Early predicting recurrent cervical cancer with combination of tissue polypeptide specific antigen (TPS) and squamous cell carcinoma antigen (SCC)

The establishment of new tumor marker combinations including strong lead-time effects in detecting recurrent cervical cancer appears to be warranted. This retrospective study includes 50 patients with recurrent squamous cell cervical cancer after operation or radiotherapy. The serial serum levels of the tumor markers tissue polypeptide specific antigen (TPS) and squamous cell carcinoma antigen (SCC) were determined. Cutoff values of 78.5 U/L for TPS and 1.5 microg/L for SCC were selected according to the 95th percentile of serum concentrations measured in healthy control patients. Comparing with other monitoring modalities, SCC and TPS showed lead-time effective in 27 and 30 cases, respectively. This difference was not statistically significant. The combination of SCC and TPS provided lead-time effects in 42 cases. Our data indicate that combination of TPS and SCC is a valuable tool in the early predicting recurrent cervical cancer.

Impaired gallbladder function in spinal cord injury on quantitative Tc-99m DISIDA cholescintigraphy

BACKGROUND

Patients with spinal cord injury (SCI) have increased prevalences of gallstones and acute acalculous cholecystitis. A possible explanation for the increased prevalence of gallstone disease in SCI patients is decreased gallbladder motility causing gallbladder stasis, a known risk factor for gallstone disease. We investigated gallbladder function in SCI.

METHODS

Twenty-five normal control subjects and 50 SCI patients were included in this study. Gallbladder function was measured by technium 99m-labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy and represented by the filling fraction (FF) and the ejection fraction (EF). The SCI patients were assigned to subgroups: old versus young, female versus male, high- versus low-level injury, and long versus short injury duration.

RESULTS

Forty-two percent of SCI patients had abnormal FFs and 54% of SCI patients had abnormal EFs. Significantly decreased FF and EF values were found in SCI patients, especially in those who were female and had high-level injuries.

CONCLUSION

With the use of quantitative Tc-99m DISIDA cholescintigraphy, we found that SCI can significantly impair gallbladder function.

Left ventricular cavity-to-myocardium count ratio in exercise and resting technetium-99m-tetrofosmin SPECT: correlation with left ventricular function

The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio) calculated in exercise and resting technetium-99m (Tc-99m) tetrofosmin single photon emission computed tomography (SPECT) images to identify patients with depressed exercise and resting left ventricular ejection fraction (LVEF). We studied 60 patients with recent coronary artery diseases (CAD) undergoing first-pass ventriculography to calculate LVEF and myocardial perfusion SPECT imaging to calculate left ventricular C/M ratios. The group A of 30 CAD patients with higher LVEF (> or = 40%) had significant higher C/M ratios than the group B of 30 CAD patients with abnormal LVEF (< 40%) during exercise and rest. However, C/M ratios between exercise and rest did not differ significantly in the both groups A and B. There is significant correlation between exercise/rest LVEF and exercise/rest C/M ratios. Tc-99m tetrofosmin C/M ratios calculated SPECT perfusion images are useful parameters in identifying patients with depressed LVEF in CAD patients.

Isolation and identification of a novel satellite DNA family highly conserved in several Cervidae species

In an attempt to amplify cervid satellite II DNA from the genomes of Indian muntjac and Chinese muntjac, a pair of primers derived from the white tailed deer satellite II DNA clone (OvDII) yielded a prominent approximately 1 kb polymerase chain reaction (PCR) product (in addition to the expected 0.7 kb satellite II DNA fragments) in both species. The approximately 1 kb products were cloned, sequenced, and analyzed by Southern blotting and fluorescence in situ hybridization (FISH). This revealed that the approximately 1 kb cloned sequences indeed represent a previously unknown cervid satellite DNA family, which is now designated as cervid satellite IV DNA. Approximately 1 kb PCR clones were also obtained from the genomes of the black tailed deer and Canadian woodland caribou with similar primer pairs. Extremely high sequence conservation (over 90% homology) was observed among the clones generated from all four deer species and PCR-Southern hybridization experiments further verified the co-amplification of two kinds of satellite DNA sequences with the same pair of primers. This satellite DNA was found to co-localize with centromeric proteins at the kinetochore by a simultaneous FISH and immunofluorescence study. Due to its high sequence conservation and close association with kinetochores, the newly identified satellite DNA may have a functional centromeric role.

