Estrogen modulates the spinal N-methyl-D-aspartic acid-mediated pelvic nerve-to-urethra reflex plasticity in rats

The effects of gonadal steroids on glutamate-mediated pelvic nerve-to-urethra reflex (PUR) plasticity were investigated in rats, which received a sham operation (Sham), ovariectomy (OVX), or ovariectomy with daily supplemental estrogen (50 microg/kg, OVX + E2). The magnitude of the repetitive stimulation (RS, 1 Hz)-induced potentiation in PUR activity decreased significantly in the OVX group when compared with the Sham groups (18.09 +/- 3.91 and 7.40 +/- 1.03 spikes/stimulation in Sham and OVX group; respectively, P < 0.01, n = 21). Supplemental estrogen (OVX + E2, 12.60 +/- 1.49 spikes/stimulation) significantly reversed the decrease in RS-induced PUR potentiation caused by OVX (P < 0.01, n = 21). The magnitude of the RS-induced potentiation in PUR activity decreased significantly after intrathecal 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo (F) quinoxaline [(20 microm, 10 microl), from 18.09 +/- 3.91 to 10.40 +/- 0.81, from 7.40 +/- 1.03 to 3.20 +/- 0.94, and from 12.60 +/- 1.49 to 8.06 +/- 0.32 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18] and D-2-amino-5-phosphonoraleric acid [(100 microm, 10 microl), from 18.09 +/- 3.91 to 1.04 +/- 0.12, from 7.40 +/- 1.03 to 1.06 +/- 0.22, and from 12.60 +/- 1.49 to 0.98 +/- 0.25 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18]. In addition, potentiation in PUR activities was induced by intrathecal l-glutamate (0.1 mm, 10 microl, from 1.04 +/- 0.02 to 21.60 +/- 0.93, from 1.10 +/- 0.06 to 8.40 +/- 1.50, and from 1.03 +/- 0.03 to 18.04 +/- 0.84 spikes/stimulation in Sham, OVX, and OVX + E2, respectively, P < 0.01, n = 18) and N-methyl-D-aspartic acid (0.1 mm, 10 microl, from 1.04 +/- 0.02 to 14.80 +/- 0.97, from 1.10 +/- 0.06 to 4.60 +/- 0.48, and from 1.03 +/- 0.03 to 9.09 +/- 0.63 spikes/stimulation in Sham, OVX, and OVX + E2); N-methyl-D-aspartic acid-mediated PUR plasticity in female rats and may contribute to alterations in urinary dysfunction after menopause.

Changes in the extracellular matrix in the anterior vagina of women with or without prolapse

To investigate the changes in the connective tissues located in the upper portion of the anterior vaginal wall, which are associated with anterior vaginal wall prolapse, 23 women with anterior vaginal wall prolapse were included in the study group and 15 women with normal genital support served as control group. The anterior vaginal wall tissue samples were obtained for immunohistochemical staining of collagen (type I, III, IV, V, VI), elastin, and glycoproteins from the extracellular matrix (fibronectin, vitronectin, laminin). The number of capillaries per arteriole and mitochondria numbers per smooth muscle cell were evaluated for demonstrating whether the anatomical prolapse affect on blood supply to these tissues. Collagen III was significantly less in the anterior vaginal wall of patients with anterior vaginal wall prolapse. Quantitative immunoreactivity of collagen I and III had significant positive correlations with ageing.

Ultra-short metformin pretreatment for clomiphene citrate-resistant polycystic ovary syndrome

OBJECTIVE

To evaluate the effect of ultra-short (12 days) metformin pretreatment in clomiphene-citrate (CC) resistant polycystic ovary syndrome (PCOS).

METHOD

Eighty women with CC-resistant PCOS were randomly allocated to metformin pretreatment or usual treatment. Forty women received 1500 mg metformin daily for 12 days, followed by clomiphene 150 mg daily for 5 days along with metformin. Forty women (control group) received the same dose of clomiphene but no metformin pretreatment.

RESULTS

In the metformin group, 17 (42.5%) women ovulated, and 6 (15%) conceived. In the control group, 5 (12.5%) women ovulated but none conceived. Compared with the control group, the metformin group had significantly higher ovulation (P = 0.03) and pregnancy rates (P = 0.026).

CONCLUSION

Twelve days of metformin pretreatment improves ovulation and pregnancy rates in women with CC-resistant PCOS.

Phylogenetic analysis of classical swine fever virus in Taiwan

Two envelope glycoprotein (Erns and E2) regions of the classical swine fever virus (CSFV) were amplified by RT-PCR and sequenced directly from 158 specimens collected between 1989 and 2003 in Taiwan. Phylogenetic analysis of the two regions revealed a similar tree topology and the Erns region provided better discrimination than the E2 region. One hundred and fifteen isolates out of the 158 isolates were clustered within subgroup 2.1 (further classified as 2.1a and 2.1b) and 2.2, which were considered to be likely of the introduced strains, whereas the remaining 43 isolates were clustered within subgroup 3.4 and were considered to be of the endemic strains. The subgroup 2.1a viruses were first detected in 1994 and predominated from 1995 onwards. However, subgroup 3.4 viruses were prevalent in the early years, not being isolated after 1996. We have observed a dramatic switch in genotype from subgroup 3.4 to 2.1a. The subgroup 2.1a isolates are closely related to the Paderborn and Lao isolates, whereas 2.1b isolates have a close relationship to the Chinese Guangxi isolates. The phylogenetic tree of 27 CSFV sequences based on the complete envelope glycoprotein gene (Erns-E2) displayed better resolution than that based on the complete open reading frame.

Herbal treatment for renal diseases

Renal fibrosis is a common consequence of chronic kidney diseases (CKD). Standard therapy to prevent progression of CKD in western medicine includes dietary protein restriction, blood pressure control, angiotensin-converting enzyme inhibition and angiotensin receptor blockade. However, little is known about the renoprotective effects of Chinese herbal medicine. Cumulative evidence suggests that some Chinese herbal medicines, including Astragalus and a mixture of Astragalus plus Angelica, Ligusticum, Triptolide and Rhubarb, have a beneficial role in slowing the progression of CKD. This effect is multi-functional and multi-targeted, and is often associated with a reduction in proteinuria and the amelioration of dyslipidaemia, but not with changes in systemic blood pressure. These mechanisms include anti-inflammation and inhibition of TGF-b overproduction. On the other hand, some Chinese herbal medicines may be hazardous to patients with renal diseases. In this review, we discuss recent advances in the research of some Chinese herbs for pharmacological intervention of progressive renal diseases and kidney-related injuries.

