[Experimental study on effects of mailuotong granule on anti-thromboangiitis obliterans]

Using experimental model of thromboangitis obliterans (TAO) in rats induced by injection of lauric acid into the femoral artery, the anti-thromboangitis obliterans effects of Mailuotong (MLT) Granule were observed. The results showed that MLT not only decreased significantly the lesion severity and extent of affected limb, plasma viscosity and level of fibrinogen, but also suppressed the arterial thrombosis, endotheliocytosis and inflammatory cell infiltration in vascular wall. MLT also reduced the organization of thrombus and facilitated thrombolysis. It showed that the therapeutic effect of MLT on TAO might be achieved by improving blood rheology, antithrombosis, thrombolysis, inhibiting endotheliocytosis and inflammatory reaction in vascular wall.

The effect of exclusive breastfeeding on development and incidence of infection in infants

Of 145 normal fullterm infants studied during the first year after birth, those exclusively breastfed for the first four months differed significantly from those not exclusively breastfed in physical and behavioral development, and resistance to infection. At four months of age, the mean weight of the exclusively breastfed group was higher (p < 0.05). At one year, the exclusively breastfed group showed more advanced. Personal-Social (p = 0.05) and gross Motor development (p < 0.05) on the Denver Developmental Screening TEst, and lesser cumulative incidence of infectious diseases (p < 0.05). This study demonstrated the beneficial effects of breastfeeding on development and resistance to infection in infants.

Chemical shift assignments and secondary structure of the Grb2 SH2 domain by heteronuclear NMR spectroscopy

The growth factor receptor-bound protein-2 (Grb-2) is an adaptor protein that mediates signal transduction pathways. Chemical shift assignments were obtained for the SH2 domain of Grb2 by heteronuclear NMR spectroscopy, employing the uniformly 13C-/15N-enriched protein as well as the protein containing selectively 15N-enriched amino acids. Using the Chemical Shift Index (CSI) method, the chemical shift indices of four nuclei, 1H alpha, 13C alpha, 13C beta and 13CO, were used to derive the secondary structure of the protein. Nuclear Overhauser enhancements (NOEs) were then employed to confirm the secondary structure. The CSI results were compared to the secondary structural elements predicted for the Grb2 SH2 domain from a sequence alignment [Lee et al. (1994) Structure, 2, 423-438]. The core structure of the SH2 domain contains an antiparallel beta-sheet and two alpha-helices. In general, the secondary structural elements determined from the CSI method agree well with those predicted from the sequence alignment.

Discrepant pattern of solid and liquid gastric emptying in Chinese patients with type II diabetes mellitus

While abnormal gastric emptying has been widely reported in patients with diabetes, its clinical relevance is still uncertain. We conducted scintigraphic gastric emptying studies in patients with Type II diabetes mellitus who had symptoms suggestive of delayed gastric emptying in an attempt to evaluate the incidence of abnormal gastric emptying and to assess the clinical parameters of the different patterns of gastric emptying. Seventy male diabetic patients were included in the study. The patients were divided into four groups according to the results of liquid and solid gastric emptying: group 1, normal liquid and solid emptying (n = 22); group 2, normal liquid but delayed solid emptying (n = 30); group 3, delayed liquid but normal solid emptying (n = 7); group 4, delayed liquid and solid gastric emptying (n = 11). To assess clinical significance, we compared duration of disease, status of blood sugar control, presence or absence of vascular complications and of peripheral neuropathy among the four groups. Of the 70 patients, 18 (25.7%) showed delayed liquid gastric emptying and 41 (58.6%) delayed solid gastric emptying. There were no significant differences in the clinical parameters of the four groups, except that patients with good sugar control were likely to have normal liquid gastric emptying. Based on the results of this study, delayed solid gastric emptying is more common than liquid gastric emptying in symptomatic Type II diabetes mellitus patients. Of the different patterns of gastric emptying, delayed liquid gastric emptying with normal solid gastric emptying is the most unusual. For Type II diabetic patients with symptoms suggestive of delayed gastric emptying, both liquid and solid gastric emptying studies should be performed.

