Comparison of peripheral nerve damages according to glucose control timing in experimental diabetes

OBJECTIVE

In addition to tight glucose control, early intensive therapy has been reported to be more important for the prevention of diabetic micro- and macro-vascular complications. What is not known exactly is the quantitative difference according to timing delay in glucose control and whether early period control is really better than late control in terms of diabetic peripheral neuropathy. In this study, we investigated the effect of timing differences in glucose control on the peripheral nerves in an experimental diabetic model.

METHODS

5 groups (6-8 rats in each group) were comprised of normal glucose rats (designated control), rats with hyperglycemia (designated DM), rats with glucose control for the entire 28-week study period (designated DM + INS [W0-28]), rats with glucose control for the early 14-week period followed by hyperglycemia for the late 14-week period (designated DM + INS [W0-14]), and rats with hyperglycemia for the early 14-week period followed by glucose control in the late 14-week period (designated DM + INS [W15-28]).

RESULTS

We found that the current perception threshold (CPT) was lower in the DM + INS (W0-28) and DM + INS (W15-28) groups than in the DM + INS (W0-14) or DM groups (P<0.05). The mean myelinated fiber area of the sciatic nerve was significantly greater in the DM + INS (W0-28) and DM + INS (W15-28) groups (63.5±2.32 and 60.1±2.14 um, respectively) than in the DM + INS (W0-14) or DM groups (55.5±2.81 or 51.5±2.64 um, respectively) (P<0.05), and the intraepidermal nerve fiber (IENF) density was significantly higher in the DM + INS (W0-28) and DM + INS (W15-28) groups (6.9±0.46 and 6.8±0.11, respectively) than in the DM + INS (W0-14) or DM groups (59.5±0.32 and 5.3±0.39/mm, respectively) (P<0.05).

CONCLUSION

Our results indicate that continuous glucose control is necessary to alleviate peripheral nerve damage and that glycemic control during the later period may be more important than early period management. The importance of continuous glucose control, including the later period of diabetes, should therefore be emphasized in diabetic peripheral neuropathy.

Association of multi-pathogenic infections with BAT2, CXCL12, Mx1 and EHMT2 variations in pigs

Porcine reproductive and respiratory syndrome virus (PRRSV), Haemophilus parasuis and Pseudorabies become a widespread problem causing great economic losses associated with reproductive disturbance, respiratory diseases, neonatal mortality, fibrinous polyserositis, meningitis and arthritis in the pig industry. The important candidate genes are assumed to play crucial roles in host defense against the diseases. The aims of this study were to evaluate the variants in HLA-B associated transcript 2 (BAT2), CXCL12, myxovirus resistance protein 1 (Mx1) and EHMT2 genes and their effects on the risk of infection PRRSV and H. parasuis in a case-control (diseased-healthy pigs) population of Duroc × Landrace × LargeWhite. The results showed that the mutations in BAT2, Mx1 and EHMT2 genes were significantly associated with the antibody and the reisk of infection PRRSV and H. parasuis. Those individuals with AA genotype of BAT2 had significantly higher Pseudorabies virus antibody than that with GG and GA (P < 0.05), and the individuals with TT genotype of EHMT2 generated higher Hog Cholera and Pseudorabies virus antibody than that wtih GG and GA (P < 0.01). These results indicated that the polymorphisms in Mx1, BAT2 and EHMT2 genes changed the diseases susceptibility and could be the potential markers assisting the pig breeding selection and disease resistance.

