Heart retransplantation for heart allograft failure in Chinese heart transplant recipients: NTUH experience

We investigated the short- and long-term results after heart retransplantation in terms of different causes of heart allograft failure. We sought to establish the data of heart retransplantation in Chinese compared with Western counterparts due to differences in heart allograft vasculopathy. From March 1995 to May 2005, eight heart transplantation recipients with allograft failure underwent retransplantation. Heart allograft failure was due to coronary vasculopathy (CAV) in six patients (75%) and acute rejection in two patients (25%). The mean interval to retransplantation was 32 to 84 months (mean 54.3 months). There were five patients who survived after heart retransplantation for CAV and no patient survived after an earlier diagnosis of acute rejection. Heart retransplantation is a feasible method with acceptable long-term survival rate for heart allograft failure. After careful pretransplant evaluation, retransplantation is acceptable. The survival after retransplantation for CAV is notably great than that after acute rejection. Heart retransplantation is the only way for patients who have cardiac allograft failure to achieve long-term survival.

L3L4ES antigen and secretagogues induce histamine release from porcine peripheral blood basophils after Ascaris suum infection

The aim of this paper was to investigate the role of porcine basophils in protective immunity. Experimental pigs were infected with 10(3) Ascaris suum eggs daily for 21 days. Control pigs were maintained helminth-free. Circulating porcine basophils were isolated from the anticoagulated whole blood of A. suum-infected and noninfected pigs by dextran (4.5%) sedimentation of erythrocytes or by the centrifugation of dextran-isolated leukocytes through discontinuous Percoll gradients. Results showed that 2.2% of the isolated leukocytes, stained with May-Grunwald Giemsa, were basophils. Each basophil from infected pigs contained 1.30 x 10(-2) to 1.20 x 10(-1) pg of histamine. Peripheral blood basophils (PBBs) from infected swine released 49% specific histamine when induced with A. suum-derived antigen (L3L4ES), 55% with anti-immunoglobulin G, and 62% with calcium ionophore A23l87. During A. suum infection, the number of isolated basophils and histamine levels peaked at 14 to 21 days postinfection and then showed a significant decrease. Percent-specific histamine released from PBBs by infected swine was significantly greater than that released by control pigs. The L3L4ES antigen and secretagogues effectively induced specific/nonspecific histamine release from PBBs and should facilitate future investigations of porcine basophils.

Acute adverse reactions to magnetic resonance contrast media--gadolinium chelates

The objective of this study was to evaluate the clinical safety of intravenous gadolinium-based contrast media used in patients who underwent MRI at a single institution. Acute adverse reactions to intravenous gadolinium-based contrast media used for MRI at the Princess Margaret Hospital, Hong Kong, SAR, from January 1999 to November 2004 were recorded in an incidence log book. The medical records of patients' demographics were retrospectively reviewed and the nature, frequency and severity of the adverse reactions were investigated and documented. The incidence of acute adverse reactions to intravenous gadolinium-based contrast media was 0.48% (45 patients with 46 adverse reactions). The severity of these adverse reactions were 96% mild, 2% moderate (one patient developed shortness of breath that required oxygen supplementation and intravenous steroidal management) and 2% severe (one patient developed an anaphylactoid reaction, but successfully recovered through timely resuscitation). No patients were recorded as having contrast extravasation and none died as a result of any adverse reaction. Among the 45 patients who developed adverse reactions, three patients (6.7%) had prior adverse reactions to iodinated contrast media, three (6.7%) had prior reactions to a different gadolinium-based contrast agent, one (2%) had asthma and nine (20%) had a history of drug/food allergy. Overall, 41% of the adverse reactions were not documented in the final MRI report or the clinical medical records. Gadolinium-based contrast media are safe and well tolerated by the vast majority of patients. In our study, the adverse reaction rate (0.48%) and the incidence of severe anaphylactoid reaction (0.01%) concur with those reported in the literature. Although most of the symptoms are mild and transient, these adverse reactions must be accurately documented and managed.

