[A case of high-pressure injection injury of hand complicated with deep chemical burn caused by industrial cement].

This article reports a patient with extensive high-pressure injection injury of the hand combined with deep chemical burn caused by high-pressure injection of industrial cement materials was diagnosed and treated in the Department of Hand Surgery, Xiaolan Hospital Affiliated to Southern Medical University in 2022. The nerves, tendons and blood vessels of the left hand were involved, and the ulnar skin of the left thumb was extensively necrosis, and a large number of extensive cement foreign bodies remained under the skin. Part of the cement was inserted into the joint capsule of the interphalangeal joint. After emergency surgical treatment, the patient was saved successfully, and the wound healed well without chemical poisoning and other related complications, which created conditions for the second stage of flap repair.

Remifentanil reduces multiple organ and energy metabolism disturbances in a rat sepsis model.

The aim of this study was to observe the effects of remifentanil on organ damage and energy metabolism in lipopolysaccharide (LPS)-induced septic rats. A total of 45 clean-grade male Wistar rats (weight 270-320 g) were randomly divided into three groups: a control group, an LPS group, and an LPS with remifentanil treatment (LPS+REM) group. After 6 hours of modeling, the levels of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in lung and kidney tissues of rats in each group were detected by ELISA. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in lung and kidney tissues were determined, and the content of lactic acid, pyruvate and epinephrine in heart and kidney tissues were detected. Reverse transcription polymerase chain reaction and the Western blot test were used to detect the expression of pyruvate dehydrogenase kinase 4 (PDK4) in the myocardial tissue. We found that remifentanil treatment inhibited the levels of IL-6, TNF-α, and MDA in the lung and kidneys 6 h after the administration of LPS and increased the level of SOD activity. Treatment with remifentanil reduced the expression of lactic acid, pyruvate, and epinephrine in the heart and kidney tissues and attenuated the expression of PDK4 messenger RNA and PDK4 protein in the myocardial tissue. We concluded that remifentanil might inhibit the release of tissue inflammatory factors, regulate the body's energy metabolism, and ultimately protect the sepsis tissue damage caused by LPS.

An OLTAM system for analysis of brown/beige fat thermogenic activity.

BACKGROUND/OBJECTIVES: Thermogenic fat is present in humans and emerging evidence indicates that increasing the content and activity of these adipocytes may lead to weight loss and improved metabolic health. Multiple reporter systems have been developed to assay thermogenic fat activity based on the transcriptional and translational activation of Ucp1, the key molecule that mediates nonshivering thermogenesis. Our study aims to develop a much-needed tool to monitor thermogenic fat activity through a mechanism independent of Ucp1 regulation, therefore effectively assaying not only canonical ß-adrenergic activation but also various non-UCP1-mediated thermogenic pathways that have been increasingly appreciated. METHODS: We detected increased luciferase activity upon thermogenic activation in interscapular brown and inguinal subcutaneous fat in ODD-Luc mice, a hypoxia reporter mouse model. We then developed an OLTAM (ODD-Luc based Thermogenic Activity Measurement) system to assay thermogenic fat cell activity. RESULTS: In both primary murine and human adipocytes and an immortalized adipose cell line that were transduced with the OLTAM system, luciferase activity can be readily measured and visualized by bioluminescence imaging in response to a variety of stimuli, including UCP1-independent thermogenic signaling. This system can offer a convenient method to assay thermogenic activity for both basic and translational research. CONCLUSIONS: The OLTAM system offers a convenient way to measure the activation of thermogenic fat and presents opportunities to discover novel signaling pathways and unknown compounds targeting metabolically active adipocytes to counteract human obesity.

The Role of Uric Acid for Predicting Future Metabolic Syndrome and Type 2 Diabetes in Older People.

