The effect of resveratrol on protecting corneal epithelial cells from cytotoxicity caused by moxifloxacin and benzalkonium chloride

PURPOSE

Moxifloxacin (MOX), a fourth generation fluoroquinolone (FQ), has a wide antibacterial spectrum, but may show cytotoxicity characterized by high productions of reactive oxygen species (ROS). This study investigated the protective role of a common antioxidant agent, resveratrol (trans-3,5,4'-trihydroxystilbene), against the cytotoxicity caused by MOX.

METHODS

Experiments were performed with a human corneal epithelial cell line (HCECs; ATCC-CRL-11515). Another commonly used FQ, levofloxacin (LEV), and the most commonly used preservatives, benzalkonium chloride (BAC), were also used for comparison with MOX. Cell viability and morphologic changes after treatment were evaluated with trypan blue exclusion assay, propidium iodine/annexin V-FITC staining, and flow cytometry. Chemiluminescence immunoassay was used for ROS quantification. MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, wound healing assay, and intracellular detections of oxidative stress were performed to evaluate the effects of resveratrol.

RESULTS

The MOX group, similar to the BAC group, showed significant cell shrinkage and death compared with the LEV group. High ROS production in HCECs of MOX group was observed both by chemiluminescence immunoassay and intracellular images. Within the observations of MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] assay, live cell images, and wound healing process in vitro, the cytotoxic effects of the MOX and BAC groups were opposed by resveratrol. Human corneal epithelial cells pretreated with resveratrol demonstrated better cell viability and healing rate in the early stage.

CONCLUSIONS

The protective effects of antioxidant agents indicate that MOX, similar to BAC, causes oxidative stress-related cell damage. The results also inspired us to think about a "supplementary regimen" to increase safety and decrease the adverse effect in the treatment of corneal infections.

Design and testing of a uniformly solar energy TIR-R concentration lenses for HCPV systems

In this paper, total internal reflection-refraction (TIR-R) concentration (U-TIR-R-C) lens module were designed for uniformity using the energy configuration method to eliminate hot spots on the surface of solar cell and increase conversion efficiency. The design of most current solar concentrators emphasizes the high-power concentration of solar energy, however neglects the conversion inefficiency resulting from hot spots generated by uneven distributions of solar energy concentrated on solar cells. The energy configuration method proposed in this study employs the concept of ray tracing to uniformly distribute solar energy to solar cells through a U-TIR-R-C lens module. The U-TIR-R-C lens module adopted in this study possessed a 76-mm diameter, a 41-mm thickness, concentration ratio of 1134 Suns, 82.6% optical efficiency, and 94.7% uniformity. The experiments demonstrated that the U-TIR-R-C lens module reduced the core temperature of the solar cell from 108 °C to 69 °C and the overall temperature difference from 45 °C to 10 °C, and effectively relative increased the conversion efficiency by approximately 3.8%. Therefore, the U-TIR-R-C lens module designed can effectively concentrate a large area of sunlight onto a small solar cell, and the concentrated solar energy can be evenly distributed in the solar cell to achieve uniform irradiance and effectively eliminate hot spots.

Increased densities of resting and activated microglia in the dentate gyrus follow senile plaque formation in the CA1 subfield of the hippocampus in the triple transgenic model of Alzheimer's disease

Alzheimer's disease (AD) is an irreversible neurodegenerative disease that is characterised by the presence of β-amyloid (Aβ) plaques, neurofibrillary tangles (NFTs) and synaptic loss specifically in brain regions involved in learning and memory such as the neocortex and the hippocampus. Aβ depositions in the form of neuritic plaques trigger activation of microglia that is believed to be a common neuropathological feature of AD brains. As an integral part of the hippocampus, the dentate gyrus (DG) plays an important role in cognitive function. Although post-mortem studies suggest later involvement of the DG into the AD progression, changes in microglia have not been studied in this subfield of the hippocampus. In the present study the numerical density (Nv, #/mm(3)) of both resting (identified by tomato lectin staining) and activated (identified by Mac-1 immunoreactivity) microglia was analysed in the molecular layer (ML) of the DG in the triple transgenic (3xTg-AD) mouse model of AD at different ages (9, 12 and 18 months). The 3xTg-AD mouse model of AD showed a significant increase in the Nv of resting (by 75%) and activated (by 67%) at 18 months of age compared to non-Tg controls. These results indicate a complex microglial remodelling during AD progression.

