Effect of transpiration on Pb uptake by lettuce and on water soluble low molecular weight organic acids in rhizosphere.

The effect of transpiration (high and low) on Pb uptake by leaf lettuce and on water soluble low molecular weight organic acids (LMWOAs) in rhizosphere has been studied. After two weeks of growth the plants were cultured in greenhouse for more four weeks and two days. Pb(NO(3))(2) solutions of different concentrations (100, 200, and 300 mg l(-1) of Pb) were then added to the quartz sand pots of different plants and studies were initiated. Blank experiments (without treating the quartz sand pots with Pb(NO(3))(2) solutions) were also run in parallel. No significant differences in the growth of the plants with the concentrations of added Pb(NO(3))(2) solutions were observed by both low and high transpirations at the end of the 0, 3rd, and 10th days of studies. The total evaporation of the volatiles during 10 days did not depend on the concentration of Pb(2+) but with high transpiration the rate of evaporation was significantly higher than with low transpiration. Uptake of Pb by shoots and roots of the plants was found to be proportional to the concentration of various Pb(NO(3))(2) solutions added and more accumulation was observed in roots than in shoots at the end of 3rd and 10th days. High transpiration created more Pb uptake than low transpiration did. One volatile acid, propionic acid and nine non-volatile acids, lactic, glycolic, oxalic, succinic, fumaric, oxalacetic, D-tartaric, trans-aconitic, and citric acids in rhizosphere quartz sands were identified and quantified by gas chromatography (GC) analysis. D-Tartaric and citric acids were major among the non-volatile acids. The amount of LMWOAs in rhizosphere quartz sands increased with the higher amount of Pb uptake and also with the duration of studies. The total quantities of the LMWOAs in the rhizosphere quartz sands were significantly higher under high transpiration with 300 mg l(-1) Pb solution addition at the end of 10th day. The present study shows prominent correlation between transpiration and uptake of heavy metal and interesting correlation between Pb contaminated level and quantity of water soluble LMWOAs in rhizosphere quartz sands. The latter thus deserves of further studies.

Prognostic factors and therapeutic outcome of isolated symptomatic middle cerebral artery stenosis.

To analyze the prognostic factors and therapeutic outcome of adult patients with isolated symptomatic stenosis of the middle cerebral artery (MCA). Forty-nine patients were retrospectively verified with isolated symptomatic stenosis of the MCA through both magnetic resonance angiogram and transcranial color-coded duplex sonography. Therapeutic outcome at 1 year or more was determined using a modified Barthel index (BI). For the purpose of analysis, the patients were divided into two groups: a good outcome group (BI > or = 12) and a poor outcome group (BI < 12 or recurrent stroke). The association between different therapeutic regimens and the percent free of recurrent stroke after the first event of cerebral infarction was assessed with Kaplan-Meier plots compared by a log-rank test. These patients accounted for 2.8% of all patients with the first event of cerebral infarction during the same period. At follow-up of 1 year or more, 63% had good outcomes whilst the other 37% had poor outcomes. Overall, 26.5% suffered from recurrent strokes during the follow-up period. According to the statistical analysis, the stepwise logistic regression revealed that only the National Institutes of Health Stroke Scale (NIHSS) at the time of admission was independently associated with a poor outcome. Furthermore, Kaplan-Meier analysis showed a significantly higher percentage of patients free of recurrent stroke events amongst those who were treated with warfarin. The NIHSS at the time of admission was a predictor of outcome amongst our patients, and stenosis of the MCA implies the danger of recurrent cerebral events. Our study also demonstrates the efficacy of oral anticoagulants in the secondary prevention in this specific group of patients. Therefore, we look forward to more prospective multicenter investigations in evaluating the efficiency of therapy in the future.

Guillain-Barré syndrome in southern Taiwan: clinical features, prognostic factors and therapeutic outcomes.

