Computer programmers show distinct, expertise-dependent brain responses to violations in form and meaning when reading code

As computer programming becomes more central to the workforce, the need for better models of how it is effectively learned has become more apparent. The current study addressed this gap by recording electrophysiological brain responses as 62 Python programmers with varying skill levels read lines of code with manipulations of form (syntax) and meaning (semantics). At the group level, results showed that manipulations of form resulted in P600 effects, with syntactically invalid code generating more positive deflections in the 500-800 ms range than syntactically valid code. Meaning manipulations resulted in N400 effects, with semantically implausible code generating more negative deflections in the 300-500 ms range than semantically plausible code. Greater Python expertise within the group was associated with greater sensitivity to violations in form. These results support the notion that skilled programming, like skilled natural language learning, is associated with the incorporation of rule-based knowledge into online comprehension processes. Conversely, programmers at all skill levels showed neural sensitivity to meaning manipulations, suggesting that reliance on pre-existing semantic relationships facilitates code comprehension across skill levels.

Fungal Planet description sheets: 1478-1549

Novel species of fungi described in this study include those from various countries as follows: Australia, Aschersonia mackerrasiae on whitefly, Cladosporium corticola on bark of Melaleuca quinquenervia, Penicillium nudgee from soil under Melaleuca quinquenervia, Pseudocercospora blackwoodiae on leaf spot of Persoonia falcata, and Pseudocercospora dalyelliae on leaf spot of Senna alata. Bolivia, Aspicilia lutzoniana on fully submersed siliceous schist in high-mountain streams, and Niesslia parviseta on the lower part and apothecial discs of Erioderma barbellatum on a twig. Brazil, Cyathus bonsai on decaying wood, Geastrum albofibrosum from moist soil with leaf litter, Laetiporus pratigiensis on a trunk of a living unknown hardwood tree species, and Scytalidium synnematicum on dead twigs of unidentified plant. Bulgaria, Amanita abscondita on sandy soil in a plantation of Quercus suber. Canada, Penicillium acericola on dead bark of Acer saccharum, and Penicillium corticola on dead bark of Acer saccharum. China, Colletotrichum qingyuanense on fruit lesion of Capsicum annuum. Denmark, Helminthosphaeria leptospora on corticioid Neohypochnicium cremicolor. Ecuador (Galapagos), Phaeosphaeria scalesiae on Scalesia sp. Finland, Inocybe jacobssonii on calcareous soils in dry forests and park habitats. France, Cortinarius rufomyrrheus on sandy soil under Pinus pinaster, and Periconia neominutissima on leaves of Poaceae. India, Coprinopsis fragilis on decaying bark of logs, Filoboletus keralensis on unidentified woody substrate, Penicillium sankaranii from soil, Physisporinus tamilnaduensis on the trunk of Azadirachta indica, and Poronia nagaraholensis on elephant dung. Iran, Neosetophoma fici on infected leaves of Ficus elastica. Israel, Cnidariophoma eilatica (incl. Cnidariophoma gen. nov.) from Stylophora pistillata. Italy, Lyophyllum obscurum on acidic soil. Namibia, Aureobasidium faidherbiae on dead leaf of Faidherbia albida, and Aureobasidium welwitschiae on dead leaves of Welwitschia mirabilis. Netherlands, Gaeumannomycella caricigena on dead culms of Carex elongata, Houtenomyces caricicola (incl. Houtenomyces gen. nov.) on culms of Carex disticha, Neodacampia ulmea (incl. Neodacampia gen. nov.) on branch of Ulmus laevis, Niesslia phragmiticola on dead standing culms of Phragmites australis, Pseudopyricularia caricicola on culms of Carex disticha, and Rhodoveronaea nieuwwulvenica on dead bamboo sticks. Norway, Arrhenia similis half-buried and moss-covered pieces of rotting wood in grass-grown path. Pakistan, Mallocybe ahmadii on soil. Poland, Beskidomyces laricis (incl. Beskidomyces gen. nov.) from resin of Larix decidua ssp. polonica, Lapidomyces epipinicola from sooty mould community on Pinus nigra, and Leptographium granulatum from a gallery of Dendroctonus micans on Picea abies. Portugal, Geoglossum azoricum on mossy areas of laurel forest areas planted with Cryptomeria japonica, and Lunasporangiospora lusitanica from a biofilm covering a biodeteriorated limestone wall. Qatar, Alternaria halotolerans from hypersaline sea water, and Alternaria qatarensis from water sample collected from hypersaline lagoon. South Africa, Alfaria thamnochorti on culm of Thamnochortus fraternus, Knufia aloeicola on Aloe gariepensis, Muriseptatomyces restionacearum (incl. Muriseptatomyces gen. nov.) on culms of Restionaceae, Neocladosporium arctotis on nest of cases of bag worm moths (Lepidoptera, Psychidae) on Arctotis auriculata, Neodevriesia scadoxi on leaves of Scadoxus puniceus, Paraloratospora schoenoplecti on stems of Schoenoplectus lacustris, Tulasnella epidendrea from the roots of Epidendrum × obrienianum, and Xenoidriella cinnamomi (incl. Xenoidriella gen. nov.) on leaf of Cinnamomum camphora. South Korea, Lemonniera fraxinea on decaying leaves of Fraxinus sp. from pond. Spain, Atheniella lauri on the bark of fallen trees of Laurus nobilis, Halocryptovalsa endophytica from surface-sterilised, asymptomatic roots of Salicornia patula, Inocybe amygdaliolens on soil in mixed forest, Inocybe pityusarum on calcareous soil in mixed forest, Inocybe roseobulbipes on acidic soils, Neonectria borealis from roots of Vitis berlandieri × Vitis rupestris, Sympoventuria eucalyptorum on leaves of Eucalyptus sp., and Tuber conchae from soil. Sweden, Inocybe bidumensis on calcareous soil. Thailand, Cordyceps sandindaengensis on Lepidoptera pupa, buried in soil, Ophiocordyceps kuchinaraiensis on Coleoptera larva, buried in soil, and Samsoniella winandae on Lepidoptera pupa, buried in soil. Taiwan region (China), Neophaeosphaeria livistonae on dead leaf of Livistona rotundifolia. Türkiye, Melanogaster anatolicus on clay loamy soils. UK, Basingstokeomyces allii (incl. Basingstokeomyces gen. nov.) on leaves of Allium schoenoprasum. Ukraine, Xenosphaeropsis corni on recently dead stem of Cornus alba. USA, Nothotrichosporon aquaticum (incl. Nothotrichosporon gen. nov.) from water, and Periconia philadelphiana from swab of coil surface. Morphological and culture characteristics for these new taxa are supported by DNA barcodes. Citation: Crous PW, Osieck ER, Shivas RG, et al. 2023. Fungal Planet description sheets: 1478-1549. Persoonia 50: 158- 310. https://doi.org/10.3767/persoonia.2023.50.05.

