Identification and characterization of a new type of asymmetrical dicentric chromosome derived from a single maternal chromosome 18

Molecular cytogenetic analysis identified a new type of dicentric chromosome involving different breakpoints at 18q in a female fetus. The chromosome anomaly was designated as an asymmetrical pseudoisodicentric chromosome 18, 46,XX,psu dic(18)(pter-->q11.2::q21.3-->pter)mat. A series of BAC clones for 18q11.2 and q21.3 regions were used to identify one breakpoint within the region q11.2 between 19.8 and 21.6 Mb from the telomere of 18p and another breakpoint within q21.3 between 55.4 and 56.9 Mb from the telomere of 18p by FISH analysis. Real-time quantitative PCR and microsatellite analysis further verified that the dicentric chromosome was maternal in origin and resulted from a break-reunion between sister chromatids of a single maternal chromosome. We propose that a loop-type configuration of sister chromatids took place and that the break-reunion occurred at cross sites of the loop to form an asymmetrical isodicentric chromosome during either mitosis or meiosis. In this case, the asymmetrical pseudoisodicentric resulted in an 18pter--> q11.2 duplication and an 18q21.3-->qter deletion, which could have led to certain dysmorphic features of 18q- syndrome in this fetus.

Predictors of renal function improvement following tacrolimus conversion in cyclosporine-treated kidney transplant recipients

The objective of this study was to evaluate the relationship between variability of cyclosporine (CsA) absorption and tacrolimus (TAC) conversion seeking factors that predict improvement in allograft function after TAC conversion. We performed a retrospective study of 44 adult kidney transplant recipients undergoing conversion from CsA to TAC-based immunosuppression. Before TAC conversion, patients had complete, consecutive, 6 monthly C2 levels and a follow-up duration beyond 6 months after TAC conversion. The patients were divided into 2 groups: one (n=23) with low variability of CsA absorption and one (n=21) with high variability of CsA absorption. At TAC conversion, the estimated glomerular filtration rate (eGFR) was similar in both patient groups. Six months after TAC conversion, eGFR improved in both groups. Stepwise regression analysis revealed the DeltaSCr6 (change in serum creatinine level at 6 months) to be independently associated with the preconversion serum creatinine (SCr; P<.0001) and the percent coefficient of variation (%CV) of SCr (P=.0034). DeltaSCr6 was inversely associated with posttransplantation years (P=.0033), and 6-month TAC blood levels (P=.0053). The DeltaSCr6 was not associated with variability of oral CsA absorption. The cutoff value of baseline SCr at TAC conversion differentiated an increase in or reduction of SCr to be about 1.0 mg/dL. Our study of CsA-treated kidney transplant recipients who underwent TAC conversion showed that a preconversion SCr>1.0 mg/dL, a high variability of SCr, and early TAC conversion predicted greater short-term benefit on graft function.

28-Day oral toxicity study of the aqueous extract from spider brake (Pteris multifida Poiret) in rats

Spider brake (Pteris multifida Poiret) is a very important folk herb and a constituent in most of the traditional herbal beverage formulas in Taiwan; however, little toxicological information is available regarding the safety following repeated exposure. The present study was conducted to evaluate the toxicity of aqueous extract from spider brake (SB) in Sprague-Dawley rats on dietary oral gavage at concentrations of 100, 500, and 1000 mg/kg b.w. day for 28 days. There were no adverse effects on general condition, growth, feed and water consumption, feed conversion efficiency, red blood cell and clotting potential parameters, clinical chemistry values, and organ weights except for neutrophils and lymphocytes being slightly diminished in male and female rats at the highest dose, respectively. Necropsy and histopathology findings revealed no treatment-related changes in any of the organs. The results obtained in this study allowed us to conclude that the SB properly utilized in the traditional oral administration could be devoid of any toxic risk.

New symptomatic compression fracture after percutaneous vertebroplasty at the thoracolumbar junction

BACKGROUND AND PURPOSE

The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures after vertebroplasty at the thoracolumbar junction.

MATERIALS AND METHODS

We conducted a retrospective analysis of 53 patients treated with percutaneous vertebroplasty at the thoracolumbar junction (T12, L1). The follow-up period was 15-27 months. The occurrence of new symptomatic vertebral compression fractures was recorded after vertebroplasty. We evaluated patient age and sex, amount of injected cement, vacuum clefts in the collapsed bodies, initial wedge angle of the compression fracture, change of the wedge angle after vertebroplasty, intradiskal cement leak, and percentage of height restoration of the vertebral body. In this report, we surveyed the possible risk factors for new symptomatic vertebral compression fractures.

RESULTS

Thirty-nine (74%) of the 53 patients had fluid and/or air in the compression fracture at the thoracolumbar junction (T12, L1). Eight (20.5%) of the 39 patients with vacuum clefts had new symptomatic compression fracture after vertebroplasty between 1 month and 4 days after surgery to 23 months and 4 days after surgery. The patients with new symptomatic compression fracture had higher initial wedge angle and wedge angle change (more than 7 degrees ) after vertebroplasty than those without fractures; these data were considered statistically significant.

CONCLUSIONS

The incidence of vacuum clefts in the compression fracture at the thoracolumbar junction is high (74%). The severity of initial wedge angle and wedge angle change affects the incidence of new symptomatic compression fracture.

Toxicity and cardiac effects of carbaryl in early developing zebrafish (Danio rerio) embryos

Carbaryl, an acetylcholinesterase inhibitor, is known to be moderately toxic to adult zebrafish and has been reported to cause heart malformations and irregular heartbeat in medaka. We performed experiments to study the toxicity of carbaryl, specifically its effects on the heart, in early developing zebrafish embryos. LC50 and EC50 values for carbaryl at 28 h post-fertilization were 44.66 microg/ml and 7.52 microg/ml, respectively, and 10 microg/ml carbaryl was used in subsequent experiments. After confirming acetylcholinesterase inhibition by carbaryl using an enzymatic method, we observed red blood cell accumulation, delayed hatching and pericardial edema, but not heart malformation as described in some previous reports. Our chronic exposure data also demonstrated carbaryl-induced bradycardia, which is a common effect of acetylcholinesterase inhibitors due to the accumulation of acetylcholine, in embryos from 1 day post-fertilization (dpf) to 5 dpf. The distance between the sinus venosus, the point where blood enters the atrium, and the bulbus arteriosus, the point where blood leaves the ventricle, indicated normal looping of the heart tube. Immunostaining of myosin heavy chains with the ventricle-specific antibody MF20 and the atrium-specific antibody S46 showed normal development of heart chambers. At the same time, acute exposure resulted in carbaryl-induced bradycardia. Heart rate dropped significantly after a 10-min exposure to 100 microg/ml carbaryl but recovered when carbaryl was removed. The novel observation of carbaryl-induced bradycardia in 1- and 2-dpf embryos suggested that carbaryl affected cardiac function possibly through an alternative mechanism other than acetylcholinesterase inhibition such as inhibition of calcium ion channels, since acetylcholine receptors in zebrafish are not functional until 3 dpf. However, the exact nature of this mechanism is currently unknown, and thus further studies are required.

