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Although negative air ionizer is commonly used for indoor air cleaning, few studies examine the concentration gradient of negative air ion (NAI) in indoor environments. This study investigated the concentration gradient of NAI at various relative humidities and distances form the source in indoor air. The NAI was generated by single-electrode negative electric discharge; the discharge was kept at dark discharge and 30.0 kV. The NAI concentrations were measured at various distances (10-900 cm) from the discharge electrode in order to identify the distribution of NAI in an indoor environment. The profile of NAI concentration was monitored at different relative humidities (38.1-73.6% RH) and room temperatures (25.2+/-1.4 degrees C). Experimental results indicate that the influence of relative humidity on the concentration gradient of NAI was complicated. There were four trends for the relationship between NAI concentration and relative humidity at different distances from the discharge electrode. The changes of NAI concentration with an increase in relative humidity at different distances were quite steady (10-30 cm), strongly declining (70-360 cm), approaching stability (420-450 cm) and moderately increasing (560-900 cm). Additionally, the regression analysis of NAI concentrations and distances from the discharge electrode indicated a logarithmic linear (log-linear) relationship; the distance of log-linear tendency (lambda) decreased with an increase in relative humidity such that the log-linear distance of 38.1% RH was 2.9 times that of 73.6% RH. Moreover, an empirical curve fit based on this study for the concentration gradient of NAI generated by negative electric discharge in indoor air was developed for estimating the NAI concentration at different relative humidities and distances from the source of electric discharge.

This work studied how wall surface materials influence the removal of airborne particles with negative air ions (NAIs) in indoor environments. Five wall surface materials—stainless steel, wood, PVC (polyvinyl chloride), wallpaper and cement paint—were applied to the inner surface of a test chamber. Two monodispersed solid NaCl particle sizes, 300 and 30 nm, were tested. The NAIs in the chamber were generated by negatively electric discharge in the range 3000–5000 ions cm - 3 . Experiments on the natural decay and application of NAIs were conducted at an air exchange rate of 1 h - 1 . The decay coefficient, the removal efficiency, the time to halve the concentration ( T 50 ) and the effective cleaning rate (ECR) were taken into account. The experimental data revealed that NAIs enhanced the removal of both 300 and 30 nm particles for each wall surface material. The decay coefficients of the NAI applications ( k a ) were 2.9–7.4 and 2.5–4.0 times higher than those of natural decay ( k n ) for 300 and 30 nm particles, respectively. However, the effect of the wall surfaces on the removal of particles was observed in both natural decay and NAI application experiments. The order of natural decay for 300 and 30 nm particles under different wall surfaces was cement paint > PVC ≅ wallpaper ≅ wood > stainless steel, as perhaps determined by the roughness of the wall materials. The overall removal efficiencies of 300 and 30 nm particles during 30 min of NAI emission were over 60% and 80%, respectively, in the chamber with wood and PVC wall surfaces. The half concentration times ( T 50 ) of NAI applications for various wall surfaces were less than 20 min, except for stainless steel and cement paint walls. The ECR demonstrated that the net effects of the NAIs for 300 nm particles followed the order wood (34.6 Lpm) > PVC (33.3 Lpm) > wallpaper (27.0 Lpm) > stainless steel (16.6 Lpm) > cement paint (14.8 Lpm). The ECR for 30 nm particles followed the order wood (41.4 Lpm) > PVC (30.4 Lpm) ≅ cement paint (30.3 Lpm) > wallpaper (27.7 Lpm) > stainless steel (20.1 Lpm). The NAI could remove particles from the wood and PVC wall surfaces substantially more effectively than from other wall materials. The various electrical characteristics and roughness of the wall materials may have been responsible for the associated of the various ECRs with the various wall surface materials.

In this study, six species of volatile organic compounds (VOCs), n -hexane, iso-butanol, toluene, p -xylene, m -xylene, and mesitylene, were selected as the target pollutants to investigate how the photocatalytic oxidation (PCO) performance is related to their physical/chemical properties. The PCO kinetics were well fit by a Langmuir–Hinshelwood (L–H) model for bimolecular surface reaction and competitive adsorption at gas flow rate above 1000 mL min −1 (reaction-controlling region), where the gas-phase mass transfer effect was negligible. The rate constants of PCO for toluene, p -xylene, m -xylene, and mesitylene ranged from 1.22 to 4.00 μmol m −2 s −1 , and were proportional to VOC-hydroxyl radical rate constant ( k OH ). The Langmuir adsorption constants of the four aromatic VOCs investigated and water ranged from 0.95 to 1.35 ppm −1 and from 5.61×10 −3 to 1.44×10 −3 ppm −1 , respectively. A strongly linear positive relationship was found between the reciprocal of the Langmuir adsorption constants of the four aromatic VOCs investigated and Henry's Law constants. Conversely, the reciprocal of Langmuir adsorption constants of water showed a strong negative relationship with Henry's Law constants (in units kPa m 3 mol −1 ) of the four aromatic VOCs investigated. The relationships noted above were not found between different classes of VOCs ( n -hexane, iso-butanol, and aromatic VOCs investigated). The percentage of residual intermediates (partially oxidized and incompletely mineralized organic compound from the primary VOCs) decreased as the inlet VOCs concentration decreased.

Anionic surfactant (sodium oleate, SO) was used to pretreat polypropylene fibrous filters to make them negatively charged. This work examines the effects on particle loading of an anionic surfactant-pretreated filter. Also, the effects of various factors, such as the particle size, the face velocity, concentration of the surfactant, and particle distribution (mono and poly) on the particle loading characteristics were evaluated. Experimental data reveal that the electric field of a filter treated with anionic surfactant (SO) could be directly measured using an electrofieldmeter, suggesting that the pretreatment with surfactant charged the filters. The results demonstrate that pretreating the filter with SO surfactant increases its particle-loading capacity. The clogging points of the untreated filter, and of the 0.01, 0.05 and 0.08 M SO-pretreated filter are 18, 23, 28 and 33 g/m 2 . The loading behavior of the SO-pretreated filter depended on the size of the particles and the operating face velocity. Additionally, the loading behavior of the SO-pretreated filter with polydisperse particles is much the same as that with monodisperse particles. However, the clogging point of the SO-pretreated filter with polydisperse particles is higher than that with monodisperse equal size.

