Hydrogen production from formic acid solution by modified TiO2 and titanate nanotubes in a two-step system under visible light irradiation.

Hydrogen gas is one of the most promising renewable energy sources, and the final product of hydrogen combustion is nothing but water. However, it is still a big challenge to produce hydrogen and store it. Many studies have been conducted into produce hydrogen from water using photocatalysts. Z-scheme photocatalysis is a two-photocatalyst system that comprises a hydrogen catalyst and an oxygen catalyst to produce hydrogen and oxygen respectively. Compared to the one-step system, the two-step system can promote the efficiency of water splitting. In addition, formic acid (FA) is a convenient hydrogen-storage material and can be safely handled in aqueous solutions. Therefore, this study investigated the photocatalytic conversion of FA solution to hydrogen using visible light with several types of hydrogen catalysts (CdS/titanate nanotubes (TNTs), CdS/TiO2, Pt/CdS/TNTs) and WO3 as the oxygen catalyst. The results showed that the yield of hydrogen with CdS/TNTs + WO3 was much higher than with CdS/TiO2 + WO3. Moreover, coating the photocatalysts with metal could further promote the reaction. The optimal platinum loading was 0.01 wt%, and the hydrogen production achieved was 852.5 µmol · h(-1) with 20 vol% FA solution.

A randomised double-blind controlled study evaluating the hypothermic effect of 150 microg morphine during spinal anaesthesia for Caesarean section.

We studied the hypothermic effect of adding 150 microg morphine during spinal anaesthesia in 60 parturients scheduled for elective caesarean section. All the parturients received intrathecal injection of a solution containing 150 mug morphine or normal saline in addition to 10-12 mg hyperbaric bupivacaine 0.5%. In both groups, a significant decrease in body temperature was noted. There was no difference in the area under the curve for temperature against time for the two groups; however, the maximum decrease in temperature from baseline was significantly larger after morphine than after saline injection (mean (SD) 1.11 (0.61) degrees C vs 0.76 (0.39) degrees C, respectively; p = 0.01) and the time to nadir temperature was significantly longer (59.5 (17.6) min vs 50.4 (15.9) min, respectively; p = 0.047). The lowest temperature observed in the morphine group was 34.3 degrees C. We conclude that intrathecal injection of 150 microg morphine intensified the intra-operative hypothermic effect of bupivacaine spinal anaesthesia for caesarean section.

Preoperative plasma N-terminal pro-brain natriuretic peptide as a marker of cardiac risk in patients undergoing elective non-cardiac surgery.

BACKGROUND: Plasma N-terminal pro-brain natriuretic peptide (NTproBNP) is a sensitive marker for heart failure. This study tested whether the preoperative plasma level of NTproBNP could predict cardiac complications in patients undergoing non-cardiac surgery. METHODS: A total of 190 consecutive patients who underwent elective non-cardiac surgery that required general anaesthesia were studied. In addition to routine preoperative evaluation, a blood sample was taken for estimation of plasma NTproBNP concentration. Postoperative cardiac complications were defined as cardiac death, acute coronary syndrome, heart failure and haemodynamic compromise from cardiac arrhythmias. RESULTS: Fifteen of the 190 patients had a cardiac complication: four had acute coronary syndrome and 13 had congestive heart failure. NTproBNP concentration was significantly higher in patients with a cardiac complication; a level greater than 450 ng/l was predictive of cardiac complications with a sensitivity of 100 per cent and a specificity of 82.9 per cent. Other factors associated with cardiac complications were a higher American Society of Anesthesiologists grade, age and clinical cardiac impairment, but in a multivariate analysis NTproBNP level was the only independent factor. CONCLUSION: Preoperative plasma NTproBNP concentration may be an independent predictor of cardiac complications in patients undergoing non-cardiac surgery.

The addition of morphine prolongs fentanyl-bupivacaine spinal analgesia for the relief of labor pain.

