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Biomedical subjects

C H Lai

Publications and source records attributed to C H Lai.

At least 91 records · Page 5Linked to original sources

Combination of high-dose chemotherapy, autologous bone marrow/peripheral blood stem cell transplantation, and thoracoscopic surgery in refractory nongestational choriocarcinoma of a 45XO/46XY female: a case report.

A 39-year-old woman having a pure gonadal choriocarcinoma with lung metastasis was referred to our hospital after hysterectomy and bilateral salpingo-oophorectomy. She was found to have a 45XO/46XY karyotype and gonadal dysgenesis. The patient's serum beta-hCG was normalized after six courses of chemotherapy with cisplatin and etoposide of conventional dose (100 mg/m2, 100 mg/m2 x 3 days), but began to fluctuate. Thoracoscopic resection of a remaining pleural lesion was negative for malignancy. However, the disease relapsed as multiple metastatic nodules in bilateral lung fields and the mediastinum. After one course of priming chemotherapy with conventional dose (1 g/m2 cyclophosphamide, 400 mg/m2 carboplatin, and 500 mg/m2 etoposide), high-dose chemotherapy with a total dose of 1500 mg/m2 carboplatin, 1200 mg/m2 etoposide, and 5 g/m2 ifosfamide followed by autologous bone marrow transplantation and peripheral stem cell support was given. Thoracoscopic surgery was performed to resect two residual solitary metastatic lung lesions. With these salvage treatments, the patient obtained complete remission and remained disease free at last follow-up (17 months). Our result suggests that high-dose chemotherapy may be effective in chemosensitive nongestational choriocarcinoma when first chemotherapy has failed.

Adult↗

Prognostic factors in patients with bulky stage IB or IIA cervical carcinoma undergoing neoadjuvant chemotherapy and radical hysterectomy.

All patients with bulky (> or =4 cm) Stage Ib or IIa cervical carcinoma treated at Chang Gung Memorial Hospital between August 1988 and December 1991 using a strategy of neoadjuvant chemotherapy with cisplatin, vincristine, and bleomycin and radical hysterectomy were reviewed. Fifty-nine evaluable patients received 1 to 3 courses of chemotherapy, and 51 underwent subsequent hysterectomy. The remaining 8 patients, not completing planned surgery, were treated with definitive radiotherapy. The overall clinical response rate was 81.4% (48/59) with 18.6% complete response. Clinical response to chemotherapy was not different by stage, histologic type, tumor size, level of squamous cell carcinoma antigen, or DNA ploidy. However, tumors with DNA indices (DI) greater than 1.3 were associated with higher clinical response rates than tumors with DI < or = 1.3 (P = 0.043). Histologically proven pelvic node metastases was noted in 18.5% (10/54) who had laparotomy. Concomitant pregnancy and more than one node metastases had significant adverse influence on recurrence and death. The 5-year survival rate of those patients who received hysterectomy was 80.3%, while only 1 of the 8 patients without hysterectomy survived. Of the 7 patients received hysterectomy despite clinical poor response, only 2 had node metastases and 3 died, whereas all the 4 patients deterred hysterectomy for poor response died. This study demonstrates the value of DNA flow cytometry in predicting chemosensitivity. However, with a DI cutoff at 1.3, only 29.2% patients could be selected. Further studies are necessary to find additional indicators that predict histological response to select better candidates for this approach and to determine optimal adjunctive treatment in case that poor prognostic features are found.

Adult↗

A randomized trial of concurrent chemoradiotherapy versus radiotherapy in advanced carcinoma of the uterine cervix.