Background: Before this study, the efficacy and safety of doubling the dosage of fluvastatin from 40 mg/day to 80 mg/day in Chinese patients with primary hypercholesterolemia remained to be determined. Methods: In this open-label, active-controlled randomized 2-center study, patients with primary hypercholesterolemia were randomized to treatment with immediate-release fluvastatin 40 mg/day (n = 30) or slow-release fluvastatin 80 mg/day (n = 31) for 12 weeks. The primary efficacy variable was percent change in low-density lipoprotein (LDL) cholesterol level from baseline. Secondary efficacy variables were percent changes in total cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol levels, and the percent of patients achieving LDL cholesterol goals of the US National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) II. Results: Both fluvastatin dosages (40 mg/day vs 80 mg/day) effectively reduced LDL cholesterol (-22.5% vs -29.9%; p = 0.087), total cholesterol (-17.3% vs -22.5%; p = 0.140), and triglyceride levels (-14.0% vs -12.3%; p = 0.813) (all p < 0.0001 for comparison with baseline), and slightly increased HDL cholesterol levels (+5.2% vs +5.6%; p = 0.917), after 12 weeks of treatment. The percent of patients achieving LDL cholesterol goals of the NCEP ATP II was 37% versus 65% (p < 0.05). The adverse event profiles for the 2 fluvastatin dosages were similar. Conclusion: In Chinese patients with primary hypercholesterolemia, doubling the dosage of fluvastatin from 40 to 80 mg once daily was effective and safe regarding reduction of LDL cholesterol level, and allowed more patients to achieve LDL cholesterol goals of the NCEP ATP II. (J Chin Med Assoc 2005;68(8):353-359)

A total of 32 patients without regional wall motion abnormality of the left ventricle underwent sequential tissue Doppler echocardiography and cardiac catheterization. Peak velocities of systolic (Sa), early diastolic (Ea), and late diastolic (Aa) motion of the mitral annulus were measured. Normal references for Sa, Ea and Aa were obtained from 138 volunteers. Indices of left ventricular (LV) systolic and diastolic function were evaluated using high-fidelity LV pressure and volume signals. By multivariate analysis, Sa, Ea and As were significantly and independently related to the maximum of the first derivative of pressure over time (dP/dt max ), LV relaxation time constant (τ), and LV ejection fraction (EF), respectively. Using the fifth percentiles of the age-stratified normal references as cut-offs, low Sa, low Ea and low Aa identified declined dP/dt max , prolonged τ and reduced EF, respectively, with good sensitivities and specificities. In conclusion, mitral annulus velocities by tissue Doppler echocardiography can be used to identify patients with declined dP/dt max , prolonged τ and reduced EF. (E-mail: chench@vghtpe.gov.tw)

Although negative air ionizers have been used in indoor air cleaning, few studies have been carried out on removal of volatile organic compounds (VOCs) by negative air ions (NAI). This study investigated the reactions of NAI and VOCs in a batch reactor. Three species of VOCs—chloroform, toluene and 1,5-hexadiene—were selected to react with NAI at relative humidities 0%, 25% and 70%. NAI was generated by a negative electric discharge at 15.0 kV. The reaction chamber was designed as a dark discharge to prevent the generation of O3 and NOx. NAI concentrations were 1.34 � 10 6 –1.24 � 10 6 ion cm � 3 at relative humidities between 0% and 70%. The results indicate that the order of reactions of chloroform and toluene with NAI was zero, and was 0.433 for 1,5-hexadiene. The reaction rate constants of chloroform, toluene, and 1,5-hexadiene were 1.74–3.07, 1.07–2.66 ppb min � 1 and 0.463–0.478 ppb 0.567 min � 1 at relative humidity from 0% to 70%. The effect of relative humidity on the reaction kinetics was obvious for chloroform and toluene but not for 1,5-hexadiene. The reaction between 1,5-hexadiene and NAI generated a relatively stable intermediate species, 4-pentenal. The oxidation of chloroform, toluene, and 1,5-hexadiene by NAI proceeded slowly. r 2004 Elsevier Ltd. All rights reserved.

This study investigates the effects of adding anionic and nonionic surfactants to the scrubbing liquid during the absorption of naphthalene ~Nap! using a wet scrubber. Both batch and continuous experiments were performed on a laboratory-scale packed tower scrubber by adding surfactants to the scrubbing liquid. An anionic surfactant sodium dodecyl sulfate ~SDS! and two nonionic polyoxy- ethylene surfactants C10E4 @tetraethylene glycol mono~decyl ether!# and C14E8 @octaethylene glycol mono~tetradecyl ether!# were used. The concentrations of the surfactant solutions all exceeded the critical micelle concentration. The results of continuous experiments indicate that the efficiencies of removal of naphthalene by C10E4 and C14E8 were 75.0 and 71.9%, respectively, at a concentration of 1.0310 22 M. The removal efficiency of naphthalene by SDS ranged from 6 to 39% at concentrations from 1.0 310 22 to 1.0310 21 M under continuous scrubbing. In the batch experiments, the batch naphthalene absorption capacities were estimated to be 31.8 mg Nap/g C10E4 , 12.9 mg Nap/g C14E8 , and 2.4 mg Nap/g SDS. A comparison was also made among SDS, C 10E4 , and C14E8 in terms of cost, foaming, impact of wastewater, removal efficiency, and absorption capacity.

