The current status of HIV screening laboratories in Korea assessed by a questionnaire survey of participants in the KCDC HIV EQAS (2006)

Using a questionnaire, we assessed the current status of the quality management systems at HIV screening laboratories in Korea. The Korea Centres for Disease Control and Prevention HIV external quality assurance scheme (EQAS) questionnaire includes 18 items divided into five groups related to HIV testing: personnel, HIV test processes, participation in the Quality Assurance programme and HIV testing equipment. Five hundred and sixty-one HIV screening laboratories participated in this questionnaire investigation; data were collected from 233 public health centres, 309 hospitals or clinics, eight blood centres and 11 commercial laboratories. The total number of HIV screening tests was about 5.5 million in 2005. The average number of HIV tests per institution was highest in blood centres (308 561), followed by commercial laboratories (56 084), hospital or clinic laboratories (6756), and public health centres (1751). Equipment and HIV test methods varied between HIV screening laboratories, and, to manage the quality of their HIV testing, most laboratories participated in several evaluation programmes such as EQAS or a laboratory accreditation programme. This study is the first questionnaire survey of HIV testing laboratories in Korea. The results could be used to evaluate and promote the quality management of HIV testing laboratories.

Transmissible infection of human 293T cells with porcine endogenous retroviruses subgroup a from NIH-miniature pig

In pig-to-human xenotransplantation, zoonotic infections have been an important barrier. The risk of zoonosis has been emphasized in xenotransplantation after finding that porcine endogenous retroviruses (PERVs) can infect human cells in vitro. Until now, transmissions of PERVs from PK15 cells have been studied in vitro and in vivo, but transmission of PERVs originating from miniature pigs have not been extensively reported. Peripheral blood mononuclear cells from miniature swine showed PERV transmission to human cells. In contrast, specific pathogen-free (SPF) pig islet cells showed no PERV transmission when co-incubated with 293T cells. To evaluate the risk of zoonosis with our experimental mini pigs, we tested the infectivity of PERVs from NIH-miniature pig primary ear cells for human 293T cells. As a result, all subgroups of infectious PERV virion (PERV-A, -B, and -C) were detected in the primary cell culture media. Unlike PERV-C, PERV-A and -B infected human 293T cells. Interestingly, only proviral PERV-A replicated in 293T cells to produce virions after infection. Our results suggested that a prevention study of PERV xenotransmission from experimental miniature pigs should concentrate on PERV-A control.

Expression patterns of microRNAs in the chorioamniotic membranes: a role for microRNAs in human pregnancy and parturition

MicroRNAs (miRNAs) are involved in the post-transcriptional regulation of gene expression during development. This study was performed to determine gestational age-dependent changes in miRNA expression in the chorioamniotic membranes and to assess the significance of miRNAs in human pregnancy and parturition. The expression profile of 455 miRNAs was compared between patients at term without labour (TNL: n = 10), in labour (TL: n = 10), and preterm labour (PTL: n = 10) using microarrays. A total of 39 miRNAs were differentially expressed between term and preterm cases, of which 31 (79.5%) were down-regulated at term. Expression of ten miRNAs, including miR-338, differentially expressed between PTL and TL groups was decreased at term. Computational analyses using miRBase Targets have identified PLA2G4B, a phospholipase implicated in parturition, as a putative target of miR-338. Inhibition of endogenous miR-338 with anti-miR-338 increased the mRNA and protein expression of PLA2G4B in decidual cells. Luciferase assay with reporter constructs confirmed that the suppression of PLA2G4B occurs through binding of miR-338 to the 3UTR of PLA2G4B. Interestingly, the expression of Dicer, a key miRNA-processing enzyme, was markedly decreased at term, particularly with labour in the chorioamniotic membranes. Collectively, the novel findings reported herein strongly suggest that post-transcriptional regulation of genes by miRNAs, coupled with the changes of miRNA processing machinery in the chorioamniotic membranes, plays a role in pregnancy and parturition. Furthermore, the expression level of Dicer in the chorioamniotic membranes dichotomizes pathological preterm labour and physiological spontaneous labour at term.

