Does hyoscine N-butylbromide shorten the active phase in labor? A meta-analysis of randomized controlled trials.

OBJECTIVES: The objective of the study is to evaluate the therapeutic effect of hyoscine N-butylbromide (HBB) in active phase of labor and its safety to mother and fetus. METHODS: A systematic literature search was conducted on Cochrane Library, Pubmed, EMBASE, CINAHL, ClinicalTrials.gov and three databases in Chinese up to March 31, 2020. Randomized controlled trials (RCTs) of HBB administration during the active phase for shortening of spontaneous labor at term compared with placebo were included. Two reviewers assessed the methodological quality and data extraction independently. We calculated pooled risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs) using Review Manager 5.3 software. Intention-to-treat principles and random-effects model were adopted for analysis and pool results. RESULTS: In total, 1448 women from 9 RCTs were included in the meta-analysis. The HBB group exhibited significantly decreased durations of active phase (MD -61.1 min; 95% CI: -87.7 to -34.4, I2 : 96%), the second stage (MD -2.0 min; 95% CI: -3.4 to -0.5, I2 : 62%), and third stage (MD -0.7 min; 95% CI: -1.1 to -0.3, I2 : 51%). Intravenous (IV) HBB group and intramuscularly (IM) HBB group were compared to the control group (MD -60.9 min; 95% CI -87.7 to -34.1, I2 : 96%). No significant differences were observed in Cesarean section, post-partum hemorrhage, instrumental labor, Apgar scores or any adverse effects. CONCLUSION: Hyoscine N-butylbromide had a significant effect of shortening the duration of the active phase of labor without adverse effects. We recommend a single dose of intravenous administrated HBB when a woman undergoes labor augmentation.

Adiponectin and leptin in overweight/obese and lean women with polycystic ovary syndrome.

AIM: The objective of this study was to evaluate the adiponectin and leptin levels in overweight/obese and lean women with polycystic ovary syndrome (PCOS). DESIGN: This was a retrospective study. PATIENTS: Of the 422 studied patients, 224 women with PCOS and 198 women without PCOS were evaluated. MAIN OUTCOME MEASURE(S): Insulin resistance and the metabolic components were assessed. The adiponectin and leptin levels were also evaluated. RESULTS: Adiponectin was negatively correlated with insulin resistance, body mass index (BMI), and total testosterone, triglyceride, and low-density lipoprotein (LDL) levels; conversely, leptin reversed the aforementioned reaction and was negatively correlated with adiponectin levels. The adiponectin to leptin ratios were significantly lower in PCOS women than in those without PCOS. Compared to women with non-PCOS, overweight/obese women with PCOS had lower serum adiponectin levels than women without PCOS, which was not the case for lean women. Conversely, lean women with PCOS had higher serum leptin levels than those without PCOS, which was not the case for overweight/obese women. CONCLUSIONS: Adipose tissue might play an important role in the metabolic complications in women with PCOS. To study the impact of obesity biomarkers in women with PCOS, overweight/obese and lean women should be considered separately.

Clinicopathologic parameters and immunohistochemical study of endometrial stromal sarcomas.

We aimed to investigate the clinicopathologic features, immunohistochemical studies, and prognosis in patients with endometrial stromal sarcoma (ESS). Clinical information was reviewed retrospectively for cases of ESS (1985-2009). A histologic review and immunohistochemical staining for the estrogen receptor, progesterone receptor, c-Kit, CD-10, Ki-67, and m-TOR were performed. Sixty-one patients (median age, 44 y; range, 22-71) were eligible for analysis (1988 International Federation of Gynecology and Obstetrics Stage I, 43; Stage II, 2; Stage III, 11; Sage IV, 4; unstaged, 1). The median follow-up period for survivors was 73 mo. Of those, the patients who underwent an adnexectomy and a pelvic lymphadenectomy, 15% and 13%, respectively, revealed metastasis. There were 20 relapses/persistence, including 13 (65%) in the pelvis and abdomen and 7 (35%) in distant sites. Eight patients died from ESS at a median duration of 14.5 mo (range, 2-50 mo) after relapse. Five- and 10-yr cancer-specific survival (CSS) rates were 88% and 85%, respectively; and 5- and 10-yr progression-free survival rates were 69% and 57%, respectively. Stage, residual disease, and high proliferative index of Ki-67 were significant prognostic factors for both progression-free survival and CSS in a univariate analysis, in addition to mitotic index for CSS. Multivariate analysis selected only residual disease as an independent variable for progression-free survival and stage and residual disease for CSS. Our results support using clinical Stage I, no residual disease, low proliferative index of Ki-67, and estrogen receptor/progesterone receptor overexpression as potential biomarkers to select patients with ESS for fertility-preservation surgery (5 such patients were alive and free).