Cow-dung colonization and decomposition following insect exclusion

The rate of dung-pat degradation in cattle pastures in south west England was examined between May and September 2002, using batches of standardized, 1.5 kg, artificially-formed cow pats. In pats in which insects were allowed free access, the rate of disappearance, measured as ash-free dry weight, was faster in spring than summer and the loss of organic matter ranged between 0.69 and 1.99% per day, equating to an estimated time for complete disappearance of 57-78 and 88-111 days in spring and summer, respectively. To assess the role of colonizing insects on decomposition, six batches of pats were constructed and either left uncovered or, using fine mesh cages, were covered for 2, 7 or 14 days following deposition to exclude colonizing insects, after which they were uncovered. After 35 days all pats were then retrieved from the field, the composition of the invertebrate community within each pat was determined and the degree of degradation, measured as ash-free dry weight, was assessed. Covered pats had significantly higher rates of ash-free dry weight loss than uncovered pats. From the 180 pats that were recovered and searched, larvae of Aphodius (Coleoptera: Scarabaeidae) were the most numerous taxon collected (1435 individuals). Aphodius larvae were significantly more abundant in pats that remained uncovered or were covered for 2 days only, compared to pats that had been covered for 7 or 14 days. The results show that the exclusion of insects for as little as two days following deposition causes a significant reduction in both the insect population and the subsequent rate of pat degradation.

Inhibition of endosomal sequestration of basic anticancer drugs: influence on cytotoxicity and tissue penetration

The basic drugs doxorubicin and mitoxantrone are known to be concentrated in acidic endosomes of cells. Here, we address the hypotheses that raising endosomal pH with the modifying agents chloroquine, omeprazole or bafilomycin A might decrease sequestration of anticancer drugs in endosomes, thereby increasing their cytotoxicity and availability for tissue penetration. Chloroquine, omeprazole and bafilomycin A showed concentration-dependent effects to raise endosomal pH, and to inhibit sequestration of doxorubicin in endosomes. Chloroquine and omeprazole but not bafilomycin A decreased the net uptake of doxorubicin into cells, but there was no significant effect on uptake of mitoxantrone. Omeprazole and bafilomycin A increased the cytotoxicity of the anticancer drugs for cultured cells, as measured in a clonogenic assay, whereas chloroquine had minimal effects on cytotoxicity despite reduced uptake of doxorubicin. Omeprazole but not chloroquine or bafilomycin A increased the penetration of anticancer drugs through multicellular layers of tumour tissue. We conclude that modifiers of endosomal pH might increase therapeutic effectiveness of basic drugs by increasing their toxicity and/or tissue penetration in solid tumours.

Detachable functional focused rigidity cast for metatarsal fractures

This article aims to assess whether a detachable functional focused rigidity cast can be used as a one-off definitive treatment for proximal 5th metatarsal fractures. A prospective trial was carried out over a 2-year period. Forty-one patients with proximal 5th metatarsal fractures (tuberosity and Jones) were recruited and treated with a detachable focused rigidity cast after appropriate consent. Of the 39 patients with follow-up, six had a Jones fracture and 33 had tuberosity fractures. All 33 patients with tuberosity fractures achieved clinical union within 4-5 weeks (mean of 4.2 weeks). Four of the six patients with Jones fractures achieved clinical union in 8-12 weeks. One achieved union in 14 weeks and one underwent open reduction and internal fixation for delayed union. There were no complications related to the cast. The results support the use of a detachable focused rigidity cast as a one-off definitive treatment of tuberosity fractures of the 5th metatarsal. However, all the Jones fractures and the diaphyseal fractures should be referred to an orthopaedic team for further management.