In end-stage renal disease (ESRD) patients undergoing regular haemodialysis (HD), the maintenance of fluid status within an optimal range is critical. We therefore examined the role of Doppler echocardiographic parameters in the assessment of fluid status in these patients.Three study groups were enrolled: 40 healthy volunteers (NTNR), 40 HD patients who were normotensive without receiving antihypertensive agents (NTHD) and 38 HD patients who had remained hypertensive (HTHD) despite antihypertensive treatment. Measurements of Doppler echocardiographic parameters from pulmonary vein (PV) and mitral inflow (Mi) were performed on a non-dialysis day. Extracellular water as a percentage of body weight (ECW%) and pre-dialysis mean blood pressure (BDMBP) were references for fluid status. The best Doppler parameter for fluid status assessment identified from the study groups was then tested in another validation groups (38 NTHD and 38 HTHD).Among all of the PV and Mi parameters, the S/D ratio (peak systolic velocity divided by peak diastolic velocity) was correlated with fluid status parameters best (with ECW%, r = -0.49, P0.001; with BDMBP, r = -0.51, P0.001). The correlations were independent of age, sex and Mi parameters. The receiver operating characteristics curve analysis demonstrated that an S/D ratio1.33 had a sensitivity of 90% and a specificity of 77% in identifying NTHD patients. When the same criterion was applied to the validation groups, the positive predictive value was 64% and the negative predictive value was 86%.The Doppler-derived S/D ratio is a potentially useful marker for the assessment of fluid status in HD patients.

Background: Patient-activated event re- corders are useful for the diagnosis of arrhythmia in patients with palpitation and presyncope. However, the utility of event recorders in patients suspected of arrhythmia but presenting with other symptoms is not clear. Furthermore, the factors influencing their utility have not been evaluated.

Pulmonary vein Doppler spectrum is highly load-dependent and thus has been used to estimate left ventricular (LV) filling pressure. However, the impact of LV function on pulmonary vein Doppler spectrum remains obscure because only load-sensitive indices were studied previously. In the present study, measurements of the pulmonary vein Doppler spectrum were correlated with load-insensitive LV systolic (end-systolic elastance [Ees]) and diastolic (relaxation time constant [tau] and beta coefficient of the end-diastolic pressure volume relationship) function indices obtained from an invasive catheterization study nonsimultaneously. The peak velocity, velocity time integral, and duration of systolic forward spectrum were significantly correlated with Ees (r = 0.35, r = 0.36, andr = 0.41, respectively;P < 0.05). The pulmonary vein diastolic velocity time integral (PVDVTI) and duration of the diastolic forward spectrum were significantly correlated with Ees (r = 0.51andr = 0.57, respectively;P < 0.01). PVDVTI was correlated with tau and the end-diastolic pressure-volume relationship (EDPVR) (r = 0.42andr = 0.40respectively,P < 0.05). On the other hand, the systolic fraction of the forward spectrum was significantly correlated with ejection fraction (for peak velocity,r = 0.63, P < 0.01; for velocity time integral,r = 0.37, P < 0.05) but not with Ees, and the diastolic fraction of the forward spectrum was significantly correlated with minimum pressure derivative over time (for peak velocity,r = 0.48, P < 0.05; for velocity time integral,r = 0.44, P < 0.05, respectively) but not with tau or EDPVR. In summary, the systolic and diastolic components of the pulmonary vein Doppler spectrum are affected variably by LV systolic and diastolic function, independent of the loading condition. The systolic and diastolic fraction of pulmonary vein Doppler spectrum appears to depend more on the loading condition than the LV systolic or diastolic function. (ECHOCARDIOGRAPHY, Volume 20, January 2003)

Hemodialysis vascular accesses are prone to recurrent stenosis and thrombosis after endovascular interventions. In vitro data suggest that indoxyl sulfate, a protein-bound uremic toxin, may induce vascular dysfunction and thrombosis. However, there is no clinical evidence regarding the role of indoxyl sulfate in hemodialysis vascular access. From January 2010 to June 2013, we prospectively enrolled patients undergoing angioplasty for dialysis access dysfunction. Patients were stratified into tertiles by baseline serum indoxyl sulfate levels. Study participants received clinical follow-up at 6-month intervals until June 2014. Primary end points were restenosis, thrombosis, and failure of vascular access. Median follow-up duration was 32 months. Of the 306 patients enrolled, 262 (86%) had symptomatic restenosis, 153 (50%) had access thrombosis, and 25 (8%) had access failure. In patients with graft access, free indoxyl sulfate tertiles showed a negative association with thrombosis-free patency (thrombosis-free patency rates of 54%, 38%, and 26% for low, middle, and high tertiles, respectively; P=0.001). Patients with graft thrombosis had higher free and total indoxyl sulfate levels. Using multivariate Cox regression analysis, graft thrombosis was independently predicted by absolute levels of free indoxyl sulfate (hazard ratio=1.14; P=0.01) and free indoxyl sulfate tertiles (high versus low, hazard ratio=2.41; P=0.001). Results of this study provide translational evidence that serum indoxyl sulfate is a novel risk factor for dialysis graft thrombosis after endovascular interventions.

The left ventricular (LV) end-systolic pressure-volume relation (ESPVR) is a load-insensitive method for evaluating LV contractility, which needs invasive measurement. Some noninvasive methods substitute peak aortic pressure (Ps) for end-systolic LV pressure by assuming there is no difference between these pressures. However, this assumption has not been directly validated. With conductance catheter and dual micromanometers, ESPVRs and the slope (EesLv) were constructed from simultaneous LV pressures (LVP) and volumes, aortic pressures (AOP) and LV volumes (Ees(AO)), and Ps and LV end-ejection volumes (VEE) (Ees(PP-EEV)) during preload reduction in 50 subjects. The ratio of steady-state P(s) over V(EE) (P(S)/V(EE)) was also checked. AOP and LVP displayed differences of 11 +/- 6 and -30 +/- 12 mm Hg at the onset and end-ejection, respectively, and -2 +/- 4 mm Hg at end-systole. Ees(AO) and Ees(LV) were nearly identical: Ees(AO) = 0.97 x Ees(LV) + 0.05, r2 = 0.99. Ees(PP-EEV) correlated with EesLV (EesPP-EEV = 0.57 x EesLV + 0.61, r2 = 0.46) but with much more scatter. Ps/V(EE) correlated worst with Ees(LV). Central AOP can be substituted for LVP to derive EesLV. Other estimation methods yield weaker and poor correlations to directly measured Ees.

