Anti-Obesity Effect of Jeju Roasted Citrus Peel Extract in High-Fat Diet-Induced Obese Mice and 3T3-L1 Adipocytes Via Lipid Metabolism Regulation

Lipid accumulation in adipocytes occurs through multifactorial effects such as overnutrition due to unbalanced eating habits, reduced physical activity, and genetic factors. In addition, obesity can be intensified by the dis-regulation of various metabolic systems such as differentiation, lipogenesis, lipolysis, and energy metabolism of adipocytes. In this study, the Jeju roasted peel extract from Citrus unshiu S.Markov. (JRC), which is discarded as opposed to the pulp of C. unshiu S.Markov., is commonly consumed to ameliorate obesity. To investigate the anti-obesity effect of JRC, these studies were conducted on differentiated 3T3-L1 cells and in high-fat diet-induced mice, and related methods were used to confirm whether it decreased lipid accumulation in adipocytes. The mechanism of inhibiting obesity by JRC was confirmed through mRNA expression studies. JRC suppressed lipid accumulation in adipocytes and adipose tissue, and significantly improved enzymes such as alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase and serum lipid profiles. In addition, it effectively modulated the expression of genes related to lipid and energy metabolism in adipose tissue. As a result, these findings suggest that JRC could be a therapeutic regulator of body fat accumulation by significantly alleviating the dis-regulation of intracellular lipid metabolism in adipocytes and by enhancement of energy metabolism (Approval No. CNU IACUC-YB-2023-98).

Anal Canal Adenocarcinomas: Prognostic Factors and Outcomes at a Single Institution

PURPOSE/OBJECTIVE(S)

Adenocarcinomas of the anal canal (AAC) represent a rarity among cancers of the digestive tract. Data guiding management is limited to retrospective studies and optimal treatment paradigms of AAC are still evolving. Here, we aim to investigate their prognostic factors and outcomes.

MATERIALS/METHODS

We reviewed anorectal adenocarcinoma patients who underwent curative-intent neo/adjuvant therapy +/- surgery at a single institution from 2015-2019. AAC were defined as tumor epicenters ≤ 2 cm from the dentate line. Our primary outcome was 5-year overall survival (OS). We also analyzed 5-year local recurrence, distant metastasis, and disease-free survival (DFS), defined as the interval after treatment completion to the first occurrence of local, regional, distant recurrence, or death. All tumors were staged according to the Rectal Cancer paradigm per AJCC 7th Staging. Kaplan-Meier and Cox-Proportional Hazards Model were used for survival analyses.

RESULTS

In our cohort, 57 patients met inclusion criteria. Median follow-up time was 54 months. The median age was 64 years; 35% of the cohort was female. The majority of tumors were adenocarcinomas (77%), with a minority of mucinous (12%) and signet ring cell (11%) histologies. The median tumor size was 4 cm, located 1 cm from the anal verge. Most tumors (63%) were grade 2, 77% had T3 disease, and 53% had clinical nodal involvement. Most patients completed neoadjuvant chemoradiation, total mesorectal excision, and adjuvant chemotherapy (54%). Fifty-four percent underwent abdominopelvic resection. Of those who received neoadjuvant therapy, 11% achieved a pathologic complete response. Seventy percent of patients completed chemotherapy, either in the neoadjuvant or adjuvant setting. At 5 years, local recurrence was 9%, regional pelvic recurrence was 12%, inguinal nodal recurrence was 2%, and distant recurrence was 25%. Five-year DFS was 63% and 5-year OS was 70%. Multivariate analysis demonstrated age, female gender, CEA, grade 3 disease, mucinous histology, and nodal involvement to be prognostic of lower OS. Receipt of neo/adjuvant chemotherapy was found to be prognostic of higher OS (HR 0.13, p<0.05).

CONCLUSION

In this cohort, the majority of whom received surgical management, we show numerically similar or higher overall survival in comparison with prior studies. This study is limited by its retrospective nature and sample sizes of an exceedingly rare entity. Receipt of neo/adjuvant chemotherapy appears to have an impact on survival. Further investigation is needed to explore the role of total neoadjuvant therapy in improving outcomes in this patient population.

Polymethoxyflavone-rich Fraction from Citrus sunki Leaves Alleviates Renal Dysfunction in Mice with Unilateral Ureteral Obstruction

Polymethoxyflavones (PMFs) are flavonoid compounds present in citrus plants that are proposed to be advantageous to human health. However, the advantageous effects of PMFs in the context of renal dysfunction are unclear. In this study, we made a PMF-rich fraction (PRF) from the leaves of Citrus sunki Hort ex. Tanaka and identified its components using liquid chromatography and mass spectrometry. We then investigated the effect of PRF—comprising 9 types of PMF—on renal dysfunction induced by unilateral ureteral obstruction (UUO) in mice. Animals were divided into four experimental groups ( n = 7 per group): I) sham-operated group (Sham); II) UUO group (UUO); III) UUO + Enalapril 0.1 mg/1 mL (UUO + Enap); IV) UUO + PRF 100 mg/kg/day (UUO + PRF). All mice were orally administered with the drugs once a day from 7 days before UUO to 1 week after UUO. After the experiments were over, serum and tissues were taken for biochemical and histological analysis. PRF promoted the recovery of body weight in the background of UUO. Biochemical and histological analysis revealed that PRF ameliorated UUO-induced renal dysfunction and moderately reversed inflammation and tubulointerstitial fibrosis. Further, PRF inhibited the expression of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), transforming growth factor-β (TGF-β), collagen I (Col-I), and collagen IV (Col-IV). These results suggest that PRF improves UUO-induced renal dysfunction by regulating the expression of inflammatory and fibrotic response-related genes.

Clerodendrum trichotomum extract improves metabolic derangements in high fructose diet-fed rats

Clerodendrum trichotomum has been reported to possess beneficial properties for human health, but its effects on metabolic syndrome have not been reported. In this study, we investigated the effect of C. trichotomum leaf extract (CT) on the metabolic derangements induced by a high-fructose (HF) diet. Sprague–Dawley rats were fed with a 46% carbohydrate diet (HC group), 60% high-fructose diet (HF group), or HF diet supplemented with CT (500 mg/kg of body weight/day, CT group) via drinking water for 16 weeks. Results showed that CT alleviated HF diet-induced insulin resistance, dyslipidemia, and hepatic steatosis In liver tissues, CT affected the signaling pathways of AMP-activated protein kinase, peroxisome proliferator-activated receptor α (PPARα), and sterol regulatory element binding protein 1. CT enriched the genes that were mainly involved in cytokine-cytokine receptor interaction, PPAR, PI3K-Akt signaling pathways, and fatty acid metabolism pathway. These results suggest that CT is a promising therapeutic against metabolic disorders.

