Enhancing routine HIV and STI testing among young men who have sex with men: primary outcomes of the get connected clinical randomized trial (ATN 139)

BACKGROUND

Regular HIV and STI testing remain a cornerstone of comprehensive sexual health care. In this study, we examine the efficacy of Get Connected, a WebApp that combines test locators with personalized educational resources, in motivating young men who have sex with men (YMSM) to undergo regular HIV and STI testing.

METHODS

Participants were randomly placed in one of two conditions. The first condition included the full version of GC (GC-PLUS), which included content tailored to users' psychosocial characteristics (e.g., age, race/ethnicity, relationship status, HIV/STI testing history). The second condition served as our attention-control and only included the testing locator (GC-TLO) for HIV/STI testing services. Participants were recruited from three cities (Houston, Philadelphia, and Atlanta) characterized by high HIV incidence. Assessments were collected at 1, 3-, 6-, 9- and 12-month follow-ups.

RESULTS

Both versions of GC were acceptable and efficacious in increasing routine HIV and STI testing over a 12-month period. 40% of the sample reported testing at least twice, with no main effects observed across the two intervention arms (OR = 1.11; 95% CI: 0.69, 1.80), p =.66). Greater intervention effects were observed among YMSM who engaged more frequently with the intervention, with regional differences observed.

CONCLUSIONS

Our findings underscore the need to cater to the diverse needs of YMSM through multilevel approaches. Broadly, mHealth HIV/STI testing interventions, such as Get Connected, would benefit from matching technologies to the local context to have the greatest impact.

TRIAL REGISTRATION

This study is registered on ClinicalTrials.gov (NCT03132415).

[Real-world efficacy and safety of lopinavir/ritonavir and arbidol in treating with COVID-19 : an observational cohort study]

Objective: To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in the treatment of COVID-19 in the real world. Methods: The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People's Hospital were retrospectively analyzed from January 21 to February 9, 2020. According to the patient's antiviral treatment regimen, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), combination therapy with LPV/r plus arbidol group (25 patients) and the conventional treatment group without any antiviral drugs (58 patients). The main observation end points of the study was the negative conversion time of nucleic acid of the novel coronavirus (2019-nCoV) in pharyngeal swab. Results: The baseline of 4 groups before treatment was consistent and comparable. The negative conversion time of nucleic acid of the 2019-nCoV in pharyngeal swab was (10.20 ± 3.49), (10.11 ± 4.68), (10.86 ± 4.74), (8.44 ± 3.51) days separately in the LPV/r group, the arbidol group, the combination therapy group, and the conventional treatment group without significant difference (F = 2.556, P = 0.058). There was also no significant difference in the rate of negative conversion rate of 2019-nCoV nucleic acid, the improvement ration in clinical symptoms, and the improvement ration of pulmonary infection in the lung CT imaging (P> 0.05). However, a statistically significant difference was found in the proportion of deterioration changing from mild/moderate to severe/critical type at day 7 (χ(2) = 9.311, P = 0.017) as follows: the combination therapy group (24.0%, 6/25), the arbidol group ( 16.7%, 6/36), LPV/r group (5.4%, 3/56) and conventional treatment group (5.2%, 3/58). Moreover, the frequency of adverse reactions in the three groups receiving antiviral drugs was significantly higher than that in the conventional treatment group (χ(2) = 14.875, P = 0.002). Conclusions: No evidences could prove that LPV/r and arbidol could shorten the negative conversion time of novel coronavirus nucleic acid in pharyngeal swab nor improve the symptoms of patients. Furthermore, the combination usage of LPV/r and arbidol may not benefit for improving the disease. Noteworthy, the adverse reactions of the antiviral drugs should be paid careful attention during the treatment.

[Effect of genetic modifiers on the clinical severity of β-thalassemia]

β-thalassemia (β-thal) is a fatal and disabling inherited blood disorder with diverse phenotypes. The same or similar genotype of β-thal can manifest variable clinical severities. It is the hotspot and emphasis in the field of hematopathy and genetic diseases to explore genetic modifiers that influence the phenotype of β-thal. This review illustrates the deteriorating and amelioratig modifiers from two aspects: genotypes of α-globin and quantitative trait locus of fetal hemoglobin (Hb F). Variations of transcription factors which reactive the γ-globin gene expression and β-globin cluster cis-acting elements were introduced emphatically. Finally, clinical applications and future development prospects of β-thal genetic modifiers are introduced by examples.

[Prevalence and risk factors of nonalcoholic fatty liver disease in patients with chronic hepatitis B receiving antiviral therapy]

Objective: To investigate the prevalence and risk factors of non-alcoholic fatty liver disease(NAFLD) in patients with chronic hepatitis B(CHB) receiving antiviral treatment. Methods: The cross-sectional study included 3 477 cases with CHB who received antiviral therapy. The prevalence of NAFLD was investigated, and then the risk factors were screened and analyzed by stepwise regression method in CHB patients with NAFLD as the dependent variable and the related influencing factors as independent variables. Results: The prevalence of NAFLD was 24.1% in CHB patients who received antiviral therapy. After adjusting for age and gender, central obesity (OR: 7.44, 95%CI: 6.06 ~ 9.14), hypertension (OR: 1.74, 95%CI: 1.51 ~ 2.20), and triglyceride (OR: 1.52, 95%CI: 1.18 ~ 1.96) were positively associated with NAFLD, and cirrhosis was negatively associated with NAFLD (OR: 0.42, 95%CI: 0.34 ~ 0.53). Patients with long-term antiviral therapy had increased risk of NAFLD. Conclusion: A significant proportion of CHB patients receiving antiviral therapy have suffered from NAFLD. Therefore, CHB patients receiving long-term antiviral treatment should pay more attention to the prevalence of NAFLD.

Treatment with epigenetic agents profoundly inhibits tumor growth in leiomyosarcoma

Leiomyosarcomas are rare mesenchymal neoplasms characterized by a smooth muscle differentiation pattern. Due to the extremely poor prognosis in patients, the development of novel chemotherapeutic regimens remains critically important. In this study, multiple leiomyosarcoma cell lines, SK-UT1, SK-LMS1, and MES-SA were treated with varying doses of the DNA Methyltransferase Inhibitors (DNMTi) 5-azacitidine (Aza), 5-aza-2-deoxycytidine (DAC), and guadecitabine (SGI-110). The effect of these epigenetic modulators was measured using both in-vitro and in-vivo models.

Of the three epigenetic modulators, Guadecitabine was the most effective at decreasing cell survival in LMS cell lines. SK-UT1 was found to be the more sensitive to all three epigenetic modulators, while SK-LMS1 and MES-SA were more resistant. The contrast in sensitivity seen was also represented by the increase in apoptosis in Aza and guadecitabine. In parallel with Aza, guadecitabine was observed to also arrest the cell cycle.

