Hepatitis C virus infection among teenagers in an endemic township in Taiwan: epidemiological and clinical follow-up studies

The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13-16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1.4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2.8%) of the 7 maritime villages was markedly higher than that (0.7%) of the other 8 villages (P < 0.001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.

Pasteurella multocida bacteremia due to non-bite animal exposure in cirrhotic patients: report of two cases

Pasteurella species are very small gram-negative coccobacilli. They are normal flora found in the oral cavity and gastrointestinal tract of many animals, and can cause various infections including septicemia and pneumonia. Human infection with Pasteurella multocida occurs commonly as a localized cellulitis caused by animal bites. This report described 2 rare cases of P. multocida bacteremia in patients with liver cirrhosis and esophageal varices. Both patients had a history of contact with sick-appearing stray dogs, but neither had been bitten. P. multocida bacteremia should be included in the differential diagnosis of febrile cirrhotic patients with esophageal varices who have a history of non-bite animal exposure. Avoidance of animal contact by immunocompromised patients is the most important factor in preventing pasteurellosis.

Sonographic features of hepatic adenomas with pathologic correlation

BACKGROUND

We compared the sonographic characteristics of hepatic adenomas with pathologic findings.

METHODS

Information over 10 years was collected on 12 patients (six men, six women; mean age = 47 years) with surgically proven hepatic adenomas. Clinical data, sonographic features, and histopathologic findings were reviewed.

RESULTS

The tumors in males were smaller and simpler than those in women (p < 0.05, Fisher's exact test). Four of the six larger tumors (>5 cm) showed mixed-echoic patterns corresponding with pathologically intratumoral hemorrhage and necrosis. Four homogeneously hypoechoic tumors had less change in tumor composition. Three homogeneously hyperechoic tumors had evident fatty changes inside. One isoechoic tumor had a hypoechoic rim, that correlated mostly to the tumor itself and compressed liver parenchyma. Seven of the 12 tumors had thin fibrous capsules that were not seen on sonography.

CONCLUSION

Hepatic adenomas have variable sonographic appearances depending on changes in the tumor. Hypoechoic, hyperechoic, and mixed-echoic patterns represent simple adenoma, adenoma with fatty metamorphosis, and hemorrhagic necrosis, respectively, in tumors.

4-Hydroxy-6-oxo-6,7-dihydro-thieno[2,3-b] pyrimidine derivatives: synthesis and their biological evaluation for the glycine site acting on the N-methyl-D-aspartate (NMDA) receptor

Bioisostere approach has been shown to be useful to augment potency or to modify certain physiological properties of a lead compound. Based upon well documented bioisosterism, an isosteric replacement of benzene ring of 4-hydroxy-2-quinolone compound (L-695902) with a thiophene moiety was carried out to prepare the title compounds, 4-hydroxy-6-oxo-6,7-dihydro-thieno[2,3-b] pyrimidines 15. The resulting bioisosteric compounds 15 were evaluated for their antagonistic activity (binding assay) for NMDA receptor glycine site.

Denitrification with acrylamide by pure culture of bacteria isolated from acrylonitrile-butadiene-styrene resin manufactured wastewater treatment system

Acrylamide is widely used in industrial applications as cement binder and solidification agent. Due to its carcinogenicity and toxicity, discharge of acrylamide to the natural water and soil systems may lead to an adverse environmental impact on water quality and thus endanger public health and welfare. This study attempts to isolate and identify the denitrifying bacteria, which utilize acrylamide as the substrate from the acrylonitrile-butadiene-styrene resin manufactured wastewater treatment system. The performance of the denitrifying bacteria for treating different initial acrylamide concentrations was also investigated under aerobic and anaerobic conditions. The test results indicated that the Pseudomonas stutzeri could remove acrylamide at concentrations below 440 mg/l under aerobic conditions. The acrylic acid and ammonia intermediates were used as carbon and nitrogen sources, respectively. However, P. stutzeri did not show the capability of metabolizing acrylonitrile under aerobic conditions. Furthermore, the P. stutzeri could utilize both acrylamide and acrylic acid in the presence of nitrate (denitrification) and acrylamide could be removed completely from the wastewater.

