[Complications of transurethral resection of prostate]

A total of 342 benign prostatic hypertrophy patients were treated at the Department of Urology, Kaohsiung Medical College Hospital from January 1972 to December 1988. Median duration of operating time was 74.4 minutes, 67 patients (20%) required a blood transfusion and the mean volume of blood per patient transfused was 1019.4 ml. Median post-operative catheter management was 7 days and the median post-operative ward time was 8.6 days. Two patients (0.5%) had a bladder lesion with peritoneal perforation and required a secondary operation for bladder suture. Secondary hemorrhaging return for treatment of clotting was seen in 11 cases (3.2%). Stress incontinence was noted in 11 cases (3.2%). Anterior urethral stricture was noted in 9 cases (2.6%), impotence occurred in only one case (0.3%) and TUR syndrome in 2 (0.6%). There were two post-operative deaths, for a mortality rate of 0.6 percent. The causes of death were sepsis in one patient and acute renal failure in the other.

Penta-acetyl geniposide inhibits the growth and development of C-6 glioma cells in rats

Experimental data are provided which demonstrate the inhibitory effects of penta-acetyl geniposide, (Ac)5-GP, on the growth and development of C-6 glioma cells inoculated into rats. In the pretreatment experiments, (Ac)5-GP prolonged the latency period of T50 (time for 50% tumour incidence). At week 7, the growth inhibition was 41% with 5 mg/kg and 75% with 10 mg/kg of (Ac)5-GP. In the post-treatment experiments, growth inhibition was less. No significant hepatotoxic effects were observed in the treated group, indicated by the constant levels of serum enzymes (e.g. asparate aminotransferase). We suggest that (Ac)5-GP is a potent chemopreventive agent on glioma cells.

[Kimura's disease: a case report]

Kimura's disease is endemic in Orientals. The pathogenesis of Kimura's disease is currently unknown, and the methods of treatment are undefined. The patient was a 21-year-old male, suffering from neck mass left over the parotid region of which the mass gradually increased and which combined with lymphadenopathy and pruritus over both lower limbs more than two years. The patient was diagnosed with Kimura's disease by neck lymph node biopsy, then received simple excision of mass and oral prednisolone therapy. The symptoms of lymphadenopathy and pruritus were improved without recurrence of neck mass.

Haemotoxic effect of phenylurea herbicides in rats: role of haemoglobin-adduct formation in splenic toxicity

Three substituted phenylurea herbicides were used for the study of the haemotoxic effects on rats of chronic exposure to these compounds. Female Sprague-Dawley rats were given monuron, diuron or fenuron (250-1000 mg/kg diet) for 14 months. The final body weights were similar to those of controls. No treatment-related effects on organ weights were observed at autopsy, except for a dose-related increase in spleen weights in rats treated with monuron or diuron, but not in those treated with fenuron. The proportion of haemoglobin in the form of methaemoglobin increased in the dosed group and resulted in a secondary anaemia with changes in the morphology of erythrocytes. Haemoglobin adducts of aromatic amines released from the herbicides were present at dose-related levels in rats treated with monuron or diuron. Compound-related lesions were observed histologically in treated rats, with increased pigmentation (haemosiderin) in the spleen, reflecting the response to the haemolytic anaemia and methaemoglobinaemia induced by the herbicides. Pigment deposition consisting of golden brown granules in the cytoplasm of the tubular epithelium in the kidney and in the Kupffer cells in the liver were observed only in rats treated with monuron. The haemotoxic effects that were observed may indicate that the formation of adducts between haemoglobin and the parent aromatic amines released metabolically from these herbicides has a role in the splenic toxicity of these compounds.

Messenger RNA intron in the nuclear 18s ribosomal RNA gene of deuteromycetes

Introns within messenger RNA genes have characteristic border sequences and a conserved region near the 3' end of the intron. All are involved in splicing to produce the mature mRNA. Introns in ribosomal RNA genes have less well-defined borders and contain no internal conservation. We report here mRNA-type introns located near the 3' end of the 18s rRNA genes of the deuteromycetes Phialophora americana and Cenococcum geophilum. Inserted sequences of various sizes have also been located at the same point in several other deuteromycete species.

Trypanosomiasis of domestic animals in China

Trypanosomiasis caused by Trypanosoma evansi (surra) is a problem of great economic importance in livestock in China because it affects important working animals: buffaloes in the south and east, and horses and cattle in the north and west. In addition, buffaloes are an important source of meat and leather for the Chinese population. In the north and west, T. evansi is found mainly in camels, whereas in the east, the south and the southwest, it is primarily buffaloes, cattle and horses that are affected by this parasitic flagellate. Although trypanosomiasis is one of the most important parasitic diseases of domestic animals in China, little information on this disease has been published. In this article Zhao-Rong Lun, Yuang Fang, Chang-Ji Wang and Reto Brun evaluate trypanosomiasis of domestic animals in China and review epidemiological studies of the past 40 years.

Overexpression and amplification of c-myc and c-Ha-ras oncogenes in pleomorphic salivary adenoma

Twenty-seven samples of pleomorphic salivary adenoma (PSA) were examined for expression and structure of c-myc, c-Ha-ras, c-erbB-2, c-sis oncogenes by RNA dot blot, DNA dot blot and Southern blot hybridization. Eighteen of 25 PSA showed 5.02 +/- 4.74 fold overexpression of c-myc oncogene, 6 of 19 PSA had 4.91 +/- 3.87 fold overexpression of c-Ha-ras oncogene. Two of 16 PSA were found to have overexpression of c-erbB-2 oncogene. In addition, 7 of 10 PSA and 1 of 9 PSA were detected to have c-myc and c-erbB-2 oncogene amplification respectively. However, no rearrangement, amplification or overexpression of c-sis gene was found. We also discussed various clinicopathological parameters of PSA, which however, had no significant correlation with expression of c-myc or c-Ha-ras oncogene. Our results indicate that activation of c-myc, c-Ha-ras and their combination may play an important role in the pathogenesis of PSA.