Treatment with guadecitabine led to a decrease in growth across the spectrum of sensitivity in LMS cell lines, both in a delayed in vitro and in vivo model; in parallel experiments, apoptotic pathways were activated in sensitive and less sensitive lines. Additional studies are required to explore potential therapeutic applications and mechanisms for leiomyosarcoma treatment.

[A 22-year-follow-up cohort study on primary liver cancer in Haimen city of Jiangsu province]

Objective: A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province. Methods: The cohort involved 89 789 adult residents aged 25-69 years. Upon the entry of this project, each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml. Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay. All the subjects were followed-up every year for vital statistics and death certificate information until 2014. Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (95%CI) for PLC mortality associated with HBsAg status and other risk factors. Results: During the 1 299 611 person-years of follow-up, a total of 2 583 PLC cases were identified, including 2 149 men and 434 women. Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100 000 person-years, respectively. Among those who died of PLC, 73.87% had been tested HBsAg positive. HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95%CI: 14.29-17.85) and 21.63 for women (95%CI: 16.16-28.96) respectively. Ageing, cigarette smoking, previous history of hepatitis, and family history of HCC were factors associated with the increased risk for PLC. Conclusion: People living in Haimen city had a high risk on PLC. HBV infection appeared the most important risk factor for HCC mortality in this area.

Genetic variability in copper-transporting P-type adenosine triphosphatase (ATP7B) is associated with Alzheimer's disease in a Chinese population

Previous experiments demonstrated that transgenic mice carrying both amyloid precursor protein and mutant ATP7B transgenes reduce amyloid plaques and diminish plasma Abeta levels. These experiments showed that a structural change of ATP7B may affect Alzheimer’s disease (AD) susceptibility. In this study three missense SNPs in ATP7B gene (rs1801243, rs1801244, and rs1801249) were chosen to test whether they were associated with AD. We tested this hypothesis using a case control design. The experimental data showed that there was a significant deviation from Hardy-Weinberg equilibrium (HWE) for SNP rs1801249 (c.3419 T greater than C, Val1140Ala) in the case group (p = 0.014) but not in the control group and that there was an association between SNP rs1801249 and AD under a recessive model (p = 0.003). The data also showed that the genotype frequency distribution of the ATP7B c.1366 G greater than C polymorphism (rs1801244, Val456Leu) differed significantly between the AD patients and the normal subjects (p = 0.012). In addition, the frequency of the TGC haplotype of SNPs rs1801243, rs1801244, and rs1801249 was significantly higher in the AD patients compared with the normal subjects (p = 8.49×10-7). These observations suggested that genetic variations in the copper transporter gene ATP7B might contribute to AD pathogenesis in the Taiwanese population.

Selenium is inversely associated with interleukin-6 in the elderly

BACKGROUND

Selenium is an essential trace element with antioxidant property. Decreased serum selenium concentration with aging had been found in previous report. In this study, we aim to investigate the association between serum selenium and the inflammatory cytokine interleukin-6 in the elderly living in long-term care facilities in Taiwan.

MATERIALS AND METHODS

A total of 336 subjects aged 65 years and older (range of age: 65 - 101 years) were recruited from eight long-term care facilities in 2002-2003. Baseline characteristics, anthropometric indices, and biochemical data were obtained. Selenium deficiency was defined as serum selenium concentration < 80 μg/L. Multiple logistic and linear regression analyses were used to examine the relationships between selenium deficiency and interleukin-6 (divided into quartiles).

RESULTS

The prevalence of selenium deficiency was 35.6% in men and 43.2% in women, respectively. After adjusting for potential confounders using multiple logistic regression analysis, interleukin-6 quartiles were significantly associated with selenium deficiency. Compared to the interleukin-6 quartile I, the adjusted odds ratios of having selenium deficiency for interleukin-6 quartile II, III, IV were 1.00(0.50~2.01), 1.24 (0.62~2.50), and 2.35(1.15~4.83), respectively. The increasing odds ratios for selenium deficiency in higher interleukin-6 quartiles revealed dose-response effects (p < 0.05). Moreover, multiple linear regression analysis showed that serum selenium was significantly inversely associated with interleukin-6 after adjusting for potential confounders.

CONCLUSIONS

Serum selenium was inversely associated with inflammatory cytokine interleukin-6 among elderly living in long-term care facilities in Taiwan. Monitoring serum selenium should be considered in these institutionalized elderly.

Association analysis of dopaminergic gene variants (Comt, Drd4 And Dat1) with Alzheimer s disease

Defects in dopaminergic transmission play important roles in the disturbance of synaptic plasticity and even in advanced cognitive behavior. However, the relationship between genes involved in the regulation of dopamine levels and predisposition for Alzheimer s disease (AD) remains unclear. The potential association of dopamine-modulating gene polymorphisms with AD was evaluated. We performed a case-control study with 120 patients and 86 healthy controls. Two catechol-O-methyltransferase (COMT) single-nucleotide polymorphisms (SNPs) (rs2020917 and rs4646312), two dopamine D4 receptor (DRD4) SNPs (rs3758653 and rs916455), and four dopamine transporter (DAT1) SNPs (rs2937639, rs6347, rs12516948 and rs11133762) were investigated. The T allele at the DRD4 SNP (rs3758653) was found to be significantly associated with AD. Our results also showed that haplotype frequencies, observed from the analyzed SNPs, were distributed significantly differently in AD patients vs control subjects. Moreover, a strong association was observed between the A allele at rs6347 of DAT1 and moderate stage of dementia. These observations suggest that genetic variations in the dopamine-modulating genes, COMT, DRD4 and DAT1, may contribute to AD pathogenesis in the Taiwanese population.

Seasonal variation and health risk assessment of polycyclic aromatic hydrocarbons in Miaoli city, Taiwan

The ambient PAHs levels in the downtown area of a traditional small city were analyzed for winter and summer seasons. A total of 16 PAHs in gaseous and particulate phase were quantified. The average gaseous PAHs were 2,189 ± 1,194 and 623.8 ± 545.1 ng/m(3) in winter and summer seasons, respectively. For the PAHs in particulate phase, they were 40.32 ± 12.15 and 11.99 ± 5.63 ng/m(3) in winter and summer seasons, respectively. These values were comparable to those reported for large cities or even higher. The estimated BaPeq was 12.32 ± 6.34 ng/m(3). As low-molecular-weight PAHs primarily existed in gaseous phase, high-molecular-weight PAHs in particulate phase became a significant fraction of total particulate phase PAHs. Particulate phase PAHs was significantly inversely associated with the ambient temperature for each individual PAHs species. However, this relationship did not exist for high-molecular-weight PAHs in gaseous phase. The results indicated the photo-degradation of high-molecular-weight PAHs should warrant a further thoughtfully investigation.

Elevated serum dehydroepiandrosterone sulphate level correlates with increased risk for metabolic syndrome in the elderly men

BACKGROUND

The previous studies regarding the association between endogenous dehydroepiandrosterone (DHEA) sulphate level and metabolic syndrome are inconsistent. This study aimed to investigate such relationship in elderly Taiwanese men.

