Search

Nasogastric decompression has been routinely used in most abdominal operations to prevent the consequences of postoperative ileus. Most surgeons traditionally continue to use nasogastric decompression, believing that its use facilitates better surgical field and reduces complications such as nausea, vomiting, aspiration, and anastomotic leakage caused by postoperative ileus. The aim of the study was to evaluate whether gastric cancer surgery could be performed safely without nasogastric decompression. Patients and Methods: We enrolled 151 patients who had been surgically treated for gastric adenocarcinoma at the Tri-Service General Hospital from January 2005 to December 2005. The mean age was 55.4 years (range 25-72 years). 76 patients (Group A) were randomized into the intubated group and the other 75 patients (Group B) were randomized into the tubeless group. All patients received epidural pain control. Postoperative complications, preoperative serum albumin levels, mean time to first orally feeding, passage of stools, hospital stay and cost of hospitalization were recorded. Results: Between the two groups, there were no significant differences in preoperative clinical characteristics, age, stage and operative parameters. The complication rate, length of hospital stay, and time to pass flatus were not different in the two groups. Only the postoperative complication rate in those patients of Group A with low serum albumin level was significantly lower than that of patients without nasogastric tube. Conclusion: There were no significant differences with respect to improvement of postoperative complications when comparing gastric cancer patients who underwent gastrectomy with or without nasogastric tube insertion. [ABSTRACT FROM AUTHOR]

The purpose of this study was to report the efficacy of gum chewing (GC) in gastric cancer patients who underwent D2 subtotal gastrectomy. Patients and Methods: 26 patients were enrolled in this study. 13 patients received GC after D2 subtotal gastrectomy (group A) and 13 did not (group B). All patients had received epidural pain control. The mean times to first bowel movement, orally feeding, passage of stools, and hospital discharge as well as cost of hospitalization were recorded. Results: Between the two groups, there were no significant differences with respect to preoperative clinical characteristics, stage and operative parameters. The times to first flatus and passage of stools and the hospital stay were shorter in group A. Also the cost of hospitalization was lower in group A, but there were no significant differences. Conclusion: Although GC is a safe, non-expansive and physiologic method, this study suggests that there is no significant improvement of postoperative bowel motility of gastric cancer patients who underwent D2 gastrectomy. This implies that the cephalic-vagal reflex plays a major role in sham feeding. [ABSTRACT FROM AUTHOR]

The complete genome sequence of " Candidatus Phytoplasma cynodontis" strain GY2015, which consists of one 498,922-bp circular chromosome, is presented in this work. This uncultivated plant-pathogenic bacterium is associated with Bermuda grass white leaf disease in Taoyuan, Taiwan., Competing Interests: The authors declare no conflict of interest.

Unlike other plants, bamboo (Bambusoideae) flowering is an elusive physiological phenomena, because it is unpredictable, long-periodic, gregarious, and uncontrollable; also, bamboo plants usually die after flowering. The flowering mechanism in Arabidopsis thaliana, a eudicot model species, is well established, but it remains unknown in bamboo species. We found 4470 and 3878 expressed sequence tags in the flower bud and vegetative shoot cDNA libraries, respectively, of the bamboo species, Bambusa oldhamii. Different genes were found expressed in bamboo flower buds compared to vegetative shoots, based on the Munich Information Center for Protein Sequences functional categorization; flowering-related genes were also identified in this species. We also identified Arabidopsis flowering-specific homologs that are involved in its photoperiod in this bamboo species, along with autonomous, vernalization and gibberellin-dependent pathways, indicating that bamboos may have a similar mechanism to control floral transition. Some bamboo expressed sequence tags shared high similarity with those of rice, but others did not match any known sequences. Our data lead us to conclude that bamboo may have its own unique flowering genes. This information can help us understand bamboo flowering and provides useful experimental methods to study the mechanisms involved.

Aims: The prognosis for patients with advanced tumors invading the inferior vena cava (IVC) is dismal and surgical treatments for these tumors are challenging. A surgical approach that avoids sternotomy and thoracotomy for tumors invading the IVC even to the level of the hepatocaval junction would be extremely helpful., Methods: The intrapericardial IVC was isolated via a transdiaphragmatic pericardial window using a transabdominal approach. Hepatectomy was then applied via an anterior approach until the IVC was seen. Total hepatic vascular exclusion was achieved by clamping the portal triad, intrapericardial IVC and infrahepatic IVC. We removed the primary tumor, the liver portion involved and the tumor thrombi, with segmental resection of the IVC. Vascular continuity was reestablished using a 20-mm-diameter polytetrafluoroethylene graft., Results: Four patients with tumors invading the IVC were treated with this method. All underwent gross en-bloc tumor resections and all survived., Conclusion: This method for the resection of IVC tumors could avoid emboli dislodging from the tumor thrombi, prevent the complications of sternotomy, cardiopulmonary bypass and shorten operative times.

