Anisotropy of the Sommerfeld coefficient in magnesium diboride single crystals

The anisotropic field dependence of the Sommerfeld coefficient gamma has been measured down to B-->0 by combining specific heat and Hall probe magnetization measurements in MgB2 single crystals. We find that gamma(B,theta) is the sum of two contributions arising from the sigma and pi band, respectively. We show that gammasigma(B,theta)=B/Bc2(theta) where Bc2(theta)=Bc2ab/sqrt[sin2theta+Gamma2cos2theta] with Gamma approximately 5.4 (theta being the angle between the applied field and the c axis) and gammapi(B,theta)=gammapi(B)=B/Bpi(B). The "critical field" of the pi band Bpi is fully isotropic but field dependent increasing from approximately 0.25 T for B< or =0.1 T up to 3 T approximately Bc2c for B-->3 T. Because of the coupling of the two bands, superconductivity survives in the pi band up to 3 T but is totally destroyed above for any orientation of the field.

The effect of Epstein-Barr virus status on clinical outcome in Hodgkin's lymphoma

The association of Epstein-Barr virus (EBV) with Hodgkin's lymphoma (HL) has been investigated over the last few years. The impact of EBV on clinical outcome is still controversial, however. In this study, we investigated the effect of EBV status on clinical outcome of HL patients. Between January 1986 and September 2004, fifty-six patients, diagnosed as having HL, were included in the analysis. Clinical data were reviewed retrospectively from the patients' records. Tissues from 56 patients were analyzed for the presence of EBV using the in situ hybridization (ISH) for EBV-encoded RNA (EBER) and immunohistochemistry for latent membrane protein (LMP)1. EBV infection was identified in 41.1% of cases by EBER ISH, 26.8% by LMP1 expression, and 26.8% by LMP1 and EBER ISH. EBER-positive HL were significantly more frequent in mixed cellularity (MC) subtype (P=0.014) and advanced stage (P=0.034). There was a trend toward shorter overall survival in EBER-positive patients without statistical significance (P=0.238). LMP1 expression also correlated with MC subtype (P=0.006) and advanced stage (P=0.007), although it did not significantly influence the survival outcome. In subgroup analysis, both EBER and LMP1 positivities were associated with longer progression-free survival in patients with age <25 years old (P=0.045). Reverse trends were shown in patients > or =25 years old. In this study, we demonstrated that the impact of tumor EBV status on prognosis may be age dependent and young patients with latent EBV infection have favorable prognosis.

Temperature-based rapid toxicity test using Ceriodaphnia dubia

Toxicants, which may cause the inhibition to the biological process in sewage/wastewater treatment plant, need to be monitored within short time to prevent from serious damage. A new method, Temperature-based rapid toxicity test (TempTox test) using Ceriodaphnia dubia, was developed and compared with the standard 48 hr acute bioassay (Std. 48-hr test). Inorganic toxicants of cadmium, zinc, copper, cyanide, chromium (III), chromium (VI) and organic toxicants of phenol, PCP and pesticides of BPMC, Diazinon, Fenitrothion were tested for TempTox test and Std. 48-hr test. Because the TempTox test is based on just temperature control, C. dubia neonates were exposed to toxicants under high temperature (35.5 degrees C) condition without any complicated pretreatment. After given exposure time of 1, 1.25, 1.5 hours, the number of the live (no toxic effect) or the dead (toxic effect) was counted with eye without the aid of any microscope and median effective concentrations (EC50 values) were determined. From the results for all toxicants, the TempTox test was proved to be as sensitive as the Std. 48-hr test with shorter-time of just 1.25-1.5 hours. Moreover, the TempTox test was further much more sensitive than alternative bioassays such as the 1-hour l.Q. test and 30-minute Microtox. The TempTox test showed a high applicability of toxicity bioassay for real sewage/wastewater treatment plant by its easiness, rapidity and sensitivity. Finally, the prototype for short-term TempTox test was introduced.

Nasal-type NK/T cell lymphoma: clinical features and treatment outcome

Nasal-type NK/T cell lymphoma is an increasingly recognised disease entity of aggressive clinical behaviour. The objective of this study was to investigate clinical features and treatment outcomes in patients with nasal-type NK/T cell lymphoma. From January 1991 to December 2003, 26 patients diagnosed as nasal-type NK/T cell lymphoma were included in the analysis. One half of patients presented with poor performance status (ECOG ⩾2); 46% of patients were categorised as high intermediate or high-risk group according to IPI; and 46% of patients were diagnosed at advanced stage. The median survival for 26 patients with nasal-type NK/T cell lymphoma was 7.4 months (95% CI, 0.1, 16.9). The treatment outcome of primary anthracycline-based chemotherapy was poor: 60% CR rate in localised disease and 0% CR rate in advanced disease. After a median follow-up of 24.4 months (range 3.1–99.0) in patients with localised disease who had achieved a CR (range 29.6–165.7), three patients (50.0%) developed disease recurrence at 6.1, 21.8, and 52.1 months, respectively, and all patients presented with locoregional failure. The predictive factors for poor survival were of age greater than 60, advanced stage and poor performance in multivariate analysis. In conclusion, Nasal-type NK/T cell lymphomas showed a poor response to the conventional anthracycline-based chemotherapy, and thus an investigation for an innovative therapy is urgently needed to improve survival in these patients.

Complex dynamics of carbon nanotube probe tips

Carbon nanotube (CNT) tips in tapping mode atomic force microscopy (AFM) enable very high-resolution imaging, measurements, and manipulation at the nanoscale. We present recent results based on experimental analysis that yield new insights into the dynamics of CNT probe tips in tapping mode AFM. Experimental measurements are presented of the frequency response and dynamic amplitude-distance data of a high-aspect-ratio multi-walled (MW) CNT tip. Higher harmonics of the microcantilever are measured in frequency ranges corresponding to attractive regime and the repulsive regime where the CNT buckles dynamically. Surface scanning is performed using a MWCNT tip on a SiO(2) grating to verify the imaging instabilities associated with MWCNT buckling when used with normal control schemes in the tapping mode. Lastly, the choice of optimal setpoints for tapping mode control using CNT tip are discussed using the experimental results.

