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We investigated the association of time to prostate-specific antigen nadir (TTPN) and logarithm of prostate-specific antigen velocity after progression Log(PSAVAP) in metastatic prostate cancer with prior primary androgen deprivation therapy (ADT). All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. Patients who developed disease progression were included in the subsequent analyses. Patients were categorized into three groups according to their TTPN: TTPN of 17 months. We compared the Log(PSAVAP) between the different TTPN groups using Mann–Whitney U-test and Kruskal–Wallis test. Further multiple linear regression analyses on Log(PSAVAP) were performed to adjust for other potential confounding factors. Among 419 patients who were treated with primary ADT, 306 patients developed disease progression with a median follow-up of 28 months. Longer TTPN was associated with lower Log(PSAVAP) (P = 0.008) within all subgroup analyses (TTPN of 17 months, P = 0.009; and TTPN of 17 months, P = 0.001). Upon multiple linear regression analyses, baseline PSA (regression coefficient 0.001, P = 0.045), PSA nadir (regression coefficient 0.002, P = 0.040), and TTPN (regression coefficient −0.030, P = 0.001) were the three factors that were significantly associated with Log(PSAVAP). In conclusion, a longer TTPN was associated with lower Log(PSAVAP) in metastatic prostate cancer patients following primary ADT. TTPN cut-offs at 3 months and 17 months appeared to have prognostic significance in predicting Log(PSAVAP). TTPN may serve as a good prognostic indicator in deciding the treatment strategy in patients with disease progression.

Objective To investigate the risk of acute myocardial infarction (AMI) after androgen-deprivation therapy (ADT) for prostate cancer in a Chinese population. Patients and methods All Chinese patients with prostate cancer who were treated primarily with radical prostatectomy or radiotherapy, with or without further ADT at our hospital from the year 2000 to 2009 were retrospectively reviewed. We compared the risk of AMI in the patients who were given further ADT (ADT group) with those who were not given any ADT (non-ADT group). Potential risk factors of AMI including age, diabetes mellitus, hypertension, hyperlipidaemia, history of stroke, ischaemic heart disease, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and duration of ADT were reviewed. The risk of AMI after ADT was first analysed using the Kaplan–Meier method, followed by Cox regression analyses including the potential risk factors mentioned. Results In all, 452 patients were included, with 200 patients in the non-ADT group and 252 patients in the ADT group. The mean (sd) age was 68.2 (5.9) years in the non-ADT group and 69.5 (6.5) years in the ADT group, and the difference was statistically significant (P = 0.031). There were no significant differences in their pre-existing medical conditions or ECOG PS. The ADT group was associated with an increased risk of AMI when compared with the non-ADT group (P = 0.004) upon Kaplan-Meier analysis. Upon multivariate Cox regression analysis, hyperlipidaemia, poor ECOG PS and the use of ADT were the only three significant factors that were associated with increased risk of developing new AMI. Conclusions There was increased risk of AMI after ADT for prostate cancer in a Chinese population. Hyperlipidaemia and poor ECOG PS were also significant risk factors for developing AMI. The risk of AMI should be considered when deciding on ADT, especially in patients with history of hyperlipidaemia and relatively poor ECOG PS.

The central function of lipoprotein lipase (LpL) is to hydrolyze triacylglycerols in chylomicrons and very low density lipoproteins. We have examined the binding of purified milk lipoprotein lipase to homogeneous synthetic lipid emulsions. Emulsions composed of either naturally occurring ester-linked lipids or the non-hydrolyzable ether analogues were prepared by sonication and pressure extrusion, and fractionated by sucrose density gradient centrifugation. Flotation analysis using the analytical ultracentrifuge indicated that the individual fractions were relatively homogeneous with respect to size with flotation coefficients and molecular weights for the separated fractions ranging from 100 to 1100 S and 5.2 x 10(7) to 6.0 x 10(8), respectively. Purified milk lipoprotein lipase bound with high affinity and in a saturable manner to emulsions prepared from the non-hydrolyzable ether-linked lipid analogues of 1-oleoyl, 2-palmitoyl phosphatidylcholine and triolein. At low concentrations of LpL, the enzyme caused aggregation of the emulsion particles by interparticle cross-linking. At higher LpL concentrations, the flotation coefficient of the emulsions decreased significantly with a concomitant increase in particle density. At saturation, the number of LpL monomers bound to lipid particles of radii 67, 75, and 79 nm was 1315, 1449, and 1466, respectively. The results demonstrate close packing of LpL on the lipid surface and are consistent with there being little disruption to the overall structure of the emulsion particle.

The solvent extraction of actinides including Am III and Cm III together with some trivalent lanthanides from nitric acid solutions by two newly synthesized malonamides, N,N′-dimethyl-N,N′ -diphenyltetradecylmalonamide (dmptdma) and N,N′-dicyclohexyl-N,N′ -dimethyltetradecylmalonamide (dcmtdma) has been investigated and compared with data for the reference malonamide, N,N′-dibutyl-N,N′ -dimethyloctadecylmalonamide (dbmocma). The dependence of the extraction on the nitric acid and malonamide concentrations together with the probable molecular structure of the extraction species from nitric acid solution suggests that there are two principal mechanisms of extraction. For low nitric acid concentrations (up to 1 mol dm -3 ) a co-ordinative mechanism dominates for the extraction of metal cations, whereas at higher nitric acid concentrations (1–14 mol dm -3 ) an ion-pair mechanism involving the mono- or di-protonated malonamide and the metal anions [M(NO 3 ) 4 ] - or [M(NO 3 ) 5 ] 2- appears to be more important. Crystal structures show that in the protonated, unalkylated species Hdcmma + (dcmma = N,N′-dicyclohexyl-N ,N′-dimethylmalonamide) and in the chelated complexes [Nd(NO 3 ) 3 (dcmma) 2 ], [Nd(NO 3 ) 3 (H 2 O) 2 (dmpma)] and [Yb(NO 3 ) 3 (H 2 O)(dmpma)] (dmpma = N,N′-dimethyl-N ,N′-diphenylmalonamide) the carbonyl oxygens lie cis to each other suggesting that it is the cis form which is involved in extraction. However, crystal structures of the free unalkylated malonamides N,N′-dicyclohexyl-N,N′ -diethylmalonamide and N,N′-dicyclohexyl-N,N′ -diisopropylmalonamide show that the carbonyl amide groups adopt a trans configuration in which the carbonyl oxygens are at maximum separation. By contrast, in the crystal structure of the diphenyl derivative dmpma the carbonyl amide groups adopt a gauche configuration with an OC · · · C O torsion angle of 57.2°. Conformational analysis confirms that the differences in these structures reflect the differences between the lowest-energy gas-phase conformations and are not caused by packing effects.

