Reentrance of interface superconductivity in a high-Tc cuprate heterostructure

Increasing the carrier density in a Mott insulator by chemical doping gives rise to a generic superconducting dome in high temperature superconductors. An intriguing question is whether a second superconducting dome may exist at higher dopings. Here we heavily overdope La2-xSrxCuO4 (0.45 ≤ x ≤ 1.0) and discover an unprecedented reentrance of interface superconductivity in La2-xSrxCuO4 /La2CuO4 heterostructures. As x increases, the superconductivity is weakened and completely fades away at x = 0.8; but it revives at higher doping and fully recovers at x = 1.0. This is shown to be correlated with the suppression of the interfacial charge transfer around x = 0.8 and the weak-to-strong localization crossover in the La2-xSrxCuO4 layer. We further construct a theoretical model to account for the sophisticated relation between charge localization and interfacial charge transfer. Our work advances both the search for and control of new superconducting heterostructures.

[Analysis of clinical effect and influencing factors of history-indicated cerclage or ultrasound-indicated cerclage in singleton pregnancy]

Objective: To investigate the clinical effect and the influencing factors of ultrasound-indicated cerclage and history-indicated cerclage in singleton gestation. Methods: The clinical data of 272 singleton pregnant women with cervical incompetence who underwent McDonald cervical cerclage due to medical history indication (history-indicated group) or ultrasound indication (ultrasound-indicated group) in Peking University First Hospital from January 2010 to February 2021 were retrospectively analyzed. The general clinical data and maternal and fetal outcomes were compared between the history-indicated group (141 cases) and ultrasound-indicated group (131 cases). According to the gestational age at delivery, 272 pregnant women who underwent cervical cerclage were further divided into ≥34 weeks group (225 cases) and <34 weeks group (47 cases), and the influencing factors of preterm birth before 34 weeks of gestation were analyzed. Results: (1) The median gestational age at cerclage was 16.6 weeks in the history-indicated group and 23.4 weeks in the ultrasound-indicated group, and the median gestational age extension at delivery was 21.4 weeks and 14.7 weeks, respectively, with statistically significant differences between the two groups (all P<0.05). (2) The full-term birth rate was 76.6% (108/141) in the history-indicated group and 71.0% (93/131) in the ultrasound-indicated group, the live birth rate was 97.2% (137/141) and 97.7% (128/131), and the median birth weight of live birth was 3 155 g and 3 055 g, respectively. The differences were not statistically significant (all P>0.05). Among 272 pregnant women with cervical cerclage, 265 neonates survived (97.4%, 265/272). The gestational age of 7 pregnant women who did not have live birth was ≤25 weeks of gestation (range: 19+1-25 weeks), and they were all clinically infected or confirmed chorioamnionitis or pathogenic microorganisms carrying during pregnancy, and their families gave up. The minimum birth weight of the surviving neonate was 850 g (gestational week of delivery was 26+6 weeks). (3) Univariate analysis showed that compared with ≥34 weeks group, the body mass index (BMI) of pregnant women in <34 weeks group was higher at 6-7 weeks of gestation (median: 24.5 vs 25.4 kg/m2), shorter cervical length (CL) at 1-2 weeks after surgery [(31.1±8.4) vs (26.1±11.0) mm], shorter CL at 26-28 weeks of gestation after surgery (median: 26.3 vs 16.0 mm), and higher incidence of elevated C-reactive protein (CRP) before and after surgery and before delivery. The differences were all statistically significant (all P<0.05). Multivariate logistic regression analysis showed that preterm birth before 34 weeks was negatively associated with CL at 26-28 weeks of gestation after cerclage (OR=0.902, 95%CI: 0.858-0.947; P<0.001), and was positively correlated with elevated CRP before delivery (OR=3.492, 95%CI: 1.652-7.381; P=0.001). There were no significant correlations between preterm birth and preoperative or postoperative CRP elevation, CL at 1-2 weeks after surgery, and BMI at 6-7 weeks of gestation (all P>0.05). Conclusions: Cervical cerclage for singleton pregnant women with cervical incompetence indicated by history or ultrasound both have good clinical efficacy, and there is no significant difference in maternal and fetal outcomes between the two groups. CL at 26-28 weeks of gestation and CRP before delivery are risk factors for preterm birth before 34 weeks of gestation after cervical cerclage.

[The beginnings and evolution of a pancreatic surgeon: a technical morphological analysis in first 5 years]

Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic-jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65),50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.

Individualized positive end-expiratory pressure with and without recruitment maneuvers in obese patients during bariatric surgery

This study aimed to determine whether regular recruitment maneuvers (RMs) are essential for obese patients (OPs) undergoing elective laparoscopic bariatric surgery (LBS) during intraoperative ventilation with individualized positive end-expiratory pressure (PEEP). Patients were randomly assigned to two arms: the RM + PEEP_-EIT arm consisted of individualized PEEP titrated by electrical impedance tomography (EIT) with two regular RMs and the PEEP_-EIT arm consisted of individualized PEEP titrated by EIT without additional RMs. For these two arms together, EIT-guided PEEP varied among individuals. The partial pressure of oxygen in arterial blood to fractional inspired oxygen (PaO₂ /FiO₂ ) ratio in the RM + PEEP_-EIT arm was higher than that in the PEEP_-EIT arm at 1 h after pneumoperitoneum (p = 0.024) and at the end of surgery (p = 0.035). There was no great difference in the PaO₂ /FiO₂ ratio between these two arms when measured 5 min prior to postanesthesia care unit (PACU) departure and on postoperative day 1. Compared with the PEEP_-EIT arm, patients in the RM + PEEP_-EIT arm had significantly higher intraoperative dynamic respiratory system compliance (p < 0.001) but consumed more vasopressors (p = 0.036). Postoperative pulmonary complications occurred in 1 of 29 patients in the RM + PEEP_-EIT arm compared with 2 of 31 patients in the PEEP_-EIT arm. Regular lung RMs can improve intraoperative oxygenation and respiratory system compliance among OPs undergoing LBS with EIT-guided individual PEEP. However, the improvement might disappear before leaving the PACU, and regular RMs resulted in more vasopressor consumption.

Effects of interchange ratio on sludge reduction and microbial community structures in an anaerobic/anoxic/oxic process with combined anaerobic side-stream reactor

Oxic-settling-anaerobic (OSA) process is effective in minimizing sludge production, by inserting an anaerobic side-stream reactor (ASSR) in the recycling bypass. Interchange ratio (IR), the quantity ratio of sludge entering the ASSR to the sludge in the main stream reactors, is one of the most important parameters for OSA process. In the present study, a laboratory-scale anaerobic/anoxic/oxic (A²/O) process combined with an ASSR (A²/O-ASSR) was operated for 366 days in parallel with a conventional A²/O process to investigate the effects of IR on sludge reduction. IR was assigned values of 5%, 8%, 10%, and 15%, and the A²/O-ASSR process achieved 14.0%, 16.0%, 24.1%, and 13.7% of sludge reduction, respectively. At the optimum IR of 10%, high through-put sequencing analysis showed that the microbes responsible for pollutant removal and ubiquitous in wastewater treatment remained predominant in the two systems, and slow-growing microbes related to hydrolysis, nitrogen and phosphorus removal increased in the A²/O-ASSR process, which probably played a key role in sludge reduction. 40.6-58.6% of sludge reduction was caused by sludge decay in the ASSR. The tiny amount of extracellular polymeric substance released in the A²/O-ASSR process was subthreshold to cause remarkable sludge reduction.