Predictors of bronchial hyperresponsiveness in chronic rhinosinusitis with nasal polyp

BACKGROUND

Chronic rhinosinusitis with nasal polyposis (CRSNP) and asthma are inflammatory lesions of the respiratory epithelium. This study was conducted to evaluate predictive factors of bronchial hyperresponsiveness (BHR) in patients with CRSNP.

METHODS

BHR was evaluated using a methacholine bronchoprovocation test (MBPT) in 122 consecutive patients newly diagnosed with CRSNP at Seoul National University Hospital from January 2004 to June 2006. The following parameters were analyzed and compared between the BHR and non-BHR groups: symptoms, atopic status, current smoking, disease severity of CRSNP based on the Lund-Mackay scoring system of sinus CT, and counts of eosinophils in the serum and nasal tissues.

RESULTS

Thirty-five percent of the patients were found to have BHR, and BHR was found to occur more frequently in patients that were currently suffering from sneezing (P = 0.007). In addition, the mean eosinophil counts of the serum and nasal tissues were higher in the BHR group than in the non-BHR group (P = 0.001 for the serum, P = 0.045 for the nasal tissues), and the eosinophil counts of the serum correlated to those of the nasal tissues (r = 0.334, P = 0.013). The disease severity, as determined by the Lund-Mackay scoring system, was not different between the two groups (P > 0.05). The best cutoff serum eosinophil count for predicting BHR in CRSNP patients was determined to be 300 cells/microl (sensitivity 70%, specificity 70%).

CONCLUSION

Taken together, these results indicate that moderate to severe sneezing and a serum eosinophil count > or = 300 cells/microl may be predictive factors for BHR in patients with CRSNP.

Comparison of glucuronidating activity of two human cDNAs, UDPGTh1 and UDPGTh2

Two human liver UDP-glucuronosyltransferase cDNA clones, HLUG25 and UDPGTh2 were previously shown to encode isozymes active in the glucuronidation of hyodeoxycholic acid (HDCA) and certain estrogen derivatives (e.g., estriol and 3,4-catechol estrogens), respectively. In this study we have found that the UDPGTh-2-encoded isoform (UDPGTh2) and HLUG25-encoded isoform (UDPGTh1) have parallel aglycone specificities. When expressed in COS 1 cells, each isoform metabolized three types of dihydroxy- or trihydroxy-substituted ring structures, including the 3,4-catechol estrogen (4-hydroxyestrone), estriol, 17-epiestriol, and HDCA, but the UDPGTh2 isozyme was 100-fold more efficient than UDPGTh1. UDPGTh1 and UDPGTh2 were 86% identical overall (76 differences out of 528 amino acids), including 55 differences in the first 300 amino acids of the amino terminus, a domain which conferred the substrate specificity. The data indicated that a high level of conservation in the amino terminus was not required for the preservation of substrate selectivity. Analysis of glucuronidation activity encoded by UDPGTh1/UDPGTh2 chimeric cDNA constructed at their common restriction sites,Sac 1 (codon 297),Nco 1 (codon 385), andHha 1 (codon 469), showed that nine amino acids between residues 385 and 469 were important for catalytic efficiency, suggesting that this region represented a domain which was critical for the catalysis but distinct from that responsible for aglycone selection. These data indicate, that UDPGTh2 is a primary isoform responsible for the detoxification of the bile salt intermediate as well as the active estrogen intermediates.

