Revised cutoff values of serum aminotransferase in detecting viral hepatitis among CAPD patients: experience from Taiwan, an endemic area for hepatitis B

BACKGROUND: To determine the best cutoff values of aspartate aminotransferase (AST) and alanine amino-transferase (ALT) in detecting viral hepatitis C infection among patients of continuous ambulatory peritoneal dialysis (CAPD). METHODS: 90 (44 male and 46 female) CAPD patients and 526 adult controls (266 male, 260 female) were enrolled. Serum AST and ALT were measured by an auto-analyser monthly. Serum HBsAg was examined using a RIA method and anti-HCV by an second-generation EIA method. The best cutoff values of AST and ALT for detecting viral hepatitis were obtained from the ROC (receiver-operating characteristic) curve. RESULTS: The prevalence of anti-HCV(+) was significantly higher in CAPD patients (16.7%) than in normal controls (4.9%), while that of HBsAg(+) was similar in both groups. CAPD patients had significantly lower levels of serum aminotransferases compared to normal controls. Mean AST were 23.8 IU/l in normal control and 18.8 IU/l in the CAPD patients (P < 0.001). Mean ALT were 21.9 IU/l in normal controls and 15.3 IU/l in the CAPD patients (P < 0.001). CAPD patients with HCV infection had higher serum AST and ALT levels than those without. However, HBV infection did not cause significant serum aminotransferase elevation in patients. The conventional cutoff values of AST (40 IU/l) and ALT (40 IU/l) for detecting viral hepatitis yielded only a sensitivity of 27.3 and 18.2% respectively; on the contrary, our revised cutoff values of AST (24 IU/l) and ALT (17 IU/l) had better sensitivities (AST, 72.7%; ALT, 63.6%). For serial aminotransferase values, the sensitivity of AST and ALT for detecting HCV were 36.4 and 27.3% by conventional criteria, and were both 81.8%, by our newly revised criteria. CONCLUSIONS: Serum aminotransferase cutoff values should be modified for screening viral hepatitis in a CAPD population. Our new cutoff criteria had important clinical implications in providing benefits of earlier detection and possible prevention from chronic hepatic deteriorations.     

Pegylated peptides. V. Carboxy-terminal PEGylated analogs of growth hormone-releasing factor (GRF) display enhanced duration of biological activity in vivo

In the present study, human growth hormone-releasing factor (hGRF) and analogs were successfully pegylated at the carboxy-terminus using a novel solid- and solution-phase strategy. Following synthesis, these pegylated hGRF analogs were evaluated for in vitro and in vivo biological activity. Specifically, hGRF (1-29)-NH2, [Ala15]-hGRF (1-29)-NH2, [desNH2Tyr1, D-Ala2, Ala15]-hGRF(1-29)-NH2 and [His1, Val2, Gln8, Ala15, Leu27]-hGRF(1-32)-OH were each C-terminally extended using a Gly-Gly-Cys-NH2 spacer (previously demonstrated not to alter intrinsic biological activity), and then monopegylated via coupling to an activated dithiopyridyl-PEG reagent. PEG moieties of 750, 2000, 5000 or 10,000 molecular weight (MW) were examined to determine the effect of polymer weight on activity. Initial biological evaluations in vitro revealed that all C-terminally pegylated hGRF analogs retained high growth hormone (GH)-releasing potencies, regardless of the MW of PEG polymer employed. Two of these pegylated hGRF analogs, [desNH2Tyr1, D-Ala2, Ala15]-hGRF (1-29)-Gly-Gly-Cys(NH2)-S-Nle-PEG5000 and [His1, Val2, Gln8, Ala15, Leu27]-hGRF(1-32)-Gly-Cys(NH2)-S-Nle-PEG5000, were subsequently evaluated in both pig and mouse models and found to be highly potent (in vivo potency range = 12-55-fold that of native hGRF). Relative to their non-pegylated counterparts, these two pegylated hGRF analogs exhibited enhanced duration of activity.     