The purpose of our study was to determine whether the chemoradiation is better than radiotherapy alone with respect to survival and treatment toxicity in patients with advanced carcinoma of the cervix. From October 1990 to April 1995, a total of 122 patients with advanced cervical carcinoma were included in this study and randomly assigned to either radiotherapy or concurrent chemotherapy and radiotherapy. The patients in the concurrent group received cisplatin, vincristine, and bleomycin every 3 weeks for a total of four courses, in combination with radiotherapy concurrently. Sixty patients were randomized to the concurrent chemoradiotherapy, and 62 were randomized to the radiotherapy alone. A tumor response was observed in 88.3% of the patients in concurrent group and in 74.2% of the patients in radiotherapy group (P = 0.04). After a median follow-up of 46.8 months, the overall disease-free survival and actuarial survival rate at 3 years were 51.7 and 61.7% in the concurrent group, and 53.2 and 64.5% in the radiotherapy group, respectively. Treatment-related toxicity appears to be higher with the combination of radiotherapy and chemotherapy compared with radiotherapy alone (36.7% versus 17.7%, P = 0.02). However, analysis by Kaplan-Meier method showed that the actuarial survival was not statistically different between the chemoradiotherapy and radiotherapy groups (mean survival time: 38.1 months versus 41.5 months, P = 0.27). In conclusion, this study showed that concurrent multiagent chemoradiotherapy did not prove to be a superior definitive therapy over radiotherapy alone for patients with advanced cervical carcinoma.

Adult↗

Retrograde lymphatic spread: a likely route for metastatic ovarian cancers of gastrointestinal origin.

In order to outline the pathways of gastrointestinal malignancies metastasizing to the ovaries, we reviewed 103 cases of metastatic ovarian tumors, and also performed para-aortic lymph node sampling on 11 patients at operation for metastatic ovarian tumors. Of the 103 patients, 74% (26/35) with gastric cancer and 67% (45/67) with colorectal cancer had lymph node metastasis at or before the diagnosis of ovarian tumor. Intraperitoneal metastases presented in 49 and 42% of patients with gastric and with colorectal cancers, respectively. Twenty-three percent of gastric cancer patients and 25% of colorectal cancer patients presented with both lymph node and intraperitoneal metastases. The ovary was the first or among the early metastatic organs diagnosed in 51 of the 53 patients with metachronous ovarian metastases. Only 4 patients with colorectal cancer and none with gastric cancer showed parenchymal organ metastases. These 4 patients also showed intraperitoneal lesions, and 3 of these 4 patients had node metastasis. Among the 11 patients who underwent prospective para-aortic lymph node sampling during operation for the ovarian tumors, only 1 had enlarged para-aortic nodes depicted by computed tomography, 2 had grossly enlarged (>/=1.5 cm) para-aortic lymph nodes noted at surgery, and 6 of the 7 patients with gastric cancer and all 3 with colorectal cancer had metastatic nodes histologically. Among the 58 nodes taken from these patients, 67% showed metastatic foci. We concluded that lymph node metastasis is frequently seen in patients with metastatic ovarian tumors of gastrointestinal origin, and hypothesized that retrograde lymphatic spread is a likely route for the metastases.

Adult↗

Identification of human papillomavirus types 16 and 18 deoxyribonucleic acid sequences in bulky cervical cancer after chemotherapy.

OBJECTIVE: The objectives of this study were to evaluate the effect of chemotherapy on the continual presence of human papillomavirus deoxyribonucleic acid sequences in bulky cervical cancer tissues and the relationship between the presence of human papillomavirus and the response of these patients to chemotherapy. STUDY DESIGN: Multiple tissue sections obtained from 33 patients with bulky cervical cancer both before and after chemotherapy were analyzed for the presence of human papillomavirus types 16 and 18 by deoxyribonucleic acid amplification. RESULTS: The cytotoxic effects of chemotherapy did not significantly alter the continual presence of human papillomavirus deoxyribonucleic acid sequences in these tissues (p = 0.8048). The presence of human papillomavirus type 16 deoxyribonucleic acid in tumors treated with neoadjuvant chemotherapy was significantly associated with favorable tumor response compared with type 18-positive patients and type 16/18-negative patients (94.7% vs 42.9%, p = 0.0059 and 94.7% vs 44.4%, p = 0.0004, respectively). Additionally, patients with type 18 deoxyribonucleic acid had a significantly higher risk of recurrence than did type 16-positive patients (p = 0.0123). CONCLUSIONS: These results seem to suggest that the presence of human papillomavirus deoxyribonucleic acid sequences may serve as a marker to predict the response of bulky cervical cancer to chemotherapy and may be useful in reassessing neoadjuvant treatment for those patients who are free of human papillomavirus or those with type 18 deoxyribonucleic acid.