OBJECTIVE: Although it is known that high uric acid (UA) level is associated with type 2 diabetes (T2DM) and metabolic syndrome (MetS), most of the previous studies were focused on adults. Since aging becomes a major problem for many societies, in this longitudinal study, we investigated the role of UA in future T2DM and MetS in a large cohort of people who were older than 65 years. DESIGN: A cross-sectional and longitudinal study. SETTING/PARTICIPANTS: 18,907 elderly (9,732 men, 9,175 women) aged above 65 years, enrolled from health check-up centers, were classified into three subgroups by 10-year intervals (young old 65-74 years, YO; old old 75-84 years, OO; and oldest old 85-94 years, ODO), with the average follow-up period of 4.3 years. MEASUREMENTS: The optimal cut-off values (CoVs) of baseline UA to predict future MetS and T2DM were determined by receiving operating characteristic (ROC) curve analysis. Using these CoVs of UA, the participants were divided into normal- and high-level groups of UA. Cox proportional hazard analysis was used to calculate hazard ratios (HRs) for the subjects with a high level of UA for the risk of future MetS and T2DM. In addition, Kaplan-Meier plots and log rank test were used to evaluate the time effect on the incidence of developing MetS and T2DM between the two groups. RESULTS: In ROC curve analysis, the optimal CoVs of baseline UA were 6.0, 6.3 and 6.7 mg/dl in YO, OO, and ODO men, respectively; 5.5 and 4.9 mg/dl in YO and OO women, respectively (all p < 0.05). However, the CoVs of UA in ODO women (6.1 mg/dl) failed to show its discriminant power (p = 0.13). The Cox regression analysis showed the YO subjects with a higher baseline level of UA had a higher risk of developing MetS (HRs 1.56 and 1.58 for men and women, respectively, both p < 0.001); as for T2DM the HRs were 1.39 and 1.57. In OO men, the HRs was 1.89 for developing future MetS. However, no significant findings could be noted in the ODO group. Kaplan-Meier plots and log rank test also showed the same findings. CONCLUSION: Our study showed that old subjects with high levels of UA will have a higher chance to have MetS and T2DM, particularly in the YO group (6.0 mg/dl for men and 5.5 mg/dl for women, respectively). Using UA as one of the metabolic biomarkers may help clinicians to early detect and prevent MetS and diabetes.

Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan.

BACKGROUND: Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. AIM: To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. DESIGN: Two stages included cross-sectional (Stage 1) and prospective (Stage 2) cohort study. METHODS: In Stage 1 18 287 subjects aged ≥60 years were enrolled; of these, 5039 without T2D and CVD advanced to Stage 2 and a mean follow-up of 3.8 years. MetS components were analysed, and in Stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In Stage 2, subjects without T2D and CVD in Stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. RESULTS: ROC curve analysis gave an optimal FPG cut-off for MetS of 93 mg/dl and 92 mg/dl for males and females, respectively. The high-FPG group had a 1.599- and 1.353-fold higher chance of developing T2D compared with the low-FPG group for males and females, respectively (95% CI: 1.606-2.721 and 1.000-1.831, P = 0.015 and 0.05). The high-FPG group had a 1.24-fold higher chance of developing CVD for females (95% CI: 1.015-1.515, P = 0.035); however, there was no difference for males. CONCLUSIONS: Our results suggest that FPG within the normal range was associated with MetS, and elderly subjects with high normal levels have a higher incidence of developing T2D for both sexes, and CVD for females, over the short-term.

Partial Protection from Metabolic Syndrome in Chronic Hepatitis C Elderly Subjects Due to Lower Triglyceride Level.

BACKGROUND: In Taiwan, persons over 65 years old have higher prevalence of hepatitis C. Among these patients, around 50% have non-alcoholic fatty liver disease (NAFLD). Since cardiovascular diseases and diabetes are main causes of death in this age group, in this cross-sectional study, we tried to evaluate the effects of NAFLD and hepatitis C on the risk of metabolic syndrome (MetS). METHODS: In total, 25 116 subjects over 65 years old who presented for routine health check-ups were enrolled. From the results of seropositivity for hepatitis C and abnormal echogenicity, they were classified into four groups: normal (N), subjects with only hepatitis C (C), subjects with only abnormal echogenicity (E) and subjects with both hepatitis C and abnormal echogenicity (CE). RESULTS: Subjects in both groups E and CE had higher abnormal MetS components than group C. Among all five components, triglyceride (TG) was the one having the highest odds ratio (OR) in determining the incidence of MetS in groups C and E. Finally, compared to group N, both groups E and CE had significantly higher OR for having MetS. However, after adjusting for confounding factors, only the significance between groups E and N remained. In other words, higher MetS was noted in group E compared to group N and there was no difference in incidence of MetS between group CE and group N. CONCLUSIONS: Chronic hepatitis C is a protective factor against having MetS and this effect might be due to lower TG level in the elderly. Further studies are warranted for the underlying mechanisms.

In situ growth of carbon nanotubes on Ni/MgO: a facile preparation of efficient catalysts for the production of synthetic natural gas from syngas.

Ni/MgO-CNTs catalysts are prepared by in situ chemical vapor deposition growth of CNTs on Ni/MgO. These catalysts exhibit an improved performance for the production of synthetic natural gas from syngas, which is attributed to the formation of highly catalytic active interfaces among Ni, CNTs and MgO.