Sasa quelpaertensis Leaf Extract Ameliorates Dyslipidemia, Insulin Resistance, and Hepatic Lipid Accumulation in High-Fructose-Diet-Fed Rats

Background: Increased dietary fructose consumption is closely associated with lipid and glucose metabolic disorders. Sasa quelpaertensis Nakai possesses various health-promoting properties, but there has been no research on its protective effect against fructose-induced metabolic dysfunction. In this study, we investigated the effects of S. quelpaertensis leaf extract (SQE) on metabolic dysfunction in high-fructose-diet-fed rats. Methods: Animals were fed a 46% carbohydrate diet, a 60% high-fructose diet, or a 60% high-fructose diet with SQE (500 mg/kg of body weight (BW)/day) in drinking water for 16 weeks. Serum biochemical parameters were measured and the effects of SQE on hepatic histology, protein expression, and transcriptome profiles were investigated. Results: SQE improved dyslipidemia and insulin resistance induced in high-fructose-diet-fed rats. SQE ameliorated the lipid accumulation and inflammatory response in liver tissues by modulating the expressions of key proteins related to lipid metabolism and antioxidant response. SQE significantly enriched the genes related to the metabolic pathway, namely, the tumor necrosis factor (TNF) signaling pathway and the PI3K-Akt signaling pathway. Conclusions: SQE could effectively prevent dyslipidemia, insulin resistance, and hepatic lipid accumulation by regulation of metabolism-related gene expressions, suggesting its role as a functional ingredient to prevent lifestyle-related metabolic disorders.

Prevention of Hyperuricemia by Clerodendrum trichotomum Leaf Extract in Potassium Oxonate-Induced Mice

Clerodendrum trichotomum is a folk medicine exhibiting anti-hypertension, anti-arthritis, and anti-rheumatism properties. However, little is known about whether the material might prevent hyperuricemia and associated inflammation. In this study, we explored whether C. trichotomum leaf extract (CTE) prevented hyperuricemia induced by potassium oxonate (PO) in mice. CTE (400 mg/kg body weight) significantly reduced the serum uric acid (UA), blood urea nitrogen (BUN), and serum creatinine levels and increased urine UA and creatinine levels. CTE ameliorated PO-induced inflammation and apoptosis by reducing the levels of relevant proteins in kidney tissues. Also, CTE ameliorated both UA-induced inflammatory response in RAW 263.7 cells and UA-induced cytotoxicity in HK-2 cells. In addition, liver transcriptome analysis showed that CTE enriched mainly the genes for mediating positive regulation of MAPK cascade and apoptotic signaling pathways. Together, the results show that CTE effectively prevents hyperuricemia and associated inflammation in PO-induced mice.

Effects of p-coumaric acid on microRNA expression profiles in SNU-16 human gastric cancer cells

BACKGROUND

p-Coumaric acid (p-CA), a phenolic compound abundantly found in edible plants, was found to induce apoptosis in SNU-16 gastric cancer cells. However, the effects of p-CA on the microRNA expression pattern in SNU-16 cells have not been reported.

OBJECTIVES

The primary objective of this study was to investigate microRNA expression profiles in p-CA-treated SNU-16 cells.

METHODS

SNU-16 cells were treated with 1.5 mM p-CA for 48 h. High-throughput RNA sequencing was performed. The accuracy and validity of the RNA sequencing results were tested by real-time PCR. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the differentially expressed microRNAs (DEMs).

RESULTS

Thirty-two DEMs were identified between p-CA-treated and control cells, 9 of which were upregulated, and 23 downregulated. GO and KEGG pathway analyses of the target genes indicated that these genes were involved in a variety of biological functions and several cancer-related pathways. The miRNA interactive network analysis identified hsa-miR-125a-5p, hsa-miR-30a-5p, and hsa-miR-7-5p as the major nodes.

CONCLUSIONS

Our findings indicated that p-CA exerted its anticancer effects in SNU-16 gastric cancer cells by modulating the expression of certain microRNAs, providing a better understanding of the anticancer properties of p-CA in gastric cancer cells.

Efficacy of a Latex Agglutination Test for Rapid Identification of Staphylococcus aureus: Collaborative Study

Fifteen laboratories completed a collaborative study comparing the efficacy of a latex agglutination kit (Aureus Test) with that of AOAC Official Method 987.09 (coagulase test for identification of Staphylococcus aureus). Each laboratory analyzed 240 strains of bacteria, including 160 isolates of S. aureus and 80 isolates of other bacteria. Upon receipt of cultures, collaborators subcultured each isolate on both tryptic soy agar (TSA) and Baird-Parker agar medium (BPA) to determine whether the growth medium has any effect on either method. For cultures grown on TSA, the latex test had sensitivity and specificity rates of 99.2 and 97.1 %, respectively, whereas the coagulase test had respective rates of 98.4 and 92.5%. For cultures able to grow on BPA, the latex test had sensitivity and specificity rates of 99.2 and 96.6%, respectively, while the coagulase test had respective rates of 98.3 and 91.3%. By using the McNemar pairwise comparison test of the 2 methods, the falsepositive and false-negative rates of the latex test were significantly lower (p &lt; 0.01) than those of the coagulase test for strains grown either on TSA or BPA. The latex agglutination test for identification of S. aureus isolated from foods has been adopted by AOAC INTERNATIONAL.

The clinical and histopathological characteristics of early-onset basal cell carcinoma in Asians

BACKGROUND

Basal cell carcinoma (BCC) is by far the most common cancer in white populations. In addition, recent reports have demonstrated an increasing incidence of BCC in Korea. We have observed a significant number of early-onset BCC cases in which the disease occurred in patients younger than 50 years.

OBJECTIVE

To investigate the clinicopathological characteristics of early-onset BCC in an Asian population, specifically in Koreans.

METHODS

One hundred and five patients with early-onset BCC were enrolled from a total of 1047 BCC patients who underwent surgery between January 1997 and December 2014 (942 patients over the age of 50 years were designated as the control group).

RESULTS

Early-onset BCC accounted for 10.03% of all 1047 cases and the incidence over time displayed an incremental trend. The early-onset group displayed similar results as the control group, with a predominance of female BCC patients and the majority of tumours displaying the following characteristics: small in size, occurring in sun-exposed areas and belonging to the noduloulcerative clinical subtype and nodular histopathological subtype. In comparison with a previous study in a Western population, the incidence of the disease in non-exposed areas of the body, as well as the proportion of tumours of the superficial histological subtype, were lower in Asian patients.

CONCLUSION

Although the clinicopathological characteristics of BCC are well-known, these characteristics have not been determined for early-onset BCC in an Asian population. Therefore, this study is the first report on early-onset BCC in Asians, specifically in a Korean patient group.

Antibunching single-photon emission and blinking suppression of CdSe/ZnS quantum dots

We demonstrated that by properly coupling to silver nanoprisms, single CdSe/ZnS semiconductor quantum dots (QDs) exhibited suppressed blinking behavior, an enhanced fluorescence intensity ( approximately 2.5 fold), increased radiative decay rates ( approximately 12.5 fold), and antibunching single-photon emission. All these modifications significantly promote the overall performance of the proposed single-photon sources based on colloidal semiconductor QDs.