Protective effects of Ligustrum lucidum fruit extract on acute butylated hydroxytoluene-induced oxidative stress in rats

Nuzhenzi, the fruit of Ligustrum lucidum Ait. (Oleaceae), is commonly used as tonic for kidney and liver in the traditional Chinese medicine prescription. The present study aimed to investigate the antioxidant activities of ethanol extract of Ligustrum lucidum fruits (ELL) and its effects on butylated hydroxytoluene (BHT)-induced oxidative stress in rats. Results showed that ELL possesses weak antioxidant activities. Compared to the BHT (1000mg/kg)-treated group, results showed that ELL at 250, 500 and 1000mg/kg significantly reduced the levels of blood urea nitrogen (BUN), serum glutamic pyruvic transaminase (sGPT), glutamic oxaloacetic transaminase (sGOT), alkaline phosphatase (sALP), lactate dehydrogenase (LDH), triglyceride (TG) and creatinine (Cr), as well as LDH in bronchoalveolar lavage fluid (BALF). It also significantly decreased the level of lipid peroxides in liver and lung. In addition, ELL significantly enhanced the levels of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) in these organs. Histopathological evaluation of the tissues revealed that ELL reduced the incidence of lung lesions, while the liver and kidney tissues were not affected by BHT administration. Taken together, the protective effect of ELL against acute BHT-induced oxidative stress in rats could be through the upregulation of antioxidant enzymes.

Analysis of factors associated with varicella-zoster virus susceptibility among children 0–12 years old in Taiwan

OBJECTIVES

Varicella is a highly infectious disease caused by varicella-zoster virus (VZV). The aim of this study was to explore the geographical difference of VZV antibody seroprevalence among children in private vaccination areas in Taiwan, controlling for potential factors relating to varicella susceptibility.

PATIENTS AND METHOD

A cross-sectional survey of the seroprevalence of VZV antibodies among children 0-12 years of age was conducted in Taiwan between August and December 2003. Sera of children visiting the outpatient unit of the participating hospitals around the island were collected. Six hundred and fifty-six parents among those of the 931 children studied agreed to answer the self-administered questionnaire regarding the possible factors associated with varicella susceptibility. IgG antibodies to VZV were measured using an enzyme-linked immunosorbent assay kit, Enzygnost anti VZV/IgG.

RESULTS

The susceptibility was the highest at age 1 year, and then decreased as the age increased. Children living in southern and eastern Taiwan showed higher susceptibility to varicella than those living in northern area (odds ratio (OR) = 2.71 and 2.10, respectively). Prior history of varicella infection, varicella vaccination, and contact with cases remained to be associated with the susceptibility after multivariate analysis.

CONCLUSIONS

Children who lived in tropical and rural regions and those who had no history of varicella infection, varicella vaccination, and contact with cases, might be more susceptible to varicella. Island-wide VZV seroprevalence surveillance is required to examine whether the geographical difference of susceptibility in Taiwan will become less significant or disappear after the mass varicella vaccination program initiated in 2004.

Synergic CSE1L/CAS, TNFR-1, and p53 apoptotic pathways in combined interferon-gamma/adriamycin-induced apoptosis of Hep G2 hepatoma cells

Many cancers are chemotherapy-resistant. Chemotherapy combined with immunotherapy offers a potential avenue for the treatment of chemotherapy-resistant cancers. In this study, we investigated the apoptotic pathways induced by combined interferon-gamma/adriamycin treatment in Hep G2 cells. Our data showed that Hep G2 cells treated with combined interferon-gamma/adriamycin enhanced cell apoptosis in comparison with that of cells treated with adriamycin. Interferon-y increased TNFR-1, CSE1L/CAS (cellular apoptosis susceptibility protein), Bax, and Bad levels. Adriamycin increased p53 and Bax, but not TNFR- 1 and CAS levels. Interferon-y did not increase p53 accumulation; nevertheless it enhanced adriamycin-induced p53 accumulation. Overexpression of IRF-1 augmented the combined interferon-gamma/adriamycin-induced p53 accumulation. Interferon-gamma co-treatment increased the stability of p53 protein induced by adriamycin. Our data suggest that TNF-gamma may greatly enhance the combined interferon-gamma/chemotherapeutic drug-induced apoptosis of cancers. Our findings also indicate that CAS, TN-FR-1, p53, Bax, and Bad may be the targets for the interferon-y-based chemo-immunotherapy of the chemotherapy-resistant cancers.

Life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy

BACKGROUND

Limited data are available on the life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy (HAART).

AIM

To provide such an estimate using a semi-parametric projection.

DESIGN

Statistical analysis.

METHODS

Follow-up data for patients newly diagnosed with HIV infection in Taiwan (HIV/AIDS Cohort) from 1 May 1997 to 30 April 2003 (n = 3351, only 1% are injecting drug users) were analysed using the Kaplan-Meier method. The survival function for an age- and gender-matched reference population was generated by the Monte Carlo method from the life-table of the general population. A constant excess hazard model was used to project long-term survival of HIV-infected patients, with linear extrapolation of a logit-transformed curve of survival ratio between HIV-infected patients and the reference population.

RESULTS

The 5-year survival rate was 58% in patients who had already developed AIDS at diagnosis (AIDS group), and 89% in those who had not (non-AIDS group). Extrapolation yielded an expected mean survival time of 10.6 years after diagnosis for the AIDS group, and 21.5 years after diagnosis for the non-AIDS group.

DISCUSSION

Our results support the expansion of HIV screening programs to minimize delay in diagnosis. With continuing advances in HAART, this estimate of survival in initially asymptomatic patients may be conservative. Their long life expectancy raises questions about what kind of preventive heath services should be offered. These should be addressed through further analysis of overall benefit and cost-effectiveness.