To determine the clinical features, prognostic factors, and therapeutic results of Guillain-Barré syndrome (GBS) in order to improve the therapeutic strategy for this disease. We retrospectively reviewed the electrodiagnostic study and medical records of patients with GBS admitted to Chang Gung Memorial Hospital, Kaohsiung, between January 1986 and December 2000. Outcomes and prognosis were followed-up after 1 year. Ninety-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 77 patients were acute inflammatory demyelinating polyradiculoneuropathy, seven were Miller Fisher syndrome, and six were axonal forms, and six were unclassified. At a follow-up of 1 year, 61 patients (64%) recovered, 30 (31%) had residua and five (5%) died. Amongst these 30 had residua, including unassisted gait in 19, assisted gait in four, and wheel/bed bound in seven. According to the statistical analysis, disabilities at the nadir (P < 0.0001) and at admission (P = 0.014) were significant prognostic factors. Variables used for the stepwise logistic regression, and the results revealed that after analysis for all the above variables, only disability at the nadir (P < 0.0001) was independently associated with the treatment failure rate. Our study revealed 27% of cases in need of respiratory support during hospitalization, and 5% of hospital-treated patients die from the complications. Furthermore, 31% had residua at a follow-up of 1 year or more. If prognostic factors are considered, disability at the nadir during hospitalization demonstrates consistently poor therapeutic outcomes. Therefore, early diagnosis, choice of appropriate treatment, and preventing complications during acute stages are essential to maximize the potential for survival.

Cerebral infarction in perinatal and childhood bacterial meningitis.

BACKGROUND: Cerebral infarction is an important neurological complication of childhood bacterial meningitis, but little is known about its epidemiology and outcomes. AIM: To determine the predictive factors, clinical features, causative pathogens, and outcomes of cerebral infarction secondary to perinatal and childhood bacterial meningitis. DESIGN: Retrospective analysis METHODS: Over the period 1986-2001, 166 perinatal and childhood patients were identified as having culture-proven bacterial meningitis, of whom 14 had cerebral infarction at admission. The clinical and CSF data of patients with and without cerebral infarctions on admission were compared. RESULTS: Cerebral infarction patients accounted for 10% (14/166) of bacterial meningitis cases, mostly in the first year of life (11/14, 79%). Salmonella species (n = 4) and Streptococcus pneumoniae (n = 4) were the most frequent causative pathogens, accounting for 57% (8/14) of episodes. Single infarctions were found in four patients and multiple infarctions in 10. At 1 year follow-up, outcome was good in three, but poor in 11. Significant differences between the two patient groups at admission included age bands, presence of seizures, hydrocephalus, disturbed consciousness on admission, and CSF lactate concentration. DISCUSSION: There was a high prevalence of cerebral infarctions when the disease was caused by S. pneumoniae and Salmonella species. Occurrence was highest in the first year of life, and the prognosis in this patient group is poor. Risk factors associated with cerebral infarction in our patients included age 28-365 days, seizures, hydrocephalus, disturbed consciousness on admission, and high CSF lactate concentrations.

Effect of barrier disruption by acetone treatment on the permeability of compounds with various lipophilicities: implications for the permeability of compromised skin.

The permeability of compromised skin barrier was investigated in vitro using acetone-disrupted hairless mouse skin as a model membrane. The effect of compound lipophilicity was studied using sucrose, caffeine, hydrocortisone, estradiol, and progesterone as model compounds. The results demonstrated that permeability barrier disruption by acetone treatment significantly enhanced the permeability of the skin to both hydrophilic and amphipathic compounds, including sucrose, caffeine and hydrocortisone. This effect was more prominent with caffeine and hydrocortisone at different transepidermal water loss (TEWL) levels. Acetone treatment, however, didn't appear to alter the percutaneous penetration of highly lipophilic compounds, such as estradiol and progesterone. The characteristics of skin permeability were described by parabolic relationships between log P(WS) (permeability coefficient of whole skin) and log K(O/W) (octanol/water partition coefficient) at different degrees of permeability barrier disruption. The optimal log K(O/W) of compounds for skin penetration appeared to decrease with an increase in TEWL levels. The maximal permeability achieved was similar through skin displaying different TEWL levels. In an attempt to explore the underlying mechanisms for the changes in skin permeability, the stratum corneum/normal saline partition coefficients of water, caffeine, and hydrocortisone either decreased or remained unaffected with an increase in TEWL. Electron microscopic examinations have revealed reductions in stratum corneum lipid content and alterations in intercellular membrane structures as a result of acetone treatment, whereas negligible changes in the number of horny layers were observed by safranin staining of the stratum corneum. We have concluded that the enhancement in skin permeability to both hydrophilic and amphipathic compounds by acetone treatment arose mainly because of the increase in stratum corneum diffusivity at higher TEWL levels. The results imply the possibility of using both TEWL and drug lipophilicity to predict alterations in skin permeability and hence the dose adjustment of topically applied medication for patients with impaired skin barrier function.