Effects of feed gas composition and catalyst thickness on carbon nanotube and nanofiber synthesis by plasma enhanced chemical vapor deposition

Many engineering applications require carbon nanotubes with specific characteristics such as wall structure, chirality and alignment. However, precise control of nanotube properties grown to application specifications remains a significant challenge. Plasma-enhanced chemical vapor deposition (PECVD) offers a variety of advantages in the synthesis of carbon nanotubes in that several important synthesis parameters can be controlled independently. This paper reports an experimental study of the effects of reacting gas composition (percentage methane in hydrogen) and catalyst film thickness on carbon nanotube (CNT) growth and a computational study of gas-phase composition for the inlet conditions of experimentally observed carbon nanotube growth using different chemical reaction mechanisms. The simulations seek to explain the observed effects of reacting gas composition and to identify the precursors for CNT formation. The experimental results indicate that gas-phase composition significantly affects the synthesized material, which is shown to be randomly aligned nanotube and nanofiber mats for relatively methane-rich inlet gas mixtures and non-tubular carbon for methane-lean incoming mixtures. The simulation results suggest that inlet methane-hydrogen mixture coverts to an acetylene-methane-hydrogen mixture with minor amounts of ethylene, hydrogen atom, and methyl radical. Acetylene appears to be the indicator species for solid carbon formation. The simulations also show that inlet methane-hydrogen mixture does not produce enough gas-phase precursors needed to form quality CNTs below 5% CH4 concentrations in the inlet stream.

The effects of RANTES/CCR5 promoter polymorphisms on HIV disease progression in HIV-infected Koreans

Recent studies have reported that two single nucleotide polymorphisms (SNPs) in the RANTES gene promoter region, -403G/A and -28C/G, are associated with a slower rate of decline in CD4(+) T-cell number, whereas genetic polymorphisms within the CCR5 promoter are linked to acceleration of AIDS progression. In this study, we investigated the distribution of SNPs in the RANTES and CCR5 promoters and the association between these SNPs and HIV-1 disease progression in HIV-infected Koreans. Twenty-seven long-term non-progressors (LTNPs), 29 AIDS patients and 39 HIV-uninfected persons were enrolled in this study. SNPs for the RANTES and CCR5 promoters were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and a direct sequencing method. In the analysis of RANTES promoter polymorphisms, the genotypic and allelic frequencies of the RANTES -28G mutation were significantly lower in HIV-infected patients than in HIV-uninfected persons (P = 0.005 and P = 0.001, respectively). The genotypic frequencies of RANTES -28G and -403A mutations did not differ significantly between LTNPs and AIDS patients. The frequencies of three CCR5 promoter polymorphisms, designated 59029 G/A, 59353T/C, and 59402G/A, did not differ significantly between HIV-uninfected and HIV-infected patients. However, the allelic frequency of CCR559353C was significantly higher in AIDS patients than in LTNPs (P = 0.003). These results suggest that RANTES-28G and CCR5 59353C mutations might be associated with HIV infection or pathogenesis in the Korean population.

Purification and characterization of antimicrobial peptides from the skin secretion of Rana dybowskii

Six antimicrobial peptides designated dybowskins were isolated from the skin secretion of Rana dybowskii, an edible frog in Korea. Dybowskin-1 (FLIGMTHGLICLISRKC) and dybowskin-2 (FLIGMTQGLICLITRKC) were isoforms differing in only two amino acid residues at the 7th and 14th positions from the N-terminus, and they showed amino acid sequence similarities with ranalexin peptides. Dybowskin-3 (GLFDVVKGVLKGVGKNVAGSLLEQLKCKLSGGC), dybowskin-4 (VWPLGLVICKALKIC), dybowskin-5 (GLFSVVTGVLKAVGKNVAKNVGGSLLEQLKCKISGGC), and dybowskin-6 (FLPLLLAGLPLKLCFLFKKC) differed in both size and sequence, and they were, in terms of amino acid sequence similarities, related to brevinin-2, japonicin-2, esculentin-2, and brevinin-1 peptides, respectively. All the peptides presented in this paper contained Rana-box, the cyclic heptapeptide domain, which is conserved in other antimicrobial peptides derived from the genus Rana. All the dybowskin peptides showed a broad spectrum of antimicrobial activity against the Gram-positive and Gram-negative bacteria (minimum inhibition concentrations (MIC), 12.5 to >100 microg/ml) and against Candida albicans (MIC, 25 to >100 microg/ml). Especially, dybowskin-4 with valine at its N-terminus was the most abundant and showed the strongest antimicrobial activity among all the dybowskin peptides. This result indicates that the dybowskin peptides from R. dybowskii, whose main habitats are mountains or forests, have evolved differently from antimicrobial peptides isolated from other Korean frogs, whose habitats are plain fields.