Adult↗

Sperm as a carrier to introduce an exogenous DNA fragment into the oocyte of Japanese abalone (Haliotis divorsicolor suportexta).

We investigated gene transfer in abalone via electroporated sperm. The mobility of sperm electroporated either in seawater or in marine invertebrate physiological solution was as good as that of the control group. The fertilization rate reached as high as 94.7-99.6% (93.0-99.7% for the control group) when 200 eggs were fertilized by 10(6) or 10(7) sperm treated with electroporation at 10 kV and 2(7) pulses for six cycles. Moreover, the fertilization rate of sperm electroporated in the presence of foreign DNA (opAFP-2000CAT) ranging from 0.1 to 3.2 micrograms and at voltages ranging from 2 to 10 kV, at 2(7) or 2(11) pulses for six or 12 cycles showed no differences from the control sperm. After DNase digestion, the genome of the electroporated sperm was analysed by polymerase chain reaction, and it was shown that a 138-bp product was amplified, corresponding to the transgene's amplification product. Southern blotting also showed that a positive band located at the same position as that of opAFP-2000CAT was found in the electroporated sperm after DNase treatment. Analysis by PCR of the genome isolated from a trochophore-stage abalone larva, derived from sperm electroporated with 3.2 micrograms opAFP-2000CAT, showed the existence of foreign DNA in 13 out of 20 examined samples (65%). The integration of the transferred DNA into the genome of transgenic abalone was also shown by Southern blot analysis. Furthermore, CAT activity was positive for the experimental larvae, but the level of CAT expression was lower than that of larvae derived from sperm electroporated with pCAT-Control vector, driven by SV40 promoter and enhancer sequences. These results demonstrate the potential for the use of sperm as mass gene transfer strategy in marine mollusks such as abalone.

Animals↗

Sertoli-Leydig cell tumour in an infertile patient after stimulated ovulation.

A 36 year-old infertile female developed a stage IV (FIGO) ovarian carcinoma consisting of a poorly differentiated Sertoli-Leydig cell tumour after receiving one course of ovulation induction with follicle stimulating hormone (FSH), human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG) followed by gonadotrophin-releasing hormone analogue (GnRHa). The patient died of liver metastasis and hepatic failure 4 1/2 months after first diagnosis, despite aggressive treatment consisting of debulking surgery and aggressive adjuvant chemotherapy.

Adult↗

Relationship of serotype, leukotoxin gene type and lysogeny in Actinobacillus actinomycetemcomitans to periodontal disease status.

Actinobacillus actinomycetemcomitans has been associated with different forms of periodontitis, particularly with localized juvenile periodontitis (LJP). The bacterium possesses several virulence factors which have been shown to interact with the host immune system. Among these factors, leukotoxin, surface antigens (serotype) and bacteriophages have been suggested directly or indirectly to influence the course of infection. However, few studies have been able to show associations between these factors and periodontal disease, alone or in combination. Thus, the purpose of the present study was to investigate possible correlations between periodontal disease status and selected virulence factors (serotype, presence of bacteriophages, and the presence of a 530 bp deletion in the promoter region of the leukotoxin gene). 36 subjects took part in the study. Serotype c was the most frequently found serotype among periodontally affected subjects, although serotypes a and b were also present. 27 out of 36 strains harbored bacteriophages, and there was strong evidence that some of the bacteriophages were different from the previously characterized phi Aa phage. A. actinomycetemcomitans containing the F-fragment phage were more frequently associated with periodontal disease. Five strains, all serotype b, 3 from LJP patients and 2 from healthy subjects, showed a 530-bp deletion in the promoter region of the leukotoxin gene.

