Gonorrhea infection increases the risk of prostate cancer in Asian population: a nationwide population-based cohort study.

This nationwide population-based retrospective cohort study evaluated the risk of developing prostate cancer among patients with gonorrhea. We identified cases of newly diagnosed gonorrhea in men between 2000 and 2010 from the Taiwan National Health Insurance Research Database. Each patient with gonorrhea was matched to four controls, based on age and index year. All subjects were followed up from the index date to December 31, 2010. The Cox proportional hazards regression model was used to assess the risk of prostate cancer. A total of 355 men were included in the study group, and 1,420 age-matched subjects without gonorrhea were included in the control group. After adjusting for age, comorbidities, urbanization level, hospital level, and monthly income, gonorrhea was significantly associated with an increased risk of prostate cancer (adjusted hazard ratio = 5.66, 95% confidence interval = 1.36-23.52). Men aged 45-70 years and those with lower monthly income were more strongly associated with prostate cancer in the study group than the control group. The higher risk for developing prostate cancer were also found in those without syphilis, without genital warts, without diabetes mellitus, without chronic obstructive pulmonary disease, without benign prostatic hypertrophy, without chronic prostatitis, and without alcoholism. The Kaplan-Meier analysis showed the risk of prostate cancer was significantly higher in the study group than in the control group. Gonorrhea may be involved in the development of prostate cancer. More intensive screening and prevention interventions for prostate cancer should be recommended in men with gonorrhea.

Hemodynamic changes during the anhepatic phase in pediatric patient with biliary atresia versus glycogen storage disease undergoing living donor liver transplantation.

OBJECTIVE: The aim of this study was to compare the hemodynamic changes caused by clamping of the inferior vena cava and portal vein in biliary atresia (BA) versus glycogen storage disease (GSD) patients undergoing living-donor liver transplantation (LDLT) without venovenous bypass. METHODS: We reviewed retrospectively the anesthesia charts of pediatric LDLT patients. Age, weight, height, blood loss, blood product use and fluid replacement between groups were compared with Mann-Whitney test, and systolic blood pressure (SBP), heart rate (HR), central venous pressure (CVP) before clamping of the inferior vena cava, and 4 measurements during anhepatic phase and 5 minutes after reperfusion were compared with analysis of variance. RESULTS: One hundred four BA patients (GI) and 12 GSD patients (GII) showed mean total blood loss among GI to be more than among GII, but the blood products and crystalloids infused during the operation were not significantly different. The changes of SBP, HR, and CVP after clamping of the IVC were significantly different between groups. CVP of GII was lower than GI, indicating that venous return among GII was more affected, subsequently showing lower SBP and higher HR. CONCLUSIONS: Total clamping of the inferior vena cava resulted a greater decrease in CVP in GII with subsequently lower SBP and faster HR compared with GI.

Right axillosubclavian vein thrombosis resolved by percutaneous rheolytic thrombectomy in a patient with a recurrent gastrointestinal stromal tumour undergoing imatinib mesylate treatment.

The manifestation and management of spontaneous axillosubclavian vein thrombosis in patients with gastrointestinal stromal tumour (GIST) undergoing oral chemotherapy have never been described. We report a patient with a recurrent GIST who was receiving maintenance imatinib yet developed a right axillosubclavian vein thrombotic occlusion. The occluded vein was unresponsive to systemic anticoagulation but was reopened by percutaneous rheolytic thrombectomy and has shown good long-term patency. Thus, for patients with recurrent GIST undergoing imatinib therapy, axillosubclavian vein thrombosis might manifest as a complication and could be managed with rheolytic thrombectomy, which thoroughly removes intravascular thrombus and effectively re-vascularizes the thrombosed vessel uneventfully.

Directed migration of Ascogregarina taiwanensis (Apicomplexa: Lecudinidae) in its natural host Aedes albopictus (Diptera: Culicidae).