MATERIALS AND METHODS

Five hundred and eighty-five elderly Taiwanese men (mean age 68.7 +/- 8.3 years) were enrolled as the baseline cohort population in 2000. In addition to a questionnaire, body mass index (BMI), blood pressure, fasting blood glucose, lipids, albumin and serum DHEA-S levels were measured for each participant. Metabolic syndrome was based on the definition by the America Heart Association/National Heart Lung Blood Institute.

RESULTS

The prevalence of metabolic syndrome was 33.3%. Using multivariate logistic regression analyses with adjustments for age, smoking, alcohol, physical activities, albumin and BMI, there was a positive relationship between serum DHEA-S level and metabolic syndrome. The highest DHEA-S quartile group had increased risk for metabolic syndrome (odds ratio = 2.68, 95% confidence interval: 1.44-5.01, P < 0.01) compared with the lowest quartile group. The mean serum DHEA-S level increased with increasing number of metabolic syndrome components.

CONCLUSIONS

The prevalence of metabolic syndrome increases with elevated DHEA-S levels among elderly Taiwanese men. Thus, elevated serum DHEA-S level should be treated as an important risk factor for metabolic syndrome in elderly men.

The metabolic syndrome increases cardiovascular mortality in Taiwanese elderly

BACKGROUND

The prevalence of the metabolic syndrome (MetS) is high among the elderly. However, evidence that mortality increases with MetS is rare. In this study, we investigated the relationship between MetS, cardiovascular disease (CVD) and all cause mortality in the elderly.

MATERIALS AND METHODS

A total 10 547 participants, aged 65 years and older, of baseline cohort were recruited from four nationwide Health Screening Centres in Taiwan from 1998 to 1999. The metabolic syndrome was defined according to the America Heart Association/National Heart Lung Blood Institute definition. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs) of CVD and all cause mortality for those with MetS for up to 8 years of follow-up.

RESULTS

The baseline prevalence of MetS was 50.1% (45.6% in men and 54.4% in women, respectively). A total of 1312 participants died; of these, 300 participants died from CVD. Adjusted for age, gender, smoking, total cholesterol and estimated glomerular filtration rate, the RRs for CVD and all cause mortality among participants with MetS were 1.48 (95% confidence interval = 1.16-1.90) and 1.16 (1.03-1.30), respectively, for participants compared to those without MetS. The mean RRs for CVD, however, ranged from 1.21 to 5.31 among different combinations of MetS components.

CONCLUSION

The elderly with MetS, compared to those without MetS, had a higher CVD and all cause mortality in Taiwan. Furthermore, different combinations of MetS components posed different risks to the mortality, which deserves further research in the future.

Induction of VX2 carcinoma in rabbit liver: comparison of two inoculation methods

Direct injection of VX2 cell suspension into the liver is simple and widely used. Implantation of a fragment of VX2 tumour into the liver using a surgical technique has also been developed in the last decade. In this study, we compared these two methods in order to find a better modality for establishing VX2 liver mass. Forty rabbits, each weighing 2.8-3.2 kg, were divided into two groups, 20 rabbits in each. In Group 1, a tumour cell suspension containing 1 x 10(6) cells in a volume of 0.1 ml, was injected slowly into the liver parenchyma using a 27-gauge needle during laparotomy. In Group 2, a 1 mm(3) fragment of VX2 carcinoma was inoculated into the sub-capsule of the left anterior lobe of the liver. In Group 1, three rabbits showed no tumour growth and 10 rabbits showed evidence of leakage and tumour seeding outside of the liver. In Group 2, all but one rabbit showed tumour growth and none showed evidence of tumour seeding. The leakage rates were 50% and 0% for Group 1 and Group 2, respectively. Overall, the success inoculation rate was 35% for Group 1 and 95% for Group 2. In conclusion, to create the VX2 liver tumour model in rabbits, direct implantation of VX2 tumour fragment into the liver achieved better results than injecting cell suspension of VX2 tumour into the liver.

Optical transition process in AgOx super-resolution near-field structure

A sandwiched 15 nm AgOx thin film of the super-resolution, near-field optical disk was studied using a confocal Z-scan system. Nonlinear optical properties of quartz glass/ZnS-SiO2 (170 nm)/AgOx (15 nm)/ZnS-SiO2 (40 nm) were measured using a Q-switch Nd : YAG pulse laser of wavelength 532 nm, pulse width 0.7 ns, and 15.79 kHz repetition rate. Transmittance and reflectance of the sandwiched AgOx thin film show important optical responses at the focused position of Z-scan. The dissociation processes of AgOx, recombination of the silver and oxygen, and the resonance of the localized surface plasmon of the nano-composites of the AgOx thin film are correlated to transmittance and reflectance at the focused position of the Z-scan for different input laser powers. An irreversible upper threshold intensity of 4.40 x 106 mW cm-2 at the focused position was found. A reversible working window of the focusing intensity between 1.86 x 106 and 4.40 x 106 mW cm-2 was measured with sandwiched AgOx thin film alone. The near-field interactions of the AgOx thin film and the recording layers of super-resolution near-field optical disk are also discussed.

Patient confidentiality, ethics and licensing in telemedicine

Telemedicine is fast becoming popular in many countries in the world. It has several advantages such as being cost saving and providing better access to health care in the remote areas in many parts of the world. However, it has some disadvantages as well. One of the major problems is the problem of patients' rights and confidentiality in the use of telemedicine. There are no standard guidelines and procedures in the practice of telemedicine as yet. Both the patient and the physician are unsure of the standard of practice and how to maintain confidentiality. The patient is uncertain as to how to protect her/his rights in the use of telemedicine. The issue of litigation is also unclear as to where the physician is practicing when he/she uses telemedicine. Is she/he practicing in the country where the patient is or is the physician practicing in the country of her/his origin? These issues need to be addressed urgently so that telemedicine will have standards of ethical practice and the patient's rights and confidentiality will be protected.

Teleprimary care in Malaysia: a tool for teleconsultation and distance learning in health care

Malaysia enjoys a comprehensive range of health services, the government being committed to the principles of universal access to high quality health care, which the Ministry of Health provides through a wide variety of nation wide network of clinics and hospitals. One of the major problems is the availability of comprehensiveness and quality of health care in remote health centres. When patients are transferred from the health centres to the hospitals for further treatment, this not only incurs inconvenience to the patients and their family but also increases the cost to the health care system. Teleprimary care is one of the tools to overcome this problem. The doctors in the remote clinics are able to discuss the problem cases through teleconsultation with the doctors and specialist in the hospitals using an audiovisual system to provide better care in the health centers without transferring the patients to the hospitals. Only the essential and needy patients are referred to the hospitals. This has not only reduced the number of patients referred to the hospitals but it has reduced the cost to the health care system. It has also provided a more comprehensive care to the patients in the health centres. The doctors in the health centers are also provided training and are also updated on the latest in medicine. This method of training has made doctors in the health centers more efficient and satisfied.