Blood-brain barrier (BBB) characteristics are induced and maintained by crosstalk between brain microvascular endothelial cells and neighboring cells. Using in vitro cell models, we previously found that a bystander effect was a cause for Japanese encephalitis-associated endothelial barrier disruption. Brain astrocytes, which neighbor BBB endothelial cells, play roles in the maintenance of BBB integrity. By extending the scope of relevant studies, a potential mechanism has been shown that the activation of neighboring astrocytes could be a cause of disruption of endothelial barrier integrity during the course of Japanese encephalitis viral (JEV) infection. JEV-infected astrocytes were found to release biologically active molecules that activated ubiquitin proteasome, degraded zonula occludens-1 (ZO-1) and claudin-5, and disrupted endothelial barrier integrity in cultured brain microvascular endothelial cells. JEV infection caused astrocytes to release vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and matrix metalloproteinases (MMP-2/MMP-9). Our data demonstrated that VEGF and IL-6 released by JEV-infected astrocytes were critical for the proteasomal degradation of ZO-1 and the accompanying disruption of endothelial barrier integrity through the activation of Janus kinase-2 (Jak2)/signal transducer and activator of transcription-3 (STAT3) signaling as well as the induction of ubiquitin-protein ligase E3 component, n-recognin-1 (Ubr 1) in endothelial cells. MMP-induced endothelial barrier disruption was accompanied by MMP-mediated proteolytic degradation of claudin-5 and ubiquitin proteasome-mediated degradation of ZO-1 via extracellular VEGF release. Collectively, these data suggest that JEV infection could activate astrocytes and cause release of VEGF, IL-6, and MMP-2/MMP-9, thereby contributing, in a concerted action, to the induction of Japanese encephalitis-associated BBB breakdown. GLIA 2015;63:1915-1932.

ObjectiveWe prospectively investigate the relation between baseline circulating endothelial progenitor cells and the subsequent development of restenosis after angioplasty of hemodialysis vascular access.BackgroundEffect of angioplasty for hemodialysis vascular access is greatly attenuated by early and frequent restenosis. Circulating endothelial progenitor cells (EPCs) play a key role in vascular repair but are deficient in hemodialysis patients.MethodAfter excluding 14 patients due to arterial stenosis, central vein stenosis, and failed angioplasty, 130 patients undergoing angioplasty for dysfunctional vascular access were prospectively enrolled. Flow cytometry with quantification of EPC markers (defined as CD34+, CD34+KDR+, CD34+KDR+CD133+) in peripheral blood immediately before angioplasty procedures was used to assess circulating EPC numbers. Patients were followed clinically for up to one year after angioplasty.ResultsDuring the one-year follow-up, 95 patients (73%) received interventions for recurrent access dysfunction. Patients in the lower tertile of CD34+KDR+ cell count had the highest restenosis rates (46%) at three month (early restenosis), compared with patients in the medium and upper tertiles of CD34+KDR+ cell count (27% and 12% respectively, p = 0.002). Patients in the lower tertile of CD34+KDR+ cell count received more re-interventions during one year. Patients with early restenosis had impaired EPC adhesive function and increased senescence and apoptosis. In multivariate analysis, the CD34+KDR+ and CD34+KDR+CD133+ cell counts were independent predictors of target-lesion early restenosis.ConclusionOur results suggest that the deficiency of circulating EPCs is associated with early and frequent restenosis after angioplasty of hemodialysis vascular access.

Purpose Vascular access thrombosis is a common complication of arteriovenous dialysis grafts that results in silent pulmonary embolism (PE) in a substantial proportion of patients. However, the impact of repeated PE on the pulmonary vasculature remains unclear. Materials and Methods From January 2010 to April 2012, 110 patients undergoing maintenance hemodialysis via arteriovenous grafts were recruited. Hemodynamic assessments, including transthoracic echocardiography and right heart catheterization, were performed at baseline and after 1 year to evaluate the changes in pulmonary artery (PA) pressures and heart function. Results Fifty-two patients completed the follow-up hemodynamic assessment at a median duration of 535 days and had at least one endovascular thrombectomy procedure (median of seven). There was no significant difference in mean PA pressures between baseline and the end of follow-up (23.1 mm Hg ± 6.8 vs 21.6 mm Hg ± 6.1; P = .16). The change in mean PA pressure did not correlate with the number of thrombectomy procedures in the overall cohort ( r = −0.02, P = .89) or in the subgroup with cardiopulmonary disease ( r = −0.30, P = .14). The changes of mean PA pressure were not associated with number of thrombectomy procedures (β = −0.03, P = .89). Conclusions Repeated endovascular thrombectomy procedures are not related to changes in PA pressure in the short term. The present results support the safety of endovascular thrombectomy in the pulmonary vasculature.

Although hemodialysis vascular access dysfunction is often caused by venous stenosis, stenosis can occur anywhere in the circuit. Herein, we report a 75-year-old woman who received repeated percutaneous angioplasty due to insufficient flow. Finally, a culprit stenosis at the subclavian artery was found and treated. Subclavian artery stenosis is often atherosclerotic in origin and is usually delayed to be diagnosed because of caveats in the care of vascular access. This case highlights important clues that can assist in the early discovery of inflow problems and reminds the physician that inflow stenosis may be hidden at a site far from the anastomosis.