Penile blood flow study in diabetic impotence

Seventy-eight male diabetics with sexual dysfunction were evaluated by a thorough history, general physical, psychological, neurological and urological examinations, routine laboratory tests, and a duplex ultrasound scan with intracavernous injection of prostaglandin E1 (PGE1). The mean patient age was 55.9 years, and the average onset of sexual dysfunction was 10.0 years after the diagnosis of diabetes. Sixty-eight patients (87.2%) had moderate or severe cavernous arterial insufficiency. Older patients and those having a longer duration of diabetes had a higher incidence of cavernous arterial insufficiency. Cigarette smoking, hypertension, and alcohol abuse were also related to cavernous arterial insufficiency. There was no significant difference in cavernous arterial insufficiency between the insulin-dependent and the insulin-nondependent groups. There were significant differences of diameters and peak blood flow velocities of cavernous arteries between 78 diabetic impotent patients and 10 controls. These findings strongly suggest that the cavernous arterial insufficiency is closely related to the diabetic impotence. In addition, the prevalence of cavernous arterial insufficiency increases with age, duration of diabetes, cigarette smoking, hypertension and alcohol abuse, but it is not definitely correlated with the type of diabetes management.

A comparative study with intracavernous injection of prostaglandin E1 versus papaverine for the diagnostic assessment of erectile impotence

The intracavernous injection of vasoactive drugs is a valuable diagnostic aid and an important tool for the treatment of erectile failure. A comparative study with intracavernous injection of prostaglandin E1 (PGE1) and papaverine was performed in 60 patients with impotence. We evaluated the efficiency and side effects of both agents. The overall positive response rate was 85.0% in the PGE1 group and 65.0% in the papaverine group which suggests PGE1 has a stronger vascular effect. The mean onset of maximal erection was after 9.6 minutes in the PGE1 group and after 6.5 minutes in the papaverine group. The mean maintenance of erection was for 53.2 minutes in the PGE1 group and for 38.6 minutes in the papaverine group. There were no systemic side effects of either agent. Three instances of injection pain and 2 of burning sensation in the penis were noted in the PGE1 group, while in the papaverine group, there were 21 reports of injection pain, 4 of prolonged erection and 2 of burning sensation in the penis. These results suggest that PGE1 is a more desirable vasoactive alternative for the diagnosis of impotence.

Occurrence of nasopharyngeal carcinoma in aboriginals of Taiwan: report of 14 cases

The authors describe the rare occurrence of nasopharyngeal carcinoma (NPC) in 14 aboriginals of Taiwan (ABT), a minor ethnic group now accounting for less than 2% of the total population in Taiwan. The observation is epidemiologically unusual, representing a low-risk ethnic group in an NPC prevalent area. With regard to patient characteristics, symptomatology and pathology, we have not found any appreciable differences in reports from other geographic areas. Serological profiles of antiEBV-VCA (Epstein-Barr virus, viral capsid antigen) antibody in 7/9 patients available for review of IgA and 5/7 patients available for review of IgG were found significantly elevated, ranging respectively from 1:40-640/1:160-1280. Interestingly, 12 of the 14 patients were found to be exclusively from the Paiwan tribe residing in Pintung, a district in southern Taiwan. Since the exact prevalence of NPC in this minority remains unknown, it is not clear whether the apparent preponderance is real or merely causal due in part to geographic bias. To a lesser extent, however, our observations indicate that NPC is not an uncommon malignancy in Paiwan aboriginals of southern Taiwan.

Inhibitory effect of geniposide on aflatoxin B1-induced DNA repair synthesis in primary cultured rat hepatocytes

We have previously demonstrated that geniposide (GP) inhibits the aflatoxin B1 (AFB1) induced-hepatotoxicity and hepatic DNA binding in rats. To address the mechanism of action, the effects of GP on AFB1-induced DNA repair synthesis and AFB1 biotransformation in cultured rat hepatocytes were investigated. By evaluation of unscheduled DNA synthesis (UDS), GP reduced AFB1-induced DNA repair synthesis in a dose-dependent manner in hepatocyte cultures. GP elevates the metabolism of AFB1 and decreases the formation of AFM1. The enzyme activities of glutathione S-transferase (GST) and GSH-peroxidase (GSH-Px) in AFB1-treated hepatocyte cultures are enhanced in the presence of GP. GP reduces AFB1-induced DNA repair synthesis through an increased AFB1 detoxication metabolism. It provides one possible mechanism for the chemopreventive activity of GP.

Pituitary oncocytoma: three cases report

Three out of 102 pituitary adenoma patients, including 2 males and one female, had their pituitary tumors diagnosed as "oncocytomas" and underwent transsphenoidal adenomectomy. The tumors were confirmed as "pituitary oncocytomas" by both immunohistochemical staining and electron microscopy. They had poorly developed subcellular organelles and were markedly hyperplastic and pleomorphic, with swollen mitochondria in the cytoplasm and scattered secretory granules along the cell membranes. Postoperative follow-up revealed that visual acuity gradually improved in all the patients, and no tumor recurrence was found. The accurate preoperative diagnosis of pituitary oncocytomas relies on endocrinological, neuroradiological clinical evaluation, and the management of this disease must be surgery with postoperative radiotherapy.

Secular trend and associated factors of twinning in Taiwan

Delivery records of public hospitals and local health centers were analyzed to investigate the secular trend of multiple births from 1955 to 1990 in Taiwan. Twinning rates decreased gradually from the late 1950s to 1973, slightly increased and remained stable from 1974 to 1980, and then increased strikingly from 1981 to 1990. During the study period, MZ rates were consistently higher than DZ rates except in 1986 when a higher DZ rate was observed. The highest MZ rate of 7.7 per 1,000 deliveries was observed in 1985, while the highest DZ rate of 4.6 per 1,000 deliveries was observed in 1986. The triplet incidence rate also declined from the early 1960s to 1973 and then increased markedly from 1974 to 1990. A case-control study including 482 MZ and 252 DZ twin pairs and 1,496 singletons was carried out in four teaching hospitals in Taipei City between October 1985 and June 1989 to examine factors related to twinning. The zygosity of twin pairs was determined by sex, placentation and red blood cell antigens. Multiple logistic regression analysis showed that the higher the maternal age, the lower the MZ and DZ rates, while the higher the parity, the higher the rates. There was no association of paternal age or of maternal educational level with twinning rates.