Acrylic acid removal by acrylic acid utilizing bacteria from acrylonitrile-butadiene-styrene resin manufactured wastewater treatment system

The aim of this study is to isolate the acrylic acid utilizing bacteria from the ABS resin manufactured wastewater treatment system. The bacteria should have the ability to remove acrylic acid and tolerate the acrylonitrile and acrylamide toxicity. The aim is also to understand the performance of isolated pure strain for treating different initial acrylic acid concentrations from synthetic wastewater. The results are: twenty strains were isolated from the ABS resin manufactured wastewater treatment system and twelve of them could utilize 600 mg/l acrylic acid for growth. Seven of twelve strains could tolerate the acrylonitrile and acrylamide toxicity, when the concentration was below 300 mg/l. Bacillus thuringiensis was one of the seven strains and the optimum growth temperature was 32 degrees C. Bacillus thuringiensis could utilize acrylic acid for growth, when the initial acrylic acid concentration was below 1,690.4 mg/l. Besides this, when the initial acrylic acid concentration was below 606.8 mg/l, the acrylic acid removal efficiency exceeded 96.3%. Bacillus thuringiensis could tolerate 295.7 mg/l acrylamide and 198.4 mg/l acrylonitrile toxicity but could not tolerate 297.3 mg/l epsilon-caprolactam.

Co-culture of Trypanosoma musculi with spleen-derived adherent fibroblasts: possible transfer of small molecules via connexons

Trypanosoma musculi, a protozoan parasite specific to mouse, was cultured in vitro in the presence of spleen-derived adherent cells. T. musculi co-cultured with adherent cells survived and proliferated indefinitely as long as cellular contact was retained. Scanning and transmission electron microscopy confirmed intimate membrane-to-membrane contact between the adherent cells and parasites. Cellular contact, therefore, seemed to be essential for trypanosomal survival and growth. Immunocytochemical studies demonstrated intense fibroblast growth factor (FGF) activity in adherent cells, and FGFR-2 in associated trypanosomes. BioPorter Lucifer yellow protein delivery reagent studies demonstrated that Lucifer yellow transfected into fibroblast was incorporated into associated trypanosomes. The results suggest the existence of viable channels reminiscent of gap junctions between associated cells. Such transfer of low molecular weight molecules might represent antiapoptotic metabolic factors that support survival of adherent trypanosomes in vitro. Immunocytochemical studies also detected connexin-32 and connexin-43 in the cytoplasm of fibroblasts and associated trypanosomes, however, restriction of connexons to trypanosome/fibroblast adherent sites was not observed. Western blots confirmed the presence of connexin protein molecules in trypanosomes.

Long-term outcomes after ARDS

Early reports of late outcomes among survivors of ARDS indicated that most patients improved dramatically after their intensive care unit stay, and few lived with residua of their once-severe pulmonary injury. Over the last decade, a collection of new studies with improved methodology and novel questions has improved our understanding of life after ARDS. After reviewing these newer investigations in the context of previously published literature, we have drawn several preliminary conclusions: (1) Long-term survival after hospital discharge is unaffected by ARDS, but is strongly affected by ARDS risk factor and comorbidities. (2) Respiratory symptoms after ARDS are more prevalent than previously indicated, but improve over the first 12 months of recovery. (3) Pulmonary function testing reveals marked impairment soon after ARDS. There is improvement over the first 6 months, with lingering mild decreases in lung volume and diffusing capacity in most patients. A small group of patients have severe impairment without improvement. (4) Quality of life, functional independence, and cognitive function are severely affected by ARDS, with dramatic improvement over the first year. Quality of life is lower than in matched critically ill controls. (5) Significant numbers of ARDS survivors suffer from posttraumatic stress syndrome. This is an exciting time for research in long-term outcomes of ARDS, with potential for future studies that validate these single-center hypotheses, explore their ramifications, and investigate the impacts of changing practices in the intensive care unit in the acute phase of ARDS.

