Pharmacokinetics of desflurane uptake into the brain and body

The aim of this study was to investigate the pharmacokinetics of desflurane uptake into the brain and body by comparing desflurane concentrations in internal jugular-bulb blood (Jdes), arterial blood (Ades) and pulmonary arterial blood (PAdes) at a fixed inspired desflurane concentration. Thirteen patients (aged 42-72 years) undergoing coronary artery bypass grafting surgery were enrolled in this study. They were anaesthetised using a constant 5% inspired desflurane concentration (CIdes) during the first hour of anaesthesia. Under constant volume-controlled ventilation, CIdes and end-tidal desflurane (CEdes) were measured with an infrared analyser. The desflurane concentration in the blood was analysed using gas chromatography, and cardiac output was measured using an Opti-Q pulmonary artery catheter. It took 24 min for the Jdes to equilibrate with Ades. Both CIdes-CEdes and Ades-PAdes gradients persisted during the study period. There was no further uptake of desflurane into the brain after 24 min but there was near-constant uptake into the body.

Developments in the synthesis of LiF:Mg,Cu,Na,Si TL material

A procedure for synthesis of the highly sensitive pellet-type LiF:Mg,Cu,Na,Si thermoluminescent (TL) detector has been newly developed. It was found that the optimum concentrations of dopants for a pellet-type LiF:Mg,Cu,Na,Si TL detector were found to be Mg: 0.2 mol %, Cu: 0.05 mol %, Na: 0.9 mol%, and Si: 0.9 mol%. The TL sensitivity of this new detector was about 30 times higher than that of the TLD-100 by light integration measurements. Reusability study of the detector was carried out for 10 cycles. The results show that the coefficients of variation for each detector separately did not exceed 0.016, and that for all 10 detectors collectively was 0.0054.

Measurement of the neutron fluence and dose spectra using an extended bonner sphere and a tissue-equivalent proportional counter

A conventional Bonner Sphere (BS) set consisting of six polyethylene spheres was modified to enhance its response to a high-energy neutron by putting a lead shell inside a polyethylene moderator. The response matrix of an extended BS was calculated using the MCNPX code and calibrated using a 252Cf neutron source. In order to survey the unknown photon and neutron mixed field, a spherical tissue equivalent proportional counter (TEPC) was constructed and assembled as a portable measurement system. The extended BS and the self-constructed TEPC were employed to determine the dosimetric quantities of the neutron field produced from the thick lead target bombarded by the 2.5 GeV electron beam of Pohang Accelerator Laboratory (PAL) and the neutron calibration field of Korea Atomic Energy Research Institute (KAERI).

Human immunodeficiency virus type 1 subtype C molecular phylogeny: consensus sequence for an AIDS vaccine design?

An evolving dominance of human immunodeficiency virus type 1 subtype C (HIV-1C) in the AIDS epidemic has been associated with a high prevalence of HIV-1C infection in the southern African countries and with an expanding epidemic in India and China. Understanding the molecular phylogeny and genetic diversity of HIV-1C viruses may be important for the design and evaluation of an HIV vaccine for ultimate use in the developing world. In this study we analyzed the phylogenetic relationships (i) between 73 non-recombinant HIV-1C near-full-length genome sequences, including 51 isolates from Botswana; (ii) between HIV-1C consensus sequences that represent different geographic subsets; and (iii) between specific isolates and consensus sequences. Based on the phylogenetic analyses of 73 near-full-length genomes, 16 "lineages" (a term that is used hereafter for discussion purposes and does not imply taxonomic standing) were identified within HIV-1C. The lineages were supported by high bootstrap values in maximum-parsimony and neighbor-joining analyses and were confirmed by the maximum-likelihood method. The nucleotide diversity between the 73 HIV-1C isolates (mean value of 8.93%; range, 2.9 to 11.7%) was significantly higher than the diversity of the samples to the consensus sequence (mean value of 4.86%; range, 3.3 to 7.2%, P < 0.0001). The translated amino acid distances to the consensus sequence were significantly lower than distances between samples within all HIV-1C proteins. The consensus sequences of HIV-1C proteins accompanied by amino acid frequencies were presented (that of Gag is presented in this work; those of Pol, Vif, Vpr, Tat, Rev, Vpu, Env, and Nef are presented elsewhere [http://www.aids.harvard.edu/lab_research/concensus_sequence.htm]). Additionally, in the promoter region three NF-kappa B sites (GGGRNNYYCC) were identified within the consensus sequences of the entire set or any subset of HIV-1C isolates. This study suggests that the consensus sequence approach could overcome the high genetic diversity of HIV-1C and facilitate an AIDS vaccine design, particularly if the assumption that an HIV-1C antigen with a more extensive match to the circulating viruses is likely to be more efficacious is proven in efficacy trials.

ADP-ribosylating binary toxin genes of Clostridium difficile strain CCUG 20309

The cdt genes that encode a binary ADP-ribosylating toxin in Clostridium difficile were first characterized from a toxigenic C. difficile strain CD196 in 1997. We report here C. difficile strain CCUG 20309 (ATCC 8864), a strain that produces toxin B but not toxin A, also carry a complete set of cdtA and cdtB genes. These genes were sequenced by cycle sequencing method. The 2 ORFs and the intergenic sequences of these 2 strains have a homology of 99.6%. Interestingly, 9 extra bases were found within the cdtA gene of strain CCUG 20309 which do not affect the downstream region of the ORF. Using the same homologous primers, the highly toxigenic reference strain VPI 10463 was found to carry only parts of the 2 ORFs while a nontoxigenic strain ATCC 8884 does not carry any of the cdt genes. Though it remains to be determined whether these genes are expressed, it is significant that strain CCUG 20309 contains the complete set of cdt genes. We speculate that the putative expressed proteins may contribute to pathogenesis, for example, enterotoxicity, of this unique strain of bacteria.

Aggressive angiomyxoma of the scrotum

Aggressive angiomyxoma is a rare and nonmetastasizing soft tissue tumor of the pelvis and perineum and occurs almost exclusively in adult females. It infiltrates locally and has a high risk of local recurrence. Recommended treatment of the symptomatic patient is wide excision with tumor-free margins and close postoperative monitoring. Herein, a case of aggressive angiomyxoma in an adult male is described, which arose in the scrotum over 12 months. The tumor showed an intermediate signal on T1-weighted MRI images. Contrast-enhanced T1-weighted images showed good enhancement. Wide excision of the tumor was performed. The surgical specimen measured 7 x 5 x 5 cm in size and weighed 80 g. The tumor's surface was smooth and had a gelatinous cut surface. Grossly, it was encapsulated with a pleura-like membrane and had a finger-like projection. Microscopically, sections showed many walled vessels of various sizes, collagen fibrils, a loose myxoid background. and spindle stroma cells. MRI and CT showed the angiomatous and myxomatous nature of the tumor wall. To the authors' knowledge, this is the first report to describe MRI findings in scrotal angiomyxoma.