Directed migration of trophozoites from the midgut toward the Malpighian tubules is essential for Ascogregarina taiwanensis (Apicomplexa: Lecudinidae) to complete its developmental cycle within the natural host Aedes albopictus. We have obtained a 275-bp actin cDNA fragment amplified from extracted mRNAs of migrating trophozoites, suggesting the involvement of actin in trophozoite motility. Down-regulation on the migration of the trophozoite was seen in mosquito larvae fed with cytochalasin D, ML-7, and BDM, indicating that myosin, in the form of an actomyosin system, may also be involved in driving motility of the trophozoite. The "protruding apparatus" (PA) formed at the anterior end of trophozoites during the migrating stage had significant deposits of actin by immunofluorescent microscopy. Moreover, PA formation was enhanced in response to elevated levels of 20-hydroxyecdysone (20-HE) in cultures of alimentary canals in which the trophozite was contained. Thus, 20-HE may also promote expression of actin and perhaps myosin simultaneously.

Development of systemic immunologic responses against hepatic metastases during gene therapy for peritoneal carcinomatosis with retroviral HS-tk and ganciclovir.

Gene therapy with retroviral mediated gene transfer of the herpes simplex thymidine kinase (HS-tk) gene into a tumor mass confers sensitivity of the tumor cells to ganciclovir (GCV). Tumor-specific immunologic responses may develop following treatment of the primary tumor with retroviral HS-tk and GCV. In the present study we assessed whether GCV treatment of HS-tk transduced colon cancer (TK+) implanted in the peritoneal cavity induced a systemic antitumor response that would inhibit growth of a second wild-type (TK-) tumor implanted in the liver. DHDK12 rat colon cancer cells were transduced in vitro with the retroviral HS-tk vector and established as a permanent cell line (TK+ cells). TK+ or TK- DHDK12 cells (6x10(6) cells) were injected intraperitoneally on day 0 into BD-IX rats. On day 10, TK- cells (3x10(6) cells) were injected into the liver in all the groups. The animals were then treated with GCV (150 mg/kg) for 13 days. TK+ peritoneal tumors underwent significant regression during therapy with GCV (0.05+/-0.004 g; n=7) compared to wild-type (TK-) tumors (2.2+/-0.7g; n=6) (P<0.05). The volume of TK- tumors in the liver was significantly lower in GCV-treated rats with TK+ peritoneal tumors (12.5+/-8.3 mm3) compared to rats with TK- peritoneal tumors (96.7+/-18.1 mm3) (P<0.05). Histology of the liver tumors in the TK+ groups showed a dense monocytic infiltrate with fibrosis and only occasional viable tumor cells. Gene therapy with retroviral HS-tk vectors may provide a novel approach to treatment of gastrointestinal cancer by both direct cytotoxicity and an indirect mechanism that may include enhanced immuno logic responses against disseminated disease.

Dose-response relationship between ischemic heart disease mortality and long-term arsenic exposure.

The cardiovascular effects of inorganic arsenic have been documented, but the dose-response relationship between ischemic heart disease (ISHD) and long-term arsenic exposure remains to be elucidated. Mortality rates from ISHD among residents in 60 villages of the area in Taiwan with endemic arseniasis from 1973 through 1986 were analyzed to examine their association with arsenic concentration in drinking water. Based on 1 355 915 person-years and 217 ISHD deaths, the cumulative ISHD mortalities from birth to age 79 years were 3.4%, 3.5%, 4.7%, and 6.6%, respectively, for residents who lived in villages in which the median arsenic concentrations in drinking water were <0.1, 0.1 to 0.34, 0.35 to 0.59, and > or = 0.6 mg/L. A cohort of 263 patients affected with blackfoot disease (BFD), a unique arsenic-related peripheral vascular disease, and 2293 non-BFD residents in the endemic area of arseniasis were recruited and followed up for an average period of 5.0 years. There was a monotonous biological gradient relationship between cumulative arsenic exposure through drinking artesian well water and ISHD mortality. The relative risks were 2.5, 4.0 and 6.5, respectively, for those who had a cumulative arsenic exposure of 0.1 to 9.9, 10.0 to 19.9, and > or = 20.0 mg/L-years compared with those without the arsenic exposure after adjustment for age, sex, cigarette smoking, body mass index, serum cholesterol and triglyceride levels, and disease status for hypertension and diabetes through proportional-hazards regression analysis. BFD patients were found to have a significantly higher ISHD mortality that non-BFD residents, showing a multivariate-adjusted relative risk of 2.5 (95% CI, 1.1 to 5.4).