Topology of feather melanocyte progenitor niche allows complex pigment patterns to emerge

Color patterns of bird plumage affect animal behavior and speciation. Diverse patterns are present in different species and within the individual. Here, we study the cellular and molecular basis of feather pigment pattern formation. Melanocyte progenitors are distributed as a horizontal ring in the proximal follicle, sending melanocytes vertically up into the epithelial cylinder, which gradually emerges as feathers grow. Different pigment patterns form by modulating the presence, arrangement, or differentiation of melanocytes. A layer of peripheral pulp further regulates pigmentation via patterned agouti expression. Lifetime feather cyclic regeneration resets pigment patterns for physiological needs. Thus, the evolution of stem cell niche topology allows complex pigment patterning through combinatorial co-option of simple regulatory mechanisms.

Module-based complexity formation: periodic patterning in feathers and hairs

Patterns describe order which emerges from homogeneity. Complex patterns on the integument are striking because of their visibility throughout an organism’s lifespan. Periodic patterning is an effective design because the ensemble of hair or feather follicles (modules) allows the generation of complexity, including regional variations and cyclic regeneration, giving the skin appendages a new lease on life. Spatial patterns include the arrangements of feathers and hairs in specific number, size, and spacing.We explorehowa field of equivalent progenitor cells can generate periodically arranged modules based on genetic information, physical–chemical rules and developmental timing. Reconstitution experiments suggest a competitive equilibrium regulated by activators/inhibitors involving Turing reaction-diffusion. Temporal patterns result from oscillating stem cell activities within each module (microenvironment regulation), reflected as growth (anagen) and resting (telogen) phases during the cycling of feather and hair follicles. Stimulating modules with activators initiates the spread of regenerative hair waves, while global inhibitors outside each module (macroenvironment) prevent this. Different wave patterns can be simulated by cellular automata principles. Hormonal status and seasonal changes can modulate appendage phenotypes, leading to ‘organ metamorphosis’, with multiple ectodermal organ phenotypes generated from the same precursors. We discuss potential novel evolutionary steps using this module-based complexity in several amniote integument organs, exemplified by the spectacular peacock feather pattern. We thus explore the application of the acquired knowledge of patterning in tissue engineering. New hair follicles can be generated after wounding. Hairs and feathers can be reconstituted through self-organization of dissociated progenitor cells.

Population dose from medical diagnostic exposure in Taiwan

Medical exposure showed a continuous increasing trend. This trend was due to the growth of diagnostic procedures such as computed tomography (CT) and interventional fluoroscopy (IVF). In the present work, results of a recent study on medical exposure in Taiwan are reported. This study analysed data from the National Health Insurance Research Database. Surveyed data on the dose indices, including the entrance surface dose in radiography, dose area product in fluoroscopy, CT dose index in CT and mean glandular dose in mammography, were applied. Using programmes and databases, dose indices were converted to the effective dose. For the year 2008, individual effective doses in Taiwan were estimated as 0.16, 0.37, 0.12 and 0.12 mSv for conventional radiography and fluoroscopy, CT, IVF and nuclear medicine, respectively. The total collective effective dose and the effective dose per individual for medical exposure were 17 788 person-Sv and 0.77 mSv, respectively.

