Sealing depth of Nd:YAG laser on human dentinal tubules

Dentin permeability and hypersensitivity are both reduced when the dentinal tubules are occluded. Previous scanning electron microscopic studies showed that Nd:YAG laser could cause melting of dentin and closure of exposed dentinal tubules without dentin surface cracking. Therefore, the aim of the present study was to evaluate the sealing depth of Nd:YAG laser on human dentinal tubules. Thirty-six dentin specimens with exposed dentinal tubule orifices were used in this study. Samples were randomly divided into three groups. Groups A and B were lased by Nd:YAG laser at energy of 30 mJ with 10 pulses/s for a stroke along the dentin surface. Group C was not lased and served as a control. Subsequently, group B was frozen in liquid nitrogen and split by a sharp chisel. Under SEM observation, nonlased specimens showed numerous exposed dentinal tubule orifices, and lased specimens showed melting of dentin and closure of exposed dentinal tubule orifices. The sealing depth of Nd:YAG laser on human dentinal tubules was approximately 4 microns.

Expression of IGFs and their receptors is a potential marker for embryo quality

PROBLEM

Insulin-like growth factors (IGFs) and insulin have been demonstrated to stimulate oocyte maturation and embryo development. Therefore, the expression of IGFs and their receptors may be an important intrinsic factor for embryo growth and may be a potential marker for embryo quality.

METHOD OF STUDY

Thirty donated day 3 embryos were cultured in vitro for an additional 3 days to observe their developmental potential and were semiquantitatively analyzed for the expression of IGF-I, IGF-II, IGF-IR, IGF-IIR, and insulin-R.

RESULTS

Our results show that the activity of these gene expressions correlates well with the morphological assessment and that high and more gene expressions were often associated with embryos of high growth potential.

CONCLUSION

The IGF system may indeed play an important role in human embryogenesis; IGF gene expressions can be a good indicator of embryonic developmental stage and/or growth potential; finally, the IGF system can serve as a marker for embryo quality.

Non-association between Rfp-Y major histocompatibility complex-like genes and susceptibility to Marek's disease virus-induced tumours in 6(3) x 7(2) F2 intercross chickens

Marek's disease (MD) is a lymphoproliferative disease caused by a member of the herpesvirus family, and the best understood genetic resistance to MD involves the chicken major histocompatibility complex (MHC) B-complex. Preliminary observations have suggested that MHC-like Rfp-Y genes might also influence the incidence of MD. This study describes the differentiation and definition of unique Rfp-Y genes in inbred lines 6(3) and 7(2), lines that possess identical B-complex genes, but that are resistant or susceptible to MD, respectively. To assess if Rfp-Y genes affect susceptibility to MD, 265 6(3) x 7(2) F2 chickens were challenged with the JM strain of MD virus at 1 week of age and were evaluated for MD lesions at up to 10 weeks of age. Genotyping of the F2 chickens for Rfp-Y haplotypes was performed by restriction fragment length polymorphism analysis of genomic DNA using TaqI and a B-FIV probe. Analysis of variance and interval mapping procedures were used to determine association between the Rfp-Y haplotypes and the phenotypic MD values of the F2 chickens. The cosegregation analysis of 265 F2 chickens indicated that there was no association between Rfp-Y haplotypes and MD susceptibility. Furthermore, the fact that the Rfp-Y haplotypes fit the 1:2:1 segregation ratio and the Rfp-Y allele frequencies did not differ significantly from 0.5 in the full population or in selected subpopulations (of either 40 MD-resistant or 39 MD-susceptible chickens) also indicated that Rfp-Y haplotypes do not significantly influence MD susceptibility. We conclude that Rfp-Y haplotypes do not play a major role in determining the genetic susceptibility to MD in 6(3) x 7(2) F2 White Leghorn chickens.

