Uptake Kinetics of Arsenic in Upland Rice Cultivar Zhonghan 221 Inoculated with Arbuscular Mycorrhizal Fungi.

Arbuscular mycorrhizal fungi (AMF) appear to be highly associated with arsenic (As) uptake in host plants because arsenate (As(V)) and phosphorus (P) share the same transporter, whereby AMF can enhance P uptake. A short-term experiment was conducted for low- (0 to 0.05 mM As) and high-affinity (0 to 2.5 mM As) uptake systems, to investigate the AMF role on As uptake mechanism in plants, which may explain As uptake kinetics in upland rice cultivar: Zhonghan 221. When concentration of As ranged from 0 to 0.05 mM, Funneliformis geosporum (Fg) significantly decreased arsenite (As(III)) and monomethylarsonicacid (MMA) uptake when (p < 0.05) compared to non-mycorrhizal (NM) treatment, since the major route for (As(III)) in rice roots-rice silicon transporter Lsi1 would be influenced by Fg inoculation at high As concentrations. Fg can also reduce As(V) uptake significantly (p < 0.05) under both uptake systems relative to NM treatment, whereas, Funneliformis mosseae (Fm) increased As(V) and MMA uptake in rice roots, with MMA uptake rate generally lower than As(III) and As(V). Using suitable AMF species inoculation with rice, As uptake and accumulation in rice grains can be reduced and the risk to human health, once consumed, can be minimized.

Outcomes of a two-tiered multifaceted elderly suicide prevention program in a Hong Kong Chinese community.

OBJECTIVES: 1) To compare the 2-year completed suicide and reattempt rates in a preintervention group of Hong Kong Chinese suicide attempters (aged 65 years and older) who received standard care and a postintervention group enrolled in a regional elderly suicide prevention program (ESPP) that adopts a two-tiered multifaceted care management model and 2) to examine the trend of suicide rates in older adults aged 65 years and older in the pre- and postintervention periods. DESIGN: The first part is an observational cohort study with baseline, follow-up, and outcome data being identified from a clinical electronic registry. The second part examines changes in suicide rates from official mortality statistics. SETTING: A government-funded suicide intervention program serving catchment population (852,796 people aged 65 years and older) in Hong Kong, China. PARTICIPANTS: Suicide attempters (aged 65 years and older) presenting to old-age psychiatric service in the pre- and postintervention phases. MEASUREMENTS: 1) Two-year rates of completed suicide and suicide reattempt and 2) changes in population suicide rates in the pre- and postintervention periods. RESULTS: The 2-year completed suicide rate was 7.58% in the preintervention group (N = 66) and 1.99$% in the ESPP group (N = 351) Χ = 6.192; p value: 0.028; df = 1). Reattempt rates were not different. At a population level, suicide rate dropped significantly only in women aged 85 years and older, relative to the preintervention period. CONCLUSIONS: The ESPP was associated with a reduced rate of completed suicide in old-age suicide attempters and might have contributed to a fall of suicide rate in women aged 85 years and older.

Resection of phaeochromocytoma extending into the right atrium in a patient with multiple endocrine neoplasia type 2A.

We report the first case of successful surgical resection of a malignant phaeochromocytoma with tumour extension into vena cava and right atrium in a patient with multiple endocrine neoplasia type 2A. A 21-year-old woman with genetic confirmation of multiple endocrine neoplasia type 2A syndrome was diagnosed with a very rare case of malignant phaeochromocytoma with tumour thrombus extension into vena cava and right atrium causing Budd-Chiari syndrome. It posed a challenge to the surgeons with regard to complete tumour resection and vascular control. Reviewing the limited literature, surgical resection by means of cardiopulmonary bypass with hypothermic circulatory arrest has been reported with success in phaeochromocytoma with advance vascular involvement. Adopting this approach, adrenalectomy with complete thrombus excision by inferior vena cava exploration and right atriotomy were performed successfully by a multidisciplinary team.

Interaction of berberine with human platelet alpha 2 adrenoceptors.

