Prognosis and clinicopathologic features in patients with gastric stump cancer after curative surgery

Background

Gastric stump ("remnant") cancer is the development of a malignancy related to previous gastric surgery. Prognosis in gastric stump cancer, compared with that in primary gastric cancer, is still controversial.

Methods

From January 1988 to December 2012 at a single medical centre in Taiwan, 105 patients with gastric stump cancer, including 85 with previous peptic ulcer disease and 20 with previous gastric cancer, were analyzed for clinicopathologic characteristics and overall survival (os).

Results

The 5-year os rates for patients with gastric stump cancer and with primary gastric cancer were 51.2% and 54.5% respectively (p = 0.035). Analysis of clinicopathologic characteristics indicated that, compared with patients having primary gastric cancer, those with gastric stump cancer had more lymph node metastasis (p < 0.001) and had been diagnosed at a more advanced stage (p = 0.047). Multivariate analysis with os as an endpoint showed that age [p = 0.015; hazard ratio (hr): 2.300; 95% confidence interval (ci): 1.173 to 4.509], tumour size (p = 0.037; hr: 1.700; 95% ci: 1.031 to 2.801), stromal reaction (p = 0.021; hr: 1.802; 95% ci: 1.094 to 2.969), and pathologic N category (p = 0.001; hr: 1.449; 95% ci: 1.161 to 1.807) were independent predictors in gastric stump cancer. The os rates for patients with gastric stump cancer who previously had gastric cancer or peptic ulcer disease were 72.9% and 50.0% respectively (p = 0.019). The Borrmann classification was more superficial (p = 0.005), lymph node metastases were fewer (p = 0.004), and staging was less advanced (p = 0.025) in patients with gastric stump cancer who previously had gastric cancer than in their counterparts who previously had peptic ulcer disease.

Conclusions

Survival is poorer in patients with gastric stump cancer who previously had peptic ulcer disease than in those who previously had primary gastric cancer. Patients with gastric stump cancer who previously had gastric cancer and could receive curative gastrectomy tended to have a better prognosis because of a more superficial Borrmann classification. Regular follow-up in patients who have undergone gastric surgery is recommended for the early detection of gastric stump cancer.

Curcumin attenuates heat-stress-induced oxidant damage by simultaneous activation of GSH-related antioxidant enzymes and Nrf2-mediated phase II detoxifying enzyme systems in broiler chickens

The object of this study was to investigate the effect of curcumin on modulating the glutathione (GSH)-related antioxidant enzymes and antioxidant responses via NF-E2-related factor 2 (Nrf2) signaling pathway in heat-stressed broiler chickens. A total of 400 one-day-old male Arbor Acres broiler chicks was reared in an environmentally controlled room. At 21 d, broiler chicks were divided into 5 treatment groups and were fed one of 4 diets under 2 temperature conditions: 22°C + a basal diet (CON treatment); 34°C for 8 h (0900-1700) + a basal diet supplemented with 0, 50, 100, or 200 mg/kg curcumin (HS, CMN1, CMN2, and CMN3 treatments, respectively). The heat treatment lasted for 20 consecutive days. The results showed that heat stress significantly increased (P < 0.05) the weekly rectal temperature and average head and feet temperature. Compared to the HS treatment, feed conversion was significantly decreased (P < 0.05) in CMN1 and CMN2 treatments. CMN1 administration significantly improved (P < 0.05) the pH24 of muscle. The abnormal changes of serum malonaldehyde and corticosterone concentrations were prevented (P < 0.05) by curcumin. Mitochondrial GSH concentration in the liver was significantly increased (P < 0.05) in CMN1 and CMN2 treatments compared with the HS treatment. The CMN1, CMN2, and CMN3 supplementations significantly increased (P < 0.05) γ-GCL, GSH-Px, and GST activities. Curcumin significantly increased (P < 0.05) the expression of Nrf2, HO-1, and γ-GCLc in the liver as compared to the CON diet. The expression of Cu/ZnSOD and CAT were increased (P < 0.05) by feeding CMN2, respectively, as compared to the HS treatment. It was concluded that curcumin supplementation enhanced the resistance of broilers to heat stress, as evidenced by reversing the FC, increasing the GSH content and GSH-related enzyme activities, and inducing the expression of Nrf2 and Nrf2-mediated phase II detoxifying enzyme genes.

Adiabatic light transfer in titanium diffused lithium niobate waveguides

We report on the realization of adiabatic light transfer in lithium niobate (LiNbO₃) waveguides. This peculiar adiabatic tunneling scheme was implemented in a three-waveguide coupling configuration with the intermediate waveguide being inclined with respect to the outer waveguides to facilitate the adiabatic passage process. We have investigated and determined the adiabatic conditions of the LiNbO₃ device in terms of the structure configuration of the waveguide system and found optimal structure parameters by both simulation and experimental approaches. Broadband adiabatic couplings of bandwidth ~456 and 185 nm and peak coupling efficiencies of >0.96 have been obtained with a 2-cm long device for TE- and TM-polarized fundamental modes, respectively. Longer (5 cm) devices were also studied and found to be useful in increasing the adiabaticity of the device, especially for the TM-polarized mode.