A competitive enzyme immunoassay for the direct determination of mometasone furoate (SCH 32088) in human plasma

Mometasone furoate (SCH 32088) is a synthetic corticosteroid which has a topical anti-inflammatory activity with a minimal potential for suppressing hypothalamic-pituitary-adrenocortical (HPA) axis. A sensitive competitive enzyme immunoassay (EIA) for measuring SCH 32088 in unextracted human plasma has been developed. The 3-(O-carboxymethyl)oxime (CMO) of SCH 32088 was synthesized and conjugated with bovine thyroglobulin, and the product was used for the production of antibodies in rabbits. SCH 32088-3-CMO was also conjugated with horseradish peroxidase, which was used as the tracer. The EIA thus developed can detect 1 pg SCH 32088 per assay or 25 pg per ml of human plasma. It can reliably quantitate SCH 32088 in human plasma from 50 pg ml-1 to 2.5 ng ml-1 with good linearity, accuracy and precision. The assay can be extended to measure SCH 32088 in plasma of laboratory animals. The availability of this sensitive assay makes it possible to evaluate the pharmacokinetics and toxicokinetics of SCH 32088 in laboratory animals and man.

Perinatal mortality and prevalence of major congenital malformations of twins in Taipei city

In order to examine perinatal mortality and prevalence of major congenital malformations in twins, deliveries in four teaching hospitals in Taipei City were studied. Among a total of 73,264 deliveries from October 1985 to June 1989, there were 844 pairs of twins. The zygosity of the twin pairs was determined by sex, placentation and 12 red blood cell antigens. There were 482 MZ and 252 DZ twin pairs identified, but the zygosity of a further 110 twin pairs was indeterminable due to lack of information on plancentation and/or blood types. A total of 4,573 singletons delivered in one study hospital from July 1986 to June 1987 were also studied as controls. The perinatal mortality rate was 7.5% for MZ twins, 1.4% for DZ twins, and 0.7% for singletons. The concordance rate of perinatal death was significantly higher in MZ (60%) than in DZ (0%) twins. The prevalence of major congenital malformations was 2.7% for MZ twins, 1.0% for DZ twins, and 0.6% for singletons. The concordance rate of major congenital malformations was 18% for MZ twins, but no DZ pair was concordant in any major congenital malformation. The concordance rate of facial clefts was 29% for MZ twins. There were 2 sets of conjoined twins giving a prevalence rate of 2.7 per 100,000 deliveries. These findings showing the prevalence of perinatal mortality and major congenital malformation to be highest in MZ twins, intermediate in DZ twins and lowest in singletons, suggest the importance of intrauterine environments in the determination of perinatal mortality and congenital malformations.

Effects of cement, cement space, marginal design, seating aid materials, and seating force on crown cementation

An evaluation of the effects of a die spacer, the seating force, the marginal design, seating aid materials, and the cement type during cementation was conducted. Two stainless steel dies were used: one with a 1 mm shoulder and the other with a shoulder and a 65-degree bevel. Ten stone dies were produced from each metal die and half were painted with four layers of die spacer. The crowns were waxed on the dies and cast in a nonprecious alloy, and the seating of crowns was measured with a micrometer before and after cementation. Comparisons were made between zinc phosphate and glass ionomer cements under two seating forces of 5 and 30 lb using an orangewood stick or E-Z-bite seating aid. ANOVA and the Newman-Keuls test revealed that the use of a die spacer, a heavier force of 30 lb, and glass ionomer cement significantly improved crown seating. The beveled preparation led to superior crown seating when the heavier force or glass ionomer cement was used. The orangewood stick and bite device had a similar effect on crown seating.

Functional study of hepatitis delta virus large antigen in packaging and replication inhibition: role of the amino-terminal leucine zipper

The large hepatitis delta antigen (HDAg) has been found to be essential for the assembly of the hepatitis delta virion. Furthermore, in a cotransfection experiment, the large HDAg itself, without the hepatitis delta virus (HDV) genome and small HDAg, could be packaged into hepatitis B surface antigen (HBsAg) particles. By deletion analysis, it was shown that the amino-terminal leucine zipper domain was dispensable for packaging. The large HDAg could also help in copackaging of the small HDAg into HBsAg particles without the need for HDV RNA. This process was probably mediated through direct interaction of the two HDAgs as a mutated large HDAg whose leucine zipper domain was deleted such that it could not help in copackaging of the small HDAg. This mutated large HDAg did not suppress HDV replication, suggesting that this effect is probably also via protein interaction. These results indicated that functional domains of the large HDAg responsible for packaging with HBsAg particles and for the trans-negative effect on HDV replication can be separated.

Penta-acetyl geniposide: isolation, identification and primary effect on C6 glioma cells in vitro

A new compound, penta-acetyl geniposide [(Ac)5-GP], was obtained from modified extract of Gardenia Fructus (San-jee-chee in Chinese). Spectral studies including ultraviolet (UV), mass (MS), nuclear magnetic resonance (NMR), infrared (IR) and elemental analysis (EA) have suggested the chemical structure of the compound as 1-(beta-D-2',3',4',6'-tetraacetyl- glucopyranosyloxy)-1,4a,5,7a-tetrahydro-7-(acetomethyl)-c yclopentapyran-4-carboxylic acid methyl ester. The antitumor bioactivity of (Ac)5-GP in vitro was studied. It exhibited the activities of reduced plating efficiency and inhibition of DNA synthesis in cultured C-6 glioma cells, but had little effect on RNA and protein synthesis. These results implied that the acetylated iridoid glycoside of Gardenia Fructus is biologically active as an antitumor agent against C-6 glioma cells in culture.