Granulopoiesis in newly diagnosed childhood solid tumors

Granulopoiesis at the diagnosis of solid tumors has not been previously reported. The purpose of this study is to detect the changes of granulopoiesis of patients with solid tumors in different clinical stages. Granulocyte-macrophage colony-forming unit (CFU-GM) assays and liquid suspension cultures of bone marrow and peripheral blood were studied in 90 children with newly diagnosed solid tumors, including 5 benign tumors and 85 malignant tumors. The malignant tumors were categorized into nonadvanced, advanced, or marrow-invaded ones. Bone marrow from children with immune thrombocytopenic purpura and peripheral blood from adult volunteers were used as controls. Granulocyte-macrophage colony formation from bone marrow in benign or nonadvanced malignant tumor was not significantly different from that of controls. However, granulocyte macrophage colony formation from bone marrow in advanced or marrow-invaded malignant tumor was significantly less than that of controls or nonadvanced malignant tumor. Furthermore, the bone marrow of patients with advanced malignant tumor occasionally had a defective proliferation pattern and the bone marrow of those with marrow-invaded malignant tumor often had a defective proliferation pattern. Peripheral blood in marrow-invaded malignant tumor had colony and cluster formations in very wide ranges. As a malignant tumor progresses into advanced stages, irrespective of marrow infiltration, bone marrow CFU-GM levels may decline and defective granulopoiesis may occur.

Midfollicular anticardiolipin and antiphosphatidylserine antibody titers do not correlate with in vitro fertilization outcome

OBJECTIVE

To determine the prevalence of anticardiolipin and antiphophatidylserine antibodies in an IVF population and to correlate their presence and specific isotype with IVF cycle outcome.

DESIGN

Retrospective clinical study using stored midfollicular sera for determination of antibody status.

SETTING

University hospital infertility clinic.

PATIENT(S)

Women who underwent IVF treatment in 1991.

INTERVENTION(S)

Midfollicular sera were used to assess antibody status during the time of stimulation for IVF.

MAIN OUTCOME MEASURE(S)

Anticardiolipin and antiphosphatidylserine antibody titers and biochemical or sonographic documentation of IVF cycle outcome.

RESULT(S)

The overall prevalence of anticardiolipin and antiphosphatidylserine antibodies in IVF patients was 7.0% and 11.2%, respectively. There was no statistically significant difference in the prevalence of these antibodies in the groups of patients with a biochemical pregnancy (0 for anticardiolipin and 2.8% for antiphosphatidylserine), spontaneous miscarriage (11.4% for anticardiolipin and 20% for antiphosphatidylserine), ongoing pregnancy (7.3% for anticardiolipin and 11.6% for antiphosphatidylserine), and patients who failed to conceive (7.2% for anticardiolipin and 10.8% for antiphosphatidylserine). There was no correlation between outcome and the antibody isotype expressed.

CONCLUSION(S)

Anticardiolipin and antiphosphatidylserine antibodies are poorly predictive of the IVF cycle outcome. Routine testing of IVF patients for the presence of these antibodies is of limited clinical utility.

The correlation of depression with functional activity in Parkinson's disease

We evaluated 109 Chinese patients with Parkinson's disease (PD) in three ways: using a standardized psychiatric interview for depression and anxiety, using standardized neurological evaluation for motor disability, and using cognitive assessment for cognitive impairment. Six of the 109 patients who had dementia and another two afflicted with organic delusional disorder were excluded from further analysis. The remaining 101 PD patients were divided into the following three groups according to the DSM-III-R criteria: major depressive disorder (n = 18), other depressive disorders (n = 25) including dysthymic disorder and depressive disorder not otherwise specified, and no depression (n = 58). The frequency of major depressive disorder of the 109 PD patients was 16.5%, and the frequency of major and other depressive disorders, taken together, was 42.2%. Using the percentage points measured on the Schwab & England Activities of Daily Living Scale as the dependent variable to fit a multivariate regression model, we found the lower score significantly correlated with the diagnosis of depressive disorder and higher score of the Hamilton Depression Rating Scale, in addition to motor disability and disease severity of PD. Given the high frequency of depression and the significant correlation between depression and performance in daily functional activites, we believe that an evaluation of PD patients for coexisting depression is necessary for a better therapeutic outcome.

