymerase chain reaction (PCR), cloned into pBLCAT3 to drive the CAT reporter gene and transfected into human erythroleukemia (HEL) cells. Transient expression of the GPIIb promoter was determined after transfected cells were treated with 1 microM pyridoxine (PN), pyridoxal (PL), pyridoxal-5-phosphate (PLP), or 4-deoxypyridoxine (4-dex) for 48 h. Our results show that the GPIIb promoter activity was down-regulated to 54, 35 and 63% in the presence of PN, PL and PLP, respectively, as compared to an untreated control whose promoter activity was 100%. However, no adverse effect on GPIIb promoter was detected by 4-dex, which is an antagonist of vitamin B6. The down-regulation effect of vitamin B6 on GPIIb promoter activity may lead to a reduction of GPIIb protein expression and thus be detrimental to platelet aggregation.

Microcapsules prepared from alginate and a photosensitive poly(L-lysine)

A photosensitive polymer, alpha-phenylcinnamylideneacetylated poly(L-lysine), was synthesized and characterized. This photosensitive poly(L-lysine) had 10% of its lysine residues reacted with alpha-phenylcinnamylidene acetyl group and displayed an absorption maximum at 329 nm. The photosensitive poly(L-lysine) was used for the preparation of microcapsules. The capsules formed from this photosensitive poly(L-lysine) and alginate were strengthened significantly by light irradiation. The photo cross-linked capsular membrane was permeable to proteins with mass transfer rate in the descending order: cytochrome C, myoglobin. and serum albumin. GH3 (a rat pituitary tumor cell line) cells were encapsulated and cultured with this microencapsulation system. The cells proliferated to a density of about 4 x 10(5) cells ml(-1) in the capsules after 6 days cultivation.

Amination of polycarbonate surface and its application for cell attachment

The polycarbonate sheet was modified with ammonia gaseous plasma and characterized by the contact angle measurement and ESCA analysis. The contact angles decreased significantly from 77 degrees to about 20 degrees-40 degrees, indicate that the polycarbonate sheet become more hydrophilic after plasma treatment. The ESCA analysis results showed that the hydrophilicity was mainly derived from the amino groups on the modified surface. In this study, a flow-chamber system was also constructed to evaluate the 3T3 fibroblast cells attachment phenomena on these modified sheets. Before the experimental run, the parameters of inoculated cell number and cell passage were examined previously. The results revealed that these two parameters are independent in shear experiment. And besides, 3-hours plating time has the better adhering fraction. The experimental results showed that the 3T3 fibroblast cells adhesion strength increased significantly on the plasma modified sheet.

Risk factors for hemorrhagic stroke in Wonju, Korea

Although stroke is a great public health challenge in Korea, there have have been few epidemiologic studies of the risk factors stroke. A case-control study was performed to evaluate the risk factors for hemorrhagic stroke in Wonju, Korea. Ninety-five subarachnoid hemorrhage (SAH) and 102 intracerebral hemorrhage (ICH) patients aged 21-86 years, and 267 controls were recruited among the inpatients of Wonju Christian Hospital during 1994-1995. Information was gathered through interview and examinations. After adjustment for age and sex, family and past history of hypertension, drinking habits, age of menarche, height, weight, body mass index, waist and hip circumference, earlobe crease, prothrombin time, white blood cell count, hemoglobin, and total cholesterol were all found to be significantly associated with both SAH and ICH. The risk factor significantly associated only with ICH was smoking habits. In multiple logistics analyses, the independent risk factors for SAH and ICH were the same. Those included family and past history of hypertension, age of menarche, earlobe crease, prothrombin time, white blood cell count, hemoglobin and total cholesterol. In general, the risk factors for SAH and ICH were similar with each other, except smoking habits. Risk factors found in this study congruent with previous studies were family and past history of hypertension, drinking habits, body mass index, prothrombin time, white blood cell count, and hemoglobin. Those incongruent or rather newly found were age of menarche, a big physique, earlobe crease, and total cholesterol.

Flat depressed early colon cancer--a case report

A flat depressed early colon cancer (FDEC) is characterized by non-polypoid growth pattern, no association of adenomatous tissues and a tendency of even small lesions toward submucosal invasion and lymph node metastasis. It supports de novo carcinogenesis of colorectal cancer, although most colorectal cancers arise in pre-existing adenoma (adenoma-carcinoma sequence). There have been few reports of small depressed cancers because of the difficulty in colonoscopic detection and the rapid development to ulcerating advanced cancers. We report a case of flat depressed early colon cancer confined to mucosa detected by indigo carmine contrast colonoscopy.

