Search

The purpose of this study is to explore the content and background context of powerlessness experienced by elderly single Chinese men with heart disease and their coping behaviors during their hospitalization stage. Data were gathered by semi-structured interviews at a leading veterans' hospital in northern Taiwan and analyzed using a qualitative content analysis mode. Twenty-six men who were 65 or older, diagnosed with heart disease, and who lived alone during the preadmission stage were recruited. Eighty-one percent (N = 21) reported that their perceptions of powerlessness occurred either in the preadmission or hospitalization stage or were expected to occur after discharge. Other complaints of powerlessness were attributed to having no choices in appropriate living places during the preadmission stage, having no control over discomfort, being unable to obtain care and companionship from families and friends, failing to get medical information about their disease and options of treatment during hospitalization, or expecting deteriorating health and receiving no assistance during emergencies or in the dying stage after discharge from the hospital.

We evaluated clinical findings including those on dentistry and in the oral cavity of children with obstructive sleep apnea syndrome (OSA). This study examined twenty-seven OSA children, who were advised by otolaryngologists to be admitted for closer examination and showed an apnea index (AI) of 5 or more on polysomnographs. Their clinical history was obtained from their mothers, and oral findings were also evaluated. The patient consisted of 15 males (56%) and 12 females (44%). The mean body mass index (BMI) was 16.0 +/- 3.0. Of the clinical findings related to sleeping and the duration of sleeping, snoring was the most frequently observed finding (100%). The mean duration of sleep, calculated from the time they went to bed (9.2 +/- 0.8 p.m.) and the time they got up (7.1 +/- 0.8 a.m.), was 9.9 +/- 1.0 hours. Of the clinical findings obtained during the daytime, hyponasal speech was the most frequently observed finding (74%). In terms of dentistry, oral breathing was the most frequently observed finding (89%). The mean duration of meals was 31.7 +/- 13.8 minutes. Results of oral examination revealed that Hellman's dental age was most frequently IIA. According to the standardized grading classification, grade I was observed in 7%, II in 63%, and grade III in 30% of subjects.

mAbs against tumor-associated carbohydrate antigens have the potential to play a prominent role in cancer immunotherapy. However, it has not been possible to fully exploit the clinical utility of such antibodies primarily, because those of adequate affinity could be derived only from murine sources. To address this problem, we prepared a single-chain Fv (scFv) antibody library from the peripheral blood lymphocytes of 20 patients with various cancer diseases. Completely human high-affinity scFv antibodies were then selected by using synthetic sialyl Lewisx and Lewisx BSA conjugates. These human scFv antibodies were specific for sialyl Lewisx and Lewisx, as demonstrated by ELISA, BIAcore, and flow cytometry binding to the cell surface of pancreatic adenocarcinoma cells. Nucleotide sequencing revealed that at least four unique scFv genes were obtained. The Kd values ranged from 1.1 to 6.2 x 10(-7) M that were comparable to the affinities of mAbs derived from the secondary immune response. These antibodies could be valuable reagents for probing the structure and function of carbohydrate antigens and in the treatment of human tumor diseases.

The gene VII protein (pVII) and gene IX protein (pIX) are associated closely on the surface of filamentous bacteriophage that is opposite of the end harboring the widely exploited pIII protein. We developed a phagemid format wherein antibody heavy- and light-chain variable regions were fused to the amino termini of pVII and pIX, respectively. Significantly, the fusion proteins interacted to form a functional Fv-binding domain on the phage surface. Our approach will be applicable to the display of generic peptide and protein libraries that can form combinatorial heterodimeric arrays. Consequently, it represents a first step toward artificial antibodies and the selection of novel biological activities.

Our aim is to determine non-insulin-dependent diabetes mellitus (NIDDM) incidence in Taiwan and examine its relation to obesity and hyperinsulinaemia in Chinese men and women. A total of 995 men and 1195 women aged 35-74 years free from diabetes in two townships in Taiwan were followed up with a second examination. At baseline general and metabolic data were recorded, and detailed anthropometric parameters and plasma glucose and insulin were assessed. World Health Organisation (WHO) criteria of fasting glucose 7.8 mmol/l or greater was utilized for defining diabetes. The age-standardized incidence rate based on the United States population in 1970 was 9.3/1000 (CI 5.8-12.8) in men and 9.3/1000 (CI 6.2-12.4) in women and the based on the WHO population in 1976 was 8.9/1000 (CI .5-12.3) in men and 8.9/1000 (CI 5.9-11.9) in women for the Chinese who had a mean BMI slightly greater than 24 (kg/m2). The predictability of the plasma glucose level was greater than that of the insulin level and the obesity indices. NIDDM incidence increased approximately threefold with each 0.67 mmol/l increase in plasma glucose level in men and women. The present study demonstrated the essential relationship of not only BMI but also central obesity indices (such as subscapular and waist circumference) to the incidence of NIDDM among men and women and a stronger relationship between NIDDM incidence and obesity in women than in men. The predictive effects of obesity indices and fasting plasma insulin values on NIDDM risk were independent of each other in men. Obesity and hyperinsulinaemia each without the presence of the other can lead to an increased risk of NIDDM. In women the NIDDM incidence increased more than additively in those with both obesity and hyperinsulinaemia compared to those with single obesity or hyperinsulinaemia. A slightly higher incidence of NIDDM in Taiwan than in western countries was found. The importance of obesity is indicated for predicting NIDDM in the community. Hyperinsulinaemia was found to play a significant role in predicting NIDDM incidence independent of obesity in men and synergistically with obesity in women.