Objectives: Acute lung injury and inflammation can occur after hepatic ischemia/reperfusion (I/R). Little is known regarding the possible role of nitric oxide synthase expression in this complex type of lung injury., Methods: Real-time polymerase chain reactions and immunohistochemistry were used to assess the mRNA and protein expression of eNOS and iNOS in lung tissue after I/R challenge to the liver. Ischemia was induced by clamping the hepatic artery and portal vein for 40 minutes. After flow was restored, the liver was reperfused for 300 minutes. Blood samples were collected to assay three inflammatory parameters: tumor necrosis factor (TNF)-alpha, hydroxyl radicals, and NO. Lung lavage samples were assayed for protein and myeloperoxidase. The expression of eNOS and iNOS in lung tissues (n = 3) was also evaluated after I/R challenge to the liver. The iNOS inhibitor aminoguanidine was also tested in this I/R model., Results: Reperfusion of the liver produced increased blood concentrations of TNF, hydroxyl radicals, and NO (P < .001; n = 8). Bronchial lavage fluids showed higher levels of protein and myeloperoxidase in the I/R than in the sham-treated group (P < .01). eNOS expression was down-regulated and iNOS expression up-regulated in I/R lung tissues (n = 3). The iNOS inhibitor aminoguanidine (10 mg/kg) significantly attenuated the lung injury., Conclusions: I/R injury to the liver induced lung injury involving systemic inflammatory responses and iNOS expression. Administration of aminoguanidine significantly attenuated the injury, suggesting that iNOS expression may play a critical role in lung injury induced by I/R of the liver.

Unlabelled: Our objective was to investigate the potential protective effects of insulin on the liver injury induced in three ischemia and reperfusion (I/R) models., Methods: Three I/R models were used: (1) I/R of the liver was produced in isolated, perfused rat livers; (2) in in situ I/R of the liver in rats, ischemia was induced by clamping off the hepatic artery and portal vein for 40 minutes, the flow then restored, and the liver reperfused for 90 minutes; (3) in in situ I/R of the liver in mice, ischemia was induced by clamping off the hepatic artery for 15 minutes, the flow then restored, and the liver reperfused for 45 minutes. In all three cases, blood samples collected before ischemia and after reperfusion were analyzed for sGOT. Plasma nitrate/nitrite, hydroxyl radicals, and tumor necrosis factor were also measured. In each model, a dose of insulin sufficient to induce euglycemia was administered to assess its protective effect on liver injury and inflammation., Results: These I/R protocols resulted in a significant increase in sGOT and in three inflammatory parameters; nitric oxide, hydroxyl radicals, and tumor necrosis factor. Pretreatment with insulin did not attenuate the liver injury in any of the three I/R models., Conclusions: Although insulin has been reported to provide anti-inflammatory benefits by reducing oxidative and nitrosative stress and cytokine release, none of these protective effects was seen in the three I/R-induced liver injury models we tested.

Unlabelled: Our objective was to investigate the mRNA and protein expressions of eNOS and iNOS in the mesenteric vascular bed after ischemia and reperfusion of the rat superior mesenteric artery (SMA) and the role of nitric oxide (NO) in the response of the vascular bed to vasoconstrictors following reperfusion of the SMA., Methods: Real-time polymerase chain reaction and immunohistochemistry were used to monitor the mRNA and protein expression of eNOS and iNOS after I/R challenge to the rat SMA. Ischemia was induced by clamping the SMA for 40 minutes, after which the flow was restored and the vessels were reperfused for 300 minutes. Blood samples were collected for assays of lactic dehydrogenase, tumor necrosis factor (TNF), hydroxyl radical, and NO. After ischemia/reperfusion, the vascular beds were separated for analysis of the expression of eNOS and iNOS. The SMA with its associated intestinal tissue was isolated and perfused in vitro with Tyrode's solution (N = 8) then challenged with phenylephrine., Results: Reperfusion of the SMA induced an increase in blood concentrations of lactic dehydrogenase (P < .001; N = 8), hydroxyl radical (P < .05), TNF (P < .001), and NO (P < .05). ENOS and iNOS mRNA expression increased 1.3 +/- 0.1-fold and 19.6 +/- 3.5-fold, respectively when compared to the sham-operated group. Protein expression increased 1.9 +/- 0.4-fold and 12.6 +/- 3.1-fold, respectively, after reperfusion (N = 3) when compared with sham-treated rats. In vitro challenge showed that administration of phenylephrine (10(-8) approximately 10(-4) nmol) produced vasoconstriction in a dose-related manner. Maximum contractile responses to phenylephrine were attenuated in reperfused SMA. Addition of the NOS inhibitor N(G)-nitro-L-arginine (L-NNA, 10(-4) M) resulted in full recovery of the response to phenylephrine., Conclusions: Ischemia/reperfusion of the SMA results in a decrease in vascular reactivity of the mesenteric vessels that is dependent on NOS expression by the intestinal vascular bed.