A phase II trial of capecitabine in previously untreated patients with advanced and/or metastatic gastric cancer

BACKGROUND

Capecitabine (Xeloda) is a novel, oral, selectively tumor-activated fluoropyrimidine with proven activity in the treatment of advanced colorectal cancer. This trial was conducted to evaluate the efficacy, safety and feasibility of capecitabine in previously untreated patients with advanced and/or metastatic gastric cancer, with a view to replacing 5-fluorouracil (5-FU) in such patients.

PATIENTS AND METHODS

Forty-four patients received capecitabine 1250 mg/m2 twice daily (2500 mg/m2/day) for 14 days followed by 7 days of rest, for up to six cycles.

RESULTS

Capecitabine produced an objective response rate of 34% (all partial responses) and stable disease in 14 patients (30%). The median time to disease progression (TTP) was 3.2 months [95% confidence interval (CI) 2.7-6.4 months] and median overall survival was 9.5 months (95% CI 6.9-13.2 months). Hand-foot syndrome (HFS), nausea, anorexia, diarrhea and vomiting were the most common adverse events. While HFS was the most frequent grade 3/4 toxicity (National Cancer Institute Common Toxicity Criteria), only 9% of patients experienced grade 3 HFS. Severe myelosuppression was not reported during the study.

CONCLUSIONS

Capecitabine monotherapy is active and well tolerated as first-line therapy in patients with advanced/metastatic gastric cancer. Larger comparative trials investigating capecitabine-based combination regimens in patients with advanced gastric cancer are warranted.

Effect of temperature and dissolved oxygen on biological nitrification at high ammonia concentrations

Effect of temperature and dissolved oxygen concentration on nitrification rate were investigated with enrichment cultures of nitrifying bacteria. Values of specific nitrite oxidation rate in the absence of ammonia were 2.9-12 times higher than maximum specific ammonia oxidation rates at the same temperatures. The presence of high ammonia levels reversed this relationship, causing maximum specific nitrite oxidation rates to fall to 19 to 45% as high as maximum specific ammonia oxidation rates. This result suggests that nitrification at high ammonia levels will invariably result in nitrite accumulation. The K(O2) for nitrite oxidation in the presence of high ammonia levels was higher than the K(O2) for ammonia oxidation when temperature exceeded 18 degrees C, whereas the opposite was true at lower temperatures. These results indicate that low oxygen tensions will exacerbate nitrite accumulation when water temperature is high.

Combination chemotherapy with epirubicin, docetaxel and cisplatin (EDP) in metastatic or recurrent, unresectable gastric cancer

Based on single agent activities and the additive or synergistic effects of three individual drugs in gastric cancer, we performed a phase II study of a new regimen combining epirubicin, docetaxel and cisplatin (EDP) for unresectable gastric cancer. The patients with histologically confirmed metastatic or recurrent, unresectable gastric cancer and no history of palliative chemotherapy were eligible for this trial. In total, 40 mg m⁻² epirubicin (reduced to 30 mg m⁻² due to high incidence of febrile neutropaenia; 75%) intravenously (i.v.) over 30 min, followed by 60 mg m⁻² docetaxel i.v. over 1 h, then 75 mg m⁻² cisplatin i.v. over 1 h was administered every 3 weeks. Between January 2002 and February 2003, 30 patients (epirubicin 40 mg m⁻², eight; 30 mg m⁻², 22) were enrolled. The median age was 52 years (range, 33–68). The patients received a median of four cycles (range, 1–8). One patient (3%) achieved a complete response, 13 (43%) showed partial responses, 13 (43%) had stable diseases and three (10%) progressed. The overall response rate was 47% (95% CI, 28–66%), and the median duration of response was 5.0 months (95% CI, 3.0–7.0). The median time to progression was 4.1 months (95% CI, 2.4–5.9), and the median overall survival was 11.0 months (95% CI, 9.5–12.4). Grade 4 neutropaenia were observed in 41%, and febrile neutropaenia in 32%, out of the patients receiving 30 mg m⁻² of epirubicin. Grade 3 nonhaematological toxicities included nausea, vomiting, anorexia and peripheral neuropathy. In conclusion, EDP is active in gastric cancer, with a manageable and predictable toxicity profile.

Treatment of multiple bilateral juvenile fibroadenomas in a teenage breast by central pedicle breast reduction, with vertical and short horizontal scar: case report

An 11-year-old girl presented with extremely large and slightly asymmetric breasts that had developed over a 1-year period. The condition was diagnosed as multiple bilateral juvenile fibroadenomas on the operative field and successfully treated with central pedicle breast reduction using a vertical and short horizontal scar design. Breast function and aesthetic appearance were preserved with no reported recurrence 5 years after surgery.

Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measures

STUDY OBJECTIVE

To examine trends in educational mortality and morbidity inequalities in Korea.

DESIGN

Census data (1990, 1995, 2000) and death certificate data (1990-91, 1995-96, 2000-01) were used for mortality. For morbidity, four waves (1989, 1992, 1995, and 1999) of Social Statistics Survey from Korea's National Statistical Office were used. Morbidity indicators were self rated health and self reported illness in the past two weeks. Trends were studied using indices for both the relative and absolute size of socioeconomic inequalities in health.

SETTING

South Korea. Patients (or Participants): Representative annual samples of the adult population aged 30-59 in Korea.