Dopamine D2 receptor gene (DRD2) is associated with alcoholism with conduct disorder

This study examined whether there is evidence for an association between alcoholism with conduct disorder and alleles of the TaqI A and TaqI B polymorphisms, both individually and as haplotypes, at the dopamine D2 receptor gene (DRD2). We studied 182 Han Chinese subjects, including 34 alcoholics with conduct disorder, 63 alcoholics without conduct disorder, and 85 nonalcoholics. Alcohol dependence and conduct disorder were defined according to DSM-III-R criteria. Significant associations were observed between TaqI A and TaqI B at the DRD2 locus, tested individually and as haplotypes, and alcoholism with conduct disorder. Our results suggested that DRD2 might be associated with conduct disorder or a predisposition to both conduct disorder and alcoholism. However, this needs to be further investigated by examining the differences among conduct disorder with alcoholism, conduct disorder only, and controls for the TaqI A and B system at DRD2.

Assessment of fetal cerebellar volume using three-dimensional ultrasound

The purposes of this study were to assess the fetal cerebellar volume during normal gestation using three-dimensional (3-D) ultrasound (US) and to establish a normal chart of fetal cerebellar volume using Altman's model of statistics. In total, 231 healthy fetuses were studied for assessment of cerebellar volume using a 3-D US volume scanner. The fetuses to be studied were selected to give a cross-sectional series (i.e., each fetus was examined only once). Polynomial regression analysis was calculated to find the best-fit model using gestational age as the independent variable and cerebellar volume as the dependent variable. Altman's model was used to calculate the age-related reference centiles for the variance of cerebellar volume. In addition, common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight, were also measured for the correlation between cerebellar volume and these indices. Our results indicated that the fetal cerebellar volume was highly correlated with gestational age in normal pregnancies with the best-fit polynomial regression equation of a second-order (r = 0.91, p < 0.0001). In addition, fetal cerebellar volume in normal gestation is also highly correlated with common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight (all p < 0.0001). Following the Altman's model, a normal growth chart of fetal cerebellar volume was established for clinical reference. In conclusion, with 3-D US, the assessment of fetal cerebellar volume becomes feasible. We believe that fetal cerebellar volume assessed by 3-D US may be useful in detecting cerebellar hypoplasia and relevant syndromes prenatally.

Systemic assessment of fetal hemodynamics by Doppler ultrasound

The aim of our study was to investigate the parameters of fetal circulation of normal pregnancies and their relationship to fetal cardiac output. We performed a cross-sectional study of 315 normal singleton pregnancies between 20 and 40 weeks' gestation without fetal chromosomal or structural malformations. After follow-up to delivery, 212 patients who fit all the criteria were enrolled for final analysis. Blood flow velocity waveforms were obtained from the tricuspid and mitral ventricular inflow, ascending aorta (AAO), pulmonary artery (PA), middle cerebral artery (MCA), renal artery (RA), umbilical artery (UA), descending aorta (DAO), inferior vena cava (IVC) and ductus venosus (DV) using duplex (real-time Doppler) ultrasound (US) scanner. The peak velocity of DV, AAO, PA and MCA were also obtained. At the intracardiac level, the ratio of peak flow velocity of E wave to peak flow velocity of A wave (E:A ratio) of mitral valve (MV) increased more rapidly than tricuspid valve (TV) E:A ratio. For the great vessels, aortic peak velocity remained higher than the pulmonary peak velocity with advancing gestation. The cardiac output closely correlated to the cardiac compliance and flow resistance indices at arterial and venous level. The acceleration time in the fetal arteries increased with advancing gestation in AAO, PA, MCA and DAO, but it decreased in RA and kept constant in UA. In addition, the acceleration time of UA was unrelated to cardiac output. The changes of the fetal intracardiac, arterial and venous impedances were remarkable through the gestation and related to cardiac output. Fetal cardiac output correlated well with the changes of arterial resistance, except with the DAO. The ventricular compliance increased with advancing gestation, especially in the left side, and was highly related to the change of cardiac output. The acceleration time in major arteries positively correlated with the gestational age and cardiac output, except in UA and RA; this indicates the difference of the changes of mean arterial pressure in uteroplacental circulation, fetal organs and great vessels. In conclusion, the fetal cardiac output correlated well with the ventricular compliance and was influenced by both hemodynamic changes in peripheral resistance and mean arterial pressure.

Fetal ear assessment and prenatal detection of aneuploidy by the quantitative three-dimensional ultrasonography

The purposes of this study were to use quantitative three-dimensional (3-D) ultrasonography to establish the normal charts of three fetal ear-growth indexes, (ear length, ear width and ear area), and to validate their efficacy in the prenatal diagnosis of fetal trisomies, either separately or as a combination. Using quantitative 3-D ultrasonography, we performed a prospective study to measure the three fetal ear growth indexes (i.e., ear length, ear width and ear area) in 129 singleton pregnancies, including 122 normal fetuses and 7 trisomies. The ear shape was also evaluated in these fetuses using both 2-D and 3-D ultrasonography. Our results showed that: First, 3-D ultrasonography offers better visualization and easier evaluation of fetal ears than 2-D ultrasonography. Second, when using the quantitative assessment of 3-D ultrasonography, the measurements of ear length, ear width and ear area were all correlated significantly with gestational age in normal pregnancies (r = 0.881, 0.848, and 0.890, respectively). In addition, 3 of 7 fetal trisomies had ear length below the tenth percentile, 1 had ear width below the tenth percentile, and 2 had ear area below the tenth percentile. Furthermore, with the combination of these three measurements, (including ear length, ear width and ear area), the sensitivity in detecting fetal trisomies was elevated to 57.1% and the specificity was 83.2%. In conclusion, 3-D ultrasonography reduces the limitations of 2-D ultrasonography in the evaluation of fetal ears. However, fetal ear measurement may not be used as a single ultrasonographic parameter in identifying aneuploid fetuses. We recommend using the combination of these three ear growth indexes to enhance the detection rate of aneuploidy.

Three-dimensional ultrasound in the assessment of fetal cerebellar transverse and antero-posterior diameters

Fetal cerebellum scanning by prenatal ultrasound (US) is very important for early detection of fetal central-nervous-system anomaly, as well as for the determination of gestational age (GA). Due to the small organ size and the unique shape of the fetal cerebellum (CL), accurate measurement of the dimensions of CL by two-dimensional (2-D) US is not easy if the appropriate plane cannot be reached. With the advent of three-dimensional (3-D) US, the disadvantages of 2-D US in assessing the fetal CL dimensions can be avoided. The purpose of this study was to assess the fetal cerebellar transverse diameter (CTD) and cerebellar antero-posterior diameter (CAD) using 3-D US. First, we compared the reproducibility of 2-D and 3-D US on the assessment of fetal cerebellar dimensions. Second, we prospectively measured CTD and CAD in 223 healthy fetuses using a cross-sectional design with an attempt to establish the normal growth charts of fetal CL. Our results showed 3-D US is superior to 2-D US in the reproducibility test of fetal cerebellar dimensions. In addition, with GA as the dependent variable, polynomial regression analysis showed that the best-fit equations for both CTD vs. GA and CAD vs. GA were the first-order. The best-fit predictive equation of GA by CTD was GA (week) = 9.0281 + 0. 58533 x CTD (mm) (r = 0.95, n = 223, SE = 1.82 weeks, p < 0.0001), and the best-fit predictive equation of GA by CAD was GA (week) = 10. 855 + 1.1672 x CAD (mm) (r = 0.82, n = 223, SE = 3.41 weeks, p < 0. 0001). Furthermore, all the correlation coefficients of CTD or CAD vs. the common fetal growth indexes were also highly significant (all p < 0.0001). In conclusion, our data of fetal CL dimensions assessed by 3-D US may serve as a useful reference in assessing fetal CL growth, dating GA or detecting fetal CL anomalies.