[Relationship between syndrome differentiation-typing and expression of platelet-activation molecule CD62P and CD63 on platelets in psoriatic patients]

OBJECTIVE

To understand the relationship between Syndrome Differentiation- Typing and platelet activation in psoriatic patients.

METHODS

Expression of platelet-activation molecules CD62P (alpha-granule membrane glycoprotein) and CD63 (lysosomal integral membrane protein) on platelets from 36 psoriatic patients with Syndrome Differentiation-Typing in TCM and 31 health subjects were investigated by using flow cytometry and specific monoclonal antibodies against activated platelet.

RESULTS

(1) Increased expression of CD62P and CD63 on platelets from psoriatic patients was observed (P < 0.001); (2) The expression of CD62P and CD63 was in following order: The group of Blood Stasis > Blood Dryness > Blood Heat; (3) Compared with the group of Blood Heat, increased expression of CD62P and CD63 was observed in the group of Blood Dryness (P < 0.001); (4) Compared with the group of Blood Dryness, increased expression of CD62P and CD63 was observed in the group of Blood Stasis (P < 0.001).

CONCLUSION

The platelet activation might play an important role in higher blood viscosity, endothelial cell injury, abnormal microcirculation, which was correlated with Blood Stasis, found in psoriasis.

Degradation behaviour of a new bioceramic: Ca2P2O7 with addition of Na4P2O7.10H2O

A newly produced bioceramic, beta-Ca2P2O7 with addition of Na4P2O7.10H2O (SDCP), has been implanted into the femoral condyle of rabbits. Within 6 weeks after implantation, most of the bioceramic is replaced by new woven bone. On the contrary, block from hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP), which are osteoconductible, do not resorb within a short period of time. We believe that the biodegradable behaviour of SDCP may occur in two steps. The first and most important step is the digestion of particles and migration of the particles by phagocytosis. The object of this study is to examine the change in morphologies, chemical compositions and crystal structure of SDCP after soaking in distilled water for a certain period of time. The SDCP ceramic was also co-cultured with leucocytes to observe how the SDCP particles were digested by the leucocytes, so that the mechanism of biodegradable behaviour of SDCP ceramic in vivo might be clarified. Four types of sintered calcium phosphate ceramics were tested in the experiment: SDCP, pure beta-Ca2P2O7 (DCP), HA and beta-TCP. They wee soaked in distilled water at 37 degrees C for up to 30 days. The microstructure and morphology of crystals deposited on the surface were observed using scanning electron microscopy. Sodium, calcium and phosphorus ion contents in the supernatant solution were detected by atomic absorption analysis and ion coupled plasma. In summary, HA and DCP showed no significant evidence of dissolution in distilled water. In static distilled water, calcium ions may be released from beta-TCP into solution during the initial 7 days and then converted into HA by reprecipitation. The results showed that the SDCP was firstly dissolved into small grains or fragments by the solution. The small fragments should be so small as to be digested by the phagocytes in a physiological environment.

Prevalence of headaches in a Chinese elderly population in Kinmen: age and gender effect and cross-cultural comparisons

OBJECTIVE

To investigate the prevalence of headaches in a Chinese elderly population.

BACKGROUND

There are few headache surveys in the elderly. Previous studies have shown a low headache prevalence in Chinese.

METHODS

TARGET POPULATION

eligible registered residents > or = 65 years old (N = 2,003) in two townships of Kinmen Island on August 1, 1993. All participants completed a headache questionnaire and underwent clinical evaluation and examination by a neurologist. Headache diagnoses were made according to the International Headache Society, 1988.

RESULTS

1,533 persons (77%) participated in the study, of whom 584 (38%) had at least one episode of headache in the previous year. One-year prevalence of migraine was 3.0%, and tension-type headache, 35%. The prevalence of migraine, but not tension-type headaches, continued to decline with age in the elderly. Life-time prevalence of "incapacitating headache" was 10%, and that of migraine, 5.2%. Forty-two percent of migraineurs stopped having migraine before this survey. In comparison with "10 years ago" 8% participants felt their current headaches were worse, 25% better, and 67%, no change, with a net improvement of 17%.