Cosolvent effects of alcohols on the Henry's law constant and aqueous solubility of tetrachloroethylene (PCE)

The effects of selected cosolvents ethyl alcohol (EtOH), isopropyl alcohol (IPA), and tertbutyl alcohol (TBA) on the Henry's law constant (H) of tetrachloroethylene (PCE) in aqueous solutions were investigated using the static headspace method. Alcohols in solution at a concentration around 20% and above acted as cosolvents increasing the aqueous solubility of PCE, which resulted in lower H values for PCE as compared to the value of H in deionized water. TBA, the most hydrophobic of the three alcohols, exhibited the strongest cosolvent effects, while EtOH had the weakest effects. A ln-linear relationship was observed between H and the volumetric fraction of alcohol added. Investigation of the solubilization of PCE in alcohol solutions confirmed the cosolvent trend observed for the three alcohols. A ln-ln relationship was observed between H and the enhanced solubility of PCE at a particular alcohol concentration. It was also observed that the value of H is a function of the enhanced solubility regardless of the type of cosolvent used. The results from this research further define the behavior of PCE in alcohol flooding solutions used in the remediation of PCE contaminated media.

Modification of forearm vascular function following short-term handgrip exercise training

This study examined the effect of low (25% of maximum voluntary contraction) and high (75% of maximum voluntary contraction) intensity short-term handgrip exercise training on localized vascular function. Forearm blood flow was evaluated in twenty-eight healthy men (age: 23 +/- 4.3) pre- and post-training in both forearms at rest, following forearm occlusion and following forearm occlusion combined with handgrip exercise using strain gauge plethysmography. The 4-week program consisted of non-dominant handgrip exercise performed 5 d/wk for 20 min at either low or high intensity. Following training a significant increase in forearm blood flow was noted for the nondominant arm in both groups after forearm occlusion (low intensity group: 16.51%; high intensity group: 20.72%; p = 0.001) and forearm occlusion combined with handgrip exercise (low intensity group: 17.71%; high intensity group: 29.27%; p = 0.001). No significant group by test interaction (p = 0.632) was found. These data show improved unilateral vasodilatory responsiveness after short-term handgrip training. In addition, the degree of change is most notable following the greatest vasodilatory stimulus. Lastly, a lack of group by treatment interaction suggests the change may be independent of training stimulus.

Sustainable soil management practices and quality of potato grown on erodible lands

Land productivity can decline when top soil is lost. In Kentucky, limited resource farmers often produce vegetable crops on erodible lands. The objectives of this study were 1) to quantify the impact of three soil management practices (SMPs) on quantity of potato produced on erodible land, 2) to evaluate the impact of pyrethrin and azadirachtin insecticides on potato tuber quality, and 3) to assess the impact of yard waste compost on the chemical composition (ascorbic acid, free sugars, phenol contents) of potato tubers. Potatoes (Solanum tuberosum L. cv. Kennebec) were grown in a silty loam soil of 10% slope. Plots (n= 18) were 3.7 m wide and 22 m long (10% slope), with metal borders of 20 cm above ground level. Two botanical insecticides, Multi-Purpose Insecticide (containing pyrethrin 0.2%) and Neemix 4EC (containing 0.25% azadirachtin) were sprayed twice on potato foliage during each of two growing seasons (1997 and 1999) at the recommended rates of 6 lbs and 2 gallons.acre(-1), respectively. The SMPs were tall fescue strips (FS) intercropped between each two potato rows, soil mixed with yard waste compost (COM) and no-mulch (NM) treatment (roto-tilled bare soil). The experimental designwas a 2 x 3 x 3 factorial with main factors of two insecticides and three SMPs replicated three times. Average potato yield was lowest in NM and FS and highest in COM treatments. Yield obtained from the bottom of the plots was greater than that obtained from the top of plots. Tuber defects (rot, scab, sun green, hollow heart, necrosis, and vascular discoloration) were significantly different between the two growing seasons. The two insecticidal treatments did not have much influence on potato yield or tuber defects. Tubers obtained from tall fescue treatments had low levels of ascorbic acid and reducing sugars compared to compost treatments.

Aspiration of an oropharyngeal airway during nasotracheal intubation

The oropharyngeal airway (OPA) has been a remarkably safe device since its invention by Guedel in 1933. This plastic device is easily placed in the mouth and used for aiding in mask ventilation. We report a case of the aspiration of an OPA causing near total upper airway obstruction.