Background: Telomerase is activated in most human cancers but is inactivate in adult somatic tissues except for some proliferating cell lineages. The maintenance of telomerase activity may be a critical step of cellular immortalization and transformation., Materials and Methods: We analyzed the expression of human telomerase reverse transcriptase (hTERT) using in situ hybridization and compared it to Ki-67 immunoreactivity in 29 cases of papillary thyroid carcinoma (PTC) and 17 cases of benign thyroid disease., Results: The hTERT messenger RNA (mRNA) was expressed in the cytoplasm of carcinoma cells with moderate (n = 10) to strong intensity (n = 10) in 69% (20 of 29) PTC cases. Human TERT was found in only 29% (5 of 17) cases of benign thyroid disease. Human TERT gene expression was preferentially detected in PTC (P = 0.021). The Ki-67 labeling index was observed in 16 cases of PTC (16 of 29; 55.2%). This result was significantly different from that of benign thyroid disease (P = 0.014). The Ki-67 labeling index related to the intensity of hTERT mRNA expression (r = 0.51; P = 0.005) and was inversely associated with the follicular variant of PTC (r = -0.413; P = 0.026). No statistically significant difference was found between hTERT expression and histological subtype of PTC., Conclusions: Our results demonstrated that expression of hTERT could be detected using in situ hybridization in PTCs and was significantly distinguishable from that of benign thyroid disease. Human TERT expression was related to the Ki-67 labeling index, indicating that coupling of telomerase activation with cell proliferation was the associated mechanism for tumorigenesis., (Copyright 2001 Academic Press.)

Various flavor esters were obtained by using recombinant lipases from Staphylococcus epidermidis as a catalyst in an aqueous environment. These esters were enzymatically synthesized to overcome the problems associated with chemical processes. This study showed that the S. epidermidis lipases could catalyze ester synthesis from decyl alcohol and fatty acids of different chain length. The wild-type and mutant lipases (M419A and V649I) could efficiently catalyze the synthesis of decyl alcohol esters of unsaturated fatty acids. In contrast, the yield of decyl laurate was better by wild-type and mutant enzyme V6491, but mutant enzyme M419A only favored the synthesis of decyl myristate. The esterification of oleic acid and various carbon-chain-length alcohols from ethanol to hexadecanol increased up to decanol by wild-type and M419A mutant enzymes and reached an optimum for dodecanol by V6491 mutant enzyme. The enzyme is potentially useful in food industries such as dairy product flavoring.

Activities of endothelial nitric oxide synthase (eNOS) are developmentally regulated and its presence at birth may play a role in the transition of cardiopulmonary circulation. Antenatal dexamethasone (Dex) therapy accelerates fetal lung maturation. We speculate that Dex therapy may enhance pulmonary eNOS protein expression in the newborn. This article examines whether antenatal Dex therapy affected the expression of eNOS in the lungs of rat pups in the postnatal period. Time-dated pregnant Wistar rats were subjected to 2 doses of Dex (0.8 mg/kg, intramuscularly, daily) or equivalent volume of normal saline at the 18th and 19th gestational day and delivered naturally. The newborn pups were randomly assigned to 4 groups by age: days 1, 3, 5, and 7. After homogenization, abundance of eNOS protein in lungs was determined by Western blot analysis. There were 7 dams in each group. Mean body weights of the pups in the Dex group were lighter than those in the control at birth and remained stunted up to day 7 (5.68+/-0.47 g v 6.34+/-0.47 g, P <.01). However, there were no differences in wet lung weights and lung/body weight ratios between both groups in the study period. Abundance of eNOS protein expression decreased in both the control and Dex groups (P < .01). Pups that received antenatal Dex had 39% more in abundance of eNOS protein expression in lungs when compared to the control on day 1 (P < .05) but there were no differences between both groups from day 3 to 7. We conclude that antenatal Dex therapy enhances the abundance of eNOS protein expression in the lung at birth and could be a factor in improving respiratory functions in infants who received antenatal steroid therapy.