Surveillance and evaluation of the infection risk of free-living amoebae and Legionella in different aquatic environments

Free-living amoebae (FLA) are ubiquitous in various aquatic environments. Several amoebae species are pathogenic and host other pathogens such as Legionella, but the presence of FLA and its parasites as well as the related infection risk are not well known. In this study, the presence of pathogenic FLA and Legionella in various water bodies was investigated. Water samples were collected from a river, intake areas of drinking water treatment plants, and recreational hot spring complexes in central and southern Taiwan. A total of 140 water samples were tested for the presence of Acanthamoeba spp., Naegleria spp., Vermamoeba vermiformis, and Legionella. In addition, phylogenetic characteristics and water quality parameters were also assessed. The pathogenic genotypes of FLA included Acanthamoeba T4 and Naegleria australiensis, and both were abundant in the hot spring water. In contrast, Legionella pneumophila was detected in different aquatic environments. Among the FLA assessed, V. vermiformis was most likely to coexist with Legionella spp. The total bacteria level was associated with the presence of FLA and Legionella especially in hot spring water. Taken together, FLA contamination in recreational hot springs and drinking water source warrants more attention on potential legionellosis and amoebae infections.

Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer

BACKGROUND

Patients with alpha-fetoprotein (afp)-producing gastric cancer have a high incidence of liver metastasis and poor prognosis. There is some controversy about clinical manifestations in these patients.

METHODS

Our study enrolled patients who, before surgery, had gastric cancer with serum afp exceeding 20 ng/mL [afp>20 (n = 58)] and with serum afp 20 ng/mL or less [afp≤20 (n = 1236)]. Clinical manifestations were compared between the groups.

RESULTS

Early gastric cancer was more frequent (30.1% vs. 4%) and advanced gastric cancer was less frequent (69.9% vs. 96%) in the afp≤20 group than the afp>20 group (p < 0.001). Liver and lymph node metastasis occurred less frequently in the afp≤20 group (4.4% vs. 27.6%, p < 0.001, and 60.7% vs. 91.4%, p < 0.001, respectively). The 1-, 3-, 5-, and 10-year survival rates of afp≤20 patients were 75.2%, 53.4%, 45.8%, and 34.6% respectively. The 1-, 3-, 5-, and 10-year survival rates of patients with afp greater than 20 ng/mL, but 300 ng/mL or less, were 46.7%, 28.9%, 17.8%, and 13.3% respectively. The 1-, 3-, and 5-year survival rates of patients with serum afp greater than 300 ng/mL were 15.4%, 7.7%, and 0% respectively. The independent predictors for survival time were afp concentration, age, peritoneal seeding, liver metastasis, lymph node metastasis, vascular invasion, TNM stage, curative surgery, serosal invasion, and Lauren classification.

CONCLUSIONS

Patients with high serum afp had a high frequency of liver and lymph node metastasis and very poor prognosis. More aggressive management with multimodal therapy (for example, chemotherapy, radiotherapy) might be needed when treating such patients.

Application of molecular biological techniques to analyze Salmonella seasonal distribution in stream water

Salmonella is a leading cause of waterborne diseases. Salmonella can survive for a long time in aquatic environments, and its persistence in the environment is of great concern to public health. Nonetheless, the presence and diversity of Salmonella in the aquatic environments in most areas remain relatively unknown. In this study, we examined three analytical processes for an optimum Salmonella detection method, and the optimized method was used to evaluate seasonal variations of Salmonella in aquatic environments. In addition, Salmonella strains were isolated by selective culture medium to identify the serotypes by biochemical testing and serological assay, and to identify the genotypes by pulsed-field gel electrophoresis based on the genetic patterns. A total of 136 water samples were collected in the study area in 9 months. Forty-one (30.1%) samples were found to contain Salmonella-specific invA gene, and most (24/41) of the detections occurred in summer. The serovars of Salmonella enterica were identified, including Bareilly, Isangi, Newport, Paratyphi B var. Java, Potsdam and Typhimurium.