Comparing whole body 18F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphate bone scan to detect bone metastases in patients with renal cell carcinomas - a preliminary report

PURPOSE

Conventional technetium-99m methylene diphosphate whole body bone scan (bone scan) has a high sensitivity but a poor specificity to detect bone metastases. However, positron emission tomography with 18F-2-deoxyglucose (FDG-PET) can offer superior spatial resolution and improved specificity. We have attempted to evaluate the usefulness of FDG-PET for detecting bone metastases in renal cell carcinomas (RCC) and to compare FDG-PET results with bone scan findings.

METHODS

Eighteen patients were selected for this study with biopsy-proven RCC. They were suspected of having bone metastases and were undergoing bone scan and FDG-PET to detect bone metastases. The final diagnoses of bone metastases were established by operative, histopathological findings or clinical follow-up longer than 1 year by additional radiographs or following FDG-PET/bone scan findings showing progressive and extensive widespread bone lesions.

RESULTS

A total of 52 bone lesions including 40 metastatic and 12 benign bone lesions found on either FDG-PET or bone scan were evaluated. FDG-PET could accurately diagnose all 40 metastatic and 12 benign bone lesions. Bone scan could accurately diagnose only 31 metastatic bone lesions. Diagnostic sensitivity and accuracy of FDG-PET were 100% and 100%, respectively,and bone scan were 77.5% and 59.6%, respectively.

CONCLUSIONS

Our data suggest that FDG-PET has a higher sensitivity and a better accuracy than that of bone scan to detect bone metastases in patients with RCC.

Approaching healthy body mass index norms for children and adolescents from health-related physical fitness

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.

Effects of buyang huanwu decoction on peripheral nerve regeneration using silicone rubber chambers

This study investigated the effect of buyang huanwu decoction on the regeneration of a 10-mm gap of rat sciatic nerve created between the proximal and distal nerve stumps, which were sutured into silicone rubber tubes. Empty silicone rubber tubes with no further treatment were used as controls. Six weeks after implantation, 89% of the animals orally administered the buyang huanwu decoction exhibited regeneration across the nerve gaps, whereas only 70% had regenerated in the control group. Both qualitative and quantitative histology of the regenerated nerves revealed a more mature ultrastructural organization with significantly higher numbers of myelinated axons, larger endoneurial areas, higher axon densities and a larger percentage of axon area per total nerve area in the buyang huanwu group than in the controls. These results showed that the buyang huanwu decoction had a growth-promoting effect on the regenerated nerves.

Effect of acupuncture stimulation on peripheral nerve regeneration using silicone rubber chambers

The purpose of this study was to determine whether acupuncture could affect the regeneration of a 10-mm gap of rat sciatic nerve created between the proximal and distal nerve stumps, which were sutured into silicone rubber tubes. Empty silicone rubber tubes with no further treatment were used as controls. Six weeks after implantation, the animals received the acupuncture or the electroneedling treatment exhibited a more mature ultrastructural nerve organization with significantly higher numbers in the axon density, the blood vessel area, and the percentage of blood vessel area occupied in total nerve area than the controls. In addition, the electroneedling could combine both the needling and the electrical stimulation to potentiate the nerve-growth promoting effect of the acupuncture treatment. These results showed that acupuncture treatment could elicit positive effects on regenerated peripheral nerves.

Bloodletting acupuncture of the engorged vein around Bl-40 (Wei-Chung) for acute lumbar sprain