Effects of FUT1 gene mutation on resistance to infectious disease

Alpha-(1,2)-fucosyltransferase (FUT1) gene has been identified as a candidate gene for regulating the expression of Escherichia coli F18 receptor gene (ECF18R) which promotes adherence of Enterotoxigenic (ETEC) and Verotoxigenic (VTEC) Escherichia coli (E. coli) via F18 fimbriae. In order to illustrate the polymorphisms of FUT1 and their effects on resistance to natural infection by Porcine Respiratory and Reproductive Symdrome Virus (PRRSV) and Haemophilus parasuis, the distributions of different genotypes and the relative risks of disease incidence in pigs were investigated. A total of 1,041 pigs representing three European breeds (Duroc, Landrace and LargeWhite), five Chinese local breeds (Wild pig, Small MeiShan, QinPing, JinHua, and JianLi) and three commercial populations (LargeWhite × JianLi, Duroc × Landrace × LargeWhite and Duroc × wild pig) were selected to analyze the genotype of the FUT1 gene by PCR-RFLP. Only the GG genotype associated with susceptibility to ECF18 bacteria was detected in Chinese local pig breeds and a population of LargeWhite × JianLi, while the AA genotype which confers resistance to ECF18 was detected in two European breeds (Duroc and LargeWhite), two populations of Duroc × wild pig and Duroc × Landrace × LargeWhite. Regarding relative risk of incidence, Duroc × Landrace × LargeWhite with genotypes GG or AG showed greater relative risk (OR = 2.040, P = 0.025; OR = 1.750, P = 0.081, respectively) than those with genotype AA during natural infection by both PRRSV and Haemophilus parasuis. It can be concluded that the mutation of FUT1 gene might play a role in pig infection by multi-pathogens, and that AA may be a favourable genotype for increasing the resistance to disease.

Arsenate removal using a combination treatment of precipitation and nanofiltration

A combination treatment of Ca-precipitation and nanofiltration membrane was studied to remove arsenate from water. The selected nanofiltration membrane was an amphoteric charged membrane, proved by the results of ATR-FTIR spectra and zeta potential. The arsenate and calcium removal efficiencies had the lowest values at the isoelectric point of the nanofiltration membrane, attributed to the loosest steric hindrance and the weakest electrostatic repulsion. Above the isoelectric point, arsenate precipitated with calcium ion to form the low solubility compound calcium arsenate, while steric hindrance was the main mechanism of arsenate removal. In contrast, below the isoelectric point, the nanofiltration membrane with positive charges rejected calcium ion by electrostatic repulsion. The high electrostatic shielding of calcium ion prevented arsenate from coming close to the NF membrane. Either high feed arsenate concentration or high calcium oxide dose improved the removal amount of arsenate during the nanofiltration membrane separation process. In addition, the arsenate removal efficiency approached the highest value at 200 μg/L of feed arsenate concentration. The optimal transmembrane pressure was in a range of 0.5-0.7 MPa to restrict the formation of fouling cake on the nanofiltration membrane surface.

Effects of monochromatic light on quality properties and antioxidation of meat in broilers

Our previous study demonstrated that blue monochromatic light was better to promote the growth and development of broilers than red light. However, consumer research suggests that the eating quality of the meat is more important. The present study was, therefore, designed to further evaluate the effects of various monochromatic lights on the muscle growth and quality properties and antioxidation of meat. A total of 288 newly hatched Arbor Acre male broilers were exposed to blue light (BL), green light (GL), red light (RL), and white light (WL) by a light-emitting diode system for 49 d, respectively. Results showed that the broilers reared under BL significantly increased BW and carcass yield as compared with RL, WL, and GL (P < 0.05), but no statistical difference was found between GL and BL in weight of thigh muscle and carcass yield (P > 0.05). Compared with RL, the muscles of breast and thigh in GL and BL had higher pH, water-holding capacity, and protein content, whereas cooking loss, lightness value, shear value, and fat content were lower (P < 0.05). Moreover, BL significantly elevated superoxide dismutase, glutathione peroxidase, and total antioxidant capability activities and reduced malondialdehyde content both in breast and thigh muscles as compared with RL and WL (P < 0.05), but there was no significant difference in the superoxide dismutase and glutathione peroxidase activities between GL and BL (P > 0.05). These results suggest that BL better improves meat quality of Arbor Acre broilers by elevating antioxidative capacity than does RL.

Identification of complex vertebral malformation carriers in Holstein cattle in south China

Complex vertebral malformation (CVM) is a recently described monogenic autosomal recessive hereditary defect of Holstein dairy cattle that causes premature birth, aborted fetuses and stillborn calves. Guanine is substituted by thymine (G>T) in the solute carrier family 35 member A3 gene (SLC35A3). A valine is changed to a phenylalanine at position 180 of uridine 5'-diphosphate-N-acetyl-glucosamine transporter protein. CVM is expected to occur in many countries due to the widespread use of sire semen. We developed a created restriction site PCR (CRS-PCR) method to diagnose CVM in dairy cows. This was tested on 217 cows and 125 bulls selected randomly from a Holstein cattle population in south China. Five Holstein cows and five Holstein bulls were identified to be CVM carriers; the percentages of CVM carriers were estimated to be 2.3, 4.0 and 2.9% in the cows, bulls and entire Holstein cattle sample, respectively.