BACKGROUND The objective of this study was to evaluate the correlation between intratumoral blood flow as assessed by color Doppler ultrasound with stage, tumor grade, depth of invasion, and lymph node metastasis in endometrial carcinoma and determine its clinical usefulness. METHODS Sixty-six patients with endometrial carcinoma were enrolled. All patients received surgical treatment. Transvaginal color Doppler ultrasound was performed before surgery to detect the arterial blood flow signals within the tumors and the lowest resistance index (RI) was recorded. Formalin fixed, paraffin embedded pathology slides were reviewed by a senior pathologist to evaluate the histologic grading, tumor size, depth of myometrial invasion, and presence of lymph node metastasis. RESULTS Intratumoral RI correlated well with surgical staging, histologic grading, the depth of myometrial invasion, and the presence of lymph node metastasis. Significantly lower RI was noted in tumors of advanced stage (> than International Federation of Obstetrics and Gynecology [FIGO] Stage I) (0.38 ± 0.09 vs. 0.54 ± 0.11; P 50% myometrial thickness) (0.38 ± 0.07 vs. 0.54 ± 0.11; P < 0.001), and tumors with lymph node metastasis (0.34 ± 0.07 vs. 0.52 ± 0.11; P < 0.001) compared with tumors with Stage I, Grade 1/2 histology, no or superficial myometrial invasion, and absence of lymph node metastasis, respectively. CONCLUSIONS Intratumoral blood flow analysis assessed by color Doppler ultrasound correlates well with surgical stage, tumor grade, myometrial invasion, and lymph node metastasis in patients with endometrial carcinoma. Assessment of tumor angiogenesis using color Doppler ultrasound provides useful information for the preoperative prediction regarding stage, histologic grade, depth of myometrial invasion, and presence of lymph node metastasis in patients with endometrial carcinoma. The authors believe routine pelvic lymph node dissection should be performed for those patients whose lowest RI values of intratumoral blood flow are ≤ 0.4 because those patients are at very high risk for pelvic lymph node involvement. Cancer 1998;82:1881-6. © 1998 American Cancer Society.

Rutin has been shown to possess beneficial health effects, including hepatoprotection. However, to date, it has not been demonstrated to have a hepatoprotective effect against cholestatic liver injury. This is the first report to show a protective effect of rutin on cholestatic liver injury. Cholestasis was produced by bile duct ligation (BDL) in male Sprague-Dawley rats for 3 weeks. Daily oral administration of rutin was started 1 week before injury and was maintained for 4 weeks. In comparison with the control group, the BDL group showed liver injury as evidenced by histological changes and elevation in serum biochemicals, ductular reaction, fibrosis, inflammation, and oxidative stress. These pathophysiological changes were attenuated by rutin supplementation. Rutin alleviated BDL-induced transforming growth factor β1 (TGF-β1), interleukin-1β, connective tissue growth factor, and collagen expression. The antifibrotic effect of rutin was accompanied by reductions in α-smooth muscle actin-positive matrix-producing cells and Smad2/3 activity critical to the fibrogenic potential of TGF-β1. Rutin attenuated BDL-induced oxidative stress, leukocyte accumulation, NF-κB activation, and proinflammatory cytokine production. Further studies demonstrated an inhibitory effect of rutin on the redox-sensitive intracellular signaling molecule extracellular signal-regulated kinase (ERK). Rutin also attenuated BDL-induced reduction in NF-E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and AMP-activated protein kinase (AMPK). Taken together, the beneficial effects of rutin were shown to be associated with antioxidative and anti-inflammatory effects as well as the downregulation of NF-κB and TGF-β/Smad signaling, probably via interference of ERK activation and/or enhancement of Nrf2, HO-1, and AMPK activity.

Background Postoperative nausea and vomiting as well as postoperative pain are two major concerns when patients undergo surgery and receive anesthetics. Various models and predictive methods have been developed to investigate the risk factors of postoperative nausea and vomiting, and different types of preventive managements have subsequently been developed. However, there continues to be a wide variation in the previously reported incidence rates of postoperative nausea and vomiting. This may have occurred because patients were assessed at different time points, coupled with the overall limitation of the statistical methods used. However, using survival analysis with Cox regression, and thus factoring in these time effects, may solve this statistical limitation and reveal risk factors related to the occurrence of postoperative nausea and vomiting in the following period. Methods In this retrospective, observational, uni-institutional study, we analyzed the results of 229 patients who received patient-controlled epidural analgesia following surgery from June 2007 to December 2007. We investigated the risk factors for the occurrence of postoperative nausea and vomiting, and also assessed the effect of evaluating patients at different time points using the Cox proportional hazards model. Furthermore, the results of this inquiry were compared with those results using logistic regression. Results The overall incidence of postoperative nausea and vomiting in our study was 35.4%. Using logistic regression, we found that only sex, but not the total doses and the average dose of opioids, had significant effects on the occurrence of postoperative nausea and vomiting at some time points. Cox regression showed that, when patients consumed a higher average dose of opioids, this correlated with a higher incidence of postoperative nausea and vomiting with a hazard ratio of 1.286. Conclusion Survival analysis using Cox regression showed that the average consumption of opioids played an important role in postoperative nausea and vomiting, a result not found by logistic regression. Therefore, the incidence of postoperative nausea and vomiting in patients cannot be reliably determined on the basis of a single visit at one point in time.

Dry deposition and air sampling were undertaken simultaneously at two traffic intersections (TA and TB sites) with several dry deposition plates and PS‐1 samplers from August to December 1995 in southern Taiwan. In addition, samples in a lane (L) and a residence (R) sites were also determined and compared. Twenty‐one individual polycyclic aromatic hydrocarbons (PAHs) were analyzed primarily with a gas chromatographyVmass spectrometer (GC/MS). At the traffic intersections, the dry deposition velocities of total‐PAHs averaged 0.38 and 0.23 cm sec‐1 in the day‐time and at night‐time, respectively. This result shows that, in the ambient of traffic intersections, significant fraction of PAH dry deposition are contributed by the road dust resuspension caused by traveling vehicles. In general, the lower molecular weight (LMW) PAHs, being primarily in the gas phase, have lower dry deposition velocities; while the higher molecular weight (HMW) PAHs, which are mainly associated with particulates, have high...