Bloodletting acupuncture is one of the most classic methods of acupuncture therapy, and is still popularly used to treat acute lumbar sprain in the oriental world. However, most physicians in the western world are not familiar with bloodletting acupuncture, though they may know ordinary acupuncture well. Furthermore based on the literature reviewed, there have been few studies which have investigated the effect of bloodletting acupuncture upon acute lumbar sprain. In this study, we tried to determine if bloodletting acupuncture is effective for acute lumbar sprain. In total, twelve patients were enrolled for analysis. Five patients were treated with ordinary acupuncture upon the contralateral SI-3 (Hou-Hsi) point alone. Seven patients were first treated with bloodletting acupuncture to the engorged vein around the ipisilateral Bl-40 (Wei-Chung), and then followed by ordinary acupuncture upon the contralateral SI-3. It was demonstrated that bloodletting acupuncture to the engorged vein around the ipisilateral Bl-40 followed by ordinary acupuncture upon the contralateral SI-3 had more pain relief than ordinary acupuncture upon the contralateral SI-3 alone (83 +/- 23% vs. 44 +/- 28%) (P < 0.01). And bloodletting acupuncture to the engorged vein around the ipisilateral Bl-40 decreased pain by 56 +/- 23%, similar to that of ordinary acupuncture upon the contralateral SI-3 alone (44 +/- 28%). These findings suggest that bloodletting acupuncture to the engorged vein around the ipisilateral Bl-40 (Wei-Chung) has a substantial contribution for treatment of acute lumbar sprain.

Antiviral activity of Plantago major extracts and related compounds in vitro

Plantago major L., a popular traditional Chinese medicine, has long been used for treating various diseases varying from cold to viral hepatitis. The aim of present study was to examine the antiviral activity of aqueous extract and pure compounds of P. major. Studies were conducted on a series of viruses, namely herpesviruses (HSV-1, HSV-2) and adenoviruses (ADV-3, ADV-8, ADV-11). The antiviral activity of EC50 was defined as the concentration achieved 50% cyto-protection against virus infection and the selectivity index (SI) was determined by the ratio of CC50 (concentration of 50% cellular cytotoxicity) to EC50. Results showed that aqueous extract of P. major possessed only a slight anti-herpes virus activity. In contrast, certain pure compounds belonging to the five different classes of chemicals found in extracts of this plant exhibited potent antiviral activity. Among them, caffeic acid exhibited the strongest activity against HSV-1 (EC50=15.3 microg/ml, SI=671), HSV-2 (EC50=87.3 microg/ml, SI=118) and ADV-3 (EC50=14.2 microg/ml, SI=727), whereas chlorogenic acid possessed the strongest anti-ADV-11 (EC50=13.3 microg/ml, SI=301) activity. The present study concludes that pure compounds of P. major, which possess antiviral activities are mainly derived from the phenolic compounds, especially caffeic acid. Its mode of action against HSV-2 and ADV-3 was found to be at multiplication stages (postinfection of HSV-1: 0-12 h; ADV-3: 0-2 h), and with SI values greater than 400, suggesting the potential use of this compound for treatment of the infection by these two viruses.

Comparing whole body (18)F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphonate bone scan to detect bone metastases in patients with breast cancer

PURPOSE

At present, bone metastases are usually assessed using conventional technetium-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with (18)F-2-deoxyglucose (FDG-PET) can offer superior spatial resolution and improved specificity. We attempted to evaluate the usefulness of FDG-PET for detecting bone metastases in breast cancer and to compare FDG-PET results with bone scan findings.

PATIENTS

The study group comprised 48 patients with biopsy-proven breast cancer and suspected of having bone metastases who underwent bone scan and FDG-PET to detect the bone metastases. The final diagnosis of bone metastases was established by operative, histopathological findings or during a clinical follow-up longer than 1 year by additional radiographs or following FDG-PET/bone scan findings showing progressive widespread bone lesions.

RESULTS

A total of 127 bone lesions including 105 metastatic and 22 benign bone lesions found by either FDG-PET or bone scan were evaluated. Using FDG-PET, 100 metastatic and 20 benign bone lesions were accurately diagnosed, and using bone scan 98 metastatic and 2 benign bone lesions were accurately diagnosed. The diagnostic sensitivity and accuracy of FDG-PET were 95.2% and 94.5%, and of bone scan were 93.3% and 78.7%, respectively.

CONCLUSIONS

Our findings suggest that FDG-PET shows a similar sensitivity and a better accuracy than bone scan for detecting bone metastases in patients with breast cancer.

Is intrapartum vibroacoustic stimulation an effective predictor of fetal acidosis?

OBJECTIVE

The hypothesis of this prospective study is that intrapartum vibroacoustic stimulation (VAS) is an effective predictor of fetal acidosis during labor. Various clinical conditions, such as term versus preterm gestation, first stage versus second stage of labor, and fetal heart rate (FHR) variable decelerations versus late decelerations will be tested.