Transcriptional control of circadian metabolic rhythms in the liver.

Diurnal metabolic rhythms add an important temporal dimension to metabolic homeostasis in mammals. Although it remains a challenge to untangle the intricate networks of crosstalk among the body clock, nutrient signalling and tissue metabolism, there is little doubt that the rhythmic nature of nutrient and energy metabolism is a central aspect of metabolic physiology. Disruption of the synchrony between clock and metabolism has been causally linked to diverse pathophysiological states. As such, restoring the rhythmicity of body physiology and therapeutic targeting directed at specific time windows during the day may have important implications in human health and medicine. In this review, we summarize recent findings on the integration of hepatic glucose metabolism and the body clock through a regulatory network centred on the PPARγ coactivator 1 (PGC-1) transcriptional coactivators. In addition, we discuss the transcriptional mechanisms underlying circadian control of the autophagy gene programme and autophagy in the liver.

Associations between genetic variants and the severity of metabolic syndrome in subjects with type 2 diabetes.

Metabolic syndrome (MetS) includes obesity, dyslipidemia, elevated blood pressure, and dysglycemia. Subjects with type 2 diabetes (T2D) exhibit features of MetS. The etiology of MetS is complex, involving both environmental and genetic factors. In this study, we examined the role of specific candidate genetic variants on the severity of MetS in T2D subjects. A total of 240 T2D subjects aged 35-64 years were recruited. Waist circumstance, plasma triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and blood pressure were measured to define MetS. Subjects were divided into 4 groups according to MetS components. Target genes involved in fibrotic and inflammatory processes, insulin and diabetes, cell growth and proliferation, and hypertension were genotyped. A total of 13 genes and 103 single-nucleotide polymorphisms (SNPs) were analyzed to evaluate their genetic association with MetS severity in T2D subjects. Univariate ordinal logistic regression using a dominant model (homozygous for the major allele vs carriers of the minor allele) revealed 6 SNP markers within 4 genes with genotypes associated with MetS risk. For the SNP genotypes of rs362551 (SNAP25), rs3818569 (RXRG), rs1479355, rs1570070 (IGF2R), and rs916829 (ABCC8), heterozygotes showed a lower risk of MetS compared with the reference group. In addition, the CC genotype was comparable to the TT genotype for rs3777411. There was no gender-specific effect. In conclusion, our results suggest that among the Han Chinese population, several SNPs increase the risk of severe MetS in T2D subjects. Further study in a large population should be conducted.

Higher normal range of fasting plasma glucose still has a higher risk for metabolic syndrome: a combined cross-sectional and longitudinal study in elderly.

INTRODUCTION: It is well known that higher fasting plasma glucose (FPG) is associated with metabolic syndrome (MetS). This relationship still exists even the FPG is within the normal range. However, most of these studies did not exclude subjects who were on medications which would affect the results of the studies. At the same time, there is no longitudinal study done to validate this correlation, especially in elderly. In this study, the relationships between normal FPG and MetS were evaluated. METHOD: We randomly selected 57,517 subjects who were ≥ 60-years old from health screening centre. In the first part of study, subjects were enrolled in the cross-sectional study to find out the optimal cut-off value of FPG with higher chances to have MetS. In the second part of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 5.3-year longitudinal study. RESULTS: There were 18,287 subjects enrolled in this study. In the first part of study, the cross-sectional study, optimal cut-off values of FPG were determined by the ROC curve and the sensitivity for these cut-off values were 56.6% in men and 60.9% in women, respectively. The result showed that lower FPG is healthier than the higher (log-rank test, p < 0.001). During the follow-up period, 5039 subjects showed hazard ratios of 2.09 for men and 1.884 for women developing future MetS. CONCLUSION: Our study is the first longitudinal design in elderly and showed that older subjects with higher FPG proved to have higher risk of Mets even the FPG is still within its normal range.

Metabolic syndrome in normoglycaemic elderly men.