Natural frequency assessment of stability of root keeper magnetic devices

The aim of the study was to evaluate the potential for using natural frequency (NF) as an indicator for assessing the stability of a magnetic keeper device used in prosthodontic treatment. A three-dimensional finite element (FE) model of a root keeper-cement-dentine system was established for NF analysis. The model was first validated against a series of in vitro experiments. Then, NF values of the first vibrational mode of the FE model with various boundary conditions were calculated. The in vitro results showed that the measured NF values of the root keeper-incisor units decreased significantly (p<0.01) from 9.07 +/- 0.37 to 5.73 +/- 0.10 kHz when the units were embedded in simulated bony tissue. Results obtained from FE simulations demonstrated that the root keeper would fully loosen when the constant values of the spring elements were lower than 10(4) N-m(-1). Furthermore, a linear increase in the NF values of the model was observed from 6.16 to 15.52 kHz, when the constant was increased from 10(4) to 10(7) N-m(-1), and the values then reached a plateau. The results indicate that the NF value of a root keeper has the potential to be used for monitoring the stability of such a device.

Electromyographic findings of paradoxical puborectalis contraction correlate poorly with cinedefecography

BACKGROUND

Both intra-anal sponge electromyography (SEMG) and needle electromyography (NEMG) are used to diagnose paradoxical puborectalis contraction (PPC). The aim of this retrospective study was to assess the correlation among SEMG and NEMG and cinedefecography (CD) in the diagnosis of PPC.

METHODS

Between 1992 and 1999, a total of 261 constipated patients underwent both CD and EMG: 64 had NEMG while 197 had SEMG. PPC was diagnosed by EMG when there was failure to achieve a significant decrease in electrical activity of the puborectalis muscle during attempted evacuation. CD criteria for PPC included lack of straightening of the anorectal angle or persistence of the puborectalis impression during evacuation. CD was considered diagnostic and EMG results were thus compared with those of CD. Agreement was calculated using the kappa statistics (kappa) for concordance.

RESULTS

Both NEMG and SEMG had low positive predictive rates (33% in NEMG, 28% in SEMG) and high negative predictive rates (91% in NEMG, and 78% in SEMG) when correlated with CD findings. Agreement between NEMG and CD was noted in 46 of 64 patients (72%, kappa=0.274) while there was agreement between SEMG and CD in 120 of 197 patients (61%; kappa=0.067); p>0.05 needle vs. sponge.

CONCLUSION

Although both NEMG and SEMG have a low positive predictive values, they have high negative predictive value for PPC. Therefore, neither NEMG nor SEMG alone are optimal tests for diagnosing the presence of PPC.

Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan

This study reports the clinical psychiatric presentations and post-traumatic symptoms among 525 survivors at Yu-Chyr District in Nantou County who sought psychiatric service in the first month following the devastating earthquake that struck the central area of Taiwan. All subjects received psychiatric interviews and assessments using the 12-item Chinese Health Questionnaire (CHQ-12) and a checklist for post-traumatic symptoms. The most common psychiatric symptoms reported were insomnia, palpitations, nervousness, and dizziness with headache. Eleven percent of the subjects reported having thought of death or having suicidal ideation. The mean score on the CHQ-12 was 6.43 (S.D.=2.89). The rate of probable psychiatric morbidity as defined by a CHQ-12 score > or =3 was 89.9%. Post-traumatic symptoms were very prevalent, particularly symptoms of re-experiencing the earthquake and hyper-arousal. Factors significantly associated with high psychiatric morbidity were being female, serious destruction of property and house, and personality characteristics of nervousness and obsessiveness. Findings of this study suggest that early psychiatric intervention, including pharmacological treatment for acute stress disorder, is indicated during the early stages following a disastrous earthquake.