Extended lamivudine treatment in patients with chronic hepatitis B enhances hepatitis B e antigen seroconversion rates: results after 3 years of therapy

A study in Chinese patients with chronic hepatitis B showed that treatment with lamivudine for 1 year significantly improves liver histology and enhances hepatitis B e antigen (HBeAg) seroconversion compared with placebo. Fifty-eight patients from this 1-year study have received long-term treatment with lamivudine 100 mg; the outcome of 3 years of lamivudine is reported here. Before treatment, all patients had detectable HBeAg. HBeAg seroconversion (HBeAg-negative, anti-HBe-positive), hepatitis B virus (HBV)-DNA suppression, alanine transaminase (ALT) normalization, emergence of YMDD variant HBV, liver histology, and long-term safety were assessed. After 3 years of continuous treatment with lamivudine 100 mg daily, 40% (23 of 58) of patients achieved HBeAg seroconversion. In patients with baseline serum ALT >2 x upper limit of normal (ULN), the rate of HBeAg seroconversion was 65% (17 of 26). Median serum HBV-DNA concentrations were below the level of detection, and median ALT concentrations were within the normal range throughout 3 years of treatment. YMDD variant HBV emerged in 33 of 58 (57%) patients during the 3 years, of whom 9 (27%) achieved HBeAg seroconversion (6 after emergence of YMDD variant HBV). ALT levels and histologic scores after emergence of YMDD variant HBV did not show major deterioration. Lamivudine was well tolerated during 3 years of therapy. In conclusion, these data in Chinese patients with chronic hepatitis B show enhanced seroconversion rates with extended lamivudine treatment. Up to two thirds of patients with moderately elevated pretreatment ALT achieved HBeAg seroconversion after 3 years of therapy.

Flash echo gray scale imaging with subtraction in assessment of small hepatocellular carcinoma treated with percutaneous ethanol injection: preliminary report

OBJECTIVE

To assess the therapeutic effect of percutaneous ethanol injection on small hepatocellular carcinoma by using a flash echo imaging system, a newly developed technique for detecting echoes from microbubble contrast agents more efficiently.

METHODS

Six patients with 7 small nodular hepatocellular carcinomas, proved by fine-needle aspiration cytologic or pathologic examination, were included. Percutaneous ethanol injection was performed until there was no intratumoral color signal on conventional color and power Doppler ultrasonography. A bubble contrast agent was then injected, and flash echo imaging in the subtraction mode was performed for assessment of the therapeutic effect. Dynamic computed tomography, magnetic resonance imaging, and hepatic angiography were also used for evaluation of the therapeutic effect.

RESULTS

Five tumors had perfusion defects that were equal in size to or larger than the tumors. No tumor stain was shown on hepatic angiography. Two tumors had partial perfusion defects. Viable tumors were confirmed by tumor resection in 1 case and cytologic examination in the other.

CONCLUSIONS

Our preliminary results show that flash echo imaging with subtraction has potential value in evaluation of the therapeutic effect of percutaneous ethanol injection on small hepatocellular carcinoma.

Denitrification with acrylonitrile as a substrate using pure bacteria cultures isolated from acrylonitrile-butadiene-styrene wastewater

This study attempted to isolate and identify the denitrifying bacteria that utilize acrylonitrile as a substrate from acrylonitrile-butadiene-styrene (ABS) resin wastewater. The performance of the denitrifying bacteria for treating different initial acrylonitrile concentrations was also investigated under anoxic conditions. The results showed that seven strains of denitrifying bacteria that can use acrylonitrile or acrylic acid as a substrate were isolated from the denitrification tank of a wastewater treatment plant in a ABS resin manufacturing plant and a lab-scale anoxic granular activated carbon-fluidized bed. The bacteria strains Acidovorax facilis B and Pseudomonas nautica could utilize acrylonitrile up to 279 mg/l as a substrate for denitrification. For complete nitrate removal, an adequate supply of acrylonitrile was necessary. Under the assumption that the acrylic acid would be completely removed, the removal of 1 mg/l nitrate by A. facilis B or P. nautica, about 0.64-0.74 mg/l acrylonitrile or 0.87-1 mg/l acrylic acid was needed. Because strains A. facilis B and P. nautica could utilize acrylonitrile for denitrification, they are expected to play an important role in the treatment of acrylonitrile in the wastewater treatment plant (denitrification and nitrification processes) and lab-scale granular activated carbon-fluidized bed.

