The impact of a novel transendometrial approach for caesarean myomectomy on obstetric outcomes of subsequent pregnancy: a longitudinal panel study.

OBJECTIVE: To evaluate the obstetric and surgical outcomes of a novel transendometrial approach for myomectomy during caesarean section in subsequent pregnancies. DESIGN: Longitudinal panel study. SETTING: Chang Gung Memorial Hospital, Taiwan, with approximately 5000 births per annum. POPULATION: Pregnant women complicated with uterine myoma. METHOD: Sixty-three pregnant women who received transendometrial myomectomy during the first caesarean delivery reported a subsequent live pregnancy and planned an elective repeat caesarean delivery. MAIN OUTCOME MEASURES: Obstetric outcomes consisted of gestational age at birth, newborn weight, Apgar score, birthweight adequacy, uterine rupture, placental abruption, placenta praevia, placenta accreta, spontaneous preterm birth and preterm premature rupture of membranes. Surgical outcomes consisted of surgical time, blood loss, blood transfusion, postoperative fever, length of hospital stay and mean adhesion score. RESULT: The mean gestational age at birth and newborn weight at the subsequent caesarean section were superior to those at the first caesarean delivery. Spontaneous preterm birth, small-for-gestational-age infants and preterm premature rupture of membranes occurred more often in the first pregnancy than in the subsequent pregnancy. The mean surgical time was shorter for the subsequent caesarean delivery than for the first caesarean delivery combined with myomectomy. The other surgical composite outcomes of blood loss, blood transfusion, postoperative fever, length of hospital stay and mean adhesion score were similar across the two stages of caesarean deliveries. CONCLUSION: The novel transendometrial approach for caesarean myomectomy may improve the obstetric outcomes of subsequent pregnancy without causing any additional immediate and long-term adverse surgical outcomes. TWEETABLE ABSTRACT: Transendometrial caesarean myomectomy may improve future obstetric outcomes.

NF1 frameshift mutation (c.6520_6523delGAGA) association with nervous system tumors and bone abnormalities in a Chinese patient with neurofibromatosis type 1.

Neurofibromatosis type 1, also known as NF1 or von Recklinghausen's disease, is a common neurocutaneous syndrome that presents with multiple café-au-lait patches, skinfold freckling, dermatofibromas, neurofibromas, and Lisch nodules. The mutations of the gene NF1, encoding the protein neurofibromin, have been identified as the cause of this disease. Here, we report a clinical and molecular study of a Chinese patient with multiple café-au-lait skin freckles, dermatofibroma, central and peripheral nervous system tumors, and bone abnormalities attributed to NF1. The patient showed >6 café-au-lait spots on the body and multiple dermatofibromas. A brain glioma and multiple nerve sheath tumors inside and outside the vertebral canal were identified by magnetic resonance imaging, which also showed multiple intercostal nerve schwannomas and hydrocephalies above the cerebellar tentorium. Talipes equinus was also apparent. A mutation analysis of the NF1 gene revealed a novel frameshift mutation in exon 43, consisting of a heterozygous deletion of four nucleotides (GAGA) between positions 6520 and 6523. No NF1 mutations were detected in the patient's parents or younger brother. These results extend the list of known mutations in this gene. The absence of the NF1 mutation in the healthy family members suggests that it is responsible for the NF1 phenotype. To our knowledge, this frameshift mutation represents a novel NF1 case, and may be associated with nervous system tumors and bone abnormalities.

Polymorphism analysis of the intron one of insulin-like growth factor 2 receptor gene (IGF2R) in FFRC strain common carp (Cyprinus carpio L.) and its relationship with growth performance.