Berberine, an alkaloid, has been found to have a myriad of pharmacological effects including hypotensive, antisecretory, sedative, and antimicrobial effects, some of which are similar to those of clonidine, an alpha 2 adrenoceptor partial agonist. The interaction of berberine with human platelet alpha 2 adrenoceptor was investigated in this study. Berberine was found to inhibit competitively the specific binding of [3H]-yohimbine. The displacement curve was parallel to those of clonidine, epinephrine, norepinephrine, with the rank order of potency (IC50) being clonidine (0.4 microM) greater than epinephrine (7.5 microM) greater than norepinephrine (14.5 microM) = berberine (16.6 microM). Increasing concentrations of berberine from 0.1 microM to 10 microM inhibited [3H]-yohimbine binding, shifting the saturation binding curve to the right without decreasing the maximum binding capacity. In platelet cyclic AMP accumulation experiments, berberine at concentrations of 0.1 microM to 0.1 mM inhibited the cAMP accumulation induced by 10 microM prostaglandin E1 in a dose dependent manner, acting as an alpha 2 adrenoceptor agonist. In the presence of L-epinephrine, berberine blocked the inhibitory effect of L-epinephrine behaving as an alpha 2 adrenoceptor antagonist. These properties are similar to those of clonidine on human platelets, suggesting that berberine is a partial agonist of platelet alpha 2 adrenoceptors. These findings may provide potential mechanisms for the hypotensive, antisecretory, and sedative effects of berberine.

Minimally invasive endoscopic-assisted parathyroidectomy for primary hyperparathyroidism.

BACKGROUND: Minimally invasive surgery for primary hyperparathyroidism (pHPT) depends on both an accurate preoperative localization and the availability of intraoperative parathyroid hormone monitoring. METHODS: Patients with sporadic pHPT and one unequivocally enlarged parathyroid gland on preoperative imaging underwent endoscopic-assisted parathyroidectomy. Intraoperative rapid parathyroid hormone (quick PTH) monitoring was performed, and surgical success was confirmed when there was a >50% decrease in quick PTH level 10 min after excision as compared with the baseline level at induction. The surgical outcome and the use of preoperative localization, together with the role played by quick PTH assay in enhancing the operative success, were evaluated. RESULTS: From 1999 to 2002, 66 of 107 patients (62%) were selected for this approach. The accuracy of 99mTc-Sestamibi scintigraphy and ultrasonography was 97% and 70%, respectively. Conversion was required in four cases due to technical problems, and four additional patients failed to show a significant decline in quick PTH levels postexcision. Two patients underwent cervical exploration without the finding of any additional pathology, and another two patients had a delayed drop in quick PTH that was confirmed 30 min postexcision. All patients had a solitary adenoma and were cured of hypercalcemia during a median follow-up of 9 months. CONCLUSIONS: Minimally invasive endoscopic-assisted parathyroidectomy can be performed expeditiously in a select group of patients based on 99mTc-Sestamibi scintigraphy. The use of quick PTH assay can ensure surgical success, but careful interpretation of the results is mandatory.

Laparoscopic resection of a pancreatic polypeptidoma with a solitary liver metastasis.

Pancreatic neuroendocrine tumor is an uncommon disease, and surgery is the only potentially curative treatment even when there is hepatic metastasis. A patient undergoing concomitant laparoscopic distal pancreatectomy and hepatectomy for pancreatic polypeptidoma with a solitary liver metastasis is reported.

Surgical treatment of pancreatic insulinomas in the era of laparoscopy.

BACKGROUND: Laparoscopic resection has been increasingly reported for pancreatic insulinomas. This report evaluates our experience with surgical treatment for pancreatic insulinomas in this era of laparoscopy and reviews the application, safety, and outcome of this surgical approach reported in the literature. METHODS: In a consecutive series of 10 patients with pancreatic insulinomas, laparoscopic resection was performed for selected patients after routine preoperative localizations. The outcome of this operative strategy was reviewed together with reported cases involving laparoscopic resection of pancreatic insulinomas. RESULTS: Laparoscopic distal pancreatectomy or enucleation was performed for four patients with tumors located at the body or tail of the pancreas, whereas open enucleation was performed for six patients with tumors located at the pancreatic head. Pancreatic leak developed in one laparoscopic and two open enucleations. A review of reported cases in the literature showed that 61 of 69 attempted laparoscopic pancreatic resections for insulinomas were performed successfully. All except two tumors were located at the body or tail of the pancreas. For 42 cases with detailed information, 41 tumors at the pancreas body or tail were removed successfully by enucleation (n = 24) or distal pancreatic resection (n = 17), and one tumor at the pancreatic head was enucleated successfully. Pancreatic fistula, the most frequent complication, occurred in 8 (19%) of 42 laparoscopic resections. CONCLUSIONS: Laparoscopic resection of pancreatic insulinomas is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.