Risk factors for hip fracture in older adults: a case-control study in Taiwan

We conducted a matched case-control study of hip fracture in older adults. Our findings suggest that hip fracture risk was determined by multiple factors. Older women characterized by low consumption of milk, peak flow rate, grip strength, and bone mineral density (BMD) had increased risk of hip fracture. Older men with impaired cognitive function and low BMD were also at higher risk of hip fracture.

INTRODUCTION

Multiple factors contribute to low-trauma hip fracture in older adults. The aim of this study was to determine important characteristics of hip fracture in older population.

METHODS

A total of 228 patients with first low-trauma hip fracture were matched with 497 controls. All 77 potential risk factors of hip fracture organized into 13 groups were analyzed using conditional logistic regression.

RESULTS

Low milk intake, peak flow rate, hand grip strength, and bone mineral density in women and low mini-mental state examination score and bone mineral density in men were further identified to be independently associated with elevated hip fracture risk.

CONCLUSIONS

The factors found in our study may help understand the etiology of hip fracture and be further adopted to evaluate the risk of hip fracture in community and clinical setting.

Morphological comparison of small nerve fibres in gastric mucosa in non-diabetic and Type 2 diabetic subjects

AIM

To determine changes in small nerve fibres in gastric mucosa in patients with Type 2 diabetes by morphological observation.

METHODS

In twenty-five non-diabetic and 21 Type 2 diabetic participants, gastric mucosal biopsy under endoscopy was performed. Innervation in gastric mucosa was detected using immunohistochemical staining. Anti-protein gene product (PGP) 9.5 positive nerves underwent morphological observation and quantitative analysis.

RESULTS

Small nerve fibres in gastric mucosa were shortened in the diabetic subjects. The ratio of gastric mucosal protrusions maintaining nerve fibres between gastric pits to total observed protrusions was lower in patients with Type 2 diabetes compared with the non-diabetic subjects (ratio of innervated protrusion/total protrusion: 0.49 +/- 0.12 vs. 0.89 +/- 0.06, P < 0.05).

CONCLUSIONS

This study sets the scene for further research to investigate the relationship between gastric mucosal nerves and autonomic neuropathy or diabetic peripheral neuropathy.

A Kunjin replicon vector encoding granulocyte macrophage colony-stimulating factor for intra-tumoral gene therapy

We have recently developed a non-cytopathic RNA replicon-based viral vector system based on the flavivirus Kunjin. Here, we illustrate the utility of the Kunjin replicon system for gene therapy. Intra-tumoral injections of Kunjin replicon virus-like particles encoding granulocyte colony-stimulating factor were able to cure >50% of established subcutaneous CT26 colon carcinoma and B16-OVA melanomas. Regression of CT26 tumours correlated with the induction of anti-cancer CD8 T cells, and treatment of subcutaneous CT26 tumours also resulted in the regression of CT26 lung metastases. Only a few immune-based strategies are able to cure these aggressive tumours once they are of a reasonable size, illustrating the potential of this vector system for intra-tumoral gene therapy applications.

Good death study of elderly patients with terminal cancer in Taiwan

OBJECTIVES

Over half of all terminal cancer patients in Taiwan are 65 or older, thus demonstrating the importance of terminal care for elderly people. This study investigates the good death status of elderly patients with terminal cancer, comparing the differences in the degree of good death among elderly and younger groups, and exploring the factors related to the good death score.

METHODS

Three hundred and sixty-six patients with terminal cancer admitted to a palliative care unit were enrolled. Two structured measurements, the good death scale and the audit scale for good death services, were used as the instruments in the study.

RESULTS

The scores of individual items and of the good death scale were increased significantly in both elderly (n = 206, 56.3%) and younger (n = 160, 43.7%) groups from the time of admission to just prior to death. However, the elderly group had significantly lower scores in 'awareness' (t = -3.76, P < 0.001), 'propriety' (t = -2.92, P < 0.01) and 'timeliness' (t = -2.91, P < 0.01) than the younger group prior to death. Furthermore, because of a lack of truth-telling, the elderly group also had significantly lower scores than the younger group in both 'respect for autonomy' and 'decision-making participation' (t = -2.17, P < 0.05; t = -2.21, P < 0.05, respectively). Multiple regression analysis revealed that 'respect for autonomy' (OR = 1.22, 95% CI = 0.76-1.67) and 'verbal support '(OR = 0.93, 95% CI = 0.34-1.51) were two independent correlates of the good death score in the elderly group.

