Fluorescence quenching of ethidium ion by porphyrin cations and quaternary ammonium surfactants in the presence of DNA

Fluorescence quenching of free and DNA-bound ethidium bromide (EB) by a number of quaternary ammonium and other compounds was studied. For free EB or bound EB at lower DNA concentration the fluorescence quenching follows the Stern-Volmer equation and at higher DNA concentration follows an exponential model. At least at low quencher concentrations the quenching efficiency varies with DNA or NaCl concentrations and is about 100 times greater for bound than free EB. The quenching pathways may involve energy transfer and conformational loosening or distortion of the DNA helix in addition to possible electron transfer.

Thapsigargin-coated intraocular lenses inhibit human lens cell growth

Cataract is responsible for rendering several million people blind throughout the world and is also by far the most common cause of low visual acuity. Although cataract surgery is common, routine and effective, posterior capsule opacification (PCO) occurs in 30-50% of patients following modern cataract surgery. This condition arises from stimulated cell growth within the capsular bag after surgery. The resulting decline in visual acuity requires expensive laser treatment, and PCO therefore prevents modern cataract surgery from being carried out routinely in underdeveloped countries. The present study, using a human lens capsular bag culture system, has confirmed that cells from a wide age range of donors proliferate in the absence of added serum protein and explains why PCO is such a common problem even in aged patients. This study also provides one possible solution for PCO by using polymethylmethacrylate (PMMA) implanted intraocular lenses as a drug delivery system. PMMA lenses coated with thapsigargin, a hydrophobic inhibitor of endoplasmic reticulum (ER) (Ca2+)-ATPase, greatly reduced cell growth in the capsular bag at relatively low coating concentrations (200 nM) but, more significantly, induced total cell death of the residual anterior epithelial cells at higher concentrations (>2 microM).

Prevalence of apolipoprotein E genotypes in ischaemic cerebrovascular disease in end-stage renal disease patients

BACKGROUND

Several studies have demonstrated that atherosclerotic complications are the major cause of morbidity and mortality in end-stage renal disease (ESRD) patients on dialysis. The allele epsilon 4 of apolipoprotein E (ApoE) gene has been associated with an increased risk for ischaemic cerebrovascular disease (ICVD) in general populations in recent preliminary cross-sectional studies.

METHODS

The aim of our study was to prospectively investigate the risk of ischaemic cerebrovascular disease with respect to the presence of Apo epsilon 4 allele in 157 Chinese uraemic patients.

RESULTS

During the 2 year follow-up, the incidence of stroke was 6.4% and the cumulative occurrence of ischaemic cerebrovascular disease was 9.6%. Further analysis showed that the cumulative occurrence of ischaemic cerebrovascular disease was 5.6% in subjects with no ApoE epsilon 4 allele and 36.8% in those with one or two ApoE epsilon 4 alleles. Univariate analysis showed that the prevalence of ischaemic cerebrovascular disease was significantly higher in the subjects with ApoE epsilon 4 allele. The mean ApoA1 plasma concentrations was significantly lower in those with ApoE epsilon 4 allele. A stepwise regression analysis showed that the presence of stroke was significantly related to the ApoE epsilon 4 genotype (P < 0.001).

CONCLUSIONS

The ApoE epsilon 4 allele can be regarded as an important risk factor for ischaemic cerebrovascular disease in uraemic patients.

Ageing-associated large-scale deletions of mitochondrial DNA in human hair follicles

Hair follicles plucked from the bi-temporal region of the scalp of 433 Chinese subjects of different ages were used for the examination of ageing-associated mutations of human mitochondrial DNA (mtDNA). By use of PCR techniques, we detected the 4,977 bp and 7,436 bp deletions of mtDNA in hair follicles from aged individuals. The frequencies of occurrence of both mtDNA deletions were found to increase with age of the subject. Moreover, we employed a semi-quantitative PCR method to determine the proportion of the 4,977 bp deleted mtDNA (dmtDNA) in hair follicles. The results showed that the average proportion of the 4,977 bp dmtDNA in hair follicles were 0.05% +/- 0.01%, 0.00%, 0.55% +/- 0.05%, 0.52% +/- 0.24%, 0.65% +/- 0.17%, 1.33 +/- 0.25%, and 1.89% +/- 0.81% for the subjects in the age groups of 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and 81-99, respectively. Furthermore, we screened all the subjects harboring the 4,977 bp and/or 7,436 bp deletions for tandem duplications in the D-loop region of mtDNA by PCR with back-to-back primers. The results showed that none of the previously reported tandem duplications were present in all the hair follicles examined. This indicates that tandem duplications do not predispose to large-scale deletions of mtDNA. However, the data suggest that mtDNA deletions occur and accumulate in hair follicles during human ageing. As hair follicles can be easily and non-invasively obtained from the human, we suggest that the aged-dependent accumulation of dmtDNAs in hair follicles may be used for the monitoring of human ageing process.