Thermoluminescence characteristics of teflon embedded CaSO4:Dy TLD

The Korea Atomic Energy Research Institute (KAERI) is manufacturing CaSO4:Dy Teflon TL pellets which have more sensitivity and stability than commercial TLD. A method is presented of preparing the CaSO4:Dy phosphor-embedded Teflon powder, which is then compressed to a thin pellet form used as the TLD element. Investigations are made to determine optimum preparation conditions and dosimetric characteristics of the CaSO4:Dy Teflon pellet such as the sensitivity, energy response, dose response, fading, re-usability, and lowest level of detection. The results show that the sensitivity of the CaSO4:Dy pellet is 2 times higher than that of the commercial Teledyne CaSO4:Dy pellet. A dose-response was observed to be linear in the range from 10(-5) to 10 Gy. The relative energy response in the low energy region was 9.6 (normalised to the 137Cs gamma source), and the fading rate was about 10% for five months. The re-usability was estimated to be more than 60 cycles, and the low level of detection dose was 22 microGy. From the results, the CaSO4:Dy pellet developed in KAERI can be successfully used in personal dosemeters through appropriate filter design for compensating the energy response.

Comparison of TLD algorithms for monochromatic fluorescent radiation and continuous spectrum X rays

A personal dosimetry system is required to measure the personal dose equivalent accurately in a wide range of radiation fields. However, the dose evaluation algorithm at the Korea Atomic Energy Research Institute (KAERI) has been developed with the spectral X ray fields described in the American National Standards Institute (ANSI) Standard N13.11 and the actual fields to be monitored may be significantly different from these. To evaluate the dose more accurately when workers are exposed to non-ANSI N13.11 radiation fields, a dose evaluation algorithm using monochromatic radiation (monochromatic algorithm) was developed using the experimental data of the energy responses of CaSO4:Dy thermoluminescent materials irradiated by monochromatic fluorescent X ray fields recently established at KAERI; this was compared with another algorithm developed on the basis of the ANSI N13.11 continuous spectrum X ray fields (spectrum algorithm). The paper concludes with discussions about some results of the algorithm test, including mixed field irradiation and angular response, conducted in an International Atomic Energy Authority/Regional Cooperation of Asia (IAEA/RCA) intercomparison study.

Analysis of the glow curves obtained from LiF:Mg,Cu,Na,Si TL material using the general order kinetics model

Three-dimensional thermoluminescence (TL) spectra based on temperature, wavelength and intensity for newly developed LiF:Mg,Cu,Na,Si TL material at the Korea Atomic Energy Research Institute (KAERI) were measured and analysed. The glow curves were obtained by integration of luminescence intensity over all wavelengths at each temperature, and various trapping parameters related to the traps were determined by analysing these curves. A computerised glow curve deconvolution (CGCD) method which was based on the general order kinetics (GOK) model was used for the glow curve analysis. The glow curves of LiF:Mg,Cu,Na,Si TL material were deconvoluted to six isolated glow curves which have peak temperatures at 333, 374, 426, 466, 483 and 516 K. The main glow peak of peak temperature at 466 K had activation energy of 2.06 eV and a kinetic order of 1.05. This TL material was also found to have three recombination centres, 1.80 eV, 2.88 eV and 3.27 eV by analysis of the TL spectra.

The application of intramolecular radical cyclizations of acylsilanes in the regiospecific formation of cyclic silyl enol ethers

Acylsilanes with terminal alpha-stannyl bromide or xanthate functionalities are prepared. Alpha-stannyl radicals generated from these acylsilanes undergo intramolecular cyclizations to give cyclic silyl enol ethers regiospecifically. The radical processes involve radical cyclization, Brook rearrangement, and beta-fragmentation in sequence. A tributylstannyl group serves as the radical leaving group. The newly formed sigma-bond and pi-bond are located between the same two carbon atoms. This approach is limited to the formation of five-membered rings. In another route, omega-bromo-alpha-phenylsulfonylacylsilanes are synthesized. The radical cyclizations of these alpha-sulfonylacylsilanes also give cyclic silyl enol ethers. The phenylsulfonyl moiety is the radical leaving group in this system. Furthermore, the newly formed sigma-bond and pi-bond are located at adjacent positions sharing a single carbon atom. The latter approach is effective for both five- and six-membered ring formation.

Definition and measurement of child malnutrition

Child Malnutrition has been defined or described in many ways. To summarize the common points, child malnutrition may be defined as a pathological state resulting from inadequate nutrition, including undernutrition (protein-energy malnutrition) due to insufficient intake of energy and other nutrients; overnutrition (overweight and obesity) due to excessive consumption of energy and other nutrients; deficiency diseases due to insufficient intake of one or more specific nutrients such as vitamins or minerals. In the assessment of child malnutrition, a large number of measures are available. Among these measuring methods, Z-score, growth charts, weight-for-length index (WLI), height standard weight, body mass index, skin fold thickness and clinical grading diagnosis standard for child malnutrition are selected for discussion. The same set of anthropometry data of a group of preschool children was analyzed by using different methods. The results showed that it was very difficult to determine the nutritional state of children using a single index. For a given group of children, Z-score method is recommended to observe their height, weight and weight for height at the same time in order to have a comprehensive understanding.

Dietary intake of some essential micronutrients in China

OBJECTIVE

Based on the data collected in the 1992 national nutrition survey in China, the food consumption and nutrients intake were calculated, and the consumption of some micronutrients was evaluated.

METHOD

Dietary data were obtained by using a three days' inventory change plus food weighing in combination with 24 hours recall method for three consecutive days. The food consumption and nutrients intake were calculated in accordance with the Chinese food composition table. The consumption of some micronutrients was evaluated in reference to the Chinese RDAs.

RESULTS

The average intakes of niacin, ascorbic acid and vitamin E were sufficient, whereas that of zinc, selenium and thiamin were between 80% and 90% RDAs. The consumption of calcium, retinol equivalent and riboflavin was low compared with the Chinese RDAs. Calcium was the most insufficient nutrient in Chinese diet.

CONCLUSION

Food fortification seems necessary for improving the nutritional status of some micronutrients in China.