Background. To evaluate the incidence of asymptomatic deep vein thrombosis (DVT) in Chinese after cesarean section (CS). Methods. This is a prospective observational study. Ethnic Chinese women who were asymptomatic for DVT and delivered by CS were included. Duplex ultrasound scan (US) of the lower limbs was carried out 3-7 days after CS. Results. From July 2000 to March 2001, a total of 93 women were examined. The mean age was 32.1 years (SD 5.0). Forty-nine of 93 CSs were elective (52.7%). The median time from CS to US was 4 days (interquartile range, 4-5 days). No case of DVT was found in these 93 women. Conclusion. The incidence of asymptomatic DVT is low in Chinese women after CS. Routine screening for DVT after CS is not warranted.

How ethnicity impacts characteristics of umbilical cord blood collected by cord blood banks remains unclear.After a systematic search, we identified 11 studies for analysis that reported on various variables of collected cord blood units.Non-Caucasian ethnicity of the cord blood donor was associated with a higher risk of failing to meet banking criteria, lower cord blood volume, reduced total nucleated cell count, fewer CD34+ cells, and reduced colony-forming units.Non-Caucasian ethnicity is associated with reductions in hematopoietic measures of collected cord blood units. Public banking efforts will have to balance issues related to building ethnic diversity within the bank and maintaining the characteristics of banked units that remain desirable by transplant centers.

Athabasca is the largest resource accumulation among three major Canadian oil sands reservoirs. Through more than twenty years of research and studies, Steam Assist Gravity Drainage (SAGD) has been proven as an economic viable commercial method to develop Athabasca oil sands. However, because very few of industrial SAGD projects have matured to date, Wind-Down (WD) and Blow-Down (BD) operation strategies are not well understood and more research and study efforts are needed. In this paper the beginning time and gas injection and production rates in WD and BD with pure methane are optimized for an Athabasca oil sands reservoir with numerical simulation. A simplified economic method and assumptions for optimization are presented and applied in this study. Six type wells are selected to capture the complexity of geological architecture (including pay thickness, and permeability and porosity heterogeneities) and fluid characteristics (thief zones) of the investigated reservoir. The optimization is based on the net values of WD and BD with 2D layer cake simulation models. The sensitivity of the net values to gas and bitumen prices is also analyzed. The strategies to optimize WD and BD for compartment areas or full fields are explored in this paper. For the areas without geomodels, a weighting method is proposed and applied. For areas with geomodels single model simulation is recommended if the areas are not large while the type well/pad methodology is suggested if the compartment areas or full fields are too large to simulate with one model. The results of this study indicate that understanding reservoir geology and optimizing WD beginning time are important and necessary to have positive WD economic values. In some cases compromise has to be made in optimization simulation due to the complexity of reservoir, availability of model and limitation of resources, and a practical optimization method with proper simplifications have to be taken. With the optimized WD and BD operation and management strategies the economy of SAGD projects can be improved significantly.

As Hong Kong manufacturers accelerate to shift their operations to China and cease or contract. Their operations in Hong Kong, many of them are taking advantage of the limitation of a source jurisdiction to team up with Chinese companies and escape the Hong Kong tax net. This relocation exercise of their manufacturing base not only allows the Hong Kong manufacturers to enjoy the preferential tax concessions for foreign investors and lower cost of production in mainland China, but also depletes the public coffers to the Hong Kong Government. We therefore postulate two hypotheses: (1) there is a negative association between the business operations in China and those in Hong Kong, and (2) there is a negative association between the business operations in China and the related Hong Kong profits tax liability. A questionnaire survey was carried out to collect data on the level of activities in both China and Hong Kong, in particular data from Hong Kong manufacturers on their Hong Kong profits tax liability. Spearman’s rank-order correlation analysis was used to test the hypotheses. The result supports that the higher the level of business operations in China, the lower the level of business operations in Hong Kong. It also reveals that the higher the level of business operations in China, the lower the related Hong Kong profits tax liability. The issue of tax base erosion is a case for Hong Kong to review its principle of taxing only profits locally generated.

The structure of the complex [Ni(HTPTZ)(H 2 O) 3 ] 3+ · 3NO 3 − · H 2 O (TPTZ = 2,4,6-tri-2-pyridyl-1,3,5-triazine) has been investigated. It has been shown that the ligand was tridentate to the nickel cation in the major coordination site and concomitantly was bound to a nitrate anion in the middle coordination site. Analogies have been drawn between the title complex and solvent extraction reagents where nitrate anion is replaced by caprate anion.

Cortisol is a marker of physiological arousal, exhibiting a characteristic pattern of diurnal activity. The daily cortisol profile has been xamined extensively and is atypical in a number of clinical disorders. However, there are very few studies focussing on the cortisol profile in adults with intellectual disabilities (ID). This paper reports a preliminary investigation into the nature of the cortisol profile in adults with mild or moderate ID and provides reflections on the challenges of psychophysiological research in this population.On two consecutive days, 39 adults with mild or moderate ID each donated saliva samples for cortisol analysis, at multiple times between waking and evening. A comparison between these data and the published literature permitted a descriptive assessment of the cortisol awakening response (CAR) and diurnal profile. A variety of psychometric measures and an assessment of behavioural history were also collected in order to describe aspects of the participants' emotional and behavioural states.Individuals with ID exhibit a diurnal cortisol secretion profile, qualitatively similar to that of the typical, healthy, adult population. However, the findings also suggested a blunted CAR, warranting further investigation. There was also some evidence that cortisol secretion was affected by anxiety and a recent history of aggression.While further work is required to characterise the CAR fully, there was no indication that the diurnal cortisol profile among people with ID differs from that of the typical population. This study also demonstrates that, although challenging, it is feasible, and acceptable to participants, to collect repeated physiological measures from men and women with mild and moderate ID.

