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C S Liu

Publications and source records attributed to C S Liu.

At least 55 records · Page 3Linked to original sources

Functional magnetic resonance imaging of lateral geniculate nucleus at 1.5 tesla.

Although activation of the lateral geniculate nucleus has been detected by functional magnetic resonance imaging with magnetic field strengths higher than 2.0 Tesla, there have been no reports of functional magnetic resonance imaging of the lateral geniculate nucleus with the more widely available 1.5 Tesla scanner. The authors used functional magnetic resonance imaging techniques at 1.5 Tesla to detect lateral geniculate nucleus activation in five of seven healthy subjects. This study shows that visual activation of the lateral geniculate nucleus can be obtained with functional magnetic resonance imaging using conventional 1.5 Tesla scanners.

Adult↗

Familial breast cancer in southern Taiwan.

The purpose of this study is to evaluate whether there are pathobiologic differences and differences in overall rates survival between familial and non-familial breast cancer patients in Taiwan. A retrospective study was performed evaluating 76 familial breast cancer patients in 69 families, which included two BRCA1 related cases and six BRCA2 related cases. Patients were compared with 425 non-familial sporadic cases. Familial breast cancer patients had similar ages and stages as non-familial patients (mean, 46.6 years vs 48.9 years, p = 0.306). However, the familial breast cancer patients with BRCA1 and BRCA2 related cases presented at lower stages (p = 0.034) and younger ages than non-familial patients (mean, 45.1 years vs 48.9 years P = 0.042). The occurrence of infiltrating ductal carcinoma and lobular carcinoma in situ was not significantly different in the two groups. Mucinous carcinoma was represented with 6.7% (4/76) and 1.3% (1/76) medullary carcinoma. The overall grade of familial breast cancer, including BRCA1 and BRCA2 related cases in 8 infiltrating ductal carcinoma, was significantly higher than that of controls. The mean follow up was 4.5 years for familial breast cancers. Five- and 10-year overall survival rates were 69% and 61% for those with a family history, compared with 86% and 64% for those in the control group (p = 0.644). There were no statistically significant differences in disease-free survival rates between the two groups at 5 or 10 years (69% vs 78% in 5 years; 48% vs 58% in 10 years) (p = 0.862). Despite the younger ages and earlier stages at presentation in familial breast cancer patients with BRCA1 and BRCA2 related cases, the familial breast cancer patients had higher grade patholobiologic characteristics, but similar prognoses when compared with sporadic breast cancer patients. Owing to the limited number of familial cases in this study, more cases and longer follow up are needed.

BRCA2 Protein↗

Simplified 13C-urea breath test for the diagnosis of Helicobacter pylori infection--the availability of without fasting and without test meal.

The conventional 13C-urea breath test (13C-UBT) for detecting Helicobacter pylori infection was performed during fasting state and with a test meal to delay gastric emptying during the test. For the convenience of propagating this test, we assessed the availability of non-fast and without test meal in 13C-UBT for the diagnosis of H. pylori infection. One hundred and five consecutive patients who received endoscopic examination were studied. All of them received endoscopic biopsy for urease test, culture and histopathology to determine whether there was a presence of H. pylori infection. Each patient received four separate 13C-UBT under the following four testing conditions. Test I) fasting state with test meal (100 ml fresh milk), Test II) non-fast (taking usual food) but with test meal, Test III) fasting state without test meal, and Test IV) non-fast and without test meal. The excess delta 13CO2 values were calculated via the breathed samples that were collected at 15 minutes after ingestion of 13C-urea. There were 61 H. pylori positive and 44 negative patients in this study, with an excess delta 13CO2 values 3.0, 4.0, 3.5 and 4.0 as a cut-off value in the four tests respectively, according to the ROC curve. The results of test I, a conventional procedure, had a good correlation with the gold standard. The sensitivity and specificity were 100% and 95% respectively. The alternative procedures in other tests also have high sensitivity and specificity at 15-minute detecting time. The sensitivity of the tests II, III and IV at 15-minute detecting times were 98%, 98% and 100%, and the specificities of those were 95%, 98% and 95% respectively. We therefore suggest that fasting and test meal possibly be omitted when the cut-off value is 4.0 per mil in the simplified 13C-UBT (non-fast and without test meal, and detection at 15 minutes after ingestion of 13C-urea) which is a simple and available procedure for clinical diagnosis of H. pylori infection.