The insulin-like growth factor 2 receptor gene (IGF2R) encodes a transmembrane protein receptor and acts to sequester and degrade excess circulating insulin-like growth factor 2, which is critical for normal mammalian growth and development. Thus, IGF2R may serve as a candidate gene underlying growth trait in the common carp. In this study, we isolated the intron one of common carp IGF2R and detected the diversity in 3 continuous generations of FFRC strain common carp. A total of 8 loci were detected within this region, which were named in accordance with their location (i.e., Loc84, Loc106, Loc119, Loc130, Loc145, Loc163, Loc167, and Loc265). Loc106, Loc119, and Loc145 were moderately polymorphic; while Loc84, Loc130, Loc163, Loc167, and Loc265 exhibited slight level of polymorphism. However, significant differences between polymorphism information content values were not observed among the different generations. For Loc145, all generations deviated from Hardy-Weinberg equilibrium. The total number of significant linkage disequilibria for all generations equaled 40. Among them, 4 pairs were detected in each population, while 8 pairs were found in the 2nd and 3rd generations. For Loc130, the G/T genotype exhibited higher body weight when compared to that of the G/G genotype. The frequency of the homozygous G/G genotype reached 87.96%; thus, we can improve FFRC strain common carp growth performance by increasing the percentage of the G/T genotype within a breeding population. Therefore, the G/T genotype could be used as a molecular marker for superior growth traits.

Mortality of breast cancer in Taiwan, 1971-2010: temporal changes and an age-period-cohort analysis.

The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971-2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age-period-cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20-44 years, to 149.78% in those aged 45-64 years (between 1971-75 and 2006-10). The mortality rates in the 45-64 age group increased steadily from 1971 to 1975 and 2006-10. The 1951 birth cohorts (actual birth cohort; 1947-55) showed peak mortalities in both the 50-54 and 45-49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use.

Quantitative adsorbate structure determination for quasicrystals using x-ray standing waves.

The quantitative structure determination of adsorbed species on quasicrystal surfaces has so far appeared to present insurmountable problems. The normal incidence standing x-ray wave field technique offers a simple solution, without extensive data sets or large computations. Its application to quasicrystals raises several conceptual difficulties that are related to the phase problem in x-ray diffraction. We demonstrate their solution for the case of Si atoms adsorbed on the decagonal Co-rich modification of the Al-Co-Ni quasicrystal to determine the local structure, comprising 6-atom clusters in particular hollow sites.

Effect modification by parental education on the associations of birth order and gender with learning achievement in adolescents.

BACKGROUND: A child's gender and ordinal position within a family have varied implications on his or her personality and cognitive development. However, little is known about whether or not parental educational level may moderate the effects of birth order and gender. METHODS: Basic Competence Test (BCT) scores of 290,588 young adolescents aged 15-16 years in Taiwan were analysed. Parental educational level was calculated as the highest educational attainment of the subjects' parents. The multiple linear regression model was used to assess the modification effects of parental educational levels on the associations of interest. RESULTS: After controlling for covariates, we noted a clear inverse relationship between birth order and BCT scores in Mandarin, Mathematics and Science. Additionally, boys had significantly lower mean scores in Mandarin, but had significantly higher mean scores in both Mathematics and Science. We also found the significant interactive effects of birth order, gender and parental educational attainment on BCT scores, in which the birth order and gender effects were more evident in higher-educated families than in lower-educated ones. CONCLUSIONS: This large cohort study confirmed that both birth order and gender may pose independent influences on BCT scores; moreover, such influences are significantly modified by parental educational attainment.

Duplicated CCAAT/enhancer-binding protein ß (C/EBPß) gene: transcription and methylation changes in response to dietary betaine in Landes goose liver.