Endometrial thickness in women with ovulatory dysfunction.

This study is designed to evaluate the relationship between endometrial thickness and clinical/biochemical parameters in women with chronic anovulation. One hundred and twenty women with ovulatory dysfunction were prospective included, endometrial thickness and endocrine and metabolic parameters were measured. The interval between the examination day and the day of the most recent menstrual bleeding (the anovulatory interval) for the studied subject was an average of 145 ± 186 days. The endometrial thickness averaged 7.1 ± 3.2 mm. Correlation analyses revealed that the endometrial thickness was positively correlated with body mass index but was not correlated with age, serum androgens, or estradiol (E2) levels. We further classified the subjects into two groups based on endometrial thickness: Group A, endometrial thickness <7 mm and Group B, endometrial thickness ≥7 mm. The anovulatory interval, follicle-stimulating hormone, luteinizing hormone, E2 and androgen levels were not significantly different between Groups A and B. Group B had higher body weight and more risk for metabolic syndrome. We concluded that endometrial thickness in women with ovulatory dysfunction is positively correlated with body weight status but is not correlated with serum androgens or E2 levels.

Obesity is the predominant predictor of impaired glucose tolerance and metabolic disturbance in polycystic ovary syndrome.

OBJECTIVE: To evaluate the contribution to glucose intolerance and metabolic syndrome of obesity combined with the diagnostic criteria of polycystic ovary syndrome (PCOS). DESIGN: Prospective study. SETTING: University teaching hospital from 31 August 2010 to 31 August 2011. POPULATION: Two hundred and twenty women with PCOS and seventy normal control women. METHODS: The clinical and biochemical characteristics of women with PCOS and control women were evaluated. Main outcome measures. The impact of obesity, hyperandrogenism, oligo-anovulation and polycystic ovary morphology on impaired glucose tolerance and metabolic disturbances. RESULTS: Obese women with PCOS had significantly higher insulin resistance than obese normal control women. Logistic regression analysis showed that obesity was the only factor that predicted impaired glucose tolerance and metabolic syndrome. Use of the area under the receiver operating characteristic curve (AUROC) for the body mass index to predict impaired glucose tolerance and metabolic syndrome was more accurate than AUROCs for serum total testosterone level and the average menstrual interval. CONCLUSIONS: Body weight status was the major factor determining the risk of impaired glucose tolerance and metabolic syndrome in women with PCOS. Obesity should be treated as the major factor determining long-term health consequences associated with PCOS.

Clinical and biochemical presentation of polycystic ovary syndrome in women between the ages of 20 and 40.

BACKGROUND: The clinical features and metabolic complications of polycystic ovary syndrome (PCOS) may change with age. This study was designed to investigate the clinical and biochemical characteristics of PCOS patients between the ages of 20 and 40. METHODS: The study included 781 Taiwanese women, of whom 453 were diagnosed with PCOS and 328 were non-PCOS controls. Anthropometric components, androgens, endocrine, insulin resistance, and metabolic components were measured and correlated with age. Above parameters were compared between younger and elder women with PCOS. RESULTS: Age had significant negative correlations with androgens (total testosterone and dehydroepiandrosterone sulfate), the modified Ferriman-Gallwey score and the prevalence of acne and hirsutism. Age had significant positive correlations with fasting glucose, cholesterol, triglycerides and low-density lipoprotein. The 453 women who fulfilled diagnostic criteria for PCOS were classified by age into two groups: Group A (20-29 years old, n= 294) and Group B (30-40 years old, n= 159). Group A had significantly higher total testosterone levels than Group B. Group B had higher fasting insulin and glucose levels, triglycerides, body mass index and waist measurements and a higher incidence of obesity than Group A. The average ovarian volume was not significantly different among the two groups. CONCLUSIONS: Increased age is accompanied by a decrease in the prevalence of both clinical and biochemical hyperandrogenism in women. Hyperandrogenism is the important factor for young women with PCOS; however, abdominal obesity and certain metabolic disturbances became major concerns for older women with PCOS.

