Effects of acupuncture on humoral immunologic function and trace elements in 20 cases of Behcet's disease

Acupuncture therapy could normalize both increased light chain K value of IgM and lowered trace element Zn content in patients with Behcet's disease with statistically significant differences, suggesting that acupuncture therapy can elevate humoral immunologic function and improve metabolism of the trace element in these patients.

[Apolipoprotein C III gene Sst I polymorphism in patients with endogenous hypertriglyceridemia in Chinese population]

OBJECTIVE

To investigate the apoC III gene Sst I polymorphism and its relationship with serum lipids and apolipoproteins (apo) levels in patients with endogenous hypertriglyceridemia in Chinese population.

METHODS

The genotype and allele frequency of apoC III gene Sst I polymorphism was assayed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Serum lipids were measured by enzymatic kits and apolipoproteins A I, A II, B100, C II, C III and E were measured by RID kits developed by Apolipoprotein Research Unit of WCUMS in 176 HTG patients whose fasting serum TG levels were > or = 2.26 mmol/L and in 199 healthy subjects whose fasting serum TG levels were < 1.82 mmol/L and TC levels < 6.2 mmol/L from a population of Chinese Han nationality in Chengdu area.

RESULTS

In both HTG group and control group, S1 allele was the major allele and homozygous S1S1 genotype was the most frequent one. The frequency of S2 allele was significantly higher than that reported in Caucasians (0.289 vs 0.06-0.16, P < 0.05). No differences were found in apoC III gene Sst I polymophism in the HTG group when compared with the control group (0.287 vs 0.289, P > 0.05). The genotype of S2S2 was not associated with higher TG and apolipoproteins levels when compared with the genotypes of S1S1 and S1S2 (P > 0.05).

CONCLUSION

These results suggest that the Sst I polymorphism of the apoC III gene was not associated with endogenoushypertriglyceridemica in Chinese population.

[Roles of Galphaq/11 mediated- and platelet-derived growth factor mediated-signal transduction pathways in rat aorta restenosis]

To observe the roles of Galphaq/11 mediated- and platelet-derived growth factor (PDGF) mediated-signal transduction pathways in proliferation and migration of vascular smooth muscle cells (VSMC) after arterial injury, a vascular cell proliferation model was established by balloon injury in rat aorta and the morphologic changes in injured vascular walls after the injury were studied. Activities of angiotensin converting enzyme (ACE) and aorta phospholipase C (PLC) were tested, and levels of platelet-derived growth factor receptor-beta (PDGFR-beta) and Galphaq/11 protein were measured by Western blot analysis. At l day after operation, injured aortic segments showed denudation in endothelial cells. Medial VSMC proliferation and intimal hyperplasia were not observed. As compared with the sham group, ACE activities were increased by 382.7 percent; (P<0.0l), but the expression of PDGFR-beta and PLC activities did not show significant changes (P>0.05). In addition, the level of Galphaq/11 protein was decreased by 20.0 percent; (P<0. 05). At l4 days after operation, sections of injured aorta showed marked intimal thickening with large numbers of VMSCs proliferating throughout intima and media. In comparison with the sham group, ACE activity, PLC activity and the level of PDGFR-beta were increased by 420.2 percent; (P<0.01), 186.2 percent; (P<0.05) and 85.0 percent; (P<0.05), respectively. While the level of Galphaq/11 protein was decreased by 33.1 percent; (P<0.01). The above data suggest that the PDGF-mediated signal transduction pathway plays an important role in VSMC proliferation.

Evaluation of coronary artery bypass graft patency using three-dimensional reconstruction and flow study of electron beam tomography

OBJECTIVE

To establish and evaluate two protocols for the noninvasive visualization and assessment of coronary artery bypass graft (CABG) patency on electron beam tomography (EBT).

METHODS

Two hundred and fourteen consecutive patients who underwent coronary artery bypass graft surgery were scanned using both EBT angiography with 3-dimensional reconstruction and EBT flow study with time-density-curve analysis.

RESULTS

There were 589 CABGs evaluated in this study (10 grafts were excluded because of artifacts). Among them, 133 (98.5%) of 135 arterial grafts were patent, and 345 (77.7%) of 444 saphenous-vein grafts were patent. Within 5 years or between 5 and 10 years after operation, arterial graft patency exceeded venous graft patency (P < 0.001). Three-dimensional EBT angiography achieved higher sensitivity, specificity and accuracy (97.7%, 94.1% and 96.7%, respectively) than did EBT flow study (88.4%, 82.4% and 85.2%, respectively) for evaluating occlusion or patency of CABG. The intra-graft flow of patent arterial and venous grafts were 4.9 +/- 2.2 ml.min-1.g-1 and 6.9 +/- 2.8 ml.min-1.g-1, respectively (P < 0.001).

CONCLUSION

The combination of EBT three-dimensional reconstruction and flow study can be more effective in the assessment of CABG anatomy and quantification of patent CABG blood flow.

[Study on apoE gene polymorphism in Chinese endogenous hypertriglyceridemia]

OBJECTIVE

To investigate apolipoprotein(apo) E polymorphism and its relationship with serum lipids and apolipoproteins in Chinese patients with endogenous hypertriglyceridemia(HTG).

METHODS

apoE genotype was assayed by polymerase chain reaction- restriction fragment length polymorphism(PCR-RFLP), serum lipids were determined by enzyme method, and apolipoproteins were measured by radial immunodiffusion assay in 225 endogenous HTG patients whose fasting serum TG levels were > or = 2.26 mmol/L and in 230 healthy subjects whose fasting serum lipids levels were TG<1.82 mmol/L, TC<6.21 mmol/L from a population of Chinese Han nationality in Chengdu area.

RESULTS

Compared with the controls, the values of BMI, TG, TC, nHDLC, apoB100, CII, CIII, E and TG/HDLC in HTG patients were significantly increased and the values of HDLC, apoAI and apoE/apoCIII were significantly decreased(P<0.001). apoE3/3 genotype and allele epsilon(3) frequency in HTG group and the control group were both the highest, and allele epsilon( 2) frequency in HTG group tended to increase than that in the control group(P>0.05). Both in HTG group and control group, the genotype of apoE2 had higher serum TG and apoE levels, lower LDLC level and decreased apoE/apoCIII ratio as compared with the genotype of apoE3 or apoE4(P<0.001).

CONCLUSION

Allele epsilon(2) of apoE gene was associated with higher serum TG and apoE levels and lower serum LDLC level, and the lower ratio of apoE/apoCIII was associated with the higher serum level of TG in endogenous HTG.

Malignant solitary fibrous tumor of the pleura with liposarcomatous differentiation

Pleural solitary fibrous tumors (SFTs) are uncommon tumors. Although these tumors have been well characterized, malignant pleural SFTs with liposarcomatous differentiation have not been reported. We report an unusual malignant pleural SFT intermixed with foci of well-differentiated liposarcoma. The patient was a 66-year-old, white man with a large, solid right pleural mass that measured 13.5 x 10.3 x 8.5 cm. The tumor was composed of spindle-shaped and plump cells embedded in dense collagenous stroma. The tumor cells were arranged in interlacing fascicles or in a patternless pattern. Marked nuclear atypia, a high mitotic rate (21 mitoses per 10 high-power fields), and areas of prominent necrosis were evident. In addition, numerous adipocytes mixed with typical lipoblasts were seen scattered throughout portions of the tumor. Immunohistochemistry revealed the tumor cells were strongly positive for CD34 and vimentin and negative for cytokeratin, desmin, smooth muscle actin (IA4), and S100. To the best of our knowledge, this case represents the first example of a malignant SFT with liposarcomatous differentiation.