The CCAAT/enhancer-binding protein ß gene (C/EBPß) is one of the key regulating factors of lipid metabolic balance in the liver. To better understand how C/EBPß affects lipid accumulation in the Landes goose liver, its DNA was cloned. The goose C/EBPß DNA sequence (2,075 bp) contains a 984-bp open reading frame and part of the 5'-flanking region, and shares 96.66 and 62.07% similarity with the chicken and human sequences at the amino acid level, respectively. Tissue expression profiling showed that the relative expression level was high in the liver and adipose tissue. To understand the effect of betaine on C/EBPß in goose liver, the relative expression levels of C/EBPß were detected under different treatments. Compared with the control group, C/EBPß expression increased in the high-carbohydrate group (P < 0.01) and decreased in the betaine treatment group (P > 0.05). Using bisulfite sequencing PCR, the gene methylation status was analyzed among the different treatment groups. None of the 54 CpG sites in the promoter region or the 28 CpG sites in the structural domain of the coding region showed any significantly different methylation patterns among the groups. Taken together, the results showed that betaine decreased the goose C/EBPß gene expression, but did not directly regulate its methylation. The data may form the basis for further investigation of the mechanisms of the effect of C/EBPß on the regulation of lipometabolism in the goose liver and the effect of betaine on lipid metabolic genes at the molecular level.

Molecular cloning and single nucleotide polymorphism analysis of IGF2a genes in the common carp (Cyprinus carpio).

We studied whether two IGF2 transcripts in common carp are similar to those found in zebrafish. The full-length IGF2a cDNA contains a 5'-terminal untranslated region (UTR) of 105 bp, a 3'-terminal UTR of 1358 bp and an open reading frame of 612 bp, which encodes a 206-amino acid protein. A 6614-bp full-length IGF2a DNA molecule, including the 5'-flanking region, was isolated. Genomic DNA structure analysis revealed that the IGF2a gene contains four exons and three introns. Bioinformatics analysis indicated that the proteins encoded by IGF2a genes in common carp have one signal peptide and one apparent transmembrane region. Bootstrapping was performed 1000 times to obtain support values for each branch. The common carp IGF2a were clustered in one group, while the outgroup (common carp IGF1) clustered in another group. We identified two new single nucleotide polymorphisms in intron 2 of the gene. One polymorphism, A/N, can be found only in the Huanghe carp. The other polymorphism, C/N, can be found in both male Huanghe carp × female Heilongjiang carp and male Huanghe carp × female Jian carp. The second polymorphism, C/N, is primarily transferred from the male and may be related to heterosis.

The effects of dietary betaine supplementation on fatty liver performance, serum parameters, histological changes, methylation status and the mRNA expression level of Spot14alpha in Landes goose fatty liver.

We evaluated the effects of betaine supplementation on liver weight, liver/body weight, serum parameters and morphological changes. Compared with the control and overfed groups, the geese that were fed the betaine diet showed increased liver weight and decreased abdominal adipose tissue weight compared with the overfeeding groups. Betaine treatment also significantly increased ChE, HDL, LDH and ALT levels (P<0.01 or P<0.05). Decreased macrovesicular steatosis and increased microvesicular steatosis were observed in the betaine-treated group, and the lipid was well-distributed in the betaine supplement group. The expression of S14alpha mRNA in the livers of the betaine-treated geese was higher than that in the control or the overfed geese. We performed sodium bisulfite sequencing of the individual alleles of this region (between +374 and -8 base pairs relative to the transcription start site), containing 33 CpG dinucleotides. In the overfed group expressing higher S14alpha transcripts, the average methylation at the 33 CpGs sites was 87.9%. This contrasted with 69.6% in the control group that showed lower expression of the S14alpha gene (P<0.01). However, no significant change in methylation in the transcription start site was found between the betaine-treated geese (82.6%) and the overfed geese (87.9%). These results indicate that the DNA methylation pattern in the S14alpha gene transcription start site may not be related to the expression of S14alpha transcript in response to betaine supplementation.

Preoperative evaluation of resectability of Klatskin tumor with 16-MDCT angiography and cholangiography.

OBJECTIVE: The objective of our study was to evaluate prospectively the preoperative use of 16-MDCT angiography and cholangiography in determining the resectability of Klatskin tumors. CONCLUSION: Preoperative MDCT angiography and cholangiography gave a good assessment of the degree of vascular and biliary involvement of the Klatskin tumor.

Correlation between meteorological conditions and mutagenicity of airborne particulate samples in a tropical monsoon climate area from Kaohsiung City, Taiwan.