Molecular detection and comparison of Acanthamoeba genotypes in different functions of watersheds in Taiwan

The protistan genus Acanthamoeba is a free-living amoeba existing in various environments. Within this protistan genus, there are some species recognized as potential human pathogens, which may cause granulomatous amoebic encephalitis, Acanthamoeba keratitis and chronic granulomatous lesions of the skin. In this study, 211 water samples were collected from two watersheds in southern Taiwan. We detected Acanthamoeba based on the PCR amplification with a genus-specific primer pair and investigation of Acanthamoeba in Puzih River and Kaoping River in southern Taiwan. Acanthamoeba species were detected in 34 (16.1%) samples. The presence or absence of Acanthamoeba within the water samples showed significant difference with the levels of water temperature and total coliforms. The most frequently identified Acanthamoeba genotype was T4 (n = 19), followed by T5 (n = 8), and then T15 (n = 3). Genotype T6, T7/T8, T11 and T12 were all detected once. Genotype T4, T5, T6, T11 and T15 of Acanthamoeba are responsible for Acanthamoeba keratitis and should be considered a potential health threat associated with human activities in environmental surface water watersheds.

Isolation and identification of Acanthamoeba species from thermal spring environments in southern Taiwan

Acanthamoeba species are free-living amoebae found in a range of environments. Within this genus, a number of species are recognized as human pathogens, potentially causing Acanthamoeba keratitis, granulomatous amoebic encephalitis, and chronic granulomatous lesions. In this study, 60 water samples were taken from four thermal spring recreation areas in southern Taiwan. We detected living Acanthamoeba spp. based on culture-confirmed detection combined with the molecular taxonomic identification method. Living Acanthamoeba spp. were detected in nine (15%) samples. The presence or absence of Acanthamoeba spp. in the water samples depended significantly on the pH value. The most frequently identified living Acanthamoeba genotype was T15 followed by T4, Acanthamoeba spp., and T2. Genotypes T2, T4, and T15 of Acanthamoeba, are responsible for Acanthamoeba keratitis as well as granulomatous amoebic encephalitis, and should therefore be considered a potential health risk associated with human activities in thermal spring environments.

Evaluation of different analysis and identification methods for Salmonella detection in surface drinking water sources

The standard method for detecting Salmonella generally analyzes food or fecal samples. Salmonella often occur in relatively low concentrations in environmental waters. Therefore, some form of concentration and proliferation may be needed. This study compares three Salmonella analysis methods and develops a new Salmonella detection procedure for use in environmental water samples. The new procedure for Salmonella detection include water concentration, nutrient broth enrichment, selection of Salmonella containing broth by PCR, isolation of Salmonella strains by selective culture plates, detection of possible Salmonella isolate by PCR, and biochemical testing. Serological assay and pulsed-field gel electrophoresis (PFGE) can be used to identify Salmonella serotype and genotype, respectively. This study analyzed 116 raw water samples taken from 18 water plants and belonging to 5 watersheds. Of these 116, 10 water samples (8.6%) taken from 7 water plants and belonging to 4 watersheds were positive for a Salmonella-specific polymerase chain reaction targeting the invA gene. Guided by serological assay results, this study identified 7 cultured Salmonella isolates as Salmonella enterica serovar: Alnaby, Enteritidis, Houten, Montevideo, Newport, Paratyphi B var. Java, and Victoria. These seven Salmonella serovars were identified in clinical cases for the same geographical areas, but only one of them was 100% homologous with clinical cases in the PFGE pattern.

Temporal transcriptomic analysis as Desulfovibrio vulgaris Hildenborough transitions into stationary phase during electron donor depletion

Desulfovibrio vulgaris was cultivated in a defined medium, and biomass was sampled for approximately 70 h to characterize the shifts in gene expression as cells transitioned from the exponential to the stationary phase during electron donor depletion. In addition to temporal transcriptomics, total protein, carbohydrate, lactate, acetate, and sulfate levels were measured. The microarray data were examined for statistically significant expression changes, hierarchical cluster analysis, and promoter element prediction and were validated by quantitative PCR. As the cells transitioned from the exponential phase to the stationary phase, a majority of the down-expressed genes were involved in translation and transcription, and this trend continued at the remaining times. There were general increases in relative expression for intracellular trafficking and secretion, ion transport, and coenzyme metabolism as the cells entered the stationary phase. As expected, the DNA replication machinery was down-expressed, and the expression of genes involved in DNA repair increased during the stationary phase. Genes involved in amino acid acquisition, carbohydrate metabolism, energy production, and cell envelope biogenesis did not exhibit uniform transcriptional responses. Interestingly, most phage-related genes were up-expressed at the onset of the stationary phase. This result suggested that nutrient depletion may affect community dynamics and DNA transfer mechanisms of sulfate-reducing bacteria via the phage cycle. The putative feoAB system (in addition to other presumptive iron metabolism genes) was significantly up-expressed, and this suggested the possible importance of Fe2+ acquisition under metal-reducing conditions. The expression of a large subset of carbohydrate-related genes was altered, and the total cellular carbohydrate levels declined during the growth phase transition. Interestingly, the D. vulgaris genome does not contain a putative rpoS gene, a common attribute of the delta-Proteobacteria genomes sequenced to date, and the transcription profiles of other putative rpo genes were not significantly altered. Our results indicated that in addition to expected changes (e.g., energy conversion, protein turnover, translation, transcription, and DNA replication and repair), genes related to phage, stress response, carbohydrate flux, the outer envelope, and iron homeostasis played important roles as D. vulgaris cells experienced electron donor depletion.