CONCLUSIONS

We have reported the highest headache prevalence among different Chinese elderly populations, but these were still lower than those reported from Western series. More than half of the elderly life-time migraineurs still had attacks of migraine. Severe headaches, including migraine but not tension-type headaches, declined with age.

Depressive disorders among older residents in a Chinese rural community

BACKGROUND

Two recent surveys of depression among Chinese elderly people sampled different populations, used different case ascertainment methods and resulted in a seven-fold difference in prevalence rates. The present study was conducted to compare prevalence rates obtained with two commonly used methods in the same population, and to examine the risk factors for depression.

METHODS

The target population included all residents aged 65 years and over in a rural Chinese community. Participants were interviewed for demographic and medical information, examined by a neurologist and administered Chinese versions of the Geriatric Depression Scale-Short Form (GDS-S), the Cognitive Abilities Screening Instrument (CASI) and an Activities of Daily Living (ADL) form. Individuals who screened positive on the GDS-S were also interviewed by a psychiatrist for diagnosis according to the DSM-III-R criteria.

RESULTS

Among the 1313 participants, 26% screened positive on the GDS-S and 13% were diagnosed as having a depressive disorder, including 6.1% with major depression. Individuals with depressive disorders were more likely to have poor ADL scores, lower CASI scores, and chronic physical illnesses. They were also more likely to be female, older, illiterate and without a spouse, but adding these variables did not increase the overall association with the GDS-S score.

CONCLUSIONS

Depression was quite common in this Chinese rural geriatric population. The prevalence rate was twice as high when judged by depression symptomatology rather than clinical diagnosis. The critical risk factors were functional impairments, poor cognitive abilities and the presence of chronic physical illnesses.

Poststroke depression among the Chinese elderly in a rural community

BACKGROUND AND PURPOSE

A door-to-door survey was conducted in two townships in the Kinmen islets to investigate the prevalence and other characteristics related to depressive disorders of stroke survivors in an elderly Chinese population.

METHODS

Our target population comprised the registered residents > or = 65 years old (n = 2056) of a total population of 26 105 on August 1, 1993. All participants answered a questionnaire, filled in a Geriatric Depression Scale-short form (GDS-S), and received a neurological examination. Depression was defined as a GDS-S score > or = 5.

RESULTS

Twenty-eight of 45 stroke survivors (62.2%) and 491 of 1471 nonstroke subjects (33.4%) were classified as depressed. The frequency of stroke survivors' depressive disorders was significantly higher that of nonstroke subjects (P < .001). Multiple regression analysis indicated that GDS-S scores were most related with the activities of daily living (R2 = .19, P = .004) in the stroke survivors.

CONCLUSIONS

Depressed mood was common after stroke, and activities of daily living were an important factor for depression in stroke survivors in the community.

Swallowing difficulty in Parkinson's disease

Dysphagia is a frequent and potentially serious complication of Parkinson's disease (PD). We examined the oropharyngeal swallowing ability in 19 PD patients (15 men and 4 women, mean age 68.42 years, mean Hoehn and Yahr stage 1.8) using modified barium swallow before and after administering oral levodopa (in combination with benserazide). Twelve (63.2%) patients demonstrated objective evidence of swallowing abnormalities; although only six patients (31.6%) had subjective complaints. Vallecula sinus and pyriform sinus residues were the most frequent abnormalities (47.4% and 42.1%); followed by delayed swallowing reflex (26.3%). Three patients demonstrated silent aspiration. In the 12 patients with abnormal swallowing, six (50%) showed objective improvement after levodopa treatment, while the remaining six showed no change. Of the former group of six, one patient showed improvement in the oral phase, but deterioration in the pharyngeal phase. We concluded that PD patients had a high percentage of objective swallowing abnormalities which could be reduced in half of the patients through the administration of levodopa treatment.