Coronary bypass in vascular patients: a relatively high-risk procedure

A premise of cardiac risk stratification is that the added risk of coronary artery bypass grafting (CABG) is offset by the improved safety of subsequent vascular reconstruction (VR). We questioned if elective CABG is patients with severe peripheral vascular disease (PVD) is a relatively high-risk procedure. A cohort study of 680 elective CABG patients from January 1993 to December 1994 was performed using three mutually exclusive outcomes of complication-free survival, morbidity, and mortality. Patient characteristic, operative, and outcome data were prospectively collected. Retrospective review determined that 58 patients had either a standard indication for or a history of VR. Overall CABG mortality was 2.5%, with statistically similar but relatively higher rates for PVD as compared to non-PVD patients. In contrast, major morbidity occurred at rates 3.6-fold higher in PVD patients (39.7%) than in disease-free patients (16.7%) after adjustment for the effects of patient and operative variables (odds ratio [OR] 3.67, 95% confidence interval [CI] 1.93-6.99). CABG morbidity in the PVD patient was most likely in those patients with aortoiliac (OR 9.51, CI 3.20-28.27) and aortic aneurysmal (OR 5.24, CI 1.28-21.41) disease types. CABG in PVD patients is associated with significant major morbidity. Such morbidity may preclude or alter the timing of subsequent VR.     

An object-oriented query evaluation scheme for logical databases inmassively parallel environment

Taking advantage of the structure of logical representations, we report an algorithm that evaluates conjunctive queries in a massively parallel environment under an object-based representation for deductive databases. By distributing objects in a database, we show that parallel evaluation of a query can be achieved in a cooperative way so that the conventional tuple-by-tuple, operation-by-operation evaluation strategy can be replaced by a global, parallel matching approach. With the proposed scheme, all conjuncts of a given query can be examined at the same time, which enables us to eliminate the need of any temporary relation. On the other hand, compared with the interpretive method, we show that any data dependency imposed by shared variables is no longer a major problem in achieving AND-parallelism by the proposed scheme     

Testing the dynamic full access property of a class of multistageinterconnection networks

The banyan network, and networks topologically equivalent to it, have recently been adopted as interconnection networks in multiprocessor systems. Often, a multiprocessor system is reconfigured when the banyan network becomes faulty. It is possible to avoid a complicated reconfiguration process as long as the faulty banyan network still possesses the dynamic full access (DFA) property. In this paper, we determine a necessary and sufficient condition for a faulty banyan network to possess the DFA property and design a test procedure based on the condition. The test procedure can be used to decompose a faulty banyan network into subsystems possessing the DFA property. We also evaluate the probability that a banyan network loses the DFA property, given the number of faulty switching elements. It is found that as long as faults do not occur in switching elements located in the first and last stages, this probability is very small, even when there are quite a few faulty switching elements     

Statistical synchronization among participants in real-time multimedia conferencing

In this paper, an algorithm to determine the set of packets generated continuously and periodically from different participants that are arriving at a node either for mixing at the master of a conference, or for simply playing back at a regular participant of a conference, is proposed. The essence of the algorithm is to estimate the expected packet arrival time (or reference time) for each participant. With the reference time at hand, the maximum jitter and the optimum waiting time for a mixer to wait packets from all participants can be determined. An enhancement to improve synchronization which deals with the estimation of the time offsets between the individual periods of the sources and the period of the receiver is also presented. The error of the proposed algorithm is enumerated by the Chernoff bound and demonstrated by simulation and is shown to be acceptable in practical application. The algorithm can also be employed when traffic sources operate with different periods.     

Effects of Al3+ and Be2+ ions combined with NaF on ciliary process adenylyl cyclase activity and aqueous humor dynamics in the rabbit eye

PURPOSE: The activity of Al3+, Ga3+, and Be2+ ions in the presence of NaF to directly activate G-proteins was investigated by their potentiative effect on forskolin (FSK)-activated adenylyl cyclase in rabbit ciliary process membranes and their effects on aqueous humor dynamics in vivo. METHODS: Adenylyl cyclase (AC) was determined by radiometric conversion of ATP to cAMP by the particulate fraction of rabbit ciliary processes. Intravitreal injections of sterile solutions of analytical grade salts were made into the center of the vitreous in a volume of 20 microliters. Intraocular pressure, aqueous humor flow, and uveoscleral outflow measurements were made by pneumatonometry, fluorophotometry, and fluorescein-dextran method, respectively. Outflow facility was determined by tonography in the intact eyes and by two-level constant pressure perfusion in cannulated eyes. RESULTS: Both Al3+ (EC50, 40 mumol/l) and Be2+ (EC50, 11 mumol/l) in the presence of 0.5-2 mM NaF activated the stimulatory G-protein Gs. Ga3+ was ineffective and did not antagonize the activation by Al3+. Intravitreal injections of Al3+ (1 mumol/eye) or Be2+ (0.5 or 1 mumol/eye) had no significant intraocular pressure (IOP) effect, nor did 1.5 or 3 mumol/eye of NaF, but when either cation was injected together with NaF, IOP decreased by up to 40% for up to 140 hr. At the time of maximum IOP effect (72 hr) aqueous humor flow determined by fluorophotometry was decreased in BeCl2+ NaF-treated eyes by 40% relative to BeCl2-treated eyes; however, tonographic facility of outflow was unaffected. Uveoscleral flow was also decreased by 38% in BeCl2+ NaF treated eyes. CONCLUSIONS: These findings support the hypothesis that Gs activation of ciliary process adenylyl cyclase decreases aqueous humor formation rate in rabbit eyes, and that activation of G-proteins mediates contraction of ciliary muscles causing a decrease of aqueous humor outflow via the uveoscleral route. The results suggest that G-proteins putatively involved in trabecular facility changes are less sensitive to activation by BeF3- than are other parameters of aqueous humor dynamics.     

