Aspiration before tissue filling with hyaluronic acid-safety enhancement by using a lidocaine-primed syringe.

OBJECTIVE: Most of the doctors would regularly aspirate the plunger of a syringe before injection to make sure that the needle would not be mis-inserted into vessels. Yet pulling the plunger back only cannot guarantee the injecting status is safe. Injecting all of the non-fluid fillers, including colloidal hyaluronic acid (HA) into the vessel may cause "No blood return while pulling back the plunger," which is defined as false-negative aspiration. METHODS: In the first experiment, HA syringes were inserted into vessel simulators in vitro with standard needle sizes and residual dosages. In the second experiment, the lidocaine-primed syringe were inserted into the vessel simulator instead to observe its aspiration. RESULTS: There was no difference using different sizes of needles or dosages except for group 0.1 mL and the lidocaine-primed syringe. The rest of the groups need to wait more seconds to observe the blood return. CONCLUSIONS: The time lag does exist in every single aspiration and 88% of the blood return would happen in 10 s. We suggested that operators should aspirate regularly before giving an injection with at least 10 s of waiting or use the lidocaine-primed syringe instead. Blood returns could mostly be recognized in both ways.

The study of IgG subclass profiles of anti-hbc in populations with different status of HBV infection.

To study IgG subclasses for the hepatitis B virus (HBV) core antigen (anti-HBc) in different populations, a comparison was made between 104 chronic carriers (60 male and 44 female) and 434 recovered individuals (247 male and 192 female). Biochemistry analyses of AST (aspartate aminotransferase) and ALT (alanine aminotransferase) were also performed. Among the 104 chronic carriers, 21 patients were found to be ALT and AST abnormal (> 25 IU/ml). After comparing these ALT and AST abnormal patients with other ALT and AST normal chronic carriers, no statistical difference was observed in the OD values of the anti-HBe (p > 0.05). The ELISA results showed the anti-HBc IgG subclass pattern was IgG1 > IgG3 > IgG4 in chronic carriers and IgG3 > IgG1 > IgG4 in recovered individuals (p < 0.05). This result suggests the IgG1/IgG3 ratio may be related with HBV status. However, in spite of the different anti-HBc IgG1/IgG3 patterns demonstrated in different populations, both anti-HBc IgG1 and IgG3 concentrations were significantly higher in chronic carriers (p < 0.05). Therefore, both the anti-HBc IgG1/IgG3 ratio and their amounts differed. They may play a significant role in chronic carriers and recovered individuals. The anti-HBc IgG subclass profiles of chronic carriers were not changed regardless of liver inflammation, and were independent of sex and age.

Correlation of viral factors with cervical cancer in Taiwan.

The correlation of viral factors with cervical cancer was investigated. 27 cervical cancer biopsies and 29 normal cervical scrapings were determined by polymerase chain reaction method for 6 viruses, including human papillomavirus (HPV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV)-1, HSV-2, and human herpes virus (HHV)-8. Among 27 biopsies of cervical cancer, HPV was identified in 18. Of these HPV-positive specimens, 9 cases of HPV type 16 were identified, 2 cases of HPV type 18 and 1 case of mixed infection with HPV types 16 and 18 were identified. Among the HPV types detected, type-16 is the most closely associated with cervical cancer and type-18 ranks second. Of the remaining 6 cases, 1 case of HPV-45, 1 case of mixed infection with HPV type 35, CMV and HSV-2, and 4 cases of unidentified HPV type were also found. EBV, HSV-1 and HHV-8 were not found in the cervical cancer samples and might have no or little relationship with cervical cancer. Among the 29 specimens in the normal female control group, no viral infection was detected. The correlation of HPV with cervical cancer was significantly different between frozen tissues and paraffin-embedded tissues. Other viruses such as HSV-2 and CMV are not predictive of cervical cancer. They might not be involved in the oncogenic processes directly but might enhance the possibility of oncogenesis or infect cancer tissues opportunistically.

Regulation of tissue inhibitors of metalloproteinase-1 gene expression by cytokines in human gingival fibroblasts.

Tissue inhibitors of metalloproteinase (TIMP) are important participants in various physiological processes that involve tissues remodeling. They help maintain a delicate balance between physiological degradation and synthesis of the extracellular matrix. A better understanding of TIMP activity will be helpful in understanding the etiology of periapical lesions and their means of treatment. The fibroblast is a prominent cellular component of the periapical tissues. The potential implications of cytokine-mediated tissue destruction still remain to be elucidated. The purpose of this study was to determine the effects of interleukin (IL)-1alpha and transforming growth factor (TGF)-beta on the expressing of TIMP-1 by primary gingival fibroblast cultures. After exposure to cytokines for 8 h, total RNA in gingival fibroblasts was isolated and evaluated by reverse-transcriptase polymerase chain reaction. Densitometric analysis of the TIMP-1 mRNA gene expression, after normalization by beta-actin, demonstrated that exposure to IL-1alpha resulted in a decreased level of TIMP-1 mRNA compared with the control groups. However, the TIMP-1 mRNA was up-regulated by TGF-beta. In addition, when the cells were cultured in combination with TGF-beta (1 ng/ml) and IL-1alpha for 8 h, the level of TIMP-1 mRNA was dramatically reduced. These results demonstrated that in human periapical tissue cytokines differentially and specifically regulate expression of TIMP-1 mRNA. An understanding of the actions of cytokines on gingival fibroblasts may result in new therapies to augment current treatment of periapical lesions.

Induction of apoptosis in human Hep3B hepatoma cells by norcantharidin through a p53 independent pathway via TRAIL/DR5 signal transduction.