The link between recognition and replication is fundamental to the operation of the immune system. In recent years, modeling this process in a format of phage-display combinatorial libraries has afforded a powerful tool for obtaining valuable antibodies. However, the ability to readily select and isolate rare catalysts would expand the scope of library technology. A technique in which phage infection controlled the link between recognition and replication was applied to show that chemistry is a selectable process. An antibody that operated by covalent catalysis to form an acyl intermediate restored phage infectivity and allowed selection from a library in which the catalyst constituted 1 in 10(5) members. Three different selection approaches were examined for their convenience and generality. Incorporating these protocols together with well known affinity labels and mechanism-based inactivators should allow the procurement of a wide range of novel catalytic antibodies.

The present community-based study was performed to provide predictive equations and lower boundaries of normal values for forced expiratory volume in one second (FEVI), forced vital capacity (FVC), and their percent ratio (FEV1%) in non-smoking, healthy adult men and women residing in communities, using ATS-recommended techniques and equipment. Use was made of data collected cross-sectionally from Nov. 1990 to Dec. 1993 in an ongoing longitudinal study on evolution of cardiovascular disease risk factors in Chinese. The spirometric values in our population reached their peak at around age 20. After age 20, a downward age trend was observed for FVC, FEV1, and FEV1%. Linear and negative relations were found in adults for each of the three spirometric values with age. Linear and positive relations were found between height and FVC or FEV1, but not between height and FEV1%. The age trends of FVC and FEV1 in Chinese adults were similar to those in Caucasians. Mean FVC and FEV1 levels of Chinese in Taiwan were systematically lower than those of Caucasians for a given height and a given age. Age and height specific percentile values of FVC and FEV1 and the age-specific percentile value of FEV1% are provided for adult men and women in this community study.

A number of radon-related properties have been surveyed in underground shopping centers in Hong Kong. These parameters include the radon concentration, the total potential alpha energy concentration of radon progeny, the equilibrium factor and the unattached fraction of radon progeny. The mean values recorded for these were 29.2 +/- 7.8 Bq/m3, 3.60 +/- 1.53 mWL, 0.46 +/- 0.16 and 0.05 +/- 0.03, respectively. Based on these figures, we have calculated the average radon dose received by employees in an underground shopping center in Hong Kong to be 0.22 mSv/yr, which represents an approximate increase of 8% over the total dose of about 2.7 mSv/yr received by the average person in Hong Kong.

For the past decade the immune system has been exploited as a rich source of de novo catalysts. Catalytic antibodies have been shown to have chemoselectivity, enantioselectivity, large rate accelerations, and even an ability to reroute chemical reactions. In many instances catalysts have been made for reactions for which there are no known natural or man-made enzymes. Yet, the full power of this combinatorial system can only be exploited if there was a system that allows for the direct selection of a particular function. A method that allows for the direct chemical selection for catalysis from antibody libraries was so devised, whereby the positive aspects of hybridoma technology were preserved and re-formatted in the filamentous phage system to allow direct selection of catalysis. This methodology is based on a purely chemical selection process, making it more general than biologically based selection systems because it is not limited to reaction products that perturb cellular machinery.

For almost 200 years inert antigens have been used for initiating the process of immunization. A procedure is now described in which the antigen used is so highly reactive that a chemical reaction occurs in the antibody combining site during immunization. An organophosphorus diester hapten was used to illustrate this concept coined "reactive immunization." The organophosphonate recruited chemical potential from the immune response that resembled the way these compounds recruit the catalytic power of the serine hydrolases. During this recruitment, a large proportion of the isolated antibodies catalyzed the formation and cleavage of phosphonylated intermediates and subsequent ester hydrolysis. Reactive immunization can augment traditional immunization and enhance the scope of catalytic antibody chemistry. Among the compounds anticipated to be effective are those that contain appropriate reactive functionalities or those that are latently reactive, as in the mechanism-based inhibitors of enzymes.

