Association of betel nut chewing with exercise performance in a military male cohort: the CHIEF study.

INTRODUCTION: Betel nut chewing may cause obesity, neurohormonal activation and inflammation, possibly impairing exercise performances. METHODS: We examined the cross-sectional association in 4388 military male adults aged 18-50 years from the cardiorespiratory fitness in armed forces study in Taiwan between 2013 and 2014. The status of betel nut chewing was classified as current and former/never based on each participant's response to a questionnaire. Physical fitness was evaluated by three basic exercise tests including 3000 m running, 2 min sit-ups and 2 min push-ups. Multiple logistic regression for the best 10% and the worst 10% performers in each exercise, and linear regression were used to determine the relationship. RESULTS: There were 564 current chewers and 3824 non-current chewers for the analysis. The linear regression shows that current betel nut chewing was positively correlated with 3000 m running duration (r=0.37, p=0.042) after adjusting for age, service specialty, body mass index, exercise frequency and alcohol intake. In addition, the logistic regression shows that as compared with non-current chewers, current chewers had lower odds of being the top 10% performers in 2 min push-ups and higher odds of being the bottom 10% performers in 2 min sit-ups (ORs and 95% CIs: 0.71 (0.50 to 0.99) and 1.32 (1.00 to 1.75), respectively). However, the associations between betel nut chewing and physical fitness were all insignificant after further adjusting for current smoking. CONCLUSIONS: Our findings suggest that the impairment of physical fitness associated with betel nut chewing of military young men might be mainly mediated or moderated by the coexisted cigarette smoking.

Comparison of the APACHE II, GCS and MRC scores in predicting outcomes in patients with tuberculous meningitis.

OBJECTIVE: To evaluate different scoring systems, including Acute Physiology and Chronic Health Evaluation (APACHE) II, the Glasgow Coma Scale (GCS) and the Medical Research Council (MRC) staging system, as well as other prognostic factors, in predicting the discharge outcomes of adult patients with tuberculous meningitis (TBM). DESIGN: We conducted a retrospective analysis of patients admitted with a diagnosis of TBM to a tertiary hospital in northern Taiwan from March 1996 to February 2006. We used APACHE II, GCS, MRC and a variety of factors within 24 h of admission to predict discharge outcomes recorded by the Glasgow Outcome Scale (GOS). RESULTS: Among 43 TBM patients, 33 had a favourable outcome (GOS 4-5), and 10 had an unfavourable outcome (GOS 1-3). The severity of APACHE II, GCS, MRC and presence of hydrocephalus correlated well with the neurological outcomes (P < 0.05). The APACHE II and GCS scoring systems were more sensitive and specific than those of the MRC in receiver operating characteristic analysis. Furthermore, in-hospital mortality could be predicted accurately with APACHE II and GCS. CONCLUSIONS: The APACHE II scoring system is at least as effective as GCS and superior to MRC in predicting the discharge outcomes of adult patients with TBM.

Multicentric giant cell tumours in an adolescent with haemophilia.

''Multicentric giant cell tumour (GCTs) of the extremity is prone to be distributed over the age range of 20-40 years, but is rare in haemophilia and in the age before 20. We report a case of a 15-year-old haemophilia boy who presented initially with two radiolucent loci in the right femur and tibia revealed from the X-ray films and then another lesion in the posterior femoral shaft shown from MRI by one year. Differential diagnosis of GCTs should be appraised in various aspects. Radiological diagnostic pitfall was avoided by the pathology disclosed GCTs without malignancy. The early diagnosis of GCTs in haemophilia may be delayed unless appearance of symptoms of pathologic fracture. Coincident multicentric GCTs do occur in haemophilic patients and their incidence might be underestimated, as it might not be judged because immediate symptoms of pain would resolve with appropriate factor replacement."

Roles of IL-4 and other factors in the trichosanthin-induced ovalbumin-specific IgE response.