Synthesis, antitumor activity, and chemical properties of silaplatin and related platinum (II) and platinum (IV) complexes derived from beta-silyl amines

Platinum (II) and platinum (IV) coordination complexes derived from beta-silyl-substituted amines were prepared. The solubility of selected complexes in water and physiological saline was measured, and the effect of the beta-silicon on the reactivity of the complex in aqueous solution was determined by HPLC. The stabilities of selected silyl complexes were compared to the carbon analogues. The cyclic complexes 2a ("silaplatin") and its Pt(IV) analogue, 2b, were very active against L1210 leukemia in vivo. Both the platinum (II) complex 2a and the platinum (IV) complex 2b produced a significant number of cures over the dose range 10-40 mg/kg. The platinum (II) complex 2a, silaplatin, was very active in vivo against an L1210 leukemia subline that was resistant to cisplatin; 2a was also active, when given ip, against ic implanted L1210. The cyclobutanedicarboxylic acid complex 3c was synthesized; this complex was active against both cisplatin sensitive and resistant L1210 leukemia but was less potent than the analogous dichloro compound 2a. The acyclic platinum (II) and platinum (IV) complexes 1a,b were synthesized and unexpectedly found to be inactive in vivo against L1210 leukemia. More lipophilic silaplatin analogues were prepared--Pt(II) complex 2c and Pt(IV) complex 2d have one additional methylene carbon compared to 2a,b, whereas Pt(II) complex 2e and Pt(IV) complex 2f have two additional methylene carbons. Cyclization of the alkyl groups attached to the silicon gave the spiro bicyclic Pt(II) complexes 10a and 11a and the Pt(IV) complexes 10b and 11b.

A proposal for a theory and detection method of cavitation potential of mitral bileaflet heart valve

We believe that cavitation damage to mitral bileaflet heart valve (MBHV) is caused by microcracks of hydrophobic pyrolite carbon. Our proposal is to detect cavitation potential of MBHV with an acoustic technique under various conditions of transvalvular pressures, ventricular dp/dt, leakage flow, and gas concentration in fluid, This modality, different from recent research in theory and technique, will lead to a standardized noninvasive and sufficiently sensitive technique for the detection of MBHV, to reject those valves believed to cause cavitation damage, and to develop cavitation-resistant MBHV.

Impact of alcohol consumption and cigarette smoking on stroke among the elderly in Taiwan

BACKGROUND AND PURPOSE

We investigated the influence of alcohol consumption and cigarette smoking on all types of stroke and cerebral infarction, in particular among a representative sample of elderly residents in Taiwan.

METHODS

This study was a component of a nationwide survey of health and living status of residents aged 65 years or older in Taiwan in which subjects received detailed physical, neurological, and laboratory examinations. Inquiries were made about medical history, and information on the amount and duration of drinking and smoking was obtained. Diagnoses of stroke were made according to the results of brain computed tomography at the onset of disease or were based on criteria established by the World Health Organization.

RESULTS

Of the 2600 subjects, there were 155 elderly persons with stroke (prevalence, 6%). Excessive drinking of more than 367.6 g/wk of alcohol was associated with a high prevalence of cerebral infarction. Consumption of < or = 367.5 g/wk of alcohol did not have an influence on stroke prevalence. The relationship between duration of alcohol drinking and stroke was equivocal. More than 30 pack-years of cigarette smoking was a significant risk factor for all types of stroke and cerebral infarction in particular. Using multiple logistic regression to control for possible confounders, it was found that smoking was an independent risk factors for all stroke and was of borderline significance for cerebral infarction. Although excessive drinking was a significant risk factor for cerebral infarction in univariate analysis, this effect was lost after adjustment for other confounders.

CONCLUSIONS

Cigarette smoking was a more important risk factor for stroke and cerebral infarction than excessive drinking of alcohol.

[Protrusion of thoracic intervertebral disk: report of 11 cases]

The authors reported 11 cases of thoracic intervertebral disk protrusion examined with plane film, myelography, CT and CT-myelography in 11 cases and MR imaging in 3. All of the 11, cases were confirmed by operation. There were 13 protrusions in the 11 cases with the locations of T10-11 in 4, T11-12 in 5 cases and T12-L1 in 4. 9 protrusions fell into central type, 1 into paracentral type and 1 into lateral type. The clinical symptoms were prominent with all 11 cases, however, most primary clinical diagnoses were erroneously given as lumber intervertebral disk protrusions and even the disorders of heart, lung, alimentary tract and urinary system. It was concluded that the main causes of the misdiagnosis included: (1) not easily to think of this entity for the clinic physicians due to its low incidence, (2) the untypical clinical manifestations. The authors considered that the exam method with the highest accuracy is CT-myelography.