Refolding and characterization of a yeast dehydrodolichyl diphosphate synthase overexpressed in Escherichia coli

Dehydrodolichyl diphosphate synthase (DDPPs) catalyzes the sequential condensation of isopentenyl diphosphate with farnesyl diphosphate to synthesize long-chain dehydrodolichyl diphosphate, which serves as a precursor of glycosyl carrier in glycoprotein biosynthesis in eukaryotes. To perform kinetic and structural studies of DDPPs, we have expressed yeast DDPPs using Escherichia coli as the host cell. Thioredoxin and His tag were utilized to increase the solubility of the recombinant protein and facilitate its purification using Ni-nitrilotriacetic acid (NTA) column. The protein was overexpressed in E. coli but mostly existed in pellet in the absence of detergent. The low quantity of soluble DDPPs was purified using Ni-NTA, Mono Q anion-exchange, and size-column chromatographies. The protein in the pellet was solubilized with 7 M urea and purified using Ni-NTA under denaturing condition. The protein refolding was achieved via the stepwise dialysis to remove the denaturant in the presence of 6 mM beta-mercaptoethanol. Detergent n-octyl-beta-d-glucopyranoside and Triton X-100 increased the solubility of the DDPPs so that refolding can be performed at higher protein concentration. Alternatively, on-column refolding was carried out in a single step to obtain the active protein in large quantities. beta-Mercaptoethanol and Triton were both required in this quick refolding process. The kinetic studies indicated that the soluble and refolded DDPPs have comparable activities (k(cat) = 2 x 10(-4) s(-1)). Unlike its bacterial homologue, undecaprenyl diphosphate synthase, yeast DDPPs activity was not enhanced by Triton.

Isolated craniosynostosis: prenatal ultrasound of scaphocephaly with polyhydramnios

Craniosynostosis is an abnormal shape or dimension of the skull caused by premature closure of one or more skull sutures. It includes scaphocephaly, brachycephaly, oxycephaly, plagiocephaly, trigonocephaly, turricephaly, and a cloverleaf-shaped head. The only cases of craniosynostosis that have been reported concern fetuses with complex and marked craniosynostosis syndromes such as acrocraniofacial dysostosis, Apert's syndrome, Beare-Stevenson cutis gyratum syndrome, Calabro's syndrome, etc. Isolated or simple craniosynostosis, however, is a developmental anomaly rarely found on routine ultrasound examination. We present a case that was diagnosed as scaphocephaly with moderate polyhydramnios by prenatal ultrasound. No other structural anomaly was detected, and the karyotyping was normal. So isolated sagittal craniosynostosis was diagnosed prenatally and was confirmed by postnatal skull radiography as well as 3-dimensional computed tomography. The infant underwent bilateral parietal craniectomy at the age of 3 months. He obtained a good result with no mental problems 4 years after the operation. To our knowledge, this is the second report on the prenatal detection of an isolated form of craniosynostosis.

Associations of CCR5, CCR2, and stromal cell-derived factor 1 genotypes with human immunodeficiency virus disease progression in patients receiving nucleoside therapy

Genotype data for CCR5, CCR2, and stromal cell-derived factor 1 (SDF-1) were obtained from 354 human immunodeficiency virus type 1 (HIV-1)-positive subjects who were being treated with nucleosides. Associations with HIV-1 load, HIV syncytium-inducing (SI) phenotype, CD4 cell count, and disease progression were analyzed. No differences in HIV-1 load or CD4 cell count were observed between wild type (+) and variant genotypes. Changes from non-SI to SI viral phenotype were more frequent in heterozygotes with a 32-bp deletion (Delta32) in the CCR5 gene than in + homozygotes (40% vs. 7%; P=.01). In a multivariate analysis, heterozygous CCR5 Delta32 was associated with reduced hazard of progression (hazard ratio, 0.32; P=.02). Subjects homozygous for the SDF-1 3'A variant had more-rapid disease progression (P=.008). The SDF-1 homozygous 3'A variant was related to more-rapid disease progression, and CCR5 Delta32 was associated with reduced rates of hazard for disease progression in nucleoside-treated subjects.

Identification of a new class of molecules, the arachidonyl amino acids, and characterization of one member that inhibits pain

In mammals, specific lipids and amino acids serve as crucial signaling molecules. In bacteria, conjugates of lipids and amino acids (referred to as lipoamino acids) have been identified and found to possess biological activity. Here, we report that mammals also produce lipoamino acids, specifically the arachidonyl amino acids. We show that the conjugate of arachidonic acid and glycine (N-arachidonylglycine (NAGly)) is present in bovine and rat brain as well as other tissues and that it suppresses tonic inflammatory pain. The biosynthesis of NAGly and its degradation by the enzyme fatty acid amide hydrolase can be observed in rat brain tissue. In addition to NAGly, bovine brain produces at least two other arachidonyl amino acids: N-arachidonyl gamma-aminobutyric acid (NAGABA) and N-arachidonylalanine. Like NAGly, NAGABA inhibits pain. These findings open the door to the identification of other members of this new class of biomolecules, which may be integral to pain regulation and a variety of functions in mammals.

Hematometra of the rudimentary horn of a unicornuate uterus resulting from cesarean section

A 30-year-old woman complained of increasing dysmenorrhea and progressive right lower-quadrant pain after cesarean section. A pelvic mass was observed and subsequently a congenital müllerian anomaly was diagnosed upon serial examination. We report the first apparent case of hematometra of the rudimentary horn of a unicornuate uterus resulting from cesarean section.

Waveforms of the ductus venosus blood flow in normal human fetuses aged 8-38 weeks

BACKGROUND

We attempted to establish normal Doppler flow velocity waveform patterns in the human fetal ductus venosus (DV), and also to establish a standardized measurement technique.

METHODS

Ductus venosus blood flow was measured in a prospective study involving 545 fetuses aged between 8 and 38 weeks in utero, the mothers of whom received prenatal care in Kaohsiung Chang Gung Memorial Hospital in a 12-month period in 1998-1999. Several DV hemodynamic parameters were assessed, including peak systolic velocity (DVP), peak systolic/diastolic (S/D) ratio, time-averaged velocity (TAMX), maximum velocity during atrial contraction (DVM), pulsatility index (PI), Pourcelot's resistance index (RI), and fetal heartbeat (FHB).

RESULTS

Technically acceptable ductus venosus blood flow velocity waveform patterns were collected from 490 of 545 pregnant women (89.9%). The mean +/- SD value for the peak systolic DV velocity during the time period of 8 to 38 weeks in utero was 0.33 +/- 0.11 meters/sec (m/s), the TAMX being 0.24 +/- 0.09 m/s. The maximum velocity during atrial contraction was 0.15 +/- 0.09 m/s, and the peak S/D velocity ratio was 2.5 +/- 1.01. The PI, Pourcelot's RI and fetal heart beat were, 0.67(+/- 0.21), 0.64 (+/- 0.11), and 163.3 (+/- 18.82 bpm), respectively. Significant increases in DVP, TAMX, and DVM with advancing gestational age were established, and decreases in PI, RI, S/D, and FHB with advancing gestational age were also observed.

CONCLUSIONS

Further investigation of DV hemodynamics throughout pregnancy may enable a greater understanding of normal placental perfusion, the fetal venous return to the heart and associated cardiac function.