Reuse potential analysis on WWTP effluent of industrial parks in Taiwan

This study examined the reuse potential of the effluents discharged from several unified wastewater treatment plants (WWTPs) of industrial parks in Taiwan, with designed capacity exceeding 10,000 CMD. Parameters were selected based on the relevant reuse purposes. The "potential recycling percentage", R of the WWTP effluent was defined as the maximal percentage of pure water extractable by the "ideal reverse osmosis module" while the RO retentate still met local effluent standards and required no treatment. The analytical results demonstrated that the WWTP effluents had potential for recycling. A pilot plant was installed in one of the WWTPs. The treatment process included a sand filter, an ultrafiltration unit (UF) and a reverse osmosis module (RO). Results of this study demonstrated that the production quantity and quality are stable and appropriate for various purposes, including both industrial and domestic applications.

Liver graft-to-recipient spleen size ratio as a novel predictor of portal hyperperfusion syndrome in living donor liver transplantation

Portal hyperperfusion in a small-size liver graft is one cause of posttransplant graft dysfunction. We retrospectively analyzed the potential risk factors predicting the development of portal hyperperfusion in 43 adult living donor liver transplantation recipients. The following were evaluated: age, body weight, native liver disease, spleen size, graft size, graft-to-recipient weight ratio (GRWR), total portal flow, recipient portal venous flow per 100 g graft weight (RPVF), graft-to-recipient spleen size ratio (GRSSR) and portosystemic shunting. Spleen size was directly proportional to the total portal flow (p = 0.001) and RPVF (p = 0.014). Graft hyperperfusion (RPVF flow > 250 mL/min/100 g graft) was seen in eight recipients. If the GRSSR was < 0.6, 5 of 11 cases were found to have graft hyperperfusion (p = 0.017). The presence of portosystemic shunting was significant in decreasing excessive RPVF (p = 0.059). A decrease in portal flow in the hyperperfused grafts was achieved by intraoperative splenic artery ligation or splenectomy. Spleen size is a major factor contributing to portal flow after transplant. The GRSSR is associated with posttransplant graft hyperperfusion at a ratio of < 0.6.

Chromosomal distribution and organization of three cervid satellite DNAs in Chinese water deer (Hydropotes inermis)

The species-specific profile and centromeric heterochromatin localization of satellite DNA in mammalian genomes imply that satellite DNA may play an important role in mammalian karyotype evolution and speciation. A satellite III DNA family, CCsatIII was thought to be specific to roe deer (Capreolus capreolus). In this study, however, this satellite DNA family was found also to exist in Chinese water deer (Hydropotes inermis) by PCR-Southern screening. A satellite III DNA element of this species was then generated from PCR-cloning by amplifying this satellite element using primer sequences from the roe deer satellite III clone (CCsatIII). The newly generated satellite III DNA along with previously obtained satellite I and II DNA clones were used as probes for FISH studies to investigate the genomic distribution and organization of these three satellite DNA families in centromeric heterochromatin regions of Chinese water deer chromosomes. Satellite I and II DNA were observed in the pericentric/centric regions of all chromosomes, whereas satellite III was distributed on 38 out of 70 chromosomes. The distribution and orientation of satellite DNAs I, II and III in the centromeric heterochromatin regions of the genome were further classified into four different types. The existence of a Capreolus-like satellite III in Chinese water deer implies that satellite III is not specific to the genus Capreolus (Buntjer et al., 1998) and supports the molecular phylogeny classification of Randi et al. (1998) which suggests that Chinese water deer and roe deer are closely related.

Chalcone inhibits the proliferation of human breast cancer cell by blocking cell cycle progression and inducing apoptosis

Chalcones are discussed to represent cancer preventive food components in a human diet that is rich in fruits and vegetables. In this study, we examined chalcone (1,3-diphenyl-2-propenone) for its effect on proliferation in human breast cancer cell lines, MCF-7 and MDA-MB-231. The results showed that chalcone inhibited the proliferation of MCF-7 and MDA-MB-231 by inducing apoptosis and blocking cell cycle progression in the G2/M phase. Immunoblot assay showed that chalcone significantly decreased the expression of cyclin B1, cyclin A and Cdc2 protein, as well as increased the expression of p21 and p27 in a p53-independent manner, contributing to cell cycle arrest. An enhancement in Fas/APO-1 and its two form ligands, membrane-bound Fas ligand (mFasL) and soluble Fas ligand (sFasL), was responsible for the apoptotic effect induced by chalcone. In addition, chalcone also triggered the mitochondrial apoptotic signaling by increasing the amount of Bax and Bak and reducing the level of Bcl-2 and Bcl-X(L), and subsequently activated caspase-9 in MCF-7 and MDA-MB-231 cells. Taken together, our study suggests that the blockade of cell cycle progression and initiation of cell apoptotic system may participate in the antiproliferative activity of chalcone in human breast cancer cells.

Characterization and adsorption properties of eggshells and eggshell membrane

The objective of this work was to study the chemical and physical characterization of eggshell and eggshell membrane particles prepared from the hen eggshell waste. Under the characterization measurements investigated, it was found that the pore structures of the two biomaterials belong to a typical Type II, indicating that they should be basically characteristic of nonporous materials or materials with macropores or open voids. Further, the chemical composition of the resulting eggshell particle was strongly associated with the presence of carbonate minerals from the Fourier transform infrared (FTIR) spectra. In contrast to the resulting eggshell membrane particle, the presence of functional groups of amines and amides was observable because of its chemical composition of fibrous proteins. From the isotherm data of methylene blue at 25 degrees C, the Freundlich model yielded a somewhat better fit than the Langmuir model. The adsorption isotherms revealed the eggshell biosorbents could only uptake the basic dye of less than 1.0mg/g in aqueous medium, which was attributed to their poor pore properties.

Spectral karyotyping and fluorescence in situ hybridization analysis of de novo partial trisomy 7p (7p21.2-->pter) and partial monosomy 12q (12q24.33-->qter)

An 8-year-old boy presenting with hypotonia, moderate mental retardation, developmental delay, and psychomotor retardation is reported. Magnetic resonance imaging of the brain at age 3 years revealed a Dandy-Walker variant. Cytogenetic analysis of the peripheral blood revealed a derivative chromosome 12 with unknown additional material attached to the distal region of the long arm of chromosome 12. The parental karyotypes were normal. Spectral karyotyping (SKY) using the 24-color SKY probes and fluorescence in situ hybridization (FISH) using the specific 7p, 7q, 12p, and 12q telomeric probes confirmed a duplication of distal 7p and a deletion of terminal 12q. The karyotype of the proband was designated as 46,XY.ish der(12)t(7;12) (p21.2;q24. 33)(SKY+, 7pTEL+, 12qTEL-). The present case provides evidence for the association of partial trisomy 7p (7p21.2-->pter) and partial monosomy 12q (12q24.33-->qter) with a cerebellar malformation and the usefulness of SKY and FISH in the identification of a de novo aberrant chromosome resulting from an unbalanced translocation.