Natural frequency analysis of periodontal conditions in human anterior teeth

The purpose of this study was to evaluate the possibility of using natural frequency (NF) analysis to detect the attachment loss of periodontal tissue. In this study, 698 anterior teeth were examined by a conventional probing method and also by NF analysis. The teeth were triggered to vibrate with an impulse hammer, and the vibrational response was detected by an acoustic sensor. Our results demonstrate no significant difference in NF values between the upper-lower/left-right quadrants of the tested teeth, although the mean natural frequency value of central incisors with periodontal disease was found to be 1.24 +/- 0.11 kHz which is significantly lower than that of teeth in a healthy condition (1.34 +/- 0.20kHz; p < 0.01). On the other hand, the mean frequency for periodontal disease involving canines (1.28 +/- 0.09 kHz) was also significantly lower than the corresponding value for healthy analogs (1.35 +/- 0.17 kHz; p < 0.05). These results suggest that NF analysis appears to be an effective method for assessing the periodontal condition of anterior teeth. Moreover, since this method is noninvasive, nondestructive, and necessitates minimal tooth contact, it can serve as an effective method for the early quantifiable testing and prevention of periodontal disease.

Association of sex, adiposity, and diet with HDL subclasses in middle-aged Chinese

BACKGROUND

There is limited information regarding the associations of lifestyle factors and sex with HDL subclasses containing apolipoprotein (apo) A-I (Lp A-I) and both apo A-I and apo A-II (Lp A-I:A-II).

OBJECTIVE

We sought to examine the relations between 2 major HDL subclasses and sex, menopausal status, nutrient intakes, and adiposity.

DESIGN

We conducted interviews and measured blood variables in 409 government employees aged 40-59 y in Taiwan.

RESULTS

Women (n = 203) had significantly higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did men (n = 206). Postmenopausal women (n = 72) had higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did premenopausal women (n = 131). Body mass index and waist-to-hip ratio were strong predictors of and exerted an independent additive effect on Lp A-I concentrations in both men and women. However, body adiposity was associated with Lp A-I:A-II concentrations only in men. Waist-to-hip ratio was an independent determinant of Lp A-I but not of Lp A-I:A-II in men and postmenopausal women after adjustment for age, body mass index, smoking, and diet. Although there were relatively weak associations between dietary factors and both HDL subclasses (r = 0.01-0.26) in men and women according to bivariate analyses, multiple regression models showed that total fat, saturated fat, and cholesterol intakes were significantly correlated with HDL cholesterol and both Lp A-I and Lp A-I:A-II in men, but not in women.

CONCLUSION

Our data suggest that body adiposity and dietary fat consumption affect 2 major HDL subclasses differently depending on subject sex and menopausal status.

Prospective study comparing wounds closed with tape with sutured wounds in colorectal surgery

HYPOTHESIS

To test the efficacy of adhesive paper tape in the closure of clean-contaminated wounds following elective colorectal resection.

DESIGN

A prospective, nonrandomized controlled study.

SETTING

A medical center that offers a mixture of primary, secondary, and tertiary care services.

PATIENTS

The group undergoing skin closure with paper tape (PT group) consisted of 150 patients. The group undergoing skin closure with interrupted suture (IS group) also comprised 150 patients. All 300 patients underwent elective colorectal resection in 1997.

MAIN OUTCOME MEASURES

The duration of skin closure, wound complication rate, and cosmetic appearance of the scar at 6 months after operation were compared using the chi(2)test or t test.

RESULTS

The mean +/- SD average duration of skin closure was 116 +/- 23 seconds for the PT group and 457 +/- 64 seconds for the IS group (P<.01). The wound complication rate was 3.3% (3 cases with wound infection; 2 with wound separation) for the PT group and 3.3% (5 cases with wound infection) for the IS group (P = 1.0). No significant differences were found between the narrowest width (mean +/- SD, 2.2 +/- 0.9 mm vs 2.3 +/- 1.0 mm) and widest width (mean +/- SD, 4.7 +/- 2.0 mm vs 4.3 +/- 1.8 mm) of scar formation between the 2 groups at 6 months after the operation. Ninety-eight percent of patients in the PT group reported satisfaction with their scar, compared with 92% in the IS group (P =.03).

