The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

 To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 μg/dl in male workers and 11.6 μg/dl in female workers. The mean BLL of lead-exposed workers was significantly (P<0.05, z-test) higher than that of the general Taiwanese population (8.6 μg/dl for males and 6.7 μg/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 μg/dl for males; 30 μg/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers’ lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae. Received: 2 September 1996/Accepted: 29 November 1996     

血管内氧合器的研制

为了探索呼吸辅助的新方法，我们采用国产聚丙烯中空纤维，自行设计、制造模具，研制出一种血管内氧合器。该氧合器是一个小的、细长的可经单侧股静脉或颈静脉切开，置入腔静脉内的装置。氧合器有效长度４０ｃｍ，膜交换面积０．０９ｍ＾２。经负压调节通过血管内氧合器的氧流量，以防止纤维破裂造成的血管内气栓的危险。一根双腔导气管使气体经同一静脉切开部位循环，气体经内芯管流经血管内氧合器尖端，然后经中空纤维束流出。目前     

A combined approach for purging multidrug-resistant leukemic cell lines in bone marrow using a monoclonal antibody and chemotherapy.

Selective removal of malignant cells (purging) from bone marrow (BM) is a concern in autologous BM transplantation (ABMT). Use of vincristine, etoposide, or doxorubicin for purging could be rendered ineffective by the presence of multidrug-resistant (MDR) tumor cells. To circumvent this particular problem, we investigated whether 17F9, a monoclonal IgG2b antibody directed against the cell surface product of the MDR gene, P-glycoprotein, is effective in selective removal of MDR cells from BM when used with rabbit complement (C'). Using two different cell lines we have demonstrated that 17F9 + C' selectively lyses MDR-positive cells. Three rounds of antibody + C' resulted in 96.4% +/- 3.6% kill of K562/DOX and 100% +/- 0% of CEM/VLB cells. Mixtures of malignant cells and normal BM resulted in 99.85% removal of K562/DOX and 99.91% removal of CEM/VLB clonogenic cells. This treatment did not affect normal committed precursors compared with C' alone. The addition of the cytotoxic agent etoposide (VP-16) following antibody purging results in a 4.6 log reduction of malignant cells. Furthermore, this antibody was effective when used against patients' leukemic blasts. These results suggest the use of 17F9 + C' is effective and selective for removal of MDR cells from BM before ABMT and the addition of VP-16 enhances the purging efficacy.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

膀胱癌组织P-gp,GST-π和TOPO-Ⅱ表达评估灌注化疗

目的：探讨膀胱癌的多药耐药性(MDR)，指导灌注化疗用药。方法：采用免疫组化法检测44例膀胱癌病理标本中P-糖蛋白(P-gp)、谷胱肽S转移酶(GST-π)和拓扑异构酶(TOPO—Ⅱ)的表达，评估肿瘤耐药谱。结果：①P-gp检测显示，54．5％的病例对阿毒索、丝裂毒索、长春新碱等抗生索类和生物碱类抗癌药高耐药。②GST-π检测显示仅34．1％的病例对顺铂、环磷酰胺等高耐药，而反有56．8％的病例对该类药无耐药或低度耐药。③TOPO-Ⅱ检测显示对阿霉索、柔红毒索、VP16等TOPO-Ⅱ抑制剂类抗癌药，仅13．6％的病例高度耐药，29．5％中度耐药。56．8％低度耐药。结论：检测膀胱癌MDR，了解多药耐药谱，可指导灌注化疗用药。     

生物衍生骨复合骨髓基质干细胞修复山羊胫骨缺损的血管化研究

目的研究生物衍生骨与骨髓基质干细胞(marrow stromal stem cells, MSCs)复合修复山羊胫骨缺损的血管化过程,了解其修复长段管状负重骨缺损的血管化情况. 方法制备生物衍生骨作为支架材料,培养、诱导MSCs作为种子细胞,二者在体外复合构建组织工程骨.20只山羊双侧胫骨中段制备成20 mm长的骨-骨膜缺损模型,采取自身左右侧对照,实验侧(右侧)缺损处植入组织工程骨,对照侧(左侧)植入单纯支架材料,采用钢板内固定.术后2、4、6及8周用墨汁灌注透明标本及血管面积图像分析方法观察血管化过程,组织学观察血管形成及成骨情况. 结果术后2、4周,实验侧血管形成较对照侧少(P<0.05);术后8周,两侧均完全血管化,差异无统计学意义(P>0.05).实验侧于术后6、8周新骨形成逐渐增加,材料降解吸收较对照组快;对照侧术后8周材料孔隙内仍无明显新骨形成. 结论生物衍生骨作为骨组织工程的支架材料,能够较快发生血管化;组织工程骨成骨能力较单纯支架材料强.     