Disruption of transforming growth factor-beta signaling through beta-spectrin ELF leads to hepatocellular cancer through cyclin D1 activation

Transforming growth factor-beta (TGF-beta) signaling members, TGF-beta receptor type II (TBRII), Smad2, Smad4 and Smad adaptor, embryonic liver fodrin (ELF), are prominent tumor suppressors in gastrointestinal cancers. Here, we show that 40% of elf(+/-) mice spontaneously develop hepatocellular cancer (HCC) with markedly increased cyclin D1, cyclin-dependent kinase 4 (Cdk4), c-Myc and MDM2 expression. Reduced ELF but not TBRII, or Smad4 was observed in 8 of 9 human HCCs (P<0.017). ELF and TBRII are also markedly decreased in human HCC cell lines SNU-398 and SNU-475. Restoration of ELF and TBRII in SNU-398 cells markedly decreases cyclin D1 as well as hyperphosphorylated-retinoblastoma (hyperphosphorylated-pRb). Thus, we show that TGF-beta signaling and Smad adaptor ELF suppress human hepatocarcinogenesis, potentially through cyclin D1 deregulation. Loss of ELF could serve as a primary event in progression toward a fully transformed phenotype and could hold promise for new therapeutic approaches in human HCCs.

Tuberculous otomastoiditis on high-resolution temporal bone CT: comparison with nontuberculous otomastoiditis with and without cholesteatoma

BACKGROUND AND PURPOSE

Our purpose was to evaluate the differential findings of tuberculous otomastoiditis (TOM) and nontuberculous chronic otomastoiditis with or without middle ear cholesteatoma on high-resolution CT of the temporal bone.

MATERIALS AND METHODS

We reviewed 19 cases of TOM, 30 cases of chronic otomastoiditis (COM), and 30 cases of COM with cholesteatoma (CHOM), all of which had been confirmed by pathologic examination after surgery or middle ear mucosal biopsy. Two neuroradiologists analyzed the findings of temporal bone CT.

RESULTS

The soft tissue attenuation in the entire middle ear cavity, preservation of the mastoid air cells without sclerotic change, and soft tissue extension to the external auditory canal (EAC) or mucosal thickening of the bony EAC, had statistical significance (chi(2) test, P < .05) between the TOM group and the COM group and between the TOM group and the CHOM group. Erosion of the ossicles and scutum was statistically significant (chi(2) test, P < .05) between the TOM group and the CHOM group.

CONCLUSION

Findings of soft tissue in the entire middle ear cavity, preservation of mastoid air cells without sclerotic change, soft tissue extension, or mucosal thickening of the EAC with intact scutum seemed to be helpful in differentiating TOM from COM and CHOM.

Measurement of ocular torsion using iterative optical flow

This work represents a new method for measuring ocular torsion using optical flow. Feature points are obtained from reference and current image, and the relative optical flows of each point are calculated. The feature points are selected according to the strength of corner on the signature of iris. This method is robust and effective in calculation.

The effects of container materials and buffer additives on decreasing the iodide concentration in a disposal vault for spent nuclear fuel

To retard the migration of iodine released from a spent fuel after the break of a container, the reducing effects on the concentration of the iodide by container corrosion products and some buffer additives were examined in a solution with bentonite. Iron and copper, and their corrosion products scarcely reduced the iodide concentration. And kaolinite, chalcopyrite, pyrite, copper ore and galena, known as having a sorption property for iodine, did not noticeably sorb the iodide. However, palm active carbon, silver metal and Ag2O lowered the iodide concentration. Especially, Ag2O put into a disposal container would effectively hinder the migration of iodine to the outside of a disposal vault without a great loss if the pore size of the compacted buffer layer is maintained below 1 mu m.