Dissipation and movement of acaricide chlorobenzilate in the environment

The dissipation of acaricide chlorobenzilate in selected soil and river water samples was studied. Under incubation conditions at 25 degrees C and 90% field capacity of moisture for 21 days, the residues of chlorobenzilate were 14 and 55% in Lukang silty clay loam and Pincheng clay, respectively. More than 80% of chlorobenzilate remained in the natural water (pH 7.2 and 7.3, respectively) and in the water adjusted to pH 5.0 when water samples collected from Green Lake and Wai-Shuang River near Taipei were treated with chlorobenzilate and then incubated for 34 days. But when the pH was adjusted to 9.0, only 60% was found in Green Lake water and 29% in Wai-Shuang River water. The dissipation of chlorobenzilate in the soil was fitted to first-order kinetics with half-lives of 5 to 36 days under various conditions in the laboratory experiments. No chlorobenzilate was detected in the leachate by a leaching experiment on the soil column for 18 days; most chlorobenzilate remained in the upper 3 cm of the column. According to assessment by the groundwater pollution-potential model (GWP), chlorobenzilate seemed to be safe in regard to groundwater contamination.

Functional approach to treatment of back pain in primary care: a preliminary report

BACKGROUND

Back pain is one of the most common problems encountered in primary care clinics and causes great loss of work time, economy and expenditure of medical care. Knowledge of the cause of low back pain and effective treatment are rudimentary. We studied the functional approach to treatment of back pain of two acute (M:F = 1:1) and thirty chronic (M:F = 12:18) patients with back pain seen at a rural primary care clinic in September and October 1992.

METHODS

Patients were included after completing an agreement form regarding the treatment plan (emphasizing therapeutic exercise, health education and as little medication as possible) in the first interview. A primary care physician specialised in family medicine personally gave treatment to the patients with free attendance to the clinic. A functional approach was adopted in four categories-therapeutic exercise, static and dynamic body biomechanics, awareness of proprioception, and maintenance of relaxed and balanced muscle tone. The patients were encouraged to perform daily activities rather than rest.

RESULTS

Two patients with acute back pain gained complete relief without medication, modalities, equipment or other treatment one and two weeks after the first visit, respectively. Among the 30 chronic patients, after eight weeks of treatment, 12/30 (40%) gained complete relief from pain, 4/30 (13.3%) obtained more than 3/4 and less than complete relief, 7/30 (23.3%) had more than 1/2 and less than 3/4 relief, 2/30 (6.7%) gained less than 1/2 pain relief, 1/30 (3.3%) had no improvement, 1/30 (3.3%) deteriorated, and 3/30 (10%) were lost during surveillance. The patients reported no loss of work time attributed to back pain. Two acute patients visited the clinic four times and three times, respectively. The former received three prescriptions for an upper respiratory infection one month after complete remission of back pain, and the latter received no prescriptions for medication. On average, each chronic patient visited the clinic 4.83 times in 8 weeks. In only 25 of 145 (17.2%) visits was medication prescribed for other indications, and in 8 of 145 (5.5%) visits vitamin B complex or Alinamin-F for placebo was prescribed. We used neither modalities nor equipment. Only 7/30 (23.3%) patients received concurrent treatment from other medical institutions. Regarding compliance with the programmed exercise at home, two acute patients complied well. Among the 30 chronic patients, 22 (73.3%) had good compliance, 3 (10%) had poor compliance, 2 (6.7%) failed to comply and 3 (10%) were lost in follow up.

CONCLUSIONS

Treating patients with back pain in primary care clinics with a functional approach by physicians appropriately trained in primary care was a good, efficacious, economic, and practical way, although neglected elsewhere. Further research and practice in our society might be worth while.

Anaerobic biodegradability of cellulose and hemicellulose in excavated refuse samples using a biochemical methane potential assay

Improved techniques are needed to predict potential methane generation from refuse buried in landfills. The Biochemical Methane Potential (BMP) test was used to measure the methane potential of ten refuse samples excavated from a Berkeley, CA, landfill. The test was conducted in 125-ml serum bottles containing phosphate-buffered medium and inoculated with anaerobically digested sewage sludge. Comparison of the measured BMP to the theoretical BMP calculated from measured cellulose and hemicellulose concentrations indicated that cellulose plus hemicellulose is not well correlated with the measured BMP. The average of the measured to theoretical BMP was 19.1% (range 0-53%, s.d. = 16.9%). Measured sulfate concentrations showed that sulfate was an insignificant electron sink in the samples tested. Once methane production from the refuse was complete, 0.072 g of Whatman no. 1 filter paper was added to two of the four serum bottles incubated for each sample. An average of 84.9% (s.d. = 2.5%) of the added filter paper was recovered as methane, suggesting that some cellulose and hemicellulose present in refuse is recalcitrant or otherwise not bioavailable.