Inhibitory action of water soluble fraction of Terminalia chebula on systemic and local anaphylaxis

We investigated the effects of the water soluble fraction of Terminalia chebula (Combretaceae) (WFTC) on systemic and local anaphylaxis. WFTC administered 1h before compound 48/80 injection inhibited compound 48/80-induced anaphylactic shock 100% with doses of 0.01-1.0 g/kg. When WFTC was administered 5 or 10 min after compound 48/80 injection, the mortality also decreased in a dose-dependent manner. Passive cutaneous anaphylaxis was inhibited by 63.5+/-7.8% by oral administration of WFTC (1.0 g/kg). When WFTC was pretreated at concentrations ranging from 0.005 to 1.0 g/kg, the serum histamine levels were reduced in a dose-dependent manner. WFTC (0.01-1.0 mg/ml) also significantly inhibited histamine release from rat peritoneal mast cells (RPMC) by compound 48/80. However, WFTC (1.0 mg/ml) had a significant increasing effect on anti-dinitrophenyl IgE-induced tumor necrosis factor-alpha production from RPMC. These results indicate that WFTC may possess a strong antianaphylactic action.

Assessment of the myocardial changes in heart transplant recipients without evident acute myocardial rejection by integrated backscatter: comparison with simultaneous dobutamine stress echocardiography and (201)thallium spect

Cardiomyocyte hypertrophy and interstitial fibrin deposition develop in cardiac allografts and contribute to the functional changes of transplanted hearts. We hypothesized that integrated backscatter (IBS) can detect these myocardial changes. A total of 32 heart transplant recipients with either no or mild acute rejection (International Society of Heart and Lung Transplantation grade IA) were enrolled in this study. IBS data of myocardium were collected immediately before simultaneous dobutamine stress echocardiography (DSE) and (201)thallium imaging. Coronary angiography and endomyocardial biopsy were also performed. Coronary angiography showed diffuse narrowing in 1 patient who also had abnormal results of IBS, DSE, and thallium results. In the other 31 patients with patent coronary arteries, there were 3 patients (10%) with abnormal DSE results, 19 patients (61%) with abnormal IBS patterns, and 16 patients (52%) with reversible thallium perfusion defects. Of the patients, 44% had cardiomyocyte hypertrophy and 56% interstitial fibrin deposition. There were significant differences in the prevalence of (201)thallium perfusion defects and serum cyclosporine levels between patients with and without abnormal IBS patterns. Pathologic changes were also associated with abnormal IBS patterns (p = 0.01). However, there was no association between abnormal IBS and DSE results. By multiple logistic regression analysis, the abnormal IBS patterns were associated inversely with serum cyclosporine level (p = 0.028). In conclusion, abnormal IBS patterns are associated significantly with perfusion heterogeneity and pathologic changes in heart transplant recipients without evident acute myocardial rejection. There is no association between abnormal IBS patterns and dobutamine-induced dyssynergy in these patients. IBS provides a noninvasive approach for detection of myocardial changes in transplanted hearts without evident acute rejection.

Influence of head-down and lateral decubitus neck flexion on heart rate variability

The purpose of this study was to examine the response of heart rate variability (HRV), a noninvasive index of autonomic control, to head-down neck flexion (HDNF), which engages both otoliths and neck muscle afferents, and to lateral decubitus neck flexion (LNF), in which neck afferents are activated, whereas otolith afferent input is not. HRV and forearm blood flow were evaluated in participants lying prone, during HDNF, lying in the lateral decubitus position, and during LNF. Compared with the prone position, HDNF resulted in lower high-frequency (46.9 +/- 7.1 vs. 62.3 +/- 6.2) and higher low-frequency (53.1 +/- 7.1 vs. 37.7 +/- 6.2) power, expressed as normalized units, along with higher low-frequency-to-high-frequency ratio (1.65 +/- 0.3 vs. 0.78 +/- 0.2), whereas LNF resulted in no alterations in HRV indexes. Furthermore, there were no significant differences in forearm blood flow or vascular resistance among any of the positions. Our data suggest that otolith organs influence autonomic modulation of the heart, supporting previous studies reporting that HDNF elicits increased sympathetic outflow. These data further suggest that HDNF results in a parasympathetic withdrawal from the heart in addition to sympathetic activation.