The hyperaggregability of platelets from normal pregnancy is mediated through thromboxane A2 and cyclic AMP pathways

There is substantial evidence of increased platelet reactivity in vivo and in vitro during pregnancy, with the risk of developing pre-eclampsia. In this study, platelet function was studied during 28-40 weeks of gestation in a group of women who remained normotensive and in a group of nonpregnant female controls. Platelet aggregation stimulated by thrombin and adenosine diphosphate was markedly enhanced in washed platelets from pregnant subjects. Thrombin (0.04 U/ml)-evoked increases in intracellular Ca+2 mobilization of Fura 2-AM-loaded platelets were also enhanced in pregnant subjects. The binding of fluorescein isothiocyanate (FITC)-triflavin (2 microg/ml) to the glycoprotein IIb/IIIa complex in thrombin-activated platelets did not differ significantly between the nonpregnant and pregnant groups. Thromboxane A2 (TXA2) formation in both resting and thrombin-activated platelets from pregnant subjects was significantly greater than from nonpregnant subjects. Levels of cyclic adenosine monophosphate (cAMP) in both resting and prostaglandin E1-treated platelets (10 micromol/l) from pregnant subjects were significantly lower than those from nonpregnant subjects. There were no significant differences between nonpregnant and pregnant subjects in platelet cAMP levels in the presence of imidazole (600 micromol/l) and indomethacin (500 micromol/l). Intracellular pH values in platelets were measured spectrofluorometrically using the fluorescent probe, BCECF-AM. The increase in intracellular pH stimulated by thrombin (0.04 U/ml) in pregnant subjects was markedly greater than that in observed nonpregnant subjects. We conclude that the agonist-induced hyperaggregability of platelets in normal pregnancy may be due, at least partly, to stimulation of the Na+/H+ exchanger and subsequently to elevated intracellular Ca+2 mobilization, and then to increased TXA2 formation and a lowered level of cAMP, which leads to further increases in intracellular Ca+2 mobilization, and finally to enhanced platelet aggregation.

Effects of cisapride on oesophageal transit of solids in patients with progressive systemic sclerosis

In most patients with progressive systemic sclerosis (PSS) the oesophagus is affected. Reflux symptoms are most frequent, whilst dysphagia also occurs. Cisapride, a prokinetic agent, may enhance motility along the gastrointestinal tract. The effects of cisapride on oesophageal transit were evaluated in 12 PSS patient using a solid-phase radionuclide oesophageal transit study. Each PSS patient was given cisapride 10 mg or placebo orally three times a day in a random, double-blind, crossover fashion. The results show that cisapride does not seem to have any impact on oesophageal transit in patients with PSS.

Colonic transit disorders in systemic sclerosis

Systemic sclerosis (SS) alters smooth muscle function throughout the gastrointestinal tract, the oesophagus being the segment most often involved. Involvement of the colon, though less common, may lead to life-threatening complications. We studied 23 unselected patients with SS and 20 age-matched healthy controls using radionuclide colon transit studies. The geometric centre (GC) at 4 and 24 hours was used to summarise overall transit in the colon. In patients with SS, colon transit was delayed (GC4: 0.39 +/- 0.36 vs 0.85 +/- 0.45; P=0.001) (GC24: 1.68 +/- 0.9 vs 2.58 +/- 1.08; P=0.006). These findings suggest that delayed colon transit is common in patients with SS.

Solid phase radionuclide esophageal transit in mixed connective tissue disease

Esophageal motility was studied in 24 patients with mixed connective tissue disease (MCTD) and 20 control subjects by the solid phase radionuclide esophageal transit study. A computer routine modified from Klein and Russel was used. Total mean transit time, regional mean transit time, residual fraction after first swallow, and retrograde index increased significantly in MCTD patients compared with normal control subjects. An abnormal total mean transit time occurred in 84% (20 of 24) of the patients with MCTD. Our results confirmed that delayed esophageal transit is common in patients with MCTD.

Cooperative and selective lithium complexation of 2,11,13,22-tetraaza-5,8,16,19- tetraoxa-1,12-dioxocyclodocosanes

[reaction: see text] Ureyleno crown ethers 2 and 3 bind with 2 equiv of Li(+) cooperatively and selectively over other alkali metal ions such as Na(+), K(+), and Cs(+). The binding constant for 3 was found to be 3.0 x 10(7) (L/mol)(2).

New cytotoxic butanolides from Litsea acutivena

Six new compounds, including one nor-neolignan, dehydroxymethylailanthoidol (1), and five butanolides, litseakolide D (2), litseakolide E (3), litseakolide F (4), litseakolide G (5), and isolincomolide D (6), were isolated from the leaves of Litsea acutivena. Their structures were elucidated from spectral analyses. The butanolides (2-6) showed significant cytotoxic activity against P-388, A549, and HT-29 cell lines in vitro.

Temporal selectivity by single neurons in the torus semicircularis of Batrachyla antartandica (Amphibia: Leptodactylidae)

We investigated the response selectivities of single auditory neurons in the torus semicircularis of Batrachyla antartandica (a leptodactylid from southern Chile) to synthetic stimuli having diverse temporal structures. The advertisement call for this species is characterized by a long sequence of brief sound pulses having a dominant frequency of about 2000 Hz. We constructed five different series of synthetic stimuli in which the following acoustic parameters were systematically modified, one at a time: pulse rate, pulse duration, pulse rise time, pulse fall time, and train duration. The carrier frequency of these stimuli was fixed at the characteristic frequency of the units under study (n=44). Response patterns of TS units to these synthetic call variants revealed different degrees of selectivity for each of the temporal variables. A substantial number of neurons showed preference for pulse rates below 2 pulses s(-1), approximating the values found in natural advertisement calls. Tonic neurons generally showed preferences for long pulse durations, long rise and fall times, and long train durations. In contrast, phasic and phasic-burst neurons preferred stimuli with short duration, short rise and fall times and short train durations.

Cytotoxic butanolides from the stem bark of Formosan Lindera communis

Two new butanolides, lincomolide A (1), lincomolide B (2), along with seven known compounds, isolinderanolide E, sepesteonol, beta-sitosterol, beta-sitosterol-beta-glucoside, tetradecane, nonanoic acid and decanol, were isolated from the chloroform-soluble portion of the stem bark of Lindera communis. Compound 1 showed cytotoxicity against P-388, KB16 and A549, and 2 exhibited cytotoxicity against P-388 cancer cell lines. Moreover, 1 showed marginal activity against HT-29, and 2 against KB16, A549 and HT-29 cancer cell lines. The structures of these compounds were determined by spectral analyses.