Amniography in the early diagnosis of hydatidiform mole.

In 16 patients with suspected hydatidiform mole the diagnosis was readily confirmed by amniography. A characteristic honeycomb pattern was seen in all cases. Opacification of the pelvic and ovarian veins was observed in 11 patients, four of whom also showed an excretory urogram. No complications occurred. We conclude that amniography is a simple, safe and reliable method of establishing the diagnosis in clinically suspected cases of hydatidiform mole. Amniography should be considered: (1) as a primary procedure where facilities for ultrasonic investigations and for chorionic gonadotrophin (HCG) determinations are not available, or (2) when ultrasonic examination and the HCG levels are equivocal.

Clock-face drawing, reading and setting tests in the screening of dementia in Chinese elderly adults.

Comprehensive neuropsychological batteries focus on the subtle cognitive deficits in dementia, but a brief screening instrument is also of immense practical value. As the clock-drawing test encompasses a number of cognitive domains frequently disturbed by the dementing process, it is considered to be a suitable screening instrument for the disorder. We documented the usefulness of a new scoring method of the clock-drawing test for screening of dementia in the elderly Chinese in Hong Kong. Fifty-three demented individuals and 53 healthy elderly controls were assessed. At a cutoff score of 3/4, the sensitivity and specificity of the clock-drawing test in screening of dementia was 83% and 79%. With a composite test of clock reading and clock setting, the positive predictive value of the clock face test was 98%. This new scoring method of clock-drawing proved to be a valid measure for screening of dementia. It is applicable in non-English speaking populations and should be a useful adjunct for quick screening assessment of dementia.

The modified Fuld Verbal Fluency Test: a validation study in Hong Kong.

Recent studies in the West have found that verbal fluency tests are useful in the detection of dementia. In this study, the Fuld Verbal Fluency Test (FVFT) was modified and tested for its usefulness as a screening instrument for differentiating demented from normal elderly Chinese in Hong Kong. Fifty-three normal and 56 demented subjects were administered the FVFT, the Cantonese version of the Mini-Mental State Examination (CMMSE), and the Chinese version of the Hamilton Depression Rating Scale. In addition to bearing significant correlation with the CMMSE, the verbal fluency scores for all semantic categories (animals, fruits, vegetables) were found to produce significant differentiation between the normal and demented groups. However, test-retest reliability for the individual verbal fluency scores was shown to be unsatisfactory, and a composite measure was recommended for use in future screening on the grounds of its enhanced reliability.

From open to laparoscopic adrenalectomy: a review of 16-year experience.

OBJECTIVE: To review the experience with adrenal surgery which was associated with significant morbidity and notable mortality in the past, although laparoscopic approach is beginning to be accepted as the procedure of choice. METHODS: The indications and results of adrenalectomy in 104 patients (36 men, 68 women) over the past 16 years were reviewed. Any potential improvement of surgical results over time was analyzed. RESULTS: Ninety-three patients (89%) had functional problems while malignancy was present in 11 patients (11%). Anterior approach was employed in 27 patients, posterior in 56, lateral in 10, and laparoscopic in 11. One patient required conversion from laparoscopic to anterior approach. No operative mortality was seen, but the morbidity occurred in 16.7%. Complication rate decreased significantly in this study period (1981-1990 versus 1991-1996, 22% versus 5%; P = 0.02). Laparoscopic adrenalectomy was successfully performed for 59% of the patients requiring adrenalectomy recently, compared to 68% of posterior adrenalectomy in the past. CONCLUSIONS: Adrenal surgery is a safe procedure, associated with acceptable morbidity, which has decreased over time. Laparoscopic adrenalectomy is becoming the preferred approach for the majority of patients requiring adrenalectomy.

Defatting of skin flaps using arthroscopic instruments--an effective alternative.