UNLABELLED: The combination intrathecal fentanyl (25 microg) and bupivacaine (2.5 mg) provides effective labor analgesia for approximately 90 minutes. The purpose of this prospective, randomized, double-blinded investigation was to determine if the addition of morphine (150 microg) to the intrathecal combination of fentanyl (25 microg) and bupivacaine (2.5 mg) would prolong labor analgesia. By using the combined spinal epidural technique, 95 healthy primiparous laboring women in early labor received 2 mL of one of the two intrathecal study solutions, either FB (n = 48): fentanyl (25 microg) and bupivacaine (2.5 mg); or FBM (n = 47): fentanyl (25 microg) and bupivacaine (2.5 mg) plus morphine (150 microg). The mean duration of labor analgesia was significantly longer in the FBM group than in the FB group (252 +/- 63 min vs 148 +/- 44 min, P < 0.01). There were no significant differences between the two groups regarding the sensory levels, the incidence of nausea, vomiting, pruritus, hypotension, or operative delivery. In conclusion, the addition of 150 microg of morphine to the intrathecal combination of fentanyl plus bupivacaine prolonged the duration of labor analgesia duration without increasing adverse effects. IMPLICATIONS: The addition of morphine (150 microg) to intrathecal fentanyl (25 microg) and bupivacaine (2.5 mg) prolongs the duration of labor analgesia duration without increasing adverse effects.

Prophylactic intravenous ondansetron reduces the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery.

UNLABELLED: Pruritus is a common side effect of intrathecal morphine injection for postoperative pain control. Its incidence is especially high in patients undergoing cesarean delivery. We investigated the effectiveness of ondansetron in preventing intrathecal morphine-induced pruritus in such patients. We included 60 consecutive nonbreastfeeding women who were scheduled for elective cesarean delivery. After the administration of spinal anesthesia with bupivacaine and intrathecal morphine 0.15 mg injection, the patients were randomly divided into three groups. Group 1 received placebo (normal saline) IV injection, Group 2 diphenhydramine 30 mg IV injection, and Group 3 ondansetron 0.1 mg/kg IV injection. The incidence of pruritus was significantly lower in the ondansetron group (25%) when compared with that in the placebo group (85%) and in the diphenhydramine group (80%) (both P < 0.05). The postoperative pain score and time to flatus passage were not significantly different among the three groups. There were no headache or extrapyramidal signs associated with ondansetron use. In conclusion, ondansetron prophylaxis significantly reduced the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery. IMPLICATIONS: Ondansetron prophylaxis significantly decreases the incidence of pruritus, a common side effect of intrathecal morphine used to treat postcesarean delivery pain.

Anesthetic management for cesarean section in a pregnant woman with impending acute liver failure--a case report.

Acute liver failure includes a constellation of clinical conditions resulting from rapid loss of hepatocyte function. The anesthesiologist may often be asked to anesthetize a patient with acute liver failure before the etiological entity of disease can be completely clarified. Most of the previous reports were concentrated in obstetric or hepatological periodicals. Reports about anesthesia for such patients are scanty. We present a case about a near term pregnant woman with a complication diagnosed as impending acute liver failure, who received total intravenous anesthesia for emergent cesarean section. Pros and cons of different anesthetic techniques for this condition are discussed.

Usefulness of intravenous propofol anesthesia for radiofrequency catheter ablation in patients with tachyarrhythmias: infeasibility for pediatric patients with ectopic atrial tachycardia.

General anesthesia is sometimes required during radiofrequency catheter ablation (RFCA) of various tachyarrhythmias because of an anticipated prolonged procedure and the need to ensure stability during critical ablation. In this study, we examine the feasibility of using propofol anesthesia for RFCA procedure. There were 150 patients (78 male, 72 female; mean age 30 years, range 4-96 years) in the study. Electrophysiologic study was performed before and during propofol infusion in the initial 20 patients and was performed only during propofol infusion in the remaining 130 patients. In the initial 20 patients, propofol infusion increased the sinus rate and facilitated AV nodal conduction. The accessory pathway effective refractory period, as well as the sinus node recovery time, atrial effective refractory period, and ventricular effective refractory period were not significantly changed. There were 152 tachyarrhythmias in 150 patients (24 atrial flutter, 31 AV nodal reentrant tachycardia, 68 AV reciprocating tachycardia, 12 ventricular tachycardia, and 17 atrial tachycardia). Most (148/152) tachycardias remained inducible after anesthesia and RFCA was performed uneventfully. However, in four of the seven pediatric patients with ectopic atrial tachycardia, the tachycardia terminated after propofol infusion and could not be induced by isoproterenol infusion. Consequently, RFCA could not be performed. Intravenous propofol anesthesia is feasible during RFCA for most tachyarrhythmias except for ectopic atrial tachycardia in children.