Complestatin is a noncompetitive peptide antagonist of N-methyl-D-aspartate and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid/kainate receptors: secure blockade of ischemic neuronal death

Complestatin, a peptide derived from Streptomyces, was found to protect cultured cortical neurons from excitotoxicity induced by N-methyl-D-aspartate (NMDA), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), or kainate. This neuroprotective behavior of complestatin was attributed to a blockade of Ca2+ ion entry and accumulation, after the activation of NMDA and AMPA/kainate receptors. Complestatin reversibly interfered with NMDA- and AMPA-mediated excitatory synaptic transmission. Complestatin also protected cortical neurons from prolonged deprivation of oxygen and glucose, more effectively than combined antagonists of NMDA and AMPA/kainate receptors. Neurotoxicity, evolving within 1 to 2 days after continuous exposure to combined NMDA and AMPA/kainate antagonists, was not observed in cortical cell cultures that were exposed to complestatin. Finally, complestatin dose dependently prevented neuronal death evolving within the inner nuclear and ganglion cell layers, after transient retinal ischemia. We conclude that complestatin possesses novel pharmacological properties that effectively prevent excitotoxicity under certain pathological conditions.

Up-regulation of Fas ligand expression by human cytomegalovirus immediate-early gene product 2: a novel mechanism in cytomegalovirus-induced apoptosis in human retina

Human CMV (HCMV) is an important pathogen that causes widespread diseases in immunocompromised individuals. Among the opportunistic HCMV infections, HCMV retinitis is most common in transplant recipients and AIDS patients. It often leads to blindness if left untreated. The question as to how HCMV infection causes retinal pathogenesis remains unresolved. Here, we report that viral immediate-early gene product 2 (IE2), but not IE1, up-regulates the Fas ligand (FasL) expression in HCMV-infected human retinal pigment epithelium cells. Increased secretion of FasL from virally infected cells into cultured medium was observed upon HCMV infection. The capability of such cell-free medium to induce apoptosis of Fas (CD95)-expressing Jurkat cells further implies that Fas-FasL interaction might mediate cell death in the lesion of HCMV retinitis. To support this idea, we observed augmented soluble FasL levels in vitreous from AIDS patients with HCMV retinitis as compared with that from AIDS patients without HCMV infection. In addition, by in situ hybridization and immunohistochemistry, we detected enhanced signals of FasL, the existence of viral IE Ags and apoptotic cells at the same sites in the lesion of HCMV-infected retina. These results strongly suggest that IE2 induction of FasL expression in human retina might be an important event that takes place in the early stage of infection and finally leads to visual loss in individuals affiliated with HCMV retinitis.

Attenuation of Zn2+ neurotoxicity by aspirin: role of N-type Ca2+ channel and the carboxyl acid group

Synaptically released Zn2+ ions enter into neurons primarily through voltage-gated Ca2+ channels (VGCC) or N-methyl-d-aspartate (NMDA) receptors, which can mediate pathological neuronal death. We studied the possibility (and underlying mechanisms) that aspirin, known to prevent NMDA neurotoxicity, would also attenuate Zn2+ neurotoxicity. Administration of 3 to 10 mM aspirin, in cortical cell cultures, attenuated the evolution of neuronal death following exposure to 300 microM Zn2+ for 30 min. This neuroprotective effect of aspirin was attributable to the prevention of Zn2+ ion entry. Aspirin interfered with inward currents and an increase in [Ca2+]i through VGCC and selective binding of omega-conotoxin, sensitive to N-type Ca2+ channel. The omega-conotoxins GVIA or MVIIC, the selective inhibitors of N-type Ca2+ channels, attenuated Zn2+ neurotoxicity. Aspirin derivatives lacking the carboxyl acid group did not reduce Zn2+ neurotoxicity. The present findings suggest that aspirin prevents Zn2+-mediated neuronal death by interfering with VGCC, and its action specifically requires the carboxyl acid group.

Identification of human immunodeficiency virus type 1 subtype C Gag-, Tat-, Rev-, and Nef-specific elispot-based cytotoxic T-lymphocyte responses for AIDS vaccine design

The most severe human immunodeficiency virus type 1 (HIV-1) epidemic is occurring in southern Africa. It is caused by HIV-1 subtype C (HIV-1C). In this study we present the identification and analysis of cumulative cytotoxic T-lymphocyte (CTL) responses in the southern African country of Botswana. CTLs were shown to be an important component of the immune response to control HIV-1 infection. The definition of optimal and dominant epitopes across the HIV-1C genome that are targeted by CTL is critical for vaccine design. The characteristics of the predominant virus that causes the HIV-1 epidemic in a certain geographic area and also the genetic background of the population, through the distribution of common HLA class I alleles, might impact dominant CTL responses in the vaccinee and in the general population. The enzyme-linked immunospot (Elispot) gamma interferon assay has recently been shown to be a reliable tool to map optimal CTL epitopes, correlating well with other methods, such as intracellular staining, tetramer staining, and the classical chromium release assay. Using Elispot with overlapping synthetic peptides across Gag, Tat, Rev, and Nef, we analyzed HIV-1C-specific CTL responses of HIV-1-infected blood donors. Profiles of cumulative Elispot-based CTL responses combined with diversity and sequence consensus data provide an additional characterization of immunodominant regions across the HIV-1C genome. Results of the study suggest that the construction of a poly-epitope subtype-specific HIV-1 vaccine that includes multiple copies of immunodominant CTL epitopes across the viral genome, derived from predominant HIV-1 viruses, might be a logical approach to the design of a vaccine against AIDS.

The expression of neuropeptides in hyperplastic and malignant prostate tissue and its possible clinical implications

PURPOSE

We characterized the incidence and pattern of distribution of neuroendocrine differentiated tumor cells in prostatic hyperplastic and carcinomatous tissue, correlated neuroendocrine differentiation with prostate specific antigen (PSA) and assessed whether neuroendocrine cells have value as an independent indicator of poor prognosis in patients with prostate carcinoma.

MATERIALS AND METHODS

We immunohistochemically evaluated hyperplastic and carcinomatous prostate specimens for chromogranin A, neuron specific enolase and serotonin expressing tumor cells. The expression of various markers in cells was analyzed and correlated with tumor DNA ploidy, disease grade and stage, PSA and clinical course in patients with prostate cancer.