CONCLUSION

The dilemma of truth-telling compromises the autonomy of the elderly patients with terminal cancer and consequently affects their good death scores. The palliative care team should emphasize the issue of truth-telling in the process of caring for terminally ill cancer patients, especially elderly patients.

Laser-micromachined Fabry-Perot optical fiber tip sensor for high-resolution temperature-independent measurement of refractive index

We propose and demonstrate a Fabry-Perot (F-P) optical fiber tip sensor for high-resolution refractive-index measurement fabricated by using 157-nm laser micromachining, for the first time to our knowledge. The sensor head consists of a short air F-P cavity near the tip of a single-mode fiber and the fiber tip. The external refractive index is determined according to the maximum fringe contrast of the interference fringes in the reflective spectrum of the sensor. Such a sensor can provide temperature-independent measurement of practically any refractive index larger than that of air and offers a refractive-index resolution of ~4 x 10(-5) in its linear operating range. The experimental data agree well with the theoretical results.

Patients with end stage renal disease: a registry at Sultanah Aminah Hospital, Johor Bahru, Malaysia

The epidemiology of new patients presenting to Sultanah Aminah Hospital Johor Bahru (HSAJB) with end-stage renal disease (ESRD) in 2003 and 2004 was analysed. Patients with ESRD were prospectively registered in the renal replacement therapy (RRT) database in the nephrology unit. The incidence of ESRD and the RRT provision rate in the district of Johor Bahru were calculated according to gender and race. There were 306 new patients in 2003 and 299 in 2004. Diabetic nephropathy contributed 56.8% new patients in 2003 and 57.9% in 2004. The mean age was 50.8 + 15.1 years in 2003 and 51.3 + 14.2 years in 2004. Males accounted for 53.3% in 2003 and 47.8% in 2004. Haemodialysis was the commonest form of RRT (60.5% in 2003, 69.9% in 2004), followed by continuous ambulatory peritoneal dialysis (30.1% in 2003, 19.4% in 2004) and renal transplantation (5.5% in 2003, 2.3% in 2004). Ninety-one percent of patients in 2003 and 90% in 2004 were alive at the end of the year they presented. The incidence of ESRD in the district of Johor Bahru was estimated as 136 per million population (p.m.p.) in 2003 and 151 p.m.p. in 2004. In the two year period the incidence of ESRD was higher among females (154 p.m.p.) than males (134 p.m.p.). Malays (194 p.m.p.) had higher ESRD incidence compared to Chinese (126 p.m.p.) and Indians (134 p.m.p.). RRT provision in Johor Bahru (92.7%) did not differ significantly with gender or race. The increasing number of patients presenting to HSAJB with ESRD especially those with diabetic nephropathy is a major concern. Prevention strategies at the primary care level may curb the burden of this chronic disease.

Genetic basis of 17 traits and viscosity parameters characterizing the eating and cooking quality of rice grain

A recombinant inbred line population derived from a cross between Zhenshan 97 and Delong 208 was used to analyze the genetic basis of the cooking and eating quality of rice as reflected by 17 traits (or parameters). These traits include amylose content (AC), gel consistency (GC), alkali spreading value (ASV), cooked rice elongation (CRE), and 13 parameters from the viscosity profile. All the traits, except peak paste viscosity (PKV), time needed from gelatinization to peak (BAtime), and CRE, can be divided into two classes according to their interrelationship. The first class consists of AC, GC, and most of the paste viscosity parameters that form a major determinant of eating quality. The second class includes ASV, pasting temperature (Atemp) and pasting time (Atime), which characterize cooking process. We identified 26 QTL (quantitative trait locus or loci) in 2 years; nine QTL clusters emerged. The two major clusters, which correspond to the Wx and Alk loci, control the traits in the first and second classes, respectively. Some QTL are co-located for the traits belonging to the same class and also for the traits to a different class. The Wx locus also affects on ASV while the Alk locus also makes minor contributions to GC and some paste viscosity parameters. The QTL clusters on other chromosomes are similar to the Wx locus or Alk locus, although the variations they explained are relatively minor. QTL for CRE and PKV are dispersed and independent of the Wx locus. Low paste viscosity corresponds to low AC and soft gel, which represents good eating quality for most Chinese consumers; high ASV and low Atemp, together with reduced time to gelatinization and PKV, indicate preferred cooking quality. The genetic basis of Atemp, Atime, BAtime, peak temperature, peak time, paste viscosity at 95 degrees C, and final paste viscosity is newly examined to reveal a complete and dynamic viscosity profile.