Fresh tumor tissues instead of paraffin-embedded sections were used to study the clinical significance of the tumor cell kinetics in cervical carcinomas by flow cytometry. We analyzed specimens from 153 women with cervical cancer, and DNA aneuploidy was found in 61 cases (39.9%). The mean age of patients with aneuploid tumors was significantly higher than the age of patients with diploid tumors (P

Adenofibroma of the endometrium is thought to be a rare benign variant of the mixed mesodermal tumor, and its preoperative diagnosis is difficult. We describe the sonographic characteristics of two cases of adenofibroma of the endometrium. In both cases the patient was receiving prolonged tamoxifen therapy following surgery for breast cancer. Sonographically, this rare disease is observed as an intracavitary mass containing multiple small cysts with low-resistance intratumor blood flow. The unique sonographic findings make the preoperative diagnosis possible. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology

In (k, n) threshold secret image sharing (TSIS), a secret image is shared into n shadow images. Any k or more shadow images can be collaborated together to reconstruct the secret image, while less than k shadow images cannot reveal any secret. All shadow images have the same importance in reconstruction process. In some applications, some participants are accorded special privileges due to their status or importance. In this paper, we consider the (t, s, k, n) essential TSIS (ETSIS) scheme. All n shadows in the proposed (t, s, k, n)-ETSIS scheme are classified into s essential shadows and (n–s) non-essential shadows. In reconstruction, we needs k shadow images with at least t essential shadow images.

Cross-circulation of conjoined twins in utero has been demonstrated and the extent of its severity has varied. Significant 'extrauterine' twin-twin transfusion syndrome after birth, however, caused by an unbalanced shunting within the circulation has not been reported. In a case of omphalopagus conjoined twins complicated by hypovolemia in one twin and hypervolemia in the other, we demonstrated by color Doppler imaging an aberrant vessel from the hepatic artery of one twin to the hepatic vein of the other. Unbalanced shunting through this aberrant vessel was suspected and urgent separation of the conjoined twins was undertaken. Circulatory changes after birth leading to 'extrauterine twin-twin transfusion syndrome' are discussed. A possible explanation of the pathophysiology of intrauterine twin-twin transfusion syndrome is also given.

Background. Much evidence has suggested that vascular density reflects the clinical behavior of cancer. In this study, the intratumoral blood flow in cervical carcinomas was assessed by transvaginal color Doppler ultrasound, and its clinical significance was evaluated. Methods. Sixty-five patients with Stage Ib-IIb cervical carcinoma exhibiting visible cervical tumor by transvaginal ultrasound were enrolled. All patients were scheduled for radical hysterectomy and pelvic lymph node dissection. Transvaginal color Doppler ultrasound was performed before surgery to search for blood flow signals from the tumor and the main uterine artery. The corresponding arterial resistance index (RI) was calculated. Clinical and pathologic data were recorded. A cytokinetic study was performed by propidium iodide staining and flow cytometry. The human papillomavirus (HPV) status was assessed by polymerase chain reaction. Results. Intratumoral blood flow was detected by color Doppler ultrasound in 46.2% (30/65) of the tumors. Patients with detectable intratumoral blood flow exhibited significantly more pelvic lymph node metastasis (10/30 vs. 2/35, P = 0.005), a higher percentage of cancer cells in the S- + G 2 M-phase (30.02 ± 18.54% vs. 19.35 ± 11.21%, P < 0.005), and a higher prevalence of HPV infection (30/30 vs. 25/35, P = 0.001) when compared with those without intratumoral blood flow. No significant difference was observed concerning the patient's age, tumor size, clinical staging, histologic type, and DNA ploidy status between these two groups. Regression analysis of the intratumoral RI value on the S- + G 2 M-phase fraction showed linear regression (n = 30, r 2 = 0.501, P < 0.01). The RI values of the main uterine artery showed no significant difference between these two groups. Conclusion. The intratumoral blood flow by transvaginal color Doppler ultrasound correlated well with a higher proliferation index, higher incidence of HPV infection, and pelvic lymph node metastasis in cervical carcinoma. Cancer 1995 ; 75 :2518-22.

Current guidelines recommend getting a 12-lead electrocardiogram (ECG) within 10 minutes after the arrival of Emergency Department for patients with ST elevation myocardial infarction (STEMI). Previous quality–improving activities in our hospital revealed that failing to target door-to-ECG time

We used the polymerase chain reaction (PCR) to study the presence and typing of human papillomavirus (HPV) DNA, and PCR/single-strand confirmation polymorphism to survey the mutations of the p53 gene in exons 5-9 in 26 bulky stage IB cervical cancers. The HPV DNA was present in 20 out of the 21 (95%) squamous-cell carcinoma tissues, including 13 cases of HPV-16, 0 case of HPV-18, and 7 cases of other HPV types. In the other 5 adenocarcinoma tissues, 3 had HPV type-18 DNA and 2 had no detectable HPV DNA. The distribution of HPV DNA in bulky tumors was not statistically different from that in the other 228 squamous-cell carcinomas and 23 adenocarcinomas of smaller size operated upon during the same period. Out of the 26 patients, 9 (35%) had lymph node metastasis at the time of operation. During the follow-up period ranging from 19 to 48 months, 9 patients had recurrence and 7 of them died of disease. The distribution of HPV types was not related to the prognosis in these patients. There were no p53 mutations detected in all the 26 samples. Thus, HPV type and the status of p53 could not serve as additional prognostic factors in stage IB bulky cervical cancers.

BACKGROUND: Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. METHODS: Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta-human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two-tailed Student's t-test and Fisher's exact test were used for statistical analysis. RESULTS: The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta-hCG level at diagnosis in diffuse type lesions (6608 +/- 6320 mIU/mL) was significantly lower than in the lacunar type (40462 +/- 39735 mIU/mL; P = 0.04) and compact type (212114 +/- 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 +/- 0.13) than diffuse type (0.66 +/- 0.10; P = 0.03) or compact type lesions (0.70 +/- 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. CONCLUSION: Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta-hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.

Flow cytometry analyses of tumors from 12 patients with cervical squamous cell carcinoma under radiotherapy were performed in this preliminary study. Six patients with a high (10%) G2/M fraction before treatment showed greater than 50% tumor reduction after initial 2000 cGy radiotherapy. Only two out of six patients with a low (10%) G2/M fraction before treatment responded favorably and three of them already had recurrence during the follow-up period of 33-40 months. Hyperploidy (DNA index1.1) was observed in 5 patients; all of them responded well to radiotherapy in contrast to three out of seven diploid tumors.