Global analysis of heat shock response in Desulfovibrio vulgaris Hildenborough

Desulfovibrio vulgaris Hildenborough belongs to a class of sulfate-reducing bacteria (SRB) and is found ubiquitously in nature. Given the importance of SRB-mediated reduction for bioremediation of metal ion contaminants, ongoing research on D. vulgaris has been in the direction of elucidating regulatory mechanisms for this organism under a variety of stress conditions. This work presents a global view of this organism's response to elevated growth temperature using whole-cell transcriptomics and proteomics tools. Transcriptional response (1.7-fold change or greater; Z >/= 1.5) ranged from 1,135 genes at 15 min to 1,463 genes at 120 min for a temperature up-shift of 13 degrees C from a growth temperature of 37 degrees C for this organism and suggested both direct and indirect modes of heat sensing. Clusters of orthologous group categories that were significantly affected included posttranslational modifications; protein turnover and chaperones (up-regulated); energy production and conversion (down-regulated), nucleotide transport, metabolism (down-regulated), and translation; ribosomal structure; and biogenesis (down-regulated). Analysis of the genome sequence revealed the presence of features of both negative and positive regulation which included the CIRCE element and promoter sequences corresponding to the alternate sigma factors sigma(32) and sigma(54). While mechanisms of heat shock control for some genes appeared to coincide with those established for Escherichia coli and Bacillus subtilis, the presence of unique control schemes for several other genes was also evident. Analysis of protein expression levels using differential in-gel electrophoresis suggested good agreement with transcriptional profiles of several heat shock proteins, including DnaK (DVU0811), HtpG (DVU2643), HtrA (DVU1468), and AhpC (DVU2247). The proteomics study also suggested the possibility of posttranslational modifications in the chaperones DnaK, AhpC, GroES (DVU1977), and GroEL (DVU1976) and also several periplasmic ABC transporters.

Comparison of apparent ileal amino acid digestibility of feed ingredients measured with broilers, layers, and roosters

The apparent ileal digestibility of amino acids in 7 feed ingredients was determined using broilers, layers, and roosters. The ingredients included 3 cereals (wheat, sorghum, and corn), 3 oilseed meals (canola, cottonseed, and soybean meals), and 1 animal protein meal (meat and bone meal). Dietary protein in the assay diets was supplied solely by the test ingredient. All diets contained 20 g/kg of acid-insoluble ash as an indigestible marker, and each diet was offered ad libitum in mash form to 5 replicate pens of broilers and layers, and 4 replicate pens of roosters. The digestibility coefficients of individual amino acids for wheat, corn, and sorghum were higher (P < 0.05) in broilers than in layers and roosters. The digestibility of most amino acids for corn and sorghum was higher (P < 0.05) in roosters compared with those in layers, whereas the digestibility for wheat in layers and roosters was similar. In general, the digestibility of amino acids in canola meal, cottonseed meal, and meat and bone meal was similar among the 3 classes of chickens. The digestibility of amino acids in soybean meal was higher (P < 0.05) for layers compared with those for broilers and roosters but similar between broilers and roosters. These results suggest that the class of chickens significantly influenced the apparent ileal digestibility of amino acids in some feed ingredients.

Influence of age on the apparent ileal amino acid digestibility of feed ingredients for broiler chickens

The apparent ileal digestibility of amino acids in 8 feed ingredients was determined using 14-, 28- and 42-d-old male broiler chickens. The ingredients included three cereals (wheat, sorghum and maize), one cereal by-product (mill run), three oilseed meals (canola, cottonseed and soybean meals) and one animal protein meal (meat and bone meal). Dietary crude protein in the assay diets was supplied solely by the test ingredient. All diets contained 20 g/kg acid-insoluble ash as an indigestible marker, and each diet was offered ad libitum in mash form to 5 replicate pens from 11 to 14 d, 25 to 28 d and 39 to 42 d post-hatching. There were 12, 6 and 6 birds per pen for the 14, 28 and 42 d samplings, respectively. The results suggest that the age of broilers significantly influenced the apparent ileal digestibility of amino acids. The effects, however, varied among amino acids and ingredients. In wheat, the digestibility of most amino acids was higher in 14- than in 28- and 42-d-old broilers. In maize, the digestibility coefficients of amino acids were higher at 28 and 42 d than at 14 d. The digestibility coefficients in maize and wheat at 28 and 42 d were similar. The digestibility of amino acids in sorghum at 42 d was higher than those at 28 d, but similar to those at 14 d except for histidine, lysine, serine and glycine, which were significantly higher at 42 d. Digestibility of amino acids in sorghum was similar between 14 and 28 d except for isoleucine, leucine, phenylalanine, glutamic acid and alanine. The digestibility of amino acids in mill run at 42 d was significantly higher than those at 14 and 28 d. There were no differences in digestibility between 14 and 28 d. In general, the digestibility of amino acids in canola meal, soybean meal and, meat and bone meal was higher at 28 and 42 d compared to those at 14 d, and similar between 28 and 42 d of age. In cottonseed meal, age had no effect on the digestibility coefficient of amino acids, except for lysine and arginine, which increased with age. Analysis of the combined results for the 8 feed ingredients showed that, in general, the digestibility coefficients of amino acids increased with advancing age of broiler chickens.