Effects of adrenalectomy and hormone replacement on B6C3F1 mice fed a high-fat diet

Bilateral adrenalectomy (ADX) causes decreased circulating leptin in both obese and lean mice. It remains unclear whether the decreased plasma leptin after ADX is due to decreased adipose tissue or is due to decreased circulating glucocorticoids. The present experiment was performed to test the hypothesis that the absence of glucocorticoids from circulation is sufficient to decrease circulating leptin. Sixty-four adult male B6C3F1 mice were individually housed and fed either Purina rat chow or an experimental diet. After 6 weeks, mice fed the experimental diet gained more weight than mice fed the control diet. Each dietary group was then subdivided into four groups: ADX with cholesterol replacement (ADX-CHOL), ADX with corticosterone (CORT) replacement (ADX+CORT), ADX with aldosterone (ALDO) replacement (ADX+ALDO), and sham operation (SHAM). Two days after surgery, mice were killed and exsanguinated and the carcasses were prepared for gravimetric analyses. Blood was collected and centrifuged and the plasma was assayed for leptin, CORT, and ALDO. Blood glucose was determined using whole blood taken before centrifugation. There was no difference in body weight due to ADX after 2 days. Mice fed the experimental diet had higher circulating leptin than those fed the control diet. The ADX+CORT groups (both experimental and control diets) had higher plasma leptin concentrations than the other groups. No differences were observed between ADX-CHOL and SHAM groups. These results suggest that circulating leptin is not directly controlled by glucocorticoids. The effect of ADX on circulating leptin reported by others may be the consequence of decreased adiposity.

Coronary artery stenoses: a phantom study using contrast enhanced three-dimensional electron beam tomography

This paper evaluated the accuracy of electron beam tomographic angiography (EBA) with conventional coronary arteriography (CCA) using four graded artificial stenoses in a postmortem swine coronary phantom model. The sensitivity, specificity, and accuracy of EBA for diagnosing significant stenosis (> or =50% stenosis) were 94.3%, 96.7%, and 95.8%, respectively. The diagnostic accuracy of EBA had no significant difference with CCA (chi(2)=0.0162; P>.05). EBA three-dimensional (3D) procedures had high interobserver reproducibility (k=.92-.95, P>.05). Maximum intensity projection (MIP) was the most sensitive and curved planar reformation (CPR) was the most accurate 3D procedure for quantitatively identifying coronary stenosis. EBA yields promising results concerning the visualization of coronary artery stenosis with high accuracy for stenoses >50%.

Biotreatment of hydrogen sulfide- and ammonia-containing waste gases by fluidized bed bioreactor

Gas mixtures of H2S and NH3 are the focus of this study of research concerning gases generated from animal husbandry and treatments of anaerobic wastewater lagoons. A heterotrophic microflora (a mixture of Pseudomonas putida for H2S and Arthrobacter oxydans for NH3) was immobilized with Ca-alginate and packed into a fluidized bed reactor to simultaneously decompose H2S and NH3. This bioreactor was continuously supplied with H2S and NH3 separately or together at various ratios. The removal efficiency, removal rate, and metabolic product of the bioreactor were studied. The results showed that the efficiency remained above 95% when the inlet H2S concentration was below 30 ppm at 36 L/hr. Furthermore, the apparent maximum removal and the apparent half-saturation constant were 7.0 x 10(-8) g-S/cell/day and 76.2 ppm, respectively, in this study. The element sulfur as a main product prevented acidification of the biofilter, which maintained the stability of the operation. As for NH3, the greater than 90% removal rate was achieved as long as the inlet concentration was controlled below 100 ppm at a flow rate of 27 L/hr. In the NH3 inlet, the apparent maximum removal and the apparent half-saturation constant were 1.88 x 10(-6) g-N/cell/day and 30.5 ppm, respectively. Kinetic analysis showed that 60 ppm of NH3 significantly suppressed the H2S removal by Pseudomonas putida, but H2S in the range of 5-60 ppm did not affect NH3 removal by Arthrobacter oxydans. Results from bioaerosol analysis in the bioreactor suggest that the co-immobilized cell technique applied for gas removal creates less environmental impact.

Optimal electrocardiographically triggered phase for reducing motion artifact at electron-beam CT in the coronary artery

RATIONALE AND OBJECTIVES

The authors performed this study to (a) investigate coronary movement with electron-beam computed tomography (CT) and (b) find the optimal electrocardiographic (ECG) triggering phase for eliminating motion artifact.

MATERIALS AND METHODS

One hundred fifty-one patients without arrhythmia were examined with electron-beam CT. First, movie scans were obtained to create displacement and velocity graphs of coronary artery movement. Then, a volume scan with an exposure time of 100 msec was obtained with various ECG trigger settings.

RESULTS

Movement patterns of coronary arteries varied with heart rate. Optimal triggering phase was before atrial systole (near 71% of the R-R interval) when heart rate was slower than 68 beats per minute and at ventricular end systole when heart rate was fast. Rate of severe motion artifacts decreased from 43% to 0% when triggering was altered from 80% of the R-R interval to the individual optimal value. Experimental values of the optimal phase at different heart rates were derived, and severe motion artifact was only 3.0% with these values.

CONCLUSION

ECG triggering set according to the heart rate enables a great reduction in motion artifacts at electron-beam CT with a 100-msec exposure time. The results may have implications for magnetic resonance imaging of the coronary artery.

[The application of spiral CT angiography in cancerous invasion of central pulmonary artery in lung cancer]

BACKGROUND

To apply spiral CT angiography( SCTA) as imaging method of pulmonary angiography and study the imaging findings of cancerous invasion of central pulmonary artery (CICPA) in lung cancer patients by means of spiral CT pulmonary angiography (SCTPA) .

METHODS

Thirty patients with central type of lung cancer proved by bronchoscopy biopsy or surgery underwent SCTPA, and 30 cases who had negative results on conventional CT as control. Technic parameters of SCTPA applied for both groups were as follows: contrast medium injection rate of 3-4ml/ s, collimation of 3mm, pitch of 1. 5, reconstruction interval of 1. 2 mm. The CT manifestations of vessel course and lumen of central pulmonary artery(CPA) were observed and the enhancement intensity of CICPA segment wasmeasured by 3-D imaging of CTA.

RESULTS

The changes of vessel course were found in 18 cases( 60%) . The direction of displacement of CPA was different depending on predominant site of the mass and the pathway of CICPA. Centripetal or eccentric stenosis of CPA lumen in various degree with rigid and smooth contour was visualized in 26 cases( 86. 7%) . Decreased enhancement intensity of CPA was significantly shown in cases whose CPA lumen severely narrowed ( P < 0. 05) , and not distinct while stenosis of CPA lumen wasmild tomoderate degree ( P > 0. 05) .

CONCLUSIONS

The direct CT signs of CICPA in lung cancer by SCTPA in this study include displacement of vessel course, stenosis of lumen and decreased intensity of contrast enhancement of CPA. SCTPA is a significant complement to conventional CT in diagnosis of CICPA in lung cancer.

Effects of scanning and reconstruction parameters on image quality in electron-beam CT angiography: coronary artery phantom study

RATIONALE AND OBJECTIVES

This study compared the image quality obtained with different scanning and reconstruction parameters for electron-beam computed tomographic (CT) angiography and sought optimal methods for visualizing the coronary artery lumen.

MATERIALS AND METHODS

Electron-beam CT angiography with contrast material enhancement was used to image 35 branches of fresh postmortem swine coronary arteries. Different collimation widths, fields of view (FOVs), reconstruction kernels, and algorithms were employed to reconstruct the acquired raw data into CT angiographic images. Image quality was compared and analyzed.