Adult↗

Age-associated alteration of blood thiol-group-related antioxidants in smokers.

Total blood glutathione and nonglutathione free sulfhydryl compounds, glutathione peroxidase, and glutathione S-transferase in erythrocytes and plasma and also lipid peroxides in plasma were investigated in 48 male smokers and 42 male nonsmokers. We found that the level of total blood glutathione was significantly increased in young smokers (age <40) but no such change was noted in aging smokers (age>/=40). The activities of glutathione peroxidase and glutathione S-transferase in plasma were significantly decreased in young smokers and the plasma levels of these two enzymes and nonglutathione free sulfhydryl compounds were more drastically decreased in aging smokers. The average concentration of plasma lipid peroxides of the aging smokers (2.76+/-0.46 nmol/ml) was significantly higher than that of the aging nonsmokers (2.32+/-0. 41nmol/ml, P=0.049). On the other hand, the level of total blood glutathione was negatively correlated with the level of plasma lipid peroxides (r=-0.305, P=0.002) and was positively correlated with the smoking index (r=0.307, P=0.019) of all the study subjects under age control. These results indicate that the activities of glutathione peroxidase and glutathione S-transferase declined to a great extent under smoking-mediated oxidative stress in the blood of both young and aging smokers. Moreover, the compensatory generation of total blood glutathione may effectively prevent plasma lipids from peroxidation in young smokers, although the activities of glutathione peroxidase and glutathione S-transferase in plasma were decreased. By contrast, total blood glutathione was inadequate for such protection in the aging smokers. We suggest that supplementation of thiol-group-related agents may be considered for the prevention or alleviation of oxidative stress in aging smokers, whose capability and capacity for the disposal of smoking-mediated free radicals and reactive oxygen species are compromised.

Adult↗

Endoscopic hydrogen peroxide spray may facilitate localization of the bleeding site in acute upper gastrointestinal bleeding.

BACKGROUND AND STUDY AIMS: A major problem encountered in the emergency endoscopic management of acute upper gastrointestinal (UGI) bleeding is poor localization of the bleeding site, which can be obscured by blood or clots. Traditional attempts to overcome this problem have been by physical methods, which have usually proved unsatisfactory. The aim of this prospective study was to show that hydrogen peroxide can be used as a dissolution agent, resulting in an alteration of the characteristics of blood clots and allowing a clearer visual field. PATIENTS AND METHODS: Twenty patients with acute UGI bleeding (13 male, seven female) were included in the study. The suspected site of bleeding was initially sprayed with 200 ml of saline and then with 25-175 ml of 3 % H2O2. Pictures of the visual field were taken before and after irrigation with both saline and H2O2. These pictures were evaluated by three gastroenterologists and scored using the following visual clearance scoring system: -3, marked worsening of visual field; -2, moderate worsening; -1, slight worsening; 0, no change; +1, slight improvement; +2, moderate improvement; + 3, marked improvement. In cases of active oozing or spurting, after initial hemostasis was achieved the bleeding point was injected with pure ethanol or cauterized with a heater probe. In order to assess the safety of 3 % H2O2 endoscopic biopsies of the antrum and the duodenal bulb were performed before and 30 minutes after its use and examined by a pathologist. RESULTS: There was a significant improvement in the mean visual clearance score after irrigation with H2O2 compared to irrigation with saline alone (2.13 vs. 0.43, P<0.001). During endoscopic examination there were 19 patients with active oozing from the ulcer base covered by an adherent blood clot; 12 of these (63.1%) achieved initial hemostasis after H2O2 spraying. Eleven of 18 (61.1 %) patients complained of a mild epigastric burning sensation during H2O2 irrigation. There was no clinically significant change in the histology of the antrum and the duodenal bulb after H2O2 therapy. CONCLUSIONS: We concluded that H2O2 is a safe and effective way to clear the visual field, facilitating the localization of the bleeding site during emergency endoscopy for acute UGI bleeding, with only mild side effects. In some cases H2O2 therapy can also induce temporary hemostasis. We recommended the use of hydrogen peroxide to improve endoscopic visualization, especially in cases where an adherent blood clot covers the suspected bleeding site.

Adult↗

The advisability of implementing cholesterol screening in school-age children and adolescents with a family history of cardiovascular disease and hyperlipidaemia.

