[The role definition of lateral arm free flap in reconstruction after head and neck cancer surgery]

Application of free flap is one of the important repair means in head and neck surgery. A variety of free flaps, such as anterolateral thigh flap, have showed unique advantages in repair for tissue defects after resection of head and neck tumor, and have became increasing popularity. Lateral arm flee flap is an important repair means in plastic surgery, which has developed more than 30 years, but the application of this flap for reconstruction in head and neck surgery is relatively backward, with few reports. This review focuses on the creativity and innovation, the relationship between anatomy and clinical application, and the application status and prospects for lateral arm flee flap in individual head and neck reconstruction surgery.

Effect of gas pressure on the sealing efficiency of compacted bentonite-sand plugs

This research relates to the assessment of the sealing ability of bentonite/sand plugs when swollen in presence of both water and gas pressures, in the context of deep underground radioactive waste storage. Compacted bentonite/sand plugs are placed inside a constant volume cell, and subjected to swelling in presence of both water and gas: swelling kinetics and effective swelling pressure Pswell are identified. Secondly, the gas breakthrough (GB) characteristics of swollen plugs are assessed to determine their ability for gas migration, which has to be minimal for sealing radioactive waste repositories. We show that gas pressure Pg does not affect significantly Pswell until a threshold Pg>2MPa. When swelling occurs inside a tube with a smooth (turned) inner surface, continuous GB occurs when Pg is equivalent to the effective Pswell (obtained without gas pressure, at 7.32MPa±0.11). When the plug swells inside a grooved tube, continuous GB does not occur up to Pg≥10.5MPa: smooth interfaces are a preferential gas migration pathway rather than grooved interfaces, and rather than water-saturated bentonite-sand plugs. With smooth tubes, in presence of Pg≥2MPa, although Pswell is not affected, gas passes through the sample at significantly lower values than Pswell, due to partial sample saturation. It is concluded that GB pressure is a more accurate indicator of partial sample saturation than swelling pressure Pswell alone.

Effect of the beta secretase-1 inhibitor on the amyloid C-terminal fragment of amyloid precursor protein processing in a hyperphosphorylated tau rat model

The amyloid C-terminal fragment (βCTF) of the amyloid precursor protein (APP) is the cleaved component of APP by beta secretase-1 (BACE1), which shows similar neurotoxicity as amyloid beta (Aβ) in many ways. Evidence suggested that in addition to Aβ, βCTF might also participate in the pathogenesis of Alzheimer's disease (AD). In recent years, the relationship between βCTF processing and hyperphosphorylated tau has attracted increasing research attention. In this study, we established an animal model of tau hyperphosphorylation with okadaic acid (OA) treatment, and analyzed βCTF processing in vivo. The βCTF level was found to increase in neurons, which was most likely caused by the induction of OA and BACE1 overexpression. Furthermore, these results provide the first evidence that βCTF can predominately accumulate in the axons of neurons in a hyperphosphorylated tau state in vivo, and suggested that the redistribution of βCTF is involved in the pathogenesis of AD. These results indicate that BACE1 could be a therapeutic target of AD by affecting the processing of βCTF.

The glucogram: A new quantitative tool for glycemic analysis in the surgical intensive care unit

BACKGROUND

Glycemic control is an important aspect of patient care in the surgical intensive care unit (SICU). This is a pilot study of a novel glycemic analysis tool - the glucogram. We hypothesize that the glucogram may be helpful in quantifying the clinical significance of acute hyperglycemic states (AHS) and in describing glycemic variability (GV) in critically ill patients.