It has been proposed that 1-aminocyclopropane-1-carboxylic acid (ACC) oxidase catalyzes the oxidation of ACC to ethylene via N-hydroxyl-ACC as an intermediate. However, due to its chemical instability the putative intermediate has never been isolated. Here, we have shown that a purified recombinant ACC oxidase can utilize alpha-aminoisobutyric acid (AIB), an analog of ACC, as an alternative substrate, converting AIB into CO2, acetone, and ammonia. We chemically synthesized the putative intermediate compound, N-hydroxyl-AIB (HAIB), and tested whether it serves as an intermediate in the oxidation of AIB. When [1-(14)C]AIB was incubated with ACC oxidase in the presence of excess unlabeled HAIB as a trap, no labeled HAIB was detected. By comparing the acetone production rates employing HAIB and AIB as substrates, the conversion of HAIB to acetone was found to be much slower than that of using AIB as substrate. Based on these observations, we conclude that ACC oxidase does not catalyze via the N-hydroxylation of its amino acid substrate. ACC oxidase also catalyzes the oxidation of other amino acids, with preference for the D-enantiomers, indicating a stereoselectivity of the enzyme.

We report here the study of the human CYP11A1 promoter in driving tissue-specific, developmentally and hormonally regulated reporter gene expression. A 4.4-kb fragment containing all known regulatory elements is more efficient than a short basal promoter fused to an upstream adrenal enhancer in driving reporter LacZ gene expression both in cell culture and in transgenic mice. The LacZ gene controlled by the 4.4- and 2.3-kb promoters was expressed in the adrenal cortex, testicular Leydig cells, ovarian corpora lutea, and granulosa cells. Transgene expression in the adrenals was stimulated by ACTH, indicating the presence of ACTH-responsive sequence. Beta-galactosidase activity was first detected in the adrenal primordia at 11.5 days postcoitum. Its expression continued throughout all stages of adrenal development in a pattern similar to that of the endogenous CYP11A1, which was expressed in all zones of the adrenal cortex, but was strongest in the X zone. The X zone grew before puberty but regressed afterward, as did the levels of CYP11A1 and LacZ gene expression in the X zone. Our study of the CYP11A1 promoter in transgenic mice led to characterization of the adrenocortical zones.

The first step in the synthesis of all steroids is the cleavage of cholesterol side chain, catalyzed by an electron transport system located in mitochondria consisting of ferredoxin reductase, ferredoxin, and cytochrome P450scc. These proteins are present in adrenal, gonad, placenta, and some parts of the brain. In addition, ferredoxin and ferredoxin reductase are also found in the kidney and liver. Whereas ferredoxin reductase levels remain constant in the cell, ferredoxin and P450scc levels are stimulated by trophic hormones using cAMP as an intracellular messenger. The ferredoxin promoter is relatively simple, consisting of a TATA box and two Sp1-binding sites. This simple module is enough to direct cAMP-dependent transcription in a steroidogenic cell-specific fashion. The regulatory region for the P450scc gene is more complex, containing many protein binding sites for different regulation purposes. Its TATA box directs cAMP-dependent transcription in a cell-type-specific manner. A transcription factor, steroidogenic factor 1 (SF1), activates P450scc gene expression. The tissue-specific expression of the P450scc gene is probably accomplished through the interaction of SF1 with other protein factors located further upstream of the control region. SF1 may also be involved in the cAMP response. An upstream region binding to cAMP-Responsive Element Binding Protein CREB and AP1 can respond to cAMP for gene activation. These analyses of regulatory elements provide the structural architecture for transcriptional regulation of the ferredoxin and the CYP11A11 gene.