Apoptosis of Trypanosoma musculi co-cultured with LPS activated macrophages: enhanced expression of nitric oxide synthase INF-gamma and caspase

Trypanosoma musculi-macrophage co-cultures were studied to investigate the biological role of lipopolysaccharide (LPS) induced cytokines in controlling the proliferation of parasites in vitro. Macrophages, isolated by peritoneal lavage, sustained the growth and proliferation of the parasites. Macrophages activated with LPS were characterized by up-regulation of nitric oxide synthase (iNOS) and phagocytosis of fluorescent latex spheres. Activated macrophages showed marked inhibition of the association and proliferation of the parasites. The LPS treated macrophages produced cytokines, especially interferon gamma (INF-gamma), which was detected by Western blot. Trypanosomes, inhibited from association with macrophages, did not proliferate and instead formed clusters held together by their flagella. Cells in these clusters were apoptotic, as demonstrated by the Apoptag reaction and gel fragmentation assay. In addition, high levels of caspase 8 and caspase 3 were shown in floating trypanosome clusters. The results would suggest that INF-gamma and other cytokines released by activated macrophages, possibly functioning through the INF-gammaR1, Fas ligand, CD95 or other death ligands in the trypanosome plasma membrane initiates the apoptosis cascade in trypanosomes.

Characterization of squid-processing byproduct hydrolysate and its potential as aquaculture feed ingredient

The squid (Loligo pealei) byproduct composed of heads, viscera, skin, fins, and small tubes was subjected to hydrolysis at 55 degrees C and natural pH (6.8) using endogenous proteases. Squid hydrolysate was characterized during the course of hydrolysis for changes in the degree of hydrolysis, viscosity, electrophoretic pattern of proteins and peptides, and amino acid and fatty acid profiles. The change in viscosity can be used to monitor the progress of protein hydrolysis up to the molecular mass of 26.63 kDa. The 2 h hydrolysis resulted in a 2-fold increase in the total free amino acids and yielded hydrolysate with protein molecular mass of < or =45 kDa having feed attractability and good amino acid and fatty acid profiles with high contents of essential amino acids and fatty acids. Such hydrolysis-induced changes can make squid byproduct hydrolysate a good source of aquaculture feed ingredient, especially for a starter diet for larval fish.

Heterogeneity of stage IIIA endometrial carcinomas: implications for adjuvant therapy

The purpose of this study was to evaluate overall survival (OS) and determine prognostic subclassifications for stage IIIA endometrial cancer. Stage IIIA endometrial cancer patients treated at M.D. Anderson Cancer Center from 1989 to 2002 were reviewed. Clinical information was obtained from the medical record. Cox regression analyses were performed to evaluate the association of pathologic criteria and OS. Patients were divided into four groups based on this analysis: E1, endometrioid/pelvic cytology only; E2, endometrioid/adnexa +/- serosal spread; NE1, nonendometrioid/pelvic cytology only; and NE2, nonendometrioid/adenexa +/- serosal spread. Forty-nine patients were identified. By multivariate analysis, histology and extent of disease were the only factors associated with OS. Five-year OS in the four subgroups based on histology and extent of disease were: E1, 79%, E2, 65%, NE1, 64%, and NE2, 13%. Histologic subtype and extent of pelvic disease are the only prognostic factors associated with OS. Patients with endometrioid tumors and extent of pelvic disease limited to positive cytology had a favorable outcome, with or without adjuvant therapy. Future prospective clinical trials should consider subclassifying patients with stage IIIA disease to better evaluate the role of adjuvant therapy.

A double-blind comparison of the efficacy and tolerability of telmisartan 40-80 mg vs. losartan 50-100 mg in Taiwanese hypertensive patients