Effects of dexamethasone on peripheral blood mononuclear cell phenotype in weanling piglets

The aim of this study was to evaluate the effect of dexamethasone treatment on the immune system of weanling piglets. Piglets were administered dexamethasone (DEX; 1mg/kg, IM) every 12h for 2 consecutive days (short-term experiment) or DEX (1mg/kg, IM) daily for 2 weeks (long-term experiment). The relative percentage of CD8(+) T cells in peripheral blood mononuclear cells (PBMCs) was significantly decreased (P<0.05) in both short- and long-term DEX-treated groups compared to their control groups. The percentage of IgM(+) cells in PBMCs of the long-term DEX-treated group was greatly increased (P<0.05) in comparison to the control group. The results of this study indicate that short-term DEX-treatment increases leucocyte function; however, long-term DEX-treatment depresses leucocyte function, especially that of CD8(+) T cells.

Anti-oxidant activity and effect of Pinus morrisonicola Hay. on the survival of leukemia cell line U937

The free radical scavenging and anti-cancer activites of Pinus morrisonicola Hay. were studied using different parts of the pine, namely, needle, bark and cone. Results showed that pine needle water extract has the highest scavenging superoxide anion activity and the lowest IC50 value in inhibiting superoxide anion formation; however, the bark water extract showed the best anti-lipid peroxidation activity. Additionally, needle water extract displayed the highest inhibition of leukemia cell line U937 growth. The results indicated that P. morrisonicola Hay. possesses potential chemopreventative and therapeutic properties.

Karyotypic evolution of a novel cervid satellite DNA family isolated by microdissection from the Indian muntjac Y-chromosome

A minilibrary was constructed from DOP-PCR products using microdissected Y-chromosomes of Indian muntjac as DNA templates. Two microclones designated as IM-Y4-52 and IM-Y5-7 were obtained from negative screening of all three cervid satellite DNAs (satellites I, II, and IV). These two microclones were 295 and 382 bp in size, respectively, and shared approximately 70% sequence homology. Southern blot analysis showed that the IM-Y4-52 clone was repetitive in nature with an approximately 0.32-kb register in HaeIII digest. Sequence comparison revealed no similarities to DNA sequences deposited in the GenBank database, suggesting that the microclone sequences were from a novel satellite DNA family designated as cervid satellite V. A subclone of an Indian muntjac BAC clone which screened positive for IM-Y4-52 had a 3,325-bp insert containing six intact monomers, four deleted monomers, and two partial monomers. The consensus sequence of the monomer was 328 bp in length and shared more than 80% sequence homology with every intact monomer. A zoo blot study using IM-Y4-52 as a probe showed that the strong hybridization with EcoRI digested male genomic DNA of Indian muntjac, Formosan muntjac, Chinese muntjac, sambar deer, and Chinese water deer. Female genomic DNA of Indian muntjac, Chinese water deer, and Formosan muntjac also showed positive hybridization patterns. Satellite V was found to specifically localize to the Y heterochromatin region of the muntjacs, sambar deer, and Chinese water deer and to chromosome 3 of Indian muntjac and the X-chromosome of Chinese water deer.

Automatic optimum order selection of parametric modelling for the evaluation of abnormal intra-QRS signals in signal-averaged electrocardiograms

Abnormal intra-QRS potentials (AIOPs) in signal-averaged electrocardiograms have been proposed as a risk evaluation index for ventricular arrhythmias. The purpose of the paper was to develop an automatic algorithm for selecting the optimum parametric model order in the analysis of AIOPs to make the modelling approach clinically more feasible. A total of 130 normal Taiwanese subjects and 87 patients with ventricular premature contractions and 23 with sustained ventricular tachycardia were recruited. The unpredictable AIQP signal was estimated from the modelling residual. The cross-correlation coefficient between the original signal and the ORS estimate was employed to evaluate the accuracy of the estimate. A pre-selected threshold cross-correlation coefficient of 0.9999 was used to determine the optimum order. The mean AIQP in lead Y for ventricular tachycardia patients was 3.9 microV, which was significantly smaller than 4.9 microV for ventricular premature contraction patients (p < 0.01) and 6.3 microV for normal subjects (p < 0.001). The linear combination of AIQP in lead Y and the time-domain parameter RMS40 provided the best global performance (the area under the receiver operating characteristic curve was 89.1%). A higher risk of ventricular arrhythmias was associated with lower AIQP in lead Y, and the automatic modelling algorithm improved the clinical feasibility of AIQP analysis.

The antiproliferative activity of prodelphinidin B-2 3′-O-gallate from green tea leaf is through cell cycle arrest and Fas-mediated apoptotic pathway in A549 cells

Prodelphinidin B-2 3'-O-gallate, a proanthocyanidin gallate isolated from green tea leaf, was investigated for its anti-proliferative activity in human non-small cell lung cancer A549 cells. The results showed that prodelphinidin B-2 3'-O-gallate inhibited the proliferation of A549 cells with no detectable toxic effects on normal WI-38 cells as measured by the XTT assay. Flow cytometric analysis showed that prodelphinidin B-2 3'-O-gallate blocked cell cycle progression in the G0/G1 phase. In addition, prodelphinidin B-2 3'-O-gallate effectively induced A549 cell apoptosis as determined by assessing the nucleosome level in cytoplasm. Enzyme-linked immunosorbent assay showed that the G0/G1 phase arrest is due to p53-independent induction of p21/WAF1. An enhancement in Fas/APO-1 and its two form ligands, membrane-bound Fas ligand (mFasL) and soluble Fas ligand (sFasL), might be responsible for the apoptotic effect induced by prodelphinidin B-2 3'-O-gallate. We suggested that prodelphinidin B-2 3'-O-gallate's activities might be potentially contribute to its overall chemopreventive effects against lung cancer, and can possibly be considered for future therapeutic application.

Elevated serum levels of a c-erbB-2 oncogene product in oral squamous cell carcinoma patients

OBJECTIVES

Amplification of the proto-oncogene c-erbB-2 (HER-2/neu) has been shown to be a prognostic marker in many kinds of cancer including oral squamous cell carcinoma (OSCC). In order to obtain further information on the c-erbB-2 gene product p185, it is necessary to quantify expression levels. In this study we used an enzyme-linked immunosorbent assay (ELISA) for the extracellular domain of p185 to determine whether a soluble oncoprotein fragment can be detected in the serum of OSCC patients.