Tyrosine hydroxylase expression in primary cultures of olfactory bulb: role of L-type calcium channels

Sensory activity mediates regulation of tyrosine hydroxylase (TH), the first enzyme in the dopamine biosynthetic pathway, in the rodent olfactory bulb. The current studies established for the first time primary cultures of neonatal mouse olfactory bulb expressing TH and tested whether L-type calcium channels mediate the activity-dependent regulation of the dopamine phenotype. After 1 d in vitro (DIV), a small population of TH-immunostained neurons that lacked extensive processes could be demonstrated. After an additional 2 DIV in serum-free medium, the number of TH neurons had doubled, and they exhibited long interdigitating processes. Membrane depolarization for 48 hr with 50 mM KCl produced a further 2.4-fold increase in the number of TH-immunoreactive neurons compared with control cultures. Increased TH neuron number required at least 36 hr of exposure to KCl. Forskolin, which increases intracellular cAMP levels, induced a 1.5- to 1.6-fold increase in the number of TH-immunostained neurons. Combined treatment with KCl and forskolin was not additive. Nifedipine, an L-type calcium channel blocker, completely prevented the depolarization-mediated increase in TH expression but did not block the response to forskolin. Treatment with Bay K8644, an L-type calcium channel agonist, also significantly increased the number of TH-expressing neurons. Depolarization also induced alterations in neuritic outgrowth, resulting in a stellate versus an elongate morphology that, in contrast, was not prevented by nifedipine. These results are the first demonstration that in vitro, as in vivo, depolarization increases TH expression in olfactory bulb and that L-type calcium channels mediate this activity-dependent regulation of the dopamine phenotype.     

Comparing the Effectiveness of Coatings on Carbide andCermet Cutting Tool Inserts

A series of metal cutting experiments was performed on a CNC lathe to evaluate the performance of various coatings on different tool substrates. The workpiece material was plain medium carbon steel and the cutting tool materials were carbide and cermet inserts coated with various single as well as multilayer coatings. Machining was done under various cutting conditions of speed and feed-rate, and for various durations of Cutting. The output parameters studied were the cutting forces (axial, radial and tangential), the surface roughness of the workpiece, as well as the tool wear (crater and flank wear). From these results, the performances of the various cutting inserts are evaluated and compared. Results show that cutting forces are significantly lower when using coated cermets than when using coated carbides although different coatings on the same substrate also result in different cutting forces. However, there is less difference in the surface roughness of the finished workpiece for the various coatings and substrates.     

Oxidative regeneration of sulfided sorbent by H2S without emission of SO2

Much SO₂, another perilous air pollutant, was emitted during the oxidative regeneration of sulfided sorbent by H₂S. In order to prevent emission of SO₂, we carried out oxidative regeneration with the physical mixture of CaO and sulfided sorbent and investigated the effect of regeneration temperature and oxygen concentration on the reactivity of CaO with S0₂. The effluent gases were analyzed by G.C. and the properties of sorbent were characterized by XRD. SEM, TG/DTA and EPMA. Deterioration of reactivity of CaO with S0₂ resulted in increment of emission of SO₁₂ due to the structural changes of CaO above 750°C and that at 850°C was more severe. Furthermore EPMA and XRD analysis revealed that product layer diffusion through the solid product, CaSO₄, was the rate limiting step for CaO sulfidation. The reaction of CaO w:.th SO₂ was first order approximately and that was accelerated by high O₂ concentration.