MATERIALS AND METHODS

Serial glucose measurements were analyzed in SICU patients with lengths of stay (LOS) >30 days. Glucose data were formatted into 12-hour epochs and graphically analyzed using stochastic and momentum indicators. Recorded clinical events were classified as major or minor (control). Examples of major events include cardiogenic shock, acute respiratory failure, major hemorrhage, infection/sepsis, etc. Examples of minor (control) events include non-emergent bedside procedures, blood transfusion given to a hemodynamically stable patient, etc. Positive/negative indicator status was then correlated with AHS and associated clinical events. The conjunction of positive indicator/major clinical event or negative indicator/minor clinical event was defined as clinical "match". GV was determined by averaging glucose fluctuations (maximal - minimal value within each 12-hour epoch) over time. In addition, event-specific glucose excursion (ESGE) associated with each positive indicator/AHS match (final minus initial value for each occurrence) was calculated. Descriptive statistics, sensitivity/specificity determination, and student's t-test were used in data analysis.

RESULTS

Glycemic and clinical data were reviewed for 11 patients (mean SICU LOS 74.5 days; 7 men/4 women; mean age 54.9 years; APACHE II of 17.7 ± 6.44; mortality 36%). A total of 4354 glucose data points (1254 epochs) were analyzed. There were 354 major clinical events and 93 minor (control) events. The glucogram identified AHS/indicator/clinical event "matches" with overall sensitivity of 84% and specificity of 65%. We noted that while the mean GV was greater for non-survivors than for survivors (19.3 mg/dL vs. 10.3 mg/dL, P = 0.02), there was no difference in mean ESGE between survivors (154.7) and non-survivors (160.8, P = 0.67).

CONCLUSIONS

The glucogram was able to quantify the correlation between AHS and major clinical events with a sensitivity of 84% and a specificity of 65%. In addition, mean GV was nearly two times higher for non-survivors. The glucogram may be useful both clinically (i.e., in the electronic ICU or other "early warning" systems) and as a research tool (i.e., in model development and standardization). Results of this study provide a foundation for further, larger-scale, multi-parametric, prospective evaluations of the glucogram.

Mapping quantitative trait loci for the lysozyme level and immunoglobulin G blocking percentage of classical swine fever virus

Increased disease resistance through improved general immune capacity would be beneficial for the welfare and productivity of farm animals. Classical swine fever (CSF) is a contagious disease in farm animals. The immunoglobulin G (IgG) blocking percentage of CSF virus (CSFV) in serum is an essential diagnostic parameter in veterinary practice. In addition, lysozymes are a part of the innate immune system. To identify quantitative trait loci (QTL) for IgG blocking percentage of CSFV and lysozyme concentration, IgG blocking percentage and lysozyme concentration in serum were measured in a composite pig population before and after challenge with modified live CSF vaccine. Through genome-wide mapping by MQREML analysis and the SOLAR software, several QTL for the lysozyme concentration and the IgG blocking percentage of CSFV were identified, respectively. Within these QTL regions, some known genes were revealed, and some of them may serve as candidate genes in the pig.

Hemodynamic simulation for surgical treatment of congenital heart disease

Numerical analysis of cardiovascular flow is one of several methods of use for the quantitative evaluation of patient-specific treatments. However, due to the complexity of vascular geometry and flow conditions, the cardiovascular flow simulation continues to be a challenging project. As the flow at the peak of systolic heart beat displayed full turbulence, the congenital heart treatments, Norwood and TCPC procedure, were investigated through the use of computational hemodynamic technology, in the present study. On the other hand, at diastolic period, the flow fell to an almost sedentary state. This indicated that the cardiovascular flow experienced a strange transition of flow from systolic peak to diastole. Thus, in order to accurately simulate this transitional flow, a very small time step was applied in the k - ε turbulent model calculation. Energy losses (EL), local pressure and wall shear stress were analyzed to estimate the result of clinical treatments. It was found that the value of EL, including the influence of respiration, was 1.5 times higher than the value of EL, disregarding respiratory influences. These results indicated that the hemodynamic outcomes of TCPC treatment are noticeably influenced by respiration. The effect of respiration plays an important role in estimating the results of TCPC treatment and thus should be included as one of the important conditions of computational hemodynamic analysis.