Lipoprotein lipase is the extrahepatic lipase responsible for the hydrolysis of triglycerides in chylomicrons and very low-density lipoproteins. Its enzymic activity and its location on the surface of endothelial cells are affected by the presence of fatty acids, implying that the protein possesses binding sites for that ligand. In this study, we examine the binding of fatty acids to LpL and describe factors that must be considered when the dissociation constant of the acceptor-ligand equilibrium is close to the critical micelle concentration of the fatty acid. The interaction of fatty acids with lipoprotein lipase (LpL) was studied by two methods. A new direct method, based on the LpL-induced increase in the apparent critical micelle concentration of the sodium soap of the fatty acid, indicates the presence of multiple high-affinity binding sites. In the second method, the specific binding of fatty acids to LpL was measured by quantitating the blue shift in the tryptophan fluorescence of LpL that occurs upon binding the ligand. Both methods suggest the existence of 4-6 fatty acid binding sites on LpL with a dissociation constant on the order of 10(-6)-10(-7) M. Further analysis of the blue shift indicates that at higher concentrations of fatty acid, large complexes are formed consisting of 260-310 molecules of fatty acid per LPL monomer. In contrast, no large complexes are formed with fatty acids that form crystals above their solubility limit.

Miltenberger blood group antigen subtype III (Mi.III) is characterized by expression of a glycophorin B-A-B hybrid (Gp.Mur) on the erythrocyte surface. The two alleles of glycophorin B are substituted with the B-A-B hybrid alleles in homozygous Mi.III (Mi.III(+/+)), and thus, Mi.III(+/+) erythrocytes lack glycophorin B (GPB) and express Gp.Mur only. Because GPB is a major component of the Rh complex on RBCs, in this study, we explored how the absence of GPB might affect Rh expression in Mi.III RBCs.(1) Mi.III+ RBCs were serologically identified and further differentiated their homozygosity or heterozygosity by immunoblot or direct sequencing. (2) RhD and RhCcEe mRNA was cloned, and their sequences analysed. (3) The expression levels of Rh antigen, Rh-associated glycoprotein (RhAG) and the U antigen in MI.III vs. non-Mi.III RBCs were assessed by flow cytometry and Western blot.Compared with the non-Mi.III samples, the surface expression of the Rh antigen was reduced to 76·4% in Mi.III(+/+) RBCs and 93·6% in Mi.III(+/-). RhAG expression was also significantly reduced in Mi.III(+/+), but not in Mi.III(+/-). The U antigen expression in Mi.III(+/-) was only 14·9% relative to the control RBCs, while GPB was half the level of the controls. The mRNA sequences of Rh polypeptides from Mi.III+ samples were identical to the NCBI reference sequences.Substitution of GPB with Gp.Mur significantly reduced the expression of Rh antigen and RhAG on the Mi.III(+/+) erythrocyte membrane. The Mi.III phenotype is predicted to induce considerable structural variations within the band 3/Rh-associated macrocomplexes.

This paper presents two novel singly-fed circularly polarised (SFCP) patch antennas at 2.45 GHz. Unlike the traditional ones, the patches are loaded by two pairs of parallel slots, acted as negative perturbation. The antennas are fed by using different capacitive feeding mechanisms, direct soldering against indirect coupling. Their performances are compared.

Rates of degradation of the triazine herbicide atrazine are reported, together with an analysis of the sequence of stages involved, using hydroxyl radicals generated by hydrogen peroxide in the presence of UV light and by the pure photochemical reaction. These conditions bring about the displacement of chlorine by hydroxyl, dealkylation of the alkylamino groups and finally deamination of the triazine ring. The significance of these results to water purification is discussed.

Though being accepted and widely employed for decades, there remains no consensus in the industry on the selection of an optimum temperature profile for the accelerated temperature cycling (ATC) test for the evaluation of board level solder joint reliability. It is generally agreed that broader temperature range and higher mean temperature should result in shorter thermal fatigue life. Yet, people have different opinions on the selection of the ramp rate and the dwell time. It was believed that the ramp rate has little influence on the solder joint thermal fatigue life. Emphasis has been put on the design of a suitable dwell time. Therefore, the JEDEC and the IPC standards did not impose strict requirements on the selection of the ramp rate. On the other hand, a certain range of dwell times were recommended. Nevertheless, there were publications showing that the ramp rate may be important and, in some situations, may even overrule the dwell time. This study attempts to investigate in detail the creep damage accumulation inside the solder joint during the ramp time and the dwell time for all practical loading conditions. Based on numerous computational simulation results, the present study reveals that there actually exist two types of creep damage accumulation. One of them corresponds to a “mild” loading condition where the creep damage is mostly accumulated during the dwell time. Another one corresponds to a “severe” loading condition in which the ramp time contributes most of the creep damage accumulation.

This study serves to validate the predictive finite element modeling approach for the solder joint thermal fatigue life analysis, with emphasis on the applicability to various lead-free solder joints. The three packages involved in the study are 8×8 mm PBGA, l0×l0 mm QFN, and 51×51 mm CBGA. They are designed to consist of SAC387, SAC305, “SAC305 ball + SAC387 paste” and “SAC387 ball + SAC305 paste” solder joints. ATC tests are performed to determine the characteristic lives of these packages. On the other hand, finite element models are developed for these test vehicles. They serve to evaluate the damage of each package, as represented by the creep strain or the creep strain energy density, accumulated during the ATC test. As demonstrated from this work, the commonly adopted power law correlation, which links the numerically calculated damage parameters with the experimentally determined characteristic lives, can be used for the solder joint thermal fatigue life prediction, even for the case with mixed solder alloys.