MAIN RESULTS

Based on trends in relative index of inequalities, the relative level of socioeconomic mortality inequality remained virtually unchanged in men and women in the past 10 years. Meanwhile, inequalities in self rated health have increased over time in both sexes. Most of the total increase in health inequalities happened between 1995 and 1999. Inequalities in self reported acute illness increased in the past 10 years.

CONCLUSIONS

The rise in inequalities in morbidity requires increased social discourse and policy discussions about health inequalities in Korean society.

Reversible dementia in systemic lupus erythematosus without antiphospholipid antibodies or cerebral infarction

Dementia is a very rare neurological manifestation of systemic lupus erythematosus (SLE) and has a deep link with antiphospholipid antibodies (APL) and cerebral infarction in its development. However, nonvascular dementia irrelevant to APL or cerebral infarction has not been reported in patients with SLE until now. We describe a case of reversible dementia in an SLE patient without APL or cerebral infarction which was successfully treated with corticosteroid and cyclophosphamide. There are two significant points in this case. One is that humoral factors other than APL might be involved in the development of dementia. Secondly, reversible dementia without APL or cerebral infarction may respond more favorably to immunosuppressive therapy.

Anisotropies of the lower and upper critical fields in MgB2 single crystals

The temperature dependence of the upper (H(c2)) and lower (H(c1)) critical fields has been deduced from Hall probe magnetization measurements of high quality MgB2 single crystals along the two main crystallographic directions. We show that Gamma(H(c2))=H(c2 axially ab)/H(c2 axially c) and Gamma(H(c1))=H(c1 axially c)/H(c1 axially ab) differ significantly at low temperature (being approximately 5 and approximately 1, respectively) and have opposite temperature dependencies. We suggest that MgB2 can be described by a single field dependent anisotropy parameter gamma(H) (=lambda(c)/lambda(ab)=xi(ab)/xi(c)) that increases from Gamma(H(c1)) at low field to Gamma(H(c2)) at high field.

Capecitabine Monotherapy in Patients with Anthracycline- and Taxane-Pretreated Metastatic Breast Cancer

The selection of chemotherapeutic regimens is challenging for metastatic breast cancer (MBC) patients whose diseases have failed to respond to anthracyline and taxane. Capecitabine has advantages of oral administration and favorable toxicity profiles. This study was conducted to evaluate the efficacy of capecitabine and to identify the subgroup of patients who would potentially have benefit from capecitabine monotherapy in patients with anthracycline- and taxane-pretreated MBC. Female patients with MBC who had been previously treated with anthracycline and taxane received oral capecitabine 2500 mg/m(2) divided in two doses daily for 2 wk with 1-wk rest period. Between September, 1999, and December, 2002, a total of 38 patients were enrolled. Among the 36 evaluable patients, one patient achieved a complete response (CR), 9 patients had partial responses (PRs), and 13 patients had stable diseases (SDs). Response rate was 26% [95% confidence interval (CI), 12-40%] and the tumor control rate (TCR, CR+PR+SD) was 61% (95% CI, 45-77%). The median follow-up duration was 27.8 mo. The median duration of response was 8.9 mo, the median time to progression was 4.6 mo, and the median overall survival was 18.1 mo. The major toxicities were hand-foot syndrome, diarrhea, and emesis. There was no treatment-related death. The predictors of better overall survival were positivity of hormone receptor, disease-free survival longer than 1 yr, non-refractoriness to anthracycline, and fewer number (<or= 3) of involved organs. Capecitabine monotherapy is effective and well tolerated for MBC patients who had previously been treated with anthracycline and taxane. The TCR could predict overall survival as well as the objective response in this study, suggesting a possible role of TCR as a surrogate marker for survival in MBC patients on salvage chemotherapy. The patients who have relatively slow growing tumor and less tumor burden could have benefit from capecitabine monotherapy following anthracycline- and taxane-based chemotherapy.

Nitrogen and phosphorus removal from swine wastewater by intermittently aerated dynamic-flow system

This study was performed to evaluate the effects of the volume fraction of an anaerobic reactor (VFAR) and SRT on the removal of T-N and T-P in both an intermittently aerated system (IAS) and intermittently aerated dynamic-flow system (IADS), respectively. When the VFAR in the total volume of reactor from both IAS and IADS are 13%, 7%, and 0% at 5 days of SRT, the removal efficiencies of T-P were 80-87%, 62-65% and <30%, respectively. However, it was observed from this study that the removal efficiencies of T-N and T-P were not correlated to VFAR at a predetermined SRT, producing greater than 5000 mg/L of MLVSS. Also, IADS was shown to have the greater buffer capacity and adaptability to resist the shock due to the loading of high concentration of N. Furthermore, IADS achieved over 80% of removal efficiency of N even at much lower C/N ratio of 4.7. Therefore, it seems that IADS has the significant advantages over other biological nutrients removal processes.

Significance of denitrifying enzyme dynamics in biological nitrogen removal processes: a simulation study

Activated Sludge Model No. 1 (ASM1) was extended to include the enzyme kinetics of denitrifying bacteria switching between oxygen and nitrate as electron acceptors. The extended ASM1 (eASM1) model was applied to two different periodic process configurations, fed-batch and Biodenipho, commonly used for nitrogen removal from wastewater. Predictions of optimal unaerated volume fraction (UVF) by eASM1 were similar to those by ASM1 for both the fed-batch and Biodenipho processes. However, eASM1 predicted substantially longer optimal cycle lengths than ASM1 for both processes. Predictions of optimal UVF and cycle length for the Biodenipho process by eASM1 were closer to current operational values for the University of Florida Biodenipho process than predictions by ASM1.

Pair-breaking and superconducting state recovery dynamics in MgB2

We present studies of the photoexcited quasiparticle dynamics in MgB2 where, using femtosecond optical techniques, Cooper pair-breaking dynamics (PBD) have been temporally resolved for the first time. The PBD are strongly temperature and photoexcitation intensity dependent. Analysis of the PBD using the Rothwarf-Taylor equations suggests that the anomalous PBD arises from the fact that in MgB2 photoexcitation is initially followed by energy relaxation to high frequency phonons instead of, as commonly assumed, e-e thermalization. Furthermore, the bare quasiparticle recombination rate and the probability for pair breaking by phonons have been determined.