High prevalence of gout and related risk factors in Taiwan's Aborigines

OBJECTIVE

To estimate the prevalence of gout and to examine its risk factors among Taiwan's Aborigines compared with non-Aborigines.

METHODS

Data were collected from persons older than 40 years living in 3 aboriginal and 2 non-aboriginal districts in Taiwan by a community survey. Cases of gout were identified from self-reporting of a doctor's diagnosis based on clinical criteria. Baseline variables and biochemical data were examined as risk factors for the development of gout.

RESULTS

The prevalence of gout history was found to be 15.2% (25/165) and 4.8% (11/231) among aboriginal men and women, respectively, compared with a prevalence rate of 0.3% among non-Aborigines. A logistic regression model showed that aboriginal men older than 60 years with hyperuricemia were more severely affected by gout than any other group (p < 0.05).

CONCLUSION

A high prevalence of gout among Taiwanese Aborigines was observed in this study and race was the most significant risk factor associated with the disease.

Eustachian tube dysfunction in the pathogenesis of cholesteatoma: clinical considerations

OBJECTIVE

This study was conducted to gain insight into the surgical management of cholesteatomas to prevent postoperative retraction of the tympanic membrane.

DESIGN

A retrospective chart review of patients presenting between July 1988 and July 1992 was conducted.

METHOD

Clinical observations were made on 85 ears from 81 patients who had tympanoplasty with mastoidectomy for middle ear cholesteatoma, with ossicular reconstruction if necessary, with a subsequent follow-up period of 36 to 84 months (mean, 60 +/- 13 months).

RESULTS

The tympanic membrane in several cases became gradually retracted postoperatively; retraction generally commenced along the margin of the cartilage used for repairing the scutum defect, and was noted as early as 9 months, and after 5 years' follow-up, in as much as 66% in the 44 ears operated.

CONCLUSIONS

Eustachian tube dysfunction was common postoperatively in cholesteatomatous ears; however, whether it was the etiology or the sequela of a cholesteatoma could not be deduced. Since a retraction pocket in the tympanic membrane can develop into a cholesteatoma, it may account for some cases with recurrence of cholesteatoma postoperatively. Therefore, the cartilage/perichondrium composite graft for repairing the bone defect should be as large as possible.

Safety and immunogenicity of a serogroups A/C Neisseria meningitidis oligosaccharide-protein conjugate vaccine in young children. A randomized controlled trial

OBJECTIVE

To assess the safety and immunogenicity of a bivalent serogroups A/C meningococcal oligosaccharide-protein conjugate vaccine compared with the licensed meningococcal polysaccharide vaccine.

DESIGN

Randomized controlled trial.

STUDY POPULATION

Ninety healthy 18- to 24-month-old children who were seen at a southern California Kaiser Permanente clinic.

INTERVENTIONS

Vaccination with either the meningococcal conjugate vaccine (at 1 of 2 dosages) or the polysaccharide vaccine, with 2 doses given 2 months apart.

MAIN OUTCOME MEASUREMENTS

Immune response to each vaccine dose as determined by measurement of serogroup-specific total antibodies by enzyme-linked immunosorbent assay (ELISA) and by assessment of serum bactericidal activity.

RESULTS

Both vaccines appeared to be safe, and nearly all children responded with greater than 4-fold increases in antibody levels. The 2 dosages of the conjugate vaccine induced similar antibody responses; therefore, the data for the 2 conjugate vaccine groups were combined. Following 2 doses, ELISA antibody levels against group C meningococcus were significantly higher in conjugate vaccine recipients than in polysaccharide vaccine recipients (16.66 microg/mL vs. 8.31 microgm/mL; P<.001), but antibody levels against group A were not significantly different 22.75 microg/mL vs 21.24 microg/mL; P=.70). The serum bactericidal assays showed striking differences between the conjugate and polysaccharide vaccine groups. Geometric mean serum bactericidal titers were significantly higher in conjugate vaccine recipients (755.6 vs 37.6 for group A, P<.001; 3197.9 vs 11.4 for group C, P<.001).

CONCLUSIONS

The immune response induced by this meningococcal oligosaccharide-protein conjugate vaccine was qualitatively different from that induced by the polysaccharide vaccine, and the antibodies it elicited provided greater functional activity.

Ultrastructure of eustachian tube mucosa in chronic otitis media with cholesteatoma

PURPOSE

Acquaintance with the severity of inflammatory condition and mucociliary destruction of the protympanic eustachian tube (ET) mucosa may provide some insight for management during surgery for cholesteatoma.