Case report: A hybrid open and endovascular approach for repairing a life-threatening innominate artery dissection using the simultaneous kissing stent technique

Managing acute innominate artery (IA) dissection associated with severe stenosis is challenging due to its rarity, possible complex dissection patterns, and compromised blood flow to the brain and upper extremities. This report describes our treatment strategy for this challenging disease using the kissing stent technique. A 61-year-old man had worsening of an acute IA dissection secondary to an extension of a treated aortic dissection. Four possible treatment strategies for kissing stent placement were proposed based on different approaches (open surgical or endovascular) and accesses (trans-femoral, trans-brachial, or trans-carotid access). We chose to place two stents simultaneously via a percutaneous retrograde endovascular approach through the right brachial artery and a combined open surgical distal clamping of the common carotid artery with a retrograde endovascular approach through the carotid artery. This hybrid approach strategy highlights the three key points for maintaining safety and efficacy: (1) good guiding catheter support is obtainable through retrograde, rather than antegrade, access to the lesion, (2) concomitant cerebral and upper extremity reperfusion is guaranteed by placing kissing stents into the IA, and (3) peri-procedural cerebral emboli are prevented by surgical exposure of the common carotid artery with distal clamping.

Relating Natural Language Aptitude to Individual Differences in Learning Programming Languages

This experiment employed an individual differences approach to test the hypothesis that learning modern programming languages resembles second "natural" language learning in adulthood. Behavioral and neural (resting-state EEG) indices of language aptitude were used along with numeracy and fluid cognitive measures (e.g., fluid reasoning, working memory, inhibitory control) as predictors. Rate of learning, programming accuracy, and post-test declarative knowledge were used as outcome measures in 36 individuals who participated in ten 45-minute Python training sessions. The resulting models explained 50-72% of the variance in learning outcomes, with language aptitude measures explaining significant variance in each outcome even when the other factors competed for variance. Across outcome variables, fluid reasoning and working-memory capacity explained 34% of the variance, followed by language aptitude (17%), resting-state EEG power in beta and low-gamma bands (10%), and numeracy (2%). These results provide a novel framework for understanding programming aptitude, suggesting that the importance of numeracy may be overestimated in modern programming education environments.

Time-weighted average sampling of airborne propylene glycol ethers by a solid-phase microextraction device

A solid-phase microextraction (SPME) device was used as a diffusive sampler for airborne propylene glycol ethers (PGEs), including propylene glycol monomethyl ether (PGME), propylene glycol monomethyl ether acetate (PGMEA), and dipropylene glycol monomethyl ether (DPGME). Carboxen-polydimethylsiloxane (CAR/PDMS) SPME fiber was selected for this study. A polytetrafluoroethylene (PTFE) tubing was used as the holder, and the SPME fiber assembly was inserted into the tubing as a diffusive sampler. The diffusion path length and area of the sampler were 0.3 cm and 0.00086 cm(2), respectively. The theoretical sampling constants at 30°C and 1 atm for PGME, PGMEA, and DPGME were 1.50 × 10(-2), 1.23 × 10(-2) and 1.14 × 10(-2) cm(3) min(-1), respectively. For evaluations, known concentrations of PGEs around the threshold limit values/time-weighted average with specific relative humidities (10% and 80%) were generated both by the air bag method and the dynamic generation system, while 15, 30, 60, 120, and 240 min were selected as the time periods for vapor exposures. Comparisons of the SPME diffusive sampling method to Occupational Safety and Health Administration (OSHA) organic Method 99 were performed side-by-side in an exposure chamber at 30°C for PGME. A gas chromatography/flame ionization detector (GC/FID) was used for sample analysis. The experimental sampling constants of the sampler at 30°C were (6.93 ± 0.12) × 10(-1), (4.72 ± 0.03) × 10(-1), and (3.29 ± 0.20) × 10(-1) cm(3) min(-1) for PGME, PGMEA, and DPGME, respectively. The adsorption of chemicals on the stainless steel needle of the SPME fiber was suspected to be one of the reasons why significant differences between theoretical and experimental sampling rates were observed. Correlations between the results for PGME from both SPME device and OSHA organic Method 99 were linear (r = 0.9984) and consistent (slope = 0.97 ± 0.03). Face velocity (0-0.18 m/s) also proved to have no effects on the sampler. However, the effects of temperature and humidity have been observed. Therefore, adjustments of experimental sampling constants at different environmental conditions will be necessary.

Prospective analysis of KRAS wild-type patients with metastatic colorectal cancer using cetuximab plus FOLFIRI or FOLFOX4 treatment regimens

Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor, has proven to be efficient in the treatment of metastatic colorectal cancer. We made a prospective study of the efficacy and toxicities of cetuximab-combination first-line (FOLFOX4) versus second/third-line (FOLFIRI) chemotherapy in 98 KRAS wild-type patients who had metastatic colorectal cancer. Wild-type KRAS had been identified by direct sequencing. Associations between clinical response/progression-free survival/overall survival/toxicities and cetuximab-combination chemotherapy timing were evaluated. The overall response rate was significantly higher for first-line treatment than for second/third-line treatment (relative risk = 1.707, 95% confidence interval = 1.121-2.598). Both progression-free survival and overall survival indicated significantly longer survival of first-line treatment than second/third-line treatment patients. This study is a validation of a molecular analysis of KRAS wild-type status for the prediction of response to cetuximab-combination chemotherapy for metastatic colorectal cancer patients; its predictive role was less prominent in the second/third-line than in the first-line treatment patients.

GaN epitaxial layers prepared on nano-patterned Si(001) substrate

We report the growth of GaN epitaxial layer on Si(001) substrate with nano-patterns prepared by dry etching facility used in integrated circuit (IC) industry. It was found that the GaN epitaxial layer prepared on nano-patterned Si(001) substrate exhibits both cubic and hexagonal phases. It was also found that threading dislocation observed from GaN prepared on nano-patterned Si(001) substrate was significantly smaller than that prepared on conventional unpatterned Si(111) substrate. Furthermore, it was found that we can reduce the tensile stress in GaN epitaxial layer by about 78% using the nano-patterned Si(001) substrate.

Electronic Health Record Goes Personal World-wide

Objective Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With “consumer empowerment” being an important issue of EHR, we are seeing a more “patient-centric” approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use.

Methods We use “B2C(2B)” to represent this new behavior of EHR sharing and exchange, with “consumer” in the center stage.

ResultsBased on different information sharing mechanisms, we summarized the “B2C(2B)” behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns.

Conclusion Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.