Background. The crucial role of angiogenesis in tumor behavior has been studied extensively in vitro. The authors assessed the in vivo angiogenesis in ovarian neoplasms by color Doppler ultrasound and waveform analysis. Methods. The intratumor artery resistance index (RI) of 222 ovarian neoplasms referred for color Doppler ultrasound evaluation was measured, and the corresponding histopathologic diagnosis was recorded. Results. Satisfactory intratumor artery waveforms were obtained at an average of 1.12 sites in 44.7% (68 of 152) of benign tumors and at 6.28 sites in 97.1% (68 of 70) of the malignant group. Great heterogeneity in RI values existed. The RI of the intratumor artery in the benign group during the follicular phase (mean, 0.678) was significantly higher (P

A tag-collision problem (or missed reads) in Radio Frequency Identification (RFID) system is the event that a reader cannot identify the tag if many tags respond to a reader at the same time. The so-called M-ary (M=2, 4, 8, …) query tree protocols were proposed for tag collision arbitration. Mathys et al. showed that ternary (M=3) query tree will bring about the optimum performance for tag identification. However, a ternary tree is impossible in the query tree protocol. In this paper, we propose a practical implementation of a ternary query tree (TQT) for identifying a binary EPC. Simulation results reveal our TQT outperforms the M-ary query tree.

This study analyzes the anesthesia manner about attributes the knee replacement surgery from Taiwan NHI (National Health Insurance) database based on cluster and association technique. This study used the National Health Insurance drug items selected narcotic agents, and then encoded with the health care doctors in bringing all the information associated with drugs, after data calibration and debugging, further details with the hospital files and data files associated with medical institutions, and then screening outpatient data, analyzing the distribution of anesthesia options. The results from this study will be able to see a knee replacement surgery for the choice of anesthesia in the domestic distribution of property and with the hospital, patients and doctors attribute the correlation among attributes.

Ergot-containing medications are widely used to treat migraine patients in some countries but nowadays intoxication is only reported rarely. We report a 35-year-old woman who presented with acute paresthesia of the extremities. An angiogram revealed diffuse vasospasm of the femoral arteries bilaterally and the right brachial artery. History taking disclosed a possible interaction between ergotamine and macrolide antibiotics. The patient's symptoms improved rapidly after discontinuation of the offending medication and administration of vasodilators. This report aims to remind physicians that catastrophic adverse effects can develop through unrecognized drug interactions, even with widely prescribed medications given in safe dosages. The importance of a detailed drug history and knowledge of drug interactions cannot be overemphasized in the diagnosis of ergotism.

Objective The aim of the study was to evaluate the role of atherosclerosis risk factors and baseline inflammatory status in the development of restenosis after successful percutaneous transluminal angioplasty (PTA) of hemodialysis arteriovenous (AV) fistulas. Research design and methods We obtained baseline plasma biochemistry and inflammatory markers in 140 patients with dysfunctional AV fistulas before the PTA procedures. Patients were followed clinically for 6 months. Results There was no significant difference in the baseline inflammatory markers between the restenosis and patency group. The Kaplan–Meier analysis showed that non-diabetic patients had higher patency rate than diabetic patients (69% vs. 48%, p =0.02) and diabetic patients with optimal glycemic control had higher patency rate than patients with suboptimal glycemic control (61% vs. 30%, p =0.01). Conclusions The presence of diabetes mellitus predicted restenosis of AV fistulas after PTA and optimal blood glucose control might be critical to the patency after PTA.

Background. The endovascular salvage of occluded autogenous radial-cephalic fistulae is a more challenging procedure than that for stenotic fistulae. To obtain an access to the fistula is one of the keys to success. Both retrograde venous approach and brachial artery approach have some disadvantages. The radial artery approach has been used in the endovascular therapy of fistula dysfunction, but few data focused on their feasibility and safety for the totally occluded fistulae. Methods. We retrospectively reviewed the patients with occluded autogenous radial-cephalic fistulae receiving endovascular salvage via the radial artery approach in our institution. From January 2004 to July 2007, 48 patients fulfilling the above criteria were enrolled. Balloon maceration was used for patients with small clots. Mechanical thrombectomy with an Arrow-Trerotola percutaneous thrombolytic device or an AngioJet rheolytic catheter was used for patients with large clot burden. Outcome variables included anatomic and clinical success, complications and primary and secondary patency. Results. All the transradial punctures were successful. Anatomic and clinical success was achieved in 96% of the cases. The post-interventional primary patency rates were 92%, 77%, 55% and 44% at 1, 3, 6 and 12 months, respectively. The post-interventional secondary patency rates were 96%, 93%, 89% and 89% at 1, 3, 6 and 12 months, respectively. The 12-month primary patency of the shortsegment thrombus group was better than that of the longsegment thrombus group (57% versus 19%, P = 0.005). The complication rate was 4%. No puncture-site-related complications were noted, and all the radial arteries were palpable at follow-up. Conclusions. An endovascular intervention through the radial artery approach is a safe and feasible strategy choice for restoring occluded autogenous radial-cephalic fistulae.

Annexin V labeled with a γ emitter can be used for the imaging of apoptosis. 99mTc is very suitable for clinical imaging with its 140-keV γ ray, 6-h half life and economical availability from a 99Mo-99mTc generator. In this study, we have constructed a form of annexin V with a N-terminal extension containing six histidine residues. The histidine-tagged annexin V (his-annexin V) can be directly labeled with 99mTc(I) tricarbonyl ion, [99mTc(OH2)3(CO)3]+.

A novel and interesting application of RFID was a banknote attached a tag to determine the authenticity of money and to stop counterfeits. At Financial Cryptography 2003, Juels and Pappu firstly proposed a practical RFID banknote protection scheme (RBPS) by using the optical and the electrical (RFID) contacts. RFID-enabled notes can be tracked by the legal law agency and verified by the merchant. However, some effective attacks on the Juels-Pappu RBPS were subsequently proposed. In this paper, we enhance the Juels-Pappu RBPS to conquer such attacks.