A low-cost (with bare chips) and high (electrical, thermal, and mechanical) performance 3D IC integration system-in-package (SiP) is designed and described. This system consists of a silicon interposer with through-silicon vias (TSV) [1–24] and redistribution layers (RDL), which carries the high-power flip chips with microbumps on its top surface and the low-power chips at its bottom surface. TSVs in the high- and low-power chips are optional but should be avoided. The backside of the high-power chips is attached to a heat spreader with or w/o a heat sink. This 3D IC integration system is supported (packaged) by a simple conventional organic substrate. The heat spreader (with or w/o heat sink) and the substrate are connected by a ring stiffener, which provides adequate standoff for the 3D IC integration system. This novel structural design offers potential solutions for high-power, high-performance, high pin-count, ultra fine-pitch, small real-estate, and low-cost applications. Thermal management and reliability of the proposed systems are demonstrated by simulations based on heat-transfer theory and time and temperature dependent creep theory.

Rates of degradation of the triazine herbicide atrazine are reported, together with an analysis of the sequence of stages involved, using hydroxyl radicals generated by hydrogen peroxide in the presence of UV light and by the pure photochemical reaction. These conditions bring about the displacement of chlorine by hydroxyl, dealkylation of the alkylamino groups and finally deamination of the triazine ring. The significance of these results to water purification is discussed.

In his article on Liang Ch'i-ch'ao (1873-1929) and the 1911 Revolution, Ernest Young has shown, among others, the error in generalizing that late Ch'ing reformers were wedded to peaceful change.1 A closer examination of the reformers' activities from 1898 to 1911 reveals that they were ready to take up arms against the Ch'ing government at critical moments, as testified by the aborted coup of 1898, the T'ang Ts'ai-ch'ang uprising of 1900, and Liang's conspiracy of 1911. At different times, K'ang Yu-wei (1858-1927) and Liang Ch'i-ch'ao advocated the use of assassination for the removal of their opponents in the imperial court. While Liang's fascination with nihilism and the terroristic tactics is thoroughly researched, little has been written on K'ang's advocacy of assassination.2 I propose to discuss K'ang's role as conspirator with special reference to his plot against the Empress Dowager Tz'u-hsi (1835-1908) between 1904 and 1906.

Cracking of the silicon chip of a wafer level chip scale package (WLCSP) is encountered during a thermal cycle test (TCT). This paper attempts to examine the failure mechanism. Both numerical and experimental efforts were devoted to investigate the problem. A series of finite element models with different combinations of material properties and geometric configurations were developed. The results showed that both the under bump metallization (UBM) and the dielectric layer Benzocyclobuten (BCB) contributed significantly to the stress level induced inside the silicon chip. In addition, solder ball pull tests were performed. The silicon cratering failure mode was reproduced which confirmed the failure mechanism as proposed by the finite element analysis. The effects of all relevant constituent materials on the chip are discussed in detail. Suggestions for the product design improvement are provided at the end of the paper.

The objective of the present study is to develop a robust high-throughput assembly process of light emitting diode arrays for wide area general lighting. Topics to be covered in this paper include the conceptual design, the flexible printed circuit substrate, flip chip assembly, yellow phosphor coating, and encapsulation. All these are integrated into one reel-to-reel assembly process. A prototype with the proposed process has been developed. A sample strip of packaged LED array has been produced as well to validate the developed assembly process.

The present study evaluates the relative thermal fatigue life of tin-silver-copper (SnAgCu or SAC) lead-free and tin-lead (SnPb) solders with custom-made BGA assembly configurations generating various stress ranges under thermal cyclic loading. Although the SAC solder bears a lower creep strain rate compared with the SnPb solder in common thermal cycling conditions, it is found that there exits conditions at which the SnPb solder joint maintain a longer life than the SAC solder joint. The determination lies on the maximum normalized equivalent stress levels (σ/E) experienced by the two kinds of solder joint during the temperature cycles. Even under the same straining and thermal cycling condition, it is observed that the maximum σ/E induced in the two kinds of solder joint are normally different, as a result of their different rate of stress relaxation. The analysis shows that both the absolute and relative magnitude of σ/E experienced by the two kinds of solder joint affect the relative life. In general, the SAC solder joint sustain a longer life at low σ/E levels, while the SnPb solder joint outperform the SAC solder joint at high σ/E levels. There exists a critical σ/E level at which both solder joints acquire similar performance. However, this margin shifts with the relative magnitude of σ/E the two kinds of solder joint suffered. Having studied the variation of σ/E for the two kinds of solder joint under various loading conditions, this study uncovers the rationale for the difference in the relative thermal fatigue life of the two kinds of solder joint.Copyright © 2009 by ASME

An account is given of the influence of landfill gas on tree growth in the field at Gin Drinkers' Bay (GDB) landfill, Hong Kong, and in the laboratory. Ten species (Acacia confusa, Albizzia lebbek, Aporusa chinensis, Bombax malabaricum, Castanopsis fissa, Liquidambar formosana, Litsea glutinosa, Machilus breviflora, Pinus elliottii, andTristania conferta), belonging to eight families, were transplanted to two sites, one with a high concentration of landfill gas in the cover soil (high-gas site, HGS) and the other with a relatively low concentration of gas (low-gas site, LGS). Apart from the gaseous composition, the general soil properties were similar. A strong negative correlation between tree growth and landfill gas concentration was observed. A laboratory study using the simulated landfill gas to fumigate seedlings of the above species showed that the adventitious root growth ofAporusa chinensis, Bombax malabaricum, Machilus breviflora, andTristania confera was stimulated by the gas, with shallow root systems being induced.Acacia confusa, Albizzia lebbek, andLitsea glutinosa were gas-tolerant, while root growth ofCastanopsis fissa, Liquidambar formosana, andPinus elliottii was inhibited. In most cases, shoot growth was not affected, exceptions beingBombax malabaricum, Liquidambar formosana, andTristania conferta, where stunted growth and/or reduced foliation was observed.