Aerodynamic Characteristics and Design Guidelines of Push–Pull Ventilation Systems

Aerodynamic characteristics such as the flow patterns, velocity field, streamline evolutions, characteristic flow modes and characteristic flow regimes of the push-pull ventilation system are cross-examined by using the laser-light sheet smoked-flow visualization method and laser Doppler velocimetry. Four characteristic flow modes, which are denoted as dispersion, transition, encapsulation and strong suction, are identified in the domain of the push-jet and pull-flow velocities at various open-surface tank widths and rising gas velocities. It is argued phenomenologically, from the aerodynamic point of view, that operating the system in the strong suction regime would be a better strategy than operating it in other characteristic regimes for the consideration of capture efficiency. Design guidelines are developed and summarized based on the results obtained from this study. The regression formulas for calculating the critical values of the push-jet and the pull-flow velocities are provided for easy access. The sulfur hexafluoride tracer gas validation technique is performed to measure the capture efficiency. The results of tracer gas validations are consistent with those obtained from the aerodynamic visualization and measurements. The operation points obtained by employing the American Conference of Governmental Industrial Hygienists design criteria are compared with the results obtained in this study for both the aerodynamics and the capture efficiency. Methods for improving the capture efficiency and energy consumptions are suggested.

Pathogenesis of jumping translocations: a molecular cytogenetics study

BACKGROUND/AIMS

Jumping translocations are rare cytogenetic aberrations in haematological malignancies, the pathogenesis of which remains to be fully characterised. We investigated the mechanism of formation of jumping translocations in a case of adult common acute lymphoblastic leukaemia (ALL) positive for the Ph translocation.

METHODS

Interphase and metaphase fluorescence in situ hybridisation (FISH) was performed using several probe systems. Results were correlated with findings on conventional cytogenetics. Granulocytes, T-cells and leukaemic B-cells in peripheral blood were sorted by immunomagnetic method and the terminal restriction fragment (TRF) length of these cellular populations was determined by Southern blot analysis.

RESULTS

Duplicated BCR-ABL fusion signals were found on a dic(14;22)der(22)t(9;22) chromosome. Clonal jumping translocations, existing as evolutionary changes, involved the donor chromosomal segment distal to 1q12 jumping onto the telomere ends of 11q, 15p, 19p and 20p. Telomere length was decreased in the neoplastic B-cell population and contributed to the formation of the dicentric chromosome that showed absence of telomere repeats at fusion ends. Subsequent pericentromeric heterochromatin decondensation of chromosome 1q occurred, and this donor segment was randomly fused to the shortened telomere ends of non-homologous chromosomes.

CONCLUSIONS

Both telomere shortening and pericentromeric heterochromatin decondensation contribute to the formation of jumping translocations, which is most probably a multi-stage process.

Otitis caused by Scedosporium apiospermum in an immunocompetent child

Scedosporium apiospermum (Pseudallescheria boydii) is a ubiquitous saprophytic mold. It is considered an infrequent but important and emerging human pathogen, mostly in immunocompromised hosts. Otomycosis secondary to S. apiospermum is extremely rare. We report an 8-year-old immunocompetent male who developed otitis media and otitis externa from S. apiospermum, which was successful treated with combination of surgical debridement and topical clotrimazole therapy. A brief literature review of infections caused by S. apiospermum follows the case presentation.

Mapping of quantitative trait loci controlling low-temperature germinability in rice (Oryza sativa L.)

Low-temperature germination is one of the major determinants for stable stand establishment in the direct seeding method in temperate regions, and at high altitudes of tropical regions. Quantitative trait loci (QTLs) controlling low-temperature germinability in rice were identified using 122 backcross inbred lines (BILs) derived from a cross between temperate japonica varieties, Italica Livorno and Hayamasari. The germination rate at 15 degrees C was measured to represent low-temperature germination and used for QTL analysis. The germination rate at 15 degrees C for 7 days of Italica Livorno and Hayamasari was 98.7 and 26.8%, respectively, and that of BILs ranged from 0 to 83.3%. Using restriction fragment length polymorphism (RFLP) and simple sequence repeat (SSR) markers, we constructed a linkage map which corresponded to about 90% of the rice genome. Three putative QTLs associated with low-temperature germination were detected. The most effective QTL, qLTG-3-1 on chromosome 3, accounted for 35.0% of the total phenotypic variation for low-temperature germinability. Two additional QTLs, qLTG-3-2 on chromosome 3 and qLTG-4 on chromosome 4, were detected and accounted for 17.4 and 5.5% of the total phenotypic variation, respectively. The Italica Livorno alleles in all detected QTLs increased the low-temperature germination rate.

Fine linkage mapping enables dissection of closely linked quantitative trait loci for seed dormancy and heading in rice

Two quantitative trait loci (QTLs) for seed dormancy (tentatively designated Sdr1) and heading date ( Hd8) have been mapped to approximately the same region on chromosome 3 by interval mapping of backcross inbred lines derived from crosses between the rice cultivars Nipponbare (japonica) and Kasalath (indica). To clarify whether Sdr1 and Hd8 could be dissected genetically, we carried out fine-scale mapping with an advanced backcross progeny. We selected a BC(4)F(1) plant, in which a small chromosomal region including Sdr1 and Hd8, on the short arm of chromosome 3, remained heterozygous, whereas all the other chromosomal regions were homozygous for Nipponbare. Days-to-heading and seed germination rate in the BC(4)F(2) plants showed continuous variation. Ten BC(4)F(2) plants with recombination in the vicinity of Sdr1 and Hd8 were selected on the basis of the genotypes of the restriction fragment length polymorphism (RFLP) markers flanking both QTLs. Genotypes of those plants for Sdr1 and Hd8 were determined by advanced progeny testing of BC(4)F(4) families. Sdr1 was mapped between the RFLP markers R10942 and C2045, and co-segregated with C1488. Hd8 was also mapped between C12534S and R10942. Six recombination events were detected between Sdr1 and Hd8. These results clearly demonstrate that Sdr1 and Hd8 were tightly linked. Nearly isogenic lines for Sdr1 and Hd8 were selected by marker-assisted selection.

Highly efficient light emission at lambda = 1.5 microm by a three-dimensional tungsten photonic crystal

For what is believed to be the first time, a three-dimensional tungsten photonic crystal is demonstrated to emit light effectively at wavelength lambda = 1.5 microm. At a bias of V = 7 V, the thermal emission exhibits a full width at half-maximum of delta lambda = 0.85 microm. Within this narrow band, the emitted optical power is 4.5 W and the electrical-to-optical conversion efficiency is approximately 22% per emitting surface. This unique emission is made possible by a large, absolute bandgap in the infrared lambda and flat photonic dispersion near the band edges and in a narrow absorption band.