[Changes of arterial oxygen tension in supine position during one-lung anesthesia].

BACKGROUND: One-lung ventilation during anesthesia (one-lung anesthesia) in patients under lateral decubitus position to help performing intra-thoracic surgical procedures was well known to have larger alveolar-to-arterial oxygen tension difference and lower arterial oxygen tension (PaO2) as compared to two-lung ventilation. In the present study, we investigate the changes of arterial oxygen tension in the supine position during one-lung anesthesia. METHODS: Forty-two patients of palmar hyperhidrosis, ASA class I-II, scheduled to receive bilateral transthoracic endoscopic sympathectomy were studied. After anesthetic induction (fentanyl, thiopental, and succinylcholine), a 35 (for female) or 37 (for male) French left-sided Robertshaw double-lumen endobronchial tube was intubated. Anesthesia was maintained with isoflurane 1.0-1.5% and 50% O2-N2O. They were changed to isoflurane 1.5-2.0% and 100% O2 during one-lung ventilation. Once the surgical operation is completed, they were changed to 100% O2 and two-lung ventilation. Arterial blood gases were measured at 4 phases: 5 min after endobronchial intubation (two-lung ventilation), 5 min after left one-lung ventilation, 5 min after right one-lung ventilation, and 5 min after accomplishing operation (two-lung ventilation). RESULTS: The results showed PaO2 were significantly lower in left and right one-lung ventilation with 100% O2 as compared with that obtained from two-lung ventilation with 50% O2 5 min after endobronchial intubation (p < 0.05). Furthermore, right one-lung ventilation had a lower PaO2 than left one-lung ventilation (p < 0.05). CONCLUSIONS: We conclude that arterial oxygen tension can be safely maintained during one-lung anesthesia with pure oxygen in healthy patients lying in a supine position.

[The effect of needleless electroacupuncture in general anesthesia during laparoscopic surgery].

BACKGROUND: Three kinds of pain-relieving substances, namely, endorphins, enkephalins and dynorphins, can be released by stimulating the relevant acupoints with the dense-disperse mode of nerve stimulator. The neurochemical mechanisms of pain relief by acupoint stimulation have been widely studied and proved. In the present study, we investigated the modulatory effect of needleless electroacupuncture on the inhaled general anesthesia during laparoscopic surgery. METHODS: Forty gynecologic patients of ASA class I-II status, scheduled for elective laparoscopic surgery, were randomly allocated to study and control groups. Induction and intubation were performed in the same fashion and anesthesia was maintained with inhaled general anesthetics: 50% N2O in oxygen and isoflurane, which was adjusted to keep the hemodynamic changes within +/- 10% of their preoperated level. HANS (LY 257), a special nerve stimulator with 2 Hz and 100 Hz dense-disperse wave, was used to stimulate the bilateral Yang Ling Chuan (G34), Zusanli (S36) acupoints in patients of the study group during the surgery. RESULTS: We found that needleless electroacupuncture significantly lowered the volume concentration of isoflurane from 1.0 +/- 0.33% to 0.74 +/- 0.19% (p < 0.05) at 30 min after the start of operation. Furthermore, it also significantly shortened the recovery time from 11.4 +/- 3.3 min to 8.8 +/- 3.2 min (p < 0.05). CONCLUSIONS: Under general anesthesia, the application of needleless electroacupuncture can reduce the volume concentration of isoflurane and shorten the post-anesthetic recovery time during laparoscopic surgery.