The objective of the present study is to develop a robust high-throughput assembly process of light emitting diode arrays for wide area general lighting. Topics to be covered in this paper include the conceptual design, the flexible printed circuit substrate, flip chip assembly, yellow phosphor coating, and encapsulation. All these are integrated into one reel-to-reel assembly process. A prototype with the proposed process has been developed. A sample strip of packaged LED array has been produced as well. Recommendations for future industrial applications are also provided.

This study investigated hyperbaric oxygen (HBO2) and platelet-derived growth factor-BB (PDGF-BB) to determine their combined effects on fibroblasts from rabbit medial collateral ligament (MCL).Cells were divided into four groups: (I) Control, (II) HBO2 treatment, (III) PDGF-BB treatment and (IV) HBO2 combined with PDGF-BB treatment. All hyperoxic cells were exposed to 100% O2 at 2.5 atmospheres absolute (ATA) in a hyperbaric chamber for 120 minutes per 48 hours. Measurement of cell growth was based on increase in cell number. Cell cycle modulations were analyzed by fluorescence-activated cell sorter (FACS). Quantity of Type I and Type III collagen was determined by western blotting and image analyzer.Treatment doses of HBO2 alone or PDGF-bb alone dependently increased cell growth. A combination of HBO2 treatment plus PDGF-bb treatment had an additive effect on cell growth in comparison with HBO2 treatment alone or PDGF-bb treatment alone. FACS analysis revealed that HBO2 alone, PDGF-bb alone and PDGF-bb plus HBO2 treatment increase the percentage of cells accumulated in S-phase. Western blotting analysis revealed that Type III collagen content was decreased significantly after HBO2 treatment alone or HBO2 plus PDGF-bb treatment but not in PDGF-bb treatment alone. In contrast, although Type I collagen content was increased after HBO2 treatment, the increase in Type I collagen (increase /original) was not statistically significant.HBO2 or HBO2 plus PDGF-bb treatment decreases the Type III collagen/Type I collagen content, which could result in mechanically stronger collagen fibrils. We propose HBO2 therapy as a potentially effective treatment for MCL healing.

We investigated the cardiovascular thrombotic risk after surgical castration (SC) versus gonadotropin-releasing hormone agonists (GnRHa) in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan–Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years) was significantly higher than the GnRHa group (71.8 ± 8.3 years) (P < 0.001). There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan–Meier analysis (P = 0.014). Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04–1.11, P< 0.001), hyperlipidemia (HR 2.455, 95% CI 1.53–3.93, P< 0.001), and SC (HR 1.648, 95% CI 1.05–2.59, P = 0.031) were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.

This paper evaluates the thermal performance of a newly developed multi-stack flip chip package using the finite element method. The effect of the major parameters, identified as the solder material, the solder joint pitch, the solder joint height and the pad diameter on the thermal performance of the package is studied. Based on the finite element results, a lumped model is developed which is capable to give quick and promising results of the junction temperatures of the package for different solder joint configuration.

The development of erythrocyte alloantibodies complicates transfusion therapy in patients with thalassemia. However, no data are available on the frequency of erythrocyte alloimmunization in patients with transfusion-dependent thalassemia in Taiwan. We analysed the clinical and transfusion records of 30 individuals (15 females and 15 males; mean age, 20 years; range, 4-31 years) with thalassemia who had regular transfusions for periods ranging from 0.5 to 20 years. Of the 30 patients, 28 who had beta-thalassemia major and two who had Hb H disease (alpha thalassemia), 11 (37%) were found to carry alloantibodies. All alloantibodies were clinically significant specificities, including four cases of anti-E, two of anti-E + c, two of anti-'Mi(a)', one of anti-'Mi(a)' + E, one of anti-D and one of anti-S. Alloimmunization to erythrocyte antigens is a frequent complication in transfusion-dependent thalassemia.

An 81-year-old Chinese woman presented with a 1-week history of increasing facial puffiness. She had 2:1 second-degree heart block and a permanent pacemaker that had been inserted 3 years previously because of syncopal episodes. Physical examination revealed facial plethora, dilated upper trunk veins, and oedematous upper limbs suggestive of superior vena cava obstruction syndrome. This was confirmed on urgent computed tomographic scan of the thorax. There was no evidence of extrinsic compression or formation of intraluminal thrombus. The underlying aetiology was a pacemaker-induced fibrotic stricture that was successfully treated with balloon venoplasty. At 3-month follow-up, the patient remained symptom-free with normal pacemaker function.

In the present study, a twenty-mer antisense oligonucleotide specific for N-methyl-D-aspartate receptor one (ANR1) was applied to striatal neurons in primary cell culture. The ANR1 was found to be specific and nontoxic. Significant reductions in expression of NR1 mRNA and proteins were resulted after a single dose of ANR1 transcripts. Interestingly, there were reductions in total NR1 proteins but two phosphorylated forms of NR1 proteins at serine 896 and 897 residues were not reduced. There was also no change in the pattern of distribution of NR1 immunoreactivity in the striatal neurons. In addition, significant reductions of NMDA-mediated peak inward current were found after application of a higher concentration of ANR1 (20-100 microM) by patch clamp recordings. The present results indicate that ANR1 is a useful agent in reducing NMDA receptor functions. The present data thus provide detailed cellular and molecular mechanisms to explain our previous findings of amelioration of motor symptoms in a rat model of Parkinson's disease. More importantly, application of ANR1 was also found to display neuroprotective effects of striatal neurons against NMDA-induced excitotoxic cell death. The findings have implications in development of new approach in prevention of cell death in neurodegenerative diseases and new treatments for these diseases.

To evaluate the incidence of asymptomatic deep vein thrombosis (DVT) in Chinese after cesarean section (CS).This is a prospective observational study. Ethnic Chinese women who were asymptomatic for DVT and delivered by CS were included. Duplex ultrasound scan (US) of the lower limbs was carried out 3-7 days after CS.From July 2000 to March 2001, a total of 93 women were examined. The mean age was 32.1 years (SD 5.0). Forty-nine of 93 CSs were elective (52.7%). The median time from CS to US was 4 days (interquartile range, 4-5 days). No case of DVT was found in these 93 women.The incidence of asymptomatic DVT is low in Chinese women after CS. Routine screening for DVT after CS is not warranted.