Acrylonitrile removal from synthetic wastewater and actual industrial wastewater with high strength nitrogen using a pure bacteria culture

A gram-negative rod-shaped bacteria (strain AAS6), capable of utilizing acrylonitrile as the sole source of both carbon and nitrogen, was utilized to investigate the removal of acrylonitrile in ABS resin manufacturing wastewater. Both synthetic wastewater, containing a high concentration of acrylonitrile, and actual wastewater obtained from an ABS manufacturing factory were used. The result indicated that strain AAS6 was capable of completely removing acrylonitrile from synthetic wastewater containing less than 889 mg/l acrylonitrile and from actual industrial wastewater containing less than 400 mg/l acrylonitrile. Whether in synthetic wastewater or actual industrial wastewater, strain AAS6 showed approximately the same ability for acrylonitrile removal and used acrylic acid, a metabolic by-product of acrylonitrile, as the carbon source and ammonium as the nitrogen source. The bacteria could not directly metabolize other chemicals found in the actual industrial wastewater. However, its metabolic activities were not inhibited by the presence of compounds such as butadiene, styrene or acrylonitrile-styrene polymer. Thus, this strain is expected to play an important role in aeration tanks for treating ABS resin manufacturing wastewater.

Biodegradation of 2,4,6-trichlorophenol in the presence of primary substrate by immobilized pure culture bacteria

In this study, pure strains that are capable of utilizing 2,4,6-trichlorophenol have been isolated from the mixed culture grown on substrates containing chlorophenolic compounds. Studies have been carried out on the capability of these isolated pure strains in suspended and immobilized forms to decompose 2,4,6-trichlorophenol. Additionally, the influence of primary substrates (e.g., phenol, 2-chlorophenol, 3-chlorophenol, 4-chlorophenol, 2,4-dichlorophenol) on the decomposition of 2,4,6-trichlorophenol by the isolated pure strains grown in immobilized form is also investigated. The results are: Through bacterial isolation and identification, three pure strains have been obtained: Pseudomonas spp. strain 01, Pseudomonas spp. strain 02 and Agrobacterium spp. Whether in suspended or immobilized forms, all strains have poor removal efficiencies of 2,4,6-trichlorophenol. However, addition of 200 mg/l phenol will enable the immobilized Pseudomonas spp. strain 01, and Pseudomonas spp. strain 02 to achieve 65% and 48% removal of 2,4,6-trichlorophenol, respectively. Addition of phenol will assist the immobilized Pseudomonas spp. strain 02 in achieving removal of 2,4,6-trichlorophenol but the removal efficiency is not good if the phenol concentration is too low. The optimum phenol concentration should be between 200 and 400 mg/l.

Anomalous systemic arterialization to normal basal segments of the left lower lobe: helical CT and CTA findings

PURPOSE

The purpose of this work was to evaluate the helical CT and CT angiography (CTA) findings of anomalous systemic artery (ASA) to the basal segments of the left lower lobe (LLL).

METHOD

Three patients (two had hemoptysis, one was asymptomatic) with blotchy nodular density in the LLL revealed on chest radiographs underwent helical CT and CTA. Bronchoscopy was performed in two of these patients. Angiography and surgery were performed in one patient.

RESULTS

All three patients demonstrated characteristic helical CT and CTA findings including 1) a sigmoid-shaped ASA originating from the lower descending thoracic aorta, with a distal bulbous configuration and four arterial branches supplying the basal segments of the LLL; 2) absence of an interlobar pulmonary artery or presence of a small artery lateral to the truncus basalis; 3) engorged vascular markings in the basal segments of the LLL; and 4) normal tracheobronchial tree and lung parenchyma.

CONCLUSION

The findings in the present three cases suggest that the use of invasive studies such as angiography or bronchoscopy may be obviated in the diagnosis of ASA to the LLL because diagnosis can be provided through a clear set of criteria on helical CT and CTA.