Whole-genome scan for signatures of recent selection reveals loci associated with important traits in White Leghorn chickens

Chicken is considered to be an excellent model for genetic studies of phenotypic and genomic evolution, with large effective population size, specialized commercial lines, and strong human-driven selection. High-density chicken SNP chips can help to achieve a better understanding of the selection mechanisms in artificially selected populations. We performed the genome-wide tests for the selection signature in 385 White Leghorn hens and mapped positively selected regions to the genome annotations. Ten QTL related to egg production, egg quality, growth, and disease resistance traits were selected for extended haplotype homozygosity tests to give a brief overview of recent selection signatures in chicken QTL. We also reported 185 candidate genes/CDSs showing top P-values and slower decay of haplotype homozygosities. Some of these genes seemed to have significant effects on important economical traits, and most of them have not been reported in chickens. The current study provides a genome-wide map of linkage disequilibrium extents and distributions and selection footprints in the chicken genome. A panel of genes, including PRL, NCKX1, NRF1, LHX2, and SFRP1 associated with egg production, metabolism traits, and response to illumination were identified. In addition, there were more genes identified that have not yet been reported in chickens, and our results provide new clues for further study.

Overexpression of ECM1 contributes to migration and invasion in cholangiocarcinoma cell

Although the expression of extracellular matrix protein-1 (ECM1) has been documented in several tumor models, the function of ECM1 has remained unclear. In this study, expression of ECM1 was detected by real time PCR and immunohistochemistry. The role and mechanism of ECM1 overexpression in cholangiocarcinoma (CCA) cells were assessed by wound-healing, matrigel invasion assay and Western blotting. Expression of ECM1 was significantly elevated in CCA tissues than that in adjacent noncancerous, cholangitis and normal bile duct tissues. Its overexpression was associated with poor differentiation, lymph node metastasis, poor prognosis, and the level of CA199, MMP-9, estrogen receptor. Knockdown of ECM1 suppressed migration and invasion of CCA cells. Using PI3K or IKK inhibitor reduced the level of phospho-Akt or phospho-IκBα as well as ECM1. Taken together, overexpression of ECM1 may contribute to CCA initiation and progression through promoting migration and invasion of CCA cells, its overexpression was associated with Akt/NF-κB signaling axis.

Genome-wide association studies for hematological traits in swine

Improving immune capacity may increase the profitability of animal production if it enables animals to better cope with infections. Hematological traits play pivotal roles in animal immune capacity and disease resistance. Thus far, few studies have been conducted using a high-density swine SNP chip panel to unravel the genetic mechanism of the immune capability in domestic animals. In this study, using mixed model-based single-locus regression analyses, we carried out genome-wide association studies, using the Porcine SNP60 BeadChip, for immune responses in piglets for 18 hematological traits (seven leukocyte traits, seven erythrocyte traits, and four platelet traits) after being immunized with classical swine fever vaccine. After adjusting for multiple testing based on permutations, 10, 24, and 77 chromosome-wise significant SNPs were identified for the leukocyte traits, erythrocyte traits, and platelet traits respectively, of which 10 reached genome-wise significance level. Among the 53 SNPs for mean platelet volume, 29 are located in a linkage disequilibrium block between 32.77 and 40.59 Mb on SSC6. Four genes of interest are located within the block, providing genetic evidence that this genomic segment may be considered a candidate region relevant to the platelet traits. Other candidate genes of interest for red blood cell, hemoglobin, and red blood cell volume distribution width also have been found near the significant SNPs. Our genome-wide association study provides a list of significant SNPs and candidate genes that offer valuable information for future dissection of molecular mechanisms regulating hematological traits.