Solitary ileal lipoma presenting with ileocolic intussusception: an unusual cause of enteritis cystica profunda

We report a 63-year-old man who presented with a history of intermittent vague abdominal pain, diarrhea, and weight loss. Colonofibroscopic examination disclosed an ileocolic intussusception with a polypoid tumor on the leading edge of the intussusception. Both double contrast barium enema and computerized tomography of the abdomen confirmed this finding. The excised specimen had an ulcerated ileal lipoma with enteritis cystica profunda on the overlying epithelium.

Liposomes-coated hydroxyapatite and tricalcium phosphate implanted in the mandibular bony defect of miniature swine

Hydroxyapatite and tricalcium phosphate have been used as bone implants for some period of time. Now unfortunately, these materials have failed to become the nucleation sites for bone regeneration. We hypothesized that coating hydroxyapatite and tricalcium phosphate with negatively charged liposomes may improve the nucleation process for new bone formation. The present study was designed to test this hypothesis. Experiments were carried out in 15 miniature swines' mandibular angle with artificial bony defects. In each of the swine, the bony defects on one side were implanted with either liposomes coated with hydroxyapatite or liposomes coated with tricalcium phosphate, while the other side served as control. At the end of the third and sixth weeks following the operation, we observed result, took histology and radiographs of the operated area. The results showed that liposomes-coated materials were biocompatible and their clinical endpoint was enhanced. At the end of the third week, the implant material was surrounded by dense connective tissues. At the end of the sixth week, there were new bone formations near the implanted material. In addition, liposomes which were immobilized in agarose gel and implanted in the defects showed new bony bridge formation. These observations suggest that liposomes have the ability in promoting repair of osseous deficiencies.

Successful surgical treatment of bilateral congenital chylothorax: a case report

A male infant was diagnosed at 19 days old to have a right chylothorax. Conservative management, including median-chain triglyceride (MCT) diet, total parenteral nutrition (TPN) and chyle drainage, were unsuccessful. The boy received a right thoracotomy with ligation of the thoracic duct and sutures of leaking lymphatic ducts at the age of 65 days. The result of the operation was satisfactory but left chylothorax developed six days later. Left thoracotomy was performed eight days later to suture the leaking lymphatic chains and finally the patient recovered well. Followed for one year, the patient's physical development was satisfactory. Prompt surgical intervention for congenital chylothorax is strongly recommended, if medical treatment fails.

Collagen synthesis in idiopathic and dilantin-induced gingival fibromatosis

Gingival fibromatosis is an uncommon but benign oral disease which causes progressive and non-hemorrhagic enlargement of the gingiva. There are two types of gingival fibromatosis: idiopathic gingival fibromatosis (GF), which is of unknown cause and may be associated with hereditary factors, and drug-induced gingival fibromatosis which is caused primarily by phenytoin intake. In cases of gingival fibromatosis, either the teeth are delayed in emergence or most of the crowns are embedded in the soft tissue even after full eruption. The objective of this study was to examine the basis of excess collagen formation in the two types of gingival fibromatosis in four patients admitted to the dental clinic at Kaohsiung Medical College Hospital, Kaohsiung, Taiwan. There were two male patients, aged ten (Case 1) and sixteen (Case 2), with idiopathic gingival fibromatosis and hypertrichosis, and two female patients, aged sixteen (Case 3) and eleven (Case 4), with Dilantin-induced gingival hyperplasia (DGH). Cultures of gingival fibroblast were established either from clinically excised hyperplastic tissues or from pre-orthodontic surgical normal gingiva. The synthesis of collagen and levels of prolyl hydroxylase, a key enzyme in collagen synthesis, were examined in the healthy and affected fibroblasts. Our studies showed that after two days in culture, fibroblasts from all four patients multiplied faster than healthy gingival fibroblasts, though the amount of DNA and protein per cell remained unchanged. In addition, all cultures (except Case 1) had a 2- to 3- fold increase of prolyl hydroxylase activity over that of the controls. As in the cases of prolyl hydroxylase activity, Case 1 did not show any change in collagen synthesis when compared to the control. However, Cases 2, 3, and 4 showed appreciable collagen increases in the cell and medium: 61% and 60% for Case 2; 16% and 36% for Case 3; and 21% and 80.7% for Case 4 respectively.