MATERIALS AND METHODS

Protympanic eustachian mucosa was obtained from 25 patients undergoing ear surgery for cholesteatoma and from 5 cadavers undergoing dissection for a gross anatomy course. The specimens were processed for both scanning electron microscopy (SEM) and transmission electron microscopy (TEM).

RESULTS

According to SEM, decreased ciliated cells were noted. Residual ciliated cells and numerous white blood cells (WBC) were noted in the protympanic mucosa of the eustachian orifice. Bacilli were commonly noted at the mucosal surface. Cilia might be collapsed and stagnated with mucus secretion. This finding was consistent with those of the TEM: that cilia of varied directions were embedded in mucus. Mucociliary function was impaired under such conditions. The mucosal alteration was severe in some children; there was no ciliated cell visible. According to the TEM, the mucosal cells contained numerous secretory granules and mitochondria. Polymorphous nuclear cells were noted in the submucosal area that was edematous. Compound cilia were rather common. Mucus blanket covered mucosal cells with widening intercellular spaces. In addition, neither cilia nor microvilli were visible in severe mucosal alteration.

CONCLUSIONS

These occurrences indicated the presence of inflammatory reaction and impairment of clearance function of eustachian mucosa in cholesteatomatous ears. Thorough irrigation during surgery and antimicrobial therapy after surgery are warranted.

Risk factors of hepatitis C virus infection in a Taiwanese aboriginal community

The aim of this study is to identify the risk factors associated with anti-HCV positive status in a Bunun aboriginal community in Taiwan. In a door-to-door survey we collected 712 blood samples, and employed an enzyme immunoassay for anti-HCV to detect the recombinant antigen of viral genome including one structural and two nonstructural proteins. The prevalence of anti-HCV was 16.9% for the whole community covering an age range of five years to 84 years, but it was 48% in individuals older than 45 years. The calculated annual incidence rate was 1.25%. Information about possible risk factors was obtained from questionnaires completed in 1992. Age, sex, village of residence, educational level, and the extraneous factor of having been iatrogenic injected during a period one or two years before the survey, showed a significant association with positive anti-HCV status. A dose response relationship between the rate of positive anti-HCV status and frequency of injections was found statistically significant (P < 0.001). Accordingly, a second visit was made to find the possible infection source, and according to information obtained from the recall of 211 interviewees, an illegal medical service was suspected of spreading the recent infection.

Breast-feeding counseling by a 24-hour telephone hot-line

A 24-hour telephone hot-line functioning as a counseling service and case registry was included in a multi-faceted breast-feeding promotion program. The mothers could speak directly to especially trained staff members in a municipal hospital. All the questions were answered according to an "Answering Book" which included the anticipated question and the optimum answer. A total of 201 calls, which included 340 problems, were recorded from January 1, 1993 to October 31, 1993. Almost all the calls were made by the mothers (99%), and more than half (57.7%) of the mothers were primiparous. Most of the calls (79.6%) were made between 8 AM to 4 PM. The questions were frequently raised when the baby was aged 8 to 14 days (23.4%). The most frequently asked questions were: (1) insufficient milk? (14.1%), (2) frequent and loose stools? (13.2%), (3) weaning? (10.3%), (4) drugs? (6.8%), (5) additional formula or water? (6.2%), and (6) maternal contraindication? (6.2%). Although the impact of this telephone consultation could not be properly evaluated, the incidence of breast-feeding during hospital stay increased from 50% to 73.4%, and breast-feeding for more than 1 month increased from 22.7% to 42.2% before and after the whole promotion program. It is recommended that health care professionals provide more help when the mother leaves the hospital. A nation-wide toll-free telephone operated by the Department of Health to increase the chance of successful breast-feeding is also recommended.

Body mass index and hyperuricemia differences between aboriginal and non-aboriginal children in Taiwan

To explore the relationship between the body mass index (BMI) and uric acid in different races before growing up into adulthood, we selected a total of 1236 five to 14 year-old children in the period from March to December 1994. The children originated from three Aboriginal tribes (the Bunun, and the Paiwan tribes--classified as South-Aborigines and Atayal tribe as North-Aborigines) and two non-Aboriginal tribes (Fukein-Taiwanese and Hakka), all of whom are from the following four countries: Chien-Shih, Sandimen, Gaushuh and Sanmin. The results showed that the percentage of hyperuricemia (> or = 7.5 mg/dl) was 28.5% (352/1236) and of obesity (BMI > or = 22 kg/m2) was 9.5% (118/1236). Increased uric acid concentration was found to be related to age, sex, BMI, race, triglyceride (TG) and cholesterol levels in both the primary analysis and after the adjusted logistic regression model. Obesity did not vary with sex (OR = 1.0; 95% CI = 0.7-1.5), or with Aborigines in north Taiwan as compared with non-Aborigines (OR = 1.0, 95% CI = 0.6-1.6), but the logistic regression model adjusted for age indicated large BMI values for children with high serum uric acid concentration, triglyceride levels and the Aborigines who originated from south Taiwan. It was concluded from this study that both of the North-Aborigines and South-Aborigines made an important influence on serum uric acid concentration in children, especially the South-Aborigines made difference to BMI as compared with non-Aborigines and North-Aborigines.