AIM: To study the mechanism of trichosanthin (TCS)-induced ovalbumin (OVA)-specific immunoglobulin E (IgE) response in vivo. METHODS: To determine whether interleukin-4 (IL-4) was involved in TCS-induced IgE production, TCS and OVA co-immunized mice were treated with anti-IL-4 monoclonal antibodies (mAb) and OVA-specific serum IgE production was measured by enzyme-linked immunosorbent assay (ELISA). To distinguish whether recombinant IL-4 (rIL-4) was sufficient to support OVA-specific IgE response, OVA alone immunized mice were treated with rIL-4 and OVA-induced IgE production were examined by ELISA in the serum. To determine whether additional factors were involved in TCS-induced IgE response, th e kinetic expression of CD40 ligand (CD40L), tumor necrosis factor-alpha (TNF-alpha), and interleukin-13 (IL-13) were measured by semi-quantitative RT-PCR in draining mesenteric lymph node (MLN) from TCS-immunized mice. RESULTS: TCS-induced OVA-specific IgE production was suppressed by anti-IL-4 antibody, whereas IL-4 alone could not induce OVA-specific IgE production. CD40L, TNF-alpha, and IL-13 all expressed high levels in MLN after both primary and secondary immune responses. Among them CD40L had the similar transient expression peak to that of IL-4. CONCLUSION: IL-4 was indispensable for TCS-induced OVA-specific IgE production, and the other three factors examined may also be involved in, but CD40L may play a more important role.

PSMA mimotope isolated from phage displayed peptide library can induce PSMA specific immune response.

Prostate-specific membrane antigen (PSMA) is a cell surface glycoprotein expressed predominantly in prostate secretory acinar epithelium and prostate cancer cells as well as in several extraprostatic tissues. Mouse monoclonal antibody 4G5 specific to the extracellular domain of PSMA was used to screen two phage displayed peptide libraries (9aa linear and 9aa cys library). Three 4G5-reactive phagotopes were identified. Sequence analysis of isolated clones demonstrated that the interaction motif "VDPA/SK" has high homology to 719-725aa on PSMA. Immunohistochemical staining of the prostate cancer sample with the PSMA-mimic phagotope (mimotope) immunized serum antibodies demonstrate that the mimotope isolated from the phage displayed peptide libraries can induce PSMA specific immune response in vivo.

An improved method for finite element mesh generation of geometrically complex structures with application to the skullbase.

An automated method has been developed to generate finite element meshes of geometrically complex structures from CT images using solely hexahedral elements. This technique improves upon previous voxel-based mesh reconstruction approaches by smoothing the irregular boundaries at model surfaces and material interfaces. Over a range of mesh densities, RMS error in surface Von Mises stress was higher in the unsmoothed circular ring models (0.11-0.24 MPa) than in the smoothed models (0.080-0.15 MPa) at each mesh density. The element-to-element oscillation in surface element stress, as measured by the average second spatial derivative of Von Mises stress along the outer surface of the ring, was higher in the unsmoothed models (11.5-15.0 kPa mm-2) than in the smoothed models (4.0-6.8 kPa mm-2). Similarly, in a human skullbase model, the element-to-element oscillation in surface Von Mises stress was higher in the unsmoothed model (5.52 kPa mm-2) than in the smoothed model (1.83 kPa mm-2). Using this technique, finite element models of complex geometries can be rapidly reconstructed which produce less error at the surface than voxel-based models with discontinuous surfaces.

Simultaneous measurement of liposome extravasation and content release in tumors.