Size and fractal dimension of particles in the River Nakdong

Water samples were collected at seven sites located along the River Nakdong on 30 occasions. Water quality, size and the fractal dimension (dF) of suspended particles were measured. The laser light scattering method was used to obtain the size and dF of suspended particles. The average size of particles in this river ranged from 89 microm and 169 microm, which appears to be relatively coarse compared with other rivers worldwide. The average dF of suspended particles in this study ranged from 1.8 to 1.9. Slight variations in fractal dimension values and other particle characteristics results from various measuring methods available. The correlation analysis showed that DO, TN, NO3 and chlorophyll-a had significant positive relationships with particles size, whereas flow rates and temperature had negative relationships. However, the factors which had positive relationships with particles size showed negative relationships with the dF of suspended particles. Generally, as the size of particles increased, the fractal dimension of particles decreased which indicated that the shape of the larger particles became more irregular relative to that of the smaller ones. To obtain and apply the statistical functional relationship between water quality characteristics, multiple linear regression equations of the size and fractal dimension of particles on explanatory variables such as pH, BOD, TSS, DO, T-N and T-P have been established.

Hepatic intra-arterial injection of 3-bromopyruvate in rabbit VX2 tumor

PURPOSE

To evaluate the antitumoral effects of an intra-arterial injection of 3-bromopyruvate (3-BrPA) on liver VX2 tumor in rabbits.

MATERIAL AND METHODS

Twenty rabbits with surgically implanted liver VX2 tumors were used. The rabbits were divided into three groups: a control, a saline, and a 3-BrPA group. Four rabbits were not treated at all, and they served as the control group. The saline group (n = 6) received only intra-arterial saline injection. The 3-BrPA group (n = 10) received an intra-arterial injection of 3-bromopyruvate through the hepatic artery. The delivered amounts of 3-bromopyruvate were as follows: 25 ml of 0.5 mM in six rabbits, 25 ml of 1.0 mM in two rabbits, and 25 ml of 2.0 mM in two rabbits. Four days after intra-arterial injection, the rabbits were sacrificed and histopathologic analysis of the explanted livers was performed with comparison of the tumor necrosis ratio (a percentage of the necrotic area versus the entire tumorous area) in each group.

RESULTS

The mean tumor necrosis ratio was 12.5+/-4.2%, 44.8+/-24.7%, and 49.4+/-14.3% in the control, saline, and 3-BrPA groups, respectively. Between the control and the saline group, and between the control and the 3-BrPA group the mean tumor necrosis ratio appeared to be significantly different (P<0.05). However, there was no statistical difference in the mean tumor necrosis ratio between the saline and the 3-BrPA group (P = 0.416).

CONCLUSION

A single session of intra-arterial injection of 3-BrPA showed no better results in terms of tumor necrosis than that of saline injection in a rabbit VX2 tumor model.

Global analysis of the human gastric epithelial transcriptome altered by Helicobacter pylori eradication in vivo

OBJECTIVE

The transcriptional profile of gastric epithelial cell lines cocultured with Helicobacter pylori and the global gene expression of whole gastric mucosa has been described previously. We aimed to overcome limitations of previous studies by determining the effects of H pylori eradication on the transcriptome of purified human gastric epithelium using each patient as their own control.

DESIGN

Laser capture microdissection (LCM) was used to extract mRNA from paraffin-embedded antral epithelium from 10 patients with peptic ulcer disease, before and after H pylori eradication. mRNA was reverse transcribed and applied on to Affymetrix cDNA microarray chips customised for formalin-fixed tissue. Differentially expressed genes were identified and a subset validated by real-time polymerase chain reaction (PCR).