Defatting is often required when skin flaps are transferred to the hand. We present three patients with skin flaps which were defatted using an arthroscopic shaver and a standard suction device. There were no complications and all three patients were satisfied with their outcomes. This method provided an effective treatment for our patients and did not require the purchase of specialised equipment.

Multiple endocrine neoplasia type 2B in a Chinese patient.

Multiple endocrine neoplasia type 2B syndrome is rarely reported in Chinese patients. A 25-year-old Chinese male presented with full-blown clinical features of this syndrome, including bilateral phaeochromocytomas, medullary thyroid carcinoma, and characteristic phenotypic features. One-stage surgical treatment was performed and subsequent genetic analysis confirmed a point mutation at codon 918 in exon 16 of the RET proto-oncogene. The mutation was arising de novo as there was no corresponding mutation found in both his parents or younger sister. Data published to date suggest there is no difference in the genetic and pathophysiologic basis, nor clinical characteristics of multiple endocrine neoplasia type 2B in Chinese patients. As the disease can be lethal, early diagnosis by prompt recognition of the characteristic phenotypic features followed by surgical treatment should improve the outcome. Family screening is essential to identify at-risk family members for prophylactic treatment.

Clinical observation on the uterotonic effect of I-mu Ts'ao (Leonurus artemisia).

Normal fertile women given an oral dose of I-mu Ts'ao decoction (30 g. dry weight equivalent) showed an increase in intra-uterine pressure in 41.3% of 121 cases. The increase ranged from 150% to over 300% of spontaneous activity before dosing. A slightly higher success rate was observed with 2 successive doses or with improved experimental skill in later cases. Ergonovine (0.2 mg i.m.) scored a success rate of 61%. Therefore, I-mu Ts'ao decoction appeared to have a relative potency of 91% compared with ergonovine when the highest success rate (55.5%) of the former is considered. Blank control with water yield a positive response rate of 2.7%. There are no observable side-effects apart from diuresis.

The problem of cervical incompetence in Malaysian women.

No abstract available.

Arsenic uptake in upland rice inoculated with a combination or single arbuscular mycorrhizal fungi.

A pot trial was conducted to investigate the role of arbuscular mycorrhizal fungi (AMF) on arsenic (As) uptake of upland rice (Oryza sativa L.) cultivar, Zhonghan 221; where the following 3 species of Glomus geosporum (Gg), G. mosseae (Gm) and G. versiforme (Gv) were applied as single or combined inoculations. In general, Gm significantly enhanced (p<0.05) total As concentration in Zhonghan 221 when compared to the non mycorrhizal (NM) treatment. The treatment inoculated with Gg + Gm increased total phosphorus (P) uptake and decreased total As uptake in the ingestible rice parts (husks and grains). In terms of AMF colonization rates, Gm had significantly higher (p<0.05) average values of 57.3% and 66.6% when grown in As0 and As40 soils, respectively, in comparison to that of Gg and Gv, and finally dropped to 3.63% when grown in As80 soil. There was a significant difference (p<0.05) between single AMF species (Gg or Gv) and AMF mixture treatments (Gg + Gv, Gg + Gm, Gv + Gm and Gg + Gv + Gm) in terms of total As concentrations in rice. No significant correlation between AMF colonization rates and As uptake in grains (r = 0.150, p > 0.01) and total P (r = 0.002, p > 0.01) were observed.

Can arbuscular mycorrhizal fungi improve grain yield, As uptake and tolerance of rice grown under aerobic conditions?

The effects of arbuscular mycorrhizal fungi (AMF) -Glomus intraradices and G. geosporum on arsenic (As) and phosphorus (P) uptake by lowland (Guangyinzhan) and upland rice (Handao 502) were investigated in soil, spiked with and without 60 mg As kg(-1). In As-contaminated soil, Guangyinzhan inoculated with G. intraradices or Handao 502 inoculated with G. geosporum enhanced As tolerance, grain P content, grain yield. However, Guangyinzhan inoculated with G. geosporum or Handao 502 inoculated with G. intraradices decreased grain P content, grain yield and the molar ratio of grain P/As content, and increased the As concentration and the ratio of grain/straw As concentration. These results show that rice/AMF combinations had significant (p < 0.05) effects on grain As concentration, grain yield and grain P uptake. The variation in the transfer and uptake of As and P reflected strong functional diversity in AM (arbuscular mycorrhizal) symbioses.