Osteoclastogenesis in the nonadherent cell population of human bone marrow is inhibited by rhBMP-2 alone or together with rhVEGF.

During bone development and repair, angiogenesis, osteogenesis, and bone remodeling are closely associated processes that share some common mediators. In the present study nonadherent human bone marrow mononuclear cells under the induction of sRANKL and M-CSF, differentiated into osteoclasts with TRAP-positive staining, VNR expression, and Ca-P resorptive activity. The effects of various combinations of rhBMP-2 (0, 3, 30, and 300 ng/mL) and rhVEGF (0 and 25 ng/mL) on osteoclastogenesis potentials were examined in this experimental system. The percentages of TRAP-positive multiple nucleated cells represent osteoclast differentiation potential, and the percentages of resorptive areas in the Ca-P coated plates resemble osteoclast resorption capability. The presence of rhBMP-2 at 30 and 300 ng/mL showed inhibitory effects on osteoclast differentiation and their resorptive capability in the human osteoclast culture system. rhVEGF (25 ng/mL) enhanced the resorptive function of osteoclast whenever it was used alone or combined with 3 ng/mL rhBMP-2. However, rhVEGF-induced resorptive function was inhibited by 30 ng/mL and 300 ng/mL rhBMP-2 in a dose-dependent manner. Statistical analysis demonstrated that an interactive effect exists between rhBMP-2 and rhVEGF on human osteoclastogenesis. These findings suggested that an interactive regulation may exist between BMPs and VEGF signaling pathways during osteoclastogenesis; exact mechanisms are yet to be elucidated.     

CT features of presacral mass: an unusual focus of extramedullary hematopoiesis

A case of beta-thalassemia with an unusual focus of extramedullary hematopoiesis is reported. The presacral area was involved producing a significant mass effect on the rectum.     

Biomechanics of the golf swing in players with pathologic conditions of the forearm, wrist, and hand

Golf is an activity generally stressful to the hands and wrists and particularly can produce increasing symptoms in players with underlying problems such as hand and wrist arthritis or tendinitis. The purpose of this study was to quantitate wrist motion and club head/ball impact force in subjects with pathologic conditions of the hand, wrist, or forearm, within a laboratory environment. A regular straight-handled golf club was compared to a new BioCurve handle design that has a 19 degrees ulnar bend. We measured and compared the effect of the two grips on wrist motion, club head velocity, ball impact force, ball impact location, and isometric torsional strength in 20 subjects who had a variety of upper extremity disorders. This data was then compared to data collected in an identical fashion from golfers without such conditions. The results of our study show that there were no differences related to club handle design on impact force or impact location, club head velocity, or club head path and face angle. Wrist kinematic differences were minimal between handle designs. The differences that were significant (P less than 0.05) centered around the decreased ulnar deviation of the left hand that resulted when subjects used the BioCurve handle design, which also allowed greater resistance to torque than the straight grip club. In addition to collecting objective data, we asked subjects for their opinions of the two grips. As a whole, the normal group and the group with pathologic conditions noted more comfort, improved grip, and less shock transmission with the BioCurve handle.     

Colposcopic assessment in microinvasive carcinoma of the cervix

Forty of the 87 patients with microinvasive carcinoma (MIC) of the uterine cervix who underwent surgery were diagnosed colposcopically and the results were compared with the cytological and histological diagnoses. The cytology showed preinvasive carcinoma in 20 (50.0%) patients and invasive carcinoma in 19 (47.5%) patients. A correct colposcopic diagnosis was made in nine (22.5%) patients as having microinvasive carcinoma, 21 (52.5%) patients preinvasive carcinoma and eight (20%) patients invasive carcinoma, to sum up accuracy rate as 32.1%. The abnormalities most commonly observed in colposcopy were mosaic, punctuation and white epithelium. In microinvasive carcinoma, the triad co-existed in 43% of the patients. Atypical vessels, characteristic of invasion, were found in only one third of the patients. Microinvasion, therefore, may not be evident on colposcopy alone. It is therefore necessary to apply cone biopsy, prior to definite therapy, to make an accurate assessment of the maximum depth and extent of the invasion prior to definitive therapy.