Molecular weight dependence of polyethylene glycol penetration across acetone-disrupted permeability barrier.

Previous studies have demonstrated that permeability barrier disruption by acetone treatment significantly enhances skin permeability to both hydrophilic and amphipathic compounds, but not to highly lipophilic compounds. The purpose of the present study was to investigate the dependence of permeability on molecular weight (MW) in acetone-disrupted hairless mouse skin in contrast to normal skin. Penetration of polyethylene glycol (PEG) 300, 600, and 1,000 over 12 h was measured using diffusion cells. High-performance liquid chromatographic methods with refractive index detection were used to separate and quantitate the individual oligomeric species in the PEG samples. Percutaneous penetration of PEGs exhibited slightly steeper MW dependency at a transepidermal water loss (TEWL) of 30-41 g/m2 per h in comparison with TEWLs of 0-10 (control skin), 10-20, and 20-30 g/m2 per h, with a higher percentage of smaller oligomer PEGs penetrating than larger ones. Increasing the TEWL of the skin increased the penetration of all the PEG oligomers, and the degree of the enhancement relative to penetration through control skin increased with MW and was maximal for oligomers with a MW ranging from 326 to 414 Da. Within the limit of quantitation of the assay, the MW cut-off for PEG penetration across mouse skin with TEWLs of 0-10, 10-20, and 20-30 g/m2 per h was 414, 590, and 942 Da, respectively, while all the measurable oligomers up to MW 1,074 Da were able to penetrate skin with TEWLs in the range 30-41 g/m2 per h. The results suggest that not only higher amounts but also more varieties of chemicals may penetrate skin with a compromised barrier than normal skin, implying a higher risk of intoxication and hypersensitization by environmental agents through diseased skin with impaired barrier function.

Hepatic focal nodular hyperplasia in children: report of three cases.

Hepatic focal nodular hyperplasia is very rare in children. We present 3 cases aged from 8 to 17 years. All of them are girls, none of whom used oral contraceptives. Case 1 was a hepatitis B carrier and was incidentally found to have focal nodular hyperplasia (FNH). The other 2 cases presented with abdominal pain. Abdominal computed tomography revealed a solitary liver tumor in cases 2 and 3, but no abnormalities in case 1. A 7-cm tumor was located in the left lobe of the liver with compression of the stomach in the 2nd case. Abdominal magnetic resonance imaging (MRI) showed a mass with isointense density to liver parenchyma on T1WI and hyperdensity on T2WI in the 1st and the 3rd cases. The inferior vena cava was compressed and displaced anteriorly in the 1st case. Because of differences in the clinical presentation and imaging studies, the 1st and 2nd cases received resection while the 3rd case was treated conservatively. Pathologic findings confirmed the diagnosis of focal nodular hyperplasia in all 3 cases. We emphasize the importance of an MRI scan in the diagnosis of hepatic focal nodular hyperplasia, and different clinical manifestations and imaging studies may lead to different management.

Interferon-inducibility is diminished in tumour-bearing mice.

Inducibility of interferons was studied in tumour-bearing mice. Using five different transplantable tumour-models, diminishing of interferon-inducibility was revealed during tumour progression, irrespectively of the tumour-model used. Diminishing of interferon-inducibility runs parallel with development of the tumours.