METHODS

During the study period, 113 patients were studied prospectively in either active phase of first stage (n = 53) or during the second stage of labor (n = 60). They were selected from cases exhibiting moderate to severe FHR variable decelerations or late decelerations. The fetuses of study subjects received a VAS for three seconds and FHR changes were recorded. Fetal scalp blood pH or umbilical arterial blood pH was obtained within 15 minutes of VAS. The relationship between FHR responses to VAS and fetal blood pH in term and preterm gestations, the relationship of two tests (VAS and fetal blood pH) to type of FHR decelerations, and the predictability of neonatal morbidity by two tests were analyzed. Where appropriate, Fisher's exact test (p < 0.05 was considered statistically different) and the odd ratio with 95% confidence intervals were used for statistical analyses.

RESULTS

Excellent association between acceleration response to VAS and pH > or = 7.20, and between a negative response to VAS (no acceleration or decelerations) and pH < 7.20 were found in the first stage of labor, the second stage of labor, and the combination of both stages together (p = 0.0001, OR = 10.6 [3.3-34.0]). It was observed that negative VAS responses for predicting fetal acidosis (pH < 7.20) were comparable between term (> or = 37 weeks) and preterm (< 37 weeks, > or = 34 weeks) fetuses. Since the preterm fetuses enrolled in the study were limited in number, it is difficult to draw adequate conclusions. The positive predictive value (PPV) of fetal acidosis was 67% in both groups of FHR variable decelerations and late decelerations, but the false negative rate of acceleration VAS response for predicting no acidosis was significantly higher in the group of late decelerations (29% vs 8%, p = 0.034). Finally, both a negative VAS response and fetal acidosis (pH < 7.20) have equal predictability for neonatal morbidity. The PPV of NICU admission by a negative VAS response was two times higher than that of fetal acidosis (PPV = 61% vs 29%, p = 0.038).

CONCLUSION

We found that intrapartum VAS was an effective predictor of fetal acidosis in cases of FHR variable decelerations, but its predictability for fetal acidosis in cases of FHR late decelerations was limited. Both VAS and fetal blood pH are good predictors of neonatal morbidity.

Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro-2-deoxyglucose in patients with indeterminate magnetic resonance imaging findings after radiotherapy

PURPOSE

The aim of this study was to evaluate the effectiveness of positron emission tomography (PET) using 18-fluoro-2-deoxyglucose (FDG) to detect recurrent nasopharyngeal carcinomas (NPC) when magnetic resonance imaging (MRI) findings are indeterminate.

PATIENTS AND METHODS

After radiotherapy, 28 NPC patients with indeterminate MRI findings were included. MRI, FDG-PET, and biopsy were performed at least 4 months after radiotherapy and within 1 week. The final results were based on histopathologic findings and a clinical follow-up of at least 6 months.

RESULTS

For detecting recurrent NPC in indeterminate MRI findings, the sensitivity, specificity and accuracy of FDG-PET were 100.0%, 92.9% and 96.4%, respectively.

CONCLUSIONS

Based on these results, we can recommend FDG-PET for detecting recurrent NPC when MRI findings are indeterminate.

Development of a method for the determination of pyrimethamine concentrations in feeds by ion-pairing high-performance liquid chromatography

An ion-pairing reversed-phase high-performance liquid chromatography (HPLC) method with diode array detection at 280 nm was developed to determine pyrimethamine concentrations in feed for laying hens. Pyrimethamine was extracted with a mixture of 5% isobutanol and 95% benzene, and the extract was cleaned up on an alumina column. The drug was eluted from an Intersil ODS-3V column (250 by 4.6 mm) with a mixture of 25% acetonitrile and 75% water (vol/vol) containing 0.01 M tetramethylammonium chloride as an ion-pairing agent and adjusted with acetic acid to pH 3.5. The flow rate was 1.0 ml/min. Mean recovery of pyrimethamine from supplemented feeds at concentrations of 2, 4, and 5 microg/g of feed were 100.5, 103.5, and 100.8%, respectively. Precision within a day ranged from 4.3 to 7.0% for the three concentrations, and day-to-day precision was 5.3% for feed supplemented at a concentration of 4 microg/g. No chromatographic interference was detected from other 2,4-diaminopyrimidine compounds or other major drugs used in poultry.