Mapping quantitative trait loci for cytokines in the pig

Increased disease resistance through improved general immune capacity would be beneficial for the welfare and productivity of farm animals. Cytokines are essential diagnostic parameters in veterinary practice. To identify quantitative trait loci (QTL) for cytokine levels in serum in the pig, Interferon-gamma (IFN-γ) and Interleukin 10 (IL-10) levels and the ratio of IFN-γ to IL-10 were measured in a composite pig population, before and after challenge with modified live CSF (classical swine fever) vaccine. Through interval mapping using the variance component approach and the permutation test, 11 QTL (five for IFN-γ, two for IL-10 and four for the ratio of IFN-γ to IL-10) with significance levels of P < 0.10 were identified, of which five were significant at the P < 0.05 level. The most significant QTL (P < 0.01) was found on chromosome 16, with effect on the ratio of IFN-γ to IL-10. Within these QTL regions, a number of known genes were revealed and their potential relationships to the studied traits were discussed. Some of these genes may serve as candidate genes for these traits in swine.

First Report of Root Rot on Rhodiola sachalinensis Caused by Fusarium verticillioides (Gibberella fujikuroi) in China

Rhodiola sachalinensis (family Crassulaceae), a perennial herbaceous plant with adaptogenic properties, cardiopulmonary protective effects, and central nervous system activities, is widely used as a traditional Chinese medicine (3). R. sachalinensis naturally exists only above 1,500 m elevation in the mountain area of Changbai Mountain (average July temperature ≤10°C), China. Introduction and cultivation of R. sachalinensis has been carried out in several low-altitude districts of northeast China. From 2007 to 2010, severe root rot disease was observed on R. sachalinensis in Siping districts, Jilin, China. Approximately 75 to 95% of the fields were affected with root rot disease incidence ranging from 85 to 100% under conditions of high temperatures (24 to 30°C) and high humidity. As the disease progressed, brown lesions expanded on lateral and main roots, and aboveground tissues shriveled and died. Over the 4- to 5-year period from culture to harvest, root rot became more serious. Symptomatic plants were collected from Siping districts. Samples were rinsed in tap water, necrotic areas were excised and cut into 2-mm pieces, surface sterilized with 5% NaOCl for 30 s, and rinsed in four successive changes of sterile distilled water. A single fungus was isolated on potato dextrose agar (PDA). The fungus was white, then pink and cottony, with nearly round margins after 8 days (27°C). Hyphae were separate and hyaline but macroconidia were sparse and occurred in a false head. Conidiogenous cells were monophialides. Microconidia in chains were abundant and mostly nonseptate, oval to clavate, and measured 8.1 to 14.5 × 2.0 to 3.4 μm. Morphological characteristics suggested the isolate was Fusarium verticillioides (Gibberella fujikuroi), which differed from the reported root rot pathogen of R. sachalinensis, F. oxysporum by forming microconidia in chains (1). The sexual stage of F. verticillioides was not observed. The internal transcribed spacer (ITS) fragments were amplified using ITS1 and ITS4 as primers and the 351-bp sequence was deposited in GenBank (Accession No. HQ025928). The ITS sequence showed 100% nucleotide sequence identity with F. verticillioides (GenBank Accession No. AY188916.1.). For pathogenicity tests, the isolate was cultured on PDA for 8 days. Inoculations were performed on 15 healthy R. sachalinensis plants by spraying a conidial suspension (2.0 × 10⁵ microconidia ml^-1) on roots wounded with a metal needle (6 wounds cm^-2) (2). Ten plants were mock inoculated with water. Plants were incubated in a growth chamber (25°C, 70 to 80% relative humidity, 300 μmol·m^-2·s^-1 light intensity, and a 12-h photoperiod). After 15 days, defoliation and root rot symptoms were similar to the original symptoms observed under field conditions. F. verticillioides was reisolated from the roots of infected plants. Control plants remained asymptomatic. To our knowledge, this is the first report of F. verticillioides on R. sachalinensis in China. References: (1) X. Y. Li et al. J. Northeast For. Univ. 34:12, 2003. (2) M. Ma. Syahit et al. Am. J. Appl. Sci. 6:902, 2009. (3) T. F. Yan et al. Conserv. Genet. 4:213, 2003.