Alcohol metabolism and cardiovascular response in an alcoholic patient homozygous for the ALDH2*2 variant gene allele

BACKGROUND

Alcohol metabolism is one of the biological determinants that can influence drinking behavior. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the principal enzymes involved in ethanol metabolism. Allelic variation of the ADH and ALDH genes can significantly affect vulnerability for the development of alcoholism. Homozygosity of the variant ALDH2*2 allele previously was believed to fully protect East Asian populations against the development of alcoholism.

METHODS

Eighty Han Chinese alcoholics who met DSM-III-R criteria for alcohol dependence and 144 nonalcohol-dependent subjects were recruited and their data combined with data from 340 alcohol-dependent and 545 nonalcohol-dependent subjects described in an earlier report (Chen et al., 1999) to assess risk for alcoholism by logistic regression analysis. Genotypes of ADH2, ADH3, and ALDH2 were determined by polymerase chain reaction and restriction fragment length polymorphism. The ALDH2 genotype was confirmed by direct nucleotide sequencing. Blood ethanol concentration was determined by headspace gas chromatography and acetaldehyde concentration by high-performance liquid chromatography with fluorescence detection of the derivatized product. Cardiovascular hemodynamic parameters were measured by two-dimensional Doppler echocardiography and sphygmomanometry. Extracranial arterial blood flow was measured by Doppler ultrasonography.

RESULTS

An alcohol-dependent patient was identified to be ALDH2*2/*2, ADH2*2/*2, and ADH3*1/*2. Following challenge with a moderate oral dose of ethanol (0.5 g/kg of body weight), the patient exhibited peak concentrations for ethanol (55.7 mg/dl) and acetaldehyde (125 microM). During 130 min postingestion, the patient generally displayed similar or even less intense cardiovascular hemodynamic alterations when compared to a previously published study of nonalcoholic individuals with ALDH2*2/*2 who had received a lower dose of ethanol (0.2 g/kg). Logistic regression analysis of the combinatorial genotypes of ADH2 and ALDH2 in 420 alcohol-dependent and 689 nonalcohol-dependent subjects indicated that risk for alcoholism was 100-fold lower for the ADH2*2/*2-ALDH2*2/*2 individuals than the ADH2*1/*1-ALDH2*1/*1 individuals.

CONCLUSIONS

The gene status of ALDH2*2/*2 alone can tremendously but not completely (as thought previously) protect against development of alcohol dependence. Individuals carrying the combinatorial genotype of ADH2*2/*2-ALDH2*2/*2 are at the least risk for the disease in East Asians. Physiological tolerance or innate insensitivity to the accumulation of blood acetaldehyde following alcohol ingestion may be crucial for the development of alcoholism in individuals homozygous for ALDH2*2.

Flavonoid glycosides from viscum alniformosanae

Two new flavonoid glycosides, (2S)-5-hydroxy-7, 3'-dimethoxyflavanone-4'-O-beta-[apiosyl (1 --> 2)]glucoside (1) and rhamnazin-4'-O-beta-[apiosyl (1 --> 2)]glucoside (2) were isolated from Viscum alniformosanae. Structures were elucidated by NMR and mass spectroscopic analysis.

No association between DRD2 locus and alcoholism after controlling the ADH and ALDH genotypes in Chinese Han population

BACKGROUND

Recent studies on the genetics of alcoholism have examined the association between alcoholism and the dopamine D2 receptor locus (DRD2); our study of Chinese Han gave negative results (Lu et al., 1996). The different genotypes at the genes encoding the enzymes involved in alcohol metabolism, class one alcohol dehydrogenase (ADH2 and ADH3) and mitochondrial aldehyde dehydrogenase (ALDH2), have previously been shown to confer different predispositions to the development of alcoholism in Chinese Han males (Thomasson et al., 1991; Chen WJ et al., 1996; Chen CC et al., unpublished data). Therefore, association studies of alcoholism in Chinese Han might be more sensitive if controlled for the genotypes of ADH2,ADH3, and ALDH2, when other loci, such as DRD2, are examined. This study employs such controls to evaluate the evidence for an association between alcoholism and TaqI-A and TaqI-B genotypes and haplotypes at DRD2 in the Chinese Han population.

METHODS

We studied 213 Chinese Han subjects (128 alcoholics and 85 nonalcoholics) with alcohol dependence defined according to DSM-III-R criteria.

RESULTS

Significant linkage disequilibrium was observed between the TaqI-A and TaqI-B sites at the DRD2 locus, as previously seen in smaller samples, but no significant association was observed between these genetic variants at the DRD2 locus and alcoholism in Chinese Han. Several different stratifications by ADH and ALDH2 genotypes were examined; no genotypes or haplotypes at DRD2 differ between alcoholics and nonalcoholics except for a small number of nominally significant p-values which do not constitute significant results given the many tests done, some of which are not independent of one another due to linkage disequilibrium. These tests included considering the high risk (ADH2*1/*1; *1/*2; ADH3*1/*2; *2/*2; and ALDH2*1/*1) and the low risk (ADH2*2/*2; ADH3*1/*1; and ALDH2*1/*2; *2/*2) groups of alcoholics, as well as nonalcoholic controls.

CONCLUSIONS

After stratification by the relevant genotypes of ADH2, ADH3, and ALDH2 no significant association exists between the genetic variants at the DRD2 locus and alcoholism in the Chinese Han population.

Molecular genetic analysis of non-astrocytic gliomas

AIMS

Oligodendroglial tumours follow genetic pathways different from but overlapping with those of astrocytic tumours. The aim of this study was to examine whether major genetic events such as loss of chromosome 10 and p53 mutation found in astrocytic gliomas are also involved in the development and anaplastic transformation of non-astrocytic gliomas and to correlate the findings with histopathological subtypes of these tumours.

METHODS AND RESULTS

Sixty-one formalin-fixed, paraffin-embedded oligodendroglial and ependymal tumours (16 oligodendrogliomas, 12 anaplastic oligodendrogliomas, seven oligoastrocytomas, 24 ependymomas and two anaplastic ependymomas) were examined for allelic deletions on chromosome 10q23 and 10q25-26 regions, mutations of PTEN/MMAC1 and p53, MDM2 gene amplification and apoptosis. The frequencies of allelic deletions at marker D10S2491 (which mapped within PTEN/MMAC1) and between markers D10S209 and D10S587 (where DMBT1 was located) were found to be < 30% in both types of non-astrocytic gliomas. High frequency of allelic deletions was detected at marker D10S215 (80%) at the proximal 10q23 region in both oligodendroglial and ependymal tumours and between markers D10S216 (42%) and D10S169 (67%) at distal 10q25-26 region in oligodendroglial tumours. No mutations of PTEN/MMAC1 were found. p53 mutations were detected in three oligoastrocytomas and one ependymoma; three out of five mutations were found in exon 4. MDM2 gene amplification was found in one ependymoma harbouring wild-type p53. The apoptotic index was lower in p53-mutated tumours than in tumours with wild-type p53.