Effect of hydroxyapatite particle size on myoblasts and fibroblasts

After surgery, the bone and soft tissues around integrated biomaterials can be adversely affected by implant-related factors acting over a period of years. However, few studies have directly addressed the effects upon the adjacent soft tissue. The present study was designed to test the biological effects of various sized hydroxyapatite (HA) particles on myoblasts and fibroblasts. Both the myoblasts and fibroblasts were mixed in in vitro culture with 0.1% (1 mg ml(-1)) of various sized HA particles (0.5-3.0, 37-63, 177-250, 420-841 microm) for 1 h, 3 h, 1 day, 3 days and 7 days to test their effects on the cell culture. The results show that adding HA particles into a cell culture can decrease the cell count significantly. The transforming growth factor-beta1 (TGF-beta1) concentrations in the culture medium decreased significantly on addition of HA particles. When calculated as a ratio to the cell number, the TGF-beta1 titre increased most significantly in the groups of medium-sized particles. The prostaglandin E2 (PGE2) concentrations in the medium increased significantly. The changes in TGF-beta1 and PGE2 concentrations with the smallest particles were most significant and persisted longer. The inhibitory effects of the HA particles on the cell culture were mediated by the increased synthesis of PGE2. Caution should be exercised before considering the use of an HA product which could easily break down into a fine powder.

Withholding gonadotropin administration is an effective alternative for the prevention of ovarian hyperstimulation syndrome

OBJECTIVE

To evaluate the outcomes of IVF and the incidence of ovarian hyperstimulation syndrome (OHSS) after discontinuing gonadotropin therapy in patients at risk of developing OHSS by delaying hCG administration until a drop in serum E2 levels was observed.

DESIGN

Retrospective study.

SETTING

IVF program at a university center.

INTERVENTIONS

Gonadotropin administration was withheld in 22 patients (group 1) when their serum E2 level was > or = 3,000 pg/mL (conversion factor to SI unit, 3.671). Patients continued GnRH analogue injections daily, and hCG was administered when serum E2 levels dropped to < or = 3,000 pg/mL. Outcomes were compared with 26 patients (group 2) in whom embryo transfer was canceled and all embryos cryopreserved for transfer during a subsequent unstimulated cycle.

MAIN OUTCOME MEASURES

Outcomes of IVF and incidence of OHSS were compared in both groups of patients. In group 1, follicular and hormonal parameters before and after the coasting interval were compared in pregnant versus nonpregnant patients. In addition, serum hormonal profiles were evaluated daily during the coasting period to determine the effects of gonadotropin withdrawal.

RESULTS

Although the mean number of oocytes retrieved was significantly higher in group 2, fertilization rates, miscarriage rates, delivery rates/stimulation cycle, and the incidence of OHSS did not differ significantly between the two groups.

CONCLUSION

Withholding gonadotropin administration is an effective alternative to prevent the development of severe OHSS in a high-risk population. Although the risk of cancellation cannot be completely eliminated, this strategy can provide a high pregnancy rate without the need to repeat multiple frozen-thawed cycles.

Simultaneous detection of multiple gene expression in mouse and human individual preimplantation embryos

OBJECTIVE

To detect simultaneously multiple gene expression in mouse and human individual embryos by reverse transcriptase-polymerase chain reaction.

DESIGN

Transcripts involved in the insulin-like growth factor (IGF) system were detected in mouse and human preimplantation embryos.

SETTING

An academic teaching hospital.

MAIN OUTCOME MEASURE(S)

Transcripts of the IGF family genes.

RESULT(S)

In the mouse, genes are expressed differentially and messenger RNA transcripts of maternal origin in nonfertilized ova decline gradually until the initiation of the embryonic genome transcription. Insulin-like growth factor-binding protein-2 (IGFBP)-2, -3, -4, and beta-actin transcripts appear to be initiated at the two- to four-cell stage, whereas IGFBP-1, -5, and -6 transcripts are initiated at later stages. Transcription, once initiated, appears to continue through to the blastocyst stage. In humans, almost all genes of the IGF system were expressed in preimplantation embryos. This is the first report of the assessment of IGF family transcripts in individual embryos, and introduces a novel method for research and clinical diagnosis of preimplantation embryos.