OBJECTIVE: Type-2 diabetes is mainly the metabolic defect involving multiple organs. To conclude their intricate relationships, the term 'ominous octet' had been proposed to denote this phenomenon. In this study, we enrolled older men without any medications for MetS components to further elucidate the relationships between normoglycaemic state and MetS. METHODS: We enrolled male subjects with FPG less than 100 mg/dl and aged 65 and older undergoing routine health check-ups in Taiwan. After excluding subjects taking medications that might affect the components of MetS, a total of 6679 men were eligible for the analysis. Study subjects were further grouped into FPG tertiles (< 91 mg/dl, 92-95 mg/dl and > 95 mg/dl for tertil 1, tertil 2 and tertil 3, respectively). RESULTS: There was a significant trend between the FPG and percentages of subjects having MetS (p = 0.009). The relationships between the MetS components were higher in FPG 2 and FPG 3 than FPG 1. In simple correlation, all of the MetS and LDL-C were positively correlated with FPG level and multiple regression further confirmed the same result except for HDL-C that became non-significant. Subjects in FPG3 had significantly higher ORs (ORs = 1.19) for having MetS than those in FPG1. CONCLUSIONS: In conclusion, higher FPG still had higher risk of having MetS in normoglycaemic range in elderly male. More strict FPG level control may be valuable in CVD prevention and warrants further investigations.

Elastic discontinuity due to ectopic calcification in a human fibrous joint.

Disease can alter natural ramp-like elastic gradients to steeper step-like profiles at soft-hard tissue interfaces. Prolonged function can further mediate mechanochemical events that alter biomechanical response within diseased organs. In this study, a human bone-tooth fibrous joint was chosen as a model system, in which the effects of bacterial-induced disease, i.e. periodontitis, on natural elastic gradients were investigated. Specifically, the effects of ectopic biomineral, i.e. calculus, on innate chemical and elastic gradients within the cementum-dentin complex, both of which are fundamental parameters to load-bearing tissues, are investigated through comparisons with a healthy complex. Complementary techniques for mapping changes in physicochemical properties as a result of disease included micro X-ray computed tomography, microprobe micro X-ray fluorescence imaging, transmission electron and atomic force microscopy (AFM) techniques, and AFM-based nanoindentation. Results demonstrated primary effects as derivatives of ectopic mineralization within the diseased fibrous joint. Ectopic mineralization with no cementum resorption, but altered cementum physicochemical properties with increasing X-ray attenuation, exhibited stratified concretion with increasing X-ray fluorescence counts of calcium and phosphorus elements in the extracellular matrix in correlation with decreased hygroscopicity, indenter displacement, and apparent strain-relieving characteristics. Disease progression, identified as concretion through the periodontal ligament (PDL)-cementum enthesis, and sometimes the originally hygroscopic cementum-dentin junction, resulted in a significantly increased indentation elastic modulus (3.16±1.19 GPa) and a shift towards a discontinuous interface compared with healthy conditions (1.54±0.83 GPa) (Student's t-test, P<0.05). The observed primary effects could result in secondary downstream effects, such as compromised mechanobiology at the mechanically active PDL-cementum enthesis that can catalyze progression of disease.

Clinical presentations of thyroid cancer patients with multiple primary cancers.

BACKGROUND: In thyroid cancer patients with multiple primary cancers, primary cancers tend to be more aggressive. AIMS: We analyzed multiple primary cancers in thyroid cancer patients and determined the differences between the incidence and the characteristics of primary cancers. MATERIALS AND METHODS: A total of 3070 patients with thyroid cancer underwent a thyroidectomy and follow-up examination at a single medical center. The times of diagnosis of the primary cancers were categorized as antecedent, synchronous, or subsequent to the diagnosis of thyroid cancer. RESULTS: After a mean follow-up period of 8.8 ± 0.5 yr, the presence of multiple primary cancers was histopathologically confirmed in 163 patients (5.3%). Patients with multiple primary cancers had a lower female-to-male ratio, an older mean age, advanced tumor-node-metastasis (TNM) stage, higher total mortality, and higher therapeutic radioactive iodide (131I) doses than patients without multiple primary cancers. Hematological malignancy and renal cell carcinoma, neither of which are among the 10 most common cancers observed in the general population of Taiwan, were the most common multiple cancers among women and men with thyroid cancer. Patient age, thyroid cancer tumor size, and thyroid cancer mortality in the antecedent, synchronous, and subsequent groups were not significantly different. CONCLUSIONS: Patients with multiple primary cancers in advanced stages had shorter disease-free survival period after treatment. Thyroid cancer patients with multiple primary cancers should be closely followed up for the occurrence of other secondary cancers in order to improve total mortality.

Study on cement mortar and concrete made with sewage sludge ash.