CONCLUSION

The telomeric end of chromosome 10q could be involved in the development and anaplastic transformation of oligodendroglial tumours. Mutations of PTEN/MMAC1 and p53, amplification of the MDM2 gene and allelic loss on chromosome 10q do not play a major part in the pathogenesis or anaplastic transformation of oligodendrogliomas and ependymal tumours.

Linkage disequilibrium at the ADH2 and ADH3 loci and risk of alcoholism

Two of the three class I alcohol dehydrogenase (ADH) genes (ADH2 and ADH3) encode known functional variants that act on alcohol with different efficiencies. Variants at both these genes have been implicated in alcoholism in some populations because allele frequencies differ between alcoholics and controls. Specifically, controls have higher frequencies of the variants with higher Vmax (ADH2*2 and ADH3*1). In samples both of alcoholics and of controls from three Taiwanese populations (Chinese, Ami, and Atayal) we found significant pairwise disequilibrium for all comparisons of the two functional polymorphisms and a third, presumably neutral, intronic polymorphism in ADH2. The class I ADH genes all lie within 80 kb on chromosome 4; thus, variants are not inherited independently, and haplotypes must be analyzed when evaluating the risk of alcoholism. In the Taiwanese Chinese we found that, only among those chromosomes containing the ADH3*1 variant (high Vmax), the proportions of chromosomes with ADH2*1 (low Vmax) and those with ADH2*2 (high Vmax) are significantly different between alcoholics and controls (P<10-5). The proportions of chromosomes with ADH3*1 and those with ADH3*2 are not significantly different between alcoholics and controls, on a constant ADH2 background (with ADH2*1, P=.83; with ADH2*2, P=.53). Thus, the observed differences in the frequency of the functional polymorphism at ADH3, between alcoholics and controls, can be accounted for by the disequilibrium with ADH2 in this population.

Platelet 5-HT and plasma MHPG levels in patients with bipolar I and bipolar II depressions and normal controls

BACKGROUND

It has been suggested that platelet serotonin (5-HT) content may reflect aspects of the presynaptic reuptake of 5-HT, while plasma 3-methoxy-4-hydroxy-phenylglycol (MHPG) levels may provide an index of central noradrenergic function.

METHODS

In order to determine if there is a biological distinction in 5-HT or noradrenergic function within bipolar I and bipolar II depressions, we measured levels of platelet 5-HT and plasma MHPG in 12 patients with bipolar I depression, 12 patients with bipolar II depression, and 20 normal healthy controls. All subjects were medication free for at least 4 weeks prior to the study.

RESULTS

There was a trend towards higher platelet 5-HT in bipolar I or II depressions when compared to normal controls, whereas there was no difference in platelet 5-HT levels between bipolar I and II depressed patients. When bipolar I and II patients were pooled, there was a significant increase in platelet 5-HT levels in bipolar depressives compared to normal controls, and there was a trend towards a weak positive correlation between platelet 5-HT and 21-item HAMD scores in the patient group. In contrast, there was no difference in plasma MHPG levels between the three groups.

LIMITATIONS

This study was limited to a small sample size, single point sampling and did not match seasons.

CONCLUSIONS

Our findings did not provide supportive evidence for a distinctive 5-HT or noradrenergic function within bipolar I and bipolar II depressions. However, the finding of increased platelet 5-HT levels in bipolar depressed patients compared to normal controls is consistent with the results of previous studies, and may suggest an increase in presynaptic 5-HT reuptake, presumably resulting from diminished synaptic 5-HT availability in this condition.

Pharmacokinetic-pharmacodynamic modeling of tolmetin antinociceptive effect in the rat using an indirect response model: a population approach

The relationship between the pharmacokinetics and the antinociceptive effect of tolmetin was characterized by an indirect model using a population approach. Animals received an intra-articular injection of uric acid in the right hindlimb to induce its dysfunction. Once dysfunction was complete, rats received an oral tolmetin dose of 1, 3.2, 10, 31.6, 56.2 or 100 mg/kg and antinociceptive effect and blood tolmetin concentration were simultaneously evaluated. Tolmetin produced a dose-dependent recovery of functionality, which was not directly related to blood concentration. An inhibitory indirect response model was used based on these response patterns and the fact that tolmetin reduced nociception by inhibiting prostaglandin synthesis. Pharmacokinetic (PK) and pharmacodynamic (PD) data were simultaneously fitted using nonlinear mixed effects modeling (NONMEM) to the one-compartment model and indirect response model. The individual time courses of the response were described using Bayesian analysis with population parameters as a priori estimates. There was good agreement between the predicted and observed data. Population analysis yielded a maximal inhibition of the nociceptive response of 76% and an IC50 of 9.22 micrograms/ml. This IC50 is similar to that for tolmetin-induced prostaglandin synthesis inhibition in vitro (3.0 micrograms/ml). The present results demonstrate that mechanism-based PK-PD analysis using a population approach is useful for quantitating individual responses as well as reflecting the actual mechanism of action of a given drug in vivo.

The lower limits of dexamethasone window in Chinese depressives

BACKGROUND

Previous studies have shown wide variation in plasma dexamethasone (DEX) concentrations following a standard 1-mg dexamethasone suppression test (DST), and significantly lower DEX concentrations in DST nonsuppressors compared with suppressors, suggesting that DEX pharmacokinetics/bioavailability is an important variable associated with DST nonsuppression.

METHODS

To determine the effect of plasma DEX levels on the DST in Chinese depressives, we measured plasma DEX and post-DEX cortisol levels at 4:00 PM in a group of 50 depressed outpatients, 28 anxiety outpatients, and 33 normal subjects during the course of 1-mg oral overnight DST.

RESULTS

We found a significant difference in the plasma DEX levels between DST nonsuppressors and suppressors in the depression group and overall subject population, and a significant negative correlation between the plasma DEX and cortisol levels in the depression, anxiety, and total groups. Within a DEX "window", the DST performance was enhanced, whereas the relationships between plasma DEX and post-DEX cortisol levels remained equally strong.

CONCLUSIONS

Our findings support a relationship between plasma DEX and post-DEX cortisol levels, a relationship that might be superimposed on the hypothalamic-pituitary-adrenal axis. Comparing our "window" range with those of previous studies, we suggest that Chinese depressives may have lower limits of plasma DEX window, and that ethnicity may be an intervening variable in both DST response and pharmacokinetics of DEX.