Low-loss, wide-angle Y splitter at approximately ~1.6- mum wavelengths built with a two-dimensional photonic crystal

We report a successful experimental realization of a photonic-crystal Y splitter operating at lambda~1.6 mum . Our device has a large splitting angle of 120 degrees and a miniature size of ~3 mumx3 mum . Furthermore, the Y-splitter loss is measured to be 0.5-1 dB at lambda=1640-1680 nm, making the Y splitter promising for integrated photonic-circuit applications. These unique properties are attributed to the new guiding principle made possible by the photonic bandgap.

All-metallic three-dimensional photonic crystals with a large infrared bandgap

Three-dimensional (3D) metallic crystals are promising photonic bandgap structures: they can possess a large bandgap, new electromagnetic phenomena can be explored, and high-temperature (above 1,000 degrees C) applications may be possible. However, investigation of their photonic bandgap properties is challenging, especially in the infrared and visible spectrum, as metals are dispersive and absorbing in these regions. Studies of metallic photonic crystals have therefore mainly concentrated on microwave and millimetre wavelengths. Difficulties in fabricating 3D metallic crystals present another challenge, although emerging techniques such as self-assembly may help to resolve these problems. Here we report measurements and simulations of a 3D tungsten crystal that has a large photonic bandgap at infrared wavelengths (from about 8 to 20 microm). A very strong attenuation exists in the bandgap, approximately 30 dB per unit cell at 12 microm. These structures also possess other interesting optical properties; a sharp absorption peak is present at the photonic band edge, and a surprisingly large transmission is observed in the allowed band, below 6 microm. We propose that these 3D metallic photonic crystals can be used to integrate various photonic transport phenomena, allowing applications in thermophotovoltaics and blackbody emission.

Development of a method for the determination of pyrimethamine concentrations in feeds by ion-pairing high-performance liquid chromatography

An ion-pairing reversed-phase high-performance liquid chromatography (HPLC) method with diode array detection at 280 nm was developed to determine pyrimethamine concentrations in feed for laying hens. Pyrimethamine was extracted with a mixture of 5% isobutanol and 95% benzene, and the extract was cleaned up on an alumina column. The drug was eluted from an Intersil ODS-3V column (250 by 4.6 mm) with a mixture of 25% acetonitrile and 75% water (vol/vol) containing 0.01 M tetramethylammonium chloride as an ion-pairing agent and adjusted with acetic acid to pH 3.5. The flow rate was 1.0 ml/min. Mean recovery of pyrimethamine from supplemented feeds at concentrations of 2, 4, and 5 microg/g of feed were 100.5, 103.5, and 100.8%, respectively. Precision within a day ranged from 4.3 to 7.0% for the three concentrations, and day-to-day precision was 5.3% for feed supplemented at a concentration of 4 microg/g. No chromatographic interference was detected from other 2,4-diaminopyrimidine compounds or other major drugs used in poultry.

Compression forces and amount of outer coating layer affecting the time-controlled disintegration of the compression-coated tablets prepared by direct compression with micronized ethylcellulose

The influence of compression force to inner core tablet or to outer coating layer of the compression-coated tablet on the function of time-controlled disintegration was investigated. The inner core tablet was directly compacted by sodium diclofenac (model drug) and ethylcellulose (EC) with 4.6-microm particle size was used as an outer coating layer. The immersion time of the compression-coated tablet previously soaked in pH 1.2 solution to simulate the residence time of the tablet in the GI tract affecting the dissolution behavior of the compression-coated tablet was also investigated. The effect of the amount of the outer coating layer used on the drug release was examined. The results indicate that sodium diclofenac released from these compression-coated tablets exhibited a longer lag of a period about 16.3 h in both distilled water and pH 6.8 buffer solution, followed by a different drug release behavior. The lag time was independent of the pH of dissolution medium, and the immersion time in pH 1.2 solution. After that lag time, the outer shell of the compression-coated tablets broke into two halves to make a rapid drug release. However, the drug release behavior of the soaked tablet in pH 6.8 buffer solution was dependent on the immersion time. The compression force < 200 kg/cm(2) to the inner core tablet influenced the release behavior of drug less, but > 200 kg/cm(2) might delay the lag time. The lag time of the compression-coated tablets was linearly correlated with the compression force to the outer coating layer (r = 0.9896). We also found that the more the amount of outer coating layer added, the longer the lag time obtained. The study demonstrates that the time-controlled disintegration of the compression-coated tablet was effectively controlled by the compression force applied and the amount of outer coating layer added.

Monte Carlo simulation of a clinical linear accelerator

The effects of the physical parameters of an electron beam from a Siemens PRIMUS clinical linear accelerator (linac) on the dose distribution in water were investigated by Monte Carlo simulation. The EGS4 user code, OMEGA/BEAM, was used in this study. Various incident electron beams, for example, with different energies, spot sizes and distances from the point source, were simulated using the detailed linac head structure in the 6 MV photon mode. Approximately 10 million particles were collected in the scored plane, which was set under the reticle to form the so-called phase space file. The phase space file served as a source for simulating the dose distribution in water using DOSXYZ. Dose profiles at Dmax (1.5 cm) and PDD curves were calculated following simulating about 1 billion histories for dose profiles and 500 million histories for percent depth dose (PDD) curves in a 30 x 30 x 30 cm3 water phantom. The simulation results were compared with the data measured by a CEA film and an ion chamber. The results show that the dose profiles are influenced by the energy and the spot size, while PDD curves are primarily influenced by the energy of the incident beam. The effect of the distance from the point source on the dose profile is not significant and is recommended to be set at infinity. We also recommend adjusting the beam energy by using PDD curves and, then, adjusting the spot size by using the dose profile to maintain the consistency of the Monte Carlo results and measured data.

Direct measurement of the quality factor in a two-dimensional photonic-crystal microcavity

A new microcavity design is proposed and structures are realized with a two-dimensional photonic-crystal slab. The cavity consists of seven defect holes that encompass a hexagon and is designed to reduce vertical light leakage. From a direct transmission measurement, a Q value of 816+/-30 is achieved at lambda =1.55 mum . This high- Q cavity will permit the realistic realization of spontaneous-emission modification and on-off optical switches.