Is the effect of silicon on rice uptake of arsenate (AsV) related to internal silicon concentrations, iron plaque and phosphate nutrition?

Solution culture experiments were conducted to investigate the effects of silicon (Si) on arsenate (As(V)) uptake by rice. The addition of Si to the pretreatment or uptake solution significantly decreased shoot and root As concentrations (P<0.001 and P<0.05). The presence of Si in the pretreatment or uptake solution also significantly decreased shoot P concentrations (P<0.001). The data demonstrated that both internal and external Si inhibited the uptake of As and P. Results of As uptake kinetics showed that the mechanism of the effect of Si on arsenate uptake is not caused by direct competition for active sites of transporters with As. The effect of Si on As uptake was not entirely mediated through the effect of Si on P uptake. Although the addition of Si to pretreatment solutions still significantly decreased shoot and root As concentrations, the extent of reduction became smaller when rice roots were coated with iron plaque.

Angle-dependent light emission from aligned multiwalled carbon nanotubes under CO(2) laser irradiation

This paper reports the light emission from aligned multiwalled carbon nanotubes (MWNTs) under continuous wave CO(2) laser (λ = 10.6 µm) irradiation. Results indicate that the light emission is dependent on the angle θ between the laser incident direction and the nanotube axis. The relative intensity of the light emission at certain wavelengths shows a Lorentzian feature when θ varies from 0° to 90°. The Lorentzian fitting curve displays a distinct tendency between shorter (λ<600 nm) and longer wavelength (λ>700 nm). A minimum intensity was observed at θ(m) close to 67° under shorter wavelength, whereas a maximum intensity was shown at θ(m) of about 60° at longer wavelength. These results show the anisotropic property of aligned MWNTs.

Quality of life of dialysis patients in Malaysia

The aims of this retrospective analysis were (i) to examine the trends of quality of life (QoL) scores and (ii) to identify the risk factors for QoL scores among 6908 dialysis patients entering dialysis between 1997 and 2002. The Spitzer QoL Index was the instrument used by the National Renal Registry of Malaysia to assess the QoL amongst dialysis patients. Demographic and biochemical data were analysed to identify risk factors for poor QoL. The median QoL-index score ranged between 9 and 10. Significant risk factors for poor QoL were female gender, age > 40, diabetes, cohort starting dialysis 2001-2002, haemodialysis modality, body mass index < 18.5, albumin < 30g/dL, cholesterol < 3.2 mmol/L, haemoglobin < 10 g/dL, diastolic blood pressure of > 90 mHg, iPTH < 100 pg/ml. The overall QoL of dialysis patients is satisfactory. The negative impact of diabetes and haemodialysis on QoL warrants further evaluation as each factor involves 50% and 90% of our dialysis population.

Arsenic sequestration in iron plaque, its accumulation and speciation in mature rice plants (Oryza sativa L.)

A compartmented soil-glass bead culture system was used to investigate characteristics of iron plaque and arsenic accumulation and speciation in mature rice plants with different capacities of forming iron plaque on their roots. X-ray absorption near-edge structure spectra and extended X-ray absorption fine structure were utilized to identify the mineralogical characteristics of iron plaque and arsenic sequestration in plaque on the rice roots. Iron plaque was dominated by (oxyhydr)oxides, which were composed of ferrihydrite (81-100%), with a minor amount of goethite (19%) fitted in one of the samples. Sequential extraction and XANES data showed that arsenic in iron plaque was sequestered mainly with amorphous and crystalline iron (oxyhydr)oxides, and that arsenate was the predominant species. There was significant variation in iron plaque formation between genotypes, and the distribution of arsenic in different components of mature rice plants followed the following order: iron plaque > root > straw > husk > grain for all genotypes. Arsenic accumulation in grain differed significantly among genotypes. Inorganic arsenic and dimethylarsinic acid (DMA) were the main arsenic species in rice grain for six genotypes, and there were large genotypic differences in levels of DMA and inorganic arsenic in grain.