RESULTS

Enrolled in our study were 31 patients with hyperplastic prostate tissue and 30 with prostatic carcinoma. Followup in cancer cases was 1 to 9 years (mean 3.7). During followup 9 patients (30%) died of cancer. We noted DNA content aneuploidy in 5 cases (16.7%) of prostate carcinoma. Chromogranin A, neuron specific enolase and serotonin were expressed in 80%, 43% and 77% of cases of prostate carcinoma and in 29%, 10% and 36% of hyperplastic tissue, respectively. Larger prostates had no higher content of various neuroendocrine cells than smaller prostates. There was higher expression of neuropeptides in carcinomatous than in hyperplastic tissue. Of the 3 peptides chromogranin A was significantly related to all parameters, including Gleason score, tumor stage, PSA and patient survival. In addition to PSA, neuron specific enolase was also closely associated with other clinicopathological parameters. Serotonin was significantly related to patient survival only but we noted no correlation with Gleason score, tumor stage or PSA. In regard to factors predictive of patient prognosis expression of the 3 neuropeptides in tumor cells, Gleason score, tumor stage and PSA were closely related to patient survival in this study

CONCLUSIONS

The growth of hyperplastic prostate tissue is related to neuroendocrine cell activity. The chromogranin A marker has the highest expression in prostate cancer. Neuroendocrine cells may represent an independent indicator of poor prognosis in patients with prostate carcinoma.

The nonlinearity and related band strength of carbon monoxide when applied in ambient air measurement using open long-path Fourier transform infrared spectrometry

The accuracy of CO concentration determination by open-path Fourier transform infrared (FTIR) spectrometry has been re-evaluated in detail. The evaluation focuses on the correction of the calibration curve--the integrated intensity of a standard spectrum--that is used as a comparison spectrum when doing quantitative analysis of CO. Results show that the calibration curve (with 0.5 cm(-1) or 1 cm(-1) resolution) is apparently inclined to be nonlinear under standard conditions, and that the threshold point of nonlinearity is approximately 0.1 atm-cm. Two commercial FTIR field monitoring systems have been used to investigate the nonlinearity trend. The experimental method consists of using open-path FTIR systems in combination with nondispersive infrared (NDIR) monitors to establish the calibration curve in a semi-closed corridor The results have been double-checked using closed-cell dynamic equilibrium systems. When the optical density is larger than a certain value, the curves begin to bend, and when the optical density approaches zero, the band strength is around 178 +/- 3 atm(-1) cm(-2) and 173 +/- 2 atm(-1) cm(-2), respectively, for 0.5 and 1 cm(-1) resolution at standard temperature and pressure (STP). These values are quite different from other published data that have been acquired by the pressurized method or by high-resolution (<0.006 cm(-1)) spectrometers. It is thought that a higher accuracy is achieved when these new calibration results are used to quantify the CO concentration. The error in concentration determination within 0.1 optical density is less than 2%, and that in the higher optical density region is less than 5%.

Prenatal sonographic appearance of Beare-Stevenson cutis gyrata syndrome: two- and three-dimensional ultrasonographic findings

Beare-Stevenson cutis gyrata syndrome is characterized by craniofacial anomalies, particularly craniosynostosis, ear defects, cutis gyrata, acanthosis nigricans, anogenit anomalies, skin tags, and prominent umbilical stump. The prenatal two- and three-dimensional ultrasonographic findings of this rare condition is reported. The detection was made at 32 weeks of gestation in a woman with polyhydramnios and fetal head anomaly. The ultrasound appearance and postnatal follow-up are presented.

Self-assembly and dynamics of [2]- and [3]rotaxanes with a dinuclear macrocycle containing reversible Os-N coordinate bonds

With a dinuclear macrocycle 2 that contains weak reversible OsVI-N coordinate bonds, self-assembly and equilibrium dynamics of [2]- and [3]rotaxanes have been investigated. When the macrocycle 2 was mixed together with threads 4a-e, which all contain an adipamide station but different sizes of end groups, [2]pseudorotaxane- and rotaxane-like complexes were immediately formed with large association constants of >7 x 103M(-1) in CDCl3 at 298 K. Exchange dynamics, explored by 2D-EXSY experiments, suggest that assembly and disassembly of complexes occur through two distinct pathways, slipping or clipping, and this depends on the size of the end groups. The slipping pathway is predominant with smaller end groups that give pseudorotaxane-like complexes, while the clipping pathway is observed with larger end groups that yield rotaxane-like complexes. Under the same conditions, exchange barriers (deltaG++) were 14.3 kcalmol(-1) for 4a and 16.7 kcalmol(-1) for 4d, and indicate that the slipping process is at least one order of magnitude faster than the clipping process. Using threads 13a and 13b that contain two adipamide groups, more complicated systems have been investigated in which [2]rotaxane, [3]rotaxane, and free components are in equilibrium. Concentration- and temperature-dependent 1H NMR spectroscopic studies allowed the identification of all possible elements and the determination of their relative distributions in solution. For example, the relative distribution of the free components, [2]rotaxane, and [3]rotaxane are 30, 45, and 25 %, respectively, in a mixture of 2 (2mM) and 13a (2mM) in CDCl3 at 10 degrees C. However, [3]rotaxane exists nearly quantitatively in a mixture of 2 (4 mM) and 13 a (2 mM) in CDCl3 at a low temperature - 10 degrees C.

Detection of chromosomal alterations in bladder cancer by comparative genomic hybridization

OBJECTIVES

To characterize which genomic alterations occur in bladder cancers of different grades and stages, and to evaluate the prognostic implication of chromosomal imbalances. Materials and methods Twelve transitional cell carcinoma cell lines were used to study chromosomal aberrations, using comparative genomic hybridization to examine metaphase cells.

RESULTS

There was a mean of 6.0 aberrations per tumour with 4.9 gains and 1.08 deletions per tumour cell line. The mean number of aberrations was the same in grade 2 and 3 tumours. High-stage (>/= T2) carcinomas had markedly more genomic gains than had low-stage (T1) tumours, with 7.2 gains and 1.3 deletions per >/= T2 tumour, and 2.7 gains and 0.8 deletions per T1 tumour, although the difference was not statistically significant. The most frequent changes were gains of chromosome 1 (seven), 9 and 16 (six), and losses of chromosomes 14 (three), 21 and Y (two). The changes 1p+, 3p+, 9q+, 14p-, 16q+ and Yp- were significantly more frequent in low-grade tumours, with 1p+, 3p+ and Yq- the most frequent in stage T1 tumours, and 16p+, 9q+ and 13q- the most frequent in stage >/= T2 tumours. Conclusion These findings indicate several genomic regions in chromosomes 1, 9, 14 and 16 that may carry genes for the development and progression of bladder cancers.

First trimester diagnosis of holoprosencephaly and cyclopia with triploidy by transvaginal three-dimensional ultrasonography

We present the prenatal three-dimensional (3D) ultrasound findings in a case of holoprosencephaly and cyclopia at 11 weeks gestation. Only holoprosencephaly with missing cyclopia were initially diagnosed because suboptimal views of the fetal face were obtained with transvaginal two-dimensional (2D) ultrasonography due to fetal position. Chromosomes identified by analysis of a fluid sample from early amniocentesis demonstrated a triploidy (69, XXX), spontaneous fetal demise occurred at 12 weeks and the pregnancy was terminated. This case demonstrated the usefulness of transvaginal 3D ultrasonography in establishing the final diagnosis.