Free-field unmasking response characteristics of frog auditory nerve fibers: comparison with the responses of midbrain auditory neurons

Previous studies in the inferior colliculus have shown that spatial separation of signal and noise sources improves signal detection. In this study, we investigated the free-field unmasking response properties of single fibers in the auditory nerve--these were compared to those of inferior colliculus neurons under the same experimental conditions to test the hypothesis that central processing confers advantages for signal detection in the presence of spatially separated noise. For each neuron, we determined the detection threshold for a probe at the unit's best azimuth under three conditions: (1) by itself, (2) when a masker at a constant level was also presented at the unit's best azimuth, and (3) when the masker was positioned at different azimuths. We found that, on average, maskers presented at a unit's best azimuth elevated the probe detection threshold by 4.22 dB in the auditory nerve and 10.97 dB in the inferior colliculus. Angular separation of probe and masker sources systematically reduced the masking effect. The maximum masking release was on average 2.90 dB for auditory nerve fibers and 9.40 dB for inferior colliculus units. These results support the working hypothesis, suggesting that central processing contributes to the stronger free-field unmasking in the inferior colliculus.

Stopped-flow kinetic study of the H2O2 oxidation of substrates catalyzed by microperoxidase-8

We have studied the oxidation of microperoxidase-8 (MP-8) by H2O2 and the subsequent reaction of the intermediates with substrate by stopped-flow experiments. Oxidation of MP-8 by H2O2 gives two intermediates, I and II. The observed rate constant for the formation of I is linearly dependent on [H2O2] and exhibits a bell-shaped dependence on pH with pKa values of 8.90 and 10.60, which are attributed to the deprotonation of MP-bound H2O2 and H2O, respectively. The observed rate constant for the conversion of I to II is independent of [H2O2], but increases sharply at pH>9.0. The predominant forms of the intermediate at pH 7.0 and 10.7 are I and II, respectively. Addition of substrate to the intermediates at pH 9.0 gives rise to three distinct stages, corresponding to the three steps (in decreasing order of rate): I-->II*, II-->MP, and II*-->MP. The rates of these steps are all linearly dependent on the substrate concentration and each individual rate constant has been determined. Substrate reactivity at pH 10.7 covers over two orders of magnitude, ranging from 1.36 x 10(7) M(-1) s(-1) for 1-naphthol to 4.03 x 10(4) M(-1) s(-1) for ferrocyanide. The substrate reactivity is linearly correlated with its reduction potential, indicating that an electron transfer process is involved in the rate-limiting step.

Ga-67 scan to detect intra-abdominal infection in patients after colorectal surgery

PURPOSE

Intra-abdominal infection is still an important issue in colorectal surgery. The Ga-67 scan is relatively inexpensive, but the delay in diagnosis and the intense physiologic bowel activity are considerable drawbacks to its use in abdominal investigations. In this study, the authors performed 24-hour Ga-67 scans and read the images with the surgeon to detect abdominal infection in patients who underwent colorectal surgery.

METHODS

Sixty-one patients who underwent colorectal surgery were enrolled in this study. Ga-67 scintigraphy was performed 24 hours, and later as needed, after the injection of 111 MBq (3 mCi) Ga-67 citrate. All scans were interpreted together by a nuclear medicine specialist and the surgeon. The intensity of Ga-67 uptake was recorded as grade 0: no uptake; grade 1: less than liver uptake; grade 2: equal to liver uptake; or grade 3: greater than liver uptake. When the intensity of Ga-67 uptake was equal to or greater than grade 2, the pattern of Ga-67 uptake was classified as changing or unchanging. A positive Ga-67 scan was defined as having an intensity of grade 2 or 3 with an unchanging pattern.

RESULTS

Nineteen abdominal infections were diagnosed, all by Ga-67 scans, for a diagnostic sensitivity rate of 100%. Of the 42 patients with no intra-abdominal infection, only 2 had positive Ga-67 scans. This resulted in a specificity rate of 95.2%. The overall accuracy of the Ga-67 scan in the detection of intra-abdominal infection after colorectal surgery was 96.7%.

CONCLUSIONS

The Ga-67 scan is useful for detecting intra-abdominal infection after colorectal surgery. Reading the images with the surgeon and using a lateral view can decrease the false-positive rate. A negative Ga-67 scan can rule out intra-abdominal infection, whereas a positive Ga-67 scan indicates the need for further patient evaluation after colorectal surgery.

Abdominal abscesses in patients having surgery: an application of Ga-67 scintigraphic and computed tomographic scanning

PURPOSE

Early detection of occult abscesses is important in patients with persistent fever after colorectal surgery. In this study, the authors evaluated the relative merits of computed tomographic (CT) and Ga-67 scans in the detection of intra-abdominal abscesses in patients who had just undergone colorectal surgery.

MATERIALS AND METHODS

Thirty-four patients who underwent colorectal surgery were enrolled in the study. Ga-67 and CT scans were obtained in all patients. Ga-67 scintigraphy was performed 24 hours, and later as needed, after the injection of 111 MBq (3 mCi) Ga-67 citrate.

RESULTS

Intra-abdominal abscesses were diagnosed in 16 of the 34 (47%) patients who had colorectal surgery. For CT scans, the overall accuracy, sensitivity, and specificity rates were 97.1%, 93.7%, and 100%, respectively. For the Ga-67 scans, the diagnostic accuracy, sensitivity, and specificity rates were 91.2%, 100%, and 95.2%, respectively. In addition, the whole-body Ga-67 scans successfully detected two cases of extra-abdominal infection, one case of pneumonia, and one case of cellulitis.

CONCLUSIONS

Computed tomographic and Ga-67 scans offer complementary information and play an important role in the investigation of sources of infection in patients after colorectal surgery.

Histologic study of effects of radiation synovectomy with Rhenium-188 microsphere

Rhenium-188 microsphere is a relatively new radiation synovectomy agent developed for the treatment of rheumatoid arthritis. It has been shown that the levels of unwanted extra-articular radiation are negligible with this agent. A histologic study was conducted to assess the effect of radiation synovectomy on synovium and articular cartilage after intra-articular injection of various doses of Re-188 microspheres into the knee joints of rabbits. Intra-articular injection of Re-188 microspheres into rabbit knee joints resulted in mild reactive inflammation and thrombotic occlusion of vessels which subsided rapidly. Sclerosis of subsynovium could be seen 12 weeks after injection. No evidence of damage to articular cartilage was noted. There was no significant difference in the articular pattern after injection of 0.3 or 0.6 mCi Re-188 microspheres. This study suggests that a treatment dose of Re-188 microspheres causes transient inflammation of synovium without any detectable damage to the articular cartilage of knee joint.