Effect of cyanide concentrations on the secondary structures of protein in the crude homogenates of the fish gill tissue

The effect of cyanide concentrations on the secondary conformation of protein in the fish gill homogenate was determined using an attenuated total reflectance (ATR)/Fourier transform infrared (FT-IR) microspectroscopy. Gills from male Tilapia zillii were isolated and homogenized in pH 8.0 Tris buffer solution and subjected to FT-IR study. The results indicate that the amide I and III bands of protein in fish gill homogenate deformed markedly with the increase of cyanide concentration. The fish gill homogenate shows a maximum peak at 1650 cm(-1) in amide I band, suggesting the predominant proportion of alpha-helical conformation. Once the KCN was added into the gill homogenate, the maximum peak shifted gradually from 1650 to 1643 cm(-1) due to the random coil structure, with the increase of cyanide concentration used. Two additional shoulders at 1657 (alpha-helix) and 1627 (beta-sheet) cm(-1) also appeared gradually, implying that the cyanide can in part induce changes in protein conformation of fish gill homogenate from alpha-helix to random coil and beta-sheet conformations.

[Diagnosis of non-typical myocarditis by applying immunohistochemical method of CD68]

OBJECTIVE

To make a distinction between myocarditis and the reaction to some pathological state of myocardium.

METHODS

Myocardium of 26 cases with sudden cardiac death were stained and LM light microscopies with immunohistochemical method 10 cases with normal myocardium were contrasted.

RESULTS

A great deal of stained positive monocyte of immunohistochemistry emerged in the parasetions of myocarditis patients with various farms and stacking(> 15).

CONCLUSION

The stain of immunohistochemistry can be used as one of the indications for diagnosing non-typical myocarditis.

Design and evaluation of drug-loaded wound dressing having thermoresponsive, adhesive, absorptive and easy peeling properties

In order to develop a novel unique wound dressing, a combination of self-adhesive Eudragit E film with antibacterial drug-loaded poly (N-isopropyl-acrylamide) (PNIPAAm) microgel beads was designed. The result indicates that the tack property of Eudragit E film increased with an increase of the PNIPAAm microgel beads added, but there was no significant difference between the dried PNIPAAm microgel beads with or without adsorbing drug. In addition, the peel strength of Eudragit E film initially decreased with the addition of PNIPAAm microgel beads, but increased to a maximum value when PNIPAAm microgel beads were added from 4% to 7.6%. then decreased again after 7.6%. The optimal concentration of PNIPAAm microgel beads was 7.6% (w/v) which had better tack and peel adhesive properties. The water uptake ratio of Eudragit E film containing PNIPAAm microgel beads was found to be temperature-dependent, suggesting that the Eudragit E film containing PNIPAAm microgel beads enabled to absorb the wound fluid. Eudragit E film containing PNIPAAm microgel beads with or without adsorbing drug had significantly reduced peel strength after 12 h-immersion in solution. All these results suggest that a novel drug-loaded wound dressing has been developed by binding a self-adhesive Eudragit E film with an antibacterial drug-loaded PNIPAAm microgel beads to achieve thermo-responsive, adhesive, absorptive and easy peeling functions.

The response of a thermoluminescent dosimeter to low energy protons in the range 30-100 keV

This study demonstrates the thermoluminescence (TL) response of CaF2:Tm (commercial name TLD-300) to 30-100 keV protons which were generated by means of a Cockcroft-Walton accelerator. The phenomenon in which the total thermoluminescent output from CaF2:Tm (TLD-300) decreases with proton energy from 30 to 100 keV (with increase of LET) can be interpreted by the track structure theory (TST). The analysis of the glow peaks: P2 (131 degrees C), P3 (153.5 degrees C) and P6 (259 degrees C), of TLD-300 show the oscillatory decreasing phenomenon as a function of incident proton energy, which can be interpreted with the TST and the oscillatory emission of electrons in a thermoluminescent dosimeter (TLD) that is caused by resonant or quasi-resonant charge transfer in ion-atom interactions in this TLD-300.

Molecular mechanisms of apoptosis induced by magnolol in colon and liver cancer cells

Magnolol has been reported to have anticancer activity. In this study we found that treatment with 100 microm magnolol induced apoptosis in cultured human hepatoma (Hep G2) and colon cancer (COLO 205) cell lines but not in human untransformed gingival fibroblasts and human umbilical vein endothelial cells. Our investigation of apoptosis in Hep G2 cells showed a sequence of associated intracellular events that included (a) increased cytosolic free Ca(2+); (b) increased translocation of cytochrome c (Cyto c) from mitochondria to cytosol; (c) activation of caspase 3, caspase 8, and caspase 9; and (d) downregulation of bcl-2 protein. Pretreatment of the cells with the phospholipase C inhibitor 1-[6-[[(17 beta)-3-methoxyestra-1,3,5(10)-trien-17-yl]amino]hexyl]-1 H-pyrrole-2,5-dione (U73122) or the intracellular chelator of Ca(2+) 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid acetoxymethyl ester (BAPTA/AM) inhibited the subsequent magnolol augmentation of [Ca(2+)](i) and also the activation of caspase-8 and caspase-9, so that the occurrence of apoptosis in those cells was greatly reduced. Pretreatment of the cells with ZB4 (which disrupts the Fas response mechanism) also decreased the subsequent magnolol-induced caspase-8 activation and reduced the occurrence of apoptosis. We interpreted these findings to indicate that the above-listed sequence of intracellular events led to the apoptosis seen in Hep G2 cells and that [Ca(2+)](i), Cyto c, and Fas function as intracellular signals to coordinate those events.

Spontaneous femoral neck fracture complicating a healed subtrochanteric fracture--a case report

A rare case of spontaneous femoral neck fracture complicating a healed subtrochanteric fracture was encountered in an 85-year-old female. The subtrochanteric fracture was caused by a minor trauma with no other combined injury. Patient received close reduction and internal fixation two days later and the fracture healed in three months. Six months after operation, spontaneous ispilateral femoral neck fracture occurred without trauma. Although there were some reports about subcapital fracture or femur neck fracture complication after operation, this is the first case of spontaneous femoral neck fracture after healed subtrochanteric fracture which was treated with a 95 degrees dynamic condylar screw (DCS) and side plate previously without technical error.

Diagnosis of congenital hypothyroidism from human anagen scalp hair by infrared microspectroscopy

A highly efficient Fourier transform infrared (FT-IR) microscopy was used to determine the biophysical structure of anagen scalp hair roots of neonates suffering from congenital hypothyroidism (CH) due to ectopic thyroid. The present results indicate that the lower composition near 1,053 cm(-1) (also assigned to the aromatic iodide stretching band) in the infrared (IR) spectra of the hair roots for CH patients was directly associated with the lower serum level of T4 and fT4, and the elevated TSH levels determined by RIA method. This strongly implies the lower evidence of the aromatic iodide stretching band in the IR spectra of hair roots. These findings suggest that FT-IR microscopy has the potential to become a good diagnostic tool and that hair can be useful as a genetic marker.