Actinobacillus Infections↗

Sustained complete remission after incomplete chemoradiation complicated with pelvic cellulitis in a patient with recurrent cervical carcinoma.

We report on a 52-year-old female patient with a bulky, recurrent cervical carcinoma involving the vagina and bladder, who developed entero-recto-vesicovaginal fistulas and sepsis with pelvic cellulitis after external radiation of 40 Gy and 2 courses of concurrent chemotherapy. Chemoradiation was interrupted and an ileostomy was performed. After recovery, no residual tumor was detectable. Thirteen months after ceasation of chemoradiation, repair of vesicovaginal and rectovaginal fistulas via posterior sagittal approach was performed. Revision of double bowel ileostomy and ileo-T-colostomy was performed 17 months later. The patient enjoyed the restoration of enteral and urinary function only temporarily. She developed rectovesical fistula and underwent an ileostomy again 6 months later. She had another episode of peritonitis and upper gastrointestinal bleeding and expired at 4 years from initiation of salvage therapy. She had no evidence of cancer recurrence during a series of laparotomies and biopsies. The dramatic regression of the tumor may be attributed to its extraordinary radiosensitivity or chemosensitivity. The acute pelvic inflammatory complications may also contribute to the tumor cell killing. The prognosis of recurrent cervical carcinoma is invariably poor except in small tumors confined to vagina. This case gives support to the efficacy of chemoradiation and the potential role of biologic therapy in treatment of this dismal disease.

Antineoplastic Combined Chemotherapy Protocols↗

Conservative treatment for cervical cancer IA1: four cases report.

Cervical carcinoma IA1 is defined as invasive cervical cancer with measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm in diameter. It has been managed by extrafascial or modified radical hysterectomy. For young female patients who want to preserve future fertility, conservative treatment using therapeutic conization should be considered. In Taiwan, there has been little information about conservative treatment for cervical carcinoma IA1. We present 4 cases of young women with cervical carcinoma IA1 treated by conization alone. Pathological reports of all specimens demonstrated squamous cell carcinoma with free margins, stroma invasion less than 3 mm and no evidence of lymphovascular space invasion (LVSI). After 5-year follow-up with pelvic examination, pap smear, and colposcopy, there was no evidence of disease recurrence. We believe that conservative treatment for cervical carcinoma IA1 without LVSI is appropriate for selected patients to preserve future fertility.

Adult↗

Spatiotemporal characteristics of central otolith neurons.

PURPOSE: To review the spatiotemporal behaviours of central otolith neurons in decerebrate animals. DATA SOURCES: Laboratory of Neurophysiology, Department of Physiology, Faculty of Medicine, The University of Hong Kong. DATA EXTRACTION: Results of key research findings from 1992 to 1997. RESULTS: With constant velocity colckwise (CW) and counterclockwise (CCW) off-vertical axis rotations as stimuli to the otolith organs, neurons in the vestibular nuclei and medullary reticular formation showed characteristic spatiotemporal behavious. One-dimensional neurons showed symmetric and stable bidirectional response sensitivities (delta) to change in velocity while two-dimensional neurons showed asymmetric and variable delta to velocity. This CW-CCW asymmetry to bidirectional rotations may provide directional coding in the modulation of neural signals. Vestibular nuclear neurons also displayed distinct spontaneous discharge patterns at the stationary and earth-horizontal position, indicating that one- and two-dimensional neurons belong to physiologically distinct etities. These spatiotemporal behavious of the vestibular nuclear neurons were also shown to be precisely controlled by imputs from the vestibulocerebellum and/or bilateral otoliths. In both the vestibular nucleus and the reticular formation, the best response orientations of one-dimensional neurons and the orientations of the maximum response vector of two-dimensional neurons were found to point in all directions close to the horizontal plane, indicating that all head orientations on this plane are encoded across an ensemble of neurons. CONCLUSION: Otolith-evoked behaviours of the one-dimensional and two-dimensional neurons constitute an important element for the recognition of the direction and orientation of head motion in space.