A new tetrahydroprotoberberine N-oxide alkaloid and anti-platelet aggregation constituents of Corydalis tashiroi

A new tetrahydroprotoberberine N-oxide alkaloid, (-)-cis-isocorypalmine N-oxide (1), together with two known compounds, 6-methoxydihydrosanguinarine (2) and norjuziphine (3), were isolated in continuing studies of the entire Formosan Corydalis tashiroi plant. The structures of these three compounds were determined through spectral analyses. In addition, compounds 1, 2, 3 and the seven alkaloids previously reported: (-)-cis-corydalmine N-oxide, (-)-trans-corydalmine N-oxide, (-)-trans-isocorypalmine N-oxide, scoulerine, protopine, oxysanguinarine and corydalmine, were found to possess antiplatelet aggregation activity.

Construction and molecular analysis of gene transfer systems derived from bovine immunodeficiency virus

Because lentiviruses are able to infect nondividing cells, these viruses might be utilized in gene therapy applications where the target cell does not divide. However, it has been suggested that the introduction of primate lentivirus sequences, particularly those of human immunodeficiency virus, into human cells may pose a health risk for the patient. To avoid this concern, we have constructed gene transfer systems based on a nonprimate lentivirus, bovine immunodeficiency virus. A panel of vectors and packaging constructs was generated and analyzed in a transient expression system for virion production and maturation, vector expression and encapsidation, and envelope protein pseudotyping. Virion preparations were also analyzed for transduction efficiency in a panel of human and nonhuman primary cells and immortalized cell lines. The virion preparations transduced most of the target cell types, with efficiencies up to 90% and with titers of unconcentrated virus up to 5 x 10(5) infectious doses/ml. In addition, infection of nondividing human cells, including unstimulated hematopoietic stem cells and irradiated endothelial cells, was observed.

Segmental dynamics of interfacial poly(methyl acrylate)-d(3) in composites by deuterium NMR spectroscopy

The interface in composite materials containing an ultrathin layer of poly(methyl acrylate)-d(3) (PMA-d(3)) on silica was studied using deuterium NMR. PMA-d(3) was deposited from solution at saturation coverage from toluene onto silica. The samples were dried and composite samples made by hot pressing the PMA-d(3)/silica samples with hydrogenated polystyrene (PS) and high (HMW) and low (LMW) molecular weight hydrogenated poly(methyl acrylate) (PMA) as the overlayer. The interfacial layers of PMA-d(3) were studied at the air-polymer-silica and polymer-polymer-silica interfaces using deuterium solid-state quadrupole-echo NMR and the results compared to those for the bulk polymer. It was found that for samples at the air-polymer-silica interface, some of the polymer segments in the surface sample had segmental mobility higher than that of the corresponding bulk PMA-d(3) sample at the same temperature. When overcoated with unlabeled polymer, the interfacial polymer at the polymer-polymer-silica interface showed reduced mobility due to the presence of the overlayer. The adsorbed PMA-d(3), in the composite samples, decreased in mobility in the order of LMW-PMA > HMW-PMA > PS. The PS sample caused the greatest reduction in the PMA-d(3) interfacial mobility. The order was consistent with the segmental mobilities of the polymers used for the overlayers. The lower the mobility of the polymer used for the overlayer, the more restricted were the polymer segments in the adsorbed PMA-d(3) layer.

Efficient human immunodeficiency virus-based vector transduction of unstimulated human mobilized peripheral blood CD34+ cells in the SCID-hu Thy/Liv model of human T cell lymphopoiesis

The methods available to efficiently transduce human CD34(+) hematopoietic stem cells (HSCs) derived from mobilized peripheral blood, such that they fully retain their engraftment potential and maintain high levels of transgene expression in vivo, have been unsatisfactory. The current murine retrovirus-based gene transfer systems require dividing cells for efficient transduction, and therefore the target HSCs must be activated ex vivo by cytokines to cycle, which may limit their engrafting ability. Lentivirus-based gene transfer systems do not require cell division and, thus, may allow for efficient gene transfer to human HSCs in the absence of any ex vivo cytokine stimulation. We constructed human immunodeficiency virus (HIV)-based vectors and compared them in vitro and in vivo with MuLV-based vectors in their ability to transduce unstimulated human CD34(+) HSCs isolated from mobilized peripheral blood. Both sets of vectors contained the marker gene that expresses the enhanced green fluorescent protein (EGFP) for evaluating transduction efficiency and were pseudotyped with either vesicular stomatitis virus glycoprotein (VSV-G) or the amphotropic murine leukemia virus envelope (A-MULV Env). The VSV-G-pseudotyped HIV-based vectors containing an internal mouse phosphoglycerate kinase promoter (PGK) were able to transduce up to 48% of the unstimulated CD34(+) cells as measured by EGFP expression. When these cells were injected into the human fetal thymus implants of irradiated SCID-hu Thy/Liv mice, up to 18% expressed EGFP after 8 weeks in vivo. In contrast, the MULV-based vectors were effective at transducing HSCs only in the presence of cytokines. Our results demonstrate that the improved HIV-based gene transfer system can effectively transduce unstimulated human CD34(+) HSCs, which can then differentiate into thymocytes and provide long-term transgene expression in vivo.

Uptake of gallium-67 citrate in clean surgical incisions after colorectal surgery

Non-specific accumulation of gallium-67 citrate (gallium) in uncomplicated surgical incisions is not uncommon. It is important to know the normal pattern of gallium uptake at surgical incision sites in order to properly interpret the gallium scan when investigating possible wound infection in patients who have undergone abdominal surgery. We studied 42 patients without wound infection after colorectal surgery and performed gallium scans within 40 days after surgery. Patients were divided into three groups according to the interval between the operation and the scan. In group A (26 patients) gallium scan was performed within 7 days after surgery, in group B (8 patients) between 8 and 14 days after surgery, and in group C (8 patients) between 15 and 40 days after surgery. Our data showed that in group A, 61.5% had gallium accumulation at the surgical incision site. In group B, 50% had accumulation of gallium at the surgical incision site, while in group C only one patient (12.5%) showed gallium uptake. It is concluded that the incidence of increased gallium uptake at clean surgical incision sites is high after colorectal surgery. Nuclear medicine physicians should bear in mind the high incidence of non-specific gallium uptake at such sites during the interpretation of possible wound infection in patients after colorectal surgery.

Human hepatocellular carcinoma is characterized by a highly consistent pattern of genomic imbalances, including frequent loss of 16q23.1-24.1

Comparative genomic hybridization (CGH) analysis was used to identify chromosomal imbalances in 52 human primary hepatocellular carcinomas (HCCs). The most prominent changes were gains of part or all of chromosome arms 8q (83% of cases) and 1q (73%) and loss of 16q (63%). Other commonly overrepresented sites were 5p, 7q, and Xq. Recurrent sites of DNA sequence amplification included 8q23--24 (five cases) and 11q13--14 (four cases). Other frequently underrepresented sites were 4q, 8p, 16p, and 17p. Taken collectively, these findings and data from other CGH studies of HCCs define a subset of chromosome segments that are consistently over- or underrepresented and highlight sites of putative oncogenes and tumor suppressor genes, respectively, involved in hepatocellular oncogenesis. Loss of heterozygosity analysis with a panel of polymorphic microsatellite markers distributed along 16q defined a minimal region of chromosomal loss at 16q23.1--24.1, suggesting that this region harbors a tumor suppressor gene whose loss/inactivation may contribute to the pathogenesis of many HCCs.