Effect of neonatal immunization with diphtheria and tetanus toxoids on antibody responses to Haemophilus influenzae type b conjugate vaccines

We randomly assigned 150 newborn infants to receive diphtheria and tetanus toxoids (DT) or Hib oligosaccharide conjugate (HbOC) at birth to determine whether exposure to the Haemophilus influenzae type b (Hib) conjugate vaccines' carrier proteins would enhance immune responses to subsequent administrations of HbOC or PRP-tetanus toxoid conjugate (PRP-T) at 2, 4, and 6 months of age. Their antibody responses were compared with those of 100 children immunized with HbOC or PRP-T beginning at 2 months of age. No serious adverse reactions were associated with neonatal vaccination. Administration of HbOC at birth did not lead to earlier or higher antibody levels. Newborn immunization with DT did not prime children for enhanced antibody responses. Moreover, Hib antibody levels were lower in DT-primed children than in children immunized beginning at 2 months of age. Diphtheria antibody levels, but not tetanus antibody levels, were also lower in children immunized with DT at birth. We conclude that neonatal immunization with Hib conjugate vaccines is not a means to provide earlier protection against invasive Hib disease. Newborn DT administration does not enhance subsequent antibody responses to Hib conjugate vaccines, and may lead to suppression of Hib and diphtheria antibody responses.

Enhanced antibody responses in infants given different sequences of heterogeneous Haemophilus influenzae type b conjugate vaccines

To evaluate the safety and immunogenicity of differing sequences of heterogeneous Haemophilus influenzae type b (Hib) conjugate vaccines, we randomly assigned 300 infants to one of six vaccination schedules. At 2, 4, and 6 months of age, subjects were given single or heterogeneous vaccines: Hib polysaccharide (PRP) conjugated to mutant diphtheria toxin (HbOC), PRP conjugated to outer-membrane protein of Neisseria meningitidis (PRP-OMP), or PRP conjugated to tetanus toxoid (PRP-T). No serious reactions were attributable to immunization with heterogeneous vaccines, and there were few significant differences in the rates of minor adverse reactions among groups. PRP-OMP was the only vaccine that induced an antibody response after the first dose, but significant booster responses were not seen after the second and third doses. Subjects given PRP-T vaccine responded well after two doses, but three doses of HbOC vaccine were needed for an equivalent antibody response. All the Hib vaccine schedules evaluated were immunogenic, and schedules initiated by PRP-OMP vaccine at 2 months of age, followed by two doses of either HbOC or PRP-T vaccine at 4 and 6 months of age, induced the highest antibody levels after each dose. Such schedules may be the best for protecting infants and children who are at greatest risk of having invasive Hib disease, such as American Indian children.

Immunogenicity of Haemophilus influenzae type b tetanus toxoid conjugate vaccine in young infants. The Kaiser-UCLA Vaccine Study Group

In a prospective, randomized, double-blind efficacy trial, the immunogenicity of 10 lots of Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugate vaccine (PRP-T) was evaluated. More than 10,000 infants received PRP-T or hepatitis B vaccine at about 2, 4, and 6 months of age along with other childhood vaccines. In a subset of infants, geometric mean concentrations of total anticapsular antibody were 0.08, 0.79, and 5.29 micrograms/mL after the first, second, and third doses, respectively. Four lots of reconstituted lyophilized PRP-T vaccine were significantly more immunogenic than 6 lots of aqueous vaccine (P = .03). In a stepwise regression model, the most important additional factors affecting anticapsular antibody concentrations were the time between the third dose and the blood draw, race, and breast-feeding status at 6 months of age. Immune responses to diphtheria and tetanus toxoids were not significantly different for infants given PRP-T or hepatitis B vaccines along with diphtheria-tetanus toxoid-pertussis vaccine.