Amount of dietary fat and type of soluble fiber independently modulate postabsorptive conversion of beta-carotene to vitamin A in mongolian gerbils

Current dietary guidelines recommend a decrease in fat intake and an increase in fiber consumption. Decreased bioavailability (BV) of carotenoids is thought to be associated with both of these recommendations. A 2 x 4 factorial design was used to test the effects of dietary fat level at 10 or 30% of total energy and fiber type using no fiber, silica, citrus pectin or oat gum (7 g/100 g) on beta-carotene (betaC) BV in 4- to 5-wk-old Mongolian gerbils. We assessed BV as both accumulation of betaC and bioconversion of betaC to vitamin A (VA) in tissues. A VA- and betaC-deficient diet was fed for 1 wk followed by one of eight isocaloric, semipurified diets supplemented with carrot powder [ approximately 1 microgram betaC, 0.5 microgram alpha-carotene (alphaC)/kJ diet] for 2 wk (n = 12/group). Increasing dietary fat resulted in higher VA (P: = 0.074) and lower betaC (P: = 0.0001) stores in the liver, suggesting that consumption of high fat diets enhances conversion of betaC to VA. The effect of soluble fiber on hepatic VA storage was dependent on fiber type. Consumption of citrus pectin resulted in lower hepatic VA stores and higher hepatic betaC stores compared with all other groups, suggesting less conversion of betaC to VA. In contrast, consumption of oat gum resulted in hepatic VA and betaC stores that were higher (P = 0.012) and lower (P = 0.022), respectively, than those of citrus pectin-fed gerbils. The level of dietary fat consumed with soluble fiber had no interactive effects on hepatic VA, betaC or alphaC stores. Results demonstrate that betaC BV is independently affected by dietary fat level and type of soluble fiber, and suggest that these dietary components modulate postabsorptive conversion of betaC to VA. This study confirms the negative effects of citrus pectin on betaC BV, and suggests that oat gum does not adversely affect betaC BV.

Adverse developmental and reproductive effects of copper deficiency in Xenopus laevis

The effect of copper (Cu) deficiency on the reproduction and development in Xenopus laevis was evaluated, culminating in the development of a defined concentration-response relationship. Separate groups of four adult frog pairs were fed one of three diets for 28 d: (1) low-copper (-Cu); (2) copper supplemented (+Cu); and (3) ASTM standard beef liver and lung (BLL). Embryos collected from frogs administered the -Cu diet had markedly decreased egg masses and viability rates and an increased rate of necrosis when compared to the other dietary treatments. Malformations in -Cu larvae included maldevelopment of the heart, eye, craniofacial region, brain, and notochord. Larvae from adults administered the -Cu diet showed delayed abnormal hindlimb development, characterized as selective reductive deficiencies distal to the femur, with poor cartilaginous development. A U-shaped dose-response curve characteristic of nutritional essentiality was developed for Cu. Overall, these studies indicated that embryos produced from frogs administered a -Cu diet are substantially less viable than embryos from frogs administered a +Cu or copper-adequate (BLL) diet.

Regulation and localization of tyrosine216 phosphorylation of glycogen synthase kinase-3beta in cellular and animal models of neuronal degeneration

Inactivation of glycogen synthase kinase-3beta (GSK3beta) by S(9) phosphorylation is implicated in mechanisms of neuronal survival. Phosphorylation of a distinct site, Y(216), on GSK3beta is necessary for its activity; however, whether this site can be regulated in cells is unknown. Therefore we examined the regulation of Y(216) phosphorylation on GSK3beta in models of neurodegeneration. Nerve growth factor withdrawal from differentiated PC12 cells and staurosporine treatment of SH-SY5Y cells led to increased phosphorylation at Y(216), GSK3beta activity, and cell death. Lithium and insulin, agents that lead to inhibition of GSK3beta and adenoviral-mediated transduction of dominant negative GSK3beta constructs, prevented cell death by the proapoptotic stimuli. Inhibitors induced S(9) phosphorylation and inactivation of GSK3beta but did not affect Y(216) phosphorylation, suggesting that S(9) phosphorylation is sufficient to override GSK3beta activation by Y(216) phosphorylation. Under the conditions examined, increased Y(216) phosphorylation on GSK3beta was not an autophosphorylation response. In resting cells, Y(216) phosphorylation was restricted to GSK3beta present at focal adhesion sites. However, after staurosporine, a dramatic alteration in the immunolocalization pattern was observed, and Y(216)-phosphorylated GSK3beta selectively increased within the nucleus. In rats, Y(216) phosphorylation was increased in degenerating cortical neurons induced by ischemia. Taken together, these results suggest that Y(216) phosphorylation of GSK3beta represents an important mechanism by which cellular insults can lead to neuronal death.