Electronic health record goes personal world-wide

OBJECTIVE

Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With "consumer empowerment" being an important issue of EHR, we are seeing a more "patient-centric" approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use.

METHODS

We use "B2C(2B) " to represent this new behavior of EHR sharing and exchange, with "consumer" in the center stage.

RESULTS

Based on different information sharing mechanisms, we summarized the "B2C(2B) " behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns.

CONCLUSION

Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.

A new fluoroscopy-free navigation device for distal interlocking screw placement

During the treatment of tibia fracture with interlocking nails, the most uncomfortable procedure is for an orthopaedic surgeon to find the location for the distal locking screws. In this study, a fluoroscopy-free non-contact navigation device was developed for the placement of distal locking screws in the tibia intramedullary nailing. This device utilizes a 3D digitization arm integrated with spatial coordinate registration module, graphical user interface module and sound-guided navigation module. The 3D digitization arm, a five-DOF passive robotic arm, was used to register the spatial coordinates of proximal and distal landmarks just before placement of the nail. The registered coordinates were then incorporated with the coordinates of the proximal landmarks after nail placement to calculate the coordinate transformation matrix. The transformed spatial coordinates of the distal screw holes were then computed in real time for interlocking nail navigation. A sound-guided navigation module was designed in which a sound with different tones and intermittence frequencies was produced, as the probe of the digitization arm navigates toward the location of distal screw holes. No intra-operative fluoroscopy was required. In vitro assessment was performed successfully with a donor bone, and a clinical case of a young male with tibia fracture was also carried out in the operating theatre. Operation time, distal screw insertion, total radiation time and accuracy of the distal interlocking screw placement were measured. The surgery was conducted under sterile conditions without complication, and the clinical course was smooth with prompt bone healing.

Effect of hormone replacement therapy on uterine fibroids in postmenopausal women—a 3-year study

OBJECTIVE

The aim of this prospective 3-year clinical study was to examine the effect of hormone replacement therapy (HRT) on uterine fibroid growth among postmenopausal women.

METHODS

Thirty-seven postmenopausal women with uterine solitary fibroids were recruited randomly for HRT in a 3-year program. All participants received 0.625 mg conjugated equine estrogen (CEE) and 5 mg medroxyprogesterone (MPA) daily. Fibroid volume was measured by transvaginal ultrasonography at baseline and then at 12-month intervals for 3 times. Clinically, significant fibroid growth was defined as an increase in volume of more than 25% compared with baseline. Also, 35 postmenopausal women with uterine fibroid were studied as control who did not receive HRT during the study period.

RESULTS

Fibroid volume had increased significantly after 1 year both in HRT users and non-users. These increases continued to the second year significantly in HRT users but not in non-users. However, the volumes declined significantly at the third year to similar levels as those measured at baseline in control. In HRT users, fibroid volume though significantly increased at the third year (vs. baseline) but declined insignificantly in comparison with the second year. Clinically, at end of the third year study, one of 34 and three of 34 women increased fibroid volume over 25% compared with baseline in HRT non-users and users, respectively.

CONCLUSIONS

HRT does increase uterine fibroid volume statistically. However, its effect appears in the first 2 years of use. The increased fibroid volume begins to decline at the third year both in HRT users and non-users. Clinically, the increased effect of HRT on uterine fibroid of postmenopausal women should be not over-emphasized at least for 3 years of usage.

A defoaming agent should be used with pronase premedication to improve visibility in upper gastrointestinal endoscopy

BACKGROUND AND STUDY AIMS

The study tested whether pronase can improve endoscopic visibility and alter the accuracy of the CLO test for H. pylori detection.

PATIENTS AND METHODS

A total of 160 patients were randomly assigned to receive one of five premedications for endoscopy: group A: dimethylpolysiloxane (DMPS) alone; group B: DMPS plus water (up to 100 ml); group C: pronase only, with 100 ml water; group D: pronase and sodium bicarbonate plus water up to 100 ml; group E: pronase, sodium bicarbonate, and DMPS, plus water up to 100 ml. Endoscopists, who were unaware of the premedication method administered, assessed visibility scores (range 1 - 4) for the antrum, lower gastric body, upper gastric body, and fundus. The higher the score, the less clear the visibility. The sum of scores from the four locations was defined as the total visibility score. A CLO test was also done during the endoscopy. One week after their endoscopy, patients in groups C, D, and E were scheduled for a (13)C-urea breath test (UBT).

RESULTS

Group E patients had a significantly lower total visibility score than those in the other four groups ( P < 0.05). Groups C and D had higher total visibility scores than the other three groups ( P < 0.05). The scores did not significantly differ between groups A and B. Based on the UBT results, the sensitivity and specificity of the CLO test were 92.6 % and 96.2 %, respectively.

CONCLUSIONS

Premedication as in group E provided the clearest endoscopic visibility. Without the application of DMPS, pronase alone cannot improve endoscopic visibility. Pronase does not influence H. pylori identification using the CLO test.

Reduction in primary nonfunction of syngeneic islet transplants with nordihydroguaiaretic acid, a lipoxygenase inhibitor

To study the effectiveness of a lipoxygenase inhibitor, nordihydroguaiaretic acid (NDGA), in the reduction of primary nonfunction, an insufficient number of syngeneic islets were transplanted underneath the renal capsule with NDGA administered daily for 4 weeks. After transplantation of the 150 islets, the decrement of blood glucose levels was significantly faster in the mice that had received NDGA than in the mice that had received no drug at all or dimethyl sulfoxide (DMSO) (p < 0.005, p < 0.05). The mean duration of temporary posttransplant hyperglycemia was 22.3 +/- 3.2 (n = 10), 35.9 +/- 2.3 (n = 14), and 33.7 +/- 4.1 (n = 6) days for the respective groups. The diabetic mice that received 300 islets had their blood glucose levels decrease faster than those that received 150 islets (19.7 +/- 1.6 vs. 35.9 +/- 2.3 days, n = 14. p < 0.0001). There was no significant difference in the blood glucose reducing effect between the mice that received 150 islets with NDGA and the mice that received 300 islets [22.3 +/- 3.2 (n = 10) vs. 19.7 +/- 1.6 (n = 14) days, p > 0.05]. The insulin content of the graft from the mice treated with 150 islets and NDGA (3.02 +/- 0.24 microg, n = 4) was higher than that from the mice that received 150 islets but no treatment (1.10 +/- 0.26 microg, n = 15, p < 0.005) or that had been treated with DMSO (1.21 +/- 0.30 microg, n = 4, p <0.05). The insulin content of the pancreas remnant had no significant differences among the three groups. The net glucose-stimulated insulin secretion was 0.82 +/- 0.14 vs. 0.20 +/- 0.10 microIU/islet x 60 min (n = 8, p < 0.005) and 0.59 +/- 0.08 vs. 0.04 +/- 0.02 microIU/islet x 60 min (n = 8, p < 0.0001) for islets cultured without NDGA vs. with NDGA at 1 and 2 weeks, respectively. However, the insulin content of the cultured islets was similar between the two groups for up to 2 weeks of incubation (at 1 week: 0.71 +/- 0.01 vs. 0.67 +/- 0.04 ng/islet, n = 8, p > 0.05; at 2 weeks: 0.71 +/- 0.02 vs. 0.80 +/- 0.07 ng/islet, n = 8, p > 0.05). Serum leukotriene B4 (LTB4) concentrations before and between the fifth and seventh days after transplantation were determined. For diabetic mice that received 150 islets, serum LTB4 levels were 25,835 +/- 3,335 and 27,631 +/- 3,136 pg/ml (n = 4, p > 0.05). For diabetic mice that received 150 islets and NDGA, the corresponding figures were 22,401 +/- 2,706 pg/ml and 27,530 +/- 2,190 pg/ml (n = 8, p > 0.05). The graft histology revealed viable islet cells and networks of close vascular structures around the islets and did not reveal microscopic differences among the samples of all four groups. In conclusion, our data revealed that daily administration of NDGA for 4 weeks enhanced isoislet engraftment and preserved three times more mass of the islet beta cells in the isografts. This result indicates that NDGA reduces primary nonfunction of islet syngeneic grafts in diabetic mice.