A multicentre, randomised, double-blind, double-dummy, parallel-group, dose-titration study was conducted to determine the efficacy and tolerability of telmisartan 40-80 mg once daily compared with losartan 50-100 mg once daily in 180 Taiwanese patients with mild-to-moderate essential hypertension. After an initial 2-week placebo run-in phase, patients were randomised in a double-blind, double-dummy fashion to receive either telmisartan 40 mg or losartan 50 mg. If blood pressure control (diastolic blood pressure [DBP] <90 mmHg or > or = 10 mmHg reduction in DBP) was achieved after 4 weeks, the dose was maintained for the second 4 weeks of the active treatment phase; if not, the dose was doubled to telmisartan 80 mg or losartan 100 mg, respectively, for the second 4 weeks of double-blind treatment. Telmisartan 40-80 mg (n = 86) was as effective as losartan 50-100 mg (n = 90) in reducing trough seated DBP (11.1 vs. 8.7 mmHg, p = 0.144), and was significantly more effective than losartan in reducing trough seated systolic blood pressure (SBP) (22.1 vs. 16.5 mmHg, p = 0.032) and standing SBP (21.0 vs. 16.3 mmHg, p = 0.033). Significantly fewer patients treated with telmisartan than those treated with losartan required uptitration after 4 weeks' treatment (32.6% vs. 61.5%, p = 0.001). Both telmisartan and losartan were well tolerated.

Biomass conversion to mixed alcohol fuels using the MixAlco process

The MixAlco process is a patented technology that converts any biodegradable material (e.g., sorted municipal solid waste, sewage sludge, industrial biosludge, manure, agricultural residues, energy crops) into mixed alcohol fuels containing predominantly 2-propanol, but also higher alcohols up to 7-tridecanol. The feedstock is treated with lime to increase its digestibility. Then, it is fed to a fermentor in which a mixed culture of acid-forming microorganisms produces carboxylic acids. Calcium carbonate is added to the fermentor to neutralize the acids to their corresponding carboxylate salt. The dilute (approximately 3%) carboxylate salts are concentrated to 19% using an amine solvent that selectively extracts water. Drying is completed using multi-effect evaporators. Finally, the dry salts are thermally converted to ketones which subsequently are hydrogenated to alcohols. All the steps in the MixAlco process have been proven at the laboratory scale. A techno-economic model of the process indicates that with the tipping fees available in New York (126 dollars/dry tonne), mixed alcohol fuels may be sold for 0.04 dollars/L (0.16 dollars/gal) with a 60% return on investment (ROI). With the average tipping fee in the United States rates (63 dollars/dry tonne), mixed alcohol fuels may be sold for 0.18 dollars/L (0.69 dollars/gal) with a 15% ROI. In the case of sugarcane bagasse, which may be obtained for about 26 dollars/dry ton, mixed alcohol fuels may be sold for 0.29 dollars/L (1.09 dollars/gal) with a 15% ROI.

Human follicle-stimulating hormone receptor (FSH-R) promoter/enhancer activity is inhibited by transcriptional factors, from the upstream stimulating factors family, via E-box and newly identified initiator element (Inr) in FSH-R non-expressing cells

To localize the regulatory elements in the human follicle-stimulating hormone receptor (FSH-R) promoter/enhancer and to determine the role of upstream stimulatingfactors (USFs) in these elements, we transiently transfected constructs of FSH-R promoter/enhancer in pGL3 luciferase reporter plasmids into Chinese hamster ovary cells and the activities were determined by measuring luciferase luminescence of the cell lysates. The 5'-flanking regions of the human FSH-R gene from nt -1485 to -1 with respect to the gene translation start site were amplified by polymerase chain reaction (PCR) and subcloned in pGL3. Deletion mutants were created using PCR or restriction enzyme digestion. Mutation in the E-box sequence from nt -124 to -119 (E-box 3), in the construct from -224 to nt -1 or in the Inr element, which encompasses the transcriptional start site at nt -99, resulted in a substantial reduction in the human FSH-R promoter/enhancer activity. Overexpression of upstream stimulating factor-1 (USF1) suppresses the activity of the human FSH-R promoter/enhancer via Inr and E-box elements. Upstream stimulating factor-2 (USF2) decreases FSH-R promoter/enhancer activity by acting on E-box 3. The results indicate that E-box 3 and the Inr element are important elements of the human FSH-R promoter/ enhancer. USF family members inhibit FSH-R gene activity by acting via these elements. USF1 and USF2 suppress human FSH-R promoter/enhancer activity by acting on E-box 3. USF1 also decreases activity by interacting with the Inr element.

