Pattern analysis and variations in the utilization of antihypertensive drugs in Taiwan: a six-year study.

BACKGROUND: In the last few years there have been changed in the pattern of consumption of antihypertensive drugs in other countries. Factors causing this variability include differences in the effectiveness of detection, guidelines for the management of hypertension, and differences in national health insurance systems among countries. AIM: The aim of this study was to reveal patterns in the use of antihypertensive drugs in Taiwan over a six year period (2001 to 2006) and compare these results with data from other countries. MATERIALS AND METHODS: This study performed descriptive analysis of data from the National Health Insurance Research Database (NHIRD) of Taiwan, and compared these findings with similar findings from around the world. Quantities were standardized using the defined daily dose (DDD) per 1000 inhabitants per day (DID) in accordance with WHO anatomical therapeutic classification and DDD measurement methodology. RESULTS: The total number of DDDs prescribed in Taiwan increased from 0.66 billion in 2001 to 1.08 billion in 2006, representing 80.6 and 129.2 DID in 2001 and 2006, respectively. This indicates a significant increase in the prescription of antihypertensive drugs in Taiwan over this period. The average annual increase ranged from 10.7% for calcium channel blockers (CCBs) to 22.1% for angiotensin II receptor blockers (ARBs). All of these patterns were statistically significant (p < 0.05). The rapid increase in the use of ARBs resulted in its surpassing ACEIs with the second highest DID (21.9) in 2006. Though the proportional use of CCBs and ARBs has increased significantly, the use of thiazide diuretics remains low. CONCLUSIONS: The consumption of antihypertension drugs in Taiwan increased during the period studied and the highest average annual increases were for ARBs and CCBs. Overall consumption of antihypertension drugs also increased in other countries, but differences in the relative increase for each class of drug suggest that further study may be required to clarify the origins and causes.

Forkhead homologue in rhabdomyosarcoma functions as a bifunctional nuclear receptor-interacting protein with both coactivator and corepressor functions.

In a search for novel transcriptional intermediary factors for the estrogen receptor (ER), we used the ligand-binding domain and hinge region of ER as bait in a yeast two-hybrid screen of a cDNA library derived from tamoxifen-resistant MCF-7 human breast tumors from an in vivo athymic nude mouse model. Here we report the isolation and characterization of the forkhead homologue in rhabdomyosarcoma (FKHR), a recently described member of the hepatocyte nuclear factor 3/forkhead homeotic gene family, as a nuclear hormone receptor (NR) intermediary protein. FKHR interacts with both steroid and nonsteroid NRs, although the effect of ligand on this interaction varies by receptor type. The interaction of FKHR with ER is enhanced by estrogen, whereas its interaction with thyroid hormone receptor and retinoic acid receptor is ligand-independent. In addition, FKHR differentially regulates the transactivation mediated by different NRs. Transient transfection of FKHR into mammalian cells dramatically represses transcription mediated by the ER, glucocorticoid receptor, and progesterone receptor. In contrast, FKHR stimulates rather than represses retinoic acid receptor- and thyroid hormone receptor-mediated transactivation. Most intriguingly, overexpression of FKHR dramatically inhibits the proliferation of ER-dependent MCF-7 breast cancer cells. Therefore, FKHR represents a bifunctional NR intermediary protein that can act as either a coactivator or corepressor, depending on the receptor type.

Filler particle leachability of experimental dental composites.

We studied the effect of matrix selection, filler composition, and filler silanization on filler leachability after storage in distilled water or artificial saliva. We evaluated 2 matrix systems, 2 filler systems and 2 silane treatment procedures, combined into 8 different dental composite materials. A total of 128 batches were made, and 2 specimens per batch were prepared. Of these 2 specimens per batch, one was stored in distilled water and the other in artificial saliva, both at 37 degrees C. We transferred the specimens each 30th day during a 3-yr period to new vials containing either freshly distilled water or newly mixed artificial saliva and analyzed the solutions the specimens had been stored in regarding Si, Ba and Al concentrations. The analyses revealed that storage solution, filler composition, and total time in the storage solution had strong effects on leachability. The average monthly leakage of the three elements was linear with time and higher in the artificial saliva. The Ba-containing filler leached Si faster in artificial saliva than in distilled water, and roughly twice as much as the quartz filler. The storage effect approached an order of magnitude, while the filler effect was roughly a factor of two. Filler leaching was linear over time.