Chromosome aberrations in lymphocytes of residents living in buildings constructed with radioactively contaminated rebars

Using the G-banding technique, we examined lymphocytes from 90 individuals (43 males and 47 females, median age 31 years) living in buildings constructed with radioactively contaminated rebars. Forty-five nonexposed control subjects (22 males and 23 females, median age 30 years), matched to the radiation-exposed individuals by sex and age, were selected for comparison. At least 500 metaphases were checked for each individual. All recognizable structural aberrations of chromosomes or chromatids were recorded. After adjusting for age and smoking status, both the percentage of cells with aberrant chromosomes (PCAC) and the number of aberrant chromosomes per 100 cells (NAC) were found to be significantly higher in the radiation-exposed females than in the control females (p < 0.05 for PCAC and NAC). This difference, however, was not observed in the comparison of radiation-exposed and control males. This suggests a possible interaction between sex and radiation exposure in their effects on chromosome aberrations.

The measurement of photoneutrons in the vicinity of a Siemens Primus linear accelerator

This study involves the measurement of photoneutron contamination emitted from a Siemens Primus medical linear accelerator by using BD-PND bubble detectors. Various bubble detectors were arranged around the linac head with the interval of I m and at the same height as the isocenter to measure the dose equivalent distribution in the treatment room. The measurements were performed for 15 MV X-rays with 40 x 40cm2 and 0 x 0cm2 fields and for 15,18, and 21 MeV electrons with 25 x 25 cm2 electron cone. Neutron dose equivalent rate at the points of measurement in the treatment room decreased with increasing distance to the isocenter. The maximum neutron dose equivalents were at the isocenter, and the values for 15MV 40 x 40 and 0 x 0 cm2 were 1843+/-90 and 169.9+/-59.9 microSv per Gy X-ray, respectively. The values for 15, 18 and 21 MeV electrons with 25 x 25 cm2 cones were 100.0+/-20.4, 262.7+/-61.2 and 349.0+/-29.6 microSv per Gy electron, respectively. The neutron contamination of electrons less than 12 MeV was below the detection limit.

Skin dose measurement by using ultra-thin TLDs

The treatment schedule for radiation therapy is often interrupted because of complicated skin reactions. Quantitative information relating beam parameters and skin reactions will be helpful. Measurements were performed for 6-15 MV photons and 6-21 MeV electrons with ultra thin TLD films (GR-200F, surface area 0.5 x 0.5cm2, nominal thickness 5 mg cm(-2)). The skin doses for various field sizes, ranging from 10 x 10 to 40 x 40 cm2, and various incident angles of beam from 0 degrees to 80 degrees were measured. The ratios of skin dose to maximum dose in phantom for 10 x 10 cm2 are 16.10+/-0.68%, 14.03+/-1.04% and 10.59+/-0.64% for 6, 10 and 15 MV, respectively. Such ratios increase with a larger field size. For electrons the ratios are 72.59+/-1.72%, 78.52+/-2.99%, 78.89+/-2.86%, 86.08+/-2.62%. 87.75+/-1.94% and 86.33+/-3.09% for 6, 9, 12, 15, 18 and 21 MeV, respectively. They also increase with a larger size. The oblique factors also increase with larger incident angle.

Nuclear localization of EGF receptor and its potential new role as a transcription factor

Epidermal growth factor receptor (EGFR) has been detected in the nucleus in many tissues and cell lines. However, the potential functions of nuclear EGFR have largely been overlooked. Here we demonstrate that nuclear EGFR is strongly correlated with highly proliferating activities of tissues. When EGFR was fused to the GAL4 DNA-binding domain, we found that the carboxy terminus of EGFR contained a strong transactivation domain. Moreover, the receptor complex bound and activated AT-rich consensus-sequence-dependent transcription, including the consensus site in cyclin D1 promoter. By using chromatin immunoprecipitation assays, we further demonstrated that nuclear EGFR associated with promoter region of cyclin D1 in vivo. EGFR might therefore function as a transcription factor to activate genes required for highly proliferating activities.

A simple classification method for residual antibiotics using E. coli cells transformed by the calcium chloride method and drug resistance plasmid DNA

Using three different plasmid DNA codings for kanamycin (KM), chloramphenicol (CP), and ampicillin- (AMP) and tetracycline- (TC) resistance, four different competent Escherichia coli strains were transformed by the calcium chloride method to produce KM-, CP- and AMP- and TC-resistant strains. Evaluation of minimum inhibitory concentrations (MIC) of 22 antibiotics, showed KM-resistant E. coli to be cross resistant only to fradiomycin (FRM); CP-resistant E. coli, especially HB101 and JM109 strains, exhibited cross-resistance only to thiamphenicol (TP). On the other hand, AMP- and TC-resistant E. coli showed cross resistance to several penicillins, tetracyclines and erythromycin. E. coli ATCC-27166, the strain most sensitive to all drugs in this experiment, was employed for disc diffusion experiments and from the pattern of appearance of the inhibition zone, eight major antibiotics were divided into three groups depending on their activity against containing each of the three plasmids. Only gentamicin (GM) activity was not affected by any of the drug resistant strains. Assay techniques utilizing three resistant strains may be the technique for screening foods for antibiotic residues in the future.

Ultrasonographic study of the coexistence of muscular torticollis and dysplasia of the hip

The consistent relationship between congenital muscular torticollis and dysplasia of the hip is now widely accepted. However, the coexistence rate of these two disorders has been reported with variations from 0 to 20%. To obtain a more accurate coexistence rate, ultrasound scanner was used as the diagnostic tool for both of these disorders.Sixty-three children (30 boys and 33 girls) younger than 6 months who had undergone ultrasound scanning of both bilateral sternocleidomastoid muscle and bilateral hips were included in this study. Forty-seven children were confirmed to have muscular torticollis, and the remaining 16 cases were diagnosed as postural torticollis. Only these 47 cases were included for analysis of the coexistence rate. Eight children were found with dysplasia of the hips associated with muscular torticollis, which included Graf's type IIa for four hips, type IIb for two hips, type IIIa for one hip, and type IIIb for one hip. From the results of the present ultrasonographic study, the coexistence rate of congenital muscular torticollis and dysplasia of the hip was concluded to be 17%. If only those dysplastic hips (type IIb, IIIa, IIIb) that required treatment were included, the coexistence rate would be lowered to 8.5%.