[Mortality patterns of Taiwan aborigines due to accidents]

The purpose of this investigation was to study ethnic differences in mortality patterns due to accidents in the various aboriginal areas of Taiwan. Mortality data was collected from the National Health Department. To compare the accident mortality of aborigines with that of the general population of Taiwan, and then calculated standardized mortality ratios for accidents in the various aboriginal groups by using the cause specific accident mortality of the general population as standardized mortality and found that mortality in Taiwan between 1971 and 1990 was 60.1 per hundred thousand due all causes of injuries 72.2 (102.2 for males and 39.5 for females). The same figures for the aborigines were 194.9 (274.1 for males and 98.7 for females), respectively. The leading causes of accidental death among the aborigines were motor vehicle accidents, suicide, drowning, accidental falls for males and suicide, motor vehicle accidents and non-drug poisoning for females. Our investigations show that the standardized mortality ratio due to accidents in the aboriginal areas is two to three times higher than that in the general population of Taiwan. These figures were differences among the aboriginal tribes, despite similarities in medical care, environmental and economic circumstances. Mortality due to accidents, especially due to suicide and poisoning, in the Atayal and Bunun tribes were particularly higher than in other tribes. Thus, the risk of an accident in these regions may be associated not only with the environment and the lack of medical resources, but with some socio-cultural factors.

[Prevalence of smoking, drinking and betel quid chewing and related factors among aborigines in Wufeng District]

This study surveyed the prevalence of smoking, drinking, betel quid chewing and related factors among adult Aborigines in Wufeng District, Hsinchu county, Northern Taiwan, as determined in a cross-sectional study (N = 504), based on random sampling. In house to house survey, 420 residents were interviewed in their homes by a structured questionnaire (with a response rate of 83.3%) and a complete set of data was collected for 360 Atayal and Saisiat Aborigines. The survey only included adults (N = 302), as the number of children were few. The life-time prevalence rate of smoking, drinking and betel quid chewing was 71.1%, 85.5%, 49.7% in men and 25.2%, 58.0%, 6.3% in women, respectively. In contrast, the one year prevalence rates were 61.0%, 65.4%, 27.0% in men and 16.8%, 25.97%, 1.4% in women, respectively. The result of multiple logistic regression were that (1) the male drinker and betel quid chewer was the highest risk group for smoking; (2) the male smoker was the highest risk group for drinking and (3) the married male smoker was the highest risk group for betel quid chewer.

[The analysis of factors affecting the sexual behavior and antibody against syphilis of deep sea fishermen]

Prostitutes may be regarded as the reservoir of sexual transmitted diseases and their customers as the transmitters. The use of condom for sexual intercourse with prostitutes is an effective way of preventing sexually transmitted infections. Deep sea fishermen usually spend a long period of time sailing the oceans, and many have contacts with prostitutes when their boat stays in harbor. This is a study of the factors which affect the fishermen who are customers of prostitutes and condom using. In all 859 Taiwanese deep sea fishermen were interviewed and samples of their blood serum were collected between January and June of 1991. Of the interviewees, 628 (73.1%) used at one time the services of a prostitute; 84% of aborigines from reserved areas and 68% of aborigines from non-reserved areas. The factors which were found to be related to a sailor's tendency to become the customer of a prostitute after adjustments in logistic regressions were marital status, educational level, tobacco smoking and alcohol consumption. Of the 628 men 100 claimed to use condoms always, 110 sometimes and the remaining 414 men never. The vast majority of aborigines from reserved areas (113/124; 91.1%) never used condoms as compared with 84.0% of aborigines from non-reserved areas and 81.8% of non-aborigines (included Hakka). As might be expected, the lesser educate as well as the aborigines from reserved areas use condoms the least frequently.

[Standardized incidence ratios for cancers in Taiwan aborigines, 1981-1987]