Arsenic sequestration in iron plaque, its accumulation and speciation in mature rice plants (Oryza sativa L.)

A compartmented soil-glass bead culture system was used to investigate characteristics of iron plaque and arsenic accumulation and speciation in mature rice plants with different capacities of forming iron plaque on their roots. X-ray absorption near-edge structure spectra and extended X-ray absorption fine structure were utilized to identify the mineralogical characteristics of iron plaque and arsenic sequestration in plaque on the rice roots. Iron plaque was dominated by (oxyhydr)oxides, which were composed of ferrihydrite (81-100%), with a minor amount of goethite (19%) fitted in one of the samples. Sequential extraction and XANES data showed that arsenic in iron plaque was sequestered mainly with amorphous and crystalline iron (oxyhydr)oxides, and that arsenate was the predominant species. There was significant variation in iron plaque formation between genotypes, and the distribution of arsenic in different components of mature rice plants followed the following order: iron plaque > root > straw > husk > grain for all genotypes. Arsenic accumulation in grain differed significantly among genotypes. Inorganic arsenic and dimethylarsinic acid (DMA) were the main arsenic species in rice grain for six genotypes, and there were large genotypic differences in levels of DMA and inorganic arsenic in grain.

Medication compliance among renal transplant patients: a Hospital Kuala Lumpur experience

This survey aims to identify prevalence, reasons and predictors of noncompliance among renal transplant patients followed up in Hospital Kuala Lumpur (HKL). All adult renal transplant patients who were at least 6 months post transplant were recruited from 10/2001 till 5/2002. Patients who consented were interviewed by a medical doctor or research assistant based on questionnaire. Noncompliers were defined as those who missed or self adjusted any dose of immunosuppressant within the preceding 4 weeks. Inter-rater agreement was assessed prior by Kappa (K) scores and they were acceptable. Out of 304 patients, 246 patients volunteered; of whom 144 (58.5%) were males. Twenty-one (9.3%) were noncompliers. Reasons for noncompliance included forgetfulness (n=8), financial constraints (n=1), fear of rejection (n=1), side effects (n=9), decision not to take (n=6), difficulty in breaking medication into correct dosages (n=1). Significant predictors of noncompliance were longer duration of transplant noncompliance to other drugs, regular use of nonprescription drugs; the lack of symptoms of fat facial cheeks and infection. Surveillance for noncompliance should not be relaxed as its predictors are diverse and persistent, especially in those who are at high risks.

Do iron plaque and genotypes affect arsenate uptake and translocation by rice seedlings (Oryza sativa L.) grown in solution culture?

The effects of Fe concentrations in the pretreatment solution on the induction of plaque and the differences between genotypes on arsenate uptake by and translocation within rice seedlings grown in nutrient solution in the greenhouse were investigated. After iron plaque on rice roots was induced in solutions containing 20, 40, 60, 80, and 100 mg Fe2+ l(-1), seedlings were transplanted into nutrient solution with 0.5 mg As l(-1). The formation of iron plaque was clearly visible as a reddish coating on the root surface after 12 h induction. Fe2+ concentrations in the pretreatment solution and 0.5 mg As l(-1) in the treatment solutions did not significantly affect rice growth. There was a significant correlation between the concentrations of Fe and As in iron plaque on the root surface for the three genotypes. About 75-89% of total As was concentrated in iron plaque (DCB-extracts). There were no significant differences in As concentrations in the roots between the three genotypes; however, As concentrations in shoots differed significantly between them. Arsenic concentrations in shoots were positively correlated with iron concentrations in the shoots. The results suggest that iron plaque may act as a 'buffer' for As in the rhizosphere.

Prevalence of erectile dysfunction and impacts on sexual activity and self-reported intercourse satisfaction in men older than 40 years in Taiwan

In order to assess the prevalence of erectile dysfunction (ED), and its association with chronic diseases and impact upon sexual activity and satisfaction during sexual intercourse, a reproductive survey was conducted among 1002 Taiwanese men aged over 40 y. The information collected comprised age, gender, level of education, history of chronic diseases, and self-reported data pertaining to erectile function, sexual activity, and sexual satisfaction during sexual intercourse. The prevalence of ED amongst study subjects was 17.7%, and the frequency increased with age. A history of chronic diseases were significantly associated with ED (P<0.05). A reduced incidence of sexual activity and a decreased level of satisfaction during sexual intercourse were observed among subjects suffering from ED as compared to those not suffering such a condition. In conclusion, based upon the results of a community-based survey the prevalence of ED among Taiwanese men aged 40 y or more was 17.7% and it increased with age. It was also found that ED was associated with various chronic diseases and that it exerted a negative impact upon sexual activity and the level of satisfaction associated with its conduct.