Molecular characterization of foot-and-mouth disease virus isolated from ruminants in Taiwan in 1999-2000

In 1999, 10 sporadic outbreaks of cattle foot-and-mouth disease (FMD) occurred in Taiwan. By the time, infection was limited to the Chinese yellow cattle (a native species of beef cattle in Mainland China), which did not develop vesicular lesions under field conditions. Five viruses isolates obtained from individual farms were confirmed to be the serotype O FMD virus (O/Taiwan/1999). During January-February 2000, however, this virus has spread to dairy cattle and goat herds, causing severe mortality in goat kids and vesicular lesions in dairy cattle. Partial nucleotide sequence of the capsid coding gene 1D (VP1) was determined for the virus isolates obtained in this study. Phylogenetic analysis of the VP1 sequences indicated that the O/Taiwan/1999 viruses shared 95-97% similarities to the virus strains isolated from the Middle East and India. The species susceptibility of the O/Taiwan/1999 virus was experimentally studied in several species of susceptible animals, showing that the virus did cause generalized lesions in dairy cattle and pigs, however, it would not cause vesicular lesions on the Chinese yellow cattle and the adult goats. These studies suggested that the O/Taiwan/1999 virus was a novel FMD virus of Taiwan and it presented various levels of susceptibility in cattle species.

Suppression of Fas ligand expression on endothelial cells by arsenite through reactive oxygen species

Chronic exposure to arsenite is associated with vascular disease, such as arteriosclerosis. However, the cellular mechanisms for vascular disease in response to arsenic are not well known. The present study has demonstrated that arsenite not arsenate decreased the Fas ligand (FasL) expression on ECV304 cells through reactive oxygen species. Incubation of ECV304 cells with arsenite decreased the FasL expression and increased the intracellular peroxide levels. In addition, hydrogen peroxide was found to suppress FasL expression in a dose-dependent manner. The antioxidant, N-acetyl-cysteine, blocked the suppression of FasL expression in response to arsenite. These data suggested that arsenite initiates endothelium dysfunction, at least partly, by suppressing the FasL expression through activating reactive oxygen species sensitive endothelial cell signaling.

High-performance liquid chromatographic determination of carbadox, olaquindox, furazolidone, nitrofurazone, and nitrovin in feed

A high-performance liquid chromatography with gradient programming method was developed to determine the amount of carbadox (CBX), olaquindox (OLQ), furazolidone (FZ), nitrofurazone (NF), and nitrovin (NTV) in feed simultaneously. Complete separation of the drugs was obtained using a C8 silica gel column with gradients of acetonitrile as mobile phase. The mobile phase used an acetonitrile gradient with an initial hold time of 1 min at 0% acetonitrile, followed by an increase to 50% acetonitrile over 10 min. The correlation coefficients (r) for calibration curves of the five feed additives were greater than 0.999. The relative standard deviations (RSDs) of peak areas from four injections for these drugs at three concentrations were less than 3.0%, although the RSD for NTV at 5 ppm was somewhat large (6.7%). The medicated feeds were extracted by pretreating with water, extracted with 95% dimethylformamide overnight at room temperature, and cleaned up on a column of alumina oxide. Recoveries of CBX, OLQ, FZ, NF, and NTV from low level spiked feed were 102.0, 94.6, 97.4, 110.6, and 66.0%, respectively, and from high level spiked feed, they were 114.09, 99.1, 97.3, 109.9, and 62.7%, respectively.

Surgical treatment for Haglund's deformity

Haglund's deformity, or "pump bump" is a common cause of posterior heel pain, characterized clinically by a painful soft tissue swelling at the level of the Achilles tendon insertion. We reviewed 30 heels in 19 patients with failure of conservative treatment. Surgical management consisted of excision of the posterior calcaneal tuberosity and bursectomy through a medial longitudinal incision. The average follow-up period was 6 years (range, 3-10 years). Only 3 heels (10%) in 2 patients had persistent pain. Twenty-seven heels (90%) were cured after operation. However, 25 heels (83%) had residual pain for a half to two years after operation and became free of symptoms thereafter. We conclude surgical treatment of Haglund's deformity produces a predictably good result (90%) but requires a long time about a half to two years for full recovery.

Primary tumour volume delineation in nasopharyngeal carcinoma and correlation with 1997 AJCC tumour stage classification

OBJECTIVE

To investigate the variability in primary tumour volume in nasopharyngeal carcinoma and compare it with the tumour staging of the 1997 American Joint Committee on Cancer.

DESIGN

Prospective study.

SETTING

Tertiary care centre.

METHOD

A series of 33 newly diagnosed patients who were treated with high-dose radiotherapy participated in the study.

MAIN OUTCOME MEASURES

Using computed tomographic scans, primary tumour volumes were measured using the summation-of-areas technique, and the variability in tumour volume was determined. The Mann-Whitney test was used for statistical analysis.

RESULTS

A large variation in primary tumour volume was observed, especially in advanced-stage cases.

CONCLUSIONS

Nasopharyngeal carcinoma shows considerable variability in primary tumour volume. Incorporation of primary tumour volume may lead to further refinement of the 1997 tumour staging system.

Isolated talonavicular arthrodesis for talonavicular arthritis

We have reviewed a single surgeon's experience with isolated talonavicular fusion in 16 patients with talonavicular arthritis. Fixation was either by staples or screws. Fifteen solid unions were achieved in the 16 patients who were followed (mean: 51 months). The average Ankle-Hindfoot Scale improved from 77.2 preoperatively to 92.9 postoperatively (p < 0.001). Subjectively, 15 patients were satisfied and one patient dissatisfied with the results. Further osteoarthritis in the adjacent joints was noted in five patients. We concluded that isolated talonavicular fusion is an effective method of treatment of talonavicular arthritis regarding pain relief and functional improvement. Though osteoarthritis was found in some adjacent joints postoperatively, the results were still satisfactory.