Standardized incidence ratios (SIR) of malignant neoplasms in Taiwanese Aborigines were analyzed. In all, 995 cases of cancers had been reported in 30 Taiwanese Aboriginal communities between 1981 and 1987. In the same time period, 137, 159 cases were registered in Taiwan and carefully categorized according to race, gender, site and frequency of occurrence. Sex and tribe-specific standardized incidence ratios with 95% confidence interval were calculated. We found that the standardized incidence ratios of all cancers in Aborigines was lower than that in the general population of Taiwan for both Aboriginal men (0.72, 95% CI:0.67-0.78) and women (0.66, 95% CI:0.59-0.72). Of selected malignant neoplasms, SIR for nasopharyngeal carcinoma was slightly elevated in men, especially in the Bunun and Rukai tribes and significantly elevated in Paiwan women (2.95, 95% CI:1.65-4.87). The SIR for gastric cancer was significantly elevated for both men (SIR = 1.22, 95% CI:1.03-1.44) and women (1.48, 95% CI:1.14-1.92), especially in Atayal and Bunun men and Atayal women. There was a higher than expected level of incidence of penis cancer and other male genital cancers, especially in Paiwan people, with the SIR as large as 6.24 (95% CI:2.02-14.53). The SIR of lymph node cancer was significantly increased in Bunun (4.21, 95% CI:1.36-9.81) and Yamei women (CI:1.50-44.89), but not for all Aboriginal men. Colon, rectum, lung, bladder and oral cancers in aboriginal men and colon, rectum, lung, breast and cervical cancer in women occurred significantly less frequently than in the general population. The SIR of colon and rectum carcinoma was significant lower for both men (0.45, 95% CI:0.32-0.61) and women (0.25, 95% CI:0.13-0.42), particularly in the Atayal and Paiwan tribes. The SIR of lung cancer was 0.52 (95% CI:0.41-0.66) in Atayal, Bunun, Paiwan men and 0.58 (95% CI:0.38-0.86) in Paiwan women. There were significantly lower than expected levels of incidence of bladder (0.18, 95% CI:0.02-0.65) and oral cancer (0.29, 95% CI:0.08-0.74) for Atayal men. Aboriginal women had significantly lower SIR of cervical cancer (0.46) especially in Atayal, Bunun, Paiwan women and of breast cancer (0.38) especially in the Atayal and Paiwan women. But cancer of esophagus, liver, gallbladder, pancreas, and prostate occurred among Aboriginal people at the same rate as in the general Taiwan.

Comparison of naturally acquired and vaccine-induced antibodies to Haemophilus influenzae type b capsular polysaccharide

The objective of this study was to assess qualitative differences in the types of Haemophilus influenzae type B (Hib) capsular polysaccharide (polyribosylribitol phosphate [PRP]) antibodies induced in children 15 to 27 months of age by (i) natural exposure, (ii) PRP vaccine, and by (iii) PRP-diphtheria toxoid conjugate vaccine, (iv) PRP-group B Neisseria meningitidis outer membrane vesicle conjugate vaccine, and (v) Haemophilus type B oligosaccharide conjugate vaccine (HbOC). The highest levels of total Hib-PRP antibody measured by radioimmunoassay and immunoglobulin G (IgG) measured by enzyme-linked immunosorbent assay were seen after HbOC immunization. IgG1 Hib-PRP antibodies predominated in all groups, and there were no differences between the groups in the proportion of IgG and IgA Hib-PRP antibodies. However, the proportions of IgM differed significantly by group. The highest proportions of IgM occurred in naturally acquired antibody and after PRP vaccine, and the lowest proportion occurred after HbOC vaccine. IgG light-chain V kappa type alpha PRP antibody was present in all groups, and the level correlated with the total IgG Hib-PRP antibody level. Therefore, HbOC induced the highest concentrations of V kappa II type alpha PRP antibody, and the naturally acquired antibody group had the lowest levels. IgG light-chain V kappa III antibody levels were also highest in the HbOC group, but there was no correlation between V kappa III antibody levels and total amount of IgG Hib-PRP antibody. These data demonstrate qualitative differences in the antibody repertoires induced by natural exposure, the Hib-PRP vaccine, and each of the different Hib conjugate vaccines. We doubt that there are major differences in the protection afforded by these different antibody repertoires, because these differences do not appear to correlate with differences in protective efficacy in older children.

PSA after definitive radiotherapy for clinically localized prostate cancer

A rising PSA level for clinically localized prostate cancer after definitive radiotherapy is an ominous finding that correlates with positive postirradiation biopsy and traditional clinical progression. The study detailed in this article found that the proportion of patients treated with radiotherapy who achieved stable PSA levels and were clinically free of disease was disappointingly low.

Comparative immunogenicity of four Haemophilus influenzae type b conjugate vaccines in Alaska Native infants

We compared the immunogenicity of the four available Haemophilus influenzae type b (Hib) conjugate vaccines in Alaska Native infants. Three of the vaccines, Hib oligosaccharide-CRM197 (HbOC), polyribosylribitol phosphate-diphtheria toxoid (PRP-D) and polyribosylribitol phosphate-tetanus toxoid (PRP-T), were given at 2, 4 and 6 months of age, and the PRP Neisseria meningitidis outer membrane protein (PRP-OMP) conjugate vaccine was given at 2 and 4 months of age. Enrollment was largely sequential by vaccine availability beginning with HbOC and ending with PRP-T. A total of 225 infants completed the full vaccination series. Groups of infants receiving the different vaccines did not differ significantly by sex, ethnicity, degree Alaska Native or age at vaccination. The only vaccine that induced a response with the first 2-month dose was PRP-OMP; 91% of infants had > or = 0.15 micrograms/ml and 57% had > or = 1.0 microgram/ml of anti-PRP antibody by 4 months of age. After two doses it also remained the most immunogenic. After the full three vaccine series, trials that requires cough of 21 days is excessively restrictive.