To provide the foundation for reasonable utilization by analysing the essential oils from Serissa serissoides in different seasons.Essential oils were obtained by steam distillation. The chemical components were separated and identified by gas chromatography-mass spectrometer (GC-MS). The relative content of each component was determined by area normalization.Forty-three peaks were identified from autumn material, representing 78.91% of the total oil. Main constituents of the essential oil from the autumn material were found to be 1b,5,5,6a-tetramethyl-octahydro-1-oxa-cyclopropa [a] inden-6-one (7.32%); methyl linolenate (4.14%); cubenol (5.97%); 2-methoxy-4-vinylphenol (10.87%); delta-9(10)-tetrahydrocostunolide-1-keto (35.51%). Seventy-two peaks were identified from spring material, representing 79.88% of the total oil. Main constituents of the essential oil from the spring material were found to be caryophyllene (3.315%); ethylbenzene (3.523%); 3-hexen-1-ol (4.537%); 2-methoxy-4-vinylphenol (6.513%); 5-propionyl-2-chlorobenzeneacetic acid, methyl ester (8.541%), germacrene D (12.311%).The same compounds in both materials are as follows: 2,2-dimethyl-6-methylene-cyclohexanepropanol; 2-methoxy-4-vinylphenol; 3,7-dimethyl-1,6-octadien-3-ol; cubenol; docosane and eicosane. It seems that they are the diagnostic components in these medicinal materials. Essential substances are different in quantity and quality in different seasons.

Importance of factors influencing the decision to proceed with cord blood transplantation in adults: results of a web-based survey of the Canadian transplant community

To study the clinical profile and genetic basis of Brugada syndrome in Chinese patients.Prospective observational study.Seven regional public hospitals, Hong Kong.The clinical and follow-up data of 50 patients (47 men, 3 women; mean age, 53 years) were collected, and genetic data of 36 probands and eight family members of three genotyped probands were analysed.Eight patients survived sudden cardiac death (group A), 12 had syncope of unknown origin but no sudden death (group B), and 30 were asymptomatic before recognition of Brugada syndrome (group C). Programmed electrical stimulation induced sustained ventricular arrhythmias in 88% (7/8), 82% (9/11), and 27% (3/11) of patients in group A, group B, and group C, respectively. New arrhythmic events occurred in 50% (4/8) of patients in group A and 17% (2/12) of patients in group B after a mean follow-up period of 30 (standard deviation, 13) months and 25 (7) months, respectively. All group C patients remained asymptomatic during a mean follow-up period of 25 (standard deviation, 11) months. Five of 36 probands and three of eight family members who underwent genetic testing were found to have a mutation in their SCN5A gene.Chinese patients with Brugada syndrome who are symptomatic have a high likelihood of arrhythmia recurrence, whereas asymptomatic patients enjoy a good short-term prognosis. The prevalence of SCN5A mutation among probands is 14%. Thus, Chinese patients with Brugada syndrome share with their western counterparts similar clinical and genetic heterogeneity.

We describe a new method for treating livedoid vasculopathy. The typical presentation of livedoid vasculopathy includes chronic, recurrent painful ulcers, satellite scar-like atrophy and telangiectasia involving the lower extremities. Histologically, these lesions show areas of ulceration and dermal vessel occlusion without frank inflammatory cell infiltration. There is currently no satisfactory therapy available for this disease. Hyperbaric oxygen (HBO) has recently established itself as one of the most effective methods of treating ischaemic wounds, including diabetic ulcers. We used this therapy in two patients whose lesions were resistant to multiple therapeutic modalities. Not only did their ulcers respond rapidly to the HBO therapy, but the disturbing wound pain also resolved at the same time. To our knowledge, this is the first successful trial of HBO therapy in livedoid vasculopathy. We believe this to be a very promising new therapy for livedoid vasculopathy and to be worth further investigation.

Circulating EBV DNA analysis has been shown to be valuable in the detection, prognostication, and monitoring of nasopharyngeal carcinoma (NPC) patients. A previous study has shown that, after radiotherapy, plasma EBV DNA levels of NPC patients would decline exponentially with a median half-life of 3.8 days. We postulate that this decline in plasma EBV DNA reflects the decrease in cancer cell population and, therefore, the rate of decline reflects the radiosensitivity of the tumor. However, this postulation would hold true only if EBV DNA is rapidly eliminated from the circulation. In this study, we determined the in vivo elimination rate of plasma EBV DNA in NPC patients.We monitored the level of plasma EBV DNA in NPC patients during and after surgical resection of NPC. The half-life of plasma EBV DNA was then calculated by plotting the natural logarithm of EBV DNA concentrations against time.The median half-life of plasma EBV DNA after surgical resection of NPC was 139 min. After a median follow-up of 6.7 days, EBV DNA was undetectable in 8 of 11 patients. One of 8 patients with undectable EBV DNA and all of the patients with detectable EBV DNA developed clinical relapse.The in vivo elimination of EBV DNA is very rapid after surgical resection of NPC. The failure of complete and rapid elimination of EBV DNA from the circulation predicts disease recurrence.

The purpose of this research was to compare the sensitivities of plasma EBV DNA in detection of postirradiation locally recurrent nasopharyngeal carcinoma (NPC), postirradiation distant metastatic NPC, and radiation-naïve NPC.Twenty-four patients with postirradiation local recurrence of NPC were assessed for plasma EBV DNA levels by a real-time quantitative PCR system. The results were compared with those of a cohort of 140 patients with newly diagnosed NPC and with those of 25 patients with distant metastatic relapse. EBV-encoded RNA positivity was also assessed in locally recurrent tumors and newly diagnosed tumors with undetectable plasma EBV DNA levels.Postirradiation locally recurrent tumors were associated with a significantly lower rate of detectable plasma EBV DNA compared with radiation-naïve tumors of comparable stage [stage I-II tumors: 5 of 12 (42%) versus 47 of 51 (92%), P = 0.0002; stage III-IV tumors: 10 of 12 (83%) versus 88 of 89 (99%), P = 0.01; Fisher's exact test], and compared with distant metastatic recurrences [15 of 24 (63%) versus 24 of 25 (96%), P0.02; Fisher's exact test]. The median EBV DNA level in patients with detectable EBV DNA was also significantly lower in locally recurrent tumors than in radiation-naïve tumors. All of the tissue samples of tumors associated with undetectable EBV DNA levels, where available, were EBV-encoded RNA positive.The sensitivity of EBV DNA in the detection of tumors regrowing from an irradiated site is much lower than that from a radiation-naïve site. Although plasma EBV DNA is very effective in detecting distant metastatic relapse of NPC, it cannot be relied on as the sole surveillance tool for detection of local relapse.