RESULTS

A total of 13 817 transcripts decreased and 9680 increased after H pylori eradication. Applying cut-off criteria (p<0.02, fold-change threshold 2.5) reduced the sample to 98 differentially expressed genes. Genes detected included those previously implicated in H pylori pathophysiology such as interleukin 8, chemokine ligand 3, beta defensin and somatostatin, as well as novel genes such as GDDR (TFIZ1), chemokine receptors 7 and 8, and gastrokine.

CONCLUSIONS

LCM of archival specimens has enabled the identification of gastric epithelial genes whose expression is considerably altered after H pylori eradication. This study has confirmed the presence of genes previously implicated in the pathogenesis of H pylori, as well as highlighted novel candidates for further investigation.

Morphological adaptation of the bone graft and fused bodies after non-instrumented anterior interbody fusion of the lower cervical spine

PURPOSE

To assess the remodelling process of the bone graft and fused bodies after non-instrumented anterior interbody fusion with autogenous iliac graft in patients with spondylosis, infections, fractures, or disorders of the cervical spine.

METHODS

68 patients aged 18 to 58 years who underwent non-plated anterior lower cervical interbody fusion with an iliac graft were retrospectively studied. Diagnoses of the patients were degenerative disc diseases (n=32), disc herniation (n=15), fractures (n=13), and tuberculosis (n=8). The Robinson and Smith technique was used to treat degenerative disc diseases and protruded disc, and the Bailey and Badgley procedure for fractures or tuberculosis of the cervical spine. 34, 25, and 9 patients underwent one-, 2-, and 3-segment fusions, respectively. 18 of the 25 patients underwent two-segment fusion with a single large bone block, and 7 with 2 separate bone blocks for each segment. Four of the 9 patients underwent three-segment fusion with a single large bone block, and 5 used separate grafts for each segment independently. Plain and stress radiography was primarily used to assess the fusion. Computed tomography and magnetic resonance imaging were also used in some patients. Some anterior graft extrusion (amounting to less than 10% of corresponding anteroposterior body width) was used to observe the remodelling during graft-take and thereafter. Postoperative cervical traction for 2 to 4 weeks, then cervical collar immobilisation for 4 to 12 weeks were strictly followed according to the numbers of fused segments. A halo vest was applied in 4 patients with fracture undergoing 3-segment fusion as they could not tolerate the prolonged bed rest or rigid cervical brace.

RESULTS

The mean time for the graft to fuse was 8.6 (range, 7-14) weeks in patients who underwent each segment fusion with independent free grafts, and 10 and 14 weeks in those who underwent 2- and 3-segment single large graft fusion, respectively. The final loss of disc height and joint angle were negligible, regardless of the extent of fusion. Bony absorption of the anteriorly protruded part of the graft began at postoperative week 10 (range, 6-28), which coincided with the time of graft-take and initiation of remodelling.

CONCLUSION

The earliest sign of bony absorption of the anteriorly protruded part of the graft indicated the initiation of the graft-take and the graft remodelling. The inwaisting sign of the surgically fused block of vertebral bodies was a morphological adaptation. Despite the altered biomechanics of the spine in the fused area, the inwaisting sign indicated maintenance of normal function at the parafusion motion segments.

Reversed discrepancy between CT and diffusion-weighted MR imaging in acute ischemic stroke

PURPOSE

We sought to determine whether an early CT ischemic lesion showing parenchymal hypoattenuation might be undetectable on diffusion-weighted imaging (DWI) in acute cerebral ischemia.

MATERIALS AND METHODS

We retrospectively evaluated CT and MR images of 70 consecutive patients with acute middle cerebral artery (MCA) infarction. All patients underwent CT and MR imaging within 6 hours of symptom onset. We determined the presence of reversed discrepancy (RD), defined as an early ischemic lesion showing parenchymal hypoattenuation on CT but no hyperintensity on DWI. CT Hounsfield units (HU), apparent diffusion coefficients (ADCs), and perfusion parameters were calculated for RD lesions.