Nonlinear perpendicular least-squares regression in pharmacodynamics

Currently available software for nonlinear regression does not account for errors in both the independent and the dependent variables. In pharmacodynamics, measurement errors are involved in the drug concentrations as well as in the effects. Instead of minimizing the sum of squared vertical errors (OLS), a Fortran program was written to find the closest distance from a measured data point to the tangent line of an estimated nonlinear curve and to minimize the sum of squared perpendicular distances (PLS). A Monte Carlo simulation was conducted with the sigmoidal Emax model to compare the OLS and PLS methods. The area between the true pharmacodynamic relationship and the fitted curve was compared as a measure of goodness of fit. The PLS demonstrated an improvement over the OLS by 20.8% with small differences in the parameter estimates when the random noise level had a standard deviation of five for both concentration and effect. Consideration of errors in both concentrations and effects with the PLS could lead to a more rational estimation of pharmacodynamic parameters.

Three-dimensional ultrasound-assessed fetal thigh volumetry in predicting birth weight

OBJECTIVE

To compare the accuracy of three-dimensional ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimensional ultrasound.

METHODS

We assessed the thigh volume of 100 fetuses using three-dimensional ultrasound. Meanwhile, their BPD, AC, and FL were measured by two-dimensional ultrasound. All infants were delivered within 48 hours after the ultrasound examinations. From polynomial regression analysis, we generated a best-fit formula for the thigh volume to predict birth weight. The accuracy of this thigh-volume formula was compared with those of three formulas commonly used in the United States. In addition, another group of 50 fetuses was measured for prospective validation.

RESULTS

The high volume assessed by three-dimensional ultrasound was highly correlated with birth weight (r = 0.89, n = 100, P < .0001). The best-fit formula for thigh volume to predict birth weight was linear, and it was superior to the other commonly used two-dimensional formulas in predicting birth weight. The predicting error (0 g), percent error (0.7%), absolute error (176.1 g), and absolute percent error (5.8%) of the thigh-volume formula were all smaller than those of the other formulas (n = 100, all P < .05). In addition, the thigh-volume formula predicted birth weight more accurately than the other two-dimensional formulas in the prospective-validation group. The three-dimensional formula had smaller mean values of predicting error (38.6 g), percent error (1.5%), absolute error (160.0 g), and absolute percent error (5.1%) than the two-dimensional formulas (n = 50, all P < or = .001), as well as the smallest variances of the above errors (178.1 g, 5.6%, 84.3 g, and 2.9%, respectively).

CONCLUSION

The three-dimensional ultrasound-assessed thigh volume has better accuracy in predicting birth weight than the commonly used formulas by two-dimensional ultrasound, and it may improve fetal weight prediction in clinical practice. However, a large-scale prospective validation study may be needed to confirm our conclusions.

Predicting birth weight by fetal upper-arm volume with use of three-dimensional ultrasonography

OBJECTIVE

Our purpose was to determine the usefulness and accuracy of the three-dimensional ultrasonography assessed fetal upper-arm volume in predicting birth weight.

STUDY DESIGN

From June 1996 to October 1996, we performed a prospective study of ultrasonography on 105 pregnant women without fetal structural anomaly or aneuploidy. Both the traditional two-dimensional ultrasonographic parameters and three-dimensional ultrasonography for fetal upper arm volume were measured within 48 hours of delivery.

RESULTS

The upper arm volume correlated well with birth weight (r = 0.92, n = 105, p < 0.0001). With use of linear and polynomial regression, we obtained a best-fit new formula, Birth weight = 1088.60 + 36.024 x Upper-arm volume. The accuracy of this new formula is compared with that of two Chinese equations predicting fetal weight reported before and other formulas commonly used in the world as well. Our formula is more accurate in predicting birth weight than all the other formulas by traditional two-dimensional ultrasonography, either in error, percentage error, or absolute error. Another group by prospective validation further proved this finding.

CONCLUSION

The upper-arm volume assessed by three-dimensional ultrasonography can accurately predict birth weight, and its accuracy is superior to the previous, formulas. Our study has at least validated the application of upper-arm volume by three-dimensional ultrasonography in estimating fetal weight. Further larger series are needed to confirm our findings.

Plasma free 3-methoxy-4-hydroxyphenylglycol predicts response to fluoxetine

This study was designed to investigate the relationship between platelet serotonin (5-HT) and plasma free 3-methoxy-4-hydroxyphenylglycol (MHPG) measures in depressed outpatients obtained from the same patient with unipolar depression during the pretreatment period and subsequent response to 6 weeks of treatment with either fluoxetine or maprotiline. Compared to the nonresponder group, the fluoxetine responders showed significantly higher pretreatment levels of MHPG, but no difference in pretreatment 5-HT levels. There were no significant differences in either 5-HT or MHPG levels between maprotiline responders and nonresponders. As to posttreatment levels, there were no between-group differences in 5-HT or MHPG between responders and nonresponders to either fluoxetine or maprotiline. When the relationships between changes in 5-HT or MHPG levels and treatment response were examined, 5-HT values showed a marked decrease in both fluoxetine responders and nonresponders, but no significant changes were found in the maprotiline treatment groups. On the other hand, MHPG levels in the fluoxetine nonresponders tended to increase (borderline significance), whereas the MHPG levels for fluoxetine responders and maprotiline responders and nonresponders were unaffected from pre- to posttreatment. Pretreatment levels of plasma free MHPG appear to predict response to fluoxetine.

Refined fetal abdominal growth assessment in normal pregnancy: Part I. Abdominal anteroposterior diameter

BACKGROUND

The assessment of the adequacy of fetal growth by parameters other than the abdominal anteroposterior diameter (AAPD) of the fetus has been studied extensively. However the designs of these studies and the statistical methods used appears to deserve some criticism, based on present knowledge. Noncross-sectional cases selection, uncertainty of the fetal normality and inadequacy in statistical method, mostly ignored the changing property of each standard deviation (SD) of each gestational age (GA) which was proposed by Altman et. al. in 1993, are the three most common flaws in previous publishes. We tried to use AAPD with a strict study design as well as a reasonable statistical method to evaluate the fetal growth.

METHODS

This study was performed in the Division of Maternal Fetal Medicine, National Cheng Kung University Hospital, Taiwan. The prenatal sonographic data of the fetuses were collected prospectively based on the following criteria: (1) accurate dating by knowing the maternal last menstration period (LMP) and early ultrasonography of the fetuses, (2) singleton pregnancy, (3) no fetal structural or chromosomal abnormality confirmed by prenatal ultrasonography and postnatal examination, (4) GA at birth was between 37 and 41 weeks' gestation, (5) no birth asphyxia, (6) appropriate birth body weight, and (7) no maternal medical disease or obstetrical complication which might predictably interfere with fetal growth. The collected data were analyzed by polynomial regression test and the best-fit equation for prediction of fetal growth was selected. The standard deviation (SD) of each GA was modeled before constructing the fetal growth centile charts by Altman's method.

RESULTS

A total of 2077 cross-sectional sonographic data meeting the above criteria were collected for statistical analysis. The best-fit equation for the prediction of fetal GA by AAPD is GA = 20.8539 - 3.36743 x AAPD + 0.86927 x (AAPD)2 - 0.03789 x (AAPD)3 +/- k x [1.2533 x (0.36772 + 0.10938 x AAPD)], (r = 0.97287, p < 0.0001). The best-fit equation for prediction of fetal AAPD by GA is AAPD = -2.49495 + 0.38247 x GA - 1.07071 x 0.001 x (GA)2 +/- k x [1.2533 x (0.01760 + 0.01372 x GA)], r = 0.97122, p < 0.0001. The SD of AAPD for each complete GA was not the same. The fetal growth centile charts in the study are presented in this article.