Polycystic ovary syndrome or hyperprolactinaemia: a study of mild hyperprolactinaemia.

Polycystic ovary syndrome (PCOS) and hyperprolactinaemia are both common causes of secondary amenorrhoea in reproductive women. The relationship between PCOS and hyperprolactinaemia has been reported with controversial results. To evaluate the clinical and laboratory features of women with mild hyperprolactinaemia and PCOS, we studied 474 Taiwan Chinese women: 101 had mild hyperprolactinaemia, 266 had PCOS and 107 were the control group. In this study, we found that 64% of the women with mild hyperprolactinaemia fulfilled the PCOS diagnostic criteria, regardless of their prolactin levels. Obese women with PCOS had significantly lower luteinising hormone (LH) and LH-to-FSH ratios than non-obese women with PCOS. Obese hyperprolactinaemic women had significantly lower follicle-stimulating hormone (FSH), but higher LH-to-FSH ratios than the non-obese hyperprolactinaemic women. For women with PCOS, the BMIs were significantly negative with LH (γ = -0.253, p < 0.001), but not with FSH (γ = -0.061, p = 0.319). For the hyperprolactinaemic women, the BMIs were significantly negative with FSH (γ = -0.353, p < 0.001), but not with LH (γ = -0.021, p = 0.837). Although PCOS-related syndrome was very prevalent in women with hyperprolactinaemia, the patterns of disturbance in gonadotropin secretion were different between the PCOS and the hyperprolactinaemia patients.

Evaluation of placental maturity by the sonographic textures.

PURPOSE: Routine ultrasound screening to predict gestational age is important for risk assessment of pregnancy complications among pregnant women. We explored a quantitative method for sonographic analysis of placental texture, with the objective of reproducible measurement. METHODS: We studied 151 pregnant women; the gestational ages of their fetuses ranged from 10 to 38 weeks. Three experienced sonographers delineated the placental contour to define the region of interest (ROI). From these sonograms, 72 texture features were derived from the spatial gray-level dependence matrices and gray-level difference matrices. We used these as input variables in a multiple linear regression analysis. RESULTS: A significant positive correlation (P < 0.01) was found between the multiple linear regression results and the corresponding gestation ages by the three assessors (r (A) = 0.755, r (B) = 0.851, and r (C) = 0.832). We also found good agreement between multiple linear regression results for the three observers. Their κ statistic values were 0.685 between assessors A and B, 0.679 between A and C, and 0.804 between B and C. CONCLUSION: Quantitative sonography using texture analysis of the placenta was useful in practice to determine gestational age.

Sonographic quantification of endometrial changes after abortion with computer-assisted image analysis.

OBJECTIVE: To examine the diagnostic feasibility of sonographic gray scale histograms to assess changes in the endometrium following abortion induced by mifepristone and misoprostol. DESIGN: Retrospective study. SETTING: Taipei Medical University-Wan Fang academic medical center. POPULATION OR SAMPLE: A total of 109 patients who matched eligibility criteria were divided into three groups: (a) complete abortion, (b) normal menstrual cycles, and (c) incomplete abortion. METHODS: Ultrasonographic examination of the uterus with fixed settings on each patient and sonographic gray scale histograms with image analysis software, using multivariate analysis by the partial least square model. MAIN OUTCOME MEASURES: Thickness, brightness, area and distribution of pixels of the endometrium and its contents. RESULTS: The groups could be discriminated (p < 0.01, Kruskal-Wallis test) using the analyzed gray scale histograms. The classification between complete and incomplete abortion reached 97% sensitivity and 100% specificity. CONCLUSIONS: Partial least square analysis of gray scale histograms of the endometrium in ultrasonographic images is useful in assessing endometrial changes.