BACKGROUND: The family basis of coronary heart disease is well recognized and it is important for family physicians to assess whether children have elevated cholesterol levels. OBJECTIVES: We aimed to evaluate the advisability of implementing cholesterol screening in children with a family history of cardiovascular disease and hyperlipidaemia. METHODS: We conducted a cross-sectional study in Taiwan from February to June 1996. There were 47,800 students in the population. A total of 4520 students were recruited by two-stage sampling. All the participants were required to fill out a structured questionnaire. RESULTS: The response rate was 92.5%. Our results show that 16-18% of the children had a positive family history of cardiovascular disease or hyperlipidaemia. Children with a family history of hyperlipidaemia were significantly more likely to have elevated total cholesterol and low-density lipoprotein cholesterol than those without such a history (both odds ratios: 1.4, P < 0.05). Positive predictive values of hyperlipidaemia were less than 13% based on family history. More than 75% of children with abnormal lipid levels would be missed. CONCLUSIONS: The data suggest that parents' self-reported family history is an ineffective means of identifying children with elevated serum lipid levels in Taiwan. Further research and modification of current National Cholesterol Education Program Panel guidelines for selective cholesterol screening in children may be warranted.

Analysis of Variance↗

Identification of five spinocerebellar ataxia type 2 pedigrees in patients with autosomal dominant cerebellar ataxia in Taiwan.

OBJECTIVES: The autosomal dominant cerebellar ataxias (ADCAs) are a group of genetically diverse neurological conditions linked by progressive deterioration in balance and coordination. Spinocerebellar Ataxia Type 2 (SCA2) is one of the ADCAs and also belongs to a special group caused by the expansion of an unstable CAG repeat encoding a polyglutamine tract. We aimed to investigate the frequency of SCA2 mutation in the ataxia patients referred to the clinic. MATERIALS AND METHODS: We screened 58 families with inherent cerebellar ataxia and 57 normal individuals by the use of radioactive genomic polymerase chain reaction (PCR) method. A simple non-radioactive PCR for rapid detection of the expanded SCA2 alleles via agarose gel electrophoresis was also employed. RESULTS: Eight SCA2 affected patients and 1 at-risk individual in 5 unrelated SCA2 families were identified. The CAG repeats of normal alleles in the sample studied range in size from 16 to 30 repeat units, while those of SCA2 chromosomes are expanded to 34 to 49 repeat units. Our results also showed that unlike SCA 1 and SCA3/MJD, the size distribution of the normal alleles showed few polymorphisms, with the 22 repeat allele accounting for 90.1%. Homozygosity in normal individuals was 80.2%. No overlap in ataxin-2 allele size between normal and expanded chromosomes was observed. CONCLUSION: This is the first report of the SCA2 gene distributions in the population of Taiwan. The SCA2 mutation accounts for 8.6% of ADCA type I families referred to us, intermediate between SCA1(1.7%) and SCA3/MJD (24%) of the ADCA type I families in our collection.

Adolescent↗

Image quality in polypseudophakia for extremely short eyes.

AIM: To evaluate the image quality produced by polypseudophakia used for strongly hypermetropic and nanophthalmic eyes. METHODS: Primary aberration theory and ray tracing analysis were used to calculate the optimum lens shapes and power distribution between the two intraocular lenses for two example eyes: one a strongly hypermetropic eye, the other a nanophthalmic eye. Spherical aberration and oblique astigmatism were considered. Modulation transfer function (MTF) curves were computed using commercial optical design software (Sigma 2100, Kidger Optics Ltd) to assess axial image quality, and the sagittal and tangential image surfaces were computed to study image quality across the field. RESULTS: A significant improvement in the axial MTF was found for the eyes with double implants. However, results indicate that this may be realised as a better contrast sensitivity in the low to mid spatial frequency range rather than as a better Snellen acuity. The optimum lens shapes for minimum spherical aberration (best axial image quality) were approximately convex-plano for both lenses with the convex surface facing the cornea. Conversely, the optimum lens shapes for zero oblique astigmatism were strongly meniscus with the anterior surface concave. Correction of oblique astigmatism was only achieved with a loss in axial performance. CONCLUSIONS: Optimum estimated visual acuity exceeds 6/5 in both the hypermetropic and the nanophthalmic eyes studied (pupil size of 4 mm) with polypseudophakic correction. These results can be attained using convex-plano or biconvex lenses with the most convex surface facing the cornea. If the posterior surface of the posterior intraocular lens is convex, as is commonly used to help prevent migration of lens epithelial cells causing posterior capsular opacification (PCO), then it is still possible to achieve 6/4.5 in the hypermetropic eye and 6/5.3 in the nanophthalmic eye provided the anterior intraocular lens has an approximately convex-plano shape with the convex surface anterior. It was therefore concluded that consideration of optical image quality does not demand that additional intraocular lens shapes need to be manufactured for polypseudophakic correction of extremely short eyes and that implanting the posterior intraocular lens in the conventional orientation to help prevent PCO does not necessarily limit estimated visual acuity.