CONCLUSION

Compared with the traditional suture method, paper tape closure in the treatment of clean-contaminated wounds was less time consuming and produced greater patient satisfaction with no increased rate of wound complications.

Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients

The control of spasticity is often a significant problem in the management of patients with spasticity. The aim of this study was to evaluate the effect of a single session of prolonged muscle stretch (PMS) on the spastic muscle. Seventeen patients with spastic hemiplegia were selected to receive treatment. Subjects underwent PMS of the triceps surae (TS) by standing with the feet dorsiflexed on a tilt-table for 30 minutes. Our test battery consisted of four measurements including the modified Ashworth scale of the TS, the passive range of motion (ROM) of ankle dorsiflexion, the H/M ratio of the TS, and the F/M ratio of the tibialis anterior (TA). The results indicated that the passive ROM of ankle dorsiflexion increased significantly (p < 0.05) compared to that before PMS treatment. Additionally, PMS reduced motor neuron excitability of the TS and significantly increased that of the TA (p < 0.05). These results suggest that 30 minutes of PMS is effective in reducing motor neuron excitability of the TS in spastic hemiplegia, thus providing a safe and economical method for treating stroke patients.

Factors influencing the dynamic behaviour of human teeth

Modal analysis is carried out to test the natural frequencies of certain human teeth, including central incisors (CIs), canines (CAs), first premolars (FPs) and first molars (FMs). A total number of 1007 teeth are tested, taking into account tooth type, oral location, age and gender, to analyse the effects of the above-mentioned factors on the natural frequency of the sample teeth. The results reveal that no significant difference in the natural frequency is noted among teeth in the four different intra-oral quadrants. Nevertheless, tooth type and age elicit an effect upon the value of the natural frequency of teeth. On the other hand, the mean value for the natural frequency of CIs (1.27 +/- 0.15 kHz), CAs (1.30 +/- 0.15 kHz), FPs (1.27 +/- 0.15 kHz) and FMs (1.16 +/- 0.12 kHz) for males are significantly lower (p < 0.01) than the analogous figure for females (1.41 +/- 0.21 kHz for CIs, 1.40 +/- 0.18 kHz for CAs, 1.37 +/- 0.20 kHz for FPs, and 1.25 +/- 0.16 kHz for FMs). Moreover, the natural frequency of teeth in male subjects varies with age (p < 0.05). The highest mean frequency of CIs, CAs and FPs for the male subjects is found for the group aged between 40 and 49 years. On the other hand, the natural frequency for the similar set of teeth for the female subjects is shown to be in no way associated with age.

Mussel watch: a review of Cu and other metals in various marine organisms in Taiwan, 1991-98

This study presents the distribution of Cu, Zn, Pb, Cd, Hg and As in various marine organisms collected along the western coast of Taiwan from 1991 to 1998, and also evaluates the time variation of Cu in oysters before (1980-85) and after (1986-98) the "green oyster" incident. The results show that relatively high geometric mean (GM) concentrations of Cu, Zn, Pb, Cd, As and Hg were generally found in Crassostrea gigas (Cu=229 microg/g, Zn=783 microg/g), Gomphina aeguialtera (Pb=30.3 microg/g), Tegillarca granosa (Cd=2.85 microg/g), Thais clavigera (As=96.9 microg/g) and Parapenaeopsis cornuta (Hg=1.35 microg/g), respectively. Especially, maximum Cu and Zn concentrations (GM=229 and 783 microg/g, respectively) in oysters (C. gigas) from different culture areas were much higher than those of the other organisms by about 1.13-458 and 2.40-63.7 times, respectively. Similarly, rock-shells (Thais clavigera) had a high capacity for accumulating Cu (GM=202 microg/g) and Zn (GM=326 microg/g) under the same physico-chemical conditions. The highest GM Cu and Zn concentrations of 1108 (range from 113 to 2806) and 1567 (range from 303 to 3593) microg/g were obtained in oysters from the Hsiangshan coastal area, one of the most important oyster culture areas in Taiwan. However, the highest GM Cd and As concentrations of 6.82 and 19.3 microg/g were found in oysters from the Machu Islands. Mean Cu concentrations in the oysters from the Erhjin Chi estuary declined from 2194+/-212 microg/g in 1986-90 to 545 microg/g (GM) in 1991-96. In the Hsiganshan area, GM Cu concentrations of 909 microg/g (1991-96) and 1351 microg/g (1997-98) in oysters were significantly higher than those of 201 microg/g (1980-85) and 682 microg/g (1986-90). The gradually increasing levels of Cu and Zn in the oysters from the Hsiangshan area have been observed year by year.