Inhibition of penta-acetyl geniposide on AFB1-induced genotoxicity in C3H10T1/2 cells

A new compound, penta-acetyl geniposide ((Ac)5-GP), was obtained from modified extract of Gardenia fructus (San-Jee-Chee in Chinese). The structure of the compound was identified as 1-(beta-D-2',3',4',6'-tetraacetyl-glucopyrannosyloxyl)-1,4a, 5,7a-tetrahydro-7-(acetomethyl)-cyclopentapyran-4-carboxylic acid methyl ester, according to the spectral data. The inhibitory effects of (Ac)5-GP on aflatoxin B1 (AFB1)-induced cytotoxicity and DNA damage were studied. In the investigation of the inhibitory effect of (Ac)5-GP on AFB1-cytotoxicity, the plating efficiency of C3H10T1/2 cells in S-9 activation system was increased. In addition, (Ac)5-GP inhibited the DNA damage of AFB1-treated C3H10T1/2 cells, and it interfered with the inhibitory effect of DNA synthesis caused by AFB1. These results suggest that the reduced DNA damage and the increased DNA synthesis from cultured C3H10T1/2 cells are important mechanisms for the inhibition of AFB1-cytotoxicity by (Ac)5-GP.

Study of the changes in collagen of the tunica albuginea in venogenic impotence and Peyronie's disease

We identified the collagen type and content of the tunica albuginea in Peyronie's disease and venogenic impotence compared with the tunica albuginea from the donor of the renal transplant and patients with penile injury. Type III collagen was detected obviously in Peyronie's plaque and was also present in venogenic impotence. It can be hardly found in normal controls. The ratios of type III to type I collagen were significantly higher in Peyronie's plaque while there was a moderate increase in venogenic impotence. The scarcity of type V collagen was noted in human tunica albuginea. The decreased percentage of glycine and alanine in Peyronie's disease and venogenic impotence implied the abnormal composition of collagen or presence of noncollagen protein. The results suggest the biochemical aberration of the tunica albuginea might interfere with the normal function of the penile drainage system.

Traumatic rupture of the corpus cavernosum

Twelve patients with fracture of the penis have been treated in this department during the last 18 years. Their mean age was 41.5 years (range 25-55) and two-thirds of the injuries resulted from coitus. Eleven patients underwent immediate exploration and repair of the tunica albuginea and only 1 still has sexual dysfunction. One patient was treated conservatively and remains impotent. Immediate surgical treatment is recommended, since it avoids the formation of penile plaque, penile fibrosis and angulation and accelerates restoration of normal penile function.

Small-form hepatitis B surface antigen is sufficient to help in the assembly of hepatitis delta virus-like particles

Hepatitis delta virus (HDV) has an envelope composed of large-, middle-, and small-form hepatitis B surface antigens (HBsAgs) provided by the helper hepatitis B virus (HBV). In order to examine the roles of individual HBsAgs in HDV assembly, we constructed plasmids containing each specific HBsAg gene and then cotransfected each plasmid with HDV cDNA into a permissive human hepatoma cell line (HuH-7) to examine the effects on HDV production. Results indicated that the plasmids containing only the HBsAg genes were able to complement HDV cDNA as efficiently as the plasmid containing the complete HBV genome in generating HDV-like particles. Moreover, the small-form HBsAg alone was sufficient for HDV packaging. The particles produced from the cotransfection experiments have density and protein composition characteristics similar to those of naturally occurring HDV. With the electron microscope, they were identified as 36- to 38-nm-diameter particles. It was concluded that only the HBsAgs were able to help in the assembly of HDV-like particles.

[Transvesical prostatectomy for benign prostatic hyperplasia--a 364 cases analysis]

During a 16 year period from January 1972 to December 1988, transvesical prostatectomies were performed on 364 patients with benign prostatic hyperplasia in the Department of Urology, Kaohsiung Medical College Hospital. The average operational procedure time was 116.1 minutes and the average amount of tissue resected was 38.3 grams. The most common complications were wound infections (6.8%), stress incontinence (1.92%), urethral stricture (4.12%) and impotence (0.27%). In this series, epididymitis and/or orchitis was noted in 4.3% of those who underwent vasectomies and 1.8% of those who did not; thus, epididymitis cannot be prevented by a prophylactic vasectomy. There was one postoperative death (mortality rate-0.27%). The present study found that 6.86% of the transvesical prostatectomy patients will require longer hospitalization and greater amounts of antibiotics due to post-operative wound infection; therefore the use of transvesical prostatectomy will decline and only be recommended for fit patients with others genitourinary diseases such as bladder diverticulum or giant bladder calculus.

Suppressive effect of geniposide on the hepatotoxicity and hepatic DNA binding of aflatoxin B1 in rats

The effects of geniposide pretreatment on both hepatic aflatoxin B1 (AFB1)-DNA binding and AFB1 hepatotoxicity in rats has been examined. For these studies, male Sprague-Dawley rats were treated with AFB1 (2 mg/kg) by i.p. administration, and the different degrees of hepatic damage were revealed by the elevations of levels of serum marker enzymes such as aspartate aminotransferase (AST), alanine amino-transferase (ALT) and gamma-glutamyltranspeptidase (gamma-GT). After pretreatment of animals with geniposide (10 mg/kg) daily for 3 consecutive days, the enzyme elevations were significantly suppressed. This suggested that the geniposide possessed chemopreventive effects on the early acute hepatic damage induced by AFB1. Under these experimental conditions, consistent elevation of the activities of glutathione S-transferase (GST) and gamma-glutamylcysteine synthetase but not glutathione peroxidase (GSH-Px) and gamma-glutamyltranspeptidase were observed. Treatment of rats with geniposide significantly lowered hepatic GSH and GSSG levels, but the ratio of GSH to GSSG was not changed. Geniposide treatment also decreased AFB1-DNA adduct formation in AFB1-treated animals. From these results, we suggest that the protective effect of geniposide on AFB1 hepatotoxicity in rats might be due to the hepatic tissues' defense mechanisms that involve the enhanced GST activity for AFB1 detoxication and induction gamma-glutamylcysteine synthetase for GSH biosynthesis.