Kaohsiung is a city of 1.5 million located in the southern part of Taiwan. It has a serious air pollution problem mainly attributable to much industrial and commercial activity. In order to estimate the effects of traffic, season, and meteorological conditions on the mutagenicity of Kaohsiung City's urban ambient particulate matter, 624 airborne particulate samples were collected on a weekly basis from 12 locations for an entire year. The mutagenic potential of acetone extracts of air samples was evaluated by the Salmonella/microsomal test with S. typhimurium TA98 in the presence and absence of S9 mixtures. The air samples from November 1990 showed the highest direct and indirect mutagenicity among the 12 months, whereas those from June and July 1991 had the lowest direct and indirect mutagenic activity, respectively. The mutagenicity showed a good correlation with amounts of the acetone extractable matter of airborne particulates. The meteorological conditions, monthly mean precipitation, and wind speed also showed a good correspondence with mutagenicity. Wind direction and temperature had a moderate relationship. The major mutagenic fractions of air samples that had the highest mutagenic activity in a month were purified using Sephadex LH-20 column chromatography, and the contents of PAHs, 1-NP, and DNPs were analyzed by HPLC. The characteristic concentration ratios of PAHs indicated that, for the main pollution sources of airborne particulates from Kaohsiung city, the mobile sources were more important than the stationary ones. The total amounts of 1-NP and DNPs in airborne particulates seemed to correspond to their mutagenicity. Although the total amounts of 1-NP and DNPs in the air samples correlated with their mutagenicity, the major mutagenic chemicals in the airborne particulate samples from Kaohsiung City need further investigation.

Room-temperature luminescence analysis of drugs with application to the Toxi-Lab drug identification system.

A method of analyzing drugs on the Toxi-Lab thin-layer chromatographic system by solid substrate room-temperature luminescence is described. Three pairs of unresolved drugs: quinine/cimetidine, caffeine/chlordiazepoxide, and phenazopyridine/lidocaine, were studied as model compounds. Their luminescence characteristics were obtained and calibration curves were found to be linear over two orders of magnitude. The effect of the nonluminescent component of each pair on the determination of the luminescent component was found to be negligible. Statistical F-tests showed that the observed differences in the slopes and intercepts of the calibration curves were due to random errors. The method was evaluated by determining quinine in urine samples at the ng level.

[Acute renal failure, neuropathy and deafness due to sodium bromate intoxication: report of one case].

The clinical manifestations of sodium bromate intoxication include among others acute renal failure and deafness. Most of the toxic manifestations are reversible with the exception of renal failure and deafness. This patient ingested about 7.5 g of sodium bromate powder, which produced gastrointestinal irritation, hypotension, fatigue, deafness, acute renal failure, anemia and peripheral neuropathy. Hemodialysis was performed three times due to acute renal failure, although the renal function improved, it did not recover completely. The patient was discharged with BUN: 42 mg/dL and creatinine: 3.4 mg/dL; she was still deaf.

[Ultrastructural changes of myocardium in rats with hypoxic pulmonary hypertension].

Ultrastructural changes of the myocardia of rats with chronic hypoxia for 40 and 60 days are reported. The rats were caged in a hypobaric chamber simulating an altitude of 5000 meters above sea level. The heart functions were examined before myocardial specimens were taken from both ventricles for electron microscopy study. The results indicated that the myofibril structure of the right ventricle remained normal in the 40 days hypoxic group, except for the occasional appearance of obscure or disappearing Z lines. The mitochondria were slightly increased in number, with a disarrangement of the mitochondria and structural changes in the cristae. The myofibrils of the 60 days hypoxic group showed more obvious structural changes, with disruption of myofilaments. Structural changes in the right ventricle were consistent with apparent decompensation of the right ventricle. The changes of myocardium and mitochondria in the left ventricle were similar to but less sever than those in the right ventricle, and this observation corresponds with a less severe decompensation of the left ventricle. The data suggest that during chronic hypoxic exposure, a decline occurring after the peak increase of cardiac compensation might signal the onset of structural changes of the myocardium.