Rheumatoid factor in hepatitis B virus surface antigen positive patients.

Rheumatoid factor (RF) is often found in the sera of patients with nonrheumatic diseases in comparison with normal individuals. We collected 95 healthy HBs antigen positive adults and 98 healthy HBs antigen negative adults. RF was present in 14.74% (14/95) of the HBs antigen positive group while it was present in 3.06% (3/98) of the HBs antigen negative group (p < 0.05). RF was positive in 15.38% (2/13) of the HBe antigen positive patients whereas it was positive in 14.63% (12/82) of the HBe antigen negative patients (p > 0.05). RF was found positive in 16.90% (12/71) of the anti-HBe antibody positive group while it was positive in 8.33% (2/24) of the anti-HBe antibody negative group (p > 0.05). We conclude that the positive rate of RF in HBs antigen positive patients is significantly higher than in that of HBs antigen negative patients. The incidence of RF positivity of the HBe antigen positive group is not higher than that of the HBe antigen negative group. The positive rate of RF in anti-HBe antibody positive group has a tendency to be higher than in that of their negative counterparts though there was no significant difference between them.

Prevalence of familial systemic lupus erythematosus in Taiwan.

A survey of familial occurrence of systemic lupus erythematosus (SLE) was conducted among 728 first-degree relatives of 102 SLE patients. All of the patients were from the rheumatology ward or outpatient clinic of Kaohsiung Medical College. Ten familial members (9.80%) in the 102 patients with SLE suffered from the same disease. Among them, one (20%) was from the 5 male patient families and 9 (9.28%) were from the 97 female patient families. The overall prevalence of SLE in first-degree relatives of SLE patients was 1.37% (10/728).

Behçet's disease with inferior vena cava occlusion--a case report.

Behçet's disease is a chronic relapsing inflammatory process affecting mucocutaneous, ocular, intestinal, articular, vascular, urogenital, and neurologic systems. Vascular lesions include superficial thrombophlebitis, large vein thrombosis and arterial aneurysm. The underlying pathologic feature was thought to be vasculitis. We report a case of a 37-year-old male patient suffering from frequent attacks of leg swelling and tenderness. Progressive engorgement of abdominal superficial veins was observed. Venography demonstrated evidence of deep vein thrombosis in both limbs. MRI of the abdomen showed thrombosis of the inferior vena cava with collateral circulation. The above symptoms improved after treatment.

Immunoglobulin and T cell receptor beta chain gene rearrangements and Epstein-Barr viral DNA in tissues of Hodgkin's disease in Taiwan.

Nineteen patients with Hodgkin's disease (HD), representing 4 different subtypes, were examined for immunophenotype and immunogenotype. Quantitative immunophenotypic analysis of 13 cases revealed a predominance of Leu1 and Leu3 T cells in all subtypes, except in the case of HD lymphocytic-depression (HDLD). The positive rate of LeuM1 and Ki1 in Reed-Sternberg (RS) cells was 65% (11/17) and 73% (11/15), respectively. In DNA hybridization analysis, 5 of the 19 cases of HD were found to have gene rearrangements--immunoglobulin (Ig) gene rearrangements in 3 cases and T cell receptor beta chain (TCR beta) gene rearrangements in 2 cases. Epstein-Barr (EBV) DNA genomes were detected in 8 cases, including 2 of 5 cases which previously had been shown to contain clonal Ig and TCR beta gene rearrangements. By contrast, there were no detectable cytomegalovirus (CMV) DNA sequences in 19 cases of HD or 30 cases of non-Hodgkin's lymphoma (NHL). Although our findings differed somewhat from those obtained on Westerners, they suggest the presence of a monoclonal lymphoid population in HD patients and that the EBV is related to the etiology of HD.

Reverse seroconversion of hepatitis B virus infectious status after allogeneic bone marrow transplantation from a carrier donor.