Phenytoin-mediated oxidative stress in serum of female epileptics: a possible pathogenesis in the fetal hydantoin syndrome

1. The concentration of serum malondialdehyde (MDA) was measured as the index of lipid peroxidation in female epileptics with phenytoin (PHT) monotherapy. Sera from 20 female epileptics with PHT monotherapy, 12 female epileptics without anticonvulsant therapy and 20 female healthy controls were sampled. The levels of serum copper (S-Cu), serum zinc (S-Zn), copper/zinc superoxide dismutase (CuZn-SOD), and reduced glutathione (GSH) were analyzed as interactive factors of the oxidative stress. 2. For the female epileptics with PHT monotherapy, serum MDA concentration (2.6 +/- 0.7 microM vs control 1.8 +/- 0.6 microM, P < 0.05), CuZn-SOD activity (178.2 +/- 63.5 U/dL vs control 97/1 +/- 36.4 U/dL, P < 0.01), and S-Cu content (126.2 +/- 36.1 micrograms/dL vs control 98.4 +/- 16.7 micrograms/dL, P < 0.05) were significantly increased, but GSH level (27.5 +/- 6.8 microM vs control 32.2 +/- 5.7 microM, P < 0.05) was significantly decreased. The level of serum MDA was associated with the elevation of CuZn-SOD activity (r = 0.54, P < 0.05) and S-Cu content (r = 0.44, P < 0.05) in all the samples collected from epileptics and controls. However, there were no significant differences in all the above parameters between the female epileptics without anticonvulsant therapy and healthy controls. 3. These results indicated that oxidative stress was enhanced in the female epileptics with PHT-monotherapy. Apart from the reactive PHT intermediate, the abnormal metabolism of S-Cu, CuZn-SOD, and GSH was highly involved in the PHT-mediated toxicity. Supplement of GSH, modification of CuZn-SOD enzyme activity and reduction of the absorption of copper may prevent the incidence of fetal hydantoin syndrome during pregnancy.

Periodontal manifestations and treatment of Sturge-Weber syndrome--report of two cases

Encephalotrigeminal angiomatosis (Sturge-Weber syndrome) is a rather uncommon congenital condition characterized by the combination of venous angioma of the leptomeninges over the cerebral cortex with ipsilateral angiomatous lesions of the face and sometimes, the skull, jaws and oral soft tissues. Two patients came to the Kaohsiung Medical College Hospital's dental clinic with complaints of localized gingival enlargement or tumor-like swelling. Based on the presence of facial nevus flammeus, examinations of angiography, radiological evidence of calcific densities, and ipsilaterally intraoral vascular hyperplasia in the lip, cheek and gingiva, encephalotrigeminal angiomatosis was diagnosed. Dental management included plaque control instructions, scaling, root planing and periodontal surgery. Recurrence of gingival enlargement in both cases was noted, so periodontal surgery was performed a second time. Close follow up and complete plaque control have kept the periodontal condition fairly well under control in these two cases. We introduce the oral manifestations and the experience of treatments in these two cases.

Human lens epithelial cell proliferation in a protein-free medium

PURPOSE

The ocular humors are relatively low in protein, yet cell growth in the human capsular bag still occurs after extracapsular cataract extraction (ECCE) surgery. This resilient growth gives rise to posterior capsule opacification (PCO) in a significant proportion (30%) of patients. This study compared the ability of human lens cells to proliferate in serum-supplemented and protein-free medium.

METHODS

Sham cataract operations were performed on human donor eyes. The capsular bag was dissected free, pinned flat on a petri dish, and incubated in Eagle's minimal essential medium (EMEM) alone or in EMEM supplemented with 10% fetal calf serum. Observations were made by phase-contrast microscopy. At the endpoint, capsules were studied by fluorescence or electron microscopy. Mitotic activity was identified using Bromo-2-deoxyuridine labeling and detection techniques. When required, an intraocular lens was implanted when surgery was performed.