Influence of donor age on mouse islet characteristics and transplantation

Old donor age has been considered as a risk factor and relative contraindication for transplantation. This study was designed to investigate the influence of donor age on islet characteristics and transplantation. Islets isolated from 8 (I-A)-, 32 (I-B)-, or 64 (I-C)-week-old C57BL16 mice were studied for number, size, insulin content, and secretion. After syngeneically transplanting 300 islets under the kidney capsule of streptozotocin-diabetic mice (R-A. R-B, and R-C, respectively), we measured recipients' metabolic parameters as well as the beta-cell mass and insulin content of the graft. Eight-week-old donors had better glucose tolerance than 32- and 64-week-old donors. However, 64-week-old donors had more pancreatic insulin content than 8- and 32-week-old donors. I-B and I-C were greater in number, larger in size, and higher in insulin content than I-A. But perifusion study showed I-C secreted less insulin, albeit with a similar stimulation index compared with that of I-A and I-B. After transplantation, the fall of blood glucose in R-C was faster than that in R-A and R-B. At 12 weeks, the recipients' blood glucose, body weight, HbA1c, and the beta-cell mass and insulin content of the graft were comparable in all groups. However, R-C had better glucose tolerance than R-A. During follow-up, R-A and R-B maintained lifelong normoglycemia and their glucose tolerance did not deteriorate. These data indicate that islets isolated from donors with different ages have different characteristics and effects on transplantation. The islets isolated from aged donors are functioning well and can be a potential source for transplantation; however, because we transplanted a large islet mass from the aged donors, the role of the islet dose needs to be further clarified.

Lactate dehydrogenase genes of caiman and Chinese soft-shelled turtle, with emphasis on the molecular phylogenetics and evolution of reptiles

L-Lactate dehydrogenase (LDH) cDNAs encoding for LDH-A(4) (muscle) and LDH-B(4) (heart) isozymes from caiman (Caiman crocodilus apaporiensis) belonging to the order Crocodilia and Chinese soft-shelled turtle (Pelodiscus sinensis) belonging to the order Chelonia were sequenced. The phylogenetic relationships of the newly determined cDNA and their deduced protein sequences, as well as the previously published sequences of vertebrate LDH isozymes, were analyzed by various phylogenetic tree construction methods. These results indicated that Chelonia is indeed more closely related to Crocodilia. The divergent times between caiman and alligator, turtle and soft-shelled turtle, and Chelonia and Crocodilia were estimated to be approximately 36, 100 and 177 million years, respectively.

Two distinctive cell binding patterns by vacuolating toxin fused with glutathione S-transferase: one high-affinity m1-specific binding and the other lower-affinity binding for variant m forms

The Helicobacter pylori VacA causes large intracellular vacuoles in epithelial cells such as HeLa or RK13 cells. Two major VacA forms, m1 and m2, divergent in an approximately 300 amino acid segment within the cell binding domain P58, display distinct cell-type specificity. Sequence analysis of four vacA alleles showed that a m1-like allele (61) and two m2 alleles (62 and v226) mainly differed in the midregion and that v225, a m1m2 chimera, was a natural double crossover from v226 and another allele. Each of these alleles was expressed as a soluble GST-VacA fusion that did not form a large oligomer. The recombinant VacA portion nevertheless assembled into higher ordered structures and possessed biological binding activity similar to that of the native VacA. A direct comparison of fusion-cell binding activity showed that m1 > m1m2 > m2 in HeLa cells, whereas there were more similar activities in RK13 cells. Vacuolating analyses of three forms revealed a positive correlation between cell binding activity and vacuolating activity. Moreover, the m1-type N-terminal half portion of the midregion was crucial for HeLa cell cytotoxicity. Kinetic, Scatchard, and inhibition analyses suggested the presence of at least two receptors: a m1-type specific high-affinity receptor (K(d) = approximately 5 nM) and a common VacA receptor interacting similarly with m1, m1m2, and m2 via a lower affinity (K(d) = 45-67 nM). Expression of mainly the m1-type receptor on HeLa cells whereas both receptors on RK13 cells may account for distinct cell binding activity and therefore for cell-type specificity.

Modeling of organic pollutant destruction in a stirred-tank reactor by ozonation

Destruction of organic contaminants in water by ozonation is a gas-liquid process which involves ozone mass transfer and fast irreversible chemical reactions. Ozonation reactor design and process optimizing require the modeling of the gas-liquid interactions within the reactor. In this paper a theoretical model combining the fluid dynamic and reaction kinetic parameters is proposed for predicting the destruction rates of organic pollutants in a semi-batch stirred-tank reactor by ozonation. A simple expression for the enhancement factor as our previous work has been applied to evaluate the chemical mass transfer coefficient in ozone absorption, 2,4-dichlorophenol (2,4-DCP) and 2,6-DCP or their mixture are chosen as the model compounds for simulating, and the predicted DCP concentrations are compared with some measured data.

Liver abscess in patients with cirrhosis of the liver: a 12-year experience

PURPOSE

Liver abscess is rare in patients with cirrhosis of the liver. The aim of this retrospective study was to investigate the incidence, clinical presentation, causal pathogens, and outcome of liver abscess in cirrhotic patients.

METHODS

We collected 21 liver abscess specimens (from 14 male patients and 7 female patients; Child A: B: C, 4: 7: 10) from 22,731 admissions of 6450 cirrhotic patients, from 1986 through 1998.