Effect of heparin-superoxide dismutase on γ-radiation induced DNA damage in vitro and in vivo

The effects of heparin-superoxide dismutase (SOD) conjugate (heparin-SOD) on γ-radiation induced DNA damage in vivo and in vitro were evaluated. Plasmid pcDNA3.0 solution was mixed with heparin-SOD, SOD, and a mixture of heparin and SOD (heparin + SOD), respectively, and irradiated with (60)Co at a dosage of 120 Gy. DNA injury was analyzed using agarose gel electrophoresis. The results showed that the degree of injury of pcDNA3.0 mixed with heparin-SOD, SOD, or heparin + SOD was less than that of untreated pcDNA3.0, and among them the degree of injury of pcDNA3.0 mixed with heparin-SOD was the least. It also showed that the protective effect increased with an increase of heparin-SOD concentration. The effects of SOD and heparin-SOD on the DNA damage and tumor inhibition rate of (60)Co γ-radiation exposure on tumor-bearing mice were also studied. Agarose gel electrophoresis showed that, when different SOD samples were administered before irradiation, the thymus DNA injuries of heparin-SOD, SOD, or heparin + SOD groups were more serious than that of the control group, and the DNA injuries of heparin-SOD or heparin + SOD groups were the most serious, which contradicted the above in vitro experiments. However, when heparin-SOD was administered post irradiation, it showed a repairing effect on the injured DNA.

In vivo antibacterial activity of nemonoxacin, a novel non-fluorinated quinolone

OBJECTIVES

To evaluate the in vivo antibacterial efficacy of nemonoxacin, a novel C8-methoxy non-fluorinated quinolone in murine systemic and local infection models.

METHODS

The efficacy of nemonoxacin in systemic infections was evaluated in mouse peritonitis models using isolates of methicillin-susceptible Staphylococcus aureus (MSSA, n=1), methicillin-resistant S. aureus (MRSA, n=1), methicillin- and levofloxacin-resistant Staphylococcus capitis (levofloxacin-resistant MRSC, n=1), penicillin-intermediate Streptococcus pneumoniae (PISP, n=1), penicillin-resistant S. pneumoniae (PRSP, n=2), Enterococcus faecalis (n=2, including 1 vancomycin-resistant Enterococcus, VRE) and Escherichia coli (n=3). The local infections included mouse pulmonary infections caused by PRSP (n=1), Klebsiella pneumoniae (n=1) and mouse ascending urinary tract infection caused by E. coli (n=1).

RESULTS

In the mouse systemic infection model, nemonoxacin demonstrated potent activity against MSSA (ED(50) =2.08 mg/kg), MRSA (ED(50) =2.59 mg/kg), levofloxacin-resistant MRSC (ED(50) =2.52 mg/kg), PISP (ED(50) =5.47 mg/kg), PRSP (ED(50) =3.68-5.28 mg/kg) and E. coli (ED(50) =3.13-5.28 mg/kg), and moderate activity towards E. faecalis infection (ED(50) =8.48-15.16 mg/kg). The therapeutic efficacy of nemonoxacin was significantly higher (P<0.01) than that of levofloxacin in infections caused by Gram-positive isolates (MSSA, MRSA, levofloxacin-resistant MRSC, PISP, PRSP and E. faecalis), but less potent than that of levofloxacin against E. coli infection (P<0.01). Nemonoxacin in vivo efficacy results with Gram-positive isolates (2- to 5-fold ED(50) advantage over levofloxacin) are consistent with the MIC data (4- to 16-fold MIC advantage of nemonoxacin over levofloxacin). In the mouse pulmonary infection model, nemonoxacin showed potent activity towards PRSP (higher than levofloxacin) and K. pneumoniae (lower than levofloxacin) infections. In the mouse ascending urinary tract infection model, nemonoxacin exhibited potent activity against E. coli infection (lower than levofloxacin).