RESULTS

It was found that human lens cells from a wide age spectrum of donors proliferate and migrate on the lens capsule in the absence of added protein. The rate of growth was age-dependent, such that the posterior capsule was completely confluent after 8.0 +/- 0 days (n = 3) and 24.4 +/- 5.3 days (n = 3) for donor lenses aged < 40 years and > 60 years, respectively. The outgrowth of epithelial cells gave rise to capsular contraction, wrinkling, and increased light scatter. Growth on the anterior surface of the intraocular lens was less prolific than on the posterior capsule.

CONCLUSION

The protein-free model replicates many features of clinically-observed PCO. The resilient cell growth on the natural collagen capsule explains the high prevalence of PCO, especially in younger patients, and suggests that inflammation and external growth factors are not necessary for PCO. Furthermore, the protein-free capsular bag system can be used to explore fundamental questions concerning the autocrine control of lens epithelial cell survival and growth.

Smoking-associated mitochondrial DNA mutations in human hair follicles

The mitochondrial DNA (mtDNA) of hair follicles was used for studying the genotoxicity of smoking-mediated carcinogens. We determined the incidences of the 4,977 bp and 7,436 bp mtDNA deletions, tandem duplication in the D-loop region and the proportion of the 4,977 bp deleted mtDNA (dmtDNA) in the total DNA of hair follicles from 213 male non-smokers and 74 male smokers, respectively. Twenty-three patients with lung cancer were also investigated. We found that the current cigarette smokers had a 3.1 times higher average incidence of the 4,977 bp dmtDNA (RR: 3.1, P < 0.001) as compared with non-smokers, and this mtDNA deletion was especially prevalent in the old heavy smokers. For the smokers of the age above 70, the average incidence of the 4,977 bp dmtDNA was 3.7 times higher in the group with a smoking index of 401-800 (RR: 3.7, P < 0.005) and 3.2 times higher in the group with a smoking index greater than 800 (RR: 3.2, P < 0.005). However, there was no statistically significant relationship between the incidence of the 7,436 bp dmtDNA and the smoking index, although there was a mild increase in the percentage of the 7,436 bp dmtDNA with the increase of the consumption of cigarettes. No tandem duplication of mtDNA in the D-loop region was disclosed in either smokers or non-smokers group. The proportions of the 4,977 bp dmtDNA in hair follicles were found to correlate with age, but did not keep increasing with cigarette consumption except in the group of subjects with a smoking index of less than 400. On the other hand, we found that the average proportion of the 4,977 bp dmtDNA in the hair follicles was 1.201 +/- 0.371% for the patients with lung cancer who had a smoking index greater than 400, while that was only 0.146% for the age-matched healthy smokers with the same smoking index. In conclusion, the high incidence of the 4,977 bp dmtDNA of hair follicles is not only associated with aging but also correlated with the amount of cigarette smoking. A high proportion of the 4,977 bp dmtDNA in the hair follicles may be considered one of the molecular events that are associated with the occurrence of smoking-associated cancers.

Clinicopathologic study of gastric carcinoma with duodenal invasion

Clinicopathologic features of 319 patients who underwent gastrectomy for adenocarcinoma of stomach were studied whether disease involved duodenum or not. Thirty-eight patients (11.9%) had duodenum invasion. Gastric carcinoma with duodenal invasion was most often Borrmann III or Borrmann IV (65.8%) type, with pylorous invasion by endoscopy (39.5%), large tumor size (73.7% > or = 5cm), lymph node metastasis (78.9%), serosal invasion (97.4%) and the incidence of the resection line not being free was high (13.2%). Duodenal invasion was most often (55.3%) direct through the deep layer or through lymphatics or venules. We need to pay more attention to finding duodenum invasion. More than 3 cm width of duodenal resection is recommended if duodenum invasion is suspected.

A study of human lens cell growth in vitro. A model for posterior capsule opacification

PURPOSE

After intraocular lens (IOL) implant surgery for cataract, cell growth on the posterior capsule is responsible for renewed visual impairment in approximately 30% of patients. The authors have, therefore, developed a human lens capsule system to study this growth in vitro.

METHODS

Sham cataract surgery, including anterior capsulorhexis, nucleus hydroexpression, and aspiration of lens fibers, was performed on donor eyes. In some cases, a polymethylmethacrylate IOL implant was placed in the capsular bag. The capsular bag was dissected free, pinned flat on a plastic culture dish, covered with Eagle's minimum essential medium supplemented with 10% fetal calf serum and observed by phase-contrast and dark-field microscopy for as long as 100 days. At the end-point, capsules were examined by fluorescence microscopy for actin, vimentin, and chromatin.