Changing trends of prostate cancer in Asia

Although Asian people have the lowest incidence and mortality rates of prostate cancer in the world, these rates have risen rapidly in the past two decades in most Asian countries. Prostate cancer has become one of the leading male cancers in some Asian countries. In 2000, the age-adjusted incidence was over 10 per 100000 men in Japan, Taiwan, Singapore, Malaysia, the Philippines and Israel. Although some of the increases may result from enhanced detection, much of the increased incidence may be associated with westernization of the lifestyle, with increasing obesity and increased consumption of fat. The differences in incidences between native Americans and Asian immigrants are getting smaller, reflecting a possible improvement of diagnostic efforts and changes of environmental risk factors in Asian immigrants. Nevertheless, the huge variations in incidences among ethnic groups imply that there are important genetic risk factors. The stage distributions of prostate cancer in Asian populations are still unfavorable compared to those of Western developed countries. However, a trend towards diagnosing cancer with more favorable prognosis is seen in most Asian countries. Both genetic and environmental risk factors responsible for elevated risks in Asian people are being identified, which may help to reduce prostate cancer incidence in a chemopreventive setting.

Optimal treatment for distal ureteral calculi: extracorporeal shockwave lithotripsy versus ureteroscopy

BACKGROUND

The optimal treatment for distal ureteral calculi remains controversial. We present data from our institution to compare the efficacy of extracorporeal shockwave lithotripsy (SWL) and ureteroscopy with different lithotripsy modalities (URSL).

METHODS

From January 1994 to September 1997, 954 distal ureteral calculi were treated at our institution using in situ SWL (Siemens Lithostar) in 524 patients and ureteroscopy (Wolf 8.0F instrument and Swiss Lithoclast) in 430 patients. Stone sizes and patient ages were similar in these two groups.

RESULTS

In the SWL group, the 3-month stone-free rate was 87%, and the effectiveness quotient (EQ) was 68.7%. In the URSL group, there was a 96% stone-free rate with an EQ of 92.1%. The SWL treatment was more expensive than URSL.

CONCLUSION

At our institution, ureteroscopy is more efficacious than SWL for the treatment of distal ureteral calculi. In selected patients who had stones >10 mm with evidence of impaction and severe colic pain, we strongly suggest that URSL is the best choice.

[The research on applications of diagnostic software in single photon emission computed tomography]

In this paper, the structure of software system, the principles of overlay programming and the running mechanism of the programs for the Single Photon Emission Computed Tomography(SPECT) made by French SOPHA MEDICAL Corp. are analyzed in detail. On this basis, a method of extending functions of the system is introduced too. All the results of the extension in software functions for organ volume determination and of the measurements for living animals have proved the correctness and reliability of the method.

Upregulation of inducible nitric oxide synthase and cytokine secretion in peripheral blood monocytes from pulmonary tuberculosis patients

SETTING

Peripheral blood monocytes (PBM) are the main source of alveolar macrophages, which have an upregulation of inducible nitric oxide synthase (iNOS) in pulmonary tuberculosis (TB). TNF-alpha and IL-1 beta are thought to be involved in the immune response to mycobacterial infection.

OBJECTIVE

To identify whether iNOS expression and cytokine release of PBM are upregulated and have a connection in TB infection.

DESIGN

The expression of iNOS immunoreactivity on PBM from TB patients and normal subjects was measured by loading with anti-macrophage iNOS polyclonal primary antibody analyzed by flow cytometry. Expression of iNOS mRNA in PBM was detected by RT-PCR. The spontaneous generation of nitrite and cytokines (IL-1 beta and TNF-alpha) by cultured monocytes was also determined.

RESULTS

Compared to normal subjects, iNOS immuno-reactivity, the capacity for spontaneous nitrite generation and the level of TNF-alpha or IL-1 beta secretion of PBM were significantly higher in TB patients. The amount of nitrite, TNF-alpha and IL-1 beta released from PBM of TB patients was inhibited by NG-monomethyl-L-arginine (L-NMMA), a competitive inhibitor of NOS. The level of iNOS immunoreactivity on PBM was highly correlated with nitrite generation both in all the subjects studied and in TB patients alone. Spontaneous TNF-alpha production showed a stronger correlation with nitrite production than with IL-1 beta.