RESULTS

The common clinical symptoms and signs included fever, chills, and abdominal tenderness. The major predisposing factors were biliary tract disease (52%) and diabetes mellitus (48%). The diagnosis rate with abdominal ultrasonography was 79%. Gram-negative aerobes were the predominant pathogens (Klebsiella pneumoniae, 66.7%; Escherichia coli, 23.8%), and occurred in 80% and 69% of blood and pus cultures, respectively, while 38% of cases showed polymicrobial pathogens. The location of the abscess was predominantly in the right lobe (71.4%), and 47.6% of patients had multiple abscesses. Six patients died (all with Child C cirrhosis). The overall mortality rate was 28.6% (6/21).

CONCLUSIONS

The incidence of liver abscess in the cirrhotic patients was low, at 0.09% (21/22,731 admissions). The clinical presentations and pathogens were not different from those in noncirrhotic patients, except that in our cirrhotic patients, there was no significant difference in mortality between those with monomicrobial and those with polymicrobial abscess: nor was there a significant difference in mortality between those with single and those with multiple abscesses. The Child C patients were the high-risk group.

Attenuation of insulin resistance by chronic beta2-adrenergic agonist treatment possible muscle specific contributions

A possible mechanism by which chronic clenbuterol treatment causes multiple physiological changes in skeletal muscle that leads to reduced insulin resistance in the obese Zucker rat (falfa) was investigated. Animals were gavaged with clenbuterol (CB) (0.8 mg x kg(-1) day(-1)), terbutaline (TB) (1.0 mg x kg(-1)day(-1)), or control (CT) vehicle for six weeks. Oral glucose tolerance and insulin responses were markedly improved in CB rats and impaired in TB rats. CB treatment caused a 24-34% gain in muscle mass in all muscle fiber types, and increases in 3-O-methyglucose transport (2-fold) and GLUT4 concentration (57%) in fast twitch glycolytic (FG) muscle. Oxidative capacity was reduced in both FG (47%) and fast twitch oxidative (FO) muscle (30%), but not in slow twitch oxidative (SO) muscle. Null model analysis for receptor occlusion demonstrated that most functional beta-adrenoceptors were lost in FO (82%) and FG (89%) fibers, but not in SO fibers. We propose that hypertrophy is the result of continuous direct activation of beta-adrenoceptors while loss in oxidative capacity may be the result of receptor down regulation. Improvements in insulin resistance may have been due, in part, to both increases in lean body mass and specific adaptations in FG muscle.

Diagnosis of Helicobacter pylori infection by stool antigen test in southern Taiwan

Helicobacter pylori (H. pylori) has been found to be associated with various gastrointestinal diseases. Confirmation of H. pylori infection includes invasive and non-invasive methods. There has been increasing interest in noninvasive tests recently. However, the geographical differences among H. pylori strains have been emphasized recently and the H. pylori strain in Taiwan showed a high cagA positive result and different vacA subtype when compared with those of Western countries. The aim of this study is to access and compare the reliability and the diagnostic accuracy of the stool H. pylori antigen tests by spectrophotometry and by the visual method, especially in Southern Taiwan. Thirty-two patients (18 men and 14 women; age range: 23-91 y/o, mean: 50.5 y/o) who underwent gastroendoscopy at Kaohsiung Medical University Hospital were enrolled in this study. H. pylori infection status was confirmed by culture or two positive test results on CLO test, histology and 13C-urea breath test (13C-UBT). The exclusion criteria included previous gastrointestinal tract surgery, use of antibiotics, proton pump inhibitor or compounds containing bismuth within 1 month of the study. Among them, 14 patients were with duodenal ulcer (DU), 4 with gastric ulcer (GU), 12 with non-ulcer dyspepsia, and 2 with GU and DU. Those patients had their stool collected for ELISA tests of H. pylori stool antigen (HpSA). The HpSA tests were positive in 16 of 18 patients diagnosed as H. pylori positive, and negative in 13 of 14 patients as H. pylori negative. The sensitivity and specificity were 88.9% and 92.9% respectively. The positive and negative predictive values were 94.1% and 86.7% respectively. The concordance of HpSA accessed by spectrophotometry and visual method is 100%, which makes this test even easier and cheaper. We concluded that stool HpSA test is a noninvasive, accurate, reliable, rapid and easy way to diagnose H. pylori infection in Southern Taiwan, either by spectrophotometry or by visual assessment.

A case of pulmonary endometriosis--a rare case report and a successful treatment experience

Endometriosis is a common disease found in reproductive age women, but pulmonary endometriosis is rare. We present a 21-year-old female with catamenial chest pain, chest tightness, severe cough, and hemoptysis. Though we could not find any definite intrapulmonary endometriotic lesion by computed tomography and bronchoscope, she was diagnosed to have pulmonary endometriosis due to the typical clinical symptoms. After 6 months of GnRH agonist application, the symptoms were completely relieved. She has been followed up and has been symptoms free for at least 6 months after administration of GnRH agonist.

Evaluation of an office-based urine test for detecting Helicobacter pylori: a Prospective Pilot Study

BACKGROUND/AIMS

To ascertain the reliability of a newly developed office-based urine test, the RAPIRUN test, used for detection of H. pylori infection.

METHODOLOGY

Urine specimens from 142 consecutive patients undergoing gastroendoscopy (77 men, 65 women; mean 52.0 years) were tested with RAPIRUN at the same time. The total reaction time for the urine test is 20 min. None of the patients had received any H. pylori eradicating treatment. The H. pylori status was evaluated based on 5 different tests: culture, histology, biopsy urease test, 13C-urea breath test, and the RAPIRUN test. A commercial office-based kit using an immunochromatographic technique was used to examine urine samples for H. pylori antibody. H. pylori status was defined as positive when the culture was positive or if 2 of the other 3 tests (histology, biopsy urease test, and 13C-urea breath test were positive.

RESULTS

Of 93 patients with H. pylori infection, 88 were tested as positive by RAPIRUN (sensitivity 94.6%). Of 48 patients without infection, 43 were found to be negative by RAPIRUN (specificity 89.6%). One case with an invalid urine test was excluded.

CONCLUSIONS

This urine test is a rapid, inexpensive, reliable and easy-to-use tool for the diagnosis of H. pylori infection in untreated patients. It can be used for mass screening of patients' H. pylori status, particularly in children, postgastrectomy patients, uncooperative patients, and patients undergoing bismuth or proton pump inhibitor treatment.