RESULTS

RD was found in 9 (12.9%) patients and at basal ganglia (89%). The mean HU of RD lesion was lower than that of normal tissue (DeltaHU, 2.33 +/- 0.74, P < .001). RD lesions showed no significant decrease of ADC (ADC ratio, 0.97 +/- 0.07, P = .059) and cerebral blood flow (relative CBF, 0.87 +/- 0.20, P > 0.05). Delayed DWI hyperintensity occurred in 8 (88.8%) RD lesions, and all lesions progressed to infarction. In 6 (66%) of 9 patients with RD, Alberto Stroke Program Early CT scores of ischemic lesions were lower on CT than those on DWI.

CONCLUSION

RD was uncommonly found mainly in basal ganglia, and all RD lesions progressed to infarction at follow-up. Early CT ischemic lesion showing parenchymal hypoattenuation may be undetectable on DWI, and DWI may underestimate extent of severe ischemic tissue in patients with acute MCA infarction.

Peripheral T-cell lymphoma in the neck: CT findings of lymph node involvement

OBJECTIVE

To describe the CT findings of lymph nodes of the neck involved in peripheral T-cell lymphomas (PTCL).

MATERIALS AND METHODS

Twenty-seven patients with pathologically proved PTCL with involvement of the lymph nodes of the neck were enrolled in this study. We retrospectively evaluated the lymph nodes on CT images with special attention to nodal necrosis, the margin, and enhancement patterns.

RESULTS

In the 27 patients studied, nodal necrosis and ill-defined margin were seen in 11 (41%) and 19 (70%), respectively. Heterogeneous enhancement of enlarged lymph nodes was noted on CT images in 19 (70%) of 27 patients. Homogeneous enhancement without ill-defined margin and/or nodal necrosis was only seen in 6 of 27 patients (22%).

CONCLUSION

Necrosis, an ill-defined margin, and heterogeneous enhancement of enlarged lymph nodes in the neck are relatively common CT features of PTCL. For patients with cervical lymph node enlargement, the presence of these findings may suggest high-grade non-Hodgkin's lymphoma, including PTCL.

Influence of weight reduction by sibutramine on female sexual function

BACKGROUND

It is well known that selective serotonin reuptake inhibitors (SSRIs) can cause sexual dysfunction, so it is possible that sibutramine, a serotonin and norepinephrine reuptake inhibitor, could induce sexual dysfunction.

DESIGN AND SUBJECTS

The effect of sibutramine on sexual function was evaluated in 46 overweight and obese (body mass index (BMI) > or = 23 kg/m2) but otherwise healthy married women (28-44 years). Participants were randomly assigned at baseline to either the sibutramine or control group. The Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function at baseline and after treatment with behavioral therapy plus sibutramine 10 mg once daily or behavioral therapy alone (control) for 8 weeks.

RESULTS

Mean weight loss from baseline to week 8 was -6.03% in sibutramine group and -0.38% in the control group. There was significant improvement of FSFI total score, arousal domain score and lubrication domain score in the sibutramine group (P<0.05), and significant differences in arousal, orgasm, satisfaction domain score and total score (P<0.05) in favor of sibutramine. Decreases in body weight and BMI were correlated with the improvement of arousal (r = -0.44 and r = -0.48, respectively) and orgasm (r = -0.45 and r = -0.46, respectively) domains.

CONCLUSION

Treatment with sibutramine plus behavioral therapy did not induce sexual dysfunction and sibutramine-induced weight reduction appeared to have a positive impact on sexual function in this small group of overweight and moderately obese women. The degree of improvement in sexual function was correlated with the degree of weight reduction.

Comparison of the amount of nuclides released from the spent fuel in contact with and without a compacted bentonite block

A spent LWR fuel specimen between Ca-bentonite blocks was leached in a simulated bentonite-saturated granitic water (SBGW) for 165 days and its results were compared with those of a specimen leached without a bentonite block. The amounts of Cs, Sb, Sr, Eu, Am, U and Pu released from a 4.3 mm thickness of a fuel pellet with a 50,400 MWD/MTU burn-up in the SBGW without a bentonite block were 2.2, 0.25, 0.15, 0.02, 0.01, 0.01 and approximately 5 x 10(-4)% of their inventories, respectively. However, the amounts of nuclides released from the specimen between the 1.4 Mg/m(3) bentonite blocks were decreased by three times at least. Moreover, the concentrations of the nuclides in the leachate were very low because most of them were retained in the bentonite blocks.