RESULTS

The contrast-to-noise ratios (C/Ns) for 1.5-, 2-, and 3-mm section thickness were 28.4 +/- 15.2, 31.9 +/- 9.3, and 33.8 +/- 14.5, respectively (P < .05). The lengths of visualized coronary artery lumina were significantly longer for 1.5-mm scanning (71.6 mm +/- 4.3) than for 2-mm (58.3 mm +/- 5.5) and 3-mm scanning (59.0 mm +/- 8.0) (P < .01). The C/Ns for 12.7-, 18.0-, and 26.0-cm FOV reconstruction were 32.8 +/- 9.9, 28.9 +/- 8.2, and 27.1 +/- 8.2, respectively (not significant), and the visualized luminal lengths were 76.1 mm +/- 12.5, 71.7 mm +/- 14.6, and 65.4 mm +/- 13.1, respectively (not significant). The highest C/N (48.2 +/- 13.3) was achieved with smooth kernels and a cone-beam algorithm, and the lowest (14.7 +/- 3.4) with very sharp kernels and a normal algorithm. Cone-beam algorithm images had significantly higher C/Ns than did normal algorithm images (P < .001), and they demonstrated longer coronary artery lumina (P < .01).

CONCLUSION

Collimation width, FOV, reconstruction kernels, and algorithms are important in the processing of high-quality electron-beam coronary angiograms. A 1.5-mm collimation width, 12.7-cm FOV, cone-beam reconstruction algorithm, and very sharp kernels should help in obtaining the best image quality and depicting the longest segments of coronary artery lumen.

[The effect of melatonin on enhancing immune function and inhibiting the ability of NO over-release in morphine dependent mice]

AIM

To observe the effects and mechanism of melatonin (MT) on the immune function of morphine dependent mice.

METHODS

A physical dependent mice model was established by repeated subcutaneous injection of morphine. The intensity of morphine withdrawal syndrome was evaluated according to the weight of immune organs, the proliferation reaction of stimulated splenic lymphocytes by Con A, the phagoindex of blood primed macrophages and the content of NO induced in the peritoneal macrophage (pM phi).

RESULTS

MT reversed the inhibitory effect of morphine on the proliferation ability of splenic lymphocytes and enhanced the phagocytosis of macrophages of morphine dependent mice obviously and prevented the over-release of NO from pM phi. The enhancing effects of MT on the phagocytosis can be prevented by naloxon.

CONCLUSION

MT can significantly enhance the immune function of morphine dependent mice and inhibit NO excessive release from pM phi.

Evaluation of electron beam tomographic coronary arteriography with three-dimensional reconstruction in healthy subjects

In this study, the authors evaluated the performance characteristics of contrast-enhanced electron-beam tomography (EBT) with three-dimensional reconstruction in defining the coronary artery lumen in healthy subjects. Thirty patients with normal coronary angiograms by selective coronary arteriography (SCA) underwent contrast-enhanced EBT examination. Measured parameters included degree of luminal enhancement, intravascular contrast-to-noise ratio (CNR), and diameter and length of visualized lumen. Ventricular cavity, aortic blood pool, and coronary artery attenuation were found to be significantly different before and after intravenous injection of contrast material (p < 0.001). CNR decreased from proximal to distal segments within each vessel (p < 0.001), with a peak of 11.2 +/- 2.3 occurring in the proximal left anterior descending coronary artery (LAD) to a low of 4.8 +/- 2.0 in the distal left circumflex (LCX). Luminal diameters visualized by EBT had no significant difference with that of SCA (p > 0.05). Therefore, EBT angiography with three-dimensional reconstruction allows for noninvasive coronary arteriography revealing long segments of the major coronary arteries in normal subjects.

Electron beam tomography with three-dimensional reconstruction in the diagnosis of aortic diseases

BACKGROUND

This study was performed to evaluate the protocols of electron beam tomographic angiography and three-dimensional reconstruction for assessing the diagnostic value of aortic diseases.

METHODS

EXPERIMENTAL DESIGN

Retrospective and comparative study.

SETTINGS

University hospital.

PATIENTS

Between 1996 and 1998, 189 cases who underwent electron beam tomographic angiography and diagnosed with aortic diseases were analyzed retrospectively. The results were compared with surgical and pathological findings in 68 cases. Electron beam tomographic angiography was used single-slice-scanning with ECG-triggering for screening of the thoracic aorta, continuous-volume-scanning, permitted by continuous X-ray exposure with table incremention, was performed for the abdominal aorta scanning without ECG-triggering. Three-dimensional reconstructions were performed with shaded-surface display, multiplanar reformatting and/or maximum intensity projection methods.

RESULTS

Electron beam tomography angiography with ECG-triggered sections of single-slice-scanning improved the image quality of the ascending aorta without motion artifacts. Continuous-volume-scanning was suitable for screening of the abdominal aorta because of minimizing exposure time (10-14 sec) and saving contrast media (total contrast material of 45.5+/-6.6 ml was needed). One hundred eighty-nine cases were diagnosed with aortic dissection (97 cases), aortic aneurysm (26 cases), pseudoaneurysm (8 cases), Marfan's syndrome (39 cases), Takayasu's arteritis (5 cases) and congenital aortic malformations (14 cases). Electron beam tomography results were compared with the findings of surgery (as gold standard) in 68 cases, the diagnostic accuracy was 97% (2 cases with aortic aneurysm were erroneously diagnosed with pseudoaneurysm).

CONCLUSIONS

Electrocardiographically triggered, contrast-enhanced electron beam tomography is feasible for the diagnosis of all kinds of aortic diseases, with excellent three-dimensional images competitive in quality with conventional selective aortic angiography or digital subtraction angiography.

Evaluation of coronary artery bypass graft patency using three-dimensional reconstruction and flow study on electron beam tomography

OBJECTIVES

To establish and evaluate two protocols for the noninvasive visualization and assessment of coronary artery bypass graft (CABG) patency on electron beam tomography (EBT).

METHODS

Two hundred fourteen consecutive patients who underwent CABG surgery were scanned using both EBT angiography with three-dimensional reconstruction and EBT flow study with time-density curve analysis.

RESULTS

There was a total of 589 CABGs evaluated in this study (10 grafts were excluded because of artifacts); 133 (98.5%) of 135 arterial grafts were patent, 345 (77.7%) of 444 saphenous vein grafts were patent. Within 5 years or 5-10 years after surgery, arterial graft patency exceeded venous graft patency (p<0.001). Three-dimensional EBT angiography achieved higher sensitivity, specificity, and accuracy (97.7%, 94.1%, and 96.7%, respectively) than EBT flow study (88.4%, 82.4%, and 85.2%, respectively) for evaluating occlusion or patency of CABGs. The intragraft flow of patent arterial and venous grafts were 4.9+/-2.2 ml/min/g and 6.9+/-2.8 ml/min/g, respectively (p<0.001).

CONCLUSION

The combination of EBT three-dimensional reconstruction and flow study can be more effectively performed in the assessment of CABG anatomy and quantification of patent CABG flow.

ThinPrep Pap Test promotes detection of glandular lesions of the endocervix

The objectives of this study were to evaluate 1) the detection rate of atypical glandular cells of undetermined significance of endocervical cell type (AGUS-EC) and 2) the correlation between AGUS-EC on cytology and biopsy results using the conventional Papanicolaou (Pap) smear test vs. the ThinPrep Pap test (TPPT). Cervical-vaginal samples processed by the conventional Pap smear for 11 mo in 1996-1997 were identified, as were TPPTs collected for the same interval in 1997-1998. Biopsy results were compared after a 9-mo follow-up for both groups. There were 112 AGUS-EC cases from 82,754 conventional Pap smears (detection rate, 0.14%) compared with 58 cases from 82,252 TPPTs (detection rate, 0.07%) (P < 0.01). Biopsies were available in 72 of 112 patients from the conventional Pap smear group and 35 of 58 patients from the TPPT groups. Five dysplastic glandular lesions/ AIS were diagnosed by biopsy in the 35 patients (14.3%)from the TPPT group, compared with 2 of the 72 patients (2.8%) from the conventional Pap smear group (P < 0.05). There were no statistically significant differences between other follow-up diagnoses for the two methods. The use of TPPT resulted in fewer cases of AGUS-EC and better correlation with histology. The TPPT appears to be as sensitive as and more specific than the conventional Pap smear for detection of endocervical glandular lesions.