Surgical outcome after curative resection of rectal leiomyosarcoma

PURPOSE

The aim of this study is to present the prognosis and possible associated prognostic factors after curative resection of rectal leiomyosarcoma.

METHODS

From 1979 to 1996 our hospital saw 40 patients with rectal leiomyosarcoma, including 19 females, who did not have metastasis initially and received curative resection and regular postoperative follow-up.

RESULTS

The mean age of the 40 patients was 58.7 years. Anal bleeding and perianal pain were the two most common symptoms at initial diagnosis. Twenty-nine patients received a radical surgical resection, such as abdominoperineal resection or low anterior resection; the other 11 patients received a wide local excision, such as transrectal excision or Kraske's operation. Sixteen tumors were classified as high-grade leiomyosarcoma, and 23 as low grade. Nineteen patients (48 percent) developed recurrence or metastasis postoperatively (median follow-up, 35 months). The overall and disease-free (1-year, 3-year, and 5-year) survival rates were 97, 90, and 75 percent and 90, 59, and 46 percent, respectively. In univariate analysis, younger group (<50 years, n = 9, P = 0.033) and high-grade leiomyosarcoma (P = 0.043) showed poorer prognosis in the disease-free survival curve. In the multivariate Cox model, gender, tumor size, tumor location, and operation type did not significantly affect disease-free survival, whereas histologic grade (P = 0.037) and age divided by a level of 50 years (P = 0.009) were shown to be independent factors. There was a strong trend toward higher local recurrence rate for the wide local excision group than for the radical resection group (55 vs. 24 percent, P = 0.067) despite the wide local excision group being composed of smaller tumors (5.1 vs. 7.5 cm, P = 0.069). There was no difference in the incidence of distant metastasis between the two groups with different operation types. The metastasis rates of the wide local excision and radical resection groups were 27 and 38 percent, respectively.

CONCLUSION

A younger age (<50 years) and a high histologic grade of tumor were the two most significant poor prognostic factors for rectal leiomyosarcoma. Radical resection may be superior to wide local excision in the prevention of local recurrence but not distant metastasis.

Identification of a fibronectin binding protein from Streptococcus mutans

The interaction of viridans streptococci with components of the extracellular matrix (ECM) plays an important role in the pathogenesis of infective endocarditis. We have identified a surface protein of Streptococcus mutans which binds the ECM constituent fibronectin (Fn). Initially, we found that S. mutans could adsorb soluble Fn in plasma, but with lower efficiency than Streptococcus pyogenes. In addition, S. mutans could bind immobilized Fn in a dose-dependent manner when tested using an enzyme-linked immunosorbent assay. Crude extracts of cell wall-associated proteins or extracellular proteins from S. mutans MT8148 specifically bound Fn through a protein with the molecular mass of ca. 130 kDa, as detected by far-Western immunoblotting. The candidate Fn binding protein (FBP-130) was purified to near homogeneity by using Fn coupled Sepharose 4B affinity column chromatography. A rabbit polyclonal antibody against FBP-130 reacted specifically with a protein of molecular mass of ca. 130 kDa in both cell wall and extracellular fractions, and the abundance of FBP was higher in the former than in the latter fractions. The purified FBP bound specifically to immobilized Fn, whereas the binding of soluble Fn to coated FBP could only be detected in the presence of high concentrations of Fn. The purified FBP, as well as anti-FBP immunoglobulin G, inhibited the adherence of S. mutans to immobilized Fn and endothelial cells (ECV304) in a dose-dependent manner. These results demonstrated that FBP-130 mediated the adherence of S. mutans specifically to Fn and endothelial cells in vitro. The characteristics of S. mutans and FBP-130 in binding Fn confirmed that viridans streptococci adopt different strategies in their interaction with ECM.