CONCLUSIONS

The SD of each complete GA changed with each specific GA. The GA of the fetus can be assessed accurately by measuring the AAPD alone. The utilization of these growth centile charts for evaluation of fetal growth is recommended.

The dopamine D4 receptor gene (DRD4) is not associated with alcoholism in three Taiwanese populations: six polymorphisms tested separately and as haplotypes

The dopaminergic system has been implicated in alcoholism but studies at the dopamine D2 receptor gene (DRD2), one of the five dopamine receptors, have not given a consistent picture of an association with alcoholism. We have now studied the dopamine D4 receptor gene (DRD4) using six polymorphisms, both separately and as haplotypes. Three groups of alcoholics from Taiwan (Atayal, Ami, and Han) diagnosed as having severe alcohol dependence using DSM-III-R criteria, together with nonalcoholics matched for gender, ethnic group, and geographic origin, were typed by polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymorphism (RFLP) for all six polymorphisms. Three out of six markers are polymorphic in all three Taiwanese populations. Although the prevalence rates of alcoholism are remarkably different, no highly significant association of this locus with alcoholism was observed in any of the three groups whether the analysis considered genotype distributions or allele frequencies at the three polymorphic markers considered individually and as haplotypes. Neither is there any obvious pattern in the data that covaries with or hints at a relationship with the very different prevalences of alcoholism in the groups studied. Especially because the powerful, multi-site haplotype analysis was not statistically significant in any of the population samples, we conclude that there is no association of the DRD4 locus with alcoholism in Taiwanese populations.

Fetal heart volume assessment by three-dimensional ultrasound

Heart volume may provide important information on the status of fetal hemodynamics. However, traditionally fetal heart volume has been assessed with the erroneous assumption that the fetal heart is spherical or elliptical. With the advent of three-dimensional ultrasound, accurate assessment of organ volume has become feasible. The objectives of this study were to compare the reproducibility of two-dimensional ultrasound and three-dimensional ultrasound in the assessment of heart volume, and to test whether heart volume assessed by the traditional method of two-dimensional ultrasound equates to that assessed by three-dimensional ultrasound. If it proved to be significantly different, we aimed to find a new constant which, if incorporated into the traditional formula used to determine heart volume, would enable us to achieve more accurate volumes with two-dimensional ultrasound. In total, 50 normal singleton fetuses ranging from 20 to 30 weeks' gestation were included in the study. Both the traditional two-dimensional and the new three-dimensional volume measurements were compared. The results showed that three-dimensional ultrasound has a better reproducibility than two-dimensional ultrasound in heart volume assessment and that heart volume assessed by the traditional formula of two-dimensional ultrasound is significantly larger than that measured by three-dimensional ultrasound (p < 0.001). We therefore propose that, if the traditional two-dimensional equation is to be used, the constant for heart volume could be modified to 0.4563 (SE = 0.0153, n = 50) to achieve more accurate results. With this new constant, the heart volume derived by two-dimensional ultrasound was not found to differ from that measured by three-dimensional ultrasound. From our series, we conclude that three-dimensional ultrasound is theoretically the best method for the assessment of heart volume. However, because of the limitations of three-dimensional ultrasound (i.e. it is not routinely available, it is more expensive and more time-consuming) two-dimensional ultrasound in practical terms should be the method of choice. Although we were able to improve the accuracy of the heart volume measurements using a new constant in the traditional two-dimensional formula, the new constant will not improve variability, which can only be reduced by three-dimensional ultrasound.

Construction of a screening inventory for major mental disorder in the Army

The development of a 29-item self-report inventory to screen for non-adaptiveness with an episode or a history of major mental disorder in the army is described. Initially, a 58-item inventory was constructed. However, through a pilot study 46 items remained. The reliability and validity test of the 46-item inventory was then carried out on 357 patients and 126 controls. Firstly, item analyses were performed which showed 12 items that distinguished between schizophrenic patients and controls, 9 items that distinguished between depressive patients and controls and 8 items that distinguished between manic patients and controls. A final 29-item inventory was found to have satisfactory reliability, sensitivity and specificity. The analyses of the best cut-off scores using the receiver-operating-characteristic curve suggested a score of 3 for the Schizophrenia Scale, 2 for the Depression Scale, and 3 for the Mania Scale. The inventory can be completed in about 5 to 10 minutes and has a simple method of scoring. The use of this screening inventory in the army is discussed.

Three-dimensional ultrasound assessment of fetal liver volume in normal pregnancy: a comparison of reproducibility with two-dimensional ultrasound and a search for a volume constant

The purposes of this study are to compare the reproducibility of two-dimensional ultrasound (2DUS) and three-dimensional ultrasound (3DUS) in the assessment of fetal liver volume (LV), and to test whether the fetal LV assessed by the traditional method with 2DUS is equal to that with 3DUS in normal pregnancy. If significantly different, we then try to calculate a new constant of fetal LV for the traditional equation from the LV values obtained with 3DUS. In total, 30 normal singleton fetuses with gestational ages ranging from 20 to 30 weeks were included for the reproducibility test and 55 cases ranging from 20 to 31 weeks gestation were enrolled for finding a new volume constant of LV. The results showed that 3DUS is superior to 2DUS in the reproducibility test of fetal LV assessment. Moreover, the LV assessed with the traditional 2DUS method (identified as LV_42) was significantly smaller than that measured with 3DUS (P < 0.001). If the traditional 2DUS equation is to be used, the multiplying factor in the equation for the calculation of LV should be modified to 0.55 (SE = 0.017, N = 55). With the new volume constant, the new derived LV with 2DUS (identified as LV 55) was not different from that with 3DUS (identified as LV_3D). In conclusion, we recommend that 3DUS, instead of 2DUS, should be used for reaching an accurate assessment of fetal LV. Otherwise, applying our new volume constant may be of help in detecting abnormal fetal liver growth when only 2DUS is available.

No association between alcoholism and multiple polymorphisms at the dopamine D2 receptor gene (DRD2) in three distinct Taiwanese populations

This study examined whether there is evidence for an association between alcoholism and the alleles of the TaqI A, TaqI B, and short tandem repeat polymorphisms (STRP), both individually and as haplotypes, at the dopamine D2 receptor gene (DRD2) in males of three populations from Taiwan. We studied 46 Chinese Han (21 alcoholics and 25 nonalcoholics), 42 Atayal (21 alcoholics and 21 nonalcoholics), and 40 Ami (20 alcoholics and 20 nonalcoholics). Alcoholism was diagnosed according to DSM-III-R criteria and all individuals in the alcoholic groups were severely affected. Significant linkage disequilibrium occurs for the three polymorphic sites in all three populations. No significant association was observed between any of the three polymorphisms at the DRD2 locus, tested individually and as haplotypes, and alcoholism in the three subject groups. We conclude that no association exists between genetic variation at the DRD2 locus and alcoholism in Chinese Han, Atayal, and Ami males.