Metabolism of chiisanoside from Acanthopanax divaricatus var. albeofructus by human intestinal bacteria and its relation to some biological activities

The metabolic pathway of chiisanoside isolated from leaves of Acanthopanax divaricatus var. albeofructus (Araliaceae) by human intestinal bacteria and by the protein fraction of leaves of this plant were investigated, and the cytotoxic and anti-rotaviral activities of chiisanoside and its metabolite, chiisanogenin, were assayed. Chiisanogenin was produced as a main metabolite, when chiisanoside were incubated for 15 h with human intestinal bacteria. This metabolic pathway proceeded more potently with the protein fraction than with human intestinal bacteria. The in vitro cytotoxicity of chiisanogenin was superior to that of chiisanoside. H+/K+ ATPase was more potently inhibited by chiisanogenin than by chiisanoside. However, the anti-rotaviral activity of chiisanoside was more potent than that of chiisanogenin.

[Effects of simulated microgravity on the contents of monoamine transmitters in human plasma during heat stress]

AIM AND METHODS

Using high performance liquid chromatography-electrochemistry detection method to study the effects of simulated microgravity of a 7-day bed-rest in - 6 degrees head-down title (HDT) position, heat stress and their combination on the contents of monoamine transmitters in human plasma, the aim of the present study is to examine effects of simulated microgravity on the contents of monoamine transmitters during heat stress and to investigate the mechanism of human responses to heat stress in spaceflight.

RESULTS

(1) The content of 5-HT, NE, E did not change significantly (P > 0.05) after simulated microgravity alone. (2) Exposed to heat stress alone, the content of 5-HT produced a marked decrease (P < 0.01) at > 40 degrees C, while the contents of NE, E had manifested increases (P < 0.01) at > or = 50 degrees C. (3) Under the effect of the combination of simulated microgravity and heat stress, compared with control group, there was a significant decrease in the content of 5-HT (P < 0.01), but NE, E did not change significantly (P > 0.05). Compared with heat stress alone, there was a significant decrease in the content of NE, E (P < 0.001), while 5-HT did not change significantly (P > 0.05).

CONCLUSION

Simulated microgravity decreased the content of heat-induced NE, E, significantly, and the suppression probably plays an important role in degraded human response to heat stress in spaceflight.

Determination of the efficiency of controlled ovarian hyperstimulation in the gonadotropin-releasing hormone agonist-suppression cycle using the initial follicle count during gonadotropin stimulation

PURPOSE

Our purpose was to evaluate the relationship between the initial follicle count during gonadotropin stimulation after gonadotropin-releasing hormone (GnRH) agonist suppression and the efficiency of controlled ovarian hyperstimulation (COH) in patients receiving treatment with assisted reproductive technologies (ARTs).

METHODS

A total of 338 COH procedures in 291 couples was performed with cycles that reached the stage of oocyte retrieval. The ovarian antral follicle number was measured using transvaginal ultrasonography at the folliculometry during gonadotropin stimulation by GnRH agonist suppression in patients undergoing ARTs. Controlled ovarian hyperstimulation was accomplished using GnRH agonist down-regulation combined with FSH and menotropin stimulation. The characteristics of oocytes after retrieval and embryos after in vitro culture and the pregnancy rates were assessed.

RESULTS

The procedures performed included 195 ET cycles, 129 TET cycles, and 14 incomplete cycles. The treatment cycles were divided into four categories according to the antral follicle number (i.e., < or = 5, 6-10, 11-15, and > or = 16) at the first folliculometry to evaluate the influence of various factors. The antral follicle count correlated significantly with the patient age, dosage of gonadotropins, serum estradiol concentration, number of antral follicles (> or = 13 mm) while receiving hCG injections, number of oocytes retrieved, and, later, number of embryos transferred. There was a trend toward an increasing number of pregnancies per cycle as the number of antral follicles increased (14.7, 26.5, 44, and 45%, respectively).

CONCLUSIONS

We were able to predict the efficiency of COH and outcome of ARTs based on the follicle count during the first folliculometry during gonadotropin stimulation after GnRH agonist suppression. The results of the folliculometry significantly predicted the ovarian response to COH and the outcome of ARTs in the current treatment cycle.

Carbon dioxide laser microsurgery for tongue cancer: surgical techniques and long-term results

Thirty-seven consecutive patients with cancer of the anterior two-thirds of the tongue without clinical neck lymph nodes or distant metastasis were treated with transoral carbon dioxide (CO2) laser microsurgery. During the operation, a monopolar coagulation-suction device was applied to achieve a clear surgical field. Under a surgical microscope, we repeatedly palpated the soft tissue to identify the tumour margins, in particular the deep margin, to maintain adequate safe margins in three dimensions. We resected the tumour by en bloc procedures rather than by vaporization or debulking. Of the 28 patients in the T1 and T2 groups, 26 patients did not receive postoperative radiotherapy. The local control rate calculated by the methods of Kaplan and Meier in all 37 patients at 5 years was 93.6%. No local recurrence occurred in the T1 or T2 cases. Nine patients suffered from neck recurrence and the neck control rate at 5 years was 74.6%. Eight of these nine patients were salvaged by surgery with adjuvant radiotherapy, and six of them finally achieved disease-free status. The 5-year disease-free survival rate for our series was 88%. Our surgical techniques using CO2 laser microsurgery are effective and advantageous methods for excision of oral tongue cancer, especially stage I and II lesions.

Chiral analysis of baclofen by alpha-cyclodextrin-modified capillary electrophoresis and laser-induced fluorescence detection

An enantioselective method for baclofen (4-amino-3-p-chlorophenylbutyric acid) based on capillary electrophoresis (CE) separation and laser-induced fluorescence (LIF) detection has been developed. Naphthalene-2,3-dicarboxaldehyde (NDA) was used for precolumn derivatization of the nonfluorescent drug. alpha-Cyclodextrin (alpha-CD) was included in the buffer as a chiral selector for the separation of NDA-labeled S-(+)- and R-(-)-baclofen. Optimal resolution and detection were obtained with an electrophoretic buffer of 50 mM sodium borate (pH 9.5) containing 7 mM alpha-CD and a He-Cd laser (lambda ex = 442 nm, lambda em = 500 nm). Combined with a simple cleanup procedure, this method can be applied to the analysis of baclofen enantiomers in human plasma. The relative standard deviation (RSD) values on peak areas of a plasma sample containing 1.0 microM racemic baclofen were 6.4 and 4.9% (n = 8) for the S-(+)- and R-(-)-enantiomer, respectively. The RSD value on migration times of both enantiomers was 0.5% (n = 8). Calibration graphs for S-(+)- and R-(-)-baclofen in plasma showed a good linearity (r > or = 0.999) in the concentration range of 0.1-2.0 microM. The limit of detection of baclofen in plasma was about 10 ng/mL.