[A study on the pulmonary amine imaging in asthmatic patients and guinea pig asthma models]

Scintigraphic technique (SPECT) with intravenous injection of 131I-HIPDM was used to study pulmonary amine imaging in asthmatic patients and Guinea pig animal models. The results showed that the patients and animals had similar characteristic changes of amine imaging: the amine scanning pictures were not well-distributed, pulmonary amine uptake was significantly decreased but the clearance speed significantly increased as compared with those in healthy controls (P < 0.05-0.01). The only difference between the patients and the animals was that the amine imaging parameters in animals during remission recovered practically to normal, while that in patients during remission did not. The mechanism and clinical significance of the above changes were discussed.

Conformation of a biologically active C-terminal hexapeptide analog of the pheromone biosynthesis activating neuropeptide by NMR spectroscopy

The solution conformation of a biologically active C-terminal hexapeptide analog of the pheromone biosynthesis activating neuropeptide Tyr-D-Phe-Ser-Pro-Arg-Leu-NH2 has been studied by NMR spectroscopy. A beta-turn conformation was identified from the NOE connectivities observed for the peptide in a mixed solvent of water and DMSO, indicating that this is the biologically active conformation of the peptide. This study also suggests that the use of such an aqueous-like solvent mixture allows the observation of a preferred conformation for small linear peptides in the presence of conformational averaging.

Ventricular septal summit stimulation in atrioventricular nodal reentrant tachycardia

In all, 18 consecutive patients with atrioventricular nodal reentry tachycardia (AVNRT) underwent right ventricular (RV) stimulation during AVNRT from either the RV apex or summit. Stimulation from the RV apex advanced the tachycardia with the same atrial sequence in 6 of 18 patients (33%), but never conclusively excluded the presence of a low atrial tachycardia. RV summit stimulation resulted in direct stimulation of the low septal right atrium in 6 patients. RV summit stimulation advanced the tachycardia in 4 patients, delayed it in 2 and terminated it in 3 without an atrial electrogram. The latter 2 findings exclude the presence of a low atrial tachycardia. Thus, in patients with AVNRT, application of extrastimuli closer to the putative reentrant site enables greater efficacy in tachycardia resetting and in excluding a low septal atrial tachycardia.

Effects of pulsatile reperfusion on globally ischemic myocardium

To evaluate the effects of pulsatile reperfusion on the post ischemic myocardium, two categories of sheep were put on cardiopulmonary bypass (CPB). In Category I, the hearts of 23 sheep were arrested by global ischemia for 30 min, reperfused with pulsatile flow in 10 animals (P group), and non pulsatile flow in 13 animals (NP group), and then defibrillated. The incidence of ventricular fibrillation was much higher in the NP group than the P group, 77% versus 40% (p < 0.05). The lipoperoxide products and creatinine kinase from coronary sinus blood were elevated, but there were no significant differences between the two groups during 2 hour reperfusion. In the P group, less ultrastructural damage was observed, and Na+ and H2O accumulations in the subendomyocardium were significantly less than in the NP group, at 7.11 +/- 0.60 versus 9.98 +/- 1.10 mg/g dry weight (p < 0.05) and 82.58 +/- 0.47% versus 84.3 +/- 0.38% (p < 0.05), respectively. In Category II, the ischemic time of 17 sheep (eight in the P group, nine in the NP group) was prolonged to 45 min, and animals were supported by CPB after defibrillation. Myocardial energy phosphates were measured with high-performance liquid chromatography, and triphenyltetrazolium chloride was used to delineate the infarct size. After 2 hour of reperfusion, there were no significant differences in myocardial AMP and ADP between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatitis D virus infection among prostitutes in Taiwan