Urinary trans,trans-muconic acid determined by liquid chromatography: application in biological monitoring of benzene exposure

We describe a sensitive and specific high-performance liquid-chromatographic method for determining the benzene metabolite, trans,trans-muconic acid (ttMA) in urine by measuring ultraviolet absorbance at 265 nm. We mix 1 mL of urine sample with 2 mL of Tris buffer containing vanillic acid as internal standard (IS) and percolate this through a preconditioned ion-exchange column. After rinsing the column with phosphoric acid solution, acetate buffer, and deionized water, we elute the analytes with 2 mL of an equivolume solution of 1.5 mol/L sodium chloride and methanol. Of this, 5 microL is injected into the HPLC column. The mobile phase used consists of, per liter, 10 mL of acetic acid, 100 mL of methanol, and the rest 5 mmol/L sodium acetate. The flow rate was started at 1 mL/min and increased to 1.5 mL/min after 6 min. ttMA and IS were detected at 5.2 and 10.2 min, respectively. The lowest detection limit is 125 pg. Analytical recovery and reproducibility generally exceeded 90%. We validated the method with urine samples collected from normal persons and from refinery workers exposed to benzene concentrations &lt; 1 microL/L. The results show that urinary ttMA is a promising biological marker for risk assessment of low-concentration benzene exposure.

[Risk-factor analysis of poor graft function after allogeneic hematopoietic stem cell transplantation for severe aplastic anemia]

目的

探讨重型再生障碍性贫血（SAA）患者行异基因造血干细胞移植（allo-HSCT）后发生植入功能不良（PGF）的危险因素。

方法

回顾性分析111例行allo-HSCT的SAA患者临床资料及移植情况，采用Cox比例风险模型对可能影响PGF的因素进行单因素及多因素分析。

结果

在111例行allo-HSCT的SAA患者中，共有16例发生了PGF（14.4%）。多因素分析结果显示，非血缘供者（HR＝2.656，95%CI 1.204～5.858，P＝0.016）及移植前血清铁蛋白浓度（SF）>1 000 µg/L（HR＝3.170，95%CI 1.400～7.180，P＝0.006）是发生PGF的独立危险因素。

结论

非血缘供者及移植前SF>1 000 µg/L的患者移植后容易发生PGF。

[A clinical analysis of 10 cases with cardiac lymphoma]

目的

分析心脏淋巴瘤的发病情况、临床特征、治疗效果及预后。

方法

收集2000年1月至2016年6月期间确诊并有心脏累及的10例淋巴瘤患者的资料，对患者的一般资料、临床表现、病理诊断、实验室检查、心脏累及方式、心脏并发症、治疗方式、疗效及预后进行分析。

结果

3 918例淋巴瘤患者中，心脏累及者10例，其中原发性心脏淋巴瘤（PCL）1例（主要累及左右心房，以心肌内多发结节包块为主），继发性心脏淋巴瘤（SCL）9例（主要为心包包块，其中出现心包积液5例，心肌肿块2例）。男性6例，女性4例，中位年龄55（19~88）岁，主要临床表现为呼吸困难7例，胸痛5例，乏力、水肿各2例。病理类型包括弥漫大B细胞淋巴瘤（DLBCL）7例，T淋巴母细胞淋巴瘤、霍奇金淋巴瘤、Burkitt淋巴瘤各1例。心脏并发症包括充血性心力衰竭7例，心律失常4例（主要为窦性心动过速、心房颤动和房室传导阻滞）。除1例高龄、一般状况差未接受治疗外，其余9例患者均接受治疗（单纯化疗4例，化疗联合放疗5例）。中位随访时间为9（1~28）个月。1例PCL患者化疗后获部分缓解（PR），无进展生存（PFS）期为6个月，总生存（OS）期为21个月。SCL患者中6例起病累及心脏者，治疗后1例获完全缓解，5例获PR，中位PFS期为5个月，中位OS期为19个月；3例病情进展累及心脏者，2例治疗后获PR，1例未治疗者死亡，中位PFS期为4个月，OS因数据截尾，未能获得。

结论

心脏淋巴瘤为少见类型，DLBCL为最常见类型，呼吸困难、胸痛为最常见临床表现，并易出现充血性心力衰竭和心律失常，治疗以系统化疗为主，总体预后差。

Isolation, identification and pathogenicity of Vibrio harveyi, the causal agent of skin ulcer disease in juvenile hybrid groupers Epinephelus fuscoguttatus × Epinephelus lanceolatus

The hybrid grouper, Epinephelus fuscoguttatus (♀) × Epinephelus lanceolatus (♂), is a newly bred cultivated marine fish species of high economic value. However, a skin ulcer disease with high mortality has occurred, and the responsible pathogen remains unknown. In this study, we summarized the epidemic status and external signs of this disease. We screened potential pathogens and finally isolated one bacterial strain ML01 from affected fish. We subjected healthy juvenile hybrid groupers to bacterial challenge tests with the isolate by immersion, immersion after dermal abrasion and intraperitoneal injection, respectively. Within 14 days post-infection, the isolate ML01 caused mass mortality of juveniles infected via immersion after dermal abrasion or intraperitoneal injection. Diseased juveniles displayed obvious signs of skin ulcers. The median lethal dose of ML01 by intraperitoneal injection was 1.10 × 10⁵ colony-forming units. ML01 was identified as Vibrio harveyi by bacterial morphology, analytical profile index identification, 16S rDNA sequencing and multilocus sequence analysis. Antibiotic susceptibility tests showed that ML01 was sensitive to ceftriaxone, doxycycline and minocycline. The results of this study suggest that V. harveyi is the causal agent of skin ulcer disease in juvenile hybrid groupers, thus providing a basis for effective control and prevention of this disease.

[Analysis of clinical effect of McDonald cervical cerclage and the related risk factors]

OBJECTIVE

To investigate the clinical effect of McDonald cervical cerclage and the affecting factors.

METHODS

Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups.

RESULTS

(1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group, there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P<0.01). Neonatal hospitalization rate was lower in preventive group (14.6%, 7/48) than therapeutic group (36.8%, 25/68) , the difference was statistically significant (P< 0.01). (3) In the failure group placental pathology was examed in 7 cases. The placental tissue showed a large number of neutrophils infiltrating in 6 cases (6/7). In the successful group, 27 pregnant women deliveried between 28 to 33(+6) weeks (26.0%,27/104), 10 pregnant women deliveried between 34 to 36(+6) weeks 10 cases (9.6%, 10/104), 67 cases deliveried after 37 weeks (64.4%, 67/104). A lot of factors including maternal age, the previous cervix operation history, perioperative application of progesterone, operation time and preoperative invasive procedure were compared between the successful group and the failure group. Only maternal age and preoperative invasive proedcure were statistically significant (P<0.05) and the others had no statistical significance (P>0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded; the preoperative cervical os in failure group [(21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P<0.05); and preoperative vaginal ultrasound measurement of cervical canal length were (18 ± 8) mm versus (19 ± 10) mm, there was no statistically significant difference (P>0.05).

CONCLUSIONS

The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of intervention measures. The term labor rate of prophylactic cervical cerclage was higher than that of the therapeutic cerclage. Older maternal age and preoperative invasive procedure may be the risk factors for cerclage. The infection may play an important factor leading to the failure of McDonald cervical cerclage.

Suppression of Inflammatory Responses by Dihydromyricetin, a Flavonoid from Ampelopsis grossedentata, via Inhibiting the Activation of NF-κB and MAPK Signaling Pathways

Ampelopsis grossedentata, an indigenous plant in southern China, has been used for treating pharyngitis in traditional Chinese medicine for hundreds of years. In this study, we explored the anti-inflammatory activity of dihydromyricetin (1), its major bioactive component, and the underlying mechanism of this action. We demonstrated that 1 suppressed the levels of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) as well as increased the level of the anti-inflammatory cytokine interleukin-10 (IL-10) in lipopolysaccharide (LPS)-treated mice. Moreover, 1 was found to markedly inhibit the production of nitric oxide (NO) and the levels of TNF-α, IL-1β, and IL-6, whereas it increased the level of IL-10 in LPS-induced RAW 264.7 macrophage cells. Compound 1 also reduced the protein expression of inducible nitric oxide synthase (iNOS), TNF-α, and cyclooxygenase-2 (COX-2) in macrophage cells. Furthermore, 1 suppressed the phosphorylation of NF-kappa B (NF-κB) and IκBα as well as the phosphorylation of p38 and JNK but not ERK1/2 in LPS-stimulated macrophages. Taken together, the present results suggest that 1 exerts its topical anti-inflammatory action through suppressing the activation of NF-κB and the phosphorylation of p38 and JNK. Thus, 1 may be a potentially useful therapeutic agent for inflammatory-related diseases.