Denitrification with epsilon-caprolactam by acclimated mixed culture and by pure culture of bacteria isolated from polyacrylonitrile fibre manufactured wastewater treatment system

The aim of this study is to isolate denitrifying bacteria utilizing epsilon-caprolactam as the substrate, from a polyacrylonitrile fibre manufactured wastewater treatment system. The aim is also to compare the performance of PAN (polyacrylonitrile) mixed bacteria cultures acclimated to epsilon-caprolactam and isolated pure strain for treating different initial epsilon-caprolactam concentrations from synthetic wastewater under anoxic conditions. The result showed that the PAN mixed bacteria cultures acclimated to epsilon-caprolactam could utilize 1538.5 mg/l of epsilon-caprolactam as a substrate for denitrification. Sufficient time and about 2200 mg/l of nitrate were necessary for the complete epsilon-caprolactam removal. Paracoccus thiophilus was isolated from the polyacrylonitrile fibre manufactured wastewater treatment system and it could utilize 1722.5 mg/l of epsilon-caprolactam as a substrate for denitrification. About 3500 mg/l of nitrate was necessary for the complete removal of epsilon-caprolactam. When the initial epsilon-caprolactam concentration was below 784.3 mg/l, the removal efficiency of epsilon-caprolactam by Paracoccus thiophilus was better than that for the PAN mixed bacteria cultures. The growth of Paracoccus thiophilus was better. However, when the initial epsilon-caprolactam concentration was as high as 1445.8 mg/l, both the epsilon-caprolactam removal efficiency by Paracoccus thiophilus and Paracoccus thiophilus specific growth rate were similar to the PAN mixed bacteria cultures.

Characterization and function of the multifaceted peripheral blood basophil

Basophils are derived from metachromatic hematopoietic precursor cells of myeloid origin. The basophilic granulocyte differentiates and matures in the bone marrow, circulates in the peripheral blood, and upon proper stimulation, migrates into the tissues. Peripheral blood basophils act as chief effector cells of the allergic response and as purveyors of various allergy-associated mediators. Under appropriate conditions, basophils can be induced to release their mediators into the extracellular space of tissues or blood of the host organism. The plasma membrane of basophils contains receptors for immunoglobulin E (IgE) homocytotropic antibody which exhibits high affinity for these granulocytes and their Fc epsilon receptors. IgE cytophilic antibody binds antigen at its Fab portion. When bound to the basophil plasma membrane, the antigen-antibody complex undergoes multivalent interactions, which create crosslinking of the Fc epsilon receptors on the basophil plasma membrane. This receptor cross-linking results in basophil degranulation and subsequent release of its pharmacologically active substances. The basophil exhibits considerable heterogeneity and is characterized as Type I, II, III, IV, V and VI based upon granule content and time of antigen stimulation. Evidence is presented showing the role of the basophil in hyperplasia, hypersensitivity, parasitic infections and other diseases.

Nitrous oxide flux from landfill leachate-sawdust nitrogenous compost

Composted nitrogenous waste has the potential to produce excessive amounts of nitrous oxide (N2O), a potent greenhouse gas that also contributes to stratospheric ozone depletion. In this laboratory study, sawdust was irrigated with varying amounts of landfill leachate with high NH4+-N content (3950 mg l(-1)). Physicochemical properties, including the amount of N2O produced, were monitored during the composting process over 28 days. A rapid decline in NH4+-N in the first 4 days and increasing NO3--N for 11 days was followed by lower but stabilized levels of available-N, even with repeated leachate irrigation. Less than 0.03% of the leachate-applied N was lost as N2O. Higher leachate applications as much as tripled N2O production, but this represented a lesser proportion overall of the total nitrogen. Addition of glucose to the composting process had no significant effect on N2O production. The derived sawdust-leachate compost supported healthy growth of Sesbania rostrata. It is concluded that compost can be produced from sawdust irrigated with landfill leachate without substantial emission of N2O, although excessive flux of N2O remains about high application rates over longer time periods.