Leukopenia and thrombocytopenia in hemodialysis patients with hepatitis B or C virus infection and non-hemodialysis patients with hepatitis cirrhosis

AIMS

To investigate the relation of leukopenia and thrombocytopenia in hemodialysis (HD) patients with hepatitis C virus (HCV) infection.

MATERIALS AND METHODS

The study included 86 HD patients with hepatitis B surface antigen-negative and hepatitis C antibody-negative, 28 HD patients with hepatitis C antibody-positive, 22 HD patients with hepatitis B surface antigen-positive, 78 non-HD patients with hepatitis B-induced liver cirrhosis and 38 non-hemodialysis patients with hepatitis C-induced liver cirrhosis. The following parameters were checked: anti-HCV, hepatitis B surface antigen, hemoglobin, hematocrit, white blood cells, platelets, calcium, phosphate, iron, ferritin, albumin, globulin, aspartate transaminase (AST), alanine transaminase (ALT) and C-reactive protein. The history of blood transfusions, medications, erythropoietin doses and adequate dialysis (KTNV) for 6 consecutive months was also recorded from charts.

RESULTS

The HD patients with positive serum anti-HCV and non-HD patients with hepatitis B- or C-induced liver cirrhosis had higher prevalences of leukopenia (39.3%, 43.6% and 50% vs. 15.1%; p < 0.001) and thrombocytopenia (67.9%, 89.7% and 81.6% vs. 34.9%: p < 0.001) than HD patients with serum anti-HCV(-)HbsAg(-). The WBC (4,432 +/- 1,394, 4,792 +/- 2,263 and 4,624 2,446 vs. 5,590 +/- 1,500/mm3; p < 0.001) and platelet counts (140 +/- 45, 80 +/- 50 and 89 +/- 65 vs. 186 +/- 62 x 10(3)/mm3; p < 0.001) of HD patients with positive serum anti-HCV and non-HD patients with hepatitis B- or C-induced cirrhosis were also lower than HD patients without anti-HCV antibody. The liver cirrhosis patients had more thrombocytopenia than the HD patients with anti-HCV(+). The WBC and platelet counts did not vary between HD patients with HbsAg(+) and HD patients with anti-HCV(-)HBsAg(-). The durations of HD, hepatitis and liver cirrhosis were not related to the leukopenia or thrombocytopenia (p > 0.05).

CONCLUSIONS

HCV infection associated with leukopenia and/or thrombocytopenia in HD patients is as common as in non-HD patients with liver cirrhosis. This may be due to the direct effect of hemopoiesis rather than the hyperspleenism of liver cirrhosis patients. There is a need for further prospective investigation to ascertain the clinical significance of leukopenia and thrombocytopenia in HD patients with anti-HCV(+). The prevalence of leukopenia and thrombocytopenia was higher in HD patients with hepatitis C than in HD patients with hepatitis B and HD patient without hepatitis.

Kuntz's fiber: the scapegoat of surgical failure in sympathetic surgery

Resection of Kuntz's fiber is considered a guarantee to treat Hyperhidrosis in sympathetic surgery. The incidence of Kuntz's fiber is about 60.0% in clinical studies while the surgical failure rate is about 1.5% when Kuntz's fiber is preserved on Endoscopic Thoracic Sympathetic Block by clamping, which is performed by clamping the upper and lower end of ganglion. We found that supererogatory resection of Kuntz's fiber is inessential; clamping of upper and lower ends of the ganglia should be a complete procedure in sympathetic surgery. Kuntz's fiber plays only anatomic, and no clinical role in surgical failure of sympathetic surgery.

Lin-Telaranta classification: the importance of different procedures for different indications in sympathetic surgery

BACKGROUND AND AIMS

The second sympathetic thoracic ganglion has long been regarded as the most important structure in all sympathetic procedures for any indication, be it hand sweating, blushing, or social phobia. Earlier, we had found an interesting new basis for the selection of more specific methods in individual disorders. The aim of the present study was to either confirm the old theory or to bring forward a more appropriate theory for sympathetic surgery to be used as a classified method.