Minimal requirements for IgE-mediated regulation of surface Fc epsilon RI

The IgE-FcepsilonRI network plays a central role in allergic inflammation. IgE levels control cell surface levels of FcepsilonRI and, in turn, FcepsilonRI levels modulate the intensity of effector responses. Treatment of allergic patients with anti-IgE Abs has been shown to induce a decrease in FcepsilonRI expression on basophils and a decrease in Ag-triggered histamine release. However, the mechanisms underlying IgE-mediated regulation of FcepsilonRI expression remain unclear. Here, we designed an in vitro model system to establish the minimal cellular requirements for regulation of FcepsilonRI by IgE. Using this system, we demonstrate that transcriptional regulation, hemopoietic-specific factors, and signaling are not required for IgE-mediated increases in FcepsilonRI expression. IgE binding to the alpha-chain is the minimal requirement for the induction of FcepsilonRI up-regulation. The rate of up-regulation is independent of the baseline level of expression. The mechanism of this up-regulation is the result of a combination of three factors: 1) stabilization of the receptor at the cell surface, which prevents receptor internalization and degradation; 2) use of a preformed pool of receptor comprising recycled and recently synthesized receptors; and 3) continued basal level of protein synthesis. It is possible that in vivo additional factors contribute to modulate the basic regulatory mechanism described here.

Solid-state trans-cis isomerization of captopril determined by thermal Fourier transform infrared (FT-IR) microspectroscopy

Thermal Fourier transform infrared (FT-IR) microspectroscopy was used to investigate the conformational isomerization of captopril in the solid state. The result indicates that the IR peak intensity of captopril for original bands decreased dramatically at 102 degrees C, but for new bands it increased with the rise of temperature. The frequency of C=O stretching mode for carboxylic acid and for amide was located at a higher wavenumber of 1747 cm(-1) and at a lower frequency of 1591 cm(-1) as compared with the general compound, suggesting the existence of trans isomer of captopril in the solid state by intramolecular hydrogen bonding. Beyond 102 degrees C, several new bands at 1720, 1645, and 1610 cm(-1) were observed with the rise of temperature, indicating the coexistence of a cis isomer. However, the cis isomer could transform gradually to the trans isomer after cooling. The thermodynamics of equilibrium mixture of cis/trans isomers were also studied. The trans isomer was more stable than the cis isomer, but the cis isomer was favored at the higher temperature.

Precision and reproducibility of temperature response of a thermo-responsive membrane embedded by binary liquid crystals for drug delivery

A thermo-responsive membrane embedding with the binary mixture of 36% cholesteryl oleyl carbonate (COC) and 64% cholesteryl nonanoate (CN) was successfully developed to achieve a rate-controlled and time-controlled drug release in response to the skin temperature (i.e., 32 degrees C) of the human body. The thermophysical properties of this binary mixture were determined by differential scanning calorimetry (DSC) and a microscopic Fourier transform infrared (FT-IR) spectrometer equipped with a thermal analyzer (FT-IR/DSC microscopic system). The phase transition temperatures of this binary mixture at 35.1 and 64.0 degrees C were clearly evidenced by both analytical methods. The temperature response of this binary mixture of COC and CN with 36%:64% ratio were also investigated for eight cycles by the isothermal FT-IR/DSC microscopic system to continuously and repeatedly alter the temperature cycle between 25 and 37 degrees C. The results show that this binary mixture revealed a good temperature response in precision, sensitivity, obedience and reproducibility. The temperature-sensitive on-off pulsatile function of drug penetration through this thermo-responsive membrane was investigated. The switching mechanism of this thermo-responsive membrane was also proposed. The present result strongly indicates that the binary COC-CN mixture-embedded membrane can be used to deliver the drug in a pulsatile fashion with respect to skin temperature.

Low tibial osteotomy for moderate ankle arthritis

Low tibial osteotomy is one of the significant advances of ankle reconstruction techniques that has been made recently in an effort to halt arthritis in its early stages and leave fusion as the last, not the only, alternative treatment of ankle arthritis. From 1989 to 1995, we performed 18 low tibial osteotomies which included 6 cases of post-traumatic arthritis and 12 cases of degenerative arthritis. The ages of the 7 male and 11 female patients ranged from 18 to 78 years with an average of 41.9 years. The follow-up period lasted a mean of 47.7 months, ranging from 25 to 82 months. The average functional score changed from 49.6 pre-operatively to 88.5 at the last follow up, and showed yearly improvement. Complications included one case of late infection and two cases of implant failure, none of which led to nonunion. The indication for low tibial osteotomy is the intermediate stage of moderate ankle arthritis with a medial joint lesion and intact lateral facet. Using pressure redistribution on the joint surface, this procedure is an alternative treatment for ankle arthritis which may save an arthritic ankle from the fate of fusion or at least postpone fusion surgery.

Cyanide-induced alterations to the biophysical conformations of the isolated fish liver

The purpose of this study is to examine the applicability of an infared spectroscopic methodology for the study of an environmental problem. The effect of cyanide concentrations on the biophysical conformation of the fish liver homogenate was determined by using an attenuated total reflectance (ATR)/Fourier transform infrared (FT-IR) microspectroscopy. Alive male model fish, Tilapia Zillii, was used. The liver from fish was isolated and homogenized in pH 8.0 Tris buffer solution. The results indicate that the IR peak intensity increased markedly in the C-H stretching range (3000-2800 cm-1), ester C = O stretching of lipids (1743 cm-1) and carbohydrate bands (1195-950 cm-1), but decreased in the amide I at 1649 cm-1 and the free asymmetric stretching band of phosphate at 1261 cm-1 with the increase of KCN concentrations. The marked release of hepatic enzymes and glutathione into homogenate induced by cyanide might account for the higher IR spectral peak intensity of fish liver tissue after treatment with KCN. The cyanide was also found to induce the protein structure of fish liver homogenate from alpha-helical conformation to beta-conformation.

Surgical treatment for concomitant fractures of the femoral neck and diaphysis: a treatment protocol

Concomitant ipsilateral femoral shaft and neck fractures are difficult to treat. The standard protocol in our hospital is plates for diaphyseal fractures and lag screws or dynamic hip screws (DHS) fixations for the femoral neck fractures. We treated 21 patients with these complex fractures between 1988 and 1998 with this protocol. All patients were injured from high-energy trauma. There were 15 males and 6 females with an average age of 44 years. The average follow-up period is 50 months. All except one patient united well. During the follow-up period, neither non-union of the femoral neck fracture nor osteonecrosis of the femoral head was noted. There was also no malunion. There were twenty good results and one poor functional result. We conclude that plate on the shaft and sliding hip screws or separate screws in the hip are a reliable method for concomitant ipsilateral femoral neck and shaft fractures.