Prevalence and clinical implications of hepatitis B virus genotypes in southern Taiwan

BACKGROUND

Hepatitis B virus (HBV) infection is a major health problem. HBV genotypes may be associated with progression of liver disease. The distribution and clinical implications of HBV genotypes in southern Taiwan are evaluated.

METHODS

We used a polymerase chain reaction-restriction fragment length polymorphism genotyping method to determine HBV genotypes.

RESULTS

The genotype distribution for 265 patients with chronic HBV infection was as follows: A, 3 (1%); B, 158 (60%); C, 90 (34%); D, 7 (2.5%); E, 0: F, 0; and unclassified, 7 (2.5%). Compared with genotype B patients, genotype C patients had a higher hepatitis B e antigen positive rate and higher fibrosis score. There was no significant difference in the mean age between genotype B and genotype C patients with hepatocellular carcinoma (HCC). However, when patients were stratified by age, the prevalence of genotype C was significantly higher in young HCC patients (<50 years of age) than in age-matched asymptomatic carriers (40% versus 10%, P < 0.001). Using multivariate analysis, the significant risk factors for advanced liver disease (cirrhosis or HCC) for patients with chronic HBV infection were old age, male gender and genotype C.

CONCLUSIONS

These results suggest that genotype C is associated with more severe liver diseases than the B variant.

Comparative positions of kinetoplasts in Trypanosoma musculi and Trypanosoma lewisi during development in vitro

The development of Trypanosoma musculi and Trypanosoma lewisi were studied in vitro in the presence of adherent splenic cells. Both parasites developed only when attached by their flagellar tips to adherent splenic cells. During the proliferation of T. musculi, the kinetoplast migrated towards the nucleus, and once in the vicinity of the nucleus, the nuclear division was triggered. The kinetoplast of T. lewisi did not migrate towards the nucleus, but remained at its original location. The nucleus and kinetoplast divided at the same time in both parasites, and parasites started dividing from their flagellar ends and T. musculi and T. lewisi daughter cells were formed within 48 h. The unavailability of the adherent splenic cells in vitro led the parasites to transform into round/oval nonviable forms.

Structure and properties of Titanium-25 Niobium-x iron alloys

The present work studies the effect of iron on microstructure, mechanical properties and corrosion behavior of Ti-25Nb based system with emphasis on improving strength/modulus ratio. Experimental data shows that cast Ti-25Nb-3Fe has a beta phase with a entirely of dendrite morphology. The bending strength/modulus ratio is 24.6 higher than Ti-6Al-4V (17.4) by 41.4% and than c.p. Ti (9.3) by 165%. The critical anodic current density of the metal in 37 degrees C Hank's solutions is lower than approximately 100 microA/cm(2). Ti-25Nb-3Fe alloy has a great potential for use as an implant material.

Effects of selenium deficiency in the development of trypanosomes and humoral immune responses in mice infected with Trypanosoma musculi

The selenium-deficient mouse-trypanosome system was used to study the effects of selenium deficiency in Swiss Webster mice infected with Trypanosoma musculi. In selenium-deficient mice, a low parasitemia was observed and infection was cleared by day 16 post-inoculation (PI), whereas control mice sustained the parasitemia until day 24 PI. There were no significant differences in size variability of the trypanosomes; however the range of variability in the length of parasites differed significantly between the three groups. In comparison to mice on complete or pair-fed diets, the selenium-deficient mice produced lower concentrations of IgG(1), IgG(2b), IgG(3), and IgM. The levels of IgG(2a) and IgA were lower than normal controls. The results of the present study indicated that there was a severe depression in primary and secondary antibody responses to sheep red blood cells in all inoculated mice. However, these responses were significantly less depressed in selenium-deficient mice.