Prenatal diagnosis of persistent fetal bradycardia: report of four cases

Persistent fetal bradycardia is infrequent in prenatal life and difficult to manage optimally. It is generally attributable to sinus bradycardia due to fetal distress, blocked atrial extrasystoles, and congenital complete heart block. We reported four cases of persistent fetal bradycardia from 1995 to 1999 in our hospital. The first, second, and third cases of sustained fetal bradycardia had congenital complete heart block with positive titers for anti-Ro/SSA antibodies in both mothers and fetuses. Because of progressive fetal hydrops in the second case, the pregnancy was terminated. The first and third cases were isolated congenital complete heart block without structural anomaly. After prenatal examination the babies were followed up closely until term and both had a good prognosis without any implantation of pacemaker. In the fourth case there was no clinically known etiology associated with sustained fetal bradycardia. The fetal heart rate returned to normal after 6 weeks of follow-up and the baby was delivered without any cardiac problems. Congenital complete heart block is the most common cause of persistent fetal bradycardia. Prenatal detailed monitoring until delivery is necessary before heart failure develops. Treatment strategies (corticosteroids, ritodrine, and plasmapheresis) are debatable and may include prophylactic therapy for high-risk pregnant women.

Chest wall thickness measurements and the dosimetric implications for male workers in the south Korean uranium industry

Using ultrasound techniques, the Human Monitoring Laboratory has measured chest wall thicknesses of a group of male workers at the Korea Atomic Energy Research Institute. A site-specific biometric equation has been developed for these workers, who are somewhat smaller than other workers reported in the literature. Chest wall thickness is an important modifier on lung counting efficiency. These data have been put into the perspective of the ICRP recommended dose limits for occupationally exposed workers: 100 mSv in a 5-year period with a maximum of 50 mSv in any one year. For measured chest wall thicknesses of 1.9 cm to 4.1 cm and a 30 min counting time, the achievable MDAs for natural uranium in the KAERI lung counter vary from 6.6 mg to 13.2 mg. These values are close to, or even exceed, the predicted amounts of natural uranium that will remain in the lung (absorption type M and S) after an intake equal to the Annual Limit on Intake corresponding to a committed dose of 20 mSv. This paper shows that the KAERI lung counter probably cannot detect an intake of Type S natural uranium in a worker with a chest wall thickness equal to the average value (2.7 cm) under routine counting conditions.

Growth pattern of renal angiomyolipoma on computed tomography: report of two cases

The incidence of renal angiomyolipoma is increased in patients with tuberous sclerosis. Renal angiomyolipomas frequently exhibit both intratumoral and subcapsular or perirenal hemorrhage when they grow into the extrarenal space. Evidence of serial morphologic change is crucial to decision-making for surgical exploration in patients with growing renal angiomyolipomas. We report two cases of angiomyolipoma of the kidney with expansion of an angiomyolipoma into the subcapsular region. Neither patient had tuberous sclerosis and both developed bleeding when the mushroom-shaped tumor reached the extrarenal space. These cases suggest that expansion of the tumor into the subcapsular region is indicative of impending rupture of a renal angiomyolipoma.

New 3,4-seco-lupane-type triterpene glycosides from Acanthopanax senticosus forma inermis

Four new 3,4-seco-lupane-type triterpene glycosides (1-4) were isolated from the leaves of Acanthopanax senticosus forma inermis. The structures of 1-4 were established as 11alpha-hydroxy-3, 4-seco-lup-4(23),20(30)-dien-3-oic acid methyl ester 28-oic acid 28-O-alpha-L-rhamnopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->6)-be ta-D-glucopyranoside, designated as inermoside (1); 1-deoxychiisanoside (2); 24-hydroxychiisanoside (3); and 11-deoxyisochiisanoside (4) by (1)H-(1)H COSY and (1)H-(13)C COSY(HMBC, HMQC) methods and FABMS.

Transcriptional analysis of multiple sclerosis brain lesions reveals a complex pattern of cytokine expression

Multiple sclerosis (MS) is a common and severe neurological disorder associated with an autoimmune response directed against myelin components within the CNS. Lymphocyte activation, extravasation, and recruitment, as well as effector function, involves the turning on and off of a number of genes, thus triggering specific transcriptional pathways. The characterization of the transcriptome in MS lesions should provide a better understanding of the mechanisms that generate and sustain the pathogenic immune response in this disease. Here we performed transcriptional profiling of 56 relevant genes in brain specimens from eight MS patients and eight normal controls by kinetic RT-PCR. Results showed a high transcriptional activity for the gene coding for myelin basic protein (MBP); however, it was not differentially expressed in MS samples, suggesting that remyelination is an active process also in the noninflammatory brain. CD4 and HLA-DRalpha transcripts were dramatically increased in MS as compared with controls. This reveals a robust MHC class II up-regulation and suggests that Ag is being presented locally to activated T cells. Although analysis of cytokine and cytokine receptor genes expression showed predominantly increased levels of several Th1 molecules (TGF-ss, RANTES, and macrophage-inflammatory protein (MIP)-1alpha) in MS samples, some Th2 genes (IL-3, IL-5, and IL-6/IL-6R) were found to be up-regulated as well. Similarly, both proinflammatory type (CCR1, CCR5) and immunomodulatory type (CCR4, CCR8) chemokine receptors were differentially expressed in the MS brain. Overall, our data suggest a complex regulation of the inflammatory response in human autoimmune demyelination.

Interaction between HIV type 1 glycoprotein 120 and CXCR4 coreceptor involves a highly conserved arginine residue in hypervariable region 3

Several seven-transmembrane chemokine receptors are known to function as entry coreceptors for human immunodeficiency virus type 1. CCR5 and CXCR4 are the major coreceptors for non-syncytium-inducing (NSI) and syncytium-inducing (SI) viruses, respectively. During the natural course of infection, the emergence of variants with a phenotypic transition from NSI to SI and rapid disease progression is associated with expanded coreceptor usage to CXCR4. Characteristic amino acids at several positions in the hypervariable region 3 (V3) of gp120 have been linked to CXCR4 utilization. Previously, we reported that a highly conserved arginine residue of V3 played an important role in CCR5 utilization. In this study, the possible involvement of the same arginine residue in CXCR4 utilization was investigated. Amino acid substitutions introduced to this arginine on R5X4 viruses were found to have a significant effect on their utilization of CXCR4. These results, taken together with those reported previously, suggest that this highly conserved arginine may contribute to the functional convergence of chemokine coreceptor utilization by human immunodeficiency viruses and may represent a unique target for future antiviral design.