Triple innominate osteotomy and rotational acetabular osteotomy in the treatment of congenital hip dysplasia

Congenital hip dysplasia is a developmental disease which predisposes patients to osteoarthritis of the hip. We compare the results and complications of triple innominate osteotomy and rotational acetabular osteotomy in the treatment of this disease. Between 1984 and 1992, 27 patients with 30 dysplastic hips received reconstructive procedures at National Taiwan University Hospital. Fourteen patients (16 hips) with a median age of 18 years were treated by triple innominate osteotomy. Nine of 16 hips had concomitant femoral osteotomy. Another 13 patients (14 hips) with a median age of 24 years were treated by rotational acetabular osteotomy. We compared the radiologic and functional results, complications and satisfaction of the patients in these two groups. Patients who underwent rotational osteotomy showed more correction in roof obliquity than patients who had triple innominate osteotomy. The functional results when evaluated by Harris scores, were better in patients who had triple innominate osteotomy than rotational osteotomy. Complications included one resubluxation of the hip in each group as well as one perforation of the hip joint and one pin break and nonunion at the osteotomy site in the rotational osteotomy group. Patients who had triple innominate osteotomy were more satisfied with the results. With proper selection of patients and accurate performance of the procedure, both triple innominate osteotomy and rotational osteotomy may be used effectively for the treatment of congenital hip dysplasia. However, in our study, patients who underwent rotational osteotomy had better anatomic correction, while those who underwent triple innominate osteotomy had better functional results.

In vitro cell behavior of osteoblasts on Pyrost bone substitute

BACKGROUND

Pyrost bone substitute has been shown to be a promising orthopedic biomaterial. However, little is known about mechanisms that are responsible for the genesis and development of the bond between bone and the Pyrost bone substitute. The purpose of this study is to elucidate the in vitro cell behavior of osteoblasts on Pyrost bone substitute.

METHODS

By using primary culture of rat osteoblasts, the changes in cell morphology during adhesion and flattening onto the surface of Pyrost bone substitute were studied in vitro. At 1 hour, at 3 hours, and at days 1, 3, and 7 after layering, the cell behavior was observed with scanning electron microscope.

RESULTS

The processes of trypsinized osteoblast adhesion and spreading on Pyrost bone substitute consisted of 1) contact of rounded osteoblasts with the Pyrost substrate; 2) attachment of osteoblasts at point of contact; 3) centrifugal growth of filopodia; 4) flattening and spreading of the osteoblasts on the Pyrost substrate; 5) division and growth of osteoblasts; and 6) suspension of the osteoblasts across the pores by their processes.

CONCLUSIONS

These results demonstrated that Pyrost can form a physico-chemical bond with osteoblasts. The Pyrost bone substitute not only supports osteoblasts attachment but also allows proliferation of the osteoblasts.

Effects of calcium phosphate bioceramics on skeletal muscle cells

With advances in ceramics technology, calcium phosphate bioceramics have been applied as bone substitutes. The effects of implants on bony tissue have been investigated. The effects upon adjacent skeletal muscles have not been determined. The focus of this work is to elucidate the biological effects of various calcium phosphate bioceramics on skeletal muscles. Four different kinds of powder of calcium phosphate biomaterials including beta-tricalcium phosphate (beta-TCP), hydroxyapatite (HA), beta-dicalcium pyrophosphate (beta-DCP) and sintered beta-dicalcium pyrophosphate (SDCP), were tested by myoblast cell cultures. The results were analyzed by cell count, cell morphology and concentration of transforming growth factor beta 1 (TGF-beta 1) in culture medium. The cell population and TGF-beta 1 concentration of the control sample increased persistently as the time of culture increased. The changes in cell population and TGF-beta 1 concentration in culture medium of the beta-TCP and HA were quite low in the first 3 days of culture, then increased gradually toward the seventh day. The changes in cell population and TGF-beta 1 concentration in culture medium of the silica, beta-DCP, and SDCP were quite similar. They were lower during the first day of culture but increased and reached that of the control medium after 7 days' culture. Most cells on B-TCP and HA diminished in size with radially spread, long pseudopods. We conclude that HA and beta-TCP are thought to have an inhibitory effect on growth of the myoblasts. The HA and beta-TCP may interfere with the repair and regeneration of injured skeletal muscle after orthopedic surgery.