Incidence of internal cancers and ingested inorganic arsenic: a seven-year follow-up study in Taiwan.

In order to elucidate the dose-response relationship between ingested inorganic arsenic and internal cancers, a total of 263 patients with blackfoot disease and 2293 healthy residents in the endemic area of arseniasis were recruited and followed up for 7 years. The information on consumption of high-arsenic artesian well water, sociodemographic characteristics, life-style and dietary habits, and personal and family history of cancers was obtained through standardized interviews. The occurrence of internal cancers among study subjects was determined through annual health examinations, home visit personal interviews, household registration data checks, and national death certification and cancer registry profile linkages. A dose-response relationship was observed between the long-term arsenic exposure from drinking artesian well water and the incidence of lung cancer, bladder cancer, and cancers of all sites combined after adjustment for age, sex, and cigarette smoking through Cox's proportional hazards regression analysis. Blackfoot disease patients had a significantly increased cancer incidence after adjustment for cumulative arsenic exposure.

Nuclear regulation of HLA class I genes in human trophoblasts.

PROBLEM: Human trophoblast expression of class I human leukocyte antigen (HLA) genes is unique in that there is no classical gene expression, but nonclassical HLA-G is expressed and only by cytotrophoblast cells. This differential expression of classical versus nonclassical class I genes suggests tissue specific regulation. Recently, a negative regulatory element (NRE), 180 bp 5' to transcription initiation was identified in a murine embryonal carcinoma cell line that markedly inhibited class I gene expression (Flanagan et al., Proc Natl Acad Sci USA 1991; 83:3145-3149). METHOD: Here we analyzed the human HLA-A2 gene for a putative NRE sequence and determined whether such a sequence is capable of binding to factors present in a variety of class I-null cell lines. RESULTS: Sequence analysis revealed that the NRE for human HLA-A2 is identical to that for mouse H-2Ld. Using gel shift assays with nuclear extracts (NE) from a variety of cell types, we demonstrated specific binding to the HLA-A2 NRE sequence. The choriocarcinoma cell lines JEG and BeWo and the F9 cells (all negative for classical gene expression) contained this DNA binding factor(s). This binding factor was not present in NE from lymphocytes or a variety of other cell lines that were positive for classical gene expression. CONCLUSION: Human trophoblasts appear to have a tissue specific nuclear binding factor that may down regulate classical class I expression upon binding to the NRE sequence. The HLA-G gene does not have this NRE region thus enabling its expression by these cells.

Expression of the nonclassic histocompatibility antigen HLA-G by preeclamptic placenta.

OBJECTIVE: Expression of the histocompatibility antigen HLA-G may be required for appropriate invasion and remodeling of uterine spiral arteries. Inappropriate expression of this antigen may result in failure of invasion, leading to partial placental ischemia and gestational disease. STUDY DESIGN: To test the hypothesis that the level of expression of HLA-G is reduced in trophoblasts from patients with gestational complications (preeclampsia, intrauterine growth retardation, or gestational hypertension) compared with patients with normal pregnancy, total ribonucleic acid was isolated from the fetal membrane or decidual interface of term placenta from several patient groups. Ribonuclease protection assay was used to determine levels of HLA-G expression, which was normalized for total ribonucleic acid input with beta-actin and for trophoblast content in the tissue by cytokeratin 8. RESULTS: When normalized for total ribonucleic acid input (beta-actin), term placental expression of HLA-G was reduced for all forms of preeclampsia but not for intrauterine growth retardation or gestational hypertension. When tissue expression of cytokeratin, an indicator of trophoblast input, was normalized for trophoblast input, was normalized for total ribonucleic acid input, primary preeclampsia and intrauterine growth retardation had reduced numbers of trophoblast per unit tissue. When controlled for trophoblast input HLA-G expression was similar to normal for all clinical groups, except for intrauterine growth retardation, which was slightly increased. CONCLUSION: Level of expression of HLA-G in placental tissue was reduced in preeclampsia. This decrease in expression appears to be related to reduced numbers of trophoblasts in placental tissue examined at term from patients with primary preeclampsia.