METHOD

Sera from 84 OSCC patients, 51 breast cancer patients (as positive controls), and 15 healthy controls were assayed in an ELISA. To study c-erbB-2 overexpression in OSCC, and breast cancer tissue samples we used an immunohistochemical technique.

RESULTS

The mean serum value (ng/ml, mean/SD) for the normal controls was 8.46/1.29. We chose the 95% level of normal controls as a cut-off to distinguish individuals with elevated levels. The breast cancer patients' and OSCC patients' serum values were 13.83/6.82 and 13.1/4.56, respectively. Significant differences (P < 0.0001) were observed between normal control and OSCC, normal control and the breast cancer group. Immunohistochemically detectable p185 (intermediate to high) was noted in 30 of 61 OSCC, and 24 of 51 breast cancer patients. There was a trend of association of serum oncoprotein fragment levels with tumor stages, but not with tumor sizes, nodal stages, metastases, and oral habits including betel quid chewing, alcohol drinking and smoking in the OSCC group.

CONCLUSION

The results of the present study raise the possibility that soluble c-erbB-2 protein levels in serum is a useful parameter for monitoring the disease status as well as the effect of therapy on patients with OSCC.

Central adenoid cystic carcinoma of the mandible manifesting as an endodontic lesion

AIM

To present a case of adenoid cystic carcinoma (ACC) in the mandible, and manifesting as a periapical lesion.

SUMMARY

A 56-year-old male suffered from pain around the right mandibular first molar for approximately 1 week. Oral examination revealed that the involved tooth was restored by a full coverage crown with no obvious abnormalities. A periapical radiograph revealed two ill-defined radiolucencies associated with the tooth, one over the mesial and another over the distal roots of the tooth; incomplete root filling and furcation involvement also being noted. The affected tooth was extracted based on the clinical impression of apical periodontitis. The surrounding tissue of the root apex was curetted and sent for histopathological examination, which revealed ACC.

KEY LEARNING POINTS

Adenoid cystic carcinoma affecting the mandible may mimic a periapical lesion. Proper diagnosis of such a lesion is dependent on thorough clinical, radiographic and microscopic examinations. Such a case highlights the benefits of biopsy and histological examination of collected tissues. Diagnosis of lesions in the mandible should include salivary gland tumours.

Cloning, characterization and physical mapping of three cervid satellite DNA families in the genome of the Formosan muntjac (Muntiacus reevesi micrurus)

Due to their high sequence diversity even among closely related species, satellite DNA sequences can be a useful molecular marker for phylogenetic and taxonomic analyses. To characterize the satellite DNA in the genome of a native muntjac species of Taiwan, the Formosan muntjac, satellite DNA clones representing three different cervid satellite DNA families from this species were isolated and analyzed. Genomic organization study of these satellite DNAs was also undertaken. Three Formosan muntjac satellite DNA clones were obtained and designated as FM-satI (1,391 bp), FM-satII (1,143 bp) and FM-satIV (1,103 bp), and found to share approximately 82, 81 and 98% sequence homology with the Chinese muntjac satellite I clone (C5), Indian muntjac satellite II clone (Mmv-0.7) and Chinese muntjac satellite IV clone (MR-1.0), respectively. These three satellite DNA families are organized in a pter<--FM-satII-FM-satIV-FM-satI-->qter orientation in the centromeric region with satII closely associated with the telomeric sequences. Satellite DNA sequence comparison, in combination with chromosome data concludes that the Formosan muntjac is likely a subspecies of M. reevesi, closely related to the Chinese muntjac. With the kinetochore satellite II DNA co-localizing with the telomeric sequences, the Formosan muntjac chromosomes could be truly telocentric.

High prevalence of asymptomatically poor muscle perfusion of lower extremities measured in systemic lupus erythematosus patients with abnormal myocardial perfusion

Patients with systemic lupus erythematosus (SLE) may develop premature atherosclerosis, notably peripheral vascular disease (PVD) presenting with intermittent claudication or gangrene. Therefore, it is important to investigate if high prevalence of poor muscle perfusion of lower extremities in SLE patients with abnormal myocardial perfusion is related to more cardiovascular risk factors. We used a well-established and noninvasive radionuclide method (xenon 133 muscle washout) to evaluate objectively the anterior tibial muscle perfusion of 34 SLE female patients without symptoms/signs of PVD in the lower extremities. The patients were separated into two groups according to myocardial perfusion imaging results. Meanwhile, 30 normal female controls with matched age distribution were also included for comparison. The muscle perfusion differed significantly ( P <0.05) between patients (1.90+/-0.41 ml/100 g per min) and controls (2.91+/-0.50 ml/100 g per min), as well as between 18 SLE patients with abnormal myocardial perfusion (1.33+/-0.43 ml/100 g per min) and 16 with normal myocardial perfusion (2.26+/-0.45 ml/100 g per min). Based on the xenon 133 muscle washout method, we conclude that muscle perfusion in the lower extremities of SLE patients without symptoms/signs of PVD is significantly decreased and related to abnormal myocardial perfusion.

Changing trends of prostate cancer in Asia

Although Asian people have the lowest incidence and mortality rates of prostate cancer in the world, these rates have risen rapidly in the past two decades in most Asian countries. Prostate cancer has become one of the leading male cancers in some Asian countries. In 2000, the age-adjusted incidence was over 10 per 100000 men in Japan, Taiwan, Singapore, Malaysia, the Philippines and Israel. Although some of the increases may result from enhanced detection, much of the increased incidence may be associated with westernization of the lifestyle, with increasing obesity and increased consumption of fat. The differences in incidences between native Americans and Asian immigrants are getting smaller, reflecting a possible improvement of diagnostic efforts and changes of environmental risk factors in Asian immigrants. Nevertheless, the huge variations in incidences among ethnic groups imply that there are important genetic risk factors. The stage distributions of prostate cancer in Asian populations are still unfavorable compared to those of Western developed countries. However, a trend towards diagnosing cancer with more favorable prognosis is seen in most Asian countries. Both genetic and environmental risk factors responsible for elevated risks in Asian people are being identified, which may help to reduce prostate cancer incidence in a chemopreventive setting.