Animals↗

Spontaneous activity of otolith-related vestibular nuclear neurons in the decerebrate rat.

The discharge properties of lateral and descending vestibular neurons responsive to constant velocity off-vertical axis rotations (OVAR) in the clockwise (CW) and counterclockwise (CCW) directions, were studied at the stationary and earth-horizontal position of decerebrate adult rats. From the coefficient of variation (CV), the spontaneous activities of OVAR-responsive neurons were classified into regular and irregular patterns. Of the neurons (n = 36) that showed symmetric and stable bidirectional response sensitivity (delta defined as CW gain over CCW gain) to OVAR (10 degrees tilt), some exhibited progressive phase shift with velocity (1.75-15 degrees/s) while others exhibited stable response phase. Most neurons of the former group (93% or 12/13) showed regular discharge pattern while only 22% (n = 5/23) of the latter group showed such a pattern. Though the phase-stable neurons showed a significantly higher average CV than the phase-shifted neurons, there was no significant difference between the mean spontaneous firing rates of these neurons. The neurons (n = 17) that showed asymmetric and variable delta to OVAR velocity can also be grouped-those that exhibited a greater gain with rotations directed towards the side of recording (I neurons) showed irregular discharge pattern while those that exhibited a greater gain with rotations directed towards the side contralateral to recording (C neurons) showed regular discharge pattern. The I and C neurons also exhibited significant difference in mean firing rates. The relationship between the response characteristics of the OVAR-responsive neurons and their spontaneous activity at the stationary and earth-horizontal position is discussed.

Action Potentials↗

Response of medial medullary reticular neurons to otolith stimulation during bidirectional off-vertical axis rotation of the cat.

In decerebrate cats, the extracellular activities of neurons in the medial medullary reticular formation were studied during constant velocity off-vertical axis rotations (OVAR) in the clockwise (CW) and counterclockwise (CCW) directions (at 10 degrees tilt). Spontaneously active neurons demonstrated sinusoidal position-dependent discharge modulations to OVAR which selectively stimulates the otoliths. Two features of neuronal responses to bidirectional OVAR were identified. Within the velocity spectrum tested (1.75-15 degrees/s), some neurons showed symmetric bidirectional response sensitivity (delta value) to CW and CCW rotations. The spread of the delta values of each of these neurons with velocity was small. This group of reticular neurons were described as exhibiting symmetric and velocity-stable bidirectional response sensitivity. The mathematically derived gain tuning ratios of these neurons were within the range of narrowly spatiotemporal-tuned neurons. Another group of reticular neurons, however, showed asymmetric bidirectional response sensitivity to CW and CCW rotations; a few of these neurons were responsive only to OVAR of one direction but not to both. For each of this second group of neurons, the spread of the delta values with velocity was large. These reticular neurons were described as exhibiting asymmetric and velocity-variable bidirectional response sensitivity. The gain tuning ratios of these latter neurons were found to be within the range of broadly spatiotemporal-tuned neurons. Single neurons of both groups displayed orientational tuning. Both the best response orientations of neurons that showed symmetric and velocity-stable bidirectional response sensitivity and the preferred orientations of neurons that showed asymmetric and velocity-variable bidirectional response sensitivity were found to point in all directions on the rotary plane. The response dynamics of the former group of neurons was also examined. All showed flat response gain across the entire velocity range. Some showed a flat response lead while others showed a progressive shift from small response lead at low velocity to phase close to zero at higher velocities. The functional significance of these medial medullary reticular neurons to the direction and orientation of head tilt is discussed.

Animals↗

The role of DNA flow cytometry in borderline malignant ovarian tumors.