Suppression of aflatoxin B1-induced hepatotoxic lesions by crocetin (a natural carotenoid)

The suppressive effects of crocetin (a natural carotenoid) on the hepatotoxic lesions induced by aflatoxin B1 (AFB1) were investigated in male Wistar rats. Rats were divided into five groups: groups I and II served as normal and solvent control respectively. Group III was given AFB1 (25 micrograms/day/rat) alone; group IV was given crocetin (0.1 mg/day/rat) alone; and group V received both AFB1 and crocetin. Rats received AFB1 and crocetin for 9 and 10 weeks respectively, and were maintained on basal diet for 35 weeks. At the end of the experiment (week 45), the incidence of liver lesions in rats of group V was significantly reduced by approximately 40% compared with group III. There were no liver lesions in rats of groups I, II and IV. A significant protective effect of crocetin on AFB1 hepatotoxicity was shown, as manifested by reduced effects on the activities of serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and gamma-glutamyl transpeptidase (P less than 0.01-0.001). From our previous results and present data, we suggest that the suppression of crocetin on AFB1 hepatotoxicity in the rats might be due to the defense mechanisms of hepatic tissues that elevated the GSH S-transferase activity and decreased the formation of hepatic AFB1-DNA adducts.

Thyroid hormone changes after cardiovascular surgery and clinical implications

Alterations in serum concentrations of total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) frequently occur in patients with nonthyroidal illnesses. These changes correlate with the severity of the illness and the prognosis. In this study, 44 patients undergoing a cardiovascular operation had significant declines in serum TT3 and TT4 levels during cardiopulmonary bypass and thereafter. Serum TT3 and TT4 concentrations reached their nadir at 30 minutes after the start of cardiopulmonary bypass with values (mean +/- standard error of the mean) of 0.77 +/- 0.12 nmol/L (50.4 +/- 7.6 ng/dL) and 68.2 +/- 10.2 nmol/L (5.30 +/- 0.79 micrograms/dL), respectively. The mean serum concentrations of TSH and TT4 returned to preoperative levels by the sixth day after operation, whereas TT3 levels remained low throughout the study period. The patients whose recovery was uneventful had higher serum TT3, TT4, and TSH levels than those who had complications or died. The trend toward recovery was initiated by a sharp increase in the serum TSH level and increases in serum TT3 and TT4 concentrations on the fourth day after operation. Patients with complications either did not show these changes or had only a transient increase in TT3 and TT4 levels. All of the patients had a normal serum free T4 level before anesthesia. Those with an uneventful recovery had a higher serum free T4 level on the sixth day after operation than those with complications. Two patients in the latter group had serum free T4 levels less than normal at that time.(ABSTRACT TRUNCATED AT 250 WORDS)

The large form of hepatitis delta antigen is crucial for assembly of hepatitis delta virus

The virions of hepatitis delta virus (HDV) contain two species of HDV-specific protein, a large and a small form of hepatitis delta antigen (HDAg). We examined the role of individual HDAgs in virion assembly in cotransfection experiments. First, we constructed a replication-competent HDV mutant expressing only the small HDAg. When cotransfected with a plasmid expressing hepatitis B virus surface antigens to the HuH-7 cells, the mutant did not produce HDV virions, whereas the wild-type HDV clone did. Therefore, though the small HDAg is important for viral replication and is incorporated into the virus, the small-form delta antigen by itself is insufficient for virion formation. When the system was co-transfected with an additional plasmid providing the large HDAg, the HDV virion was then recovered. There was also evidence suggesting that the large HDAg could be copackaged into the HBsAg particles, without the presence of the HDV genome and the small HDAg. The results indicate a crucial role of the large HDAg in HDV assembly.

Experimental antitumor agents from Solanum indicum L

beta-Sitosterol (SI-0), beta-sitosterol glucoside (SI-1), dioscin (SI-2), methyl protoprosapogenin A of dioscin (SI-3), methyl protodioscin (SI-4) and protodioscin (SI-5) were isolated and characterized from the whole plant of Solanum indicum L. (Solanaceae). Except for beta-sitosterol, these compounds have not been previously isolated from Solanum indicum L. Both CHCl3 soluble (SI-IV) and insoluble (SI-V) fractions of the ethanolic extract (SI-I) showed cytotoxicity on seven cancer cell lines: Colo-205 (colon), KB (nasopharynx), HeLa (uterine cervix), HA22T (hepatoma), Hep-2 (laryngeal epidermoid), GBM8401/TSGH (glioma) and H1477 (melanoma). The purified constituents, SI-2 and SI-4 showed more potent effects by DEA and MTT assay. SI-2,3,4 and 5 also demonstrated cytotoxicity on cultured C6 glioma cells by PRE assay, ans SI-3,4 and 5 showed a tumor inhibitory effect in vivo in C6 glioma cells. In addition, SI-2 had an inhibitory effect on the DNA synthesis of C6 glioma cells at 10 micrograms/ml.

Colour duplex sonography in the assessment of impotence

We present our experience with colour duplex sonography (Acuson 128) in the assessment of 83 impotent men. Cavernosal artery measurements were taken before and after the intracorporeal injection of papaverine. The peak velocities following papaverine injection correlated well with the degree of clinical response. Percentage diameter change corresponded with some groups of clinical erection grade, although it was not as good a discriminator as peak velocity. Twelve patients with 24 cavernosal arteries were also examined using pharmacological selective arteriography. Correlation between duplex sonography and arteriography showed an accuracy of 87.5%, specificity of 100.0% and sensitivity of 82.4%. All patients with a clinically good response following papaverine injection had peak bilateral cavernosal artery velocities greater than or equal to 25 cm/s. Amongst the remaining suboptimal responders, 18 also had this finding. Fifteen of these underwent pharmacological cavernosography and 14 exhibited venous leakage. Duplex sonography is a valuable and non-invasive tool in the assessment of impotence and can provide valuable information in deciding the course of further evaluation and treatment. The procedure was always completed more quickly with the guidance of colour Doppler.