CONCLUSION

The NO and cytokine synthase activities of monocytes appear to be concomitantly upregulated in response to mycobacterial infection. The enhanced NO generation by monocytes in TB patients may play an autoregulatory role in amplifying the synthesis of pro-inflammatory cytokines.

[Improvement of amplification method for Cryptosporidium parvum oocysts from mice]

OBJECTIVE

To establish a simplified amplification method for obtaining a large number of purified Cryptosporidium parvum oocysts from infected C57BL/6N mice.

METHODS

All mice in the experimental groups were immunosuppressed by given different concentrations of dexamethasone phosphate added in drinking water throughout the experiment. The recovery and purity of the oocysts obtained using different purification methods was compared. The infectivity of the oocysts obtained from the same origin but different animals and different purification methods in a bovine fallopian tube epithelial cell culture system was studied.

RESULTS

4.16 x 10(9) oocysts were obtained in 30 mice in the 3rd group with dexamethasone of 20 micrograms/ml in drinking water. No significant difference in the oocyst recovery, purity and infectivity was found between methods using saturated saline floatation and sucrose density gradient centrifugation. The infectivity of the oocysts obtained from the same origin but different animals was similar.

CONCLUSION

A simplified amplification method for obtaining a large number of purified Cryptosporidium parvum oocysts from the infected mice was established.

Recycling and reuse of industrial wastes in Taiwan

Eighteen million metric tons of industrial wastes are produced every year in Taiwan. In order to properly handle the industrial wastes, the Taiwan Environmental Protection Administration (Taiwan EPA) has set up strategic programs that include establishment of storage, treatment, and final disposal systems, establishment of a management center for industrial wastes, and promotion of recycling and reuse of industrial wastes. The Taiwan EPA has been actively promoting the recycling and reuse of industrial wastes over the years. In July 1995 the Taiwan EPA amended and promulgated the Criteria for the Industrial Waste Storage, Collection and Processing Facility, July, 1995 that added articles related to general industrial waste recycling and reuse. In June 1996 the Taiwan EPA promulgated the Non-listed General Industrial Waste Reuse Application Procedures, June, 1996, followed by the Regulations Governing the Permitting of Hazardous Industrial Waste Reuse, June 1996, setting up a full regulatory framework for governing industrial waste reuse. To broaden the recycling and reuse of general industrial wastes, the Taiwan EPA has listed 14 industrial waste items for recycling and reuse, including waste paper, waste iron, coal ash, tempered high furnace bricks (cinder), high furnace bricks (cinder), furnace transfer bricks (cinder), sweetening dregs, wood (whole/part), glass (whole/part), bleaching earth, ceramics (pottery, brick, tile and cast sand), individual metal scraps (copper, zinc, aluminum and tin), distillery grain (dregs) and plastics. As of June 1999, 99 applications for reuse of industrial wastes had been approved with 1.97 million metric tons of industrial wastes being reused.

DNA adduct level in lung tissue may act as a risk biomarker of lung cancer

Lung cancer is a leading cause of mortality in Taiwan. We hypothesised that high susceptibility to DNA damage in the target organ acts as a risk biomarker for the development of lung cancer. To verify this hypothesis, the aromatic/hydrophobic DNA adduct levels of non-tumorous adjacent lung tissues from 73 primary lung cancer patients and 33 non-cancer controls were evaluated by 32P-postlabelling assay. Wilcoxon rank sum test showed that DNA adduct levels in lung cancer patients (49.58+/-33.39 adducts/10(8) nucleotides) were significantly higher than those in non-cancer controls (18.00+/-15.33 adducts/10(8) nucleotides, P<0.001). The DNA adduct levels among lung cancer and non-cancer samples were not influenced by smoking behaviour and cigarette consumption. Our data also showed that the polymorphisms of cytochrome P4501A1 (CYP1A1) Msp1, glutathione S-transferase M1 (GSTM1) and the combination of both genetic polymorphisms were not related to the DNA adduct levels. Interestingly, positive association between CYP1A1 protein expression and DNA adduct levels was found when CYP1A1 protein expression in lung specimens from lung cancer patients was examined by immunohistochemistry. Multivariate linear regression analysis indicated that the DNA adduct level was not associated with gender, smoking behaviour, or genetic polymorphisms of CYP1A1 and GSTM1. Moreover, multivariate logistic regression analysis showed that persons with high DNA adduct levels (>48.66 adducts/10(8) nucleotides) had an approximately 25-fold risk of lung cancer compared with persons with low DNA adduct levels (</=48.66 adducts/10(8) nucleotides). In conclusion, DNA adduct levels in lung tissue may be a more reliable lung cancer susceptibility biomarker than DNA adduct levels in leucocytes. In addition, higher susceptibility to DNA damage in lung cancer patients may partly play a role in the development of lung cancer.