Detection of human leukocyte antigen class I messenger ribonucleic acid transcripts in human spermatozoa via reverse transcription-polymerase chain reaction.

OBJECTIVE: To determine by reverse transcription-polymerase chain reaction (PCR) whether human leukocyte antigen (HLA) class I messenger RNA (mRNA) is present in mature human spermatozoa. DESIGN: Mature human spermatozoa was isolated from donor semen using a swim-up technique. Total RNA was extracted via guanidinium isothiocyanate-cesium chloride ultracentrifugation. By the method previously validated in our laboratory, reverse transcription-PCR was performed using primers specific for HLA class I transcripts. Positive control cells included a choriocarcinoma cell line (JEG) and human fetal tissue. Transformed peripheral blood lymphocytes (PBL) were used as a negative control for somatic cellular contamination. RESULTS: Human spermatozoa were positive for HLA class I (-G and -B) mRNA by reverse transcription-PCR, consistent with the positive controls. We did not detect any mRNA for beta-actin, retinoblastoma (RB), CD4, or kappa light chain genes in the sperm complementary DNA samples, verifying that the class I mRNA detected was not due to somatic cellular contamination of the purified sperm samples. CONCLUSION: These experiments provide the first evidence that mRNA for HLA class I molecules are present in mature human spermatozoa. The physiological role of these transcripts is unknown at present. Further experiments characterizing the expression of HLA class I (-G and -B) mRNA in oocytes and preimplantation embryos are in progress.

Human placental lactogen directly inhibits rat cartilage growth processes in vivo and in vitro.

We have recently reported that human placental lactogen inhibits the growth of young female rats without changing the serum levels of insulin like growth factor-I. Accordingly, experiments were conducted to determine whether human placental lactogen could directly inhibit cartilage growth processes in vivo and in vitro. Osmotic minipumps with attached polyethylene catheters were used to infuse the hormone for seven days into the left hindlimb of three-month-old female rats via the common iliac artery. The right hindlimb of each animal served as an internal control. Infusion of the placental lactogen at 10 micrograms/rat/day caused a slight (10%) but significant decrease in the width of the tibial epiphysial cartilage plate and a higher dose (100 micrograms/rat/day) caused a greater degree of inhibition (25%). However, the higher dose also inhibited the tibial cartilage plate of the contralateral (non-infused) limb. The possibility that human placental lactogen could directly inhibit cartilage anabolic activity in vitro was evaluated by measuring the incorporation of 35SO4 into costal cartilage explants from three to four-month-old female rats. The placental hormone inhibited the incorporation of 35SO4 in a dose-related manner at concentrations ranging from 1.0 to 100 micrograms/l. As a test of the specificity of this inhibition the effect of the hormone on the incorporation of 35SO4 into cartilage explants from Coho salmon was determined. The placental lactogen did not affect incorporation of the sulfate into the fish cartilage over a range of doses from 1.0 to 1000 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Human placental lactogen inhibits growth without changing serum levels of IGF-1 in rats: an apparent specific action of the hormone.