Astigmatism↗

The hemodynamic changes of gastroduodenal regional blood flow after Helicobacter pylori eradication in patients with duodenal ulcer scar.

Duodenal ulcer (DU) is frequently accompanied by Helicobacter pylori (Hp) infection and associated with the imbalance of aggressive factors and defensive factors. To investigate the possible relationship between Hp and regional gastric blood flow, 26 endoscopically proved DU (scar stage) and Hp infection patients were included and received triple therapy (colloid bismuth subcitrate 120 mg qid for 4 weeks, amoxicillin 500 mg qid for 2 weeks and metronidazole 250 mg tid for 2 weeks). Regional gastroduodenal blood flow (RGDF) was measured at DU scar area and antrum lesser curvature site by laser Doppler flowmetry during endoscopic examination, before and one month after triple therapy. In 22 patients with Hp eradication the RGDF was significantly elevated at antrum lesser site after triple therapy (p < 0.05) but there was no difference at DU scar area. However, in 4 patients without Hp eradication no difference of RGDF in these two points was found. Therefore, Hp appears to have direct effects on gastric microcirculation.

Adult↗

Acinetobacter baumannii bloodstream infection: clinical features and antimicrobial susceptibilities of isolates.

The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58%) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89%) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P < 0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6%) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19% of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.

Acinetobacter Infections↗

Serum cholesterol levels and prevalence of hypercholesterolemia in school-aged Taiwanese children and adolescents: the Taichung Study.

BACKGROUND: Atherosclerosis has become one of the leading causes of death in Taiwan. Hypercholesterolemia is a major risk factor for coronary atherosclerosis. To evaluate the mean total cholesterol values and the prevalence of hypercholesterolemia in school-aged Taiwanese children and adolescents, an epidemiologic survey was conducted. METHODS: After two-stage sampling of 52 primary schools and 26 junior high schools in Taichung City, we randomly selected 3,924 children (2,070 boys and 1,854 girls). Blood total cholesterol (TC), triglyceride (TG) and high-density lipoprotein (HDL)-cholesterol were measured. Response rate was 86.8%. Subjects' ages ranged from seven to 14 years old. RESULTS: From this cross-sectional survey, the following characteristics (mean +/- SD) were documented for boys and girls, respectively: TC, 162 +/- 28 and 165 +/- 29 mg/dl; TG, 74 +/- 33 and 80 +/- 32 mg/dl; HDL-cholesterol, 61 +/- 13 and 59 +/- 12 mg/dl; and low-density lipoprotein (LDL)-cholesterol, 87 +/- 24 and 90 +/- 25 mg/dl. The mean TC across all age groups ranged from 149 to 172 mg/dl for boys and 157 to 170 mg/dl for girls. In boys, the TC concentration was highest at age 11 (172 mg/dl), and in girls was highest at age 7 (170 mg/dl). Borderline hypercholesterolemia (TC > 170 mg/dl) was found in 36.5% of boys (13.5-53.1%) and 39.7% of the girls (28.3-48.6%). Hypercholesterolemia (TC > 200 mg/dl) was found in 9.7% of males (3.1-16.6%) and 10.3% of the females (5.0-14.9%). CONCLUSIONS: The prevalence of borderline hypercholesterolemia was 38.0% for TC and 17.2% for LDL-C, and for hypercholesterolemia, it was 9.9% for TC and 5.8% for LDL-C. The higher TC levels in Taiwanese children were primarily due to higher HDL-C and TG levels.

Adolescent↗

Association between serum uric acid and cardiovascular risk factors among elderly people in Taiwan.