BACKGROUND: The role of flow cytometric DNA analysis in predicting prognosis of patients with borderline malignant ovarian tumors has been controversial. METHODS: Fifty cases of patients with borderline malignant ovarian tumors were analyzed by histology and by flow cytometry on paraffin embedded tissue. Multiple tissue blocks and serial sections were analyzed for each tumor. The results of DNA analysis were correlated to clinicopathologic data. RESULTS: DNA aneuploidy was demonstrable in 4 cases (8%) when the most atypical section was analyzed. The overall rate of aneuploidy was 14% if additional blocks and serial sections were studied. Two patients died from tumor. One of the two patients had an initial diagnosis of Stage IIc mucinous borderline tumor with DNA indices (DI) of 1.12, 1.42, and 2.04. She had a recurrence in the contralateral ovary 1 year later (DI = 1.83), and a second frankly malignant recurrence diffusely in peritoneum (DI = 1.89). The other patient had an initial diagnosis of Stage IIIc mucinous borderline ovarian tumor with pseudomyxoma peritonei. DNA diploidy was obtained in all of the samples from the primary tumor. An aneuploid peak (DI = 1.28) was demonstrated in only one serial section of the peritoneal implants. Of the other 5 patients who had aneuploid histograms but were disease-free, the DNA indices were 1.35, 1.14/1.18, 1.15, 1.20, and 1.31 and were demonstrable only in either 1 or 2 of the blocks or unproven on serial sections. All patients with diploid-peridiploid tumors were alive and disease free. CONCLUSIONS: Reproducible DNA aneuploidy of high DI may be predicting a poor outcome, whereas the significance of inconsistently reproducible aneuploidy of low DI remains to be determined. Further studies of prospective DNA analysis with adequate sampling are necessary to define the role of flow cytometry in patients with borderline malignant ovarian tumors.

Adolescent↗

Squamous cell carcinoma arising in mature cystic teratoma of the ovary.

Treatment results of 26 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma of the ovary were analyzed. Four nulliparous patients with stage Ia tumors underwent conservative salpingo-oophorectomy. Following surgery, 2 patients had successful pregnancies. The remaining 7 patients with stage Ia tumors were observed after hysterectomy and bilateral salpingo-oophorectomy. Fifteen patients with stage Ic-IV tumors underwent cytoreductive surgery followed by cis-platinum-based chemotherapy with or without sequential radiotherapy. The mean survival was 63.9 months. The overall actuarial disease-free survival at 2 years was 69%, and by stage was as follows: stage I, 100% (13/13); stage II, 100% (2/2); stage III, 30% (3/10); and stage IV, 0% (0/1). A significant difference in disease-free survival was noted in stage (P = 0.0001). Optimal versus suboptimal operation was associated with a median Kaplan-Meier survival of 65 months versus 34.8 months, with actuarial disease-free survival at 2 years of 60 and 0%, respectively (P = 0.0210). Our study shows that 67% (16/24) of the patients had SCC antigen levels exceeding 2 ng/ml, which by stage was as follows: stage I, 5/11 (45%); stage II, 1/2 (50%); stage III, 9/10 (90%); and stage IV, 1/1(100%). After completion of treatment, all 8 patients with recurrent lesions had reelevated SCC antigen levels in series SCC antigen monitoring. In conclusion, positive prognostic factors of disease-free survival were optimal cytoreduction and lower FIGO stage. We suggest that multimodality therapy, including aggressive cytoreduction followed by cis-platinum-based chemotherapy with or without sequential radiotherapy, is recommended. In addition, we suggest that serum SCC antigen monitoring may be helpful in early detection of cancer recurrence.

Adult↗

Comparison of the efficacy of tropisetron versus a metoclopramide cocktail based on the intensity of cisplatin-induced emesis.