Reaction kinetics of solid-state cyclization of enalapril maleate investigated by isothermal FT-IR microscopic system

To investigate the reaction kinetics of the solid-state degradation process of enalapril maleate, a Fourier transform infrared microspectroscope equipped with thermal analyzer (thermal FT-IR microscopic system) was used. The isothermal stability study was conducted at 120-130 degrees C for 1-2 h and changes in the three-dimensional plots of the IR spectra of enalapril maleate with respect to heating time were observed. The study indicates that the bands at 1649, 1728, and 1751 cm(-1) assigned to intact enalapril maleate gradually reduced in peak intensity with heating time. However, the peak intensities at 1672 and 1738 cm(-1) (due to enalapril diketopiperazine (DKP) formation) and at 3250 cm(-1) (corresponding to water formation) gradually increased with heating time. The solid-state diketopiperazine formation and the degradation process of enalapril maleate via intramolecular cyclization were found to be simultaneous. The isothermal decomposition curves were sigmoidal and were characterized by induction and acceleration periods, indicating the presence of autocatalytic solid-state decompositions. Moreover, the power-law equation (n = 1/4) was found to provide the best fit to the kinetics of decomposition. This isothermal FT-IR microscopic system was easily used to investigate the degradation of enalapril maleate and the concomitant formation of DKP. The solid-state reaction of enalapril maleate required an activation energy of 195+/-12 kJ/mol to undergo the processes of decomposition and intramolecular cyclization.

Continuous UVB irradiation to modify the biophysical properties and protein conformation of rat skin

In order to determine the continuous irradiation effects of UVB on the skin of live Sprague Dawley (SD) rats, the changes in biophysical properties and protein conformation of the skin were studied. The continuous UVB irradiation affecting the water content, skin color and protein structure of the rat skin was investigated by using a skin surface hygrometer, a Chroma meter and an attenuated total reflection (ATR)/Fourier transform infrared (FT-IR) spectroscopy. Test areas on the dorsal skin were continuously irradiated with 600 +/- 10 microW/cm2 UVB for 56 h. Part of the dorsal skin was covered with a bandage as a non-irradiated control. The results indicated that the water content of the irradiated skin decreased with UVB irradiation, but the non-irradiated control skin exhibited a higher level of water content. The decrease in the skin's water-binding capacity from cracks induced by continuous UVB irradiation, and the occlusive dressing of the non-irradiated skin to prevent water loss and form full hydration might be responsible for the results. The decrease of L* value and the increase in a*, b* and delta E values in the skin color parameters with UVB irradiation indicates an incremental darkening of the skin and a marked increase in erythema. However, there was no significant change in skin color for the non-irradiated control skin. A slight modification of the protein secondary structure in the skin after continuous UVB irradiation was also evidenced by transforming the alpha-helix structure into a beta-sheet structure after long-term continuous UVB irradiation. Continuous UVB irradiation of SD rat skin may decrease the skin's water-binding capacity, cause darkening, increase erythema and modify the protein secondary structure of the skin.

Presence of Epstein-Barr virus latent membrane protein 1 gene in the nasopharyngeal swabs from patients with nasopharyngeal carcinoma

BACKGROUND

Nasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in southeastern China and Taiwan. Early detection of the local disease followed immediately by proper treatment is essential to increase the cure and survival rates. Because every NPC tumor cell carries Epstein-Barr Virus (EBV) genomes, detection of EBV genomic DNA such as latent membrane protein 1 gene (LMP1) might indicate the presence of NPC. We developed a simple and noninvasive technique of nasopharyngeal swabbing to acquire nasopharyngeal cells for detecting the presence of EBV genome. The aim of this study was to investigate the feasibility and reliability of this technique.

METHODS

We collected nasopharyngeal cells by means of a nasopharyngeal swabbing technique and detected the presence of EBV LMP1 with polymerase chain reaction (PCR). Thirty-eight swab specimens were obtained from patients with NPC who were newly diagnosed or were just beginning radiotherapy. Two groups of control subjects were recruited, including 20 patients with other head and neck cancers and eight family members of the NPC patients. An additional group of 65 NPC patients were enrolled in the course of regular follow-up after definitive radiotherapy.

RESULTS

All of the samples yielded sufficient DNA for PCR amplification. Thirty-six of 38 NPC swab samples were positive for EBV LMP1, and all the control subjects had swab sample results negative for EBV. All five patients with suspected local recurrence exhibited positive EBV test results.

CONCLUSIONS

Demonstration of EBV LMP1 in the nasopharyngeal swab specimens detected NPC with a sensitivity of 94.7% and specificity of 100%. This study confirms the reliability and feasibility of nasopharyngeal swab in the predicting and screening of NPC.

Quantitative analysis of bending efficiency in photonic-crystal waveguide bends at lambda = 1.55 mum wavelengths

Based on a photonic-crystal slab structure, a 60 degrees photonic-crystal waveguide bend is successfully fabricated. Its bending efficiency within the photonic bandgap is measured, and near 100% efficiency is observed at certain frequencies near the valence band edge. The bending radius is ~1mum at a wavelength of lambda~1.55mum . The measured eta spectrum also agrees well with a finite-difference time-domain simulation.

Simvastatin treatment on postprandial hypertriglyceridemia in type 2 diabetes mellitus patients with combined hyperlipidemia

Recent studies have shown that statins are effective in reducing fasting low-density lipoprotein-cholesterol (LDL-C) and triglyceride levels. However, it remains unknown if treatment with statins also lowers daily postprandial triglyceride concentrations, which may promote atherogenesis in type 2 diabetes subjects. Forty-one subjects with type 2 diabetes and combined hyperlipidemia who had stable glycemic control were randomly assigned to take simvastatin 20 mg (n = 27) or a placebo (n = 14) once daily for 12 weeks. The medication dosage was doubled after 4 weeks if a subject's LDL-C was not less than 130 mg/dL. Among these participants, 24 subjects (15 on simvastatin and 9 on placebo) agreed to take a meal tolerance test with isocaloric mixed meals (carbohydrate, 52%; fat, 33%, and protein, 15% of the daily caloric intake) and daytime hourly blood sampling from 8 AM to 4 PM. Simvastatin treatment reduced the fasting total cholesterol level from 237 +/- 5 to 178 +/- 6 mg/dL (-25%), the LDL cholesterol level from 150 +/- 6 to 87 +/- 5 mg/dL (-40%), and raised high-density lipoprotein-cholesterol (HDL-C) level from 36 +/- 2 to 40 +/- 2 mg/dL (+11%) (all P <.001). Fasting and daily ambient triglyceride concentrations from 8 AM to 4 PM decreased significantly in response to simvastatin administration (P <.001), but not to the placebo (P =.305). Simvastatin treatment not only decreased total cholesterol and LDL-C levels and increased HDL-C levels effectively, it also decreased fasting, as well as daily postprandial triglyceride concentrations, but had no effect on glycemic control in type 2 diabetes subjects with combined hyperlipidemia.