Women's preference for cesarean delivery and differences between Taiwanese women undergoing different modes of delivery.

BACKGROUND: The rate of cesarean delivery was 35% in 2007 in Taiwan. It is unclear how many of the cesarean deliveries were without medical indications. Women's preference for cesarean delivery during their course of pregnancy has rarely been studied and therefore our objectives were to examine rate of cesarean deliveries without medical indications, to explore women's preference for cesarean delivery as their gestation advances, and to compare background and perinatal factors among women who underwent different modes of delivery in Taiwan. METHODS: This prospective study applied a longitudinal design. The study participants were 473 women who received prenatal care at four hospitals in Taipei and answered structured questionnaires at 20 to 24 weeks of pregnancy, 34 to 36 weeks of pregnancy, and 5 to 7 weeks after delivery. RESULTS: Of the 151 women (31.9%) who had cesarean deliveries, 19.9% were without medical indication. Three indications: malpresentation, prior cesarean section, and dysfunctional labor together accounted for 82.6% of cesarean section with medical indications. The prevalence of maternal preference for cesarean delivery was found to be 12.5% and 17.5% during the second and third trimester, respectively. Of the women who preferred cesarean delivery during the second trimester, 93.2% eventually had a cesarean delivery. Women who were older, with older spouses, and who had health problems before or during pregnancy were more likely to have cesarean deliveries. CONCLUSIONS: About 20% of cesarean deliveries were without medical indications. Women's preference for cesarean delivery during the second trimester predicts subsequent cesarean delivery. Counseling regarding mode of delivery should be offered early in pregnancy, especially for women who are older or with older spouses, have health problems, or had a prior cesarean section.

Ultrasonographic evaluation of endometrial changes using computer assisted image analysis.

AIM: To examine the usefulness of a gray scale histogram and computer assisted image analysis software in assessing physiologic states of the endometrium with ultrasonography. METHODS: Seventy patients at the Taipei Medical University-Wan Fang Hospital who matched eligibility criteria were categorized into one of three groups: (i) normal menstrual cycle, (ii) postmenopausal, and (iii) post incomplete abortion. Ultrasonography of the uterus was performed on each patient and the endometrium was analyzed with ImageJ image analysis software. RESULTS: A statistically significant difference in signal intensity scores of the gray level histogram, represented as m(j), was found between the groups. CONCLUSION: Ultrasonographic images analyzed using computer assisted image analysis software and gray level histogram are useful in assessing the physiological state of the endometrium.

A comparative study of cutaneous manifestations of hyperandrogenism in obese and non-obese Taiwanese women.

PURPOSE: The aim of the study was to investigate the impact of obesity on cutaneous manifestations of clinical hyperandrogenism. METHODS: A total of 627 Taiwanese women of reproductive age were included. RESULTS: Women with acne had a greater incidence of PCOS, hyperandrogenemia and hirsutism, and had higher serum total testosterone than women without acne. Obese women, even with significantly higher serum total testosterone levels, had lower incidence of acne than non-obese women, and this was found uniformly across the hyperandrogenemia and the non-hyperandrogenemia groups. Although BMI had a significantly positive correlation with serum total testosterone in the studied women, obese women presented less acne than the non-obese subjects. CONCLUSIONS: Obese women, regardless of having higher serum testosterone levels, had a lower incidence of acne than non-obese women; however, the factuality was not found in hirsutism.

In vitro study of the tocolytic effect of oroxylin A from Scutellaria baicalensis root.