RESULTS

Within 24 hours, there was evidence of cell growth in the equatorial region. After 2 to 3 days, cells were normally observed growing from the rhexis onto the posterior capsule and across the anterior surface of the IOL, if present. Growth proceeded rapidly so that the posterior capsule, for example, was totally covered by a confluent monolayer of cells at 5.8 +/- 0.6 days and 7.2 +/- 0.7 days for capsules aged < 40 years and > 60 years, respectively. Total cover of the anterior IOL surface generally followed 4 to 5 days behind that of the capsule. Capsular wrinkles became increasingly apparent as time progressed, causing a marked rise in light scatter. An increase in capsular tension also occurred, and the actin filaments became more polarized near the wrinkles.

CONCLUSIONS

The model presented here for posterior capsule opacification shows many of the changes seen in vivo, including rapid lens cell growth, wrinkling, tensioning, and light scatter in the posterior capsule. It will be possible to develop strategies for inhibiting cell growth with this system.

Scanning electron microscopic study of monofilament suture knots

AIMS/BACKGROUND

Interrupted corneal sutures are used routinely by many cataract and corneal surgeons. A slim compact knot facilitates burial and allows atraumatic suture removal, with decreased risk of wound dehiscence. The size and morphology of knots tied in different configurations were investigated.

METHODS

10-0 nylon suture material was used to tie knots on porcine corneal cataract sections using 2/1/1 (reef and granny), 3/1/1, and 1/1/1/1 (slip knot) configurations. 10-0 Mersilene was used to tie 2/1/1 reef knots. Scanning electron micrographs of the knots were digitised and their maximal lengths and widths estimated. In addition, the area of each knot was calculated and used as an index of its volume.

RESULTS

2/1/1 reef knots were significantly smaller in all dimensions compared with the other knots (all p < 0.03) except for the maximal width of 2/1/1 granny knots which were no wider than the 2/1/1 granny knots. The Mersilene knots were larger than the nylon ones.

CONCLUSION

The use of 2/1/1 reef knots is recommended for corneal suturing.

Evaluation of the severity of Helicobacter pylori infection with urease test: its correlation with histopathology and bacterial density

In 69 patients, the severity of Helicobactor pylori (H. pylori) infection was evaluated by bacterial density of tissue implants and inflammatory responses by histology. The specimens were taken from gastric angle and antrum (greater and lesser curvature sides) by gastroduodenal endoscopy. In urease test, the severity was measured in 3 grades according to color change of the agar: those change are within 30 minutes (grade 3), 30 minutes to 3 hours (grade 2), and 3 to 6 hours (grade 1), respectively; while the grade 0 indicated no color change occurring 6 hours after tissue inoculation. The severity of infection was assessed according to the bacterial density under high power microscopic fields (Gram's stain). Grade 0 indicated no bacterium seen; grade 1, only 1 to 10 bacteria at all fields; grade 2, 1 to 3 bacteria in each high power field; and grade 3 was 4 bacteria or more on average in each high power field. The degree of inflammatory response was evaluated by inflammatory cell infiltration (H & E stain) and classified into grade 0, 1 and 2, which indicated the inflammatory cell infiltration below 50%, between 50% and 75%, and above 75%, respectively. There are no positive relationships among urease test reaction time, bacterial density grading and degrees of inflammatory cell infiltration. Clinically, the reaction time of urease test cannot reflect the severity of H. pylori infection semi-quantitatively, either in terms of bacterial density or cellular inflammatory response.

Type IV hyperlipoproteinemia and moderate instability of CAG triplet expansion in the androgen-receptor gene. Lipid, sex hormone and molecular study in a Chinese family with Kennedy-Alter-Sung disease