The CYP11A1 gene encodes the cholesterol side-chain cleavage enzyme P450scc, which catalyzes the synthesis of steroids from cholesterol. This gene is expressed only in steroidogenic organs such as the adrenal, gonad, placenta, and brain. We have characterized an upstream regulatory element of the human CYP11A1 gene, termed AdE, which contributed to its cell type-specific expression. The AdE sequence contains two protein binding regions, AdE1 and AdE2, which bind many proteins including NF1- and Sp1-like proteins as shown by electrophoretic mobility shift assay, footprinting, competition, antibody supershift, and mutagenesis of the binding sites. When cloned in front of the CYP11A1 promoter or the heterologous thymidine kinase promoter, AdE sequences enhanced expression of the reporter gene in steroidogenic cell lines of the adrenal, gonad, and placental origin but not in nonsteroidogenic cell lines such as COS-1 and Rat-1. The function of AdE1 and AdE2 was lower when present individually than together. The combined action of multiple transcription factors binding to the AdE sequence brings about the final activation of the CYP11A1 gene in a tissue-specific manner.

Helicobacter pylori has been documented to be associated with chronic type B gastritis, peptic ulcer and gastric cancer. In order to examine the seroprevalence and risk factors for Helicobacter pylori infection in Taiwan, a total of 871 adolescents were selected randomly from junior high school children in 20 study precincts and townships. Serum samples collected were tested for IgG antibodies against Helicobacter pylori by enzyme-linked immunosorbent assay using commercial kits. The overall seropositive rate was 21.1% showing no gender difference. There was a striking geographical variation in seroprevalence of Helicobacter pylori infection ranging from 4.6% to 37.1% in 20 precincts and townships. The seroprevalence was highest in the north (25.4%), medium in central Taiwan (21.9%), and lowest in the south (18.7%). The higher the age-adjusted mortality from gastric cancer in a given study area, the higher the seroprevalence of Helicobacter pylori in the area. Metropolitan and aboriginal areas had higher seroprevalences than urban and rural areas, but the difference was not statistically significant. The seroprevalence was higher for those who had no sibling (29.4%) or had a sibship size of > or = 6 (31.1%) than for those with a sibship size of 1-5 (20.0%), but the difference was not statistically significant either.

Over 50 years ago Kögl and Erxleben reported that tumor proteins contain appreciable amounts of D-amino acids. This postulate remained highly controversial for several years, during which time several researchers either supported or refuted the hypothesis. We have analyzed several sets of tumors and normal control tissues for the presence of D-aspartate (D-Asp) and D-glutamate (D-Glu). Most tumors contain less D-Asp than the control tissues, whereas nearly half of the tumors contain 1.6 to 5.4 times more D-Glu than the controls. The tumors averaged 0.72% D-Asp and 0.61% D-Glu compared to 0.94% D-Asp and 0.35% D-Glu in the control tissues. However, within the limits of experimental error, there is no significant difference in the level of these D-amino acids between the tumors and normal tissues.

During the last two decades an economic boom has occurred in Taiwan, a region where the prevalence of both hepatitis A and B virus infection was formerly very high. To examine the impact of socioeconomic developments on the secular trend and geographical variation in hepatitis A and B virus infection, 875 adolescents selected randomly from 20 junior high schools were studied. Serum samples collected from the subjects were tested for hepatitis A antibody (anti-HAV) and hepatitis B surface antigen (HBsAg) by enzyme immunoassay using commercial reagents. The anti-HAV prevalence increased from northern through central to southern Taiwan; the prevalence was highest in aboriginal townships and lowest in metropolitan precincts. This striking variation in anti-HAV prevalence in different geographical locations and at different urbanization levels remained significant in multiple logistic regression analysis. The HBsAg prevalence was significantly higher in aboriginal townships than in rural and urban townships and metropolitan precincts. In addition, HBsAg prevalence was related inversely to the number of physicians per 1,000 population. The prevalence of both anti-HAV and HBsAg declined significantly during the last decade in Taipei City and County. The decrease in anti-HAV prevalence may be due to improvements in environmental hygiene, water supply, and food sanitation, while the decline in the HBsAg carrier rate may result from the use of disposable needles and syringes as well as screening for HBsAg in blood banks.

Normal protein-bound L-aspartyl/L-asparaginyl residues may undergo post-translational modification by racemization to D-aspartate, or by isomerization to the L-isoaspartyl form in which the peptide chain links through the beta carboxyl group of the residue. Based on preliminary results reported here, proteins associated with Alzheimer neurofibrillary tangle preparations contain a significantly greater number of these modified aspartyl residues than the unaffected proteins from the surrounding gray matter or in comparable preparations from normal brains.

Normal protein-bound L-aspartyl/L-asparaginyl residues may undergo posttranslational modification by racemization to D-aspartate. Based on preliminary results reported here, proteins associated with Alzheimer neurofibrillary tangle preparations contain a greater number of these racemized D-aspartyl residues than the unaffected proteins from the surrounding gray matter or in comparable preparations from normal brains.