To investigate the role of lipoprotein lipase (LPL) gene on Chinese patients with hypertriglyceridemic type 2 diabetes.Three subject groups, including hypertriglyceridemic group, normalipidemic type 2 diabetes group and healthy controls, were recruited and screened for sequence changes in LPL gene with PCR, SSCP, restriction analysis and direct DNA sequencing. LPL mass and activity in post-heparin plasma and in in vitro expression were investigated. Comparative modeling was performed via Swiss-PDB Viewer to provide the potential 2-D structures of wildtype and mutant proteins.Four missense mutations, Ala71Thr, Val18Ile, Gly188Glu and Glu242Lys, were identified in patients with hypertriglyceridemic type 2 diabetes, and not in both normalipidemic diabetes and the control subjects. The four missense mutations were located in the highly conserved amino acid sites, which are involved in highly conserved exon 3, 5, or 6 regions. They led to reduced LPL mass and enzyme activities in both post-heparin plasma and in vitro expression. The modeled structures displayed the differences to a great extent between the mutant and wide-type molecules.These results indicated that the 4 missense mutations lead to LPL deficiency and subsequent hypertriglyceridemia. The LPL deficiency predispose a progressive diabetic pathway to those affected individuals. LPL gene is one of susceptibility gene for hypertriglyceridemic type 2 diabetes.

Despite the increasing clinical applications of circulating EBV DNA analysis as a tumor marker, the molecular nature of these EBV DNA molecules remains unclear. We subjected plasma/serum samples of nasopharyngeal carcinoma and lymphoma patients to DNase digestion and ultracentrifugation and showed that circulating EBV DNA molecules are "naked" DNA fragments instead of being contained inside virions. We further showed that these EBV DNA fragments were relatively short, and 87% of them were shorter than 181 bp. These results provide fundamental information that may improve our understanding of the release of tumor-derived nucleic acids into the blood of cancer patients.

We explored factors related to early catch-up growth in healthy children in Göteborg, Sweden. Most (82.9%) infants born small for gestational age (SGA) showed catch-up growth during their first 6 months, and 94.3% reached a final height within the normal range. At 6 months, 21 SGA children remained short and 45 non-SGA babies fell below the -2 SDS cutoff in height. Of these 66 short infants, 10 (15.2%) remained short into adulthood and 56 showed spontaneous catch-up growth. Fetal growth should be defined by body size at 6 months of age rather than at birth because most SGA infants catch up before 6 months, and furthermore, fetal growth regulatory mechanisms, such as insulin-like growth factor-I and -II, are the primary growth-promoting factors until 6 months of age.

Increased fetal DNA in maternal plasma/serum has been reported in pregnancies complicated by preeclampsia. We hypothesized that impaired clearance of fetal DNA might contribute, at least in part, to the above-mentioned phenomenon.We studied 7 preeclamptic and 10 control pregnant women. All had male fetuses. Serial blood samples were obtained from before delivery to 6 h postpartum. Male fetal DNA in maternal plasma was measured by real-time quantitative PCR for the SRY gene on the Y chromosome.The median fetal DNA concentrations before delivery were significantly higher in the preeclamptic women than in the controls (521 vs 227 genome-equivalents/mL for preeclamptic and control women, respectively; Mann-Whitney rank-sum test, P = 0.017). The median fetal DNA concentrations at 6 h after delivery were also significantly different between the two groups (208 vs 0 genome-equivalents/mL for preeclamptic and control women, respectively; Mann-Whitney rank-sum test, P = 0.002). A first-order clearance model was found to best describe the kinetics of maternal plasma fetal DNA clearance. Moreover, we observed a significant difference in the median apparent clearance half-lives of fetal DNA between the preeclamptic women (114 min) and controls (28 min; Mann-Whitney rank-sum test, P = 0.007).This study represents the first documentation of impaired fetal DNA clearance from maternal plasma in preeclampsia. Such an abnormality in circulating DNA clearance may also be present in other medical conditions associated with quantitative aberrations in circulating DNA concentrations.

Recent work on the coding of spatial information in central otolith neurons has significantly advanced our knowledge of signal transformation from head-fixed otolith coordinates to space-centered coordinates during motion. In this review, emphasis is placed on the neural mechanisms by which signals generated at the bilateral labyrinths are recognized as gravity-dependent spatial information and in turn as substrate for otolithic reflexes. We first focus on the spatiotemporal neuronal response patterns (i.e. one- and two-dimensional neurons) to pure otolith stimulation, as assessed by single unit recording from the vestibular nucleus in labyrinth-intact animals. These spatiotemporal features are also analyzed in association with other electrophysiological properties to evaluate their role in the central construction of a spatial frame of reference in the otolith system. Data derived from animals with elimination of inputs from one labyrinth then provide evidence that during vestibular stimulation signals arising from a single utricle are operative at the level of both the ipsilateral and contralateral vestibular nuclei. Hemilabyrinthectomy also revealed neural asymmetries in spontaneous activity, response dynamics and spatial coding behavior between neuronal subpopulations on the two sides and as a result suggested a segregation of otolith signals reaching the ipsilateral and contralateral vestibular nuclei. Recent studies have confirmed and extended previous observations that the recovery of resting activity within the vestibular nuclear complex during vestibular compensation is related to changes in both intrinsic membrane properties and capacities to respond to extracellular factors. The bilateral imbalance provides the basis for deranged spatial coding and motor deficits accompanying hemilabyrinthectomy. Taken together, these experimental findings indicate that in the normal state converging inputs from bilateral vestibular labyrinths are essential to spatiotemporal signal transformation at the central otolith neurons during low-frequency head movements.