OBJECTIVE: The success of liposome-based drug delivery systems for tumor targeting relies on maximum extravasation of liposomes into tumor interstitium, as well as optimal release of contents from the liposomes once within the tumor Liposome extravasation and content release are two separate processes that can be individually or jointly manipulated so a method is needed to monitor these two processes independently and simultaneously. In this report, we describe a method to measure liposome extravasation and content release in tumor tissues growing in a rat skinfold window chamber preparation. METHODS: Mixtures of liposomes containing either doxorubicin or calcein, both of which are fluorescent, and liposomes surface-labeled with rhodamine were injected intravenously. Fluorescent, light intensities in a tumor region in two fluorescent channels were measured using an image-processing system. Light intensities of plasma from blood samples were also measured using this system. These measurements were used to calculate the amounts of liposomes and released contents in both plasma and tumor interstitium. The calculations were based on the fact that the liposome surface labels and contents emit fluorescent light at different wavelengths and when encapsulated, the contents fluorescence is self-quenched. The model included equations to account for fluorescent light "cross-contamination" by the two fluorochromes as well as equations relating the measured fluorescent light intensities to the amounts of liposomes and released contents. This method was applied to three situations in which liposome extravasation and content release were manipulated in different, predictable ways. RESULTS AND CONCLUSION: Our results indicate that this method can perform simultaneous independent and quantitative measurements of liposome extravasation and content release. This method can potentially be used to study drug delivery of other carrier systems in vivo.

Prostitutes, prostitution and STD/HIV transmission in mainland China.

China's opening to the world has enabled massive social and economic transformations and the liberalization of many policies, but also the rise of coincident social problems and diseases. A revival of wide-scale female prostitution since the 1980s has now accelerated to a nationwide dilemma. Prostitutes have long been considered to be reservoirs, if not 'vectors' for the transmission of sexual diseases. A well established STD epidemic in the last decade, plus the presence of growing HIV infections in China now, underscore the need to evaluate the prostitute's role in STD and HIV propagation. This report examines unobtrusive data on female prostitutes in the People's Republic of China through an analysis of prison records from eight sexually segregated prisons (six in Sichuan Province and two in Guizhou Province), two female re-education institutions, and arrest records for convicted prostitutes from four counties in Sichuan Province and Chengdu City (also in Sichuan). Collectively, these data represent 2057 female prostitution cases, and span the years 1988-1990. Demographics are examined to enable a profile of the prostitute as based on data reviewed, and this is contrasted to the stereotype of the prostitute as described in government propaganda against prostitution. STD prevalence rates in the samples are examined and contrasted to two other studies on STDs in nonprostitution populations made available to the authors. Prostitute arrest records reveal a majority had active STD infection[s] at the time of their apprehension, with gonorrhea being the most common bacterium; in many instances, prostitutes also had a history of other sexually transmitted diseases. Thus, data examined support the notion of prostitution as an agent in STD transmission. Presence of HIV infection in prostitutes could not be corroborated through sampled records, nor could prostitution itself be confirmed as an agent in HIV transmission at present. However, given the type of clients serviced by prostitutes in China, a prostitute's own risk of HIV infection is discussed. Control measures by the Chinese government to curb prostitution are examined at both national and provincial levels. Questions are raised as to the effectiveness of present tactics as adjunctive strategies in reducing STD infection and HIV risk in the prostitution population.

Cytomegalovirus recurrence in seropositive pregnant women attending obstetric clinics.

To understand reasons for cytomegalovirus (CMV) recurrence, a cohort of 350 CMV-seropositive pregnant women attending obstetric clinics in Taiwan was examined for cervical or urinary CMV shedding. Urine specimens were collected from 350 women and cervical secretion specimens were collected from 220 women. We measured the association of various factors with CMV recurrence, which was defined as viral shedding identified by the presence of a CMV-specific gene sequence amplified by the polymerase chain reaction in seropositive individuals. CMV recurrence status was independently associated with a sexual activity composite variable, which was defined by three sexual activity indicators: age at first sexual intercourse, total years of sexual experience, and average frequency of sexual intercourse prior to pregnancy. Pregnant women with a history of genital tract infection were more likely than women without such history to experience cervical CMV recurrence. Similarly, pregnant women with previous urinary tract infections were more likely to experience urinary CMV recurrence. The findings indicate that multiple exposure to CMV by sexual activity prior to pregnancy is an important determinant of CMV recurrence during pregnancy.