Kennedy-Alter-Sung (KAS) disease in a hereditary lower motor neuron disease. In this study, we investigate 2 KAS patients presenting with progressive muscle weakness and wasting, action tremor, perioral fasciculation and gynecomastia. Three carriers and 5 healthy members from this 3-generation KAS Chinese family and 60 normal Chinese controls were included in this study. Hormone studies revealed normal serum level in thyrotropin, prolactin, testosterone, leuteinizing hormone, follicle stimulating hormone, and estradiol. Lipid study disclosed type IV hyperlipoproteinemia in 2 KAS patients and 3 healthy members. Molecular studies revealed that the number of CAG triplet repeats in the first exon of androgen receptor gene of the normal allele is in the range of 15-19 and 12-25 in this family and normal controls, respectively. However, the number of CAG repeat of androgen receptor gene were unstable in the mutant alleles with a range of 41-45 and increased from generation to generation (genomic anticipation) in the 2 KAS patients and 3 female carriers. We conclude that the CAG triplet repeats in mutant allele were unstable in the family with the KAS disease. Furthermore, type IV hyperlipoproteinemia may be a co-transmitted syndrome in the family with KAS disease.

Utility of Argyrophilic nucleolar organizer regions (AgNOR) in differentiating malignant from benign of colorectal tumors

BACKGROUND

Argyrophilic nucleolar organizer regions (AgNOR) can reflect the activity of cellular proliferation. The purpose of this study is to evaluate the potential value of AgNOR in differentiating benign from malignant colon epithelial neoplasms, and to determine the correlation between the nucleus AgNOR and the grade of colonic adenocarcinomas.

METHODS

In this study, AgNOR technique was applied to 61 paraffin embedded sections of colorectal tissue including normal mucosa (n = 10), adenomatous polyp (n = 16), and adenocarcinoma (n = 35).

RESULTS

The mean +/- standard error (SE) numbers of AgNOR dots per nucleus of normal mucosa, adenomatous polyp, and adenocarcinoma were 2.17 +/- 0.07 (n = 10) 3.89 +/- 0.10 (n = 16) and 5.52 +/- 0.10 (n = 35), respectively (p < 0.00001). In addition, the mean numbers of AgNOR dots per nucleus of well differentiated (WD) adenocarcinoma (n = 14), moderately differentiated (MD) adenocarcinoma (n = 11) and poorly differentiated (PD) adenocarcinoma (n = 10) were 5.20 +/- 0.12, 5.81 +/- 0.20, 5.67 +/- 0.15, respectively. MD and PD tumor had significantly higher AgNOR count than that of WD tumor (p < 0.05). However, there was no significant difference between MD and PD colorectal adenocarcinoma.

CONCLUSION

AgNOR method is a simple, rapid method in diagnosis of colorectal tumors, and it provides a useful adjunct to histopathology in the diagnosis of colorectal tumors.

Differentiation of Aspergillus parasiticus from Aspergillus sojae by random amplification of polymorphic DNA

Aspergillus parasiticus and Aspergillus sojae are two morphologically similar species belonging to the Aspergillus section flavi. A new method to distinguish the two species, the aflatoxin producer A. parasiticus and the koji mold A. sojae, was developed. Single primers with arbitrary sequences were used to generate random amplified polymorphic DNA (RAPD) markers from strains of these two species. Three decamers, OPA-04, OPB-10, and OPR-01, allowed adequate discrimination between strains of A. parasiticus and A. sojae in RAPD analyses. A. sojae was further separated into group I and group II with the three primers. On the other hand, A. parasiticus was divided into group A and group B when amplified with OPA-04 and OPR-10 primers. The previously misidentified stain CCRC 32423 and the misclassified strain CCRC 30227 were identified as Aspergillus flavus and A. sojae, respectively, on the basis of RAPD patterns and morphological characteristics. We suggest that the RAPD technique is a rapid and reliable tool to distinguish A. parasiticus from A. sojae.

Does Helicobacter pylori infection play a role in the pathogenesis of non-ulcer dyspepsia--a study of gastric emptying time

To investigate the relationship between gastric motility and Helicobacter pylori infection in patients with non-ulcer dyspepsia, 28 patients and 10 asymptomatic healthy persons underwent gastroduodenal endoscope examinations and scintigraphic test of solid phase gastric emptying time using Chinese fried rice as a test meal. Clinical symptoms were also recorded using questionnaires for scoring. Half emptying times for ingested food (t1/2) between H. pylori infected (190.86 +/- 112.53 minutes) and uninfected patients (227.69 +/- 179.29 minutes) were not different statistically. Seven of the 15 patients with H. pylori infection (46.6%) had delayed gastric emptying time (t1/2 > 197.7 minutes), compared to 4 out of 13 without infection (30.07%) (p > 0.05). There was also no association between the status of H. pylori infection and severity of clinical symptoms (total symptoms scores: H. pylori positive: 10.07 +/- 3.84; H. pylori negative: 7.62 +/- 2.25) (p > 0.05). Seven patients from whom H. pylori was found to have been eradicated using triple therapy (colloid bismuth subcitrate 120 mg q i d, tetracycline 500 mg q i d and metronidazole 250 mg q i d for 14 days) did not show significant changes in gastric emptying time (before: 171.14 +/- 128.13; after: 158.57 +/- 182.49 minutes) but showed improvement in total symptoms scores (before: 9.28 +/- 3.85; after: 3.85 +/- 4.22) (p = 0.0277).