Anterior ankle-foot orthosis effects on postural stability in hemiplegic patients

OBJECTIVES

To evaluate the effects of an anterior ankle-foot orthosis (AFO) on static and dynamic postural stability in hemiplegic patients.

DESIGN

A cross-sectional assessment of hemiplegic subjects with and without an AFO.

SETTING

Outpatient department of a rehabilitation hospital.

PATIENTS

A convenience sample of 24 subjects who had been prescribed an anterior AFO.

OUTCOME MEASURES

Postural sway index and postural symmetry (body weight distribution through the affected leg) when standing were measured as static postural stability. Maximal balance range in anterior-posterior and lateral directions and the affected leg's weight bearing after weight shift to affected side were measured as dynamic postural stability.

RESULTS

When wearing the anterior AFO, there was no significant difference and small effect size (r<0.3) in postural sway index (p = .35), postural symmetry (p = .21), and maximal balance range in anterior-posterior direction (p = .46). There was a significant improvement and large effect size (r>0.5) in lateral weight shifting (p<.01) and weight bearing through the affected leg after weight shifted to the affected side (p<.01).

CONCLUSIONS

The significant effects of the anterior AFO in long-term hemiplegic patients were on lateral weight shifting and weight bearing through affected leg after weight shifted to the affected side. Postural sway, postural symmetry, and anterior-posterior weight shifting were not significantly affected.

Prognostic value of anti-Epstein-Barr virus antibodies in nasopharyngeal carcinoma (NPC)

INTRODUCTION

Epstein-Barr virus (EBV) is a ubiquitous human herpes virus with worldwide infection. It is associated with Burkitt's lymphoma in Africa and nasopharyngeal cancer (NPC) in Asian countries. EBV-coded DNA was found to be present in epithelial elements of NPC, and is usually associated with non-keratinizing (WHO type II) or undifferentiated carcinoma (WHO type III). Transcriptional analyses of EBV genome expression in NPC demonstrate an activated viral state in some of these tumors, leading to elevated levels of serum anti-viral capsid antigen (VCA) antibody in NPC patients.

METHODS

Eighty patients with histological diagnoses of NPC according to the 1978 WHO classification were referred to the Department of Radiation Oncology at Chang-Hua Christian Hospital for curative radiotherapy from 1985 to 1995. The patients were staged according to the AJCC staging system. A mean dose of 7,020 cGy in 39 fractions was delivered to the primary tumor using a telecobalt-60 unit or 6-10 MV X-ray linear accelerator. Pre- and postradiotherapy serum levels of anti-EBV/VCA IgG and IgA were determined for all patients using the indirect immunoperoxidase assay (IPA). Multivariate analysis was done to determine which factors affected the patients' treatment outcome and survival.

RESULTS

Five patients were excluded from this study due to incomplete radiotherapy, leaving 75 patients eligible for analysis. Overall local control was 77.3%, with a mean disease-free interval of 19.7 months. Factors affecting local control included radiation dose and pretreatment anti-EBV/VCA IgG titer. The overall 5-year actuarial survival for the 75 patients was 75%, with a median survival of 129.5 months. The 5-year actuarial survival rates for stage I + II, III, and IV patients were 90%, 40%, and 45%, respectively. Prognostic factors for survival included tumor histological type and pretreatment anti-EBV/VCA IgA titer, while prognostic factors for local control included total radiation dose received and pretreatment anti-EBV/VCA IgG titer.