Pharmacodynamic modeling of finasteride, a 5 alpha-reductase inhibitor

Finasteride is a 4-azasteroid inhibitor of one isoenzyme of 5 alpha-reductases that converts testosterone to dihydrotestosterone (DHT). We characterized the time course of DHT concentrations. The following model was used to assess DHT pharmacodynamics: [formula: see text] where joint fitting of three dose levels yielded kin0 = 28% change/hour, kout = 0.28 hour-1, IC50 = 0.012 ng/ml, and Emax = 0.7. The modification of a previous model with the maximum partial effect factor, Emax, may be useful in characterizing the pharmacodynamics of drugs with similar indirect mechanisms.

Effect of corticosteroid binding globulin on the pharmacokinetics of prednisolone in rats

PURPOSE

The effect of exogenous corticosteroid binding globulin (CBG) on the pharmacokinetics of intravenous prednisolone was determined in rats to test the "free hormone hypothesis."

METHODS

A dose of CBG to yield 95% binding with 1000 ng/ml of prednisolone in vitro in rat plasma or saline was administered before dosing 2 mg/kg of prednisolone hemisuccinate or methylprednisolone intravenously. Drug concentrations in plasma samples were assayed by HPLC.

RESULTS

Single administration of CBG decreased apparent prednisolone clearance by 56% (155 to 66 ml/min/kg) and reduced apparent VSS by 35% (4.1 to 2.7 L/kg) (p < 0.001). Methylprednisolone pharmacokinetics, studied as a negative control because the drug does not bind to CBG, did not change.

CONCLUSIONS

The corticosteroid bound to CBG does not appear to be available for removal by clearance organs.

Acceleration time in normal fetal umbilical artery at term and its relationship to the cord blood hematocrit

The purpose of this study was to test the hypothesis that the acceleration time (AT) of the fetal umbilical artery remains constant at term for normal pregnancies. In addition, we also examined whether the AT has any correlation with umbilical cord blood hematocrit (Hct). In total, 539 normal-term fetuses with menstrual ages (MA) ranging from 37 weeks to 42 weeks were enrolled in a cross-sectional design. The AT of the fetal umbilical artery was measured prior to delivery using a high-resolution, real-time Doppler scanner. All were delivered within 2 days of the ultrasound examination. At parturition, blood from the umbilical vein was collected and the red cell indices, including the Hct, were determined. The results indicated that the mean values of AT of the umbilical artery remained constant during normal-term pregnancies from 37 weeks to 42 weeks, menstrual age (mean: 0.104 sec, SE: 0.001 sec, n = 539). Although the AT was thought to be affected by the Hct, the AT had no correlation with umbilical venous Hct (n = 539, r = 0.002, p > 0.05). This constant value of the AT may be used as a reference for fetal physiology and perinatal medicine.

Cognitive development in Yucheng children

We have been following up the biological and mental development of children exposed prenatally to polychlorinated biphenyls and their contaminants (Yucheng children). When we started this 12-year follow-up study in August 1985, 118 Yucheng children we assigned a non-exposed child matched by sex, age, locality of residence, mother's age, socio-economic status of the family. This article reports the cognitive aspect of the development of Yucheng children as compared to their matched controls. A consistent tendency which indicates that Yucheng children score lower in each kind of measurement tool at each age level has been observed. This seems to imply that congenitally exposure to PCBs and their contaminants has long-term adverse effects on the cognitive development of human being.

Physiologic indirect response models characterize diverse types of pharmacodynamic effects

A family of four basic physiologic indirect response models has been proposed to account for the pharmacodynamics of drugs that act by way of inhibition or stimulation of the production or loss of endogenous substances or mediators. Such models were applied previously to account for the anticoagulant effects of warfarin, adrenal suppression by corticosteroids, cell trafficking effects of corticosteroids, antipyretic effects of ibuprofen, and aldose reductase inhibition. Additional responses that can be readily characterized with such models include muscular contraction from pyridostigmine, diuresis from furosemide, bronchodilation from terbutaline, prolactin secretion after cimetidine, and potassium suppression by terbutaline. This report shows that indirect response models, rather than "link" or "hypothetical effect compartment" models, may be more appropriate for diverse drugs when time lags exist between plasma or biophase drug concentrations and the time course of pharmacodynamic responses.

High-performance liquid chromatographic determination of rutaecarpine in rat plasma: application to a pharmacokinetic study

A simple and sensitive high-performance liquid chromatographic method for determination and identification of rutaecarpine in rat plasma has been developed. Up to 0.1 ml of plasma containing rutaecarpine was deproteinized by acetonitrile, which contained an internal standard (paeonol). The supernatant was injected onto a reversed-phase column using a acetonitrile-water-orthophosphoric acid (85%) (60:40:0.1, v/v/v, pH 2.5-2.8) as the mobile phase and ultraviolet detection at 344 nm. It was applied to the pharmacokinetic study of rutaecarpine in rat after a 2 mg/kg intravenous administration. A biphasic process with a rapid distribution followed by a slower elimination phase was observed from the plasma concentration-time curve. Compartmental analysis yielded a two-compartment model.

Prediction of fetal macrosomia by single ultrasonic fetal biometry

A total of 1,056 fetuses underwent single ultrasonographic measurement of fetal biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated body weight within five days of delivery. The accuracy of these parameters and estimated body weight equations in the prediction of macrosomia (birth weight > or = 4,000 g) was evaluated. With the use of receiver operator characteristic curves, the optimal cutoff value for each parameter with the best sensitivity, specificity and accuracy was selected. BPDs > or = 9.4 cm had the best sensitivity (68.8%), specificity (74.3%), and accuracy (74.1%). ACs > or = 35 cm had the best sensitivity (81.3%), specificity (81.5%), and accuracy (81.5%). FLs > or = 7.0 cm had the best sensitivity (68.8%), specificity (74.5%), and accuracy (74.3%). The estimated body weight equations did not increase the prediction values whether or not FL was included. Both had the same prediction values at > or = 3,700 g, ie, sensitivity (71.9% vs 71.9%), specificity (92.1% vs 93.8%), and accuracy (91.5% vs 93.2%). The results showed AC to be the best single parameter for predicting macrosomia. Combinations of these parameters were better than a single parameter in the prediction of macrosomia.

Clinical validation of two equations in antenatal prediction of Chinese fetal weight by ultrasonography

The purpose of this series is to prospectively validate the Chinese equations for predicting fetal weight developed in a previous study. A total of 640 Chinese fetuses were examined antenatally for biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) by real-time ultrasonography within two days of delivery. The results showed the actual birth weight (BW) to be highly correlated with the estimated body weight for both the equation using BPD and AC (EBW1) (r = 0.888, p less than 0.0001) and the equation using BPD, AC and FL (EBW2) (r = 0.890, p less than 0.0001). Our results demonstrate that the Chinese equations developed by Hsieh et al are a better fit for Chinese fetuses than the foreign equations are. Also, the two Chinese equations predict fetal weight well between 2,000 g and 4,000 g, but further modification is needed in cases where the BW is less than 2,000 g or greater than 4,000 g.