This study investigated the feasibility of reusing wastewater sludge ash in construction materials to replace partial materials. Wastewater sludge sampled from thermal power plant was burned into sludge ash at 800°C in the laboratory. The sludge incineration ash has low heavy metal including Pb, Cd, Cr and Cu, so it belongs to general enterprise waste. The chemical composition of sludge incineration ash was summed up in SiO2, CaO, Fe2O3 and MgO. Then the wastewater sludge ash is also found to be a porous material with irregular surface. When the sludge ash was used to replace mortar or concrete cement, its water-adsorption capability will result in the reduction of mortar workability and compressive strength. Cement is being substituted for sludge ash, and 10 percent of sludge ash is more appropriate. Sludge ash is reused to take the place of construction materials and satisfies the requests of standard specification except for higher water absorption.

Research on burden of chronic diseases among rural-urban residents in Xuzhou.

OBJECTIVES: To investigate the burden of chronic diseases among rural-urban residents in Xuzhou, China. STUDY DESIGN: Retrospective study. METHODS: The mortality rates and standardized mortality rates of neoplasms, diabetes mellitus, ischaemic heart disease and cerebrovascular diseases were calculated for the 10 years from 1997 to 2006 in Xuzhou. The potential years of life lost, rate of life lost and standardized rate of life lost were calculated for each disease. Direct treatment costs were also analysed. RESULTS: The age-standardized mortality rates of the four diseases were 150, 9, 78 and 96 per 100,000, respectively. The standardized rates of life lost among urban residents were 11.7, 0.8, 4.9 and 4.1 per thousand, respectively, and among rural residents were 15.0, 0.3, 2.9 and 2.8 per thousand, respectively. The total direct medical expenses, including outpatient and inpatient costs, was 6.07 hundred million Yuan. CONCLUSION: Chronic diseases place a heavy burden on rural and urban residents in Xuzhou. A multidimensional and multidisciplinary health promotion and disease management plan is urgently needed to control these diseases.

The experiences of carers in Taiwanese culture who have long-term schizophrenia in their families: a phenomenological study.

Schizophrenia is a severe illness with little hope of recovery and requires long-term care. The purpose of this study was to explore the experiences of carers who live with someone with long-term schizophrenia, within the cultural context of Taiwan. The study was conducted in a community setting in central Taiwan. A qualitative phenomenological approach was used to explore the experiences of carers. Purposive sampling was used by selecting the carers who were close relatives of the clients, had lived with the clients for at least 1 year and bore most of the responsibilities. Semi-structured face-to-face interviews were conducted to collect the data and narratives were analysed using Colaizzi's (1978) seven-step method. Data saturation was achieved after interviewing 10 carers. Three themes and eight sub-themes were identified: burdens of caring (helping clients' illness, lack of professional support and family conflicts), emotional burdens (sadness, worry and fear) and strategies of coping (cognitive and religious coping strategies). Our study supported the importance for nurses to understand the cultural aspects of mental illness, particularly the widespread cultural beliefs and patterns of help seeking behaviours, in order to provide culturally sensitive health care.

Management of intraductal papillary mucinous neoplasms of the pancreas.

Over the last decade, the diagnosis and treatment of intraductal papillary mucinous tumors (IPMN) of the pancreas has evolved. They represent a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Several non-invasive and invasive imaging modalities allow adequate visualization of these lesions. Multidetec-tor computed tomography (MCT) and magnetic resonance (MR) Cholangiopan-creatography are generally used as fist line imaging techniques, whereas invasive techniques as endoscopic ultrasound or endoscopic retrograde cholangiopancreatography are usually considered in the setting of an uncertain diagnosis. Multiple factors have to be taken into consideration in order to establish an adequate management of these lesions. Main duct and combined IPMN, as well as branch duct lesions larger than 3 cm or containing aggressive features as solid component are considered indications for surgical resection. On the other hand, follow-up through imaging is advocated for small, benign appearing lesions, as well as for post-surgical patients. In the later setting, the follow-up protocol should consider the aggressiveness of the resected lesion and the surgical margins, in order to establish an optimal time interval of imaging.

The reproducibility of the virtual organ computer-aided analysis program for evaluating 3-dimensional power Doppler ultrasonography of diffuse thyroid disorders.