The effect of sildenafil on oesophageal motor function in healthy subjects and patients with nutcracker oesophagus

Type 5 phosphodiesterase terminates the action of nitric oxide (NO) induced 3',5'-cyclic monophosphate (cGMP). Sildenafil inhibits this phosphodiesterase, increases cellular cGMP concentrations and enhances NO-induced smooth muscle relaxation. We investigated the effect of sildenafil on the oesophageal motor function of healthy subjects and patients with nutcracker oesophagus. Eight healthy volunteers and nine patients with nutcracker oesophagus participated in this study. The participants underwent oesophageal manometries on two separate days after either 20 mL of distilled water or 0.8 mg kg-1 sildenafil dissolved in 20 mL of water was infused into the stomach. Lower oesophageal sphincter (LOS) resting pressure, the duration of LOS relaxation and the amplitudes of oesophageal pressure waves were examined before, and 7.5, 15, 30 and 60 min after either placebo or sildenafil. In both healthy subjects and patients with nutcracker oesophagus, sildenafil decreased resting LOS pressure and the amplitude of peristaltic pressure waves at 3, 8 and 13 cm above LOS. Sildenafil also prolonged the duration of LOS relaxation. It had no effect on the velocity of peristalsis or the amplitude of peristaltic pressure waves 18 cm above LOS. Sildenafil may be considered as an alternative treatment in nutcracker oesophagus although there are several limitations to be overcome.

Recurrent transverse myelitis in primary antiphospholipid syndrome—case report and literature review

Transverse myelitis is an uncommon but well-known neurologic complication of systemic lupus erythematosus, and antiphospholipid antibodies have been implicated as having a pathogenic role of myelopathy in primary and secondary antiphospholipid syndrome. Transverse myelitis usually is monophasic, but recurrent transverse myelitis was reported in association with systemic lupus erythematosus, multiple sclerosis, and spinal arteriovenous malformations. It has been reported extremely rarely in patients with primary antiphospholipid syndrome. Herein we describe a patient with both conditions and propose that recurrent transverse myelitis should be included as a very rare feature of primary antiphospholipid syndrome.

Nonlinear dynamic perspectives on dynamic force microscopy

Dynamic force microscopy (DFM) utilizes the dynamic response of a resonating probe tip as it approaches and retracts from a sample to measure the topography and material properties of a nanostructure. We present recent results based on nonlinear dynamical systems theory, computational continuation techniques and detailed experiments that yield new perspectives and insights into DFM.A dynamic model including van der Waals and Derjaguin-Müller-Toporov contact forces demonstrates that periodic solutions can be represented as a catastrophe surface with respect to the approach distance and excitation frequency. Turning points on the surface lead to hysteretic amplitude jumps as the tip nears/retracts from the sample. New light is cast upon sudden global changes that occur in the interaction potential at certain gap widths that cause the tip to "stick" to, or tap irregularly the sample. Experiments are performed using a tapping mode tip on a graphite sample to verify the predictions.

Removal of nitrogen and phosphate from wastewater by addition of bittern

Removal of nitrogen and phosphate through crystallization of struvite (MgNH(4)PO(4).6H(2)O) has gained increasing interest. Since wastewaters tend to be low in magnesium relative to ammonia and phosphates, addition of this mineral is usually required to effect the struvite crystallization process. The present study evaluated the feasibility of using bittern, a byproduct of salt manufacture, as a low-cost source of magnesium ions. High reaction rates were observed; the extent of nitrogen and phosphorus removals did not change beyond 10 min. Phosphorus removals from pure solutions with bittern added were equivalent to those obtained with MgCl(2) or seawater. Nitrogen removals with bittern were somewhat lower than with the alternate Mg(2+) sources, however. Application of bittern to biologically treated wastewater from a swine farm achieved high phosphate removal, but ammonia removals were limited by imbalance in the nitrogen:phosphorus ratio.

Two-band superconductivity in MgB2

The study of the anisotropic superconductor MgB2 using a combination of scanning tunneling microscopy and spectroscopy reveals two distinct energy gaps at Delta(1)=2.3 meV and Delta(2)=7.1 meV at 4.2 K. Different spectral weights of the partial superconducting density of states are a reflection of different tunneling directions in this multiband system. Temperature evolution of the tunneling spectra follows the BCS scenario [Phys. Rev. Lett. 3, 552 (1959)]] with both gaps vanishing at the bulk T(c). The data confirm the importance of Fermi-surface sheet dependent superconductivity in MgB2 proposed in the multigap model by Liu et al. [Phys. Rev. Lett. 87, 087005 (2001)]].

Knowledge and attitudes of Korean parents towards their son's circumcision: a nationwide questionnaire study

OBJECTIVE

To evaluate knowledge about the foreskin and circumcision, and to understand the attitudes of parents to circumcision in Korea, where circumcision in childhood is widely practised with no particular religious or medical background.

SUBJECTS AND METHODS

A nationwide study involving questionnaires was conducted on 5500 parents with at least one son attending elementary school. Responses were obtained from one of the parents.