Hypotetraploidy in a patient with small cell carcinoma

While numerical and structural chromosomal abnormalities characterize many hematopoietic and nonhematopoietic malignancies, the occurrence of polyploidy is by and large rare. We report here an interesting patient with small cell carcinoma (SCC) and hypotetraploidy initially referred to us because of a question of acute nonlymphocytic leukemia, M3 subtype, with a question of a 15;17 translocation characteristic of acute promyelocytic leukemia. However, the patient did not have a 15;17 translocation and the final hematopathologic analysis of the bone marrow aspirates and immunohistochemistry studies subsequently revealed the patient to have SCC. Small cell carcinoma is a highly malignant and a very aggressive neoplasm. A review of the literature, using Medline, Cancerlit, and the Science Citation Index, revealed that in most, if not all, reports, the presence of polyploidy is noted as a rare entity. In leukemia, reports of polyploidy point to a distinct category of patients with a poor risk for which more intensive treatment is needed. Limited information is currently available to assess the risk of polyploidy in small cell carcinoma. Our case is important not only because of the relative rarity of polyploidy, but also because insights gained from the study of this and other similar patients may help shed additional light on the mechanism of carcinogenesis, which is not fully known to date. As polyploidization is a manifestation of genetic instability and as genetic instability has been implicated in the genesis and progression of many cancers, it is perhaps not too surprising that polyploidy in our case was associated with a poor disease outcome. The patient has since expired.

Performance of the annular denuder system with different arrangements for HNO3 and HNO2 measurements in Taiwan

Experiments on different annular denuder system (ADS) arrangements for sampling nitrous acid (HNO2) and nitric acid (HNO3) gases were conducted in this study to evaluate their sampling artifacts. The evaluation basis is the one that employed one sodium chloride denuder for sampling HNO3 gas and two sodium carbonate (Na2CO3) denuders for sampling HNO2 gas, which is a commonly employed ADS arrangement in many field applications in the United States. A field study was conducted in Hsinchu, Taiwan, and the results indicated that this ADS arrangement may yield over 80% relative errors for HNO3 gas. It also showed that the relative errors for HNO2 gas can be less than 10% as sampled with only one Na2CO3 denuder. This is attributed to the fact that the ambient HNO3 concentration measured in this study was relatively low while the HNO2 concentration was high, as compared to typical concentrations of these two gases measured in the United States. The sampling error of HNO3 gas may be due to high concentrations of N-containing interfering species present in Taiwan's atmosphere. Because the relative sampling errors of HNO3 and HNO2 gases depend mainly on their concentrations in the atmosphere as well as concentrations caused by interfering species, the risk for high error while measuring low HNO2 concentrations by only one Na2CO3 denuder is also possible. As a result, it is suggested that pretests are necessary to evaluate possible sources and degrees of sampling errors before field sampling of HNO2 and HNO3 gases. The sampling errors of these two gases can, therefore, be minimized with a better arrangement of the ADS.

Detection and analysis of intracoronary artery stent after PTCA using contrast-enhanced three-dimensional electron beam tomography

We evaluated several three-dimensional methods of contrast-enhanced electron beam tomography (EBT) for evaluation of intracoronary stent characteristics after percutaneous transluminal coronary angioplasty (PTCA). Twenty-six patients who had undergone PTCA and stenting (31 stents) were investigated by using contrast-enhanced, electrocardiographically (ECG) triggered EBT scanning. EBT results were compared with conventional selective coronary arteriography (SCA). Overall, 27 intracoronary stents had been identified on EBT images (87.1%), while 4 stents could not be evaluated because of impaired image quality. EBT correctly identified the only case in which there was a residual stenosis at the distal portion of the stent. As compared with SCA results, EBT showed an over-estimation of intracoronary stent diameter (p < 0.001) and accurate measurement on the visualized length of the stents (p > 0.05). Fifty Hu, 100 Hu and 150 Hu were used as the observed window levels on three-dimensional (3-D) images; the accuracy for stent assessment increased with ascending window levels. EBT can reliably characterize coronary artery stents and may become a useful non-invasiveive method for patency evaluation of stented coronary segments after PTCA.

Rapid detection of glycoprotein G gene for the diagnosis and typing of herpes simplex virus infection in genital herpes

OBJECTIVE

To develop a new, rapid, and convenient technique for the diagnosis and typing of herpes simplex virus (HSV) in genital herpes (GH).

METHODS

Using samples from skin vesicle fluid and urogenital mucosal swabs of subjects with GH, conventional polymerase chain reaction (PCR) (directed to polymerase gene: PCRpG) were compared with a newly developed PCR (directed to HSV glycoprotein gene: PCRgG). Both PCR methods were compared with virus isolation culture (VI) with indirect immunofluorescent staining (IIF).

RESULTS

80 samples from 40 GH patients (25 males) were tested. Positive results were seen in 52.5% (42/80) using PCRgG compared with 40% (32/80) by VI. Most of PCRgG positive samples (95.1%) were caused by HSV-2 infection. In samples from healing lesions, HSV was detected more often by PCRgG, than by VI. The results of typing by PCRgG and IIF were highly consistent.

CONCLUSION

PCRgG is more sensitive than VI and PCRgG in detecting HSV in urogenital samples from subjects with GH. PCRgG is a convenient technique for the rapid detection and typing of GH.

[Mechanism of selenium protecting against free radical damages during myocardial ischemia/reperfusion in rats]

OBJECTIVE

To investigate the mechanism of selenium (Se) protecting against free radical damages during myocardial ischemia/reperfusion (I/R) in rats.

METHODS

All rats were separated into three groups: control, organic Se and inorganic Se supplemented groups. Myocardial I/R was established by operation in all three groups. Biochemical assays, atomic absorption spectrophotometry, RT-PCR and cDNA sequence scanning were performed to examine the changes in myocardial MDA level, GSH-Px activity and gene expression, GSH-Px cDNA nucleotide sequence, as well as Se and Ca2+ and Mg2+ concentrations in the heart muscle during I/R.

RESULTS

The administration of Se for 7 days did not significantly change the content of Se in the plasma and blood cells. In the two Se-supplemented groups, after reperfusion for 30 minutes, myocardial Se concentration and GSH-Px activity were increased significantly, and GSH-Px expression was elevated with a normal cDNA sequence, and at the same time, MDA contents in the two Se-supplemented groups were lower than that in the control group.

CONCLUSION

Se supplementation can protect against free radical damages during myocardial I/R by increasing myocardial Se content and improving both the expression and activity of GSH-Px.

A variant Klinefelter syndrome patient with an XXY/XX/XY karyotype studied by GTG-banding and fluorescence in situ hybridization

Klinefelter syndrome is the first human sex chromosomal abnormality to be reported. The majority of Klinefelter syndrome patients have the XXY karyotype. Approximately 15% of Klinefelter patients, however, are mosaics with variable phenotypes. Among the variant Klinefelter genotypes are such karyotypes as XY/XXY and XX/XXY. The variation in phenotypes most likely depends on the number of abnormal cells and their location in body tissues. In this paper we report the case of a 42-year-old patient with Klinefelter syndrome and a rare variant mosaic XXY/XX karyotype initially identified by GTG-banding. This was confirmed by fluorescence in situ hybridization (FISH) using a dual-color X/Y probe. The patient presented with erectile dysfunction and few other physical findings. Thus, this case illustrates a rare variant of Klinefelter syndrome with a relatively mild phenotype. It also illustrates the utility of FISH as an adjunct to conventional cytogenetics in assessing the chromosome copy number in each cell line of a mosaic. In our case, FISH also detected the presence of a small population of cells with the XY karyotype not previously detected in the initial 30-cell GTG-banding analysis. Thus, through a combination of GTG-banding and FISH, the patient was determined to be an XXY/XX/XY mosaic. Given that most individuals with Klinefelter syndrome are infertile, and that these individuals may wish to reproduce with the aid of modern reproductive technology, such as testicular fine needle aspiration and intracytoplasmic sperm injection, it is important that accurate estimation of the frequency of abnormal cells be obtained for accurate risk estimation and genetic counseling, as recent studies in patients with mosaic Klinefelter syndrome revealed that germ cells with sex chromosomal abnormalities were nevertheless capable of completing meiosis.