Endotracheal tube fires during carbon dioxide laser surgery on the larynx--a case report

Endotracheal tube (ETT) fire is a catastrophic disaster that may occur during laser surgery of the upper airway. Several means are available for protection of polyvinyl chloride (PVC) tube from fire, but they are not perfect in prevention of fires caused by laser beam. The PVC tube is hazardous for carbon dioxide (CO2) laser surgery if it is not well wrapped with metallized foil tape. We report a case that a PVC ETT wrapped with aluminum foil ignited during CO2 laser surgery of the larynx. In this report, we emphasize the shaft of the PVC tube must be completely wrapped with aluminum foil to prevent exposure of any surface if it is used in CO2 laser surgery of the upper aero digestive tract.

Performance and simulation of ozone absorption and reactions in a stirred-tank reactor

This research investigates the mass transport of gaseous ozone accompanied by decomposition and ozonation reactions in the liquid phase. Absorption experiments were carried out under semibatch mode by continued injection of gaseous ozone into an agitated vessel containing an aqueous solution of 2,4- or 2,6-dichlorophenol at 25 degrees C. Under the influence of a fast reaction between the dissolved ozone and dichlorophenol, the mass transfer rate of ozone is enhanced greatly resulting in rapid destruction of the dichlorophenol. Simulations of the experimental results suggest that the complete mixing model can be applied to describe the fluid flow patterns in both the gas and liquid phases. The results of this study indicate that dichlorophenols can be removed effectively from aqueous solutions of pH near neutrality and that there is little additional advantage in carrying out the treatment process in alkaline solutions.

Prolonged paralysis associated with succinylcholine--a case report

Prolonged paralysis is a rare complication of succinylcholine. We report a case of palmar hyperhidrosis who underwent transthoracic endoscopic sympathetic ganglionectomy under general anesthesia with a facemask developed prolonged paralysis following the operation. The prolonged paralysis supposedly caused by intraoperative use of succinylcholine was recognized and confirmed by laboratory examination which showed low pseudocholinesterase activity. In this report, we describe the course of the event and discuss the causes of delayed awakening associated with anesthesia and its management.

Increase of calmodulin III gene expression by mu-opioid receptor stimulation in PC12 cells

Calmodulin (CaM) is a principal multifunctional mediator of Ca2+ signaling in cells. It is reported that morphine increases CaM contents in mouse brain. However, the precise mechanism of CaM induction by morphine is unknown. We investigated the changes of CaM by opioid receptor stimulation in mRNA and protein levels. Expression of CaM was increased in dose- and time-dependent manners by morphine with RT-PCR assay in PC12 cells, and naloxone inhibited the effect of morphine. The expression was also increased with DAMGO (mu-opioid agonist), but not by DPDPE (delta) and U50488 (kappa). Northern blot analysis revealed that the CaMIII gene was responsive to morphine or DAMGO. CaM protein increased by DAMGO were distributed in both soluble and membranous fractions in the cells. Taken together, the data suggest that morphine induces the expression of CaMIII gene through mu-opioid receptor stimulation.

Determination of bisbenzylisoquinoline alkaloids by high-performance liquid chromatography (II)

After the earlier analysis of nine bisbenzylisoquinoline alkaloids with ion pair chromatography, seven other bisbenzylisoquinoline alkaloids were analyzed using gradient elution with an acetonitrile-phosphate buffer (pH 8.0) mixture, and UV detection. Four alkaloids were detected in the stem woods of a Lauraceous plant, Dehaasia triandra Merr. and their contents determined. LC-MS suggested that a major unknown compound in the plant was also a bisbenzylisoquinoline alkaloid.

Genome-wide search for loss of heterozygosity using laser capture microdissected tissue of breast carcinoma: an implication for mutator phenotype and breast cancer pathogenesis

Breast cancer is considered to display a high degree of intratumor heterogeneity, without any obvious morphological and pathological steps to define sequential evolution, and its progression may vary among individual tumors. In an attempt to elucidate these etiological and phenotypic complexities, the present study, based on the fundamental concept that genomic instability is the engine of both tumor progression and tumor heterogeneity, was conducted to test the hypothesis that breast cancer pathogenesis is driven by double-strand break (DSB)-initiated chromosome instability (CIN). The rationale underlying this hypothesis is derived from the clues provided by family breast cancer syndromes, in which susceptibility genes, including p53, ATM, BRCA1 and BRCA2, are involved within the common functional pathway of DSB-related checkpoint/ repair. Because genomic deletion caused by DSB is reflected in the genetic mechanism of loss of heterozygosity (LOH), this genome-wide LOH study was conducted, using 100 tumors and 400 microsatellite markers. To minimize the effect of heterogeneity within tumors, the experimental technique of laser capture microdissection was used to ensure that genetic and phenotypic examinations were based on the same tumor cells. Support for our hypothesis comes from the observations that: (a) the extent of DSB-initiated CIN in tumors significantly increased as tumors progressed to poorer grades or later stages; (b) in the sequential steps toward CIN, the loci of p53 and ATM, the key checkpoint genes against DSB, were lost at the earliest stage; and (c) many loci identified to be important in breast tumorigenesis were the genomic sites possibly harboring the genes involved in DSB-related checkpoint/repair (including RAD51, RAD52, and BRCA1) or CIN (including FA-A, FA-D, and WRN), and a higher number of these loci showing LOH was significantly associated with increased level of DSB-initiated CIN (P < 0.0001). Breast cancers are thus considered to be sequentially progressive with CIN. However, CIN might also cause genetic heterogeneity, which was revealed by the findings that LOH at some markers was observed only in the component of ductal carcinoma in situ but not in the invasive component of the same tumors. In addition, some markers were found to preferentially lose at specific tumor grades, implying their contribution to genetic heterogeneity during tumor development. Therefore, this study suggests that breast cancer progression is clonal with regard to CIN, but different breast cancers would present distinct molecular profiles resulting from genetic heterogeneity caused by CIN.

Fatal anaphylactoid shock associated with protamine for heparin reversal during anesthesia

A 19-year-old female was scheduled for elective surgery of repair of ventricular septal defect (VSD). She had no known previous food or drug allergy history. She was not previously exposed to protamine and did not have any of the risk factors pointing to protamine hypersensitivity reaction. Unfortunately there were two anaphylactoid shocks occurring during this surgery. One was caused by intravenous (i.v.) administration of antibiotics, and the other happened following i.v. drip of protamine sulfate for reversal of systemic heparinization. She had none of the risk factors suggestive of hypersensitivity to drugs and was therefore considered not at risk for such severe adverse reactions which happened. This article was to discuss the anaphylactoid shock induced by antibiotics and protamine during anesthesia, and the prevention and management of such a reaction.

Changes in portal venous hemodynamics in patients with severe acute hepatitis over one year

PURPOSE

A wide range of portal vein blood flow velocity (PVV) values can be found in acute hepatitis. We studied course and medical significance of PVV changes in patients with severe acute hepatitis over a 1-year period.