Neutrophil adherence to lung epithelial cells induce interleukin-8 release

BACKGROUND

Neutrophil recruitment to the lungs and transmigration through the pulmonary epithelium to reach the respiratory tract are characteristics of airway inflammation. Interleukin-8 (IL-8) plays a critical role in the recruitment of neutrophils to epithelial cells. We investigated the effect of neutrophil adherence to epithelial cells on cytokine secretion.

METHODS

The production of IL-8 from cultured A549 epithelial cells was assayed and neutrophil adherence assay in the presence or absence of interferon-gamma (IFN-gamma) plus tumor necrosis factor-alpha (TNF-alpha) plus interleukin-1 beta (IL-1 beta) stimulation was studied on cultured A549 epithelial cells. The role of an adhesion molecule in the modulation of neutrophil adherence was examined by pretreatment with intercellular adhesion molecule-1 (ICAM-1) blocking antibody.

RESULTS

There was an increase in IL-8 release from epithelial cells that was time-dependent and in the magnitude of neutrophil adherence to the epithelial cells. Stimulation of epithelial cells with IFN-gamma +TNF-alpha +IL-1 beta significantly increased IL-8 release and neutrophil adherence. The spontaneous or IFN-gamma +TNF-alpha +IL-1 beta-induced IL-8 release was significantly augmented after the addition of neutrophils. The inhibition of neutrophil adherence to epithelial cells by ICAM-1 blocking antibody downregulated the augmented release of IL-8 with or without IFN-gamma +TNF-alpha +IL-1 beta stimulation. Placing a membrane filter on cultured epithelial cells to prevent neutrophil adherence significantly decreased IL-8 release from epithelial cells with IFN-gamma +TNF-alpha +IL-1 beta stimulation.

CONCLUSION

Our results indicate that lung epithelial cells not only provide a harboring site for neutrophils to be activated, but also amplify the neutrophil sequestration in the lung by releasing IL-8. Moreover, the release of IL-8 is dependent on the adherence between neutrophils and lung epithelial cells.

Pregnancy in a previous cesarean section scar: case report

An ectopic pregnancy developing in a previous cesarean section scar is an extreme rarity among all ectopic pregnancies. Due to the difficulty of making an accurate diagnosis, this kind of ectopic pregnancy is the most dangerous and life-threatening type. A 30-year-old woman, who was gravida 4, para 3, was admitted to our emergency room with massive vaginal bleeding. She had undergone a cesarean section due to a breech birth 3 months prior to this admission. Ultrasound examination showed a pregnancy located in the low corpus uterus. The possibility of a spontaneous abortion in progress or a cervico-isthmic pregnancy were considered. Due to the massive vaginal bleeding and unstable vital signs of the patient, surgical intervention was decided upon to save the woman's life. We first performed dilatation and curettage. There was no gestational villi and severe vaginal bleeding was noted during this procedure. An emergent exploratory laparotomy was then performed, followed finally by a hysterectomy. Pathologic findings confirmed the diagnosis of a pregnancy in the previous cesarean section scar. Diagnosis, prevention, clinical evaluation and management of these conditions are discussed.

Behavioral and trigeminal neuronal effects of rat brainstem-nanoinjected opiates

Single injections of Met-enkephalin (ME; 27 rats) and artificial cerebrospinal fluid (ACF; 9 rats) in nucleus reticularis paragigantocellularis (PGC) and periaqueductal gray (PAG), and simultaneous conjoint PAG + PGC injections were made, and effects on facial responsiveness and caudal-trigeminal nuclear neuronal activity studied. It was found that all ME injections depressed the evoked excitatory neuronal and behavioral responses to noxious stimulation. Conjoint injections had apparently additive effects in comparison to single injection effects. Neither conjoint nor single injections had systematic effects on spontaneous neuronal activity. The ACF had no effects on any neuronal or behavioral activity.

Effects of single and simultaneous combined nanoinjections of Met-enkephalin into rat midbrain and medulla on activity of differentially nociresponsive ventral medullary neurons

Neuronal activity classified by receptive field, adequate stimulus, and raphe-spinal (R-S) projection in 48 lightly anaesthetized rats was recorded from raphe magnus (RM) area. Effects of nanoinjections of Met-enkephalin in periaqueductal gray (PAG; 2 or 10 micrograms), nucleus reticularis paragigantocellularis (PGC; 1 or 5 micrograms), and both sites (conjointly) were studied. Most of the 78 neurons studied responded to noxious stimulation, some with increased responses ('on-cells') and some with decreased responses ('off-cells').

MAJOR FINDINGS

(1) Met-enkephalin in PAG and PGC depressed the response of on-cells and enhanced the response of off-cells; (2) for a given RM or R-S cell, PAG and PGC effects were typically identical; and (3) conjoint injections tended to produce greater effects than single effects, whether enhancing or depressing.