[Application of intravenous and inhalational combined anesthesia with midazolam, fentanyl 1 and enflurane in cleft palate repair operation]

OBJECTIVE

To observe the effects of intravenous and inhalational combined anesthesia with midazolam, fetanyl l and enflurane in the cleft palate repair operation.

METHODS

128 patients prepared for cleft palate repair operation were selected randomly. Anesthesia was induced with 0.2-0.3 mg/kg midazolam, 3-5 micrograms/kg fentanyl 1, and intubation was facilitated with 1-2 mg/kg succinylcholine. Anesthesia was maintained with fentanyl 1 and enflurane, and changes of hemodynamics and incident rates of hiccup, cough and vomit were observed during and after operation.

RESULTS

1. After inducing, systolic pressure (SP) was decreased by 5%-8%, diastolic pressure (DP) decreased by 8%-10%(P < 0.05), and there were no significant changes in heart rates (HR) (P > 0.05). After intubation, there were no significant changes in SP, DP and HR. 2. After induction, the incident rates of hiccup and cough were 3.1% and 7.8% respectively. After operation, the incident rate of vomit was 7.0%. 3. The volume of lost blood was 5% less than the patient's whole blood volume.

CONCLUSION

The anesthetic way is easy to be controlled with few side effects, and patients can revive easily, so it is a safe, efficient and perfect way in cleft palate repair operation.

[Studies on apoptosis of human lung adenocarcinoma cells induced by oltipraz]

OBJECTIVE

To study whether oltipraz can induce apoptosis of human lung adenocarcinoma (GLC-82) cells and its possible mechanism.

METHODS

Light microscopy, DNA electrophoresis, flow cytometry and video time-lapse monitoring were used to observe apoptosis of GLC-82 induced by oltipraz.

RESULTS

GLC-82 cells treated with oltipraz underwent the arrest of cell mitosis at metaphase, higher percentage of G(2)/M and peak of apoptosis were found, and cell body shrunk, nuclear chromosome condensed or fragmented and nuclear DNA fragment displayed "laden" bands in apoptic cells. Apoptosis of GLC-82 induced by oltipraz was more obvious at a concentration of 120 microg/ml.

CONCLUSION

Oltipraz could induce apoptosis of GLC-82 at certain concentrations, which associated closely with the arrest of mitotic cycle.

Angiotensin I converting enzyme gene polymorphism and insulin resistance in patients with angina pectoris

The association between insertion/deletion polymorphism of the angiotensin I converting enzyme (ACE) gene and insulin resistance (IR) was investigated in 64 consecutive patients (F/M: 11/53) with angina pectoris without clinically manifest diabetes mellitus who underwent diagnostic coronary angiography. The observed frequency distribution of ACE genotypes did not deviate from that predicted from the Hardy-Weinberg equilibrium in this group. Patients with the ACE-ID genotype had significantly lower IR, as assessed by an oral glucose tolerance test (OGTT) and by homeostatic model assessment (HOMA), compared to those with the ACE-II genotype, as assessed by a multiple comparison analysis. Patients were divided into two groups with low and high HOMA-IR, and the I allele was seen more frequently in the high HOMA-IR group than in the low HOMA-IR group (0.62 v 0.47, respectively, by chi2 test, P < .05). Logistic regression analysis showed that the odds ratio for insulin resistance in patients with the II genotype, compared to those with the ID and DD-genotypes (assuming that the I allele has a recessive effect), was 4.0 (95% confidence interval, 1.2 to 16.5; P = .037), after adjusting for the presence of significant coronary atherosclerosis. In conclusion, the D allele was not associated with higher insulin resistance in patients with angina pectoris; that is, patients with the ID and DD genotypes were associated with a significantly lower risk of insulin resistance, compared to those with the II genotype.

Electron-beam CT angiography with three-dimensional reconstruction in the evaluation of coronary artery bypass grafts

RATIONALE AND OBJECTIVES

The authors evaluated the use of electron-beam computed tomographic (CT) angiography and three-dimensional (3D) reconstruction for evaluation of coronary artery bypass grafts (CABGs).

MATERIALS AND METHODS

Sixty patients (53 men and seven women; mean age, 56 years +/- 8) with 152 CABGs (29 internal mammary artery and 123 saphenous vein grafts) underwent electron-beam CT with 3D reconstruction. The time from bypass surgery to CT scanning was 7 days to 120 months (mean, 17 months +/- 28). Enhanced single-section and flow mode studies were performed in all cases. The results were correlated with CABG operation records, and patency was determined with time-attenuation curves.

RESULTS

All patients were successfully examined. On the basis of time-attenuation curve criteria, 124 (81.6%) of 152 grafts were patent. The patency rate for the internal mammary artery subgroup was 93% (27 of 29 grafts); for the saphenous vein graft subgroup, 78.9% (97 of 123 grafts).

CONCLUSION

Used in contrast-enhanced, single-section mode and flow studies with time-attenuation curves, electron-beam CT angiography with 3D reconstruction can provide quantitative data for evaluation of CABG patency.

Structure-activity studies related to ABT-594, a potent nonopioid analgesic agent: effect of pyridine and azetidine ring substitutions on nicotinic acetylcholine receptor binding affinity and analgesic activity in mice

Analogs of A-98593 (1) and its enantiomer ABT-594 (2) with diverse substituents on the pyridine ring were prepared and tested for affinity to nicotinic acetylcholine receptor binding sites in rat brain and for analgesic activity in the mouse hot plate assay. Numerous types of modifications were consistent with high affinity for [3H]cytisine binding sites. By contrast, only selected modifications resulted in retention of analgesic potency in the same range as 1 and 2. Analogs of 2 with one or two methyl substituents at the 3-position of the azetidine ring also were prepared and found to be substantially less active in both assays.

Three-dimensional reconstruction of electron beam computed tomography angiography for evaluating coronary artery bypass grafts

OBJECTIVES

To probe into electron beam computed tomography (EBCT) angiography and 3-D reconstruction of coronary artery bypass grafts (CABG) and to evaluate the clinical application of EBCT angiography and 3-D reconstruction of CABG.

METHODS

EBCT angiography with 3-D reconstruction was achieved in 150 patients (142 men and 8 women, mean age, 57 +/- 8 years) with 399 grafts including 100 internal mammary artery grafts (IMG), 296 saphenous vein grafts(SVG) and 3 radial artery grafts (RAG) respectively. The time from bypass surgery to EBCT scanning ranged from 7 days to 120 months, averaging 15 +/- 28 months. Enhanced single slice mode (SSM) and flow studies were performed in all patients. The results of 3-D reconstruction of CABG were compared with bypass operation records and with coronary arteriograms (7 patients).

RESULTS

150 patients underwent successfully EBCT angiography and CABG 3-D reconstruction. According to 3-D reconstruction of the coronary bypass grafts with flow studies, 318 of 399 coronary bypass grafts were patent including IMG patency in 87/100 (87%), SVG in 228/296 (77%) and RAG in 3/3 (100/100). The overall patent rate was 79.7%. In 7 patients with 12 coronary bypass grafts, EBCT studies showed graft patency (7 grafts) and occlusion (5), which were confirmed by conventional graft angiography.

CONCLUSIONS

EBCT angiography with 3-D reconstruction is effective in providing the entire anatomic structure of coronary bypass grafts and evaluating coronary bypass graft patency. EBCT flow study can provide quantitative data for evaluating coronary bypass graft patency and for supplemental diagnosis of CABG 3-D reconstruction. EBCT angiography is a noninvasive technique that could replace conventional coronary arteriography for follow-up survey of coronary bypass surgery in future.