Assessing progression and efficacy of treatment for diabetic retinopathy following the proliferative pathway to blindness: implication for diabetic retinopathy screening in Taiwan

AIMS

The natural history and treatment efficacy of diabetic retinopathy (DR) play important roles in the evaluation of screening. Therefore, the natural history of DR and rates of transition after treatment (including metabolic control and laser photocoagulation) from no diabetic retinopathy (NDR) to blindness were quantified.

METHODS

We studied a cohort of 795 patients with diabetes mellitus (DM) receiving fundus examination in the ophthalmology out-patient department of one medical centre between 1 January 1990 and 31 December 1992 in Taiwan. Follow-up data until 31 December 1998 were collected by chart review. Two multistate Markov models were proposed to assess the efficacy of the treatment regime in reducing progression to blindness.

RESULTS

The average times spent in states (i) no diabetic retinopathy (NDR), (ii) background diabetic retinopathy (BDR), (iii) preproliferative diabetic retinopathy (PPDR), and (iv) proliferative retinopathy (PDR) were 10.86 years, 8.33 years, 1.67 years, and 2.17 years, respectively. Early detection of PPDR may lead to a 60% reduction in PDR and an 83% reduction in blindness. Simulated results based on these parameters show that an annual screening programme, a biennial screening regime and a 4-yearly screening regime can lead to 54% (95% confidence interval (CI): 44-62%), 51% (95% CI: 41-59%), and 46% (95% CI: 36-54%) reductions in blindness, respectively.

CONCLUSIONS

Assessing the progression of DR following the proliferative pathway in this study suggests that screening for DR is worthwhile and that a 4-year interscreening interval for patients as yet without DR may be justified.

Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities

AIM

To clarify the mechanism of the therapeutic action of icariin on erectile dysfunction (ED).

METHODS

PDE5 was isolated from the human platelet and PDE4 from the rat liver tissue using the FPLC system (Pharmacia, Milton Keynes, UK) and the Mono Q column. The inhibitory effects of icariin on PDE5 and PDE4 activities were investigated by the two-step radioisotope procedure with [(3)H]-cGMP/[(3)H]-cAMP. Papaverine served as the control drug.

RESULTS

Icariin and papaverine showed dose-dependent inhibitory effects on PDE5 and PDE4 activities. The IC(50) of Icariin and papaverine on PDE5 were 0.432 micromol/L and 0.680 micromol/L, respectively and those on PDE4, 73.50 micromol/L and 3.07 micromol/L, respectively. The potencies of selectivity of icariin and papaverine on PDE5 (PDE4/PDE5 of IC(50)) were 167.67 times and 4.54 times, respectively.

CONCLUSION

Icariin is a cGMP-specific PDE5 inhibitor that may be developed into an oral effective agent for the treatment of ED.

Polynucleotide viral vaccines: codon optimisation and ubiquitin conjugation enhances prophylactic and therapeutic efficacy

Papillomavirus infection is a major antecedent of anogenital malignancy. We have previously established that the L1 and L2 capsid genes of papillomavirus have suboptimal codon usage for expression in mammalian cells. We now show that the lack of immunogenicity of polynucleotide vaccines based on the L1 gene can be overcome with codon modified L1, which induces strong immune responses, including conformational virus neutralising antibody and delayed type hypersensitivity. Conjugation of a ubiquitin gene to a hybrid gene incorporating L1 and the E7 non-structural papillomavirus protein improved E7 specific CTL responses, and induced protection against an E7 expressing tumour, but induced little neutralising antibody. However, a mixture of ubiquitin conjugated and non-ubiquitin conjugated polynucleotides induced virus neutralising antibody and E7 specific CD8 T cells. An optimal combined prophylactic/therapeutic viral vaccine might therefore comprise ubiquitin conjugated and non-ubiquitinated genes, to induce prophylactic neutralising antibody and therapeutic cell mediated immune responses.