Semisynthetic combinatorial antibody library methodology in the phage-display format was used to select for a cysteine residue in complementarity-determining regions. Libraries were panned with an alpha-phenethyl pyridyl disulfide that undergoes disulfide interchange. Out of 10 randomly picked clones, two contained an unpaired cysteine, one of which was studied. The antibody catalyzed the hydrolysis of the corresponding thioester where the electrophilic carbonyl occupies the three-dimensional space that was defined by the reactive sulfur atom during selection. The reaction operates by covalent catalysis. Although the steady-state rate enhancement relative to the activated thiol ester substrate is modest, hydrolysis of the acylated cysteine intermediate is remarkably efficient with a catalytic advantage of about four orders of magnitude. The results suggest that iterative mechanism-based selection procedures can recapitulate the enzymatic mechanisms refined through evolution.

Lens crystallins from the African ostrich (Struthio camelus) were isolated and characterized. Four crystallin fractions corresponding to alpha-, delta/beta- and beta-crystallins similar to those of duck crystallins were isolated, but epsilon-crystallin was found to be absent. The native molecular masses and subunit structures of the purified fractions were analysed by gel filtration. SDS/PAGE and isoelectric focusing, revealing various extents of heterogeneity in each orthologous crystallin class. An ion-exchange chromatographic method was used for the large-scale preparation of delta-crystallin suitable for structural and enzymic studies. It was unexpectedly found that the purified native delta-crystallin of ostrich lens possessed high argininosuccinate lyase activity, in contrast with chicken delta-crystallin. The c.d. spectra indicated a predominant beta-sheet structure in alpha- and beta-crystallins, and a significant contribution of alpha-helical structure in the delta-crystallin fraction. The estimate of secondary structures from c.d. spectroscopy for each crystallin class bears a resemblance to that of duck crystallins, except that ostrich delta-crystallin possesses much less helical content than duck delta-crystallin. Comparison of crystallin compositions and structures from aquatic and terrestrial birds revealed distinct differences.

The activity of N-acetyl hexosaminidase (beta-2-acetamido-2-deoxy-D-glucoside:N-acetamido-deoxyglucohydrolase, E.C. 3.2.1.30) was significantly greater in sera of patients with solid malignant tumors than in sera of healthy volunteers or of patients with nonmalignant ailments. The increased activity was found in the two major isozymes, hexosaminidase A and hexosaminidase B, but the increase in the latter isozyme was more prominent than in the former. Measurement of the levels of the hexosaminidase isozymes may provide an ancillary diagnostic test for malignancy.

The major forms of human serum hexosaminidases A and B (Hex A and Hex B) were isolated from normal subjects and cancer patients using DEAE-cellulose. In normal serum, Hex A was heat-labile and had an apparent KM of 1.13 mM and Vmax of 0.51 mumol/ml/h; Hex B was heat-stable and had an apparent KM of 0.85 mM and Vmax of 0.22 mumol/ml/h. Both forms had the same pH optimum, at 4.3. Hex A and Hex B from the sera of cancer patients resembled their normal counterparts in heat stability, pH optimum, and apparent KM (1.07 mM for Hex A, 0.88 mM for Hex B). In contrast, the Vmax values for the cancer sera isozymes were greater than those of normal sera (0.70 and 0.40 mumol/ml/h for Hex A and Hex B, respectively).

Lens crystallins were isolated from the homogenates of reptilian eye lenses derived from three different species by gel-permeation chromatography and characterized by gel electrophoresis, amino-acid analysis, N-terminal sequence analysis and circular dichroism. Four fractions corresponding to alpha-, delta/epsilon/beta-, beta- and gamma-crystallins were obtained for the crystallins from caiman lenses, whereas delta- and gamma-crystallin fraction were present in lesser amounts or missing in the turtle and snake lenses, respectively. The native molecular masses for these purified fractions and their polypeptide compositions were determined by gel filtration and SDS-gel electrophoresis, respectively, revealing the typical subunit compositions for each classified crystallin. The spectra of circular dichroism indicate a predominant beta-sheet structure in alpha-, beta- and gamma-crystallins, and a major contribution of alpha-helical structure in delta/epsilon-crystallin fraction, which bears a resemblance to the secondary structure of delta-crystallin from the chicken lenses. Comparison of the amino-acid contents of each orthologous class of reptilian crystallins with those of evolutionary distant species still exhibited similarity in their amino-acid compositions. N-terminal sequence analysis of the crystallin fractions revealed that all fractions except that of gamma-crystallin are N-terminally blocked. Extensive sequence similarity between the reptilian gamma-crystallin polypeptides and those from other vertebrate species were found, which establish the close relatedness of gamma-crystallins amongst the major classes of vertebrates.

gamma-Crystallins were isolated from the homogenate of frog eye lenses (Rana catesbeiana) by exclusion gel chromatography and further purified by cation-exchange chromatography. They were