SAF values for internal photon emitters calculated for the RPI-P pregnant-female models using Monte Carlo methods

Estimates of radiation absorbed doses from radionuclides internally deposited in a pregnant woman and her fetus are very important due to elevated fetal radiosensitivity. This paper reports a set of specific absorbed fractions (SAFs) for use with the dosimetry schema developed by the Society of Nuclear Medicine's Medical Internal Radiation Dose (MIRD) Committee. The calculations were based on three newly constructed pregnant female anatomic models, called RPI-P3, RPI-P6, and RPI-P9, that represent adult females at 3-, 6-, and 9-month gestational periods, respectively. Advanced Boundary REPresentation (BREP) surface-geometry modeling methods were used to create anatomically realistic geometries and organ volumes that were carefully adjusted to agree with the latest ICRP reference values. A Monte Carlo user code, EGS4-VLSI, was used to simulate internal photon emitters ranging from 10 keV to 4 MeV. SAF values were calculated and compared with previous data derived from stylized models of simplified geometries and with a model of a 7.5-month pregnant female developed previously from partial-body CT images. The results show considerable differences between these models for low energy photons, but generally good agreement at higher energies. These differences are caused mainly by different organ shapes and positions. Other factors, such as the organ mass, the source-to-target-organ centroid distance, and the Monte Carlo code used in each study, played lesser roles in the observed differences in these. Since the SAF values reported in this study are based on models that are anatomically more realistic than previous models, these data are recommended for future applications as standard reference values in internal dosimetry involving pregnant females.

Specific absorbed fractions for internal photon emitters calculated for a tomographic model of a pregnant woman

Specific absorbed fractions are essential for calculation of radiation dose from internal emitters. Existing specific absorbed fractions for pregnant women were calculated using the stylized models; in this work, a partial-body tomographic model for a pregnant woman was constructed from a rare set of CT images. Based on this tomographic model, the Monte Carlo code, EGS4-VLSI, was used to derive specific absorbed fractions. Monoenergetic, isotropic photon emitters from 15 keV to 4 MeV were distributed in different source organs, and doses were calculated to many target regions in the body. Even though the results showed general agreement with previous studies for higher energies, significant differences were also found, especially for lower energies. The main reasons for the differences are due to the variation of mass, geometry, and organ distances, and they demonstrate the influence of more realistic body models on dose calculations.

Use of the VIP-Man model to calculate energy imparted and effective dose for x-ray examinations

A male human tomographic model was used to calculate values of energy imparted (epsilon) and effective dose (E) for monoenergetic photons (30-150 keV) in radiographic examinations. Energy deposition in the organs and tissues of the human phantom were obtained using Monte Carlo simulations. Values of E/epsilon were obtained for three common projections [anterior-posterior (AP), posterior-anterior (PA), and lateral (LAT)] of the head, cervical spine, chest, and abdomen, respectively. For head radiographs, all three projections yielded similar E/epsilon values. At 30 keV, the value of E/epsilon was approximately 1.6 mSv J(-1), which is increased to approximately 7 mSv J(-1) for 150 keV photons. The AP cervical spine was the only projection investigated where the value of E/epsilon decreased with increasing photon energy. Above 70 keV, cervical spine E/epsilon values showed little energy dependence and ranged between approximately 8.5 mSv J(-1) for PA projections and approximately 17 mSv J(-1) for AP projections. The values of E/epsilon for AP chest examinations showed very little variation with photon energy, and had values of approximately 23 mSv J(-1). Values of E/epsilon for PA and LAT chest projections were substantially lower than the AP projections and increased with increasing photon energy. For abdominal radiographs, differences between the PA and LAT projections were very small. All abdomen projections showed an increase in the E/epsilon ratio with increasing photon energy, and reached a maximum value of approximately 13.5 mSv J(-1) for AP projections, and approximately 9.5 mSv J(-1) for PA/lateral projections. These monoenergetic E/epsilon values can generate values of E/epsilon for any x-ray spectrum, and can be used to convert values of energy imparted into effective dose for patients undergoing common head and body radiological examinations.

Colorectal carcinoma among ethnic Chinese in Singapore: trends in incidence rate by anatomic subsite from 1968 to 1992

BACKGROUND

Recent epidemiologic studies have suggested that the anatomic distribution of colorectal carcinoma may have undergone a distal to proximal shift over several decades, which has been attributed variously to environmental and genetic factors as well as preventive intervention.

METHODS

Trends in subsite distribution and the incidence rate of colorectal carcinoma among Chinese in Singapore between 1968 and 1992 were explored using data from the Singapore Cancer Registry (n = 10,489). Age-standardized incidence rates were computed and compared further using age-period-cohort models by subsite and gender.

RESULTS

The proportion of lesions in the distal colon was found to have increased from 23.2% to 24.4% whereas that for the proximal colon and rectum were fairly consistent over the past 25 years. Our results also showed that age-standardized rates have doubled in proximal lesions (2-3% annually) and more than doubled in distal lesions (3-4% annually) whereas rates in rectal carcinoma have shown a slight increase or stability over time. The patterns of change in all subsite tumors could be attributed to a significant birth cohort effect.

CONCLUSIONS

The results of the current study suggest that incidence rates have increased rapidly with no distal to proximal shift observed among ethnic Chinese in Singapore over the past 25 years. The pattern of change differs from findings reported in high incidence countries such as the U. S. and parts of Europe, suggesting that the preventive intervention and early diagnostic capabilities that may have played an important role in these countries have had less effect in Asia. The rapid overall increase in the incidence rate of colon carcinoma supports the role of dietary and other environmental factors as possible risk factors.

Urinary total isothiocyanate (ITC) in a population-based sample of middle-aged and older Chinese in Singapore: relationship with dietary total ITC and glutathione S-transferase M1/T1/P1 genotypes

Isothiocyanates (ITCs), degradation products of glucosinolates (which occur naturally in a variety of cruciferous vegetables), have been shown to exhibit chemopreventive activity. These compounds are metabolized in vivo to form the corresponding dithiocarbamates, which are the major urinary metabolites of ITCs, by a pathway involving the glutathione S-transferase (GST) class of enzymes. Using a newly developed assay that measures total ITC (primarily ITC conjugates) in urine, we examined the relationships between cruciferous vegetable intake (obtained from a food frequency/portion size questionnaire administered in person); dietary total ITC level; GSTM1, GSTT1, and GSTP1 genotypes; and levels of total ITC in spot urine samples collected from 246 Singapore Chinese (111 men and 135 women), ages 45-74 years, who are participants of the Singapore Cohort Study on diet and cancer. Consumption level of cruciferous vegetables was high in study subjects (mean consumption = 345 times per year, mean daily intake = 40.6 g), which was >3 times the comparable level of intake in the United States. Mean daily intake of total ITC among study subjects was 9.1 micromol, and there was a 2.5-fold difference between the 25th and 75th percentile values. Seventy-three % of study subjects tested positive for ITC in urine, and there was a 4-fold difference between the 25th and 75th percentile values among the positive subjects. There was a highly significant positive association between dietary intake and urinary excretion levels of total ITC (two-sided P = 0.0003) that was stronger than the association between overall cruciferous vegetable intake and urinary ITC level, which also was statistically significant (P = 0.0004). There was no difference in urinary ITC levels between GSTM1-null and GSTM1-positive study subjects (P = 0.61) or between subjects with differing GSTP1 genotypes (P = 0.77), but urinary excretion of ITC was significantly higher among GSTT1-positive subjects, relative to GSTT1-null subjects (P = 0.006). The strength of the association between GSTT1 genotype and urinary total ITC level was highly dependent on the level of cruciferous vegetable consumption (or dietary ITC level) in study subjects. Among subjects in the lowest tertile of cruciferous vegetable intake, there was little evidence of an association between GSTT1 genotype and urinary total ITC level (P = 0.67). In contrast, there was a strong and statistically significant association between GSTT1 genotype and urinary total ITC among subjects in the highest tertile of cruciferous vegetable intake (P = 0.02), whereas those in the middle tertile of cruciferous vegetable consumption exhibited an association of intermediate strength (P = 0.04). These results suggest the presence of GSTT1 inducers in cruciferous vegetables.