Few studies examine the association between serum uric acid (SUA) and acute coronary syndrome (ACS). We aimed to investigate the association between SUA and ACS in a prospective study of ethnic Chinese. Enrolled were 128569 adults ≥ 20 yrs from 4 MJ Health Checkup Clinics in Taiwan during 1994 –1996, excluding those with heart disease, stroke, renal disease and cancer disease. All physical examination, biochemical test and structured questionnaire were executed in standardized central labs. ACS was defined by main ICD-9 of 410 – 414 from claim data of National Health Insurance for hospitalization and from Death certification registry. Cox proportional hazard model was used to estimate the hazard ratios (HRs) between levels of SUA and ACS events. A total of 2049 subjects (Men: 1239/Women: 810) developed ACS during the period from baseline to Dec.31.2002. Men had higher ACS incidence than women (2.84 vs. 1.61 per 1000 person-years [PY]; p < .0001). Independent risk factors of ACS unfolded from this study included age, male sex, waist circumference, body mass index, triglycerides, total-cholesterol, hypertension, diabetes, uric acid, and current smoking. The crude incidences of ACS were 1.27, 2.06, 3.27 and 4.61 per 1000 PY in that order for four consecutive SUA groups (group1

Objectives: To evaluate the technical success, safety and patency of cutting balloon angioplasty for the treatment of resistant dialysis access stenoses. Background: Cutting balloon angioplasty has been proposed to be useful in treating resistant dialysis access stenoses. However, they are based on experience with very limited cases and formal patency data is insufficient. Methods: The author retrospectively reviewed 896 percutaneous transluminal angioplasty (PTA) procedures for the treatment of dysfunctional or thrombotic dialysis access. Thirty-seven of 623 patients with native fistulas and 23 of 273 patients with synthetic grafts had residual stenoses of more than 30% after conventional PTA at an inflation pressure of 24 atm for 60 sec. In these 60 patients, additional cutting balloon PTA was performed. Results: The overall technical success rate was 96.7% and clinical success rate was 98.3%. Only one patient experienced mild local extravasation. The postintervention primary patency rates for native fistula group (N = 37) were 100%, 86.4%, and 67.5% at 1-month, 3-month, and 6-month; the postintervention primary patency rates for synthetic graft group (N = 23) were 87.0%, 60.9%, and 34.2% at 1-month, 3-month, and 6-month respectively. Conclusions: For resistant venous stenoses of dialysis access, cutting balloon PTA is effective, safe, and seems to provide comparative primary patency as suggested by guidelines. © 2008 Wiley-Liss, Inc.

This work investigated the size distribution of the droplet nuclei and coughed droplets by test subjects. The size distributions of droplet nuclei coughed by test subjects were determined with an aerodynamic particle sizer (APS) and scanning mobility particle sizer (SMPS) system (system 1). Coughed droplets were only sampled with the APS system (system 2). Two different schemes were employed in system 2. Furthermore, the size distribution of coughed droplets of different ages and gender was investigated to identify the effects of age and gender on droplet size distribution. Results indicated the total average size distribution of the droplet nuclei was 0.58-5.42 microm, and 82% of droplet nuclei centered in 0.74-2.12 microm. The entire average size distribution of the coughed droplets was 0.62-15.9 microm, and the average mode size was 8.35 microm. The size distribution of the coughed droplets was multimodal. The size distribution of coughed droplets showed three peaks at approximately 1 microm, 2 microm, and 8 microm. These analytical findings indicate that variation for average droplet size among the three age groups was insignificant (p > 0.1). Moreover, the variation in average droplet size between males and females was also insignificant (p > 0.1). Also, the variation in droplet concentration between males and females was significant (p > 0.1). Droplet nuclei concentrations from male subjects were considerably higher than that from females. Comparison of the droplet concentrations for subjects in different age groups demonstrated that subjects in the 30-50-year age group have the largest droplet concentrations.

Many anesthesiologists in medical centers (MC) or in anesthesiologist-training hospitals (ATH) are accustomed to present their research data in the form of poster abstracts at the annual meetings of Taiwan Society of Anesthesiologists (TSA) to represent their academic gainings in a designated period of time. However, an orphaned P value without mentioning the related specified statistical test has frequently been found in these articles. The difference in presentation of statistical test after P value between MC/ATH and non-MC/non-ATH in recent three TSA consecutive annual meetings was explored in this article.We collected the proceedings handbooks of TSA annual meetings in a period spanning 3 yrs (2003 to 2005) and analyzed the hospital characteristic of first institute-byliner in the poster abstract. Data were analyzed with Fisher's exact test and statistical significance was assumed if P0.05.Included were 101 poster abstracts with byliners of 20 hospitals. Only 2 of the 20 hospitals were accredited as non-ATH and 4 as non-MC. There were 64 (63%) abstracts without specified statistical test after P value and no significant difference was found among each category. (P = 0.47 in ATH vs. non-ATH and P = 0.07 in MC vs. non-MC).The basic concept of P value with specified statistical test was not applicable comprehensively in poster abstracts of the annual conferences. Based on our wishful intention, we suggest that the anesthesia administrators and senior anesthesiologists at ATH or MC, and the members of the committee responsible for running academic affairs in TSA, should pay attention to this prodigy and work together to improve our basic statistics in poster presentation.

This study was undertaken to determine the effects of using an electret filter on aerosol penetration. Various factors, including particle size (0.05 to 0.5 micro m), aerosol charge state (neutral and single charge), face velocity (0.1, 0.3, 0.5 and 1.0 m/s), and relative humidity (RH 30% and RH 70%), were examined to assess their effects on aerosol collection characteristics. The results presented here demonstrate that the electric fields of the electret and discharged filter were -1.53 x 104 and -1.3 x 102 (V/m). The penetration through the electret filter with singly charged aerosol and neutral aerosol ranged from 0.4% to 13% and 14% to 29%, respectively. According to these results, the coulombic capture force was dominant for the smaller aerosol and the dielectrophoretic capture mechanism was considered important for the larger aerosol. The level of penetration through the electret filter increased with increasing face velocity and relative humidity. The temperature did not affect the penetration through the electret. Furthermore, from the regression analysis conducted during the operating conditions of this work, the aerosol charge was shown to exert the greatest influence on aerosol penetration.