CONCLUSION

We found that there was a significant difference in the geometric mean titer of anti-EBV/VCA IgA antibodies before and after radiotherapy. Prognostic factors affecting NPC patients' actuarial survival included tumor histology and pretreatment IgA titer, while prognostic factors for local control of NPC included total radiation dose received and pretreatment IgG titer.

Stapled colonic J-pouch-anal anastomosis without a diverting colostomy for rectal carcinoma

PURPOSE

Colonic J-pouch reconstruction is designed to improve functional outcome of coloanal anastomosis. Most surgeons use a diverting colostomy to avoid severe pelvic sepsis caused by anastomotic breakdown.

METHODS

We report the outcome of 30 consecutive patients with colonic J-pouch-anal anastomosis without a diverting colostomy performed between November 1992 and October 1993. All patients had carcinoma of the lower two-thirds of the rectum. Patients were seen every three months. Functional results were compared with those of 21 rectal cancer patients with straight coloanal anastomosis who underwent surgery in the same period and 20 normal patients.

RESULTS

There were two anastomotic leakages and one postoperative death. After one year, patients with pouch anastomosis had significantly less frequency of defecation and rectal urgency compared with those with straight anastomosis (P < 0.01); 48 percent of patients with straight anastomosis had more than five bowel movements per day, whereas all patients with pouch anastomosis had five or less bowel movements per day. Manometric studies showed maximum tolerable volume was significantly higher in patients with pouch anastomosis (81 vs. 152 ml; P < 0.01).

CONCLUSIONS

Stapled colonic J-pouch-anal anastomosis without a diverting colostomy is a reliable procedure that provides good, long-term functional results.

Monitoring lead pollution near a storage battery recycling plant in Taiwan, Republic of China

This study presents the distribution of blood lead levels and lead in various environmental samples (water, sediments, soils, and air) near the Shing-Yie storage battery recycling plant in Taiwan before (July 1990 to June 1991) and after (July 1992 to June 1993) amelioration. Before amelioration, the average blood lead levels in the neighborhood of the plant were in the range of 10.55 +/- 5.7 to 12.28 +/- 7.9 micrograms/dl. After amelioration, relatively lower average concentrations of blood lead (range 8.35 +/- 3.0 to 9.13 +/- 2.5 micrograms/dl) were generally found; however, these averages were still higher than that (7.79 +/- 3.5 micrograms/dl) from other lead-unpolluted areas of Taiwan. An exceedingly high geometric mean (GM) lead concentration (128 micrograms/L) was found in the downstream river water of the Tawulum River passing by the plant. The concentrations of lead (GM = 372 and 418 micrograms/g) in the downstream river sediments were higher than those (GM = 123 and 158 micrograms/g) in the upstream river sediments before and after amelioration, respectively. Furthermore, lead species in river sediments were analyzed by a sequential leaching technique. The sum of phases I, II, and III accounted for 83.7% of total lead at station R2 (nearest to the plant). Maximum lead concentration (GM = 2402 micrograms/g) in dust at the soil surface from station S1 (nearest to the plant) was much higher than those from the other stations by about 18 times before amelioration. However, the maximum value dropped to 1,155 micrograms/g after amelioration. On the whole, the geometric mean concentration of lead in dust at the soil surface nearest to the plant was > 1,000 micrograms/g and decreased to < 100 micrograms/g in the 15-30 cm depth soil about 2 km away from the plant. Before amelioration, the geometric mean lead concentration of 4.57 micrograms/m3 (range 0.102-37.6 micrograms/m3) in the air near the plant was higher than that at the background locations, the geometric mean value of which was 0.08 micrograms/m3.