HPLC analysis of isoflavonoids and other phenolic agents from foods and from human fluids

A fast, precise and selective diode array HPLC method is presented for the extraction and analysis of soy isoflavonoids from foods and from human urine, plasma, and breast milk in support of mechanistic and epidemiologic studies assessing the potential cancer protective role of soya or isoflavones. Solid phase or solvent extraction was chosen for isolation, and enzymatic or acid hydrolysis procedures were used for aglycone production depending on the matrix to be analyzed. C-18 reversed-phase HPLC was applied to selectively separate and quantitate daidzein (1), glycitein (3), and genistein (4), including their malonyl (a) and acetyl (b) esters, and their mammalian metabolites equol (6) and O-desmethylangolensin (7), as well as formononetin (2), biochanin-A (5), and coumestrol (8) using a gradient elution system. UV absorbance scans and authentic standards were applied for identification purposes, additional to fluorometric monitoring, electrochemical detection, and GC/ MS analysis after trimethyl silylation. Detection limits of 20-microl injections were found to be 1.09, 0.53, 3.28, and 1.00 pmoles for daidzein, genistein, equol, and O-desmethylangolensin (DMA), respectively, by monitoring at the individual compound's absorption maximum. The proposed method was applied to monitor isoflavone levels in soy foods and in human plasma, urine and breast milk after challenge with roasted soybeans. Implications of the presented results on the potential activity of isoflavones to prevent cancer by exposing newborn infants to these agents are discussed.

Isoflavonoid levels in spot urine are associated with frequency of dietary soy intake in a population-based sample of middle-aged and older Chinese in Singapore

Soy products contain high amounts of isoflavonoids, which have been shown to exhibit possible cancer-protective properties. Chinese populations in Asia, in particular, have a high level of soy intake and a relatively low risk of hormone-dependent cancers. In this study, we assessed the distributions of dietary soy isoflavonoids (daidzein, genistein, and glycitein) and urinary soy isoflavonoids and their metabolites (daidzein, genistein, glycitein, equol, and O-desmethylangolensin) among 147 Singapore Chinese (76 men and 71 women) ages 45-74 years, who are participants of the Singapore Cohort Study on diet and cancer. Urinary values were measured from spot samples collected 10-20 months following recruitment, when usual dietary habits were assessed by a structured food frequency/portion size questionnaire administered in person. Dietary levels of daidzein and genistein were comparable within individuals and about seven times higher than the level of dietary glycitein. All three dietary isoflavonoids showed an approximately 3.5-fold difference between the 25th and 75th percentile values. Similarly, daidzein was the most abundant and glycitein the least abundant of the five isoflavonoid compounds in urine. There was a 4.9-fold difference between the 25th and 75th percentile values for the sum of the five urinary isoflavonoids. Among study subjects, there were statistically significant, dose-dependent associations between frequency of overall soy intake and levels of urinary daidzein (two-sided P = 0.03) and sum of urinary daidzein, genistein, and glycitein (two-sided P = 0.04). In contrast, there were no associations between frequency of overall soy intake and levels of the two daidzein metabolites (equol and O-desmethylangolensin) in urine (two-sided P = 0.85 and 0.34, respectively). We suggest that within the range of exposures experienced by Singapore Chinese, urinary level of daidzein or the sum of daidzein, genistein, and glycitein obtained from a spot sample can serve as a biomarker of current soy consumption in epidemiological studies of diet-disease associations.

Genetic variation of 3 beta-hydroxysteroid dehydrogenase type II in three racial/ethnic groups: implications for prostate cancer risk

BACKGROUND

Elevated prostatic dihydrotestosterone (DHT) has been suggested to increase the risk of prostate cancer. The HSD3B2 gene encodes the type II 3 beta-hydroxysteroid dehydrogenase: one of two enzymes that initiate the inactivation of DHT. Thus, the HSD3B2 gene is a candidate gene for predisposition to prostate cancer.

METHODS

We have determine the distribution of a complex dinucleotide repeat in the HSD3B2 gene in high-risk African-Americans, intermediate-risk Euro-Americans, and low-risk Asians. Genomic DNA from 312 individuals was amplified by polymerase chain reaction (PCR) and analyzed by electrophoresis on denaturing polyacrylamide gels.

RESULTS

We have found that certain alleles are either unique to or much more common in either African-Americans, Asians, or Euro-Americans. Our data also substantially expand the number of alleles reported for the complex dinucleotide repeat polymorphism in the HSD3B2 gene.

CONCLUSIONS

Our report demonstrates substantial genetic variation in the HSD3B2 gene. We hypothesize that allelic variants of the HSD3B2 gene may play a role in predisposition to prostate cancer, and in explaining the substantial racial/ethnic variation in risk.

A prevalent missense substitution that modulates activity of prostatic steroid 5alpha-reductase

Prostate cancer is the most common serious cancer diagnosed in men in the United States. This disease is also characterized by a striking racial/ethnic variation in incidence: highest in African-Americans, intermediate in Caucasians, slightly lower in Latinos, and lowest in Asians. Ample biochemical and epidemiological evidence suggests a role for androgens, particularly testosterone and dihydrotestosterone, in prostate cancer etiology. We have analyzed a candidate gene for prostate cancer, SRD5A2, encoding prostatic steroid 5alpha-reductase type II, which converts testosterone into the more bioactive dihydrotestosterone, for mutations. We report here one amino acid substitution, V89L, which replaces valine at codon 89 with leucine. This substitution is a "germline" (constitutional) DNA polymorphism, and it is common, panethnic, and reduces in vivo steroid 5alpha-reductase activity. This substitution is particularly common among Asians and may explain the low risk for prostate cancer in this population.

Strength of linkage disequilibrium between two vitamin D receptor markers in five ethnic groups: implications for association studies

Markers in the 3' end of the vitamin D receptor gene have recently been associated with prostate cancer risk. To evaluate the adequacy of the commonly used BsmI restriction fragment length polymorphism as a marker of this locus, we genotyped 627 individuals from five ethnic groups for this marker, as well as for a polymorphic site in the 3' untranslated region of this gene. At the latter site, we identified 12 alleles, A13 to A24, of a poly(A) microsatellite. Allele size followed a bimodal distribution with distinct short (A13-A17) and long (A18-A24) allele populations. Poly(A) allele frequency differed by ethnicity, with the frequency of short alleles being highest in non-Hispanic whites (41%), intermediate in Hispanics and African-Americans (31 and 29%, respectively), and lowest in Japanese-Americans and Chinese (8 and 9%, respectively). In each of the ethnic groups, some degree of coupling was observed between BsmI B and short poly(A) alleles and between BsmI b and long poly(A) alleles. However, the strength of the linkage disequilibrium varied by ethnicity, with departures from complete disequilibrium producing disagreement between the BsmI and poly(A) genotypes. Genotypic disagreement was lowest in Japanese-Americans and non-Hispanic whites (6 and 7%, respectively), intermediate in Chinese and Hispanics (11 and 19%, respectively), and highest among African-Americans (37%), indicating that BsmI is not a good marker for the vitamin D receptor 3' untranslated region genotype in all populations. This finding may explain contradictory results from recent association studies using the BsmI marker.