CONCLUSIONS

The results validated the potent efficacy of nemonoxacin in vivo. The higher efficacy of nemonoxacin than of levofloxacin towards infections caused by Gram-positive cocci (especially MRSA, levofloxacin-resistant MRSC, PRSP and VRE) warrants investigation of its clinical use.

Rare earth-cobalt hard magnetic nanoparticles and nanoflakes by high-energy milling

High-energy ball milling has been shown to be a promising method for large-scale fabrication of rare earth-transition metal nanoparticles. In this work, we report crystallographically anisotropic SmCo(5), PrCo(5) and Sm(2)(Co, Fe)(17) nanoparticles (particle size smaller than 10 nm) obtained by surfactant-assisted ball milling and study their size and properties as a function of the milling conditions. By milling nanocrystalline precursor alloys, we obtained SmCo(5) platelets (flakes) approximately 100 nm thick with an aspect ratio as high as 10(2)-10(3). The unusual shape evolution of this brittle material is attributed to its increased plasticity in the nanocrystalline state. The nanoflakes are susceptible to re-crystallization annealing and exhibit a room-temperature coercivity of up to 19 kOe. The successful fabrication of rare earth-cobalt nanoparticles and ultra-thin flakes provides hope for the development of nanocomposite permanent magnets with an enhanced energy product.

Surface magnetism in amine-capped ZnO nanoparticles

Magnetic behaviors of pure ZnO nanoparticles have been investigated both experimentally and theoretically. It is found that monodisperse ZnO nanoparticles wrapped with oleylamine with an average particle size of about 9.6 nm prepared by thermal decomposition do show ferromagnetic behavior with a saturation magnetization of about 34 memu g(-1) and coercive force of about 22 Oe, whereas ZnO nanoparticles with an average particle size of 5.2 nm prepared by ultrasonic irradiation without solvents show a weak ferromagnetic property with a saturation magnetization of about 0.12 memu g(-1) and coercive force of about 150 Oe at ambient temperature. First-principles calculations reveal that the 2p holes on the atoms at the surface (dangling bond of O atoms at ZnO(0001) or 2p electrons of N atom in NH(3) adsorbed on Zn(0001)) could be the source for the magnetic behavior of oxide nanoparticles.

Dietary zinc intake and brain cancer in adults: a case–control study

Little is known about the aetiology of brain tumours. One putative factor suggested from animal models is a protective effect of dietary Zn. We tested the hypothesis that increased compared with low dietary Zn intake is protective against brain tumour development. We conducted a population-based case–control study in the UK, of adults aged 18–69 years, between 2001 and 2004 aiming to identify possible risk factors. Dietary information was collected from 637 cases diagnosed with a glioma or meningioma, and 876 controls. Data were obtained from a self-completed FFQ. Multivariate logistic regression analysis was conducted, adjusting for socio-demographic factors, season of questionnaire return, multivitamin supplementation and energy intake. Although a weak protective effect was observed for the third quartile of intake (normal compared with low intake) in the meningioma group, this was limited to the specific brain tumour subtype and quartile, and was not significant after also adjusting for intake of other elements. Overall there was no significant effect of Zn intake. No association or dose–response relationship was observed between increased compared with low Zn intake and risk of glioma or meningioma.

Wurtzite-to-Rocksalt Structural Transformation in Nanocrystalline CoO

Hexagonal CoO nanocrystals are coarsened under hydrothermal conditions to investigate the effect of particle size on phase transformation and stability property. Structural stability and phase transformation of the hexagonal CoO phase have been investigated by X-ray powder diffraction with Rietveld refinement, transmission electron microscopy, X-ray absorption fine structure, and differential scanning calorimeter. It is found that the hexagonal CoO phase is a metastable phase, which increases its grain size from 50 to 250 nm for refluxing times from 1 to 6 h at 200 degrees C. After 12 h, cubic-structured CoO grains with an average grain size of 20 nm are observed, which spread around big hexagonal CoO grains. After about 24 h, only the cubic CoO phase with an average grain size of 25 nm is detected. The onset temperature of hexagonal-to-cubic phase transformation in CoO is estimated to be 378 degrees C by DSC, using a heating rate of 20 deg/min. The results obtained indicate that the hexagonal-to-cubic phase transformation in nanocrystalline CoO is by nucleation and growth mechanism, starting from the surface to the center of the hexagonal grains.