A pilot trial of quantitative Tc-99m HMPAO and Ga-67 citrate lung scans to detect pulmonary vascular endothelial damage and lung inflammation in patients of collagen vascular diseases with active diffuse infiltrative lung disease

Diffuse infiltrative lung disease (ILD) includes a heterogeneous group of disorders predominantly affecting lung parenchyma and sparing the airway. To assess the degree of pulmonary vascular endothelial damage in active ILD, lung/liver uptake ratios (L/L ratio) on technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan were determined in 30 patients with active ILD. Meanwhile, the gallium-67 citrate (Ga-67) uptake index (GUI) on Ga-67 lung scan was used to evaluate the severity of lung inflammation in active ILD. In this study, high-resolution CT (HRCT) was used to evaluate disease activity in ILD. The results show statistically significant differences between normal controls and patients with active ILD as shown in L/L ratios and GUI. However, when the patients were divided into two groups of 15 patients with normal chest X-ray findings and 15 with abnormal X-ray findings, there was no significant difference in those parameters. In addition, there was no statistically significant difference between the groups in HRCT scoring. No good correlation between the degree of pulmonary vascular endothelial damage and the severity of lung inflammation was found. In addition, there were no good correlations between HRCT scoring vs GUI and HRCT vs L/L ratio in different study subgroups. In conclusion, L/L ratios on Tc-99m HMPAO and GUI on Ga-67 lung scans differ from chest X-ray findings and have the potential to detect the degree of pulmonary vascular endothelial damage and severity of lung inflammation in active IDL. However, the relationships between HRCT scoring, GUI, and L/L ratio in patients with collagen vascular diseases and active ILD are not significant.

Simultaneously evaluating the effects of one-week fluticasone propionate inhalation therapy on lung ventilation and permeability in children with asthma

This study evaluated the effects of fluticasone propionate inhalation therapy on lung ventilation and alveolar permeability by quantitative Tc-99m DTPA radioaerosol inhalation lung scintigraphy in 15 children with asthma. Lung ventilation was evaluated as the distribution percentage (D%) of Tc-99m DTPA radioaerosols in the central, intermediate and peripheral regions of the right lung. Alveolar permeability was measured by the rate of Tc-99m DTPA radioaerosol clearance curve from the peripheral alveoli of the right lung and represented as slope. The D% and slopes were calculated before and after one-week inhalation therapy (100 microg fluticasone propionate two times daily for one-week) to evaluate the effects of inhalation therapy on lung ventilation and alveolar permeability. The preliminary results revealed statistically significantly improved lung ventilation but no significant change of alveolar permeability in the right lung after one-week fluticasone propionate inhalation therapy in children with asthma. We suggest that the widely available and noninvasive Tc-99m DTPA radioaerosol inhalation lung scintigraphy can simultaneously evaluate lung ventilation and alveolar permeability in one study and should contribute to any disorder involving both alveoli and airways.

Pleomorphic adenoma with extensive necrosis: report of two cases

Pleomorphic adenoma (PA) is the most common neoplasm for both the major and minor salivary glands. While PA is occasionally associated with cystic change or hemorrhage necrosis, spontaneous infarction appears to be very uncommon. We report two unusual cases of extensive necrosis of PA; one occurred in the palate with the necrotic tumor mass slipping into the oral cavity. This phenomenon, possibly associated with incision biopsy, has never been described previously. A second case, arising in the parotid with spontaneous tumor necrosis, poses some dilemma in differential diagnosis.

Isolated fatal renal mucormycosis in a patient with chronic obstructive pulmonary disease and tuberculosis

Renal mucormyosis is a rare entity and normally diagnosed at postmortem. Isolated cases diagnosed antemortem are even rarer and only a few cases have been reported. The disease is associated with a high mortality rate, especially in patients with underlying disease. Clinical presentation is non-specific and includes flank pain, fever and pyuria with or without haematuria. Identifying fungal hyphae microscopically is essential for diagnosis. We present a rare isolated fatal case of renal mucormycosis in a 77-year-old man with chronic obstructive pulmonary disease (COPD) and old tuberculosis (TB) who had been diagnosed after a right nephrectomy. We believe early diagnosis and appropriate treatment for fungal infection, together with the predisposing underlying disease, is crucial for survival.

Twenty-year follow-up of the Carpentier-Edwards standard porcine bioprosthesis in the Oriental population

AIM

The 20-year period long-term results of porcine bioprosthetic valve use are limited. In addition, the majority of these reports come from Western countries. Given the scanty information reported in Oriental countries, this study was therefore designed to examine 20-year long-term results in patients who received a Carpentier-Edwards porcine bioprosthetic valve in an effort to contribute further information on the long-term clinical performance of porcine prosthetic valves from a viewpoint of results in the Oriental population.

METHODS

From July 1979 to April 2001, 82 patients received valve replacement with a standard Carpentier-Edwards porcine valve. There were 40 men and 42 women with a mean age of 42.3+/-15.1 years (range 16 to 73 years). Follow-up time extended more than 20 years (mean 10.9+/-3.2 years, range 0.5 to 21.5 years ) for a total of 719.5 patient-years.

RESULTS

The overall operative mortality was 16.9% (14 of 83 procedures). At 5, 10, 15, and 20 years, the actuarial survival rate of patients was 71.7%, 66.9%, 55.5%, and 44.4%, respectively. Actuarial estimates of freedom from structural valvular deterioration (SVD) at 5, 10, 15, and 17 years were 96.3%, 64.0%, 24.3%, and 24.3%, respectively; from reoperation 96.3%, 64.5%, 24.5%, and 24.5%; from operated valvular endocarditis 96.8%, 92.6%, 92.6%, and 92.6%; and from overall thromboembolism 96.3%, 88.5%, 67.2%, and 52.2%. In normal sinus rhythm, actuarial estimates of freedom from thromboembolism at 5, 10, 15, and 17 years were 100.0%, 100.0%, 81.8%, and 81.8%, respectively. Whereas for those in patients with atrial fibrillation, the estimates of freedom from thromboembolism were 94.5%, 82.4%, 57.7%, and 38.5%.

CONCLUSION

This study demonstrates the very satisfactory 20-year period long-term performance of freedom from bleeding events, thromboembolism (except in patients with atrial fibrillation), and valvular endocarditis in Oriental patients undergoing replacement with a porcine valve. However, the remarkable rate of SVD and reoperation ensued at 6 years after bioprosthesis implanted which does not differ from the series reported from Western countries.

The effects of one-week fluticasone propionate inhalation therapy for Tc-99m DTPA radioaerosol distribution in asthma of children: a preliminary report

This study evaluated the effects of fluticasone propionate inhalation therapy for the distribution pattern of Tc-99m DTPA radioaerosols in 10 children with asthma. The homogeneous degree of depositing Tc-99m DTPA radioaerosol was evaluated using a modified standard score system over the bilateral lungs. The baseline scores were calculated from Tc-99m DTPA radioaerosol inhalation lung scintigraphy before inhalation therapy (100 microg fluticasone propionate two times daily for one week), and the scores were recalculated after inhalation therapy to evaluate the effects of one-week of fluticasone propionate inhalation therapy for Tc-99m DTPA radioaerosol distribution patterns. After one week of fluticasone propionate inhalation therapy, the scores were decreased in all of the 10 children, which may mean that the bronchial constriction degree due to asthma is decreased. In addition, there was a significantly statistical difference in the scores before and after one-week fluticasone propionate inhalation therapy (p < 0.05). In conclusion, one-week fluticasone propionate inhalation therapy could significantly improve the bronchial constriction due to asthma in children based on the evidence of Tc-99m DTPA radioaerosol inhalation lung scintigraphic findings.