MATERIAL AND METHODS

Altogether 193 patients were treated in Taiwan and 55 in Finland according to the new selective principle. Endoscopic sympathetic block of the second thoracic ganglion (ESB 2) was used as a method for conflicted type of social phobia or blushing for 25 patients. ESB 3 was used for facial sweating and blushing for 55 patients. ESB 4 was used for hand and axillary sweating for 168 patients. Reflex sweating was taken as the most important sign of unsuccessful surgery.

RESULTS

All patients benefited of the procedure in their presenting symptoms. Four of 25 cases in ESB 2 -group and three of 55 cases in ESB 3 -group had unacceptable reflex sweating. No patient with reflex sweating was found in ESB 4 -group. These results confirm our previous findings, that sympathetic nerves innervate the human body in similar dermatome fashion as the peripheral nervous system. According to this, we organized the various sympathetic disorders into three main categories: those restricted within the head, like conflicted type social phobia and conflicted type blushing, to Group 1; those on the head and face, like sweating with or without blushing, to Group 2; and those in the hands and underarms to Group 3. The principle of different surgical procedures for different disorders of the sympathetic system are proposed: ESB 2 for Group 1, ESB 3 for Group 2, and ESB 4 for Group 3 disorders.

CONCLUSIONS

We call this new classification "Lin-Telaranta classification". Not only the incidence of complication rates is lowered but also the side effects can be predicted by the Lin-Telaranta classification in sympathetic surgery.

Endoscopic t4-sympathetic block by clamping (ESB4) in treatment of hyperhidrosis palmaris et axillaris--experiences of 165 cases

Prevention of postoperative complications becomes relatively important when surgical procedures are easy to learn and perform. Endoscopic Thoracic Sympathetic Surgery (ETS), which is now more accessible to surgeons after the 2nd International Symposium of Thoracic Sympathicotomy, would be the typical examples in surgery. Reflex sweating is one of the famous and annoying complications that surgeons endeavor to avoid but in vain in ETS. Incidentally, we found that preservation of sympathetic tone to the head is the main influential factor in avoiding reflex sweating in ETS; and with the lower sympathetic ganglion blocked, the more sympathetic tone to the head is preserved. T4-sympathetic block is an ideal procedure that can treat palmar and/or axillary hyperhidrosis and preserve most of sympathetic tone to head. We used T4-sympathetic block by clamping (ESB4) in treatment of 165 cases of Hyperhidrosis et axillaris and attained excellent operative results without reflex sweating from August 1, 2000 to February 28, 2001. We concluded, ESB4 is the method that can treat hand and axillary hyperhidrosis without inducing reflex sweating.

A survey on anesthesia for thoracoscopic sympathetic surgery in treatment of hyperhidrosis palmaris in Taiwan

Thoracoscopic approach to sympathetic surgery has gained its popularity and emerged as the main stream in the treatment of hyperhidrosis palmaris in Taiwan. Different kinds of anesthesia have been practiced and reported in these surgeries. We made a survey of anesthetic methods in twelve medical centers and regional hospitals of the island. It was found out that the choice of the anesthesia was mainly dependent on the mutual trust and the full communication between the anesthesiologist and the surgeon, both based on their skills and the operative methods chosen by the surgeon. Single-lumen endotracheal tube with general inhalation anesthesia is practiced in most of the hospitals surveyed. Sevoflurane and desflurane are the choices of the inhalational anesthetic agents. In short, the anesthesiologists tend to practice the type of anesthesia that is simple but safe enough to secure the airway of the patient throughout the thoracoscopic sympathetic surgery.

Antileukemic activity of Bidens pilosa L. var. minor (Blume) Sherff and Houttuynia cordata Thunb

To evaluate the anti-leukemic activity of Bidens pilosa L. var. minor (Blume) Sherff and Houttuynia cordata Thunb., cytotoxicity tests with an XTT-based colorimetric assay were used. Five leukemic cell lines, namely L1210, U937, K562, Raji and P3HR1, were cultured with hot water extracts of B. pilosa var. minor or H. cordata. Hot water extracts of B. pilosa var. minor inhibited these five leukemic cells with IC50s between 145 microg/ml and 586 microg/ml. The effect was greatest on four cell lines, namely L1210, P3MR1, Raji and K562, with IC50s below 200 microg/ml and a selective index of more than 5. Hot water extract of H. cordata inhibited these five leukemic cells with IC50s between 478 microg/ml and 662 microg/ml. The selective index was between 1.5 and 2.1. B. pilosa var. minor was more effective than H. cordata in inhibiting most of the leukemic cells in our study. We suggest that B. pilosa L. var. minor (Blume) Sherff may prove to be a useful medicinal plant for treating leukemia.