Effects of sympathetic stimulation on C-fibre responses in rabbit

Unmyelinated C-fibre responses to electrical stimulation were recorded in common peroneal, sural and tibial nerves of rabbits. Three distinct C elevations, here called C1, C2 and C3, were recorded. C2 is probably of somatic origin because it was depressed due to collision by peripheral stimulation of cutaneous receptors. The conduction velocity of C3 corresponded to that of sympathetic post-ganglionic fibres. During sympathetic trunk stimulation the A-fibre responses were not significantly changed while C responses, especially C2, were reduced in amplitude and slightly delayed. The C-fibre responses were also influenced by intra-arterial infusion of noradrenaline. In most cases, the latency of the response was increased. The effect of sympathetic stimulation was completely blocked by hexamethonium, and partly blocked by phentolamine, an adrenergic alpha-receptor blocking agent which also blocked the effect of noradrenaline. The findings suggest that there are adrenergic receptors distributed along unmyelinated somatic afferent fibres. Sympathetic activity may release noradrenaline in the peripheral nerve, resulting in changed conductive properties in unmyelinated fibres transmitting sensory information.

Psychological assessment and AIDS research with intravenous drug users: challenges in measurement

The instruments used for psychological assessment have been under close scrutiny for many years. In particular, ethnic and racial minorities have pointed out that misapplication of instruments standardized to White middle-class norms can result in incorrect assessments. An analogous situation exists with IVDUs. In the work of the present authors with IVDUs, they were found to be a very diverse group. Contrary to common wisdom, they differ by race, ethnicity, age, and drug use profiles. However, their economic circumstances and social stigma make them a special case in terms of psychological assessment. Given the unique characteristics of IVDUs, it behooves researchers to carefully examine the standardized instruments that are available for psychological evaluation. Too often, measures standardized on White middle-class samples lack the value neutrality that makes them applicable across disparate groups. In addition, many such measures are designed with certain presumptions that do not necessarily hold true with this population (e.g., willingness and/or ability to communicate intimate information about one's feelings and psychological states). This article briefly describes some of the challenges encountered in examining standardized instruments for use in the study of IVDUs, their health psychology and AIDS-related behavior. Concerns with self-report biases, literacy, attentional focus, measurement constructs, and drug states confounding psychological states all pose challenges to psychological research with this heterogeneous population. While the need for direct intervention on the sexual and needle-sharing behaviors of IVDUs remains paramount in the combat against the spread of AIDS, researchers must also continue with the further development of basic measurement tools.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential stress effects on responses to noxious stimuli as measured by tail-flick latency and squeak threshold in rats

In the present study tail-flick latency (TFL) and squeak threshold (ST) were investigated in different environmental conditions in normotensive Wistar Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). The TFL did not vary significantly during the testing period (120 min). The ST increased gradually and significantly with time when measured in rats restrained in the TFL test tube. Freely moving rats transferred to the TFL test tube showed a marked decrease of the ST. During the stay in the TFL test tube, the ST value increased gradually. Also after transfer from the test tube to the home cage the threshold increased to the same level as freely moving rats. There were no significant differences in these effects between WKY and SHR. Naloxone (1 mg kg-1 i.v.) decreased the ST in both freely moving and restrained animals of either strain. Intravenous injection of morphine (mg kg-1) gave a pronounced threshold increase of ST in both groups. It is suggested that animals restrained in the TFL test tube become hyperalgesic. The adaptation to stress is reflected in the ST but not in the TFL. Squeak threshold appears to be influenced by a tonically active endorphin system.

DNA-directed in vitro synthesis of proteins involved in bacterial transcription and translation

The in vitro synthesis of elongation factor (EF)-Tu (tufB), the beta beta' subunits of RNA polymerase, ribosomal proteins L10 and L12 directed by DNA from the transducing phage lambda rifd 18, EF-Tu (tufA), EF-G, and the alpha subunit of RNA polymerase directed by DNA from the transducing phage lambda fus3 has been investigated in a crude and a partially defined protein-synthesizing system. Proteins L10 and L12 are synthesized in the partially defined system almost as well as in the crude system. However, the synthesis of EF-Tu, EF-G, and the alpha and beta beta' subunits of RNA polymerase is far less efficient in the partially defined system. An active fraction that stimulates the synthesis of these latter proteins has been obtained by fractionation of a high-speed supernatant on DEAE-cellulose. Because previous studies showed that this fraction (1 M DEAE salt eluate) contains a protein, called L factor, that stimulates beta-galactosidase synthesis in vitro, L factor was tested for activity. Although L factor stimulates the synthesis of the beta beta' subunits, it has little or no effect on the in vitro synthesis of the other products studied. In the present experiments, the ratio of L12/L10 and of EF-Tu (tufA)/EF-G formed is 4-6. These values are consistent with in vivo results.