Tattooing as a risk of hepatitis C virus infection

The association of hepatitis C virus (HCV) infection and tattooing was studied in 87 tattooed and 126 tattoo free healthy young men who did not engage in intravenous drug use or multiple sexual activity. Antibody against HCV (anti-HCV) was tested in serum specimens by enzyme immunoassay with C100-3, NS3, and core antigens; 11 of the 87 (12.6%) tattooed and 3 of the 126 (2.4%) tattoo free subjects were positive for anti-HCV (odds ratio = 5.9, 95% CI = 1.6-22.0). A relationship was demonstrated by an increased risk for HCV infection with an increasing number of tattooed site (P(trend) = 0.002). All but one of the 87 tattooed subjects had been infected by hepatitis B virus (HBV) and 25 were carriers of hepatitis B surface antigen (HBsAg). None of the 25 HBsAg carriers was positive for anti-HCV whereas 11 of the 62 HBsAg non-carriers had anti-HCV, suggesting a negative association between the HBsAg carriage and the long lasting anti-HCV (P = 0.02, Fisher's exact). The status of the tattooer was also an important determinant for HCV infection; the risk was higher if tattooing was done by a non-professional friend than by a professional tattooist. Tattooing, probably with improperly sterilized needles, can clearly pose an increased risk for HCV infection in Taiwan. This study indicates the need for legal standards for hygienic tattooing as part of preventive measures for the control of parenterally transmitted infections.

Sexual patterns and human immunodeficiency virus infection among homosexuals in Taiwan

Between 1988 and 1991, 64 homosexual men and 43 bisexual men were screened for human immunodeficiency virus (HIV) in Southern Taiwan; 5 of them were found to carry HIV antibodies. According to a self-administered questionnaire completed before screening, the average age of the men in the study group was 27 years, and the average duration of practiced homosexuality was 3.8 years. Occupations included student, merchant, laborer, officer, and soldier, and many of the men (45/107) had some junior college or university level education. A relatively high proportion (48/107) of these subjects reported having only 1 sexual partner, and there was a significant association between HIV antibody status and number of sexual partners (P = 0.025). Of the 107 subjects, 58 had practiced anal intercourse and more than a third of them (37/107) indicated that they had participated in receptive anal intercourse, 42 in insertive anal intercourse, and 21 in both of the above. All five carriers of HIV had practiced receptive anal intercourse, in which transmission of HIV from inserter to receptor was highly likely (P = 0.004). Of the men who came forward for HIV testing, the bisexual men tended to be older and often married.

Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors

The prevalence of betel quid chewing habit in Taiwan was surveyed in a group of Chinese people from Kaohsiung city and in a second group from the aboriginal inhabitants of South Taiwan. In all 1299 participants constituted Group 1 (85.2% response rate) and 827 Group 2 (70.1% response rate). People were interviewed in their homes in house-to-house survey, according to a structured questionnaire developed and evaluated by the authors. Of the Kaohsiung inhabitants covering all ages and both sexes, 6% was a current betel chewer and 4% was an ex-chewer, whereas 42% of the aborigines aged over 15 yr was a current chewer and 1% an ex-chewer. Lifetime prevalence was 10%. Betel chewing enjoys islandwide popularity among the 20 million inhabitants of Taiwan; the number of current and ex-users was estimated at 2.0 million (95% CI 1.6-2.4 million). The betel quid was prepared in two different ways. In one, used mainly by aborigines, fresh areca nut was simply wrapped with betel leaf and in another, popular mainly among Chinese, a lengthwise piece of betel fruit and lime paste was sandwiched between two halves of an areca nut. A high proportion of chewers was also a smoker and drinker, but tobacco was not found to be chewed together with betel quid. Consumption varied between 14 to 23 portions per day, with individual frequencies ranging widely from 1 to over 200 portions a day. A statistical analysis of sociodemographic factors showed that lesser educated older men, blue collar workers, smokers and drinkers were the likeliest betel chewers.