[Studies on inhibition of human lung carcinogenesis in early stage by oltipraz and its effects on some gene expression and regulation]

By using human fetal lung (HFL) as experimental material, the inhibition of HFL carcinogenesis in early stage by oltipraz and its molecular mechanisms were studied. The results showed that oltipraz is effective in the inhibition of carcinogenesis prior to or at the same time with Cigarette Smoking Condensate(CSC) treatment; oltipraz can decrease GSTs activity and GST-pi protein content along with its inhibition of HFL carcinogenesis; oltipraz can decrease mp53 expression; oltipraz can prevent but can not reverse the ras gene mutation; oltipraz can induce apoptosis of GLC cell obviously in a dosage of 120 micrograms/ml. Meanwhile, it is related to high expression of c-fos and low expression of GST-pi in apoptosis; oltipraz may affect c-fos gene expression through induction of a protein factor which links with DSE.

Inhibition of intimal hyperplasia after vein grafting by in vivo transfer of human senescent cell-derived inhibitor-1 gene

The senescent cell-derived inhibitor (sdi)-1 (p21) protein has been identified as a downstream mediator of the tumor suppressor p53 in the cell cycle regulation. In this study, we focused on the function of sdi-1 gene in inhibiting vascular smooth muscle cell (VSMC) proliferation after vein grafting in a rabbit model. To test the hypothesis, we transfected human sdi-1 gene by an intra-operative approach. Accompanied by markedly increased sdi-1 protein, the significant increase in PCNA-stained VSMCs in vein grafts was inhibited by transfection of sdi-1 gene. Moreover, at 2 weeks after transfection, transfer of sdi-1 gene resulted in a significant inhibition in neointimal formation, compared with control vector. Of importance, immunohistological studies determining the expression pattern of myosin heavy isoforms, adult type specific SM2 and embryonic specific SMemb/NMHC-B, demonstrated expression of the adult phenotype of VSMCs in the neointima of sdi-1 gene-transfected vein grafts at 2 weeks after the operation, while the neointima was predominantly composed of embryonic phenotype of VSMCs in the control grafts. Overall, these results demonstrate that a single intraluminal incubation of human sdi-1 gene can result in a significant inhibition of neointimal formation after vein grafting, associated with phenotypic change of VSMCs from neonatal to adult type in a rabbit model. Inhibition of hyperplasia in a graft model by transfection of sdi-1 gene may be due to the change in VSMC phenotype from neonatal to adult, in addition to the inhibition of VSMC growth.

Synthesis and structure-activity relationships of pyridine-modified analogs of 3-[2-((S)-pyrrolidinyl)methoxy]pyridine, A-84543, a potent nicotinic acetylcholine receptor agonist

Analogs of 3-[2-((S)-pyrrolidinyl)methoxy]pyridine, (A-84543, 1) with 2-, 4-, 5-, and 6-substituents on the pyridine ring were synthesized. These analogs exhibited Ki values ranging from 0.15 to > 9,000 nM when tested in vitro for neuronal nicotinic acetylcholine receptor binding activity. Assessment of functional activity at subtypes of neuronal nicotinic acetylcholine receptors indicates that pyridine substitution can have a profound effect on efficacy at these subtypes, and several subtype-selective agonists and antagonists have been identified.

[Effect of hypoxia on spleen mono nuclear cell DNA content and proliferation of neonatal rats]

Effects of hypoxia on the immune function of neonatal rats at the age of 14 days as well as on the levels of ACh, catecholamine in spleen were studied. After the animals were exposed to hypoxia at 5 km simulated altitude in hypobaric chamber for 5 days, there was 43.4% decrease in DNA content in spleen mono nuclear cell and a 13.2% decrease in mono nuclear cell proliferation. Similar suppression of these two parameters of immune function in exposure to 7 km for 24 h was also noted, which decreased by 39% and 19.8% respectively. The suppressive effect of 7 km for 24 h hypoxia on DNA content was partly blocked when rats were pretreated with DSP-4 intracerebroventricularly one day before hypoxia. The levels of catecholamine in spleen increased, while the levels of ACh decreased after 7 km exposure for 24 h. These observations indicate that hypoxia may suppress cellular function of neonatal rats and its action may be mediated by activation of sympathetic nervous system and inhibition of parasymphathetic one.

[An autopsy case of pulmonary thromboembolism: a delayed complication of a victim by traffic accident]

A 35-year-old male had fallen down from his motor bike caused a fracture of the medial condyle of the right tibia and the acromion of the left scapula. He had received screw fixed operation for his right tibia and had been in the hospital for one month. He died suddenly in the hospital and was autopsied to find out the cause of death. On external examination, it was found that affected leg was bruised and swollened. Partially organized thrombosis in the posterior tibial vein was revealed and bilateral pulmonary arteries were packed with reddish massive thromboemboli. The causes of the posterior tibial vein thrombosis were intimal damage and decreased venous flow, attributable to bed rest for long days and external fixation of the lower extremity. We presumed that direct cause of death was a large thromboemboi which were migrated from posterior tibial vein and lodged at the bifurcation of the pulmonary artery causing obstruction of pulmonary blood flow. Finally we opened the direct cause of death was pulmonary thromboembolism due to leg injury. Clinical instability may hinder the diagnostic elevation and delay therapeutic intervention, it is the most often happened in sudden death cases within the hospital. The importance of early diagnosis and early prevention is underscoped, because the symptoms of pulmonary thromboembolism are not always produced. To prevent fatal pulmonary thromboembolism in trauma, prophylactic use of low-dose heparin therapy and/or the use of oral anticoaglant (warfarin) have been effective and recommended in USA and Western Europe. The routine use of these therapy has not yet been spread in Japan, because the incidence is still apparently lower than in USA and Western Europe as well as the risk of hemorrhage. If the victims of road traffic accident receive the prophylactic use of low-dose heparin and/or oral anticoaglant (warfarin), it might be an effective way to reduce mortality.

[Anesthetic management to reduce blood loose in surgical process of palatoplasty]

869 cases with palate cleft, aged from 2 to 12 years old, received palatoplasty surgery in Department of Oral Maxillofacial Surgery, West China University of Medical Science from 1987 to 1996 were reviewed. The effect of anesthetic method on blood loose during surgical procedure was analyzed specifically. It was found that the amount of blood loose was quite different with different anesthetic method. Simple method of anesthetic medication which could dramatically reduce the amount of blood loose in palatoplasty operation was recommended. The key points of anesthetic method for palatoplasty operation, especially in application for children were discussed.

An electrocution death of an infant who had received an electric shock from an uncovered oval shaped lamp switch in his mouth while in a hospital

A male infant aged one year and nine months was found dead on a bed after admission to hospital with suspected pneumonia. The patient apparently put an uncovered oval shaped lamp switch (pendant switch) into his mouth and died of electric shock after contacting the exposed wires of the switch (100 V, 60 Hz alternating current). There were extensive first- to fourth-degree burns on the inner surface of the both lips. Because the histological findings were consistent with electric burns and the burns showed vital reactions, electric shock was judged to be the cause of death. The pendant switch is normally a very convenient piece of bedside equipment for inpatients. However, when the patient is an infant who naturally puts all the objects into the mouth, such a switch should be placed out of reach, and it should be certain that the cap is not loose.