METHODS

Portal venous hemodynamics were studied by Doppler sonography in 90 patients at study enrollment and 3, 6, and 12 months following an episode of severe acute hepatitis.

RESULTS

Forty-one survivors who had a maximum PVV at enrollment greater than or equal to the value measured at the third month were classified as the "declining PVV" group. Thirty-six survivors who had a maximum PVV at enrollment less than the value measured at the third month were classified as the "rising PVV" group. Thirteen patients died of acute hepatic failure and were classified as the fatality group. The fatality group had significantly lower maximum PVV, worse liver biochemical test results, and a higher prevalence of ascites at enrollment. In contrast, the declining PVV group showed significantly better liver biochemical test results and a lower prevalence of ascites. There was no significant difference in portal vein blood flow between the rising and declining PVV groups since portal vein diameter increased while PVV decreased.

CONCLUSIONS

An initially decreased PVV can be found in some patients with severe acute hepatitis and is inversely correlated with the severity of liver damage.

Molecular cloning and characterization of Amida, a novel protein which interacts with a neuron-specific immediate early gene product arc, contains novel nuclear localization signals, and causes cell death in cultured cells

Amida was isolated by the yeast two-hybrid system as a novel protein which associated with Arc, a non-transcriptional immediate early gene specific to the brain. Amida was confirmed to be associated with Arc in vitro and in vivo. Amida shows no homology to known proteins. Amida is ubiquitously expressed, although it is abundant in the brain. A transfection study revealed that Amida was localized in the nucleus and after 72 h the transfected cells underwent apoptosis. Furthermore, we found two nuclear localization signals and a domain needed for interacting with Arc was encompassed by two nuclear localization signals. Co-transfection experiment with Amida and Arc suggested that Amida transported Arc into the nucleus and negatively regulated Amida-induced cell death. These results indicate that Arc together with Amida may modulate cell death in the brain.

Inhibition by naloxone of promoter activity of the neurofilament gene in SK-N-SH cells

Chronic administration of morphine is known to decrease the levels of neurofilaments (NFs) in the ventral tegmental area. We ligated a promoter region of the mouse 68-KDa neurofilament (NF-68) gene to the pGL3-enhancer vector containing a luciferase gene, transfected it into SK-N-SH cells and then analyzed transcriptional activity in the cells treated with agonists or antagonists of opiate receptors. The activity of the NF-68 promoter was suppressed by naloxone about 55% at 10(-5) M and 30% at 10(-7) M at 48 h, but suppressed not by morphine. Naltrexone at 10(-5) M suppressed the promoter activity about 20%, but levallorphan, DAMGO, DPDPE and U50488 did not. The inhibition by naloxone was dose-dependent and not reversed by morphine. The inhibitory effect of naloxone was not observed in N18TG-2 cells and PC12 cells. Experiments with various deletion mutants revealed that a region responsible for naloxone suppression spans from -328 to -101 in the gene. These results suggest that naloxone has the ability to suppress transcriptional activity in some neurons.

Heterogeneous Helicobacter pylori isolates from H. pylori-infected couples in Taiwan

Helicobacter pylori strain diversity was investigated in 55 H. pylori seropositive couples in Taiwan in biopsy samples from the antrum and corpus. Two DNA typing methods were used to characterize 90 isolates from 25 couples. In only 1 of the 25 couples was the same strain colonized from both partners. Comparison of isolates from 2 sites in each of 40 patients showed that 9 pairs were distinct but might be related. Peptic ulcer occurred in 77.8% of these 9 patients compared with 29% of 31 patients with the same predominant strain in 2 biopsies (P=.025). Random amplified polymorphic DNA and sequence analyses of 2 closely related isolates from 1 patient support the hypothesis that development of genetic diversity of H. pylori results from horizontal genetic exchange during long-term colonization of mixed bacterial populations.

Effect of carbohydrate supplementation on postexercise GLUT-4 protein expression in skeletal muscle

The effect of carbohydrate supplementation on skeletal muscle glucose transporter GLUT-4 protein expression was studied in fast-twitch red and white gastrocnemius muscle of Sprague-Dawley rats before and after glycogen depletion by swimming. Exercise significantly reduced fast-twitch red muscle glycogen by 50%. During a 16-h exercise recovery period, muscle glycogen returned to control levels (25.0 +/- 1.4 micromol/g) in exercise-fasted rats (24.2 +/- 0. 3 micro). However, when carbohydrate supplementation was provided during and immediately postexercise by intubation, muscle glycogen increased 77% above control (44.4 +/- 2.1 micromol/g). Exercise-fasting resulted in an 80% increase in fast-twitch red muscle GLUT-4 mRNA but only a 43% increase in GLUT-4 protein concentration. Conversely, exercise plus carbohydrate supplementation elevated fast-twitch red muscle GLUT-4 protein concentration by 88% above control, whereas GLUT-4 mRNA was increased by only 40%. Neither a 16-h fast nor carbohydrate supplementation had an effect on fast-twitch red muscle GLUT-4 protein concentration or on GLUT-4 mRNA in sedentary rats, although carbohydrate supplementation increased muscle glycogen concentration by 40% (35.0 +/- 0.9 micromol/g). GLUT-4 protein in fast-twitch white muscle followed a pattern similar to fast-twitch red muscle. These results indicate that carbohydrate supplementation, provided with exercise, will enhance GLUT-4 protein expression by increasing translational efficiency. Conversely, postexercise fasting appears to upregulate GLUT-4 mRNA, possibly to amplify GLUT-4 protein expression on an increase in glucose availability. These regulatory mechanisms may help control muscle glucose uptake in accordance with glucose availability and protect against postexercise hypoglycemia.

Difference of plasma leptin levels in venous and arterial cord blood: relation to neonatal and placental weight

To investigate the physiological significance of umbilical plasma leptin in the fetal growth and its possible origin of production during pregnancy, plasma leptin concentrations in venous and arterial cord bloods were measured in 42 neonates (male = 23, female = 19, gestational age 36-41 weeks, birth weight 2600-4000 g). Leptin concentrations in umbilical veins (5.65 +/- 0.53 ng/mL, n = 42) and umbilical arteries (0.56 +/- 0.07 ng/mL, n = 42) were significantly (P < 0.001) lower than those in maternal peripheral veins (22.36 +/- 1.06 ng/mL, n = 42). Mean plasma leptin concentration (+/- SEM) in venous cord blood was significantly (P < 0.001) higher than that of arterial cord blood. There was significantly positive correlation (r = 0.447, P < 0.01) between umbilical venous leptin levels and neonatal body mass index (BMI). A positive correlation (r = 0.435, P < 0.01) was also found between umbilical arterial leptin and neonate BMI. There was no positive correlation between umbilical leptin levels in venous cord blood and placental weight. We thus conclude that umbilical plasma leptin may play an essential role in the fetal growth and metabolism during pregnancy and placenta is one of the major sources of leptin production, but the level of leptin in umbilico-placental circulation is independent of the weight of placenta.