Effect of riboflavin-binding protein deficiency on riboflavin metabolism in the laying hen

Normal chicken eggs contain substantial amounts of riboflavin, all of which is bound to a specific, high-affinity, riboflavin-binding protein (RfBP). Two hens, genetically unable to produce RfBP and thus unable to deposit sufficient riboflavin in their eggs, were compared to two normal hens with respect to the biological half-life of [14C]riboflavin, the tissue distribution of 14C-labeled flavins, and the relative contributions of tissue and dietary riboflavin to flavins deposited in the egg. The biological half-life of [14C]riboflavin was slightly but insignificantly less in the RfBP-deficient hens (11.5 +/- 1.7 days vs 15.1 +/- 3.3 days). The 14C-labeled flavin content of a variety of tissues 3 weeks after the intraperitoneal injection of 5 microCi of riboflavin was also very similar among the four hens. In contrast, the 14C-labeled flavin content of egg yolk, egg albumen, and blood plasma from RfBP-deficient birds was less than 10% of normal. For all hens, the specific radioactivity of flavins in yolk and albumen was similar to that in liver but less than that in heart. We conclude that riboflavin deposited in egg had equilibrated with the large hepatic flavin pool and was not derived preferentially from unlabeled dietary riboflavin. Other than the inability to deposit riboflavin in their eggs, hens of the mutant strain have normal riboflavin metabolism.

[Comparison of two commercial potassium chloride tablets for slow-release in an in vitro dissolution test]

Two commercial slow-release potassium chloride tablets, Slow-K and Addi-K have the characteristics of slow-release in the different dissolution conditions. The two tablets had similar dissolution profiles in simulated intestinal fluid (pH 6.8), simulated gastric fluid (pH 1.2) and water; which indicates that, the dissolution rates of the two commercial potassium chloride tablets are independent of the pH values of the dissolution medium. The release patterns of potassium chloride fitted the First order model and Higuchi matrix model. These were distinguished by differential rate treatment, which showed that the release followed the First order pattern. It was found that the dissolution rate of Addi-K were more rapid than Slow-K in different dissolution conditions.

Polymerase chain reaction technique for detection of human immunodeficiency virus type I

A total of 7 cases were assayed by polymerase chain reaction (PCR) with an HIV-1 primer set matched the polymerase region. One homosexual man who was HIV-1 antibody negative was used as a negative control, the other cases included HIV-1 antibody positive asymptomatic, ARC and AIDS cases. The length of the amplified DNA segment was 115 base pairs (bp) and the appearance of this segment showed positive reaction with the HIV-1 antigen. These six HIV-1 antibody positive cases, including an asymptomatic infant showed a segment size of about 115 bp and were recognized as HIV-1 positive infections, and whereas the HIV-1 antibody negative case did not.

Taiwan's first case of perinatal transmission of HIV confirmed by a modified western blot test

A 25-year-old Chinese woman, was found HIV antibody positive on December 14, 1988. During our follow-up, we tested her American husband and found him to be seronegative. Unfortunately, her six-month-old infant was seropositive. The standard Western blot test was used in the first stage of analysis. The bands which appeared on the infant's strip were p15, p24, p31, p55 and gp120/gp160, but using the modified Western blot test the bands which appeared were p15, p24, p31, gp41, p53, p55, p64 and gp120/gp160. All the bands appearing on the infant's strips which used a modified Western blot test had higher intensities than those of a standard procedure. The mother was apparently infected with HIV through intercourse with her ex-boyfriend, who was a European. AZT was given to the mother because her T4 cell count was 338 per microliter and because of persistent cervical lymphadenopathy. The infant, which was bottle-fed and had been delivered by caesarean section, may have become HIV infected during the uterine stage.

Pyridoxine supplementation of lactating mothers: relation to maternal nutrition status and vitamin B-6 concentrations in milk

Vitamin B-6 status, assessed by plasma pyridoxal phosphate (PLP) concentrations, and vitamin B-6 concentrations in breast milk were examined in 47 lactating mothers supplemented with different amounts of pyridoxine.HCl (PN.HCl) during pregnancy and the first 6 mo of lactation. PLP concentrations in cord blood and maternal plasma at 2 d postpartum and vitamin B-6 concentration in colostrum were positively correlated with the amount of PN.HCl supplementation prenatally (r = 0.71, p less than 0.001; r = 0.74, p less than 0.001; and r = 0.78, p less than 0.001, respectively). Correlations between the amounts of PN.HCl supplementation postnatally and plasma PLP concentrations increased with the length of supplementation. Plasma PLP concentrations were also correlated with vitamin B-6 concentrations of milk samples, which were obtained on the same day as plasma. PN.HCl supplements between 2.5 and 4.0 mg/d (2.1-3.4 mg PN equivalents) ensured vitamin B-6 adequacy of the mother and maintained relatively saturated concentrations of vitamin B-6 in breast milk.