Cloning and characterization of a cotton lipid transfer protein gene specifically expressed in fiber cells

A cotton genomic library was screened using a fiber-specific cDNA (GH3) encoding a lipid transfer protein (LTP). One genomic clone (1.7 kb DNA insert) containing the Ltp gene (Ltp6) was sequenced and characterized. The Ltp6 contains an open reading frame of 360 bp, which is interrupted by a single intron (136 bp) located in the region corresponding to the C-terminal of the protein. The derived amino-acid sequence of LTP6 is 64% homologous to that of GH3. Like the GH3 gene, the Ltp6 is specifically expressed in fiber cells in a temporal manner. However, its expression level is lower than that of GH3.

Biocompatibility and osteoconductivity of the pyrost bone substitutes

The purpose of this study was to re-evaluate the bone regeneration power and the in vitro biocompatibility of the Pyrost bone substitute. Twenty-four adult New Zealand White rabbits were used. Bony defect over both iliac crest and mid-diaphyseal portion of the ulna bone were created. Appropriate sized-block of Pyrost bone substitute were implanted. Four of the animals were killed at each postoperative month to evaluate its bone regeneration power by histologic study. The Pyrost bones were co-cultured with osteoblasts to evaluate its biocompatibility. The results showed that Pyrost bone substitute was quite stable and incorporated well with active bone regeneration. The Pyrost heal better at the iliac crest than at the ulnar defect. The Pyrost was compatible to the osteoblasts. Osteoblasts had successfully seeded and mitotically expanded on the porous surface of the Pyrost bone graft. The result showed that Pyrost bone obviously exerts an intense stimulus on osteo-regeneration in the presence of osteoblasts. We consider Pyrost to be an alternate to the conventional preserved allografts that is occasionally necessary.

NSAID-induced gastrointestinal damage. Epidemiology, risk and prevention, with an evaluation of the role of misoprostol. An Asia-Pacific perspective and consensus

The problem of nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal toxicity was reviewed by members of the Asia Pacific League of Associations for Rheumatology (APLAR) in a consensus conference in September 1992. This paper by the participants presents the consensus conclusions incorporating knowledge from recent publications. There had been a high level of concern that much of the toxicity had resulted from extensive and indiscriminate prescribing of NSAIDs. The implementation of evidence-based guidelines was considered likely to be able to effect a substantial reduction in toxicity without significant loss of overall therapeutic benefit. The evidence from which such guidelines could be developed is critically appraised.

The Kinmen Neurological Disorders Survey (KINDS): a study of a Chinese population

We conducted an epidemiological study of several neurological disorders among the Chinese aged 50 years or older on the islet of Kinmen. All participants were interviewed and examined by neurologists. From the targeted population of 5,061 individuals, 3,915 (77.4%) of them completed the evaluations. Among the 4,087 individuals with whom face-to-face contact was made, the refusal rate was 4.2%. The disorders of interest were dementia, Parkinson's disease, essential tremor, stroke, transient ischemic attacks, and migraine. Among the 3,915 participants, 366 cases were found with 1 or more of the surveyed neurological disorders on the prevalence day, August 1, 1993, yielding a prevalence of 93.5/1,000. The purpose of this study, the general methodology, and some overall findings are presented in this communication in order to provide a common background for detailed findings on each disorder to be reported separately.