Fructus aurantii reduced portal pressure in portal hypertensive rats.

The purpose of this study was to investigate the effects of Fructus Aurantii (the unripe fruits of Citrus aurantium L.) on portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation (PVL) in Sprague-Dawley rats. Sham-operated (Sham) rats served as controls. Hemodynamic and in vitro contractile studies were performed at 14 days after surgery. Both the aqueous extract of Fructus Aurantii and synephrine, one of its purified principles with pressor activity, were infused into the conscious PVL and Sham rats via a syringe pump. Fructus Aurantii (1.25, 2.5, & 5.0 mg/kg/min) dose-dependently reduced portal pressure in PVL and Sham rats, with the percentage change in portal pressure more pronounced in PVL rats. Mean arterial pressure was dose-dependently elevated by Fructus Aurantii. Synephrine (0.095, 0.19, & 0.38 mg/kg/min) also dose-dependently reduced portal pressure and elevated mean arterial pressure in PVL and Sham rats. Fructus Aurantii (2.8-280 micrograms/ml) induced dose-dependent contractile responses mainly in aorta and mesenteric artery, but little response in portal vein. The results showed that Fructus Aurantii infusion reduced portal pressure, possibly by way of arterial vasoconstriction.

Lung deposits of lipiodol in normal and cirrhotic rats.

The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n = 55) and cirrhotic rats (n = 20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced military pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential risk factor for developing pulmonary complications after Lipiodol administration.

The hypotensive and negative chronotropic effects of dehydroevodiamine.

The cardiovascular effects of dehydroevodiamine, an alkaloid isolated from Evodia rutaecarpa Jussieu, were studied in both in vivo and in vitro experiments. The in vivo experiments revealed that i.v. administration of dehydroevodiamine elicited a slight but significant reduction in blood pressure and a marked decrease in heart rate which was confirmed by an increased cycle length of the electrocardiogram. However, a hemodynamic experiment with microspheres showed that the total peripheral resistance was not altered by dehydroevodiamine. The blood flows of various organs were not significantly changed except those of kidney and skin, in which blood flow was decreased. In vitro, the spontaneously beating atria were significantly suppressed by dehydroevodiamine in a dose-dependent manner. These findings suggested an important effect of dehydroevodiamine in suppressing the heart, which may largely contribute to the hypotensive effect of this alkaloid. However, its vasodilator effect on hindquarter muscles cannot be neglected.

Protein and metabolizable energy requirements of hand-fed squabs from hatching to 28 days of age.

Incubator-hatched squabs were hand fed slurries containing 14% diet and 86% water by weight for the 1st 4 days, followed by 20% diet and 80% water for the next 2 to 3 days. From Days 7 to 28, the slurry contained 25% diet and 75% water. A diet containing about 61% isolated soybean protein, 8.9% soybean oil, 21.5% glucose, 4% CaHPO4.2H2O, and 1.3% CaCO3 supplemented with vitamins and trace elements supported the optimum growth of squabs for the first 7 days. It contained 3,675 kcal metabolizable energy (ME)/kg and 53.3% crude protein (CP). The composition of the optimum diet for feeding from Days 7 to 289 was as follows: corn starch, 58.37%; isolated soybean protein, 23.1%; cellulose, 8.0%; soybean oil, 3.0%; CaHPO4.2H2O, 3.0; methionine, .3%; CaCO3, 1.0; plus vitamins and trace minerals. This diet provided 3,200 kcal ME/kg and 20% CP.