Two hundred and sixty-three adult licensed, 233 adult and 157 teenage unlicensed prostitutes from Taiwan were studied for prevalence and risk factors of hepatitis D virus (HDV) infection. The hepatitis B carrier rate among the three groups was 21, 15 and 20%, respectively, not significantly different from that of the general population in this area. However, the prevalence of HDV infection among carrier prostitutes was 55, 36 and 16%, respectively, much higher than that in general hepatitis B carriers. Univariate analysis revealed that the history of conducting paid sex for more than 12 months (P < 0.03), ear-piercing (P < 0.02), tattooing (P < 0.02), and gonorrhoea or syphilis (P < 0.005) were significant factors associated with HDV infection among these subjects. Multivariate analysis revealed that the history of ear-piercing and venereal diseases (P < 0.001) were still significant. In summary, genital ulcers caused by venereal diseases due to frequent sexual contact with multiple partners, and use of unsterilized needles in ear-piercing or tattooing play important roles in the high prevalence of HDV infection in prostitutes.

[Effect of anhydrous glycerol injection into the mental foramen of rabbit on inferior nerve:An experimental study]

In this experiment anhydrous glycerol was injected into the mental foramen of rabbits to determine neurolytic effects on the peripheral trigeminal nerve by electrohysiologic and morphologic methods.The rabbits underwent unilateral injection of anhydrous glycerol and the control side was injected with normal saline.The results show that partial fibers are effected (myelinated and unmyelinated fibers at random).Glycerol injection increased the average latencies and reduced the average amplitudes of compound action potentials.Morphologic examination disclosed myelin swelling,disintergrationan d axonal shrinking,axonolysis.One week after the injection,eletrophysiologic and morphologic changes were most severe and signs of regeneration were noted in the fifth week,By 16 weeks after injection,the nerve fibers appeared almost normal.

Electrocardiographic and electrophysiologic characteristics of anterior, midseptal and right anterior free wall accessory pathways

OBJECTIVES

The objective of this study was to define the electrocardiographic (ECG) and electrophysiologic characteristics of midseptal, anteroseptal and right anterior free wall accessory pathways.

METHODS

The fully pre-excited 12-lead surface ECGs and ECGs during orthodromic atrioventricular (AV) reentrant tachycardia were compared for 13 patients with an anteroseptal, 7 with a midseptal and 7 with a right free wall accessory pathway. Routine electrophysiologic studies were performed in all and stimulation of the right ventricular summit during tachycardia was accomplished in 10 patients.

RESULTS

Differences in the surface ECGs were not sufficiently sensitive to distinguish among accessory pathway locations. Premature ventricular complexes induced from the right ventricular septal summit during ventricular activation either advanced the succeeding atrial depolarization or terminated the tachycardia in three of six patients with a septal pathway and in none of the four with a right anterior pathway. The change in ventriculoatrial (VA) interval with the development of right bundle branch block during orthodromic AV tachycardia proved most helpful in distinguishing these pathways. Patients with a right anterior free wall pathway showed a change in VA interval > or = 40 ms, whereas those with an anteroseptal pathway showed changes of 20 to 30 ms and those with a midseptal pathway showed no change.

CONCLUSIONS

Anteroseptal, midseptal and right anterior free wall pathways may be distinguished by using programmed stimulation of the summit of the right ventricular septum and especially with changes in the VA interval with development of right bundle branch block during orthodromic AV reentrant tachycardia.

Insular cistern hematoma. A special type of subarachnoid hemorrhage

The clinical manifestations of 20 cases of insular cistern hematoma were characterized by sudden onset violent headache, vomiting, bloody CSF, and subhyaloid hemorrhage (1/3 cases). CT scan showed semilunar high density image centering on the insular cistern with serrate internal edge. The average volume of the hematoma was 20 ml. By means of cerebral angiography, operation and/or autopsy, 7 cases were identified as aneurysm of middle cerebral artery, 6 as aneurysm of posterior communicating artery, and 2 as amyloid angiopathy. In the other 5 cases, the etiology was unknown.

Use of suppressor analysis to identify DNA polymerase mutations in herpes simplex virus which affect deoxynucleoside triphosphate substrate specificity

Herpes simplex virus DNA polymerase mutations which map in the N-terminal part of the protein and appear to alter deoxynucleoside triphosphate (dNTP) substrate specificity are described. These mutations suppress a drug hypersensitivity associated with the downstream mutation, Aphr10. We suggest that the mutant residues form part of the dNTP-binding site, a site previously thought to be confined to the C terminus.