Hormonal regulation of expression of messenger RNA encoding insulin-like growth factor binding proteins in human endometrial stromal cells cultured in vitro

To investigate the presence of messenger RNA (mRNA) encoding insulin-like growth factor binding proteins (IGFBP) in human secretory endometrial stromal cells cultured in vitro, total cellular mRNA and protein extracted from cells treated with various hormones were detected and identified by Northern and Western blotting techniques respectively. Northern blot analysis detected 1.4 and 2.5 kilobase (kb) mRNA transcripts for IGFBP-2 and IGFBP-3 respectively, in both control and progestin-treated human endometrial stromal cells in vitro. However, the 1.5 kb mRNA transcript of IGFBP-1 was detected only in progestin-treated cells but not in the controls. Progestin alone markedly stimulated cellular BP-1 protein and mRNA, but only moderately stimulated cellular IGFBP-2 and IGFBP-3 protein mRNA in a dose-dependent fashion. Adding relaxin at the same time as progestin further enhanced the stimulatory effects of progesterone. Oestradiol had a stimulatory effect on cellular IGFBP-2 mRNA, but had an inhibitory effect on protein and mRNA of IGFBP-3, also in a dose-dependent fashion. In general, for each specific binding protein, the amount of cellular mRNA correlated well with the amount of cellular protein. Therefore, IGFBP protein and mRNA transcript in human secretory endometrial stromal cells appears to be under hormonal influence. These hormones may control the synthesis of IGFBPs at the transcription rather than the translation level.

Weight bearing influence on knee joint bony contact movements: an in vivo video-fluoroscopy study

In order to understand the effects of body weight-bearing on knee joint bony contact movements, a video-fluoroscopic digitizing system with in vivo human knee extension-flexion motions of 12 healthy adults under body weight-bearing and non-weight-bearing conditions was studied. These 12 subjects were equally separated into two groups consisting of a body weight-bearing group and a non-weight-bearing group. Video-fluoroscopic images were digitized to get three parameters from the knee joint bony geometry. These three parameters were the radius of rotation, the are length of rotation, and the contact point of the tibiofemoral joint, and they were used to decide the knee joint bony contact status of the sliding, spinning and rocking motions. The results showed that the knee bony contact movements under body weight-bearing conditions had about 4 times the incidence rate of the sliding motion under non-weight-bearing conditions. The incidence rate of the sliding motion was greatest when the knee flexion was less than 30 degrees. The knee bony contact movements under non-weight-bearing conditions had a larger spinning motion incidence rate and smaller rocking motion incidence rate than they did under weight-bearing conditions. The larger spinning motion incidence rate when the knee joint flexion was greater than 60 degrees. In conclusion, the body weight-bearing factor should be considered in studying knee joint bony contact movements.

Endometrial pattern in diethylstilboestrol-exposed women undergoing in-vitro fertilization may be the most significant predictor of pregnancy outcome

The objective of this study was to compare prospectively pregnancy outcome as it is related to ultrasonic endometrial echo pattern in women exposed to diethylstilboestrol (DES) in utero by their mother's consumption with women not exposed to DES, all of whom were undergoing in-vitro fertilization (IVF). Pregnancy outcome relative to endometrial thickness and pattern was evaluated in 540 cycles of IVF including DES (n = 50) and non-DES-exposed (n = 490) women. Endometrial patterns were designated as p1 = solid; p2 = ring; and p3 = intermediate. DES patients exhibited p1 more often than the majority of the non-DES-exposed group. There was no significant difference in endometrial thickness among the cycles where p1 was noted when comparing the DES (10.3 mm) with the non-DES-exposed (10.7 mm) groups. Notably, within the group exhibiting p1, no pregnancies occurred in the 18 cycles of DES-exposed women compared with a 39.2% clinical pregnancy and 36.5% delivery rate in the non-DES-exposed controls (P < 0.0001 and P = 0.008 respectively). Pregnancy rates were not significantly different in the cycles where the other endometrial patterns were found when comparing the two groups. The impact of uterine shape on pregnancy outcome was also investigated. A T-shaped uterine configuration was noted in 11 out of 18 (61.1%) cycles of DES-exposed women with pattern p1 compared with nine out of 23 (39.1%) with pattern p2. Of cycles where a T-shaped uterus was demonstrated, none out of 11 (0%) with pattern p1 compared with four out of nine (44.4%) with pattern p2 resulted in pregnancy (P = 0.026). These data suggest that endometrial pattern is one of the most significant variables for pregnancy outcome in DES-exposed women undergoing IVF.