Determination of heterocyclic amines in flame-grilled fish patty by capillary electrophoresis

A simple and reliable capillary zone electrophoretic (CZE) method for quantifying mutagenic and carcinogenic heterocyclic amines (HCAs) in cooked foods with UV-visible diode-array detection is described. The buffer system consisted of 50 mM disodium hydrogen phosphate, 30 mM sodium chloride, 20 mM citric acid and 26% methanol at pH 2.1. An uncoated silica tubing, 51 cm in length, was used for the CZE separation. The capillary tubing temperature was maintained at 25 degrees C with a constant voltage of 20 kV. The reproducibility of the method was over 95% for a five-replicate analysis of 10 micrograms/l-spiked 2-amino-3,4,7,8-tetramethylimidazo[4,5-f]quinoxaline (4,7,8-TriMeIQx) and the detection limit was in the low microgram/l range with coefficients of variation between 6 and 18%. An analytical run took only 15 min for 12 known HCAs. Using this procedure, up to 30 samples could be analysed in a single day. The method is reliable and can be used for screening of various HCAs. It has been applied to assess the concentrations of heterocyclic amines in otak-otak, a Malay-style grilled fish patty. The major mutagenic contaminant found in this foodstuff was 2-aminodipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2) (286-1068 micrograms/kg), followed by 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) (1.6-13.0 micrograms/kg) and 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) (14.0-87.5 micrograms/kg). Two co-mutagens norharman (NH) and harman (H) were also detected in otak-otak at levels of 2.0-13.0 micrograms/kg and 12.8-21.3 micrograms/kg, respectively. The substantial amount of Glu-P-2 detected in otak-otak is probably a result of the ingredients used and the high temperature grilling process.

Increased iron in the substantia nigra of 6-OHDA induced parkinsonian rats: a nuclear microscopy study

The trace elemental concentrations, including iron, in the substantia nigra (SN) of a 6-OHDA induced rat model of Parkinson's disease were measured using nuclear microscopy. Only rats that exhibited amphetamine induced rotation of more than 7 turns/min were used. The results showed that the iron levels were significantly increased in the 6-OHDA lesioned SN, compared with the intact contralateral SN, and the SN of normal control rats injected with ascorbic acid, which showed no significant difference in iron levels between injected and non-injected sides. In both 6-OHDA lesioned and ascorbic acid injected SN, there were no alterations in the levels of calcium, magnesium, copper and zinc. In the 6-OHDA lesioned SN there was an almost complete loss of tyrosine hydroxylase positive cells in the SN. These results suggested that the 6-OHDA induced dopaminergic cell death may be related to the increased iron.

Cytotoxicity and DNA strand breaks induced by benzene and its metabolites in Chinese hamster ovary cells

The cytotoxicity of benzene (BZ) and its major metabolites phenol (PHE), hydroquinone (HQ), catechol (CAT), 1,4-benzoquinone (BQ), 1,2,4-benzenetriol (BT), trans,trans-muconic acid (ttMA) and S-phenylmercapturic acid (S-PMA) was assessed by exposing Chinese Hamster Ovary (CHO) cells to these compounds. Benzene was the least toxic (LD50 = 20 mM), while BQ showed the highest potency (LD50 = 10 microM), followed by HQ (LD50 = 40 microM). It was found that the trend of cytotoxicity was: BQ > HQ > > CAT > ttMA > BT > S-PMA > > PHE > BZ. 1,4-Benzoquinone and HQ also demonstrated considerable ability to induce DNA strand breaks in CHO cells, which was assayed using the fluorimetric analysis of DNA unwinding. The other metabolites were unable to cause DNA strand breaks. When HQ was administered in combination with other metabolites, no synergism was observed in the induction of DNA strand breaks. From these results, it can be seen that BQ and HQ are the most bioreactive species among the benzene metabolites when tested on CHO cells. Differences between the results obtained in our study and other studies were discussed.

Benzene metabolites enhance reactive oxygen species generation in HL60 human leukemia cells

Benzene is myelotoxic and leukemogenic in humans. The mechanisms leading to these effects, however have not been fully elucidated. One of the underlying mechanisms is believed to be the oxidative damage caused by its metabolites. A comparative study was undertaken to examine the relationships between reactive oxygen species (ROS) production, lipid peroxidation and subsequent cytotoxicity induced by five major benzene metabolites. The generation of ROS by benzene metabolites was demonstrated by the significant and dose-dependent increase of intracellular ROS formation in HL60 human promyelocytic leukemia cells in vitro. 1,4-Benzoquinone (BQ) was found to be the most potent metabolite in induction of ROS formation, followed by 1,2,4-benzenetriol (BT) and to a lesser extent, phenol (PH) and trans, trans-muconaldehyde (MD). No significant effect was observed when the cells were treated with trans, trans-muconic acid (MA). The enhancement of ROS production by BQ was effectively inhibited by the addition of catalase, deferoxamine (DFO) and dimethyl sulfoxide (DMSO), but unchanged by superoxide dismutase (SOD), suggest that hydrogen peroxide (H2O2) and hydroxyl radicals (OH) are the two major forms of ROS involved. The results also demonstrate that the ability of benzene metabolites in enhancing ROS generation is closely correlated to their capacity in causing lipid peroxidation and subsequent cytotoxicity. These findings together with earlier parallel observations on DNA damage suggest that ROS play an important role in the mechanism of carcinogenesis induced by benzene metabolites.

Biomarkers of exposure to low concentrations of benzene: a field assessment

OBJECTIVE

To carry out a comprehensive field investigation to evaluate various conventional and recently developed biomarkers for exposure to low concentrations of benzene.

METHODS

Analyses were carried out on environmental air, unmetabolised benzene in blood and urine, urinary trans, transmuconic acid, and three major phenolic metabolites of benzene: phenol, catechol, and hydroquinone. Validations of these biomarkers were performed on 131 never smokers occupationally exposed to the time weighed average benzene concentration of 0.25 ppm (range, 0.01 to 3.5 ppm).

RESULTS

Among the six biomarkers studied, unmetabolised benzene in urine correlated best with environmental benzene concentration (correlation coefficient, r = 0.76), followed by benzene in blood (r = 0.64). When urinary metabolites were compared with environmental benzene, trans, trans-muconic acid showed a close correlation (r = 0.53) followed by hydroquinone (r = 0.44), and to a lesser extent with urinary phenol (r = 0.38). No correlation was found between catechol and environmental benzene concentrations. Although unmetabolised benzene in urine correlates best with benzene exposure, owing to serious technical drawbacks, its use is limited. Among the metabolites, trans, trans-muconic acid seems to be more reliable than other phenolic compounds. Nevertheless, detailed analyses failed to show that it is specific for monitoring benzene exposures below 0.25 ppm.

CONCLUSION

The overall results suggest that most of the currently available biomarkers are unable to provide sufficient specificity for monitoring of low concentrations of benzene exposure. If a lower occupational exposure limit for benzene is to be considered, the reliability of the biomarker and the technical limitations of measurements have to be carefully validated.

Detection of elevated reactive oxygen species level in cultured rat hepatocytes treated with aflatoxin B1

Accumulating evidence demonstrates that oxidative damage is one of the underlying mechanisms to the cytotoxicity and carcinogenicity of AFB1. The main objective of this study is to show that AFB1 increases reactive oxygen species (ROS) formation in hepatocytes. The ROS level was detected using a fluorescence probe, 2',7'-dichlorofluorescin diacetate (DCFH-DA), which could be converted to highly fluorescent dichlorofluorescein (DCF) with the presence of intracellular ROS. It was found that AFB1 exposure significantly enhanced DCF fluorescence formation in cultured rat hepatocytes. A dose-response of AFB1 was also observed within the range of 10 nM to 1000 nM. Catalase (CAT) was able to completely prevent the increase of DCF fluorescence in AFB1-treated cells in a dose-dependent manner (from 500 to 2000 U/ml). Moreover, the significant inhibitory effects of desferrioxamine (DFO) and dimethyl sulfoxide (DMSO) on DCF fluorescence formation were also observed in both control and AFB1-treated hepatocytes. Therefore, results from the present study provide in vitro evidence indicating the generation of ROS in cultured rat hepatocytes caused by AFB1 exposure. It is postulated that the metabolic process of AFB1 by cytochrome P450 might be the possible source of the elevated ROS level in AFB1-treated hepatocytes. The enhanced level of ROS may be responsible for the oxidative damage caused by AFB1, which may ultimately contribute to the cytotoxic and carcinogenic effects of AFB1.