Atomic structure of Al(89)La(6)Ni(5) metallic glass

Atomic structures of amorphous Al(89)La(6)Ni(5), prepared by single-roller melt spinning, and pre-annealed at 493 and 588 K for 1 h, were characterized by differential scanning calorimetry, x-ray diffraction with a large wavevector transfer value, La L(3)-edge and Ni K-edge x-ray absorption fine structure and the reverse Monte Carlo technique. In the as-prepared amorphous alloy, our study reveals that the Ni-Al distance is 2.38 ± 0.02 Å coupled with a coordination number as low as 6.2. The Al-Al distance was found to be ∼4.5% shorter than the nominal atomic diameter of aluminium and the coordination number to be ∼39% less than expected from the dense random packing model. Crystallization of the Al(89)La(6)Ni(5) glassy alloy at high temperatures can be described as follows: [amorphous alloy] [Formula: see text] [fcc-Al] + [bcc-(AlLa)] + residual amorphous [Formula: see text] [fcc-Al] + [o-Al(3)Ni ] + [o-La(3)Al(11) ].

Amorphouslike diffraction pattern in solid metallic titanium

Amorphouslike diffraction patterns of solid elemental titanium have been detected under high pressure and high temperature using in situ energy-dispersive x-ray diffraction and a multianvil press. The onset pressure and the temperature of formation of amorphous titanium is found to be close to the alpha-beta-omega triple point in the P-T phase diagram. Amorphous Ti has been found to be thermally stable up to 1250 degrees C for at least 3 min at some pressures. By analyzing the conditions for producing amorphous elemental Zr and Ti, we observed a multi-phase-point amorphization phenomenon for preparing single-element bulk amorphous metals. The results reported may open a new way to preparing single-element bulk amorphous metals with a high thermal stability.

Surgical treatment for cancer of the oesophagus and gastric cardia in Hebei, China

BACKGROUND

Southern Hebei Province has one of the highest incidences of oesophageal cancer in the world. This study describes a single-centre experience with oesophagectomy for this condition.

METHODS

The reported articles on surgical treatment for cancer of the oesophagus and gastric cardia from a single department between September 1952 and December 2000 were summarized and the results compared.

RESULTS

Between September 1952 and December 2000, the resectability rate increased from 78.8 to 96.0 per cent for oesophageal cancer and from 69.6 to 94.8 per cent for cancer of the cardia. The surgical mortality rate decreased from 4.6 to 1.1 per cent. There was little change in the overall 5-year survival rate; it increased from 21.2 to 23.9 per cent for patients with oesophageal cancer and from 15.2 to 17.6 per cent for those with cancer of the cardia.

CONCLUSION

The rate of postoperative complications and deaths following oesophagectomy for cancer has fallen steadily over the past five decades but long-term survival remains disappointing. Improved survival is likely to be dependent on earlier diagnosis and adjunctive therapies.

Evaluation of bone mineral density of the lumbar spine and proximal femur in population-based routine health examinations of healthy Asians

PURPOSE

To understand the peak bone mineral density (BMD) and annual loss of BMD of the lumbar spine (L-BMD) and the proximal femur (F-BMD) and the prevalence of osteoporosis in both sexes in Taipei City, Taiwan.

MATERIAL AND METHODS

The medical records from a recent 3-year period of annual health examinations at a single institution were reviewed. A total of 1514 men (mean age 49.08 +/- 13.62) and 1955 women (48.07 +/- 14.12), who lived in the Taipei area, had no major systemic disorders, and who had undergone both L-BMD and F-BMD examinations, were recruited.