Scutellariae Radix is one of the well-known tocolytic Chinese herbs. Oroxylin A is isolated from the root of Scutellaria baicalensis. The main syndrome of preterm birth is caused by uterus contractions from excitatory factors. Administration of tocolytic agents is a strategy to prevent the occurrence of preterm births. The aim of this study was to investigate the effects of oroxylin A on contractions of uterine strips isolated from non-pregnant female Wistar rats (250-350 g). Contractions of the uterus were induced with acetylcholine (Ach) (1 microM), PGF2alpha (0.1 microM), oxytocin (10-3 U/ml), KCl (56.3 mM), tetraethylammonium (TEA; 1 and 10 mM), 4-aminopyridine (4-AP; 5 mM), glipizide (30 microM), a nitric oxide synthase (NOS) inhibitor (LNNA; 10-3M), a beta-receptor blocker (propranolol; 10 microM), and a cyclooxygenase inhibitor (indomethacin; 60 microM). The inhibitory effects of the amplitude and frequency of spontaneous contractions by oroxylin A were antagonized with Ach (IC50 22.85 microM), PGF2alpha (IC5027.28 microM), oxytocin (IC50 12.34 microM), TEA; 1 and 10 mM (IC50 52.73 and 76.43 microM), 4-AP (IC50 67.16 microM), and glipizide (IC5027.53 microM), but oroxylin A was not influenced by Ca2+-free medium, LNNA, propranolol, or indomethacin. Otherwise, oroxylin A-mediated relaxation of the rat uterus might occur through opening of uterine calcium-dependent potassium channels or adenosine triphosphate potassium channel activation. This suggests that oroxylin A is the tocolytic principle constituent of Scutellariae Radix, and oroxylin A may provide a lead compound for new tocolytic drug development in the future.

Nocturia among women aged 60 or older in Taiwan.

BACKGROUND: From a public health point of view, it is important to evaluate the prevalence of nocturia and to identify the associated factors for nocturia among the elderly that might impair the quality of life of sufferers. However, those among the Taiwanese female population aged 60 or older are still unclear. AIMS: To estimate the prevalence of nocturia in Taiwanese women aged 60 or older and to assess its associated factors. METHODS: Nocturia, defined by the International Continence Society, and its associated problems were evaluated, and medical history and sociodemographic variables were recorded. A sample of 2410 female was selected by a multistage random sampling method. RESULTS: Six hundred and twenty-one women who were selected had been deceased. Face-to-face interviews with 1523 women were completed, producing a response rate of 85.1% (1523 of 1789) and 73.5% (1120 of 1523) of the interviewees reported having had nocturia. Age, diabetes mellitus, hypertension, prior drug allergy and urinary incontinence significantly increased the risk of nocturia. CONCLUSIONS: Although the pathophysiologies of nocturia are still not all known, it is a common condition among Taiwanese women. Multiple approaches are necessary to treat the patients with nocturia. Treatment of nocturia in this patient population can both improve their quality of life and reduce the risk of deterioration in their general state of health.

Neuroprotective Action of Human Wharton's Jelly-Derived Mesenchymal Stromal Cell Transplants in a Rodent Model of Stroke.

Wharton's jelly-derived mesenchymal stromal cells (WJ-MSCs) have distinct immunomodulatory and protective effects against kidney, liver, or heart injury. Limited studies have shown that WJ-MSCs attenuates oxygen-glucose deprivation-mediated inflammation in hippocampal slices. The neuroprotective effect of intracerebral WJ-MSC transplantation against stroke has not been well characterized. The purpose of this study was to examine the neuroprotective effect of human WJ-MSC (hWJ-MSC) transplants in an animal model of stroke. Adult male Sprague-Dawley rats were anesthetized and placed in a stereotaxic frame. hWJ-MSCs, pre-labeled with chloromethyl benzamide 1,1'-dioctadecyl-3,3,3'3'- tetramethylindocarbocyanine perchlorate (CM-Dil), were transplanted to the right cerebral cortex at 10 min before a transient (60 min) right middle cerebral artery occlusion (MCAo). Transplantation of hWJ-MSCs significantly reduced neurological deficits at 3 and 5 days after MCAo. hWJ-MSC transplants also significantly reduced brain infarction and microglia activation in the penumbra. Grafted cells carrying CM-Dil fluorescence were identified at the grafted site in the ischemic core; these cells were mostly incorporated into ionized calcium-binding adaptor molecule (+) cells, suggesting these xenograft cells were immuno-rejected by the host. In another set of animals, hWJ-MSCs were transplanted in cyclosporine (CsA)-treated rats. hWJ-MSC transplants significantly reduced brain infarction, improved neurological function, and reduced neuroinflammation. Less phagocytosis of CM-dil-labeled grafted cells was found in the host brain after CsA treatment. Transplantation of hWJ-MSC significantly increased glia cell line-derived neurotrophic factor expression in the host brain. Taken together, our data support that intracerebral transplantation of hWJ-MSCs reduced neurodegeneration and inflammation in the stroke brain. The protective effect did not depend on the survival of grafted cells but may be indirectly mediated through the production of protective trophic factors from the transplants.