RESULTS

The response rate was 76.1% (4183); circumcision was most common in boys when aged 11 years, followed by neonatal circumcision. Of the parents, 91.3% believed that circumcision is necessary, while 2.1% believed it to be unnecessary. The principal reasons given for circumcision were 'to improve penile hygiene' (82.4%), followed by 'to improve future sexual potency' (7.5%). Among those who did not believe circumcision to be necessary, the most common reason was the expectation of spontaneous retraction of the prepuce with age (55.1%). Most (88.4%) of the parents believed that smegma is not a clean material, and is infected by microorganisms. Most parents (80.6%) thought that circumcision would prevent genital tract infection of the future spouse. Peer pressure was one of the most influential factors in deciding upon circumcision; 41.9% of the parents were anxious that their child might be ridiculed by his peer group unless he was circumcised, while 27.4% of the parents believed that their child might be ridiculed if he was circumcised. Mothers were more positive about circumcision than fathers (P < 0.05). Parents with a higher education and higher socio-economic status were also more positive about circumcision (P < 0.05). Mothers were prone to emphasize improved sexual potency (P < 0.05). There was no significant difference in response between urban and rural areas.

CONCLUSION

This study indicates that common beliefs held by parents about the prepuce or circumcision differ significantly from current medical knowledge, and these beliefs have a major influence on the practice of circumcision in Korea. More clinical research on the natural history of the foreskin is needed, and it is critical that both children and parents are informed about the potential benefits and disadvantages of circumcision.

Efficacy of low-dose clarithromycin triple therapy and tinidazole-containing triple therapy for Helicobacter pylori eradication

BACKGROUND

Proton pump inhibitor-based triple therapies are recommended as the first-line treatment for Helicobacter pylori eradication.

AIM

To evaluate the efficacies of low-dose clarithromycin triple therapy and tinidazole-containing triple therapy in a metronidazole resistance prevalent area and to compare the efficacies with standard triple therapy.

METHODS

In a randomized, multicentre, prospective study, a total of 352 patients with duodenal ulcer or non-ulcer dyspepsia were randomly divided into three groups according to the administered regimen: OAC250 group (omeprazole, 20 mg, amoxicillin, 1000 mg, and clarithromycin, 250 mg), OAC500 group (omeprazole, 20 mg, amoxicillin, 1000 mg, and clarithromycin, 500 mg) and OTC group (omeprazole, 20 mg, tinidazole, 500 mg, and clarithromycin, 500 mg). The three groups received each regimen twice daily for 7 days. Upper gastrointestinal endoscopy was performed before and 4 weeks after treatment. H. pylori status was determined by rapid urease test and 13C urea breath test.

RESULTS

The eradication rates in the OAC250, OAC500 and OTC groups were 76.2%, 65.7% and 64.8% (95% confidence interval: 67.9-84.4%, 56.7-74.8% and 55.7-73.9%), respectively, by intention-to-treat analysis (P=0.149) and 92.8%, 87.2% and 84.1% (95% confidence interval: 84.4-97.3%, 77.9-93.8% and 73.9-91.2%), respectively, by per protocol analysis (P=0.088). All regimens were well tolerated and compliance was excellent.

CONCLUSIONS

Both low-dose clarithromycin triple therapy and tinidazole-containing triple therapy are effective and safe regimens for H. pylori eradication.

Hydraulic properties and leachate level analysis of Kimpo metropolitan landfill, Korea

Hydraulic properties of waste and cover soil from Kimpo Metropolitan Landfill were experimentally measured by laboratory tests. The degree of compaction was changed to identify the effect on hydraulic conductivity, field capacity, and permanent wilting point. Properties were utilized in developing a reliable numerical tool for leachate analysis. HELP, a simulation model for hydrologic evaluation of landfill performance, was adopted for that purpose. For calibration, results from simulation using the parameter values measured by laboratory tests were compared against the field data. The model was applied to predict the leachate level change according to the degree of compaction and cover soil thickness variation. It was found that the increase in the degree of compaction for intermediate cover soil and waste results in the decrease of field capacity and hydraulic conductivity, hence, the increase of leachate level. The effect of cover layer thickness on the leachate level was minor. Based on the findings from laboratory and numerical experiments, a guideline for reclamation practice was recommended.

Optical properties of c-axis oriented superconducting MgB2 films

Temperature dependent optical conductivities and dc resistivity of c-axis oriented superconducting (T(c) = 39.6 K) MgB2 films (approximately 450 nm) have been measured. The normal state ab-plane optical conductivities can be described by the Drude model with a temperature independent Drude plasma frequency of omega(p,D) = 13 600+/-100 cm(-1) or 1.68+/-0.01 eV. The normal state resistivity is fitted by the Bloch-Grüneisen formula with an electron-phonon coupling constant lambda(tr) = 0.13+/-0.02. The optical conductivity spectra below T(c) of these films suggest that MgB2 is a multigap superconductor.

A case of isolated posterior capsule rupture and traumatic cataract caused by blunt ocular trauma

An isolated rupture of the posterior capsule that is caused by a blunt ocular trauma has been rarely reported and is usually detected incidentally during surgery for a complicated cataract. We found an isolated posterior capsule rupture on the third day after trauma in a 25-year-old man who was admitted for the treatment of traumatic hyphema and we performed a phacoemusification and anterior vitrectomy with PC-IOL, implantation because of the traumatic cataract which had progressed after the injury. The PC-IOL was implanted safely into the capsular bag without severe enlargement of the posterior capsular rupture. The break seems to function as a capsulotomy which provides a clear visual axis. We report this case with a review of the literatures.

A single center's 30 years' experience of esophageal adenocarcinoma

BACKGROUND

Adenocarcinoma of the esophagus has been reported to be increasing in incidence in a number of regions throughout the world, while the incidence of squamous cell carcinoma (SCCA) of the esophagus is mostly stable or decreasing. To evaluate the increasing tendency of adenocarcinoma of the esophagus.

METHODS

We studied retrospectively the records of patients with histologically proven esophageal cancer between 1970 and 1999 at the Yonsei Medical Center.

RESULTS

Total cases of esophageal cancer were 969 patients of which the cases of adenocarcinoma and SCCA were 27 patients and 918 patients, respectively. The ratio of esophageal adenocarcinoma to SCCA was 0.0375 in the 1970s, 0.0241 in the 1980s and 0.0292 in the 1990s. There was no statistical difference (p = 0.811) in the ratios of adenocarcinoma of the esophagus between the three consecutive 10-year groups.