A 35-year-old man with acute promyelocytic leukemia received an allogeneic bone marrow transplant (BMT) in second complete remission. The donor was his 18-year-old brother, a chronic hepatitis B virus (HBV) carrier with detectable serum hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B virus DNA (HBV DNA). Before BMT, the recipient was immune to HBV, with serum antibody to HBsAg (anti-HBs), antibody to HBeAg (anti-HBe) and normal liver function. Examination of the recipient serum drawn 2 months after BMT revealed reverse seroconversion from anti-HBs/anti-HBe to HBsAg/HBeAg, which remained positive thereafter. Upon reducing cyclosporin 6 months after BMT, acute hepatitis occurred with HBV DNA in serum as evidence of active HBV replication; the patient then developed chronic hepatitis which progressed to cirrhosis and hepatic decompensation within 8 months. Transfusion of HBV DNA/HBeAg-positive bone marrow is thus harmful even when the recipient has anti-HBs prior to BMT.

Characterization of muscarinic receptor subtypes in canine left ventricular membranes.

The pharmacological characteristics of muscarinic receptor (mAChR) subtypes in canine left ventricular membranes (LVM) were determined using [3H] quinuclidinyl benzilate ([3H]QNB) and [3H]N-methyl scopolamine ([3H]NMS) as ligands. Binding of [3H]QNB and [3H]NMS was saturable with respect to the radioligand concentrations. Analysis of binding isotherms by Scatchard plot showed that [3H]QNB and [3H]NMS bound to an apparently homogeneous population of mAChRs in LVM, with KD values of 390 +/- 100 and 285 +/- 34 pM and Bmax values of 240 +/- 20 and 133 +/- 9 fmol/mg protein, (n = 6), respectively. The Hill coefficients for [3H]QNB and [3H]NMS binding were 0.95 +/- 0.02 and 0.99 +/- 0.01, respectively. Based on the competitive inhibition of [3H]ligand binding, atropine and NMS as well as the selective M1 antagonist PZ revealed no selectivity for these mAChRs. PZ competed with [3H]QNB or [3H]NMS for a single binding site with a Ki value of 0.23 +/- 0.03 microM and 0.62 +/- 0.10 microM, (n = 6), respectively, which is close to the values of M2 or M3 receptors. The data indicate that the M1 receptor subtype did not exist in canine LVM. Competition of [3H]ligand binding with selective M2 antagonists, AF-DX 116 and methoctramine and the selective M3 antagonists, 4-DAMP and hexahydrosiladifenidol, gave a best fit for a two-binding site model. The inhibition of carbachol-mediated phosphoinositide hydrolysis by PZ, AF-DX 116 and 4-DAMP, generated an affinity profile for this response also dissimilar to that described for the classical cardiac M2 response. Although no other muscarinic receptor mRNA has been detected in this tissue, these data suggest the presence of a second population of muscarinic sites, which may signify an M2 receptor diversity.

Study of bone marrow cells in non-Hodgkin's lymphoma by DNA analysis.

Using Southern-blot analysis, we studied samples of bone marrow (BM) cells from 73 patients with non-Hodgkin's lymphoma (NHL) in various clinical status. The frequency of gene rearrangement was disease-status dependent with a frequency of 65.8% at the diagnostic stage, 81.8% after relapse and 33.3% upon complete remission (CR). BM involvement was evident in a substantial portion of patients with untreated and relapsed lymphoma. The significance of BM involvement by DNA hybridization in relation to conventional clinical staging and histological grade was studied. By Southern-blot analysis, BM involvement was found in 76% of the patients at clinical stages (CS) I-III. The incidence of BM involvement in low, intermediate and high grades of NHL (Working Formulation) was 57%(4/7), 67%(22/33), and 89%(8/9) respectively. A comparative study of conventional BM biopsy vs DNA hybridization in a group of 47 NHL patients showed that all 12 patients (100%) with morphological BM involvement and 25 out of 35 patients (71%) with morphologically normal BM had clonal rearrangements of immunoglobulin (Ig), heavy chain and/or light chain; or T-cell receptor beta chain (TCR beta) genes in BM cells. The false negative rate in conventional BM biopsy was 53%(25/47). Southern-blot analysis on lymph nodes (LN) and BM cells from 37 patients showed that 6 patients (16%) had cross-lineage or different rearranged patterns in the same or different tissues. Southern-blot analysis was found to be highly reliable for the detection of even minimal populations of lymphoma cells in the BM and therefore should be the diagnostic choice for clinical staging of lymphoma.

An isozyme-selective affinity label for rat hepatic acetyltransferases.