Effect of imaging time on gallium renal scan

AIM

Gallium renal imaging has been reported to be useful in monitoring disease activity and predicting the response to therapy in lupus nephritis. Gallium renal images are usually obtained 48 h after the injection of 67Ga citrate, but 72-h images sometimes are the only available pictures. The aim of the present study was to determine whether the time intervals from injection to imaging had any effect on the grading of gallium renal scintigraphy.

METHODS

Fifty-five patients with lupus nephritis underwent gallium renal imaging at both 48 h and 72 h post-injection of 111 MBq of 67Ga citrate. The relative uptakes of 67Ga by the kidneys and the spine was judged visually on the analog images. Renal uptake was rated on a scale of 0-3.

RESULTS

Fifty-three patients (96.3%) had the same grading of renal uptake in the 48-h and the 72-h images. Only two patients (3.7%) had a different grading in the 72-h images when compared to the 48-h images. The correlation between the 48-h renal uptake and 72-h renal uptake was excellent, with a Spearman R value of 0.94. No significant difference was noted between these two groups, with a P value of 0.76 (using a Wilcoxon matched pairs test).

CONCLUSION

A gallium renal scan can be obtained either 48 h or 72 h after injecting 67Ga citrate. The imaging time did not interfere with the grading of renal uptake in lupus nephritis.

Structural events during the refolding of an all beta-sheet protein

The refolding kinetics of the 140-residue, all beta-sheet, human fibroblast growth factor (hFGF-1) is studied using a variety of biophysical techniques such as stopped-flow fluorescence, stopped-flow circular dichroism, and quenched-flow hydrogen exchange in conjunction with multidimensional NMR spectroscopy. Urea-induced unfolding of hFGF-1 under equilibrium conditions reveals that the protein folds via a two-state (native <--> unfolded) mechanism without the accumulation of stable intermediates. However, measurement of the unfolding and refolding rates in various concentrations of urea shows that the refolding of hFGF-1 proceeds through accumulation of kinetic intermediates. Results of the quenched-flow hydrogen exchange experiments reveal that the hydrogen bonds linking the N- and C-terminal ends are the first to form during the refolding of hFGF-1. The basic beta-trefoil framework is provided by the simultaneous formation of beta-strands I, IV, IX, and X. The other beta-strands comprising the beta-barrel structure of hFGF-1 are formed relatively slowly with time constants ranging from 4 to 13 s.

Intra-tumoural injection of 90Y microspheres into an animal model of hepatoma

BACKGROUND

Intrahepatic arterial injection of 90Y glass microspheres (90Y microspheres) is a useful therapeutic modality for inoperative liver tumour. Recently, a new concept of interstitial radiotherapy in the treatment of hepatic malignancies has been carried out with even more encouraging results. However, information regarding this technique is still very rare. The purpose of this study was to analyse the kinetics and biodistribution of 90Y microspheres in rats with hepatic tumours following intra-tumoural injection.

METHODS

Twenty male Sprague-Dawley rats with hepatoma were killed at 1 h, 24 h, 48 h and 72 h (five rats each time) after intra-tumoural injection of approximately 7.4 MBq of 90Y microspheres. Samples of various organs were obtained and used to calculate the tissue concentrations and radiation doses.

RESULTS

Our data showed that the radioactivity in the tumour was very high throughout this study. The lung was the only organ other than the tumour which showed high radioactivity. The concentrations of radioactivity in other organs, such as normal liver, muscle, spleen, bone, testis, and whole blood were quite low throughout the study.

CONCLUSION

Direct intra-tumoural injection of 90Y microspheres is extremely attractive as a clinical therapeutic alternative in hepatoma patients.

Adversarial search by evolutionary computation

In this paper, we consider the problem of finding good next moves in two-player games. Traditional search algorithms, such as minimax and alpha-beta pruning, suffer great temporal and spatial expansion when exploring deeply into search trees to find better next moves. The evolution of genetic algorithms with the ability to find global or near global optima in limited time seems promising, but they are inept at finding compound optima, such as the minimax in a game-search tree. We thus propose a new genetic algorithm-based approach that can find a good next move by reserving the board evaluation values of new offspring in a partial game-search tree. Experiments show that solution accuracy and search speed are greatly improved by our algorithm.

Tunnel study of on-road vehicle emissions and the photochemical potential in Taiwan

Motor vehicle emission factors of carbon monoxide (CO) and non-methane volatile organic compounds (NMVOCs) were calculated inside the Chung-Cheng Tunnel of Kaohsiung in Taiwan. The results were compared with those model predictions from the Mobile Taiwan 2.0 model. Individual concentrations of 21 species of NMVOCs were also determined. Photochemical potential of NMVOCs was evaluated by using the maximum incremental reactivity (MIR). Field data showed that the integrated emission factors of CO and NMVOCs for actual fleet were 6.3 and 1.5 g/veh km, respectively. The error range of these factors may be up to 45%. The predicted values by the Mobile Taiwan 2.0 model closely matched the observed data. Concentrations of isopentane, 2-methylpentane, toluene and m,p-xylene were the dominant species of NMVOCs. The ratio of maximum incremental reactivity to NMVOCs concentration was 3.9, similar to those of the studies in the US Fort McHenry and Tuscarora Tunnel.

Effects of 90Y-microspheres on liver tumors: comparison of intratumoral injection method and intra-arterial injection method

Internal radiation therapy using intrahepatic arterial injection of 90Y-labeled glass microspheres (90Y-microspheres) has proven to be a promising therapeutic modality for inoperative liver tumor. Recently, direct intratumoral injection of 90Y-microspheres has been performed with even more encouraging results. The purpose of this study was to compare the treatment efficacy of these 2 methods using 90Y-microspheres.

METHODS

Forty-eight male rats, each bearing a hepatic tumor, were divided into 4 groups (12 rats in each group) to evaluate the efficacy of treatment. Group 1 received an intratumoral injection of 37 MBq (1 mCi) 90Y-microspheres. Group 2 received an intratumoral injection of 0.1 mL normal saline as the control group. Group 3 received an intra-arterial injection of 37 MBq (1 mCi) 90Y-microspheres. Group 4 received an intra-arterial injection of 0.1 mL normal saline as the control group. Tumor size was measured by liver sonography before injection as well as at 2 and 4 wk after injection. Survival time was calculated from the day of treatment to 2 mo after treatment by Kaplan-Meier survival analysis. The response rate was evaluated by the change in tumor size and survival time. Fisher's exact, 2-tailed test was used to compare response rates.