RESULTS

In women, peak L-BMD (1.078 +/- 0.133 g/cm2) occurred in the 30 to 39-year age group, whereas peak F-BMD (0.873 +/- 0.101 g/cm2) occurred in the 17 to 29-year age group. In men, peak L-BMD (1.095 +/- 0.137 g/cm2) and F-BMD (0.989 +/- 0.140 g/cm2) both occurred in the 17 to 29-year age group. The estimated annual bone loss was 0.69% of peak L-BMD in women over 50 years; in the proximal femur this was 0.688% in women and 0.332% in men. In women over 60 years, approximately half of the population had osteoporosis in the lumbar spine.

CONCLUSION

We report descriptive BMD data of a Chinese population recruited from a Taipei urban area who underwent routine health examination. The values are similar to or higher than those of Japanese, Canadian and Greek populations. L-BMD was lower than that in the Lebanese, and F-BMD of both sexes was lower than that reported in the Greek study.

[Ultra-pathological study on the syncytium of Schistosoma mansoni exposed to cyclosporin Ain vitro]

OBJECTIVE

To study the ultra-pathological changes of syncytium of Schistosoma mansoni after cyclosporin A (CsA) treatment.

METHODS

MF1 mice were infected with Schistosoma mansoni cercariae. Six weeks later, the adult worms were recovered by portal vein perfusion. After the worms were exposed to CsA of 20 micrograms/ml for 24 h, the drug-induced damage of the worm surface was observed by SEM and TEM.

RESULTS

Incubation of male and female schistosomes with 20 micrograms/ml of CsA for 24 h resulted in disruption of the tegument and rupture of the spines. Progressive surface damage and swelling and vacuolization of the tegument led to eventual disruption of the syncytium.

CONCLUSION

The antischistosomal action of CsA is direct, the syncytium is the main site for CsA attack.

Viral load of high-risk human papillomavirus in cervical squamous intraepithelial lesions

OBJECTIVES

This case-control study was conducted to investigate the role of viral load of high-risk human papillomaviruses (HPVs) in the development of cervical squamous intraepithelial lesions (SILs) and invasive cancers.

METHODS

A total of 30 female cases who had histological evidence of low-grade SIL (n=10) or high-grade SIL and above (n=20) were identified as the case group at the Tri-Service General Hospital, Taipei between September 1998 and March 1999. In addition, 80 female controls who had normal cervical cytology were enrolled and individually matched on age (+/-5 years) and date of recruitment to each case. Cervical swabs collected from study subjects were tested for the positivity and viral load of high-risk HPVs by Hybrid Capture II assay. Additionally, subjects completed a risk factor questionnaire.

RESULTS

Among sex behavioral factors studied, younger age at first intercourse was associated with a significantly elevated risk of cervical SIL and invasive cancers. With respect to HPV infection, high-risk HPV DNA was present in 70% (21/30) of case and 21% (17/80) of control subjects, resulting in an odds ratio (OR) of 6.6 [95% confidence interval (C.I.)=2.6-17.0]. Moreover, women who had a high viral load were at significantly greater risk for cervical SIL and invasive cancers than those who were infected with a low viral load (OR=18.0, 95% C.I.=3.0-108.5).

CONCLUSIONS

Among the variables tested, infection with a high viral load of high-risk HPVs is the strongest determinant for cervical SIL and cervical cancers in Taiwan.

Enantioselective synthesis for the antipodes of slagenins B and C: establishment of absolute stereochemistry

[reaction: see text] The total synthesis for the (-)-antipode of slagenin B (12) and the (+)-antipode of slagenin C (13) was achieved with the condensation of glyoxal hydrate 10 and urea as the key step. The absolute stereochemistries of naturally isolated slagenins B and C were assigned to be (9R,11R,15R)-1b and (9R,11S,15S)-1c, respectively.