Anti-HBc IgG subclasses in different populations by comparing a variety of ELISA plates

The number of IgG subclasses for hepatitis B virus (HBV) core antigen (anti-HBc), demonstrated for HBV-infected individuals, was measured by enzyme-linked immunosorbent assay (ELISA). Four commercially available hepatitis B core antigen (HBcAg) plates and one prepared plate were tested for ELISA sensitivity by the detection of 14 serum samples drawn from HBV chronic carriers, cured patients, vaccinees, and non-infected individuals. Differences in optical density (OD) values were obtained by comparing data gathered from the five plate types, suggesting that different plates may have different binding capabilities for each anti-HBc IgG subclass and, thus, contribute to the different ELISA sensitivities. Of these plates, the GB plate showed the most obvious absorbance changes for anti-HBc subclasses in different populations. These data also indicated different patterns for IgG-specific subclasses for various populations. For HBsAg+ carriers, the OD for IgG1 was greater than for IgG3. By contrast, the OD for IgG3 was higher than that for IgG1 in those subjects who were negative for HBsAg.

Baicalein, a novel apoptotic agent for hepatoma cell lines: a potential medicine for hepatoma

This study has demonstrated that baicalein has anticancer effectiveness against human hepatoma cells. The dose response of baicalein in Hep G2 and Hep J2 cells indicates that baicalein decreased viability >90%. In comparison, baicalein had only minimal effects on the viability of control Chang liver cells. Flow cytometric analysis showed that baicalein inhibited the cell cycle of Hep G2 cells in the S phase. In addition, baicalein treatment resulted in a decreased mitochondrial transmembrane potential and damaged the integrity of the cell membrane. The TdT-mediated dUTP-biotin nick end labeling assay results indicated that baicalein elicited a significant increase of DNA fragmentation in Hep G2 cells after incubation for 48 hours. These results indicate that baicalein is an effective antihepatoma agent with minimal influence on noncancer cells. The effects of baicalein on Hep G2 cells include inhibition of the S phase of the cell cycle, dysfunction of mitochondria, and initiation of apoptosis.

Quantitative analysis of end-tidal carbon dioxide during mechanical and spontaneous ventilation in infants and young children

Capnography provides a substitute for monitoring of arterial carbon dioxide tension (PCO(2)). We performed a prospective study to evaluate a new application of capnography, using quantitative curve analysis in the pediatric ICU. Twenty-five infants and children admitted to the pediatric ICU after cardiovascular surgery for congenital heart diseases were included in the study. Capnographic curves were recorded during 3 phases of mechanical and spontaneous ventilation: phase 1, immediate postoperative period; phase 3, preextubation period; and phase 2, period between phases 1 and 3. Each recording included 17 sec of capnographic tracings from consecutive spontaneous and/or ventilator-driven breaths. Quantitative curve analysis was made to define parameters including peak value of exhaled PCO(2) (P), mean rate of rise of PCO(2) (R), and area under each capnographic curve (A). Qualitative inspection of the wave contour showed no obvious difference in phase 3 during spontaneous and mechanically assisted ventilator breaths. However, an obvious difference existed between spontaneous and mechanically assisted breaths in phase 2. For each parameter (P, R, and A), there was a significant difference in phases 2 and 3 from spontaneous breaths. However, there was no significant difference in phases 2 and 3 from ventilator-assisted breaths. We further calculated the ratio of parameters of spontaneous breaths (S) and ventilator-assisted breaths (V) in phase 2 and phase 3. The ratio of S/V for P, R, and A showed significant differences between phase 2 and phase 3. We conclude that quantitative analysis of exhaled end-tidal PCO(2) curves revealed significant changes of specific parameters during the transition from the ventilator-dependent state to the spontaneously breathing ventilator-independent state. This new approach provides a new way to estimate respiratory status in infants and children receiving ventilator therapy. Through quantitative capnographic curve analysis, if P, R, and A from spontaneous breaths approached those of ventilator-assisted breaths, patients have resumed reasonable pulmonary mechanics, and extubation may then be considered.