To investigate the role of a potential diabetes-related mitochondrial region, which includes two previously reported mutations, 3243A--G and 3316G--A, in Chinese patients with adult-onset type 2 diabetes.A total of 277 patients and 241 normal subjects were recruited for the study. Mitochondrial nt 3116 - 3353, which spans the 16S rRNA, tRNA(leu(UUR)) and the NADH dehydrogenase 1 gene, were detected using polymerase chain reaction (PCR), direct DNA sequencing, PCR-restriction fragment length polymorphism and allele-specific PCR. Variants were analyzed by two-tailed Fisher exact test. The function of the variants in 16S rRNA were predicted for minimal free energy secondary structures by RNA folding software mfold version 3.Four homoplasmic nucleotide substitutions were observed, 3200T--C, 3206C--T, 3290T--C and 3316G--A. Only the 3200T--C mutation is present in the diabetic population and absent in the control population. No statistically significant associations were found between the other three variants and type 2 diabetes. The 3200T--C and 3206C--T nucleotide substitutions located in 16S rRNA are novel variants. The 3200T--C caused a great alteration in the minimal free energy secondary structure model while the 3206C--T altered normal 16S rRNA structure little.The results suggest that the 3200T--C mutation is linked to the development of type 2 diabetes, but that the other observed mutations are neutral. In contrast to the Japanese studies, the 3316G--A does not appear to be related to type 2 diabetes.

This study was a randomised controlled trial designed to assess the effectiveness of progressive muscle relaxation training (PMRT) in the clinical management of chemotherapy-related nausea and vomiting as an adjuvant intervention to accompany pharmacological antiemetic treatment (metoclopramide and dexamethasone i.v.). Seventy-one chemotherapy-naive breast cancer patients of an outpatient oncology unit of a university hospital in Hong Kong participated, with 38 subjects randomised to the experimental group and 33 to the control group. The intervention included the use of PMRT 1 h before chemotherapy was administered and daily thereafter for another 5 days (for a total of six PMRT sessions). Each session lasted for 25 min and was followed by 5 min of imagery techniques. The instruments used for data collection included the Chinese versions of the Profile of Mood States and the State-Trait Anxiety Inventory (measured before chemotherapy and then at day 7 and day 14 after chemotherapy), and the Morrow Assessment of Nausea and Vomiting Scale, which was used daily for the first 7 post-chemotherapy days. The use of PMRT considerably decreased the duration of nausea and vomiting in the experimental group compared with the control group ( P0.05), whereas there were trends toward a lower frequency of nausea and vomiting ( P=0.07 and P=0.08 respectively). Neither nausea nor vomiting differed in intensity between the two groups. The significant effects were mainly evident on the first 4 post-chemotherapy days, when differences were statistically significant. Although there was a significantly less severe overall mood disturbance in the experimental group over time ( P0.05), this did not apply in the case of anxiety. Such findings suggest that PMRT is a useful adjuvant technique to complement antiemetics for chemotherapy-induced nausea and vomiting and that incorporation of such interventions in the care plan can enhance the standards of care of cancer patients who experience side effects of chemotherapy.

Natural killer/T-cell (NK/T-cell) lymphoma is a highly aggressive tumor for which no serological tumor marker has yet been established to be useful clinically. We investigated the potential of circulating EBV DNA as a tumor marker for this malignancy.A real-time quantitative PCR assay was used to measure circulating EBV DNA.Plasma EBV DNA levels were measured in 18 patients with NK/T-cell lymphoma at presentation and during therapy. Plasma EBV DNA was detected in 17 of the 18 patients (median, 659 copies/ml; interquartile range, 181-17,042 copies/ml) but in none of 35 control subjects (p0.0001). Serial measurements of plasma EBV DNA levels during therapy showed a close correlation between clinical response and changes in plasma EBV DNA levels. Clinically responding patients showed a fall of plasma EBV DNA levels to low or undetectable levels, whereas those who failed therapy showed a rapid increase in plasma EBV DNA levels. Most importantly, patients with high baseline plasma EBV DNA levels (or = 600 copies/ml) demonstrated a significantly inferior survival than those with low baseline plasma EBV DNA (600 copies/ml; 21% versus 78%; P = 0.024).Plasma EBV DNA, as measured by real-time quantitative PCR, is a useful tumor marker for diagnosis, disease monitoring, and prediction of outcome in patients with NK/T-cell lymphoma.

We are interested in the possible role of central glial cells in pathogenesis of Parkinson's disease of mammals. Parkinsonism model was induced by systemic 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration, and the reactive glial cells were examined by immunocytochemical visualization of nestin protein in the brains and spinal cords of C57 mice. Abundant nestin-like immunoreactivity was predominately found in the caudate putamen of MPTP-treated mice and about 481-fold of nestin-like immunoreactive cells increased compared with that of control animals, indicating that significant up-regulation of nestin protein occurred in these regions. Majority of nestin-like immunoreactive cells characterized with astrocytic profiles of multiple, radical and hypotrophic processes, and showed a distribution and dynamic patterns similar to that of glial fibrillary acid protein (GFAP)-immunoreactive cells in the caudate putamen. Double immunofluorescence confirmed that 100% of nestin-like immunoreactive cells exhibited GFAP-immunoreactivity while nestin/GFAP double-labeled cells constituted about 84% of total GFAP-immunoreactive cells in the caudate putamen, indicating these nestin-like immunoreactive cells belong to a reactive population of the astrocytes. On the other hand, no obvious changes of nestin- or GFAP-like immunoreactivities were detected in the globus pallidus, the substantia nigra and the ventral tegmental area after MPTP-treatment. The results have provided morphological evidence for the regional activation of astrocytic glial cells following systemic MPTP administration, suggesting that a large population of reactive striatal astrocytes might play an important role in initial pathogenesis or acute stage of Parkinson's disease in mammals.