Biomarkers: a molecular approach to cancer epidemiology

The rapidly evolving field of molecular epidemiology represents a paradigm shift in medical research, illustrating the convergence of basic, clinical and epidemiologic research, as well as the application of laboratory methods to population studies. As a complement and improvement to traditional epidemiologic approaches, the use of biomarkers offers more accurate exposure assessment at an individual level, better understanding of the biological mechanism of carcinogenesis by tracking a continuum of events between exposure and disease, as well as the ability to discern host or genetic factors that may account for variations in cancer susceptibility among individuals or ethnic populations. Further, biomarkers have also proved useful in cancer diagnosis and prognosis. This article attempts to review the latest progress in molecular cancer epidemiology and to summarise the current state of research in Singapore.

Molecular epidemiology: issues in study design and statistical analysis

Traditional analytical epidemiology is directed at identifying the association between risk factors and occurrence of disease by using crude exposure data derived from questionnaires or clinical measures, and taking clinical disease as the end point. With the rapid development in molecular biology and laboratory methods, it is now possible to use biomarkers which are capable of identifying molecular events for epidemiologic research. This improved sensitivity enables us to develop a mechanistic understanding of disease causation: a step closer to the unravelling of the "black box" of traditional epidemiology. Biomarkers may be classified as internal indicators of exposure (biomarkers of exposure), indicators of preclinical adverse effect (biomarkers of effect) or indicators of an intrinsic or acquired susceptibility to disease (biomarkers of susceptibility). Biomarkers provide a better definition of exposure and disease status and consequently they could help to reduce misclassification bias in both exposure and disease, reduce the follow-up time in prospective studies, as well as identify possible interactions between risk factors on disease occurrence. However, a biomarker needs to be validated and its distribution in large populations described before it can be used profitably for aetiologic research. Also, the use of biomarkers in epidemiologic research raises other interesting epidemiological and statistical issues like confounding, effect modification and the analysis of repeated measurements. Molecular epidemiology is a multidisciplinary endeavour which comprises molecular biology, epidemiology and biostatistics. Clearly then, to carry out research in this field profitably, the molecular biologist, epidemiologist and biostatistician must acquire not only expertise in their respective fields, but also an integrated understanding of all three fields. The molecular biologist is not merely a laboratory bench worker; the epidemiologist, a field data-collector and the biostatistician, a number cruncher. They must work together to pry open the "black box" to gain a greater insight into how risk factors operate to initiate disease onset and ultimately to make use of this knowledge base to implement preventive measures.

Tumour suppressor p53 and Rb genes in human hepatocellular carcinoma

Aberrations of the p53 and Rb tumour suppressor genes were examined in 12 human hepatocellular carcinoma (HCC)-derived cell lines from different geographic areas and 9 local HCCs by restriction fragment length polymorphisms (RFLP), polymerase chain reaction-single-strand conformation polymorphisms (PCR-SSCP) and DNA sequencing. The relationships between genetic changes and hepatitis B virus (HBV) DNA integration in samples were compared. None of the cell lines and tumours showed structural changes in the Rb gene, while 6 cell lines and 2 tumours had mutation or deletion in exons 5 to 8 of p53. Mutations include an AGG --> AGT (Arg --> Ser) transversion at codon 249 in PLC/PRF/5 and Mahlavu, an AAT --> AAA (Asn --> Cys) transversion at codon 200 in TONG/HCC, an AAG --> GAG (Lys --> Glu) transition at codon 139 in HCC-T, a CAT --> CGT (His --> Arg) transition at codon 214 in SC4, and a CCC --> CTC (Pro --> Leu) transition at codon 250 in SC8. In Huh4, an 18-bp deletion from codon 264 to 270 resulted in loss of Leu-Gly-Arg-Asn-Ser-Phe from the amino acid sequences 265 to 270, whereas Hep3B had a 7-kb deletion after exon 7 of p53. Our data indicate that whereas Rb may not have pleiotropic effects on HCC, p53 aberrations are frequently involved in hepatocarcinogenesis. Further, HBV infection appears to be unrelated to the micro-genetic changes of p53. The G to T codon-249-mutation is consistent with HCCs arising from areas at high risk for both aflatoxin B1 (AFB1) exposure and HBV infection.

Evaluation of biomarkers for occupational exposure to benzene

OBJECTIVE

To evaluate the relations between environmental benzene concentrations and various biomarkers of exposure to benzene.

METHODS

Analyses were carried out on environmental air, unmetabolised benzene in urine, trans, trans-muconic acid (ttMA), and three major phenolic metabolites of benzene; catechol, hydroquinone, and phenol, in two field studies on 64 workers exposed to benzene concentrations from 0.12 to 68 ppm, the time weighted average (TWA). Forty nonexposed subjects were also investigated.

RESULTS

Among the five urinary biomarkers studied, ttMA correlated best with environmental benzene concentration (correlation coefficient, r = 0.87). When urinary phenolic metabolites were compared with environmental benzene, hydroquinone correlated best with benzene in air. No correlation was found between unmetabolised benzene in urine and environmental benzene concentrations. The correlation coefficients for environmental benzene and end of shift catechol, hydroquinone, and phenol were 0.30, 0.70, and 0.66, respectively. Detailed analysis, however, suggests that urinary phenol was not a specific biomarker for exposure below 5 ppm. In contrast, ttMA and hydroquinone seemed to be specific and sensitive even at concentrations of below 1 ppm. Although unmetabolised benzene in urine showed good correlation with atmospheric benzene (r = 0.50, P < 0.05), data were insufficient to suggest that it is a useful biomarker for exposure to low concentrations of benzene. The results from the present study also showed that both ttMA and hydroquinone were able to differentiate the background level found in subjects not occupationally exposed and those exposed to less than 1 ppm of benzene. This suggests that these two biomarkers are useful indices for monitoring low concentrations of benzene. Furthermore, these two metabolites are known to be involved in bone marrow leukaemogenesis, their applications in biological monitoring could thus be important in risk assessment.

CONCLUSION

The good correlations between ttMA, hydroquinone, and atmospheric benzene, even at concentrations of less than 1 ppm, suggest that they are sensitive and specific biomarkers for benzene exposure.

Codon 249 mutation of the p53 gene is a rare event in hepatocellular carcinomas from ethnic Chinese in Singapore

The present study characterised p53 mutations in 44 hepatocellular carcinomas (HCCs) from Chinese patients residing in a high-incidence area. Twelve point mutations (27%) were detected in tumour tissues using single-strand conformation polymorphism analysis followed by direct DNA sequencing. Remarkably, no mutations were observed at codon 249. This is in contrast to HCCs from other high HCC incidence areas with endemic aflatoxin exposures, in which codon 249 is a mutational hot spot. It is therefore suggested that risk factors other than dietary exposure to aflatoxin may contribute to the high HCC incidence in Singapore.