Structure-property relationship of cast Ti-Nb alloys

The present work is a study of the microstructure, mechanical properties and corrosion behaviour of a series of binary Ti-Nb alloys with Nb contents up to 35 wt%, with emphasis placed on the structure-property relationship of the alloys. The results indicate that crystal structure and morphology of the Ti-Nb alloys are sensitive to the Nb content. The cast c.p. Ti has a hexagonal alpha phase with a lath type morphology. The alloys containing 15 wt% or less Nb are dominated by a hexagonal alpha' phase with an acicular, martensitic structure. When containing 17.5-25 wt% Nb, the alloys are primarily comprised of an orthorhombic alpha" phase. With 27.5 wt% Nb, metastable beta phase starts to be retained. With Nb contents higher than 30 wt%, the equi-axed beta phase is almost entirely retained. Small amounts of omega phase are detected in alloys containing 27.5 and 30 wt% Nb. Among all present alloys, Ti-10Nb and Ti-27.5Nb exhibit the highest strengths, while the alpha"-dominated (17.5 and 20Nb) and beta-dominated (> 30Nb) alloys have the lowest moduli. All Ti-Nb alloys show excellent corrosion resistance in Hank's solution at 37 degrees C. From the present data, the microhardness, bending strength and modulus of the various phases in Ti-Nb alloys are compared and tentatively summarized as follows: Microhardness: omega > alpha' > alpha" > beta > alpha (c.p. Ti) Bending strength: omega > alpha' > alpha" > beta > alpha (c.p. Ti) Bending modulus: omega > alpha (c.p. Ti) > alpha' > alpha" > beta

Fatal hepatic failure after emergence of the hepatitis B virus mutant during lamivudine therapy in a patient with liver cirrhosis

Lamivudine therapy for chronic hepatitis and decompensated liver cirrhosis related to the hepatitis B virus (HBV) resulted in improvement of liver function and inhibition of viral replication. Despite emergence of the HBV mutant, e-antigen seroconversion and improvement of liver function may be achieved with continuation of lamivudine therapy. Although hepatic decompensation has been reported in a few cases after the emergence of lamivudine-resistant mutants, fatal cases of non-transplant patients have only rarely been reported in the literature. Here, we describe a patient with HBV-related liver cirrhosis who died after a breakthrough infection with a lamivudine-resistant mutant. Hepatic failure and mortality developed after flare-up of severe hepatitis after 13 months of lamivudine treatment. Emergence of the HBV mutant with substitution of isoleucine for leucine at residue 426 (L4261) in combination with isoleucine for methionine at residue 550 (M5501) was observed at 10 and 13 months of treatment.

A retrospective study for the outcome of pulmonary resection in 49 patients with multidrug-resistant tuberculosis

BACKGROUND

Outcome of treatment using only chemotherapy for multidrug-resistant tuberculosis is usually considered not to be satisfactory. The combination of chemotherapy with surgical treatment has been producing higher acid-fast bacilli (AFB) negative sputum conversion and longer survival rates. This treatment strategy may be the solution for patients with multidrug-resistant tuberculosis.

MATERIALS AND METHODS

A retrospective review was performed of the medical records and laboratory findings of 49 patients with multidrug-resistant tuberculosis among 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital, Korea.

RESULTS

The mean number of drugs to which the patients were resistant was 4.5. Patients had a mean age of 35 years. Cavitary lesions on plain chest X-ray were shown in 43/49 patients (87.8%); 31 had positive sputum cultures preoperatively (63.3%). The surgical techniques used were as follows: 12 pneumonectomies, 28 lobectomies, seven lobectomies with segmentectomies or wedge resections, one wedge resection and one cavernoplasty. The AFB negative sputum conversion rate was 93.5% with continuous postoperative chemotherapy. There were no deaths after surgery. Postoperative complications that developed were six cases of air leakage over a week, one of postoperative bleeding and one of wound infection.

CONCLUSIONS

This study demonstrated the effectiveness of pulmonary resection with postoperative chemotherapy in cases of multidrug-resistant tuberculosis. Although there are different ideas about indications for surgery and the length and content of postoperative drug regimens, pulmonary resection should be considered an effective measure in combination with chemotherapy for treatment of multidrug-resistant pulmonary tuberculosis.