In order to understand the distribution of serum uric acid and the relationship between serum uric acid and the cardiovascular risk factor among elderly people, a cross-sectional study was conducted in Chung-Shing-Shin-Tseun community in Taiwan in May 1998. All individuals aged 65 and over were collected. A total of 1123 persons, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 63.3%. However, only 586 respondents had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. The mean uric acid values were 7.4 +/- 1.8 mg/dl in men and 6.3 +/- 1.6 mg/dl in women, respectively (p < 0.001). Multivariate linear regression showed that serum uric acid was significantly correlated with sex and body mass index. Simple correlation showed that serum uric acid was significantly correlated with diastolic pressure, total cholesterol, triglyceride and creatinine. Age, systolic pressure and fasting glucose were not related to serum uric acid. In our conclusion, the uric acid values are high among elderly people. The serum uric acid levels are significantly associated with the cardiovascular risk factors among elderly people.

Age Factors↗

Alterations of small-molecular-weight antioxidants in the blood of smokers.

Plasma alpha-tocopherol, ascorbate, retinol, uric acid, and lipid peroxides were investigated in 39 male smokers and 64 male non-smokers. The average level of plasma alpha-tocopherol of 35-45-year-old smokers (1.74+/-0.49 microg/mg total lipid) was significantly lower than that of age-matched non-smokers (2.55+/-0.88 microg/mg total lipid, P = 0.032). Similarly, the plasma alpha-tocopherol of smokers aged above 45 (1.66+/-0.29 microg/mg total lipid) was lower than that of the age-matched non-smokers (2.38+/-1.26 microg/mg total lipid, P = 0.014). However, no difference in plasma level of alpha-tocopherol was found between smokers and non-smokers below the age of 35. The average concentration of ascorbate in plasma was significantly decreased only in those smokers older than 45 (0.33+/-0.16 mg/dl vs non-smokers 0.53+/-0.19 mg/dl, P = 0.003). The average level of lipid peroxides (measured as malondialdehyde,MDA) in the plasma of smokers (2.77+/-0.51 nmol/ml) was higher than that of non-smokers (2.35+/-0.21 nmol/ml) aged above 45 (P = 0.034). No differences in the plasma levels of uric acid and retinol were noted between smokers and non-smokers in all age groups. Using partial correlation analysis under age control, we found that the plasma level of alpha-tocopherol was negatively correlated with the plasma level of MDA (r = -0.523, P = 0.038). In contrast, the plasma level of ascorbate was only weakly correlated with the plasma level of MDA (r = -0.341, P = 0.094). Moreover, we found a negative correlation between the plasma level of alpha-tocopherol and smoking index (r = -0.414, P = 0.006) under age control, but there was no correlation between plasma level of ascorbate and smoking index (r=0.221, P = 0.193). These results indicate that adequate levels of alpha-tocopherol and ascorbate may protect the plasma from oxidative damage elicited by smoking-mediated reactive oxygen species (ROS) and free radicals in young smokers. However, the antioxidant activities of alpha-tocopherol and ascorbate may be overwhelmed by the long-standing oxidative stress elicited by cigarette smoking in elderly subjects.

Adult↗

Nonaqueous capillary electrophoretic separation and thermo-optical absorbance detection of five tricyclic antidepressants and metabolism of amitriptyline by Cunninghamella elegans.

We developed a technique based on nonaqueous capillary electrophoresis and laser-based thermo-optical absorbance detection to assay five antidepressants with similar structures and mass-to-charge ratios. A mixture of methanol and acetonitrile with ammonium acetate was essential to achieve baseline resolution of these compounds. We investigated the effects of ammonium acetate concentration, temperature, applied voltage, and capillary length on separation efficiency. The nonaqueous capillary electrophoresis and laser-based thermo-optical absorbance detection technique was used to study the metabolism of amitriptyline by Cunninghamella elegans. Sample preparation procedures were simplified for fast screening of the parent drug and its metabolites. Reproducible electropherograms were obtained from replicate cultures of C. elegans growing in the presence of amitriptyline.

Amitriptyline↗

On-line nonaqueous capillary electrophoresis and electrospray mass spectrometry of tricyclic antidepressants and metabolic profiling of amitriptyline by Cunninghamella elegans.