CONCLUSIONS

infection by H. pylori in patients with non-ulcer dyspepsia did not influence solid phase of gastric emptying time and was not associated with clinical symptoms. Eradication of H. pylori infection relieved the clinical symptoms of the patients with non-ulcer dyspepsia.(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term follow-up and serological study after triple therapy of Helicobacter pylori-associated duodenal ulcer

OBJECTIVE

The purpose of this study was to monitor the change of IgG antibodies to Helicobacter pylori during the course of a long-term follow-up after the eradication of H. pylori, as well as to evaluate the efficacy of triple therapy in preventing the recurrence of duodenal ulcer (DU).

METHODS

Twenty-three DU patients with positive H. pylori were studied; among those patients, 20 ulcers healed after initial treatment of triple therapy. Each patient received a follow-up endoscopy and biopsy examination every 3 months for 1 yr, or whenever the ulcer symptoms recurred. Serological tests for IgG antibodies were performed with a commercial ELISA.

RESULTS

Of the 20 patients with healed ulcers, one dropped out of this study; the recurrence rate of DU at 1 yr was 5% (1/19). There was no recurrence of ulcer in 17 H. pylori-negative patients and only one recurrence out of two H. pylori-positive patients. After the eradication of H. pylori, the seroconversion rates of IgG were 5%, 21%, 42%, 76%, and 94% at 0, 3, 6, 9, and 12 months, respectively. After 6 months, 95% (18/19) of the patients in which H. pylori was eradicated had at least a one-grade fall in IgG titers (p < 0.001). One patient had a relapse of H. pylori which was accompanied with re-elevating IgG titers.

CONCLUSIONS

We conclude that seroconversion, which usually occurs after 1 yr, indicates complete eradication of H. pylori. Furthermore, we suggest that the success of the eradication of H. pylori can be judged without endoscopic examination, 8 months after treatment by triple therapy, according to the fall of IgG titers or seroconversion. Re-elevating IgG titers may be a warning of the possibility of relapse or reinfection of H. pylori.

Histiocytosis X involving thyroid gland: a case report

Diffuse histiocytosis X involving thyroid gland is rare. A 10-year-old boy with progressively enlarged neck mass, skin rash over scalp and face, splinter hemorrhage, otitis externa, episodes of pneumothorax and abnormal liver function was hospitalized. Thyroid scan showed a nonfunctioning mass in the right lobe of the thyroid and needle aspiration biopsy suspected histiocytosis X. Right thyroid lobectomy was performed and revealed histiocytosis X in light and electron microscopic examinations.

Hyperbaric oxygen therapy in hemorrhagic radiation cystitis: a report of 20 cases

Radiation cystitis with macroscopic hematuria has been a frustrating clinical problem for urologists. Since 1985 hyperbaric oxygen (HBO) has been used to treat this disease, showing favorable results. Between November 1989 and October 1992, 20 female patients with hemorrhagic radiation cystitis were treated with HBO at a pressure of 2.5 atm abs, breathing 100% O2 for 100 min in our multiplace hyperbaric chamber. After an average of 44 HBO sessions, macroscopic hematuria was completely halted in 16 patients (80%) and markedly decreased in 2 patients (10%). Comparison of the cystoscopic findings before and after HBO showed a significant decrease in hemorrhagic sites and telangiectasis of the bladder mucosa. One patient had urinary frequency and urgency without hematuria during her hospital stay. After 30 sessions of HBO therapy, her symptoms subsided, and the cystoscopic findings were much improved. Only one patient failed to respond to HBO and underwent ileal conduit diversion. The mean follow-up period was 14 mo. (5-41 mo.). From our clinical results and cystoscopic findings, we suggest that HBO is an effective and safe treatment for hemorrhagic radiation cystitis.