Cisplatin-induced emesis is one of the most feared side effects in cancer treatment. High-dose metoclopramide may prevent only 30-40% of cases of acute emesis. Investigations to test the efficacy of new antiemetics are mandatory. We compared the efficacy, toxicity, and patients' preference for tropisetron, a new 5-hydroxytryptamine3 (HT3) receptor antagonist, with those of a combination of high-dose metoclopramide, dexamethasone, diphenhydramine, and lorazepam (metoclopramide cocktail) in a randomized crossover study for the control of nausea and vomiting during cisplatin-containing chemotherapy. A total of 62 chemotherapy-naive women were included and followed over 3 consecutive courses. Detailed analysis comparing the incidence of acute emesis for each 4 h period following cisplatin infusion was also performed. Complete protection from acute emesis was obtained in 48% of patients receiving tropisetron and 29% of patients receiving the metoclopramide cocktail over the first two courses of chemotherapy (P = 0.029). When the frequency of acute emesis in all patients was compared on a daily basis, no significant difference was found. When emesis frequency was compared over each 4 h period following infusion of cisplatin, tropisetron was superior to the metoclopramide cocktail during the first, the second, and the first and second periods (P = 0.0001, P = 0.01 and P = 0.0006, respectively). This superiority reversed after 12 h but did not reach statistical significance (P = 0.112). Tropisetron was more effective in controlling acute nausea, but metoclopramide provided better control of delayed emesis. A drop in efficacy over successive courses was observed in patients receiving metoclopramide first but was not seen in tropisetron-first patients. A tendency for tropisetron preference was observed. Tropisetron is more effective than the metoclopramide cocktail in the control of chemotherapy-induced vomiting within 8 h of the implementation of cisplatin and in the control of nausea on the 1st day. To improve the control of chemotherapy-induced emesis, further investigations on the additional tropisetron dosing at 8 h after cisplatin infusion or the combination use of tropisetron and other antiemetics by a continuous 4 h period of observation and comparison are mandatory.

Adult↗

Tissue distribution and developmental expression of type XVI collagen in the mouse.

The expression of a recently identified collagen, alpha 1 (XVI), in adult mouse tissue and developing mouse embryo was examined by immunohistochemistry and in situ hybridization. A polyclonal antiserum was raised against a recombinant fusion protein, which contained a segment of 161 amino acids in the N-terminal noncollagenous domain of the human alpha 1 (XVI) collagen. Immunoprecipitation of metabolically labelled human or mouse fibroblast cell lysates with this antibody revealed a major, bacterial collagenase sensitive polypeptide of approximately 210 kDa. The size agrees with the prediction from the full-length cDNA. Immunofluorescence examination of adult mouse tissues using the affinity purified antibody revealed a rather broad distribution of the protein. The heart, kidney, intestine, ovary, testis, eye, arterial walls and smooth muscles all exhibited significant levels of expression, while the skeletal muscle, lung and brain showed very restricted and low signals. During development, no significant expression of the mRNA or protein was observed in embryo of day 8 of gestation, but strong signals was detected in placental trophoblasts. Expression in embryos was detectable first after day 11 of gestation with weak positive signals appearing in the heart. In later stages of development, stronger RNA hybridizations were observed in a variety of tissues, particularly in atrial and ventricular walls of the developing heart, spinal root neural fibers and skin. These data demonstrate that type XVI collagen represents another collagenous component widely distributed in the extracellular matrix and may contribute to the structural integrity of various tissues.

Aging↗

Multicenter trial of modified Gamma nail in East Asia.

The mismatch of the standard Gamma nail in the Chinese femora led to the modification of its femoral shaft component based on the anthropometric study of 28 pairs of Chinese femora. A multicenter clinical trial was done in 6 countries and regions in East Asia. Three hundred forty-nine fractures were treated and studied. More than 60% of the fractures were unstable by Evans classification. The average age of the patients was 73.6 years. The male to female ratio was 2:3. The mean followup period was 11.7 months. The result of the trial showed that the intraoperative complication rate was 7.7%, and complications primarily were related to faulty operative technique. There were 7.2% postoperative complications related to the fractures that again decreased toward the later stage of the trial. Functionally, there was progressive improvement of the hip score within the followup period. The results show that the modified Gamma nail gave better results in the treatment of geriatric trochanteric fractures by minimizing reaming, thereby reducing complications related to the implants.

Activities of Daily Living↗