Autologous bone marrow mixed with HLA-haploidentical allogeneic marrow transplantation for treatment of patients with malignant blood diseases

We have previously demonstrated that syngeneic marrow mixed with H-2 haploidentical marrow transplantation could provide not only protection against graft-versus-host disease (GVHD) but also anti-leukemic (GVL) effects in mice. In the present studies, we report clinical observations using autologous marrow mixed with HLA-haploidentical allogeneic marrow transplantation for treatment of patients with malignant blood diseases. Sixteen cases, including 12 with acute leukemia and four with advanced malignant lymphoma, were treated by autologous marrow, which was purged in vitro by hyperthemia (42.5 degrees C for 70 min) following incubation for 5 days with interleukin 2 (IL-2) in liquid culture and mixed with HLA haploidentical marrow cells from their sibling or parent. Acute GVHD was not observed in any patient after transplantation. Hematological rescue in the clinical setting was demonstrated in all cases but one who died early from hepatic veno-occlusive disease (VOD). Five cases who were transplanted at the time of CR2 or CR3 and in advanced phase of lymphoma, relapsed 4 to 7 months after transplantation. The relapse rate was 31.3%. None of eight patients who received allogeneic BMT within 2 h after ABMT relapsed with median follow-up of 12 months and two of them died from procedure-related complications. Seven cases are still alive and disease-free with a median follow-up of 12 months. Mixed chimerism was found in 3/6 cases, who had different sex donors, by analysis of sex chromosomes. These results show that mixed transplantation is a safe, effective and new approach to treating patients with malignant tumors. In order to detect the effects of GVL, studies are now in progress in our clinic.

Influence of ganglioside GM3 and high density lipoprotein on the cohesion of mouse brain tumor cells

Previous findings with various murine tumor cell lines suggest an association between ganglioside GM3 and cell cohesive properties. The influence of GM3 on cohesion was studied in two mouse brain tumor cell lines: ependymoblastoma (EPEN) and CT-2A. In culture, the EPEN cells grow as islands and contain GM3 as the only ganglioside, whereas the CT-2A cells grow as a fusiform cell monolayer and contain GM2, GM1, and GD1a as major gangliosides and low amounts of GM3. To examine the role of GM3 in cohesion, both cell lines were treated with 1) C. perfringens neuraminidase, 2) anti-GM3 monoclonal antibody (mAb DH2), or 3) were grown in serum-free medium. All three treatments caused a significant increase in the number of non-cohesive and protoplasmic process-bearing cells for the EPEN, but had no effect on the morphology of the CT-2A cells. The neuraminidase treatment removed GM3 from both cell lines and caused a significant accumulation of GM1 in the CT-2A cells. EPEN cell cohesion and GM3 content returned to control levels after removal of neuraminidase. EPEN cell cohesion was restored in serum-free medium with added high density lipoprotein (HDL). The HDL effect on the EPEN cell cohesion was dose-dependent and was not seen with other lipoproteins. We suggest that EPEN cell cohesion could involve an interaction between extracellular HDL, acting as a bridge, and GM3 molecules on opposing cell surfaces.

Polymorphism of the apolipoprotein A-IV gene and its significance in lipid metabolism and coronary heart disease in a Japanese population

Apolipoprotein A-IV (apo A-IV) is involved in the metabolism of both triglycerides and high-density lipoproteins (HDLs). Apo A-IV has been suggested as participating in several stages of reverse cholesterol transport. Uncertainty about the exact biochemical function of apo A-IV has made the use of genetic apo A-IV polymorphism (variants) attractive in evaluating its physiological role. To date, although some reports indicate that DNA polymorphisms at this locus play an important role in the metabolism of lipids and lipoproteins in western (Caucasian) populations, no similar comprehensive analysis has been performed in a distinct Japanese population. Using DNA sequencing and a restriction fragment length polymorphism (RFLP) study with polymerase chain reaction (PCR), the following allele frequencies were established: (a) codon -8 (G-->A, non-synonymous) allele 2 = 0 (n = 105); (b) codon 9 (A-->G, synonymous) allele 2 = 0.388 (n = 152); (c) codon 347 (A-->T, non-synonymous) allele 2 = 0 (n = 900); (d) codon 360 (T-->G, non-synonymous) allele 2 = 0 (n = 800); (e) VNTR exon 3 [(CTGT)3 and (CTGT)4] (CTGT)3 = 0.262 (n = 105); and (f) MspI (newly detected polymorphic site) polymorphism (C C/T GG) within intron 2, allele 2 = 0.096 (n = 193). The frequencies of these polymorphisms, except for that of the newly identified MspI site, are completely different from those reported in western populations. Among the 900 subjects examined, we found one ACT (Thr) to ACG (Thr) synonymous mutation at codon 347, which does not change the primary structure of apo A-IV. The apo A-IV allele frequency in patients (166 men and 56 women) with angiographically proven coronary heart disease (CHD) was also studied [codon 9 allele 2 = 0.329 (n = 217); VNTR exon 3 (CTGT)3 = 0.262 (n = 84); MspI within intron 2, allele 2 = 0.092 (n = 222)]. Furthermore, we evaluated serum lipid and lipoprotein levels quantitatively in control subjects and Japanese CHD patients. These polymorphisms did not show any consistent and significant association with lipid and lipoprotein parameters. In addition, no gender-specific effects of apo A-IV polymorphisms on lipid parameters adjusted for confounding factors were observed in either CHD patients or control subjects. Our results indicate that the apo A-IV gene is not a major determinant of the risk for CHD in Japanese.

Rapid and clear detection of ABO genotypes by simultaneous PCR-RFLP method

We reported a new approach of ABO genotyping by a polymerase chain reaction and restriction fragment length polymorphism method. Instead of amplifying the loci containing the positions of nucleotides 258 and 700 of cDNA of the A transferase separately, we successfully amplified these 2 loci together in one reaction mixture using 2 sets of primers. The amplified DNA products were digested at the same time with restriction enzymes Kpn I and Alu I. The digested DNA products were then separated by electrophoresis on polyacrylamide gel. In addition, we evaluated the influence of various amplification parameters (concentration of template DNA, primers, Taq DNA polymerase, MgCl2, and number of cycles). In particular, high Mg2+ concentration (3.5 mM) made effective amplification of this locus without producing any unspecific band. By using that optimized condition for PCR, together with a simultaneous approach, our study proved to be time saving, more economic, and convenient in interpreting the results.

Analysis of a new polymorphism in the human apolipoprotein A-I gene: association with serum lipoprotein levels and coronary heart disease

Systematic sequencing of the coding and exon flanking regions of the apolipoprotein (apo) A-I gene has identified a new polymorphic Msp I site (C C/T-GG). This polymorphism is situated between the transcriptional starting site and the signal peptide start coding site (intron 1), so may influence the efficiency of surrounding splicing, thereby interfering with the expression of the apo A-I gene product, or serve as a linkage marker with a hitherto unidentified mutation defect responsible for hyperlipidemia and/or premature coronary heart disease. However, there was no significant difference in the allele frequencies between control and coronary heart disease subjects in a Japanese population. The -78 G-->A promoter polymorphism of apo A-I, previously reported in Western populations, has also been analyzed. The results show that neither mutation is likely to be the etiology for predisposition to a change of high-density lipoprotein cholesterol and/or variation in lipid and lipoprotein levels, or for the occurrence of coronary heart disease in Japanese populations.

Continuous production of high degree casein hydrolysates by immobilized proteases in column reactor

The enzymatic complete hydrolysis of casein was investigated by using immobilized endopeptidase and exopeptidase packed in the jacketed column reactors. The mass transfer efficiency of proteins was improved by using sliced shrimp chitin hull as enzyme support, which formed a network structure inside the column reactor that prevented the formation of protein precipitate and increased the line flow rate of protein solution. The specificity of the protease was of crucial importance for both the hydrolysis degree and the free amino acid content of the hydrolysates. Of the enzymes, tested, the immobilized A. oryzae protease was the most effective enzyme in breaking down the casein molecules and releasing the free amino acid from casein hydrolysates. The immobilized pancreatic and kidney exopeptidase could lead to a 20% increase of free amino acids. The free amino acid content of casein hydrolysates was 34.81% after processing and could reach to 64% if the column length was doubled, but 100% hydrolysis was impossible as the reverse reaction was also taking place. The casein hydrolysates was characterized by its high degree of hydrolysis and high content of free amino acids. It can be applied in infant formula, element diet, and as a protein ingredient for food industry.