Monoclonal anti-idiotypic antibodies to platelet activating factor (PAF) and their interaction with PAF receptors

Monoclonal anti-idiotypic antibodies (3C3F3E4 and 10D3F8H7) that interact with platelet activating factor (PAF) receptors were generated using an auto-anti-idiotypic approach by immunizing mice with an aldehydic analog of PAF coupled to bovine thyroglobulin. The resulting hybridomas were screened for anti-idiotypic antibody (anti-anti-PAF) with F(ab')2 fragments of affinity-purified polyclonal rabbit anti-PAF antibody. These antibodies displayed internal image properties of PAF and were considered as Ab2 beta according to the following criteria: (a) they bound to F(ab')2 fragments of the affinity-purified rabbit polyclonal anti-PAF antibody that had high affinity for PAF; (b) they inhibited [3H]PAF binding to rabbit polyclonal anti-PAF antibody and its F(ab')2 fragment in a concentration-dependent manner; (c) they displaced [3H]PAF from the anti-PAF antibody/[3H]PAF complex specifically; (d) they inhibited [3H]PAF binding to PAF receptors on rabbit platelet membranes dose dependently; (e) they displaced [3H]PAF from the [3H]PAF/PAF receptor complex specifically; and (f) they stimulated rabbit platelets to aggregate, and this aggregation could be inhibited or totally blocked by specific PAF receptor antagonists WEB 2086 and SRI 63-441. All of the above are consistent with the first successful production of monoclonal antibodies that mimic PAF and interact specifically with the PAF binding domain of PAF receptors on rabbit platelet membranes.

Effects of crocetin on the hepatotoxicity and hepatic DNA binding of aflatoxin B1 in rats

The effects of crocetin pretreatment on both hepatic aflatoxin B1 (AFB1)-DNA binding and AFB1 hepatotoxicity in rats has been examined. For these studies, male Wistar rats were treated with AFB1 (2 mg/kg) by i.p. administration, and the different degrees of hepatic damage were revealed by the elevations of levels of serum marker enzymes such as aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase and gamma-glutamyltranspeptidase. After pretreatment of the animals with crocetin (2 or 6 mg/kg) daily for three consecutive days, the enzyme elevations were significantly suppressed. This suggested that the crocetin possessed chemopreventive effects on the early acute hepatic damage induced by AFB1. Under these experimental conditions, consistent elevations of hepatic glutathiones (GSH) and activities of glutathione S-transferase (GST) and glutathione peroxidase (GSH-Px) were observed. Crocetin treatment also decreased AFB1-DNA adduct formation in AFB1-treated animals. From these results, we suggest that the protective effect of crocetin on AFB1 hepatotoxicity in rats might be due to the hepatic tissues' defense mechanisms that elevated the cytosol GSH and the activities of GST and GSH-Px.

Modulatory effect of crocetin on aflatoxin B1 cytotoxicity and DNA adduct formation in C3H10T1/2 fibroblast cell

Crocetin is a carotenoid isolated from the seeds of Cape jasmine (Gardenia jasminoides). The cytotoxicity and DNA-adduct formation of rat microsome-activated aflatoxin B1 (AFB1) in the C3H10T1/2 cells were significantly inhibited by pretreatment of crocetin. Most significant inhibition was found at the time of 9 h after crocetin pretreatment. Under these experimental conditions, consistent elevation in the cytosolic glutathione (GSH) levels and the activities of GSH S-transferase (GST) and GSH-peroxidase (GSH-Px) were observed. Crocetin treatment also resulted in a decrease in AFB1-DNA adduct formation in vitro, while no effect of crocetin on the formation of AFB1-8,9-oxide in vitro system was detected as measured by the Trisdiol method. From these results, we suggested that the protective effect of crocetin on the AFB1-cytotoxicity in C3H10T1/2 cells might be due to the cellular defense mechanisms that elevated the cytosol GSH and the activities of GST and GSH-Px.

Surgical treatment of the ruptured bladder: 22 years reviewed

During the 22-year interval from 1964 to 1985, 36 patients with bladder injuries were treated at the Kaohsiung Medical College Hospital. Thirty-two cases were male (89%) and 4 cases were female (11%), the sex ratio of patients was 8 to 1, respectively. The average patient age was 33 years and 75% were less than 40 years of age. Hematuria was present in all of the patients and it was microscopic in 25%. Traffic accidents accounted for 55% of the injuries; penetrating trauma was responsible in only 6% of the patients. Of the 36 bladder trauma cases, 11 (30.5%) had intraperitoneal injury, 24 (66.7%) had extraperitoneal injury and 1 (2.8%) had intraperitoneal and extraperitoneal injury. Of the 28 cases with pelvic fracture and bladder trauma in this study, 18 (60%) had extraperitoneal rupture, and 9 (30%) had intraperitoneal rupture. The position of intraperitoneal rupture was mostly at the posterior wall and dome, whereas that of the extraperitoneal rupture was partly located at the anterior wall and the bladder neck. Bladder rupture was treated by operative repair of the defect, bladder drainage by suprapubic cystostomy and/or urethral catheter and drainage of the perivesical space. The mortality rate with the ruptured bladder was 17%. Multiple injuries associated with the ruptured bladder and postoperative complications especially septic shock, were the main causes of mortality.

Chronological changes in genetic variance and heritability of anthropometric characteristics among Chinese twin infants

In order to examine the chronologic changes in genetic variance and heritability of anthropometric characteristics of Chinese infants in Taiwan, a total of 521 pairs of same-sexed twin neonates given birth in four major general teaching hospitals in Taipei City were studied. Based on the placental pattern and 12 red blood cell antigens, 428 MZ and 93 DZ twin pairs were identified and followed up to the age of one year. There was no significant genetic variance for all anthropometric characteristics adjusted for sex and gestational week before the age of six months. After adjusting for sex and gestational week, a significant genetic variance was observed at the age of six months, with heritability values of 0.51 (weight), 0.63 (head circumference), 0.77 (chest circumference), and 0.53 (arm circumference), as well as at one year, although with considerably lower heritability values. This implies that growth is dynamically determined by both genetic and environmental factors during infancy.