Enhancing effect of polyoxyethylene alkyl ethers on the skin permeation of ibuprofen

The influence of polyethoxylated non-ionic surfactants on the transport of ibuprofen across rat skin was investigated. The skin permeation of ibuprofen from a series of 17 polyoxyethylene (POE) alkyl ethers containing 5% ibuprofen was determined using Franz diffusion cells fitted with excised rat skins. Differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FT-IR) were performed for the physicochemical characterization of ibuprofen-surfactant interaction. In vitro transdermal flux through excised rat skin was found in the decreasing order of POE(5)cetyl/oleyl ether (110.24 microg/cm(2)/h)>POE(2)lauryl ether (99.91 microg/cm(2)/h)>POE(2)oleyl ether (67.46 microg/cm(2)/h)>POE(10)stearyl ether (66.19 microg/cm(2)/h). POE(2)oleyl ether showed the longest lag time (2.47 h). The enhancers containing the EO chain length of 2-5, HLB value of 7-9 and an alkyl chain length of C16-C18 were effective promoters of ibuprofen flux. FT-IR and DSC studies to probe the nature of the interaction between the ibuprofen and surfactant indicated that the hydrogen bonding state of ibuprofen was changed from the dimeric form to the carbonyl-hydroxyl (C=O-HO) hydrogen bond form in the presence of excess POE alkyl ether. These results indicated that this new system may be used in developing a transdermal formulation with improved skin permeation of ibuprofen.

A humanized anti--4-1BB monoclonal antibody suppresses antigen-induced humoral immune response in nonhuman primates

The interaction of 4-1BB and its ligand plays an important role in the regulation of T-cell-mediated immune responses. In this study, the authors examined the effect of a humanized anti--4-1BB monoclonal antibody (H4B4) on ovalbumin-induced immune responses in baboons. Previously, a mouse monoclonal antibody, 4B4 against the human 4-1BB molecule, was generated and characterized. Based on this antibody, a humanized version of 4B4 monoclonal antibody was constructed and the resultant antibody, H4B4, showed full recovery of the binding activity of the original antibody 4B4: a 1.5-fold increase in affinity for 4-1BB. In addition, H4B4 mediated antibody-dependent cellular cytotoxicity of activated human peripheral blood T cells and CEM cells in a dose-dependent manner. Weekly administration of H4B4 at doses of 1 or 4 mg/kg could suppress immunoglobulin G production against ovalbumin. This was not a result of the overall immune suppression, because the numbers of B and T cells and the total immunoglobulin G production were not altered during treatment with H4B4. These findings suggest that treatment with H4B4 may be a valid therapeutic approach to control unwanted immune responses in persons with autoimmune diseases.

Anterolateral thigh vastus lateralis myocutaneous flap for vulvar reconstruction after radical vulvectomy: a preliminary experience

BACKGROUND

There are many myocutaneous flap methods which have been reported for the immediate reconstruction of large vulvar defects created by deforming radical cancer surgery in the female perineum except for the anterolateral thigh vastus lateralis myocutaneous flap. The present report describes our preliminary experience with the use of this flap in a patient who underwent radical vulvectomy for locally advanced squamous cell carcinoma of the vulva.

CASE

A 75-year-old woman underwent radical vulvectomy with bilateral inguinal lymphadenectomy due to right vulvar squamous cell carcinoma. The large vulvar defect was immediately reconstructed by using anterolateral thigh vastus lateralis myocutaneous flap. The postoperative course was uneventful. In addition to the expected primary healing, the neovulva had a relatively normal appearance with satisfactory sensation and function and the donor defect was found to be minimal both functionally and aesthetically.

CONCLUSION

This technique can be used as an alternative method for vulvar reconstruction after radical vulvectomy. Further studies are warranted to prove the efficacy of this myocutaneous flap in reconstructing large vulvar defects.

Determination of sulfite in Oriental herbal medicines

Sulfite was detected in 7 varieties of Oriental herbal medicines (Pueraria radix, Zingiberis rhizoma, Platycodon radix, Adenophora radix, Pinellia tuber, Astragalus radix, and Paeonia radix) on the Korean market. Sulfiting of commercial Oriental herbal medicines by fumigation with burning bituminous coal was simulated, and the accumulation of sulfite was investigated by using fresh Platycodon radix roots obtained from a growing field. The sulfite level reached a plateau in 9 h, and the maximum sulfite level found by the Monier-Williams (MW) method (AOAC 990.28) was 1020 ppm. The sulfite content in the simulated Platycodon radix sample determined by alkali extraction followed by ion-exclusion chromatography with electrochemical detection (AOAC 990.31) was approximately 17% lower on average than the MW results. Free-sulfite levels determined by acid extraction and ion-exclusion chromatography with electrochemical detection were between 19 and 49% of the MW results. The advantages of different methods for sulfite determination and the significance of the results are discussed.

Effects of induction anesthetic agents on outcome of assisted reproductive technology: a comparison of propofol and thiopental sodium

BACKGROUND

The use of propofol, as compared to barbiturates (e.g. thiopental), for short surgical procedures has been associated with more rapid recovery from the procedure. Propofol, an intravenous anesthetic drug, is frequently used as an adjunct to transvaginal oocyte retrieval but little is known about its effects upon fertilization, embryo development, and pregnancy rate when used drug the for induction of general anesthesia. This study was conducted to compare the outcome of assisted reproductive technology (ART) with the use of propofol versus thiopental sodium for the induction of general anesthesia during oocyte retrieval.

METHODS

In this retrospective study, 92 cases of infertile patients who underwent oocyte retrieval under the induction of general anesthesia with, respectively, either propofol (Group I, 72 cases) or thiopental sodium (Group II, 20 cases) were compared for fertilization rate, cleavage rate, and pregnancy rate.

RESULTS

The fertilization rate was 68.9% for Group I and 66.7% for group II (p = 0.614). The cleavage rate was 96.5% for Group I and 94.8% for Group II (p = 0.294). The rate of good embryo grading and poor embryo grading was, respectively, 85.1% and 14.9% for Group I, versus 85.7% and 14.3% for Group II (p = 0.887). The pregnancy rate was 30.5% for Group I and 20.0% for Group II (p = 0.354). The implantation rate and abortion rate was, respectively, 9.1% and 18.2% for Group I versus 7.2% and 25.0% for Group II (implantation rate, p = 0.590; abortion rate, p = 0.600).

CONCLUSION

There were no significant differences between these two groups for fertilization rate, cleavage rate, pregnancy rate, implantation rate and abortion rate. We suggest cautious use of propofol for the procedure of oocyte retrieval despite its associated more rapid post-operative recovery including less nausea/vomiting.