Wharton' jelly mesenchymal stromal cell therapy for ischemic brain injury.

Increasing evidence have supported that Wharton's jelly mesenchymal stem cell (WJ-MSCs) have immunomodulatory and protective effects against several diseases including kidney, liver pathologies, and heart injury. Few in vitro studies have reported that WJ-MSCs reduced inflammation in hippocampal slices after oxygen-glucose deprivation. We recently reported the neuroprotective effects of human WJ-MSCs (hWJ-MSCs) in rats exposed to a transient right middle cerebral artery occlusion. hWJ-MSCs transplantation significantly reduced brain infarction and microglia activation in the penumbra leading with a significant reduction of neurological deficits. Interestingly, the grafted hWJ-MSCs in the ischemic core were mostly incorporated into IBA1 (+) cells, suggesting that hWJ-MSCs were immunorejected by the host. The immune rejection of hWJ-MSCs was reduced in after cyclosporine A treatment. Moreover, the glia cell line-derived neurotrophic factor expression was significantly increased in the host brain after hWJ-MSCs transplantation. In conclusion, these results suggest that the protective effect of hWJ-MSCs may be due to the secretion of trophic factors rather than to the survival of grafted cells. This paper is a review article. Referred literature in this paper has been listed in the references section. The data sets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors' experiences.

Effect of arginine on cellular adhesion molecule expression and leukocyte transmigration in endothelial cells stimulated by biological fluid from surgical patients.

This study investigated the effect of different arginine (Arg) concentrations on adhesion molecule expression on endothelial cells (ECs) and leukocytes and the transendothelial migration of polymorphonuclear neutrophils (PMNs) through ECs stimulated by plasma or peritoneal drain fluid (PDF) from surgical patients. Human umbilical vein ECs (HUVECs) and PMNs from healthy subjects were treated with different concentrations (0, 50, 100, and 1000 micromol/L) of Arg for 24 h. After that, HUVECs were stimulated for 3 h with plasma or PDF from patients who underwent abdominal surgery, and PMNs were allowed to transmigrate through ECs for 2 h. The HUVEC expression of cellular adhesion molecules (CAMs) and integrin (CD11b) and the interleukin (IL) 8 receptor expression on PMNs were measured by flow cytometry. The PMNs transmigrating through ECs were also analyzed. The results showed that CAM and integrin expressions in PDF groups were higher than those in control groups. Among the PDF groups, IL-8 secretions from ECs and PMNs were lower with 100 and 1000 micromol/L Arg than with 0 and 50 micromol/L Arg, and this was consistent with the expression of the IL-8 receptor on PMNs. In addition, CAM expressions on ECs and CD11b expression on PMNs, as well as PMN transmigration, were lower with 100 and 1000 micromol/L Arg than with 0 and 50 micromol/L Arg. The HUVECs stimulated by plasma from surgical patients had similar effects on surface molecule expression as PDF; however, as shown in PDF stimulation, the effects were not so obvious. Inhibition of nitric oxide production results in high CAM and IL-8 expressions comparable with groups with low Arg administration. The results of this in vitro study suggest that ECs and PMNs were activated after patients' plasma or PDF stimulation. A low Arg concentration comparable with catabolic conditions resulted in higher adhesion molecule expression and greater transendothelial migration of neutrophils. Arginine administration at levels similar to or higher than physiological concentrations reduced IL-8 and CAM expression, and PMN transmigration was also decreased after stimulation with plasma or PDF from surgical patients. Inactivation of NO results in high CAM and IL-8 expression. This finding indicated that NO may be an important endogenous inhibitor for EC-PMN interaction and neutrophil transmigration.

Relationship between viral factors, axillary lymph node status and survival in breast cancer.