Genetic variance and heritability of temperament among Chinese twin infants

In order to examine the genetic variance and heritability of temperament among Chinese infants in Taiwan, a total of 62 pairs of same-sexed twin infants given birth in four major general teaching hospitals in Taipei City were studied. Based on placentation and 12 red blood cell antigens, 44 MZ and 18 DZ pairs were identified. Temperament was assessed at the age of six months by the Chinese edition of Carey's Temperament scale. Significant genetic variance was observed for activity level, approach or withdrawal, intensity of reaction, quality of mood, and threshold of responsiveness, with a heritability of 0.64, 0.56, 0.74, 0.39, and 0.45, respectively. There was no significant intrapair difference in temperamental characteristics between monochorionic and dichorionic MZ twins.

Experiences in the treatment of chyluria in Taiwan

From 1967 through 1986, 55 patients with chyluria were treated by renal pelvic instillation of 10 ml. 0.5% silver nitrate solution and surgical disconnection of the renal pedicle lymphatics was done in 9 (16.3%) due to persistent chyluria after instillation therapy. Among these 46 renal pelvic instillation patients and 9 operated patients followed for 2 years chyluria recurred in 11 (22.7%) and 5 (55.5%), respectively. Renal pelvic instillation is a safe and effective method to treat chyluria.

[Pharmacological localization of Horner's syndrome. Case report]

Horner's syndrome is derived from an interruption of the sympathetic pathway at any point along its course between the hypothalamus and the orbit. This pathway is generally considered to consist of three neurons. It had been suggested that the pupillary response to various pharmacologic agents will aid in localizing the lesioned neuron in the sympathetic pathway. We had the opportunity to observe a patient who developed Horner's syndrome as a consequence of pulmonary apex adenocarcinoma. Clinical, radiologic and pharmacologic studies are presented. The methods of pharmacologic localization are discussed.

Ecological correlation between arsenic level in well water and age-adjusted mortality from malignant neoplasms

A significant dose-response relation between ingested arsenic and several cancers has recently been reported in four townships of the endemic area of blackfoot disease, a unique peripheral artery disease related to the chronic arsenic exposure in southwestern Taiwan. This study was carried out to examine ecological correlations between arsenic level of well water and mortality from various malignant neoplasms in 314 precincts and townships of Taiwan. The arsenic content in water of 83,656 wells was determined by a standard mercuric bromide stain method from 1974 to 1976, while mortality rates of 21 malignant neoplasms among residents in study precincts and townships from 1972 to 1983 were standardized to the world population in 1976. A significant association with the arsenic level in well water was observed for cancers of the liver, nasal cavity, lung, skin, bladder and kidney in both males and females as well as for the prostate cancer in males. These associations remained significant after adjusting for indices of urbanization and industrialization through multiple regression analyses. The multivariate-adjusted regression coefficient indicating an increase in age-adjusted mortality per 100,000 person-years for every 0.1 ppm increase in arsenic level of well water was 6.8 and 2.0, 0.7 and 0.4, 5.3 and 5.3, 0.9 and 1.0, 3.9 and 4.2, as well as 1.1 and 1.7, respectively, in males and females for cancers of the liver, nasal cavity, lung, skin, bladder and kidney. The multivariate-adjusted regression coefficient for the prostate cancer was 0.5. These weighted regression coefficients were found to increase or remain unchanged in further analyses in which only 170 southwestern townships were included.

A facile synthesis of an aldehydic analog of platelet activating factor and its use in the production of specific antibodies

The multistep synthesis of a platelet activating factor (PAF) analog having a reactive aldehyde group at the omega-end of the sn-1 position is described. A novel ozonolysis of a double bond was employed to generate the aldehyde group in high yield under mild conditions. The aldehyde group was generated at the last step of the synthesis to avoid any reactions of protection and deprotection. The natural chiral center at the sn-2 position was introduced at the first step so that no steric resolution of the final product was needed. This analog of PAF was conjugated to thyroglobulin via reductive amination and then used to immunize rabbits for production of specific antibodies. The purified antibodies bind stereospecifically to tritiated PAF and crossreact minimally with lyso-PAF, plasmalogens and other phospholipids. The solid-phase radioimmunoassay thus developed detects as low as 20 pg of PAF per assay tube and should be applicable to the quantitation of PAF in biological systems.

Effect of ethanol on hepatotoxicity and hepatic DNA-binding of aflatoxin B1 in rats

The hepatocarcinogen aflatoxin B1 is converted to reactive metabolites that bind covalently to cellular macromolecules. These metabolites may also react with glutathione, resulting in the formation of glutathione conjugates and detoxication of the reactive metabolite. When rats were pretreated with ethanol by gastric intubation at a dose of 100 mmol/kg, 6 hr (the time of maximal GSH depletion) before the administration of aflatoxin B1, the covalent binding of 8,9-epoxide-aflatoxin B1 to DNA in vivo was increased by 47% and the hepatotoxicity was also potentiated. However, the covalent binding was not increased by pretreatment with ethanol 18 hr (time with approximately normal GSH levels) before administration of the toxin, and no potentiation of hepatotoxicity was observed. Pretreatment with a non-toxic dose of ethanol had no effects on the activity of glutathione S-transferase and glutathione peroxidase. These results suggest that the depletion of GSH and the increased formation of DNA-adduct from the liver constitute an important mechanism for the potentiation of aflatoxin B1-induced hepatotoxicity by ethanol.

[Treatment of Wilms' tumor in children]

During the last 13 years, the Kaohsiung Medical College Hospital has treated a total of nine patients with nephroblastoma (Wilms' tumor). Among them, six were male and three were female. The age of the patients ranged from 7 months to 11 years old with an average of 3.25 years. 88.9 percent of the patients complained of abdominal mass. However, the initial symptom was gross hematuria in 33.3% of the patients. Seven out of the nine patients underwent simple nephrectomy while the remaining two were treated with the more conservative open biopsy. All patients died within three years of initial treatment except two, who never came back for follow-up treatment and whom we were unable to trace to determine whether they had survived. Nevertheless, the combination of surgery and postoperative chemotherapy helped to prolong the life of patients with Wilms' tumors.