An on-line nonaqueous capillary electrophoresis-electrospray mass spectrometry (ESI-MS) technique was developed using a commercial ion spray interface. The nonaqueous capillary electrophoresis ESI-MS system was used to profile tricyclic antidepressants of similar structures and mass-to-charge ratios. We found that pure methanol can be used as a sheath liquid to obtain stable ion spray from nonaqueous capillary electrophoresis. The flow rate of the coaxial nebulizing gas affected baseline signals, separation efficiency, and migration times. Other nonaqueous capillary electrophoresis operating conditions and electrospray parameters were optimized for enhanced baseline separation and high sensitivity detection. The effect of sample stacking on separation and detection was evaluated. The calculated detection limits were approximately 3 pg injected onto the capillary. ESI mass spectra of tricyclic antidepressants from a single quadrupole MS were obtained and elucidated. The information was used to propose fragmentation pathways of the tricyclic antidepressants. The method was also used to analyze the metabolites of amitriptyline produced by the fungus Cunninghamella elegans. Sixteen metabolites were detected and most of them were tentatively identified as demethylated and/or hydroxylated, and/or N-oxidized products.

Amitriptyline↗

Urinary N-acetyl-beta-glucosaminidase as an indicator of renal dysfunction in electroplating workers.

OBJECTIVES: To investigate chromium-induced renal dysfunction in electroplating workers. METHODS: A cross-sectional study was used to evaluate four biochemical markers of renal function. A total of 178 workers were divided into 3 comparable groups consisting of 34 hard-chrome plating workers, 98 nickel-chrome electroplating workers. and 46 aluminum anode-oxidation workers, who represented the reference group. Ambient and biological monitoring of urinary chromium were performed to measure exposure concentrations. RESULTS: Overall, urinary chromium concentrations were highest among hard-chrome plating workers (geometric mean 2.44 microg/g creatinine), followed by nickel-chrome electroplating workers (0.31 microg/g creatinine) and aluminum workers (0.09 microg/g creatinine). Airborne chromium concentrations were also highest in the hard-chrome plating area (geometric mean 4.20 microg/m3), followed by the nickel-chrome electroplating area (0.58 microg/m3) and the aluminum area (0.43 microg/m3). A positive correlation was found between urinary chromium and airborne concentrations (r=0.54, P < 0.01). Urinary concentrations of N-acetyl-beta-D-glucosaminidase (NAG) were also highest among hard-chrome plating workers (geometric mean 4.9 IU/g creatinine), followed by nickel-chrome workers (3.4 IU/g creatinine) and aluminum workers (2.9 IU/g creatinine). The prevalence of "elevated" NAG (>7 IU/g creatinine) was significantly highest among hard-chrome plating workers (23.5%), then among nickel-chrome workers (7.1%) and aluminum workers (8.7%). Differences in beta2-microglobulin, total protein, and microalbumin were not significant. CONCLUSION: The author's evidence indicates that NAG is an early indicator of renal dysfunction in hard-chrome plating workers.

Acetylglucosaminidase↗

Quantification of Helicobacter pylori infection: Simple and rapid 13C-urea breath test in Taiwan.

The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.

Adolescent↗

Intraoperative non-puncture laparoscopic examination of contralateral internal inguinal rings is feasible in children with unilateral hydrocele.

BACKGROUND: Intraoperative non-puncture laparoscopic examination using the hernia sac as the scope entrance has been successfully conducted in children with unilateral inguinal hernia. This technique selects patients for contralateral inguinal exploration. In spite of the thin and narrow processus vaginalis, children with unilateral hydrocele encounter the same problem of subsequent contralateral inguinal hernia or hydrocele. In this study, we discuss the feasibility of this technique in children with unilateral hydrocele. METHODS: From July 1993 to September 1995, 91 children with unilateral hydrocele were examined during surgery at our institution. The results, including success rate, complications, patent rate of contralateral internal ring and contralateral subsequent hernia or hydrocele, at at least one year follow-up, were compared with those of 329 children with unilateral hernia undergoing the same examination during this period. RESULTS: A patent contralateral processus vaginalis was recognized in 31 children and all were confirmed by surgical exploration. The examination failed in three patients, of whom two had a tear in the processus vaginalis and one had retroperitoneal air dissection as a result of false insertion of the laparoscopic sheath. One patient had a postoperative wound infection. No patient with contralateral obliterated processus vaginalis developed inguinal hernia or hydrocele during follow-up of at least one year. The results were similar to those of the 329 children with hernia who underwent the same procedure in the same period. CONCLUSIONS: Intraoperative non-puncture laparoscopic examination is feasible in children with unilateral hydrocele.

Child↗