Previous work in our laboratory has shown that the internal environment of rats has reduced growth-promoting activity during the second half of gestation and this condition is associated with resistance to the anabolic effects of GH. The placenta appears to be responsible for this condition but injections of estradiol plus progesterone into virgin females did not mimic it. Accordingly, it seemed worthwhile to test the effects of a placental lactogen (PL) for possible growth inhibitory effects. In the present study the effects of human (h)PL on skeletal growth in young female rats and on the growth of embryonic tissue transplants under their kidney capsules were investigated. Human (h) and bovine (b) GH, and ovine prolactin (oPRL) were also tested to determine whether the results obtained with hPL were specific. Twice daily subcutaneous injections of a high dose of hPL (10 mg/day), but not of oPRL (5 mg/day) for 7 days inhibited both host tail growth and tibial epiphyseal plate width, and growth of whole 10-day embryo transplants. Injections of hGH at 1 mg/day for 8 days significantly increased host skeletal growth and growth of 12-day embryonic head transplants; at the same dose, neither bGH nor oPRL affected growth of the embryonic heads or of the host tibial epiphyseal plate width, but the bGH increased host tail growth. By contrast, the 1 mg/day dose of hPL significantly reduced the host's tibial epiphyseal plate width, tail growth, and transplant growth; lower doses of hPL (10 and 100 micrograms/day) were also inhibitory.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration of growth hormone to pregnant rats on a reduced diet inhibits growth of their fetuses.

During gestation, female rats become resistant to the anabolic actions of GH. The importance of this resistance for conceptus growth was investigated by treating pregnant dams on a reduced diet with ovine (o) or bovine (b) GH during days 10-20 of gestation. Reducing food intake to 60% that of ad libitum-fed controls significantly depleted maternal inguinal fat stores by day 20 of gestation, but it did not affect the growth of the fetuses or the placentas. In the food-restricted dams, twice daily injections of oGH (1 mg/day) or bGH (5 mg/day) during days 10-20 of gestation increased their inguinal fat pad wet weight by 28% and 62%, respectively, but had no effect on the wet weight of maternal heart, liver, or spleen. The dams treated with bGH had significantly heavier kidneys than the PBS- or oGH-treated females. On day 20 of gestation, control animals fed a 60%-diet had total serum insulin-like growth factor-I levels that were depressed to the same extent as those in ad libitum fed dams (i.e. to about 25% of the levels in nonpregnant females). Both the oGH and bGH treatments significantly elevated maternal serum insulin-like growth factor-I to 42% and 300%, respectively, of the levels in the untreated underfed dams. Compared to virgin controls, maternal tibial epiphyseal plate width was also significantly diminished in dams fed ad libitum or a 60% diet. Nevertheless, oGH and bGH were effective at augmenting maternal tibial epiphyseal plate width to equal those in virgin controls. Both doses of GH significantly reduced placental and fetal weights compared to those of PBS-injected dams on a 60% diet, and dams treated with the higher dose of GH were in an advanced stage of fetal and placental resorption by day 20 of gestation. Thus, maternal resistance to the anabolic actions of GH appears to be an important adaptation for diverting nutrients from the mother to the fetus.

Incisión transuretral de prostata: informe preliminar y protocolo inicial. / Transuretheral incision of the prostate: preliminary report and first protocol

Se informa de protocolo prospectivo y randomizado de la incisión transuretral de prostata (I.T.U.P.) como método alternativo de tratamiento de uropatía obstructiva por adenoma prostático pequeño. Los resultados a largo plazo se someterán a evaluación crítica

Factors affecting the production of amphotericin A.

Factors affecting amphotericin A synthesis of Streptomyces nodosus, NDMC-034 were studied. Iron, magnesium and manganese were found to stimulate amphotericin A synthesis at concentrations ranging from 10-100 microM. The optimum inoculum size, and the pH of production medium before sterilization for producing amphotericin A, were found to be near 10% (v/v) and pH 7.8, respectively. Carrying out fermentation in a complex medium using pharmamedia as nitrogen source resulted in an amphotericin A yield of up to 3.4 g/liter. A novel isolation and purification process for amphotericin A from the fermentation broth was developed, using an extracting isopropyl alcohol and methanolic solution containing 2% CaCl2. Amphotericin A exhibits a much lower acute toxicity in mice than amphotericin B.