Benign Breast Diseases Associated With Cyclosporine Therapy in Renal Transplant Recipients

PURPOSE

Our aim was to correlate the radiologic characteristics of cyclosporine-induced benign breast diseases with clinical and pathologic findings.

MATERIALS AND METHODS

The clinical, mammographic, and ultrasonographic records of 33 female renal transplant recipients who received cyclosporine were retrospectively reviewed. Eleven patients had 46 breast masses on ultrasonography. We performed core needle biopsies on 20 masses and reviewed the pathologic findings.

RESULTS

Among 33 female renal transplant recipients, 11 (33%) had 46 benign breast lesions detected on ultrasonography. We performed core needle biopsies on 20 of the 46 masses. On pathologic examination, 12 were fibroadenomas, 6 showed fibrocystic changes, and 2 revealed dense fibrosis. Regardless of the final pathologic diagnosis, more than half of the lesions revealed severe lymphatic and venular swellings. Among 11 patients with breast lesions on ultrasonography, 10/11 (91%) showed multiplicity, and 7/11 (64%) bilaterality. Mammographically, patients with breast lesions revealed heterogeneous or extremely dense breast patterns, and 8 of 11 patients, circumscribed masses. Twenty-two patients without breast lesions showed scattered fibroglandular densities (n = 7), or heterogeneously dense (n = 11) or extremely dense (n = 4) breast patterns, and 3 of 22 patients showed vague or asymmetric densities that needed further evaluation.

CONCLUSION

The development of new breast lesions in patients after renal transplantation should suggest a diagnosis of cyclosporine-induced benign breast disease including fibroadenoma, fibrocystic changes, and dense fibrosis.

Prognostic significance of glycaemic control in patients with HBV and HCV-related cirrhosis and diabetes mellitus

AIMS

Diabetes mellitus (DM) is frequently observed in patients with cirrhosis, particularly that due to hepatitis C virus (HCV) infection. However, no studies have focused on the clinical significance of glycaemic control in cirrhotic patients because of their short life expectancy and poor hepatic function. The aim of this study was to evaluate the prognostic impact of glycaemic control in patients with hepatitis B virus (HBV) and HCV-related cirrhosis and DM.

METHODS

A total of 434 patients with HCV-related (HCV group, n = 88) or HBV-related (HBV group, n = 346) cirrhosis were studied retrospectively. We determined the prevalence of DM and treatment methods for hyperglycaemia and status of glycaemic control, and the patients' outcome.

RESULTS

The prevalence of DM was 43.2% (38/88) in the HCV group and 19.7% (68/346) in the HBV group. Patients in the HCV group were older with a female preponderance. DM was detected before the diagnosis of cirrhosis or simultaneously in 92% and 79% in the HCV and HBV groups, respectively. Most patients were treated with insulin or oral hypoglycaemic agents. However, blood glucose levels were maintained within the normal range in 34.2% of the HCV group and in 23.5% of the HBV group. Forty-six patients died during the observation period in both groups. Hepatic failure was the most common cause of death, and sepsis and variceal bleeding were more frequent in the HCV group than in the HBV group. Multivariate analysis showed that Child-Pugh class was the most important factor for survival in both groups. In the HCV group, the status of glycaemic control was a significant independent factor of survival (P = 0.018). In the HBV group, age and the development of spontaneous bacterial peritonitis were significant.

CONCLUSION

DM is more frequent in patients with HCV-related cirrhosis than in patients with HBV. Strict control of blood glucose levels could improve survival in HCV patients. A precise assessment of the risks and benefits of glycaemic control is required to reduce the mortality and morbidity of patients with cirrhosis and DM.