PURPOSE: Our previous study based on the results of polymerase chain reaction and Southern hybridization for the detection of Human papilloma virus (HPV), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus (HSV)-1, HSV-2, and Human herpesvirus (HHV)-8 DNA in non-familial breast cancer patients suggest that the viruses associated with breast cancer are HHV-8 > EBV (P < 0.01). Therefore, efforts were made to further investigate the association between breast cancer with nodal status and viral infections. METHODS: Sixty-two breast cancer patients and their mammary specimens were enrolled in this retrospective study. The presence of these six potential oncogenic viruses was analyzed to establish the relationship between nodal status and treatment outcome. Statistical analyses were used for the assessment of variables, including viral positivity and clinical feature. RESULTS: Viral positivity was not significantly different comparing node-positive and node-negative patients (P > 0.05). When the viral factors were not entered for statistical analyses, no variable was significantly related to overall survival. However, tumor stage, tumor size, nodal status , and estrogen receptor were significantly related to relapse-free survival (P < 0.05). For viral factors, the number of infecting viruses is related to the overall and relapse-free survivals. Only when V0 or V(0, 1) was grouped for comparison with other multiply virus-infected subgroups, were the overall and relapse-free survivals significantly different (P < 0.005 or P < 0.001). The results suggest that HSV-1, HHV-8, EBV, CMV, and HPV were related to overall survival, however, only HHV-8 and CMV were related to relapse-free survival (P < 0.05 or P < 0.01). CONCLUSION: Virus factor is significantly related to human breast cancer, not only in terms of the oncogenetic process, but also in overall and relapse-free survivals.

Effects of omega-3 fatty acids on leukocyte Th1/Th2 cytokine and integrin expression in rats with gut-derived sepsis.

OBJECTIVES: This study examined the effect of fish oil (FO)-enriched diets before and/or omega-3 fatty acid-containing total parenteral nutrition (TPN) after sepsis on the distribution of the T-lymphocyte subpopulation, intracellular cytokine, and intestinal immunity in rats with gut-derived sepsis. METHODS: Rats were assigned to a control or one of four experimental groups. The control group and groups 1 and 2 were fed a semipurified diet, and groups 3 and 4 received FO instead of 20% soybean oil. After feeding the diets for 10 d, sepsis was induced by cecal ligation and puncture (CLP) in the experimental groups, whereas a sham operation was performed in the control group. TPN was maintained for 3 d after the CLP or sham operation. The control group and groups 1 and 3 were infused with conventional TPN, whereas the TPN solution used for groups 2 and 4 were supplemented with FO. All rats were sacrificed 3 d after the operation to examine their immune responses. RESULTS: Plasma and intestinal immunoglobin A levels were higher in the FO-supplemented groups than in the control group and group 1. Lymphocyte interferon-gamma expression in groups 3 and 4 was significantly lower, whereas interleukin-4 expression was higher than those of the control group and groups 1 and 2. The splenocyte CD4 percentage in groups 3 and 4 and the CD4/CD8 ratio in group 4 were significantly higher than those in group 1. CONCLUSION: These findings suggest that FO administration before and/or after CLP are not immunosuppressive. FO-enriched diets before or before and after CLP resulted in a T-helper type 2 response and enhanced immunoglobulin A secretion. In addition, the splenocyte CD4 levels and CD4/CD8 ratio were maintained in rats with gut-derived sepsis.

Estimation of acceptable mercury intake from fish in Taiwan.

The US Food and Drug Administration (USFDA) and Environmental Protection Agency (USEPA) are advising women and young children to avoid eating fish that contain high levels of mercury (Hg). However in Taiwan, the annual Black Fin Tuna Festival encourages the public to consume fish. The aim of this study was to assess fish intake in relation to the health risks of mercury exposure and calculate the acceptable and safe intake of fish in children and women of childbearing age. From the Monte Carlo simulation, based on USEPA's reference dose (0.1 microgkg(-1)d(-1)), we found that 21.6%-24.3% and 45.6%-57.4% of the daily mercury dose estimates exceeded the reference dose for typical and high-seafood consumers. The acceptable ingestion rates are <50 g d(-1) (children) and 90.8 +/- 15.7 g d(-1) (women of childbearing). Sensitivity analysis suggests that Hg concentration in fish may be a key parameter to aid governments as they offer guidance for risk management.