CONCLUSION

In conclusion, unlike the US and other western countries, it seems that the ratio of esophageal adenocarcinoma compared to SCCA has not increased among patients with esophageal carcinoma at the Yonsei Medical Center.

Experimental studies on the antiviral agent famciclovir in Behçet's disease symptoms in ICR mice

BACKGROUND

Chronic oral aphthae, recurrent genital ulcers and uveitis are the three main manifestations of Behçet's disease (BD). The aetiopathogenesis of BD is still obscure, but herpes simplex virus (HSV) is one of the possible causal factors. Various kinds of drugs, including immunosuppressants and aciclovir have been used in treatment, but effectiveness is variable.

OBJECTIVES

To demonstrate the efficacy of famciclovir, an antiviral compound that acts against HSV, varicella-zoster virus and hepatitis B virus, in a murine model of BD.

METHODS

Using the HSV-induced BD mouse model, famciclovir was administered variously before and after inoculation or from the day of lesion occurrence, with appropriate controls. Ulceration of the mouth and genital skin and eye involvement were monitored. In addition, spleen cytokine expression was measured by polymerase chain reaction.

RESULTS

Pretreatment and concurrent treatment did not affect the occurrence of BD, but treatment from the appearance of lesions was effective in improving BD and preventing recurrence. After famciclovir, interleukin 2 expression correlated with the recurrence of BD symptoms.

CONCLUSIONS

This model suggests the possible role of immune response to viral infection in the development and activation of BD. The study provides a rationale for clinical trials of famciclovir in the human form of BD.

Reconstruction of palatal defect using mucoperiosteal hinge flap and pushback palatoplasty

This article describes a simple, new surgical technique to provide a complete two-layer closure of palatal defect resulting from a surgical complication of trans palatal resection of skull base chordoma. The nasal layer was reconstructed with triangular shape oral mucoperiosteal turn over hinge flap based on anterior margin of palatal defect and rectangular shaped lateral nasal mucosal hinge flaps. The oral layer was reconstructed with conventional pushback V-Y advancement 2-flaps palatoplasty. Each layer of the flaps were secured with two key mattress suture for flap coaptation. This technique has some advantages: simple, short operation time, one-stage procedure, no need of osteotomy. It can close small- to medium-sized palatal defect of palate or wide cleft palate and can prevent common complication of oronasal fistula, which could be caused by tension.

Patterns of oculomotor nerve distribution to the levator palpebrae superioris muscle, and correlation to temporary ptosis after blepharoplasty

Transient diplopia, blepharoptosis, or both conditions are rare postoperative complications of blepharoplasty performed with the patient under local anesthesia. It has been hypothesized that some cases of postoperative diplopia and blepharoptosis could be attributed to the myotoxic effects of local anesthetics to the extraocular muscles and the levator muscle or to the neurotoxic effects of lidocaine. In 30 cadavers, the superior division of the oculomotor nerve was severed en bloc 1.5 cm anterior to the annulus of Zinn with the levator palpebrae superioris (LPS) and the superior rectus muscles. These muscles were detached from their origins, and their attachments to the scleral and tarsal plates were divided respectively. The specimens were treated in guanidine-hydrochloride and Alizarin Red solution, and were dissected under an operating microscope. The nerve branches of the superior division of the oculomotor nerve innervated the proximal third (type I) in 2 of 30 LPS muscles (6.7%), in 8 of 30 muscles (26.7%) extended to the middle third (type II), and reached the distal third (type III) in 20 of 30 muscles (66.7%). The terminal branches ran through the medial third (type IIIa) in 6 of 20 type III LPS muscles (30%), the central third (type IIIb) in 8 muscles(40%), and the lateral third (type IIIc) in 6 muscles (30%). The oculomotor nerve ends that extend forward to the distal third of the LPS muscle (type III) are exposed and vulnerable to local anesthetics and may be numbed during blepharoplasty. If this is so, postoperative blepharoptosis may be caused by transient paralysis of the LPS muscle, and great care should be taken during the injection of local anesthetics near the LPS.

Study on gelatin-containing artificial skin IV: A comparative study on the effect of antibiotic and EGF on cell proliferation during epidermal healing

Gelatin-hyaluronate sponge with and without antibiotic and epidermal growth factor (EGF) were prepared and compared. Four types of sponges were applied on the full-thickness dorsal skin defect of Wistar rat. The effects of antibiotic and EGF in gelatin-hyaluronate sponge on wound healing were investigated by light microscopy and image analyzer at postoperative days of 5, 12 and 21. An immunohistochemical technique, employing PC10, a monoclonal antibody against proliferating cell nuclear antigen (PCNA) was applied to wounded tissue sections. The number of PC10-positive cells was very high for the sponge with EGF at postoperative day 5, then gradually decreased with time. Also we found that antibiotics restrained the cell proliferation during the migratory phase. The sponge with both antibiotic and EGF showed good wound healing performances on the whole for a healing period. The epithelium was regenerated fast with EGF-impregnated sponges at day 5, but each sample had nearly the same length of regenerated epithelium at day 12.

High current-carrying capability in c-axis-oriented superconducting MgB2 thin films

In high-quality c-axis-oriented MgB2 thin films, we observed high critical current densities ( J(c)) of approximately 16 MA/cm(2) at 15 K under self-fields comparable to those of cuprate high-temperature superconductors. The extrapolated value of J(c) at 5 K was estimated to be approximately 40 MA/cm(2). For a magnetic field of 5 T, a J(c) of approximately 0.1 MA/cm(2) was detected at 15 K, suggesting that this compound would be a very promising candidate for practical applications at high temperature and lower power consumption. The vortex-glass phase is considered to be a possible explanation for the observed high current-carrying capability.