AIM: The aim of this study was to evaluate the intra- observer and inter-observer reproducibility of 3-dimensional (3D) power Doppler ultrasonography with the virtual organ computer-aided analysis (VOCAL) program for measuring thyroid volume and vascular indices in patients with diffuse thyroid disorders. MATERIALS AND METHODS: Patients with diffuse goiters were examined by 3D ultrasonography from August 2005 to July 2006. The parameters for vascular assessment included the vascularization index (VI), flow index (FI), vascularization-flow index (VFI), and thyroid size, and were obtained using the VOCAL program. This program used plane A and a 30 degrees rotational step. Intra-observer and inter-observer repeatability are presented as intra-class correlation coefficient (intra-CC) and inter-class correlation coefficient (inter-CC), with values >0.70 being acceptable. RESULTS: Sixty-three patients in total were enrolled for this study, including 19 patients with simple goiter and 44 patients with autoimmune thyroid disease (AITD) (23 Graves' disease, 21 Hashimoto's thyroiditis). Thyroid volume and 3 vascular indices showed excellent reproducibility in the AITD group (intra- CC>0.9373 and inter-CC>0.8763) and its subgroups. The VI had excellent consistent reproducibility in the simple goiter group (intra-CC>0.8987 and inter-CC>0.8881), but the other parameters did not. CONCLUSIONS: Based on this study, 3D power Doppler ultrasonography with the VOCAL program is a reliable tool for evaluating diffuse thyroid disorders due to an autoimmune process. The VI is the most reliable parameter.

Increase in excitatory amino acid concentration and transporters expression in osteoarthritic knees of anterior cruciate ligament transected rabbits.

OBJECTIVE: The present study aimed to determine the role of excitatory amino acids (EAAs) and EAA transporters (EAATs) in an osteoarthritis (OA) model of rabbit knees. METHODS: OA was induced in New Zealand white male rabbits by anterior cruciate ligament transection (ACLT) in one knee of one hind limb; the other knee left unoperated. Rabbits that received ACLT of knee were assigned to the ACLT group (n=6), while a sham-operated group (n=6) underwent arthrotomy with no ACLT. Six naïve rabbits that received no surgery were used as normal control. The width of the knee joint was measured to determine the severity of joint inflammation. Before operation and at 10, 20, and 30 weeks after operation, knee joint dialysates were collected by microdialysis and assayed for EAAs by high-performance liquid chromatography. Gross morphology and histopathology and EAATs glutamate/aspartate transporter (GLAST) and glutamate transporter-1 (GLT-1) expression in the articular cartilage of the knees were evaluated by immunohistochemistry and western blot analysis. RESULTS: In the ACLT knees, a significant increase in the joint width was observed (5.3+/-0.9 mm, P<0.05) at 30 weeks after operation, while the sham-operated and naïve knees showed no difference as compared with the basal values. The concentrations (microM) of aspartate and glutamate in knee dialysates at 30 weeks after ACLT in naïve, sham, and ACLT were 0.36+/-0.07 and 4.5+/-1.10; 0.38+/-0.09 and 4.61+/-1.11; 0.67+/-0.18 and 9.71+/-2.89, respectively. Levels of glutamate and aspartate in the dialysates obtained from the ACLT knees increased by 213.3+/-29.6% and 187.5+/-33.8% (P<0.05) when compared to those in the sham-operated knees. Both naïve and ACLT chondrocytes were positively stained by antibodies against GLAST and GLT-1. GLAST and GLT-1 protein expressions were significantly increased in the ACLT knees (P<0.05). CONCLUSION: Our findings indicate an involvement of EAAs and EAATs in the pathogenesis of OA in ACLT rabbits.

Longitudinal analysis of inpatient care utilization among people with intellectual disabilities: 1999-2002.

BACKGROUND: There has been no longitudinal study in Taiwan to identify the nature and the scale of medical care utilization of people with intellectual disabilities (IDs) up to the present. The aim of this study is to describe inpatient utilization among people under ID care in institutions in order to identify the pattern of medical care needs and the factors affecting utilization in Taiwan. METHOD: The subject cohort was 168 individuals with ID who were cared for by a large public disability institution from 1999 to 2002 in Taipei, Taiwan. RESULTS: On the examination of the inpatient care that these persons underwent, it was found that these individuals had a heightened need (inpatient rate: 10.1-14.9%) for inpatient care compared with the general population with disabilities (9.37%) in Taiwan. The main reasons for hospitalization were pneumonia, gastrointestinal disorders, cellulites, orthopaedic problems, epilepsy and bronchitis. Using the full model of Generalized Estimating Equations for inpatient care utilization, the factors including low income family, living in an institution, being a subject with cerebral palsy and being a high outpatient user all influenced the use of inpatient care. CONCLUSIONS: This study highlights that health authorities need to promote health planning more in order to ensure an excellent quality of health monitoring and health promotion among people with ID cared for by institutions.