Involvement of reactive oxygen species in aflatoxin B1-induced cell injury in cultured rat hepatocytes

The role of reactive oxygen species (ROS) in AFB1-induced cell injury was investigated using cultured rat hepatocytes. Malonaldehyde (MDA) generation and lactate dehydrogenase (LDH) release were determined as indices of lipid peroxidation and cell injury, respectively. Exposure to AFB1 for up to 72 h resulted in significantly elevated levels of LDH being released into the medium as well as the MDA generation in cultured hepatocytes. These effects were dose-dependent, indicating that AFB1 was capable of inducing oxidative damages in the cell. Further, MDA generation and LDH release were effectively inhibited by the addition of the following: (1) superoxide dismutase (500 units/ml), (2) catalase (1500 units/ml), (3) 10 mM desferrioxamine (a specific iron chelator), or (4) 260 mM dimethyl sulfoxide (a hydroxyl radical scavenger). These evidences therefore suggest that ROS, such as superoxide radicals, hydroxyl radicals and hydrogen peroxides, are involved in AFB1-induced cell injury in cultured rat hepatocytes.

Mutations of the tumour suppressor gene p53 in colorectal and hepatocellular carcinomas

The present study describes mutations of the tumour suppressor gene p53 in a local collection of colorectal and hepatocellular carcinomas (HCCs). Tumour DNA was extracted from both fresh and paraffin-embedded tissues and exons 5-8 of the p53 gene were amplified by polymerase chain reaction (PCR). Mutations were detected by single-strand conformation polymorphism (SSCP) analysis followed by direct DNA sequencing. Of the 38 colorectal carcinomas and 42 HCCs examined, 15 (39%) and 13 (31%), respectively, showed p53 mutations. Two-thirds (10/15) of the mutations in colorectal carcinomas were base transitions with a predominance at CpG dinucleotide sites--a pattern characteristic to an endogenous process in cancer development. Three mutational hotspots at codons 175, 248 and 282 were also identified. Mutations did not correlate with histological grade, Dukes stage, or metastasis. However, tumours at the distal site of the colorectum showed a higher proportion of mutations than the proximal site. In the case of HCCs, majority (9/13) of the mutations were base transitions and no mutations were observed at codon 249. This is in contrast to results from other high-incidence areas such as Africa and China, where aflatoxin is believed to be a major aetiologic factor for liver cancers. The results therefore suggest that other risk factors, rather than dietary exposure to aflatoxin, may contribute to the high HCC incidence in Singapore.

Aflatoxin B1-induced 8-hydroxydeoxyguanosine formation in rat hepatic DNA

A time- and dose-dependent increase in 8-hydroxydeoxyguanosine (8-OHdG) was observed in rat hepatic DNA after a single i.p. injection of aflatoxin B1 (AFB1). It was also found that pre-treatment with selenium or deferoxamine significantly reduced 8-OHdG level in AFB1-administered rats. In contrast, no reduction in 8-OHdG concentration was found in vitamin E-pre-treated rats. These results provide evidence that AFB1 causes oxidative DNA damage in rat liver, which may involve hydroxyl radicals as the initiating species. It is postulated that AFB1-induced oxidative DNA damage (8-OHdG formation) may constitute an important pathway in AFB1 hepatocarcinogenesis.

Inhibition of aflatoxin B1-induced cell injury by selenium: an in vitro study

Dietary selenium is an essential trace element in human nutrition. Selenium has been shown in animal studies to inhibit aflatoxin hepatocarcinogenesis. However, the cellular mechanism responsible for the inhibition has not been thoroughly studied. This study examines the effect of two selenium compounds, namely, sodium selenite and selenium-enriched yeast extract (SeY), on the cytotoxicity, DNA-binding and mutagenicity of aflatoxin B1 (AFB1) in cultured Chinese hamster ovary (CHO) cells. CHO cells, after treatment with 2 micrograms ml-1 selenite or 80 micrograms ml-1 SeY, exhibited increased resistance to AFB1-induced cell killing. At a concentration of 50 micrograms ml-1 AFB1, cell survival, measured by the clonogenicity assay, was increased by 21- and 10-fold in selenite- and SeY-treated cells, respectively. However, selenium treatment did not appear to affect AFB1-DNA binding. Similarly, no effect was observed on AFB1 mutagenicity, as determined by the hypoxanthine-guanine phosphoribosyl transferase (HPRT) gene mutation assay. The results showed that selenium could effectively protect cells from AFB1 cytotoxicity in cultured cells but had no effect on AFB1-DNA adduct formation or mutagenesis. It is suggested that there are multiple pathways of AFB1 toxicity and that selenium can modulate AFB1-induced cell killing independent of its genotoxicity.

Characterization of p53 gene mutations in colorectal carcinomas from an Asian population

A series of colorectal carcinomas from an Asian population in Singapore were analyzed for mutations in the tumor suppressor gene p53. Based on single-strand conformation polymorphism (PCR-SSCP) analysis and direct DNA sequencing, 15 of 38 tumors (39%) were found to contain mutations in exons 5-8 of the p53 gene. The point mutations were predominantly base transitions. Among the 10 transitions, 5 were at CpG dinucleotide sites. One-third (5/15) of the mutations were found at previously identified hotspot codons 175, 248 and 282. In one case, an insertion of a 6-base pair sequence was found. p53 mutations did not correlate with tumor histological grade, Dukes' stage, or metastases. However, tumors at the distal site showed a higher proportion of mutations than the proximal site. Further, no mutation was found in the normal mucosa adjacent to tumor site, suggesting that no germ-line mutations were present. The results were compared with those from other studies and are discussed in connection to possible etiological factors that are specific to the local population.

Elevated levels of benzene-related compounds in the urine of cigarette smokers

Benzene exposure causes leukemia and lymphomas. Recent epidemiological findings have also shown an association between cigarette smoking and an increased risk of leukemia. However, further evidence is required to document the biological plausibility of this association. In evaluating this link, it is important to note that cigarette smoke contains benzene and various pyrolytic compounds, among other carcinogens. This study aims to determine the uptake of benzene by measuring 3 benzene-related compounds in cigarette smokers and non-smokers. Urinary concentrations of catechol (CAT), hydroquinone (HQ), and trans,trans-muconic acid (tt-MA) were measured by high-performance liquid chromatography (HPLC) with fluorimetric and UV detection, respectively. The results showed that these compounds were present in all urine samples. However, the concentrations were significantly higher in smokers than in non-smokers. The mean level of urinary tt-MA was 0.19 +/- 0.09 mg/g creatinine for 46 male smokers and the corresponding value for 40 non-smokers was 0.14 +/- 0.07 mg/g creatinine. The mean concentrations of HQ and CAT were 0.81 +/- 0.4 and 3.51 +/- 2.6 mg/g creatinine for smokers, and 0.45 +/- 0.4 and 1.94 +/- 1.2 mg/g creatinine for non-smokers, respectively. These results suggest that cigarette smoking is associated with a significant additional exposure to benzene and its related compounds. Furthermore, significant correlations were observed between the concentrations of cotinine, the metabolite of nicotine, and the above compounds. These findings suggest that the exposure originated from cigarette smoking.

Amplification of cDNA via RT-PCR using RNA extracted from postmortem tissues

Analysis of cDNA derived from messenger RNA is of advantage over using genomic DNA in genetic analysis of large genes, especially those with lengthy intron sequences. However, because of its instability and rapid degradation, RNA extraction from postmortem tissues has not been attempted. Here, we report the successful extraction of intact mRNA from various postmortem tissues from accidental and sudden death cases. Subsequently with reverse transcriptase-polymerase chain reaction (RT-PCR), we were able to amplify cDNA fragments of different lengths up to 0.9 kb. The described method therefore provides a useful tool in genetic analysis of postmortem tissues.

Inhibition of aflatoxin B1-DNA binding and adduct formation by selenium in rats

The effect of selenium on aflatoxin B1-DNA binding and adduct formation was studied. Male Fischer 344 rats, fed with up to 8 ppm of sodium selenite in drinking water for 8 weeks, were given a single i.p. dose of aflatoxin B1. The rats were killed 24 h later and the amount of AFB1 bound to hepatic DNA and the amount of DNA adducts formed were determined. Selenium pretreatment resulted in a dose-dependent inhibition of AFB1-DNA binding as well as adduct formation. This was accompanied by an increase of reduced glutathione (GSH) in the liver of selenium-treated animals. These results suggest that selenium could effectively inhibit AFB1-induced DNA damage, which may be partially responsible for its anticarcinogenic effect against AFB1.