Helicobacter pylori infection in Korea

Helicobacter pylori is a gram-negative bacterium that was first isolated in 1982. Since then, H. pylori infection in humans has been shown to be associated with gastritis, peptic ulcer disease, gastric carcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma as well. The epidemiology, transmission, and pathogenicity of H. pylori has been a subject of intensive study. Successful treatment improves the cure rate of peptic ulcerations and treatment with antimicrobials also decreases the recurrence rate of these diseases. Better regimens having less toxicity and a good eradication rate have also been developed. A better understanding of the pathophysiologic mechanisms relating to H. pylori induced mucosal damages would result in more options for the prevention of peptic ulcers and carcinogenesis. Korea has a relatively high incidence of H. pylori infection and gastric cancer. Growing interest has developed in view of its importance in being associated with various gastroduodenal diseases. Furthermore, along with a high incidence of H. pylori-related disease in Korea, because the interaction between H. pylori, host factors and environmental factors is important in disease pathogenesis, we need to have precise data on the characteristics of H. pylori-related diseases that occur in Korea. In the present report we review the epidemiology, transmission route, diagnosis, pathogenesis, treatment methods and relationship with gastroduodenal diseases with in special references to basic and clinical data that have been published.

Zn2+-induced ERK activation mediated by reactive oxygen species causes cell death in differentiated PC12 cells

Recent studies have provided evidence that Zn2+ plays a crucial role in ischemia- and seizure-induced neuronal death. However, the intracellular signaling pathways involved in Zn2+-induced cell death are largely unknown. In the present study, we investigated the roles of mitogen-activated protein kinases (MAPKs), such as c-Jun N-terminal kinase (JNK), p38 MAPK and extracellular signal-regulated kinase (ERK), and of reactive oxygen species (ROS) in Zn2+-induced cell death using differentiated PC12 cells. Intracellular accumulation of Zn2+ induced by the combined application of pyrithione (5 microM), a Zn2+ ionophore, and Zn2+ (10 microM) caused cell death and activated JNK and ERK, but not p38 MAPK. Preventing JNK activation by the expression of dominant negative SEK1 (SEKAL) did not attenuate Zn2+-induced cell death, whereas the inhibition of ERK with PD98059 and the expression of dominant negative Ras mutant (RasN17) significantly prevented cell death. Inhibition of protein kinase C (PKC) and phosphatidylinositol-3 kinase had little effect on Zn2+-induced ERK activation. Intracellular Zn2+ accumulation resulted in the generation of ROS, and antioxidants prevented both the ERK activation and the cell death induced by Zn2+. Therefore, we conclude that although Zn2+ activates JNK and ERK, only ERK contributes to Zn2+-induced cell death, and that ERK activation is mediated by ROS via the Ras/Raf/MEK/ERK signaling pathway.

Deep middle masseteric artery (dMMA) attributed to hemorrhage in resection of masseter muscle and mandibular angle

This study aimed to investigate pertinent arterial supplies of masseter muscle to prevent fatal hemorrhage in resection of masseter muscle and/or mandibular angle ostectomy. Fifty-three postmortem cadavers of Koreans were used for the work. Color latex was injected into the arteries to outline 17 of 53 specimens. We found that an artery branches off the external carotid artery and enters the masseter muscle at the midpoint of its posterior margin 31 mm above the gonion. We termed this the middle masseteric artery. The middle masseteric artery is divided into superficial and deep branches. The deep branch of the middle masseteric artery travels deep in the muscle close the periosteum of the mandible in 94% of cases. The average diameter is 1.23 +/- 0.26 mm. A small artery with 1.23-mm diameter is enough to cause massive bleeding if severed. The deep branch of the middle masseteric artery is vulnerable in such procedures as resection of the masseter muscle and/or ramus and angle of the mandible.

Innervation of the lower eyelid in relation to blepharoplasty and midface lift: clinical observation and cadaveric study

Ectropion or scleral show resulting from weakness of the lower eyelids is not uncommon after lower blepharoplasty or midface lift via blepharoplasty incision. Denervation of the pretarsal orbicularis oculi muscle (OOM) attributes to such complications. The authors analyzed 102 patients who underwent midface lift via lower blepharoplasty incision for the past 3 years and investigated the motor nerve innervation of the lower OOM in 20 cadavers. They encountered two cases of ectropion attributed to the denervation of the pretarsal OOM: one with dry-eye syndrome and scleral show, and the other with a "polar bear-like appearance" (i.e., outer eversion of the lower eyelid). All pretarsal and preseptal OOMs were innervated by five to seven terminal twigs of the zygomatic branches of the facial nerve that approached the muscle at a right angle. The medial portion of the lower OOM was innervated by one to two terminal twigs of the buccal branch, and the middle portion was innervated with two to three twigs of the zygomatic branch. The lateral portion was supplied by the uppermost zygomatic branch, which split into two to four twigs. The mean horizontal distance between the lateral canthus and the zygomatic branch was 2.31 +/- 0.29 cm (range, 1.7-2.7 cm) and the vertical distance was 1.20 +/- 0.20 cm (range, 0.8-1.5 cm). The critical zone was a circle with 0.5-cm radius, and its center was located 2.5 cm inferolaterally (30 deg) from the lateral canthus. It is very important to understand the motor nerve innervation of the lower eyelid and the "critical zone" to avoid postoperative ectropion or weakness of the lower eyelid resulting from paralysis of the pretarsal or preseptal OOM.

Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine

We evaluated the clinical efficacy and safety of spinal anesthesia with 0.5% hyperbaric ropivacaine compared with 0.5% hyperbaric bupivacaine for elective cesarean delivery. Sixty healthy, full-term parturients were randomly assigned to receive either 12 mg of 0.5% hyperbaric bupivacaine or 18 mg of 0.5% hyperbaric ropivacaine intrathecally. There were no significant differences in demographic or surgical variables or neonatal outcomes between groups. Onset time of sensory block to T10 or to peak level was later in the Ropivacaine group (P < 0.05). The median (range) peak level of analgesia was T3 (T1-5) in the Bupivacaine group and T3 (T1-4) in the Ropivacaine group. Time for sensory block to recede to T10 did not differ between groups. Duration of sensory block was shorter in the Ropivacaine group (188.5 +/- 28.2 min vs 162.5 +/- 20.2 min; P < 0.05). Complete motor block of the lower extremities was obtained in all patients. Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (113.7 +/- 18.6 min vs 158.7 +/- 31.2 min; P < 0.000). The intraoperative quality of anesthesia was excellent and similar in both groups. Side effects did not differ between groups. Eighteen milligrams of 0.5% hyperbaric ropivacaine provided effective spinal anesthesia with shorter duration of sensory and motor block, compared with 12 mg of 0.5% hyperbaric bupivacaine when administered for cesarean delivery

IMPLICATIONS

Eighteen milligrams of 0.5% hyperbaric ropivacaine provided effective spinal anesthesia with shorter duration of sensory and motor block, compared with 12mg of 0.5% hyperbaric bupivacaine when administered for cesarean delivery.

Rescue treatment with abciximab in acute ischemic stroke

In acute ischemic stroke, reocclusion after an initially successful thrombolysis treatment can occur and is associated with increased morbidity and mortality. The authors present the successful use of abciximab, a platelet glycoprotein IIb/IIIa receptor inhibitor, in a patient with a thrombotic occlusion of the proximal middle cerebral artery, which was refractory to combined IV and intra-arterial thrombolysis and percutaneous intracranial balloon angioplasty.

Pituitary adenomas: early postoperative MR imaging after transsphenoidal resection

BACKGROUND AND PURPOSE

Although there have been several reports on postoperative MR imaging of the sella, immediate postoperative changes (usually within 3 days) have not been extensively analyzed. The purpose of this study was to establish the value of early postoperative MR imaging in differentiating residual tumor from postoperative surgical changes in the sella after transsphenoidal resection of pituitary adenomas.

METHODS

Eighty-three patients with surgically proven pituitary adenomas (32 nonfunctioning, 24 prolactin-secreting, 22 growth hormone-secreting, and five prolactin- and growth hormone-secreting tumors) were studied prospectively. All patients underwent dynamic MR imaging within 7 days after surgery. We analyzed the postoperative MR images by focusing on changes in the pituitary gland, signal intensity, resorption of implanted material, and visibility of residual tumor. The patients were divided into four groups according to enhancement pattern of the postoperative pituitary mass: no enhancement, nodular enhancement, peripheral rim enhancement, and a combination of nodular and peripheral rim enhancement.

RESULTS

Postoperative changes included resorption of implanted material and reexpansion of the pituitary gland. In 22 patients, residual tumors were found, and all patients showed nodular or combined enhancement. The residual tumors were confirmed by immediate reoperation in three patients, by hormonal assay and follow-up MR images in 11 patients with functioning adenomas, and by growth of the tumor on follow-up MR images in eight patients with nonfunctioning adenomas. Forty-eight patients showed no enhancement and 13 patients showed peripheral rim enhancement.

CONCLUSION

Early postoperative dynamic MR imaging after transsphenoidal resection in pituitary adenoma is very effective in differentiating residual tumor from postoperative surgical changes.

MgB2 superconducting thin films with a transition temperature of 39 kelvin

We fabricated high-quality c axis-oriented epitaxial MgB2 thin films using a pulsed laser deposition technique. The thin films grown on (1 i 0 2) Al2O3 substrates have a transition temperature of 39 kelvin. The critical current density in zero field is approximately 6 x 10(6) amperes per cubic centimeter at 5 kelvin and approximately 3 x 10(5) amperes per cubic centimeter at 35 kelvin, which suggests that this compound has potential for electronic device applications, such as microwave devices and superconducting quantum interference devices. For the films deposited on Al2O3, x-ray diffraction patterns indicate a highly c axis-oriented crystal structure perpendicular to the substrate surface.

Carriage of antibiotic-resistant pneumococci among Asian children: a multinational surveillance by the Asian Network for Surveillance of Resistant Pathogens (ANSORP)

To investigate the nasal carriage of antibiotic-resistant pneumococci by children, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be nonsusceptible to penicillin. Prevalence of penicillin nonsusceptibility was highest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban areas, enrollment in day care, and a history of otitis media. The most common serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common clone, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resistance among isolates of pneumococci carried nasally in children in Asia and the Middle East and showed that this is due to the spread of a few predominant clones in the region.

The usefulness of the new "double-catheter technique" in the treatment of parent artery incorporated wide-necked aneurysm with guglielmi detachable coils. Technical notes

SUMMARY

We describe a technique used to treat a widenecked aneurysm in which the neck is incorporated with the parent artery. The patient was a 54-year-old woman who had suffered a grade III subarachnoid haemorrhage. Angiogram and three-dimensional CT showed a large, widenecked aneurysm of the basilar bifurcation area with the right posterior cerebral artery incorporated in the aneurysm sac. A microcatheter was placed in the right posterior cerebral artery (PCA). Another catheter was placed within the aneurysm lumen. When making a first frame with a GDC, we made sure that the frame of the coil did not overlap the PCA positioned microcatheter. Then, with the microcatheter positioned at the PCA, the angiogram was done. The flow pattern and dye-disappearance time were checked. Subsequent coils were introduced, but not beyond the frame of the first coil to maintain PCA flow. This new "double-catheter technique" represents a viable option for treating wide-necked aneurysms, especially when the parent artery is incorporated in a wide-necked aneurysm and the delineation of the parent artery is impossible.