RESULTS

In the rats treated by intratumoral injection of 90-Y-microspheres, 83.3% (10/12) showed a good response. In contrast, all 12 rats in the control group showed a poor response. The difference was significant (P < 0.00001). Eighty-three percent (10/12) of the rats survived >60 d after intratumoral injection of 90Y-microspheres, whereas only 25% (3/12) of the control rats survived >60 d. The difference was significant (P = 0.0068). In the rats treated by intra-arterial injection of 90Y-microspheres, 58.3% (7/12) showed a good response to the treatment. All rats in the control group showed a poor response. The difference was significant (P = 0.0023). Sixty-six percent (8/12) of the rats survived >60 d after intra-arterial injection of 90Y-microspheres, whereas only 16.7% (2/12) of the control rats survived >60 d. The difference was significant (P = 0.0385). However, the response rate and survival time between the intratumoral treatment group and the intra-arterial treatment group showed no significant difference (P = 0.3707 and 0.3988, respectively).

CONCLUSION

Both methods (intratumoral treatment and intraarterial treatment) showed a significantly good response rate and prolonged survival time compared with those of the control groups. However, no significant difference was found in the response rate or survival time between intratumoral treatment and intra-arterial treatment.

Does bowel preparation improve the quality of abdominal gallium scintigraphy?

Physiological accumulation of gallium in the intestine is a major weakness of gallium scintigraphy in evaluating the abdomen. In this study, we used two different cathartics to evaluate the efficacy of bowel cleansing in improving the quality of abdominal gallium imaging. One hundred and fifty patients underwent gallium scintigraphy and were randomly divided into three groups. Group A received no bowel preparation, Group B received 30 ml of castor oil the night before imaging, and Group C received bisacodyl the night before imaging. Gallium activity in the intestine was rated on a three-point scale from 0 to II based on the anterior view of a delayed 48-h gallium image. Our data showed that the incidence of gallium accumulation in the small intestine was low. On the contrary, there was high prevalence of gallium activity in the colon. Forty-eight percent of Group A patients had obvious gallium activity in the colon. The percentage decreased significantly to 28% and 22% in Groups B and C, respectively. No significant difference was noted between Group B and Group C. In conclusion, our data suggest that the application of either castor oil or bisacodyl significantly improves the quality of 48-h abdominal gallium scintigraphy. There were no significant differences in the efficacy of bowel cleansing on gallium activity between these two laxatives.

Semi-quantitative evaluation of gallium-67 scintigraphy in lupus nephritis

Within nuclear medicine there is a trend towards quantitative analysis. Gallium renal scan has been reported to be useful in monitoring the disease activity of lupus nephritis. However, only visual interpretation using a four-grade scale has been performed in previous studies, and this method is not sensitive enough for follow-up. In this study, we developed a semi-quantitative method for gallium renal scintigraphy to find a potential parameter for the evaluation of lupus nephritis. Forty-eight patients with lupus nephritis underwent renal biopsy to determine World Health Organization classification, activity index (AI) and chronicity index (CI). A delayed 48-h gallium scan was also performed and interpreted by visual and semi-quantitative methods. For semi-quantitative analysis of the gallium uptake in both kidneys, regions of interest (ROIs) were drawn over both kidneys, the right forearm and the adjacent spine. The uptake ratios between these ROIs were calculated and expressed as the "kidney/spine ratio (K/S ratio)" or the "kidney/arm ratio (K/A ratio)". Spearman's rank correlation test and Mann-Whitney U test were used for statistical analysis. Our data showed a good correlation between the semi-quantitative gallium scan and the results of visual interpretation. K/S ratios showed a better correlation with AI than did K/A ratios. Furthermore, the left K/S ratio displayed a better correlation with AI than did the right K/S ratio. In contrast, CI did not correlate well with the results of semi-quantitative gallium scan. In conclusion, semi-quantitative gallium renal scan is easy to perform and shows a good correlation with the results of visual interpretation and renal biopsy. The left K/S ratio from semi-quantitative renal gallium scintigraphy displays the best correlation with AI and is a useful parameter in evaluating the disease activity in lupus nephritis.

Normal ranges of renal physiological parameters for technetium-99m mercaptoacetyltriglycine and the influence of age and sex using a camera-based method

162 normal Chinese men and women underwent a 99mTc MAG3 renal study. Seventy-two males and 90 females were evaluated in 5 age groups: group 1, 61-80 years; group 2, 51-60 years; group 3, 41-50 years; group 4, 31-40 years, and group 5, 21-30 years. Each subject was required to fit the following criteria: (1) clinically no history of renal, urinary disorders and systemic diseases, normal blood pressure, kidney morphology, urinary examination and serum creatinine, and (2) for the gamma camera study normal hydration and renal images, and no pelvic, ureteric dilatation or retention of tracer should be found. The normal range of common physiological parameters for 99mTc MAG3 renal studies was measured in normal subjects. The effective renal plasma flow (ERPF, camera-based Schlegel method), percent function in each kidney (renal index, RI), time of peak renal parenchymal activity (Tmax) and half time of parenchymal activity following the peak (T1/2) were evaluated. The Tmax and T1/2 were determined with regions of interest over the entire kidney. The results showed that (1) between the sexes, there were no significant differences for any parameter; (2) between the age groups, the only significant difference was a decrease in ERPF, normalized for body surface area, with increasing age (group 1, 511.3 +/- 91.2; group 2, 559.5 +/- 102.1; group 3, 577.1 +/- 79.2; group 4, 607.8 +/- 101.1, and group 5, 610.2 +/- 109.2), and (3) the RI, Tmax and T1/2 were symmetrical and did not vary between the sexes or age groups (left vs. right: RI = 49.6 +/- 2.2 vs. 50.4 +/- 2.2%, Tmax = 3.63 +/- 1.13 vs. 3.75 +/- 1.11 min, and T1/2 = 5.38 +/- 1.65 vs. 5.83 +/- 1.88 min). We find that (1) ERPF for 99mTc MAG3 decreases with age in normal Chinese, which is similar to the results of Western countries, and (2) the RI, Tmax and T1/2 were symmetrical and did not vary between the sexes or age groups in normal Chinese, and are also similar to the results of Western countries.

Coumarins and antiplatelet constituents from the root bark of Zanthoxylum schinifolium

Further study on the chloroform-soluble portion of the root bark of Zanthoxylum schinifolium led to the isolation of eight new coumarins: methylschinilenol (1), hydroxyepoxycollinin I (2), 8-methoxyanisocoumarin H (3), hydroxyschininallylol (4), hydroxyepoxycollinin II (5), schinitrienin (6), schininallylone (7), and isoschinilenol (8), along with twenty-six known compounds including fourteen coumarins, and nine alkaloids. The structural elucidation was determined by spectroscopic data. Among the isolates, terpenyl-coumarins and furoquinolines were the active constituents with antiplatelet aggregation in vitro and collinin (10) showed significant anti-HBC DNA replication activity.