Aflatoxin B1-induced lipid peroxidation in rat liver

Aflatoxin B1 (AFB1) is a potent hepatotoxic and hepatocarcinogenic mycotoxin. The mechanism of cellular damages caused by AFB1 has not been fully elucidated. Lipid peroxidation is one of the main manifestations of oxidative damage and has been found to play an important role in the toxicity and carcinogenesis of many carcinogens. In this study, we investigated the induction of lipid peroxidation by AFB1 in the liver of Fischer 344 rats. Malonaldehyde (MDA) and conjugated dienes, both products of lipid peroxidation, were determined in liver homogenate and subcellular fractions. An increase of MDA and conjugated dienes in liver homogenate was detected 1 day after AFB1 administration. It reached the peak level 3 days after dosing and remained at an elevated level up to 14 days. The induction of MDA by AFB1 was also found to be dose-dependent. Measurements of lipid peroxidation in the subcellular fractions revealed that microsomes had the highest concentration of MDA, followed by those of the nuclear fraction and mitochondria. MDA concentration was not detectable in the cytosolic fraction. Further, it was found that pretreatment with selenium and vitamin E, both antioxidants, and deferoxamine, a specific iron chelator, significantly inhibited lipid peroxidation as well as liver cell damage. These results provide in vivo evidence that AFB1 can cause lipid peroxidation in rat liver. Oxidative damages caused by AFB1 may be one of the underlining mechanisms for AFB1-induced cell injury and DNA damage, which eventually lead to tumorigenesis.

Biological monitoring of exposure to low concentrations of styrene

A field study was conducted on 39 male workers exposed to styrene at concentrations below 40 ppm (time weighted average, TWA). Analyses were carried out on environmental air, exhaled air, blood, urine, and two major urinary metabolites of styrene: mandelic acid (MA) and phenylglycoxylic acid (PGA). Head space gas chromatography (GC) with a flame ionization detector (FID) was used for determination of styrene in blood and urine. Postexposure exhaled air was analyzed using capillary GC. Environmental styrene exposure was measured by personal sampling using carbon cloth personal samplers. Urinary metabolites of styrene were determined by high pressure liquid chromatograph (HPLC). When the end-of-shift breath, blood, and urine styrene levels were compared with environmental TWA values, blood styrene correlated best with styrene in air (r = 0.87), followed by breath styrene (r = 0.76). Poor correlation (r = 0.24) was observed between environmental styrene exposure and urine styrene. When styrene metabolites were compared with environmental styrene, the sum of urinary MA and PGA correlated better with styrene in air than MA or PGA alone. The correlations between urinary metabolites and environmental styrene improved when corrected for the specific gravity of urine. Even better correlations were observed when the urinary metabolites were corrected for creatinine. The correlation coefficients for environmental styrene and end-of-shift MA, PGA, and MA+PGA were 0.83, 0.84, and 0.86, respectively. The correlation coefficients between environmental styrene and next morning urinary metabolites fell to 0.47, 0.61, and 0.65 for MA, PGA, and MA+PGA, respectively. These results suggest that determination of the total MA and PGA in urine samples is preferred than separate measurements of MA or PGA. The good correlation between environmental exposure and styrene in the exhaled air also suggests that breath styrene level can be a useful indicator for low level styrene exposure, as the method is specific, noninvasive, and rapid. Urinary styrene seems to be a less reliable indicator for low level styrene exposure.

Kinetics of styrene urinary metabolites: a study in a low-level occupational exposure setting in Singapore

Biological monitoring of styrene exposure commonly involves measurement of styrene metabolites, mainly mandelic acid (MA) and phenylglyoxylic acid (PGA), in the urine of exposed subjects. Previous studies on the kinetics of styrene metabolites in urine were mostly conducted in a controlled environment on subjects exposed to high concentrations of styrene. In this study, we examined subjects exposed to low levels of styrene in a fiber-reinforced plastics (FRP) plant to see whether the excretion kinetics of styrene metabolites are similar under field conditions. Eight healthy Chinese male volunteers were exposed to styrene for 4 h with a mean environmental concentration of 11 ppm. Urine samples were collected continuously for 20 h after termination of the exposure and concentrations of urinary MA and PCA were determined. The results showed that MA was rapidly excreted in urine after the exposure, with a half-life of 2.1 h or 1.9 h when corrected with urine creatinine. The excretion of PGA followed that of MA and the half-life was 8.1 h or 5.1 h after correction with creatinine. The half-lives are considerably shorter compared to those in previous reports, suggesting that environmental factors, exposure conditions, or ethnic differences may affect the excretion kinetics of styrene metabolites. The fast excretion of styrene metabolites is also consistent with the observation that urine MA and PGA levels correlated better with the half-day time-weighted average (TWA) concentration of environmental styrene than with the whole-day TWA concentration. Our findings thus underscore the need for information on excretion kinetics in order to develop an appropriate biological monitoring scheme for specific exposure settings and subjects.

Simultaneous determination of hydroquinone, catechol and phenol in urine using high-performance liquid chromatography with fluorimetric detection

A method was developed for simultaneous determination of urinary hydroquinone, catechol and phenol using high-performance liquid chromatography (HPLC) with variable-wavelength fluorimetric detection. Urine samples, after acid hydrolysis, were saturated with sodium sulphate and extracted by diethyl ether. The two buffers used for gradient elution were (A) 10 mM sodium acetate containing 0.5% (v/v) acetic acid and (B) the same as buffer A but containing an additional 20% (v/v) acetonitrile. Hydroquinone, catechol and phenol were separated in a C18 column and detected at 2.9, 6.8 and 13.6 min, respectively. The recovery and reproducibility were generally over 90%. Over 300 extracted samples were analysed and no change in column efficiency was noted. Comparisons were also made with HPLC using ultraviolet (UV) detection and with gas chromatography (GC). The proposed method appears to be more sensitive and reliable than other existing methods. This new method was also validated with urine samples collected from cigarette smokers and from refinery workers exposed to low concentrations of benzene.

Urinary trans,trans-muconic acid determined by liquid chromatography: application in biological monitoring of benzene exposure

We describe a sensitive and specific high-performance liquid-chromatographic method for determining the benzene metabolite, trans,trans-muconic acid (ttMA) in urine by measuring ultraviolet absorbance at 265 nm. We mix 1 mL of urine sample with 2 mL of Tris buffer containing vanillic acid as internal standard (IS) and percolate this through a preconditioned ion-exchange column. After rinsing the column with phosphoric acid solution, acetate buffer, and deionized water, we elute the analytes with 2 mL of an equivolume solution of 1.5 mol/L sodium chloride and methanol. Of this, 5 microL is injected into the HPLC column. The mobile phase used consists of, per liter, 10 mL of acetic acid, 100 mL of methanol, and the rest 5 mmol/L sodium acetate. The flow rate was started at 1 mL/min and increased to 1.5 mL/min after 6 min. ttMA and IS were detected at 5.2 and 10.2 min, respectively. The lowest detection limit is 125 pg. Analytical recovery and reproducibility generally exceeded 90%. We validated the method with urine samples collected from normal persons and from refinery workers exposed to benzene concentrations < 1 microL/L. The results show that urinary ttMA is a promising biological marker for risk assessment of low-concentration benzene exposure.

Percutaneous transaortic closure of postinfarctional ventricular septal rupture

We report a case of successful closure of a postinfarctional ventricular septal defect by means of the transaortic approach with a balloon catheter. This method brought about substantial improvement in cardiopulmonary function before an elective operation and made it possible to successfully perform the operation on the patient, an 81-year-old woman, on the 22nd day of admission.