OBJECTIVE: To investigate the inhibitory activities of norcantharidin (NCTD), a demethylated analogue of cantharidin, on Hep3B cells (a human hepatoma cell line) with deficiency of p53. METHODS: The survival rate of the Hep3B cells after treating with NCTD was measured by MTT assay. Cell cycle of treated cells was analyzed by flow cytometry, and DNA fragmentation was observed by electrophoresis. The influence of inhibitors for various caspases and anti-death receptors antibodies on the NCTD-induced apoptosis in the cells was determined. RESULTS: NCTD treatment resulted in growth inhibition of Hep3B cells in a dose- and time-dependent manner. Cell cycle analysis of the cells after treatment with NCTD for 48 h shows that NCTD induced G(2)M phase arrest occurs at low concentration ([Symbol: see text] 25 µmol/L) but G(0)G(1) phase arrest at high concentration (50 µmol/L). The addition of both caspase-3 and caspase-10 inhibitors completely inhibited DNA fragmentation. Addition of anti-TRAIL/DR5 antibody significantly inhibited DNA fragmentation. CONCLUSION: NCTD may inhibit the proliferation of Hep3B cells by arresting cell cycle at G(2)M or G(0)G(1) phase, and induce cells apoptosis via TRAIL/DR5 signal transduction through activation of caspase-3 and caspase-10 by a p53-independent pathway.

Relation of hepatolithiasis to helminthic infestation.

BACKGROUND AND AIM: The relation of helminthic infestation to hepatolithiasis is a subject of dispute. This case-control study was undertaken to evaluate the prevalence of helminthiasis in hepatolithiasis patients and to compare the clinicopathological features of hepatolithiasis between patients with and without helminthiasis. METHODS: The prevalence of ascariasis or clonorchiasis was evaluated using ELISA in 131 patients with hepatolithiasis who were treated at Show-Chwan Memorial Hospital and 121 subjects who constituted a control group. The patients' detailed histories and medical charts were reviewed. RESULTS: The prevalence of positive immunodiagnosis of ascariasis and clonorchiasis was higher in patients with hepatolithiasis than in control subjects (33.6%, 44/131 vs 17.4%, 21/121, odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.28-4.56, P = 0.005; and 6.9%, 9/131 v 0.8%, 1/121, OR = 8.85, 95% CI = 1.12-188.69, P = 0.02). Patients with helminthiasis rarely had concurrent gallbladder stones (26%, 12/47 vs 55%, 46/84, OR = 0.28, 95% CI = 0.12-0.66, P = 0.002). Prior to the diagnosis of hepatolithiasis in adulthood, most of the patients with helminthiasis tended to have a history of recurrent abdominal pain in their childhood and an asymptomatic 'lucid interval' during their teenage years (70.2%, 33/47 vs 39.3%, 33/84, OR = 3.64, 95% CI = 1.59-8.42, P = 0.0005). However, the prevalence of intrahepatic duct stricture (38.3%, 18/47 vs 40.5%, 34/84, OR = 0.91, 95% CI = 0.41-2.02, P > 0.05), secondary biliary cirrhosis (6.4%, 3/47 vs 3.6%, 3/84, OR = 1.84, 95% CI = 0.28-12.03, P > 0.05), cholangiocarcinoma (2.1%, 1/47 vs 0%, 0/84, OR = approximately , P > 0.05), and stone recurrence (54.8%, 24/42 vs 50.0%, 38/76, OR = 1.33, 95% CI = 0.58-3.06, P > 0.05) did not significantly increase. CONCLUSIONS: Helminthiasis is a possible risk factor for hepatolithiasis, although it is unlikely to increase the incidence of complications, including bile duct stricture, secondary biliary cirrhosis, and cholangiocarcinoma. Patients with helminthiasis tend to have a history of an asymptomatic 'lucid interval' between the periods of recurrent abdominal pain in their childhood and the diagnosis of hepatolithiasis in their adulthood.

Involvement of viral and chemical factors with oral cancer in Taiwan.

BACKGROUND: The association between oral squamous cell carcinoma (OSCC) and viral and chemical factors is uncertain. Therefore the correlation of viral and chemical factors with oral cancer in Taiwan was investigated. METHODS: Thirty-seven paraffin-embedded oral cancer biopsies and 36 normal oral tissue specimens were examined by the polymerase chain reaction method for six viruses: HPV, CMV, EBV, HSV-1, HSV-2 and HHV-8. To elucidate the role of arecoline in the oncogenesis of oral cancer, human buccal fibroblasts, oral submucosal fibroblasts and three cancer cell lines KB, GNM and TSCCa were used for MTT cytotoxity assay and flow cytometry DNA content analysis. RESULTS: Two (5.4%) HSV-1-positive and four (10.8%) HPV-positive cases were recognized in oral cancer biopsies. Among the four HPV-positive tissues, two were further typed as HPV-16, one was identified as HPV-18- and HSV-1-positive; and one contained both HPV-16 and HPV-18. One sample presented HSV-1 only. Arecoline, at a concentration lower than 0.8 micro g/ml, increased cell growth (all cell types); at higher concentrations (25-400 micro g/ml) it was cytotoxic. The cell cycle was demonstrated to be altered either by low or high concentrations of arecoline treatment, depending on the cells treated. CONCLUSIONS: The data demonstrated that HPV, HSV-1 and betel quid chewing were significantly associated with OSCC, but HSV-2, CMV, EBV and HHV-8 were not. We suggest that the most determinative factor for oral cancer may be chemical in nature rather than viral infection.