Ileal aberrant pancreas induces intussusception and gastrointestinal bleeding in an adult woman--case report

Aberrant pancreas is a congenital anomaly. In surgical series, its incidence varied from 0.2 to 0.8%. About 70% of aberrant pancreas occur in the gastrointestinal tract. Eighty percent of them locate in the stomach and duodenum, and only 0.2% in the ileum. We report on a 25-year-old woman with ileal aberrant pancreas who suffered from ileal intussusception and recurrent gastrointestinal bleeding. The diagnosis was confirmed by surgery and histology. She is symptom-free after surgery.

Sequential sonographic changes of the gallbladder in hemobilia: case report of a patient with intrahepatic duct stones

The sonographic features of hemobilia in the gallbladder have been reported with variation, including an echogenic mass, hypoechoic mass, and scattered intraluminal echoes. The sequential sonographic changes of hemobilia in the gallbladder were observed in a 59-year-old male patient with bilateral intrahepatic duct stones. The sonograms of hemobilia in the distended gallbladder initially showed a hyperechoic, homogeneous, movable mass-like lesion, 36 hours before the onset of upper gastrointestinal (UGI) bleeding. A hypoechoic mass-like lesion with a hyperechoic ring was found 5 days after the onset of UGI bleeding. A faint hypoechoic mass-like lesion was found 7 days after the onset of UGI bleeding (the day of no further bleeding). Scattered echoic densities were found 9 days after the onset of UGI bleeding, then disappearance of the lesion was noted 12 days after the onset of UGI bleeding. The sonographic patterns of hemobilia in the gallbladder vary depending on the timing of lysis of the blood clot. It should be differentiated from gallbladder cancer, a stone, a polyp, sludge, acute gangrenous cholecystitis, and gallbladder empyema.

Pseudomyxoma peritonei with high serum CA19-9: report of three cases

Pseudomyxoma peritonei (PMP) is an unusual form of intraabdominal neoplasm that produces a large amount of extracellular mucin. It is often associated with mucinous tumors of gastrointestinal tract or ovary. Herein, we report 3 patients with pseudomyxoma peritonei with high serum carbohydrate antigen 19-9 (CA19-9) levels. The first patient, who had a CA19-9 level of 1132 U/ml, had well-differentiated rectal cancer and died of chemotherapy complications, pneumonia and septic shock; one month after admission. The other 2 cases with CA19-9 levels of 2520 U/ml and 679 U/ml had tumors of unknown origins and had survived more than 1 year and 3 months after treatment, respectively. Usually, elevated serum CA19-9 levels are found in patients with pancreatic, biliary, colorectal, gastric or liver cancers. However, many studies have shown high serum CA19-9 levels are associated with mucinous carcinoma. Immunochemical studies also showed positive staining of CA19-9 in mucinous tumors. PMP is composed of large amounts of mucin, therefore, we suggest that serum and ascites CA19-9 levels should be routinely checked in patients with PMP.

Calmodulin functions as an activator of Pur alpha binding to single-stranded purine-rich DNA elements (PUR elements)

Pur alpha is a single stranded DNA-binding protein and binds to a consensus sequence (GGN)n. We have reported that the DNA-binding activity of a single stranded cyclic AMP response element-binding protein (ssCRE-BP) is suppressed in cerebellum treated chronically with morphine, ssCRE-BP is identical to Pur alpha and the DNA binding activity of Pur alpha is markedly enhanced by a heat stable activator in the nuclear extract. In this report, we purified this activator. The amino acid composition and partial amino acid sequence were determined to be identical to those of calmodulin (CaM), which enhanced the binding of GST-Pur alpha to various PUR elements in the 5' non-coding regions of the neuropeptide Y, myelin basic protein and nicotinic Ach receptor beta 4 subunit genes. The data suggest a novel gene expression pathway mediated by Ca/CaM-Pur alpha which may regulate a variety of genes in addition to those regulated through the CREB pathway.

Regulation of GLUT4 protein expression and glycogen storage after prolonged exercise

The purpose of this study was to determine the time course of GLUT4 protein accumulation following an exercise-carbohydrate supplementation regimen, and to evaluate the effect of this regimen on GLUT4 mRNA regulation. Rats were exercised by swimming and intubated with 1 mL of a 50% glucose solution immediately post-exercise. Exercise significantly reduced muscle glycogen by 50%. By 1.5 h of recovery, muscle glycogen was normalized, but continued to increase above the control level during the next 16 h. A faster and larger repletion of glycogen occurred in the fast-twitch red compared with the fast-twitch white muscle during the 16 h of recovery. GLUT4 protein concentration in fast-twitch red muscle was significantly increased above control by 1.5 h of recovery, and progressively increased throughout the recovery period. Fast-twitch white muscle demonstrated a similar trend, but the increase in GLUT4 protein did not reach significance until 5 h of recovery. Fast-twitch red muscle GLUT4 mRNA was increased by 53% above control immediately post-exercise, but returned to the control level by 1.5 h of recovery. GLUT4 mRNA associated with polysomes, however, increased significantly during this time and remained elevated for a minimum of 5 h. The results suggest that the increased GLUT4 protein expression following a regimen of exercise-carbohydrate supplementation occurs sufficiently fast to contribute to the resynthesis of muscle glycogen, and is controlled by both pre-translational and translational mechanisms.

A single stranded DNA-binding protein, ssCRE-BP/Pur alpha, in rat lung and its increase in allergic airway inflammation

ssCRE-BP/Pur alpha is a single stranded DNA-binding protein and may be involved in gene replication and transcription and in the development of morphine dependence. We found a ssCRE-BP/Pur alpha (45 kDa) in rat lung that was larger than those (40 kDa) identified in rat and mouse brains and mouse lung. Immunohistochemistry showed that ssCRE-BP/Pur alpha is primarily distributed in the lung epithelium. As allergic inflammation induces various gene expressions, we investigated the changes of Pur alpha during airway inflammation. Ovalbumin-sensitized rats were used for inducing allergic airway inflammation. The expression and DNA-binding activity of 45-kDa ssCRE-BP/Pur alpha were significantly increased in the sensitized rat lungs 24 hr after antigen challenge, but not in those of rats nonsensitized or sensitized with ovalbumin and challenged with saline. Immunohistochemistry and in situ hybridization demonstrated that the vascular endothelial cells and numerous infiltrated eosinophils around the airways were stained with anti-Pur alpha antibody. These data suggest that rat lung and the eosinophils contain a 45-kDa ssCRE-BP/Pur alpha that is increased when airway inflammation occurs.