Regulation of cholesterol 7 alpha-hydroxylase in the liver. Purification of cholesterol 7 alpha-hydroxylase and the immunochemical evidence for the induction of cholesterol 7 alpha-hydroxylase by cholestyramine and circadian rhythm.

Two cholesterol 7 alpha-hydroxylase isozymes were purified from liver microsomes of cholestyramine-treated female rats by using anion exchange high performance liquid chromatography. These two cytochrome P-450 isozymes were similar in electrophoretic mobility, immunocross-reactivity, and Vmax but differed in Km for cholesterol, turnover number, and charges. Antibody against the major isozyme was raised in rabbit. This antibody specifically inhibited microsomal cholesterol 7 alpha-hydroxylase activity. Immunoblot of microsomal polypeptides indicated that microsomal cholesterol 7 alpha-hydroxylase enzyme levels were increased in parallel with cholesterol 7 alpha-hydroxylase activity upon the treatment of rats with diet supplemented with cholestyramine. Both cholesterol 7 alpha-hydroxylase activity and enzyme levels were drastically reduced immediately after the removal of cholestyramine from the diet. Cholesterol 7 alpha-hydroxylase activity was also detected in the microsomes of kidney, heart, and lung in about 7-27% of the level found in the liver. 3-Methylcholanthrene treatment induced cholesterol 7 alpha-hydroxylase activity and enzyme level. In contrast, pregnenolone-16 alpha-carbonitrile or dexamethasone treatment greatly depressed enzyme and activity in rats. Cholesterol 7 alpha-hydroxylase enzyme level was 2-3-fold higher in liver microsomes of rats maintained under the reversed light cycle than under the normal light cycle. In genetically obese Zucker rats, cholesterol 7 alpha-hydroxylase activity and enzyme level did not respond to the change in the light cycle, however, were induced to the same levels as in the lean rats by cholestyramine treatment. This study provided the first direct evidence that the bile acid feedback regulation and circadian rhythm of microsomal cholesterol 7 alpha-hydroxylase activity involved the induction of cholesterol 7 alpha-hydroxylase enzyme level.

The rate of estrone production by mouse blastocysts increases with estradiol-17 beta concentration in medium.

Following the finding of 17 beta-hydroxysteroid dehydrogenase activity in mouse blastocysts, the present study examined the relation of estrone (E1) production rate to estradiol-17 beta (E2) concentration in the medium. When Day 5 blastocysts were cultured in 107-6,860 ng E2/ml medium, the amount of E1 formed during the first 5 hours (y) was found to increase linearly with the logarithm of E2 concentration (x), as represented by the equation y = 2,161x - 3,947. However, there was a sharp decline during the next 5 hours of culture except for the 107 ng E2 culture. The E1 production then remained steady for up to 46-58 hours. There was a tendency for further decline during the 46-70-hour period. The results indicate that (1) E2 may be metabolized to E1 and, probably, another unknown steroid; (2) E1 production rate is E2-dose dependent; and (3) the blastocyst possesses the enzymatic capability to change the steroid milieu to suit its own needs and/or to cause local effects in the uterus for its proper implantation.

The presence of 17 beta-hydroxysteroid dehydrogenase activity in preimplantation rat and mouse blastocysts.

When Day 5 rat blastocysts and Day 4 and 5 mouse blastocysts were cultured in 53 microliters of medium containing 1340 or 2680 pg [3H]estradiol (E2), large amounts of [3H]estrone (E1) were detected in the medium at daily intervals for up to 5 days. This indicates the presence of 17 beta-hydroxysteroid dehydrogenase in the embryos. The activity was higher at a higher concentration of E2 and was also higher in mouse than in rat blastocysts. In the mouse, the activity was higher in Day 5 than Day 4 blastocysts during the first day in culture; then it decreased in Day 5 but increased in Day 4 blastocysts. The importance of E2 in embryonic development and implantation as suggested by others may be related to the activity of 17 beta-hydroxysteroid dehydrogenase.