Affinity chromatography of an ammonium sulfate precipitate obtained from rat hepatic cytosol resulted in the separation of two fractions of N-acetyltransferase (NAT) activity. NATI catalyzed the S-acetylcoenzyme A (AcCoA)-dependent acetylation of p-aminobenzoic acid (PABA); NAT II catalyzed the N-hydroxy-2-acetylaminofluorene (N-OH-AAF)-dependent acetylation of 4-amino-azobenzene (AAB) (N,N-acetyltransferase), the AcCoA-dependent acetylation of procainamide (PA), and the N-arylhydroxamic acid N,O-acyltransferase (AHAT) activity that results in the conversion of N-OH-AAF and related hydroxamic acids to electrophilic reactants. 1-(Fluoren-2-yl)-2-propen-1-one (vinyl fluorenyl ketone, VFK) was shown to be a potent and irreversible inactivator of NAT II activities. A 200-fold higher concentration of VFK was required to inactivate NAT I activity than was required for inactivation of NAT II activities. Similar selectivity in the inactivation of the isozymes was observed when experiments were conducted with enzyme preparations that contained both NAT I and NAT II activities. The presence of substrates and products of the NAT II-catalyzed reactions such as AcCoA, 2-acetylaminofluorene (2-AAF), and N-acetyl-4-aminoazobenzene (N-Ac-AAB) protected NAT II from the inactivating effects of VFK, providing evidence that VFK is an active site directed inhibitor (affinity label) of NAT II. Studies with 1-(fluoren-2-yl)-2-propan-1-one (EFK), an analogue of VFK in which the alpha, beta-unsaturated vinyl ketone group of VFK has been replaced with an ethyl ketone group, demonstrated that the conjugated ketone of VFK is required for inactivation of enzyme activity. The results of these studies suggest that agents such as VFK should have utility as probes of acetyltransferase multiplicity and in the investigation of the active site topography of the enzymes.

[Screening of antibodies to human T-cell leukemia virus type I (HTLV-I) in sera of blood donors and comparison of different methods].

Nine hundred and sixty five serum samples of blood donors from the blood bank of Veterans General Hospital Taipei were screened for antibodies to human T-cell leukemia virus type I (HTLV-I) by different methods. Adult T-cell Leukemia cell lines MT-1, MT-2, KH-2 and MT-2 stimulated by phorbol 12-myristate 13-acetate (PMA) were used as target cells in immunofluorescence microscopy (IF) examination with positive rates as 0.20% (2/965), 0.62% (6/965), 0.20% (2/965) and 0.51 (5/965) respectively. In addition to these, enzyme-linked immunosorbent assay (ELISA) gave a 2.59% (25/965) positive rate and particle agglutination (PA) test revealed a positive rate of 0.93% (9/965). The samples positive in IF were also positive in PA and those positive in PA were found positive in ELISA without exceptions. The 25 ELISA positive samples as well as 75 samples randomly chosen from the ELISA negative ones received Western blot (WB) analysis as a confirmation test. Only 3 of these 100 were considered positive in WB, giving a final positive rate of 0.31%, (3/965), and all of them were originally positive in both PA and ELISA. Particle agglutination test as the screening test and Western blot analysis as the confirming one were suggested to be a routine procedure for detecting anti-HTLV-I antibodies in blood banks through detailed comparison and discussion.

Polymorphic reticulosis: a malignant lymphoma of B-cell lineage.

Whether the pathogenesis of polymorphic reticulosis is from T cells, B cells, or histiocytes has been controversial. In this study, the Southern blot hybridization technique was used to analyze immunoglobulin and T-cell receptor beta-chain genes and to perform the conventional surface marker analysis in two patients with polymorphic reticulosis. The immunophenotype demonstrated the presence of predominantly mature, activated T-lymphocytes, minimal B-cells, and no natural killer cells or monocytes/granulocytes. The mature T-cell phenotype could be due to either inflammatory infiltrates or neoplastic cells of peripheral T-cell type, because the two coexist in polymorphic reticulosis tumors. The value of surface marker examination is limited in the analysis of PMR tumors. However, genetic analysis revealed that only Ig genes were rearranged, with no rearrangement of the TCR beta gene. Rearrangement of immunoglobulin genes occurs in B-lineage lymphoid neoplasms and is thought to be a criterion for diagnosis of lymphoid neoplasms. Based on genetic analysis and clinicopathologic information, this study concluded that polymorphic reticulosis is a malignant lymphoma of B-cell lineage.