Evaluation of the older cadaveric kidney donor: the impact of donor hypertension and creatinine clearance on graft performance and survival

BACKGROUND

The use of older donors for cadaveric renal transplantation (CRT) remains controversial because older donors are associated with decreased graft survival, yet offer the opportunity for donor pool expansion. We investigated the impact of two age-related donor factors, hypertension and calculated creatinine clearance (C(Cr)), as predictors of graft outcome in recipients of CRTs from donors > or =55 years of age.

METHODS

We reviewed 33,595 recipients of CRTs reported to UNOS since 4/1/94, of which 4,732 were from donors aged > or =55 years. Outcome measures were graft survival, serum creatinine, and incidence of delayed graft function with 3 years of follow-up. We first analyzed the effect of hypertension on outcome from donors > or =55 years: 2679 donors had no hypertension, 1058 had hypertension < or =10 years, and 557 had hypertension > 10 years. Next, the effect of donor C(Cr) as a risk predictor was investigated. Based on this analysis, recipients of older donors were grouped into two cohorts for comparison: 2570 donors with C(Cr)<80 ml/min and 2162 donors with C(Cr) > or =80 ml/min.

RESULTS

Actuarial graft survival from donors aged <55 years was 88.0, 83.4, and 78.5% at 1, 2, and 3 years, vs. 80.6, 73.5, and 65.3% from donors > or =55 years (P<0.0001). When stratified by hypertension, older donors hypertensive > 10 years had survivals of 77, 66, and 57% vs. 81, 73, and 65% from donors without hypertension (P<0.017) and 80, 74, and 66% from donors hypertensive <10 years (P<0.017). When stratified by C(Cr), older donors with C(Cr) <80 ml/min had survivals of 77, 69, and 62% vs. 83, 76, and 66% from donors with C(Cr) > or =80 (P<0.0001). Finally, older donors with both hypertension > 10 years and C(Cr) <80 ml/min had survivals of 77, 61, and 53%.

CONCLUSIONS

Long-standing hypertension and low calculated creatinine clearance are risk factors for decreased graft survival of CRTs from older donors. When both factors are present, graft survival is significantly decreased.

Telomerase activity in peripheral blood for diagnosis of hepatoma

BACKGROUND

Telomerase activity may be used as a molecular marker for the detection of circulating hepatoma cells in blood of patients with hepatoma.

METHODS

Telomerase activity in peripheral blood from hepatocellular carcinoma (HCC) patients was assessed by using a highly sensitive and non-radioisotope telomerase polymerase chain reaction (PCR) ELISA. Initially, tissue telomerase activity was measured in the hepatoma and non-tumour portions by using PCR ELISA within the same specimen, to compare its sensitivity with the conventional telomeric repeat amplification protocol (TRAP) method. Second, telomerase activity was measured in the peripheral blood obtained from patients with HCC, patients with chronic liver disease and in healthy controls.

RESULTS

Of the 17 HCC patients, telomerase activity was found to be positive in 14 (82%) by using TRAP and 15 (88%) by using PCR ELISA, indicating that PCR ELISA is a reliable tool for the measurement of telomerase activity. By using the Telomerase PCR ELISA assay, telomerase activities in the peripheral blood of 20 HCC patients was 1.65 +/- 0.78 units. This was significantly greater than the results obtained for 20 chronic liver disease patients (0.43 +/- 0.36 units) and 20 healthy controls (0.39 +/- 0.14 units; P < 0.0001).When the arbitrary cut-off level was set at 0.7 units (maximum value of healthy controls + 0.1), the positive frequency of telomerase activity was 25% for chronic liver disease and 80% for HCC patients (sensitivity 80%, specificity 75%). Among the HCC patients, high telomerase activity in the peripheral blood was shown at stage III HCC with vascular invasion (2.10 +/- 0.62 units, n = 9). This was significantly higher than patients at stage II of HCC (1.28 +/- 0.72 units, n = 11, without vascular invasion; P = 0.012).

CONCLUSION

These results suggest that peripheral blood telomerase activity, which may reflect haematogenous micrometastasis, is potentially a practical diagnostic/predictive marker of HCC.