Direct cardiotoxic effects of cocaine and cocaethylene on isolated cardiomyocytes

We investigated the cardiotoxic effects of cocaine and cocaethylene on the Ca2+ flux responsible for excitation-contraction coupling in isolated ventricular rat myocytes. We simultaneously measured intracellular Ca2+ transients and cell length in isolated cardiac myocytes loaded with a fluorescent Ca2+ indicator, indo-1, during electrical field stimulation at 1 Hz. The cell length was estimated by video dimension analysis. We also measured the activities of Ca2+ ATPase and Ca2+ release channels of cardiac sarcoplasmic reticulum membrane vesicles. Both cocaine and cocaethylene produced significant decreases in both peak intracellular Ca2+ and the cell-contraction rate in a dose-dependent manner. The K0.5 for the reduction of peak intracellular Ca2+ was 157.5 microM for cocaine, but 90.0 microM for cocaethylene. Both cocaethylene and cocaine inhibited neither Ca2+ ATPase nor Ca2+ release channel activity. These results demonstrate that cocaethylene has a more potent direct negative inotropic action on cardiomyocytes, without preventing Ca2+ flux through the cardiac sarcoplasmic reticulum membrane.

Prevalence of genital Chlamydia trachomatis infection in selected populations in China

BACKGROUND

Chlamydia trachomatis is an important pathogen of the urogenital tract. Numerous epidemiologic studies have reported on the prevalence of chlamydia world wide. However, the prevalence of Chlamydia trachomatis in China has not been widely studied.

GOAL OF THIS STUDY

To identify Chlamydia trachomatis in three distinct populations in China. Urogenital specimens were collected from men with no prior history of sexual intercourse (virgin), men seen at a sexually transmitted disease clinic, and female prostitutes.

STUDY DESIGN

Two-hundred urethral swabs were collected from group one, and 100 urethral swabs from group two, and 109 cervical swabs from group three. All specimens were tested for chlamydia by tissue culture isolation using McCoy cells and an iodine stain.

RESULTS

Chlamydia trachomatis was not isolated from the virgin males. The prevalence of chlamydia in men seen at a sexually transmitted disease clinic was 13% (13/100) and in female prostitutes, 37.6% (41/109).

CONCLUSION

The prevalence of chlamydia seen in these three groups is similar to rates found in previous studies done in the United States and Europe in similar populations. Patients with multiple sex partners in China need to be screened for C. trachomatis.

Determining surgical indications for acute type B dissection based on enlargement of aortic diameter during the chronic phase

BACKGROUND

In patients with Stanford type B dissection who have been treated successfully with medical hypotensive therapy during the acute phase, a large number have incurred the risk of surgery during their chronic phases because of enlargement of the dissected aorta. The purpose of this study was to determine the indications for surgical treatment of acute type B dissection by studying chronic-phase enlargements of aortic dissections in patients treated successfully with medical hypotensive therapy during the acute phase.

METHODS AND RESULTS

In 41 patients with type B dissection who had been treated medically during the acute phase, univariate and multivariate factor analyses were made to determine the predominant predictors for chronic-phase enlargement (> or = 60 mm) of the dissected aorta. Computed tomography was performed every 4 to 14 months to observe whether there was enlargement of the maximum aortic diameter. The predominant predictors for aortic enlargement in the chronic phase were the existence of a maximum aortic diameter of > or = 40 mm during the acute phase (P < .001) and a patent primary entry site in the thoracic aorta (P = .001). The values of actuarial freedom from aortic enlargement for the patients with a large aortic diameter (> or = 40 mm) during the acute phase and a patent primary entry site in the thorax at 1, 3, and 5 years were 70%, 29%, and 22%, respectively. No aortic enlargement was observed in the other patients throughout the entire follow-up period.

CONCLUSIONS

These data suggest that patients with acute type B dissection who have a large aortic diameter (> or = 40 mm) and a patent primary entry site in the thorax should be treated surgically during the acute phase on the condition that the surgical risk in this phase is limited.

A new case of apoA-I deficiency showing codon 8 nonsense mutation of the apoA-I gene without evidence of coronary heart disease

We report a 39-year-old Japanese man with HDL and apoA-I deficiency as well as data from members of his family. Corneal opacity and a stomatocyte were found but not tonsillar hypertrophy, xanthomas, or splenomegaly. His serum HDL cholesterol, apoA-I, apoA-II, and LDL cholesterol levels were t mg/dL, < 3 mg/dL, 6 mg/dL, and 175 mg/dL, respectively. Plasma triglyceride, phospholipid, apoB, apoC-III, and apoE levels were all within normal limits. Lecithin:cholesterol acyltransferase activity was half of normal, while lipoprotein lipase and hepatic triglyceride lipase activities were within normal limits. ApoA-I deficiency was confirmed by combined isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis and by an immunoblotting method. We surveyed the apoA-I gene of the patient and five of his family members by direct sequencing after amplification by polymerase chain reaction and found a codon 8 nonsense mutation (TGG --> TAG, Trp --> stop) in exon 3 of the apoA-I gene. The results of a pedigree analysis by DNA sequencing and restricted fragment length polymorphism (Sty I) were consistent with an autosomal codominant trait. Coronary angiography was performed to evaluate coronary atherosclerosis, but no significant luminal narrowing was detected. An intracoronary ultrasound study showed mild intimal hyperplasia in segment 6. In summary, this is a case of apoA-I deficiency without evidence of coronary heart disease.

Amplification of DAT1 (human dopamine transporter gene) 3' variable region in the Japanese population

Amplification of the human dopamine transporter gene (DAT1) was performed by the polymerase chain reaction, and polymorphism of the VNTR locus was analyzed in a population sample of 176 randomly selected Japanese individuals. Genomic DNAs were extracted from whole blood, and the 3' untranslated region of the human DAT1 gene was amplified. The amplification products were distinguished by agarose gel electrophoresis, and visualized directly by ethidium bromide staining. In this way, four alleles were visualized directly and designated A, B, C, and D in decreasing order according to size. The relative frequencies of DAT1 allels A through D were 0.0171, 0.0625, 0.9119, and 0.0085, respectively. Evidence of significant deviations from the Hardy-Weinberg equilibrium was observed from these Japanese population data. The DAT1 locus was estimated to have a heterozygosity index of 13% and polymorphic information content of 0.16.

[Deaths due to heat waves during the summer of 1994 in Osaka Prefecture, Japan]

The summer of 1994 was unusually hot and dry in Japan, setting a record for high temperature and low rainfall in many areas. The daily record of temperature of July and August which were announced by Osaka District Meteorological Observatory exceeded the past ones. The daily recorded temperature of 75 consecutive days in Osaka city was above 30 degrees C with the maximum 39.1 degrees C on 18 August 1994 and 38 degrees C on 16 July 1994. The number of unusual deaths (except traffic accidents) in Osaka Prefecture was 655 and 733 in the month of July and August respectively which exceeded the number of death for the corresponding period of the last 5 consecutive years by 1.5 folds, which was directly proportionate to the change of temperatures. This was due to the illness of the people concerned. We investigated the age, sex and rectal temperature during the inquest and compared them with those of the same period of 1992, which we kept as control. On comparing age and sex of the dead bodies, the cases of 1994 were older than those of 1992, which was due to increased number of death of female aged 70 or more. On comparing the rectal temperatures of those who were found indoors within 8 hours after death, the average temperature of 1994 was also higher than that of 1992. Between the age groups of 75 or more and 74 or younger, the rectal temperature of the former is significantly higher than those of later age group. While regarding the room temperature of the high rectal temperature (39 degrees C < or =) group, no significant difference was observed between the age groups of 75 or more and 74 or younger. In general, the number of unusual deaths in the summer of 1994 in Osaka was more compared to those of previous years. The analysis of the recorded rectal temperatures demonstrated that, 75 or older age group has a tendency to hyperthermia. Since the aging society of Japan is gradually increasing, preventive measures will be necessary when forecasting heat wave to reduce the morbidity and mortality of the aged people.