[Primary tumor of the female urethra--a report of two cases]

From 1972 through 1986, 173 female patients with urinary tract tumors were treated at Kaohsiung Medical College Hospital. Only 2 (1.2%) had primary transitional cell carcinoma of the anterior urethra. These patients were treated with local excision of the tumor, one patient remained alive for more than three years while the other one was lost during the post-operative follow-up. Primary female urethral tumors are mostly malignant tumors. Prompt diagnosis and aggressive treatment is the only way to prolong the patients' survival time.

Chronological changes in genetic variance and heritability of systolic and diastolic blood pressure among Chinese twin neonates

In order to examine the chronological changes in genetic variance and heritability of arterial systolic and diastolic blood pressure (SBP and DBP of Chinese infants in Taiwan, a total of 339 same-sexed twin neonates born in four major general teaching hospitals in Taipei City were studied. Based on placentation and 12 red blood cell antigens, 274 monozygotic (MZ) and 65 dizygotic (DZ) twin pairs were identified and followed up to the age of one year. Both SBP and DBP were measured by Doppler blood pressure monitor. Within-pair mean squares of SBP and DBP were consistently smaller in MZ than DZ twins at ages one month and over. The findings remained unchanged after the adjustment for the effects of age, sex, gestational age, placentation and physical state during blood pressure measurement. Falconer's heritability indices for adjusted SBP and DBP at ages two months and over ranged from 0.29 to 0.55 and from 0.27 to 0.45, respectively. The study indicates an important genetic influence on blood pressure during infancy.

Genetic variance and heritability of serum cholesterol and triglycerides among Chinese twin neonates

In order to examine the genetic variance and heritability of serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides, a total of 349 pairs of same-sexed twin neonates born in four major general teaching hospitals in Taipei City were studied. Based on the placental pattern and 12 red blood cell antigens, 271 monozygotic (MZ) and 78 dizygotic (DZ) twin pairs were identified. There was a significant genetic variance for total cholesterol, HDL-C, LDL-C, and triglycerides both unadjusted and adjusted for sex, gestational age and placentation. The unadjusted heritability of total cholesterol, HDL-C, LDL-C, and triglycerides was 0.59, 0.30, 0.25 and 0.75, respectively; while the corresponding adjusted heritability was 0.74, 0.38, 0.31, and 0.49, respectively. Intrapair variance of serum lipids was not significantly different between monochorionic and dichorionic MZ twins.

Inhibition of growth and development of the transplantable C-6 glioma cells inoculated in rats by retinoids and carotenoids

Experimental data were provided to demonstrate the inhibitory effects of retinoids (retinal, retinoic acid, retinyl acetate and retinyl palmitate) and carotenoids (beta-carotene, lycopene and crocetin) on the growth and development of the C-6 glioma cells inoculated in rats. In the pretreatment experiments, most of these compounds could prolong the latency period of T50 (time for 50% tumor incidence). At week 7, the growth inhibition was 57-67% (P less than 0.02) with carotenoids and 40-55% (P less than 0.05) with retinoids. In the post-treatment experiments, the growth inhibition was 30-55% (P less than 0.05) with carotenoids and 21-42% (P less than 0.05) with retinoids. No significant hepatotoxic effect was observed in all treated groups as indicated by the constant levels of serum enzymes (e.g. aspartate amino-transferase, alanine amino-transferase and alkaline phosphatase) and bilirubin. The mechanisms of tumor inhibition through the enhancement of anti-tumor immunity by both carotenoids and retinoids were discussed.

[Surgical treatment of ureteropelvic junction stricture]

Forty-five patients with hydronephrosis due to pelviureteric junction stricture were operated on at Kaohsiung Medical College Hospital between 1971 and 1986. In unilateral cases, the left kidney was affected more frequently than the right (24 to 13), while 8 (18%) had bilateral ureteropelvic stricture. Of the 45 cases, 24 cases (53%) underwent Anderson-Hynes pyeloplasty, 5 cases underwent Y-V plasty, 5 cases underwent ureterolysis and 11 cases underwent simple nephrectomy due to severe hydronephrosis. Except for the 11 nephrectomy cases, 11 of the remaining 34 cases had ureteral catheter placement and 9 cases had double-J ureteral catheter placement, postoperatively; another 14 cases received no ureteral stent for draining urine. The results were very encouraging with clinical improvement in 64% of the patients, and improvement in the pelviocaliceal system and early appearance of contrast medium in the ureter in 47% of the patients. The results of pyeloplasty with and without a nephrostomy or ureteral stent were compared. Patients with a nephrostomy or ureteral stent tended to have an increased incidence of urinary tract infections and longer hospital stays. In general, the results of treatment were poorer for patients with a nephrostomy or ureteral stent, than for patients without.

[Study on carcinogenic activity of several nickel compounds in mice]

This paper reports the result of the tumor in site induced by several nickel compounds in mice. Three nickel compounds (Ni3S2, NiCl, pure nickel powder) were injected separately to the right arm pit subcutaneously (5 mg/mouse). At the end of the 62nd week, the tested mice were sacrificed. Only nickel sulfide induced tumors in the site of injection, the incidence of tumor was 36%. The majority of the tumors were fibrosarcomas, only 2 rhabdomyosarcomas. The tumors might infiltrate into the surrounding tissues, a few metastasized to the liver and/or the lungs.

Inhibitory effects of carotenoids and retinoids on the in vitro growth of rat C-6 glioma cells

The inhibitory effects of 4 retinoids, namely, retinal (Ral), retinoic acid (RA), retinyl acetate (RAc), and retinyl palmitate (RP), and 3 carotenoid including beta-carotene (BCT), lycopene (LCP), and crocetin (CCT) on the growth and DNA synthesis of rat C-6 glioma cells were studied. All the retinoids and carotenoids caused reduction of plating efficiency and inhibition of the cellular growth. RA was the most potent inhibitor of plating efficiency, followed in decreasing order by RAc, Ral, LCP, RP, BCT, and CCT. The effects of various doses of retinoids and carotenoids on the inhibition of DNA synthesis were clearly demonstrated in the growing C-6 glioma cells, whereas negligible effects of these compounds on the RNA and protein synthesis were observed. These results suggested that retinoids or carotenoids are biologically active as anti-tumor agents against brain tumor cells in culture, while carotenoids appeared to be less active.