Comparing thallium-201 spect mammoscintigraphy and ultrasonography to detect breast cancer in mammographical dense breasts

The aim of our study was to compare the usefulness of thallium-201 (Tl-201) single photon emission computed tomography (SPECT) mammoscintigraphy and ultrasonography to detect breast cancer in mammographical dense breasts. This study included 32 Taiwanese female patients with indeterminate mammographic probability of malignancy due to mammographical dense breasts. Both Tl-201 SPECT mammoscintigraphy and ultrasonography were performed for each patient. Then, all of the 32 breast masses undervent biopsies or operations to obtain finally pathological diagnoses. Based on the finally pathological diagnoses, 24 masses were breast cancer and 8 masses were benign breast tumors among the 32 patients. Twenty-two cancers and one benign tumor had positive Tl-201 SPECT mammoscintigraphic findings. The sensitivity, specificity, and accuracy were 92%, 88%, and 91%. Twenty-two cancers and 5 benign tumors had positive ultrasonographic findings. The sensitivity, specificity, and accuracy were 92%, 38%, and 78%, respectively. To detect breast cancer in patients with non-diagnostic mammogram because of mammographically dense breasts, Tl-201 SPECT mammoscintigraphy and ultrasonography have the same sensitivity to screen breast masses. However, due to its higher specificity, Tl-201 SPECT mammoscintigraphy should be useful to confirm the ultrasonographic findings.

Epidemiological and genetic studies of myotonic dystrophy type 1 in Taiwan

To investigate the prevalence and genetic characteristics of myotonic dystrophy type 1 (DM1) in Taiwan, DM-suspected patients and their families identified during the period of 1990-2001 had their clinical records reevaluated and the CTG repeat sizes at the DM1 locus examined. A total of 96 subjects belonging to 26 families were identified as DM1 patients, which gave a minimal disease prevalence of 0.46/100,000 inhabitants. Clinical anticipation was frequently observed in affected families, even in some parent-child pairs with transmission contraction of the CTG repeat size. The inverse correlation between age at onset and CTG repeat length was significant only in patients with small expansions. In addition, a DM1 carrier with a childhood-onset son was found to have CTG length heterogeneity in the range of 40-50, indicating that premutation alleles could be unstable during gametogenesis as well as in somatic tissues. Our data demonstrated that DM1 is a rare disease in Taiwan and showed that transmission contraction of repeat size is more likely to occur in alleles with large repeats.

Usefulness of technetium-99m methoxyisobutylisonitrile liver single photon emission computed tomography to detect hepatocellular carcinoma

Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) has been shown to be useful in identifying several types of tumors, such as breast, lung and thyroid cancers. The usefulness of Tc-99m MIBI liver imaging in detecting hepatocellular carcinoma (HCC) is still controversial. In this study, 22 patients with HCC performed Tc-99m MIBI liver single photon emission computed tomography (SPECT). Twenty of 22 patients (90.9%) showed negative liver SPECT findings without significant Tc-99m MIBI uptake in HCC, and only 2 patients (9.1%) showed positive liver SPECT findings with significant Tc-99m MIBI uptake in HCC. In addition, no significant correlation between liver SPECT findings with sex, age, alpha feto-protein serum level, HCC differentiation, and virus hepatitis status was found. We concluded that Tc-99m MIBI liver SPECT is not a sensitive tool to detect HCC.

In vitro antiviral activities of Caesalpinia pulcherrima and its related flavonoids

The aim of this study was to search for new antiviral agents from Chinese herbal medicine. Pure flavonoids and aqueous extracts of Caesalpinia pulcherrima Swartz were used in experiments to test their influence on a series of viruses, namely herpesviruses (HSV-1, HSV-2) and adenoviruses (ADV-3, ADV-8, ADV-11). The EC50 was defined as the concentration required to achieve 50% protection against virus-induced cytopathic effects, and the selectivity index (SI) was determined as the ratio of CC50 (concentration of 50% cellular cytotoxicity) to EC50. Results showed that aqueous extracts of C. pulcherrima and its related quercetin possessed a broad-spectrum antiviral activity. Among them, the strongest activities against ADV-8 were fruit and seed (EC50 = 41.2 mg/l, SI = 83.2), stem and leaf (EC50 = 61.8 mg/l, SI = 52.1) and flower (EC50 = 177.9 mg/l, SI = 15.5), whereas quercetin possessed the strongest anti-ADV-3 activity (EC50 = 24.3 mg/l, SI = 20.4). In conclusion, some compounds of C. pulcherrima which possess antiviral activities may be derived from the flavonoid of quercetin. The mode of action of quercetin against HSV-1 and ADV-3 was found to be at the early stage of multiplication and with SI values greater than 20, suggesting the potential use of this compound for treatment of the infection caused by these two viruses.

Sex differences in the middle ear of the bullfrog (Rana catesbeiana)

Impedance transformation by the middle ear of terrestrial vertebrates is considered to be a function of the ossicular lever apparatus, which increases force and decreases velocity at the stapes footplate relative to the tympanic membrane, and the ratio of tympanic membrane area to stapes footplate area (the area ratio), which increases pressure at the stapes. A recent vibrometric study has found that the velocity ratio between tympanic membrane and stapes footplate is higher in male bullfrogs (Rana catesbeiana) than in females. Although the tympanic membrane area is known to be larger in male bullfrogs, the area ratio has apparently never been compared between the sexes. The hypothesis that a lower area ratio in males helps to compensate for the higher velocity ratio was investigated by comparing tympanic membrane, stapes footplate and operculum areas in frogs of both sexes. Contrary to expectation, the difference in stapes footplate area between males and females is very small, and area ratios are considerably higher in males. Area ratios increase with increasing body size in both sexes. Operculum area does not differ between the sexes. The apparent difference in impedance transformation between male and female frogs might be necessary due to different inner ear impedances, or might reflect serious inadequacies in the conventional models of middle ear function.

Usefulness of quantitative Tc-99m HMPAO and Ga-67 citrate lung scans in detecting pulmonary vascular endothelium damage and lung inflammation in patients with systemic lupus erythematosus: a preliminary report

Pulmonary vascular endothelium damage in 34 patients with systemic lupus erythematosus (SLE) was measured by technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan. The degree of damage was represented as lung/liver uptake (L/L) ratio. The patients were divided into two subgroups according to the following criteria: (a) clinical features, separated as stable or flare stage and (b) chest X-ray findings separated as positive or negative results. Meanwhile, quantitative gallium-67 citrate (Ga-67) lung scan was performed as Ga-67 uptake index (GUI) to evaluate the severity of inflammation in the SLE lungs. The results show (a) no significant statistical differences in the degree of pulmonary vascular endothelium damage (the L/L ratio on Tc-99m HMPAO lung scan) between the two subgroups according to clinical features or chest X-ray findings and (b) no good correlation between the degree of pulmonary vascular endothelium damage and lung inflammation (GUI on Ga-67 lung scan). In conclusion, the change in pulmonary vascular endothelium damage in SLE may be unrelated to the clinical presentation or chest X-ray findings, and its degree is not related to the severity of pulmonary inflammation.

Usefulness of mammoscintigraphy with thallium-201 single photon emission computed tomography to differentiate palpable breast masses of young Taiwanese women when comparing with mammography

Sixty young Taiwanese women with palpable breast masses detected by mammography and/or physical examinations underwent mammoscintigraphy with thallium-201 (Tl-201) single photon emission computed tomography (SPECT) to assess its value for differentiating breast masses. The results showed that 42 of the 45 cases of breast carcinoma were detected by Tl-201 SPECT mammoscintigraphy. Fourteen of the 15 of benign breast lesions were differentiated by Tl-201 SPECT mammoscintigraphy. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Tl-201 SPECT mammoscintigraphy were 93%, 93%, 98%, 82%, and 93%, respectively. Thirty-eight of the 45 cases of breast carcinoma were detected by mammography. Twelve of the 15 of benign breast lesions were differentiated by mammography. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of mammography were 84%, 80%, 93%, 63%, and 83%, respectively. We concluded that Tl-201 SPECT mammoscintigraphy significantly improves the accuracy when comparing with mammography for the differentiating breast cancer in Taiwanese women.

Usefulness of whole body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent ovarian cancer based on asymptomatically elevated serum levels of tumor marker

The aim of this study was to evaluate practice usefulness of whole body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent ovarian cancer based on asymptomatically elevated tumor marker (CA-125) serum levels. Whole-body FDG-PET was performed in 28 patients with suspected recurrent ovarian cancers and asymptomatically increased serum levels of tumor marker (CA-125 antigen) but negative or equivocal other imaging modality results. All of these 28 asymptomatic patients had serum levels of CA-125 antigen >35 U/ml. The final diagnosis of recurrent ovarian cancer was established by operation/biopsy histopathological findings or clinical follow-up longer than 1 year by additional morphologic imaging techniques. Among the 28 patients, the final diagnoses of recurrent ovarian cancers and benign lesions were established in 20 and 8 patients, respectively. FDG-PET accurately diagnosed recurrent ovarian cancers in 19 patients and benign lesions in 7 patients. When asymptomatically elevated serum levels of CA-125 antigen, the diagnostic sensitivity, specificity, and accuracy of FDG-PET to detect recurrent ovarian cancers were 95.0%, 87.5%, and 92.9%, respectively. FDG-PET is a useful technique to detect recurrent ovarian cancers for patients suspected of recurrent ovarian cancers due to asymptomatically elevated serum levels of CA-125 antigen.

Early predicting recurrent cervical cancer with combination of tissue polypeptide specific antigen (TPS) and squamous cell carcinoma antigen (SCC)

The establishment of new tumor marker combinations including strong lead-time effects in detecting recurrent cervical cancer appears to be warranted. This retrospective study includes 50 patients with recurrent squamous cell cervical cancer after operation or radiotherapy. The serial serum levels of the tumor markers tissue polypeptide specific antigen (TPS) and squamous cell carcinoma antigen (SCC) were determined. Cutoff values of 78.5 U/L for TPS and 1.5 microg/L for SCC were selected according to the 95th percentile of serum concentrations measured in healthy control patients. Comparing with other monitoring modalities, SCC and TPS showed lead-time effective in 27 and 30 cases, respectively. This difference was not statistically significant. The combination of SCC and TPS provided lead-time effects in 42 cases. Our data indicate that combination of TPS and SCC is a valuable tool in the early predicting recurrent cervical cancer.

Impaired gallbladder function in spinal cord injury on quantitative Tc-99m DISIDA cholescintigraphy

BACKGROUND

Patients with spinal cord injury (SCI) have increased prevalences of gallstones and acute acalculous cholecystitis. A possible explanation for the increased prevalence of gallstone disease in SCI patients is decreased gallbladder motility causing gallbladder stasis, a known risk factor for gallstone disease. We investigated gallbladder function in SCI.

METHODS

Twenty-five normal control subjects and 50 SCI patients were included in this study. Gallbladder function was measured by technium 99m-labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy and represented by the filling fraction (FF) and the ejection fraction (EF). The SCI patients were assigned to subgroups: old versus young, female versus male, high- versus low-level injury, and long versus short injury duration.

RESULTS

Forty-two percent of SCI patients had abnormal FFs and 54% of SCI patients had abnormal EFs. Significantly decreased FF and EF values were found in SCI patients, especially in those who were female and had high-level injuries.

CONCLUSION

With the use of quantitative Tc-99m DISIDA cholescintigraphy, we found that SCI can significantly impair gallbladder function.

Left ventricular cavity-to-myocardium count ratio in exercise and resting technetium-99m-tetrofosmin SPECT: correlation with left ventricular function

The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio) calculated in exercise and resting technetium-99m (Tc-99m) tetrofosmin single photon emission computed tomography (SPECT) images to identify patients with depressed exercise and resting left ventricular ejection fraction (LVEF). We studied 60 patients with recent coronary artery diseases (CAD) undergoing first-pass ventriculography to calculate LVEF and myocardial perfusion SPECT imaging to calculate left ventricular C/M ratios. The group A of 30 CAD patients with higher LVEF (> or = 40%) had significant higher C/M ratios than the group B of 30 CAD patients with abnormal LVEF (< 40%) during exercise and rest. However, C/M ratios between exercise and rest did not differ significantly in the both groups A and B. There is significant correlation between exercise/rest LVEF and exercise/rest C/M ratios. Tc-99m tetrofosmin C/M ratios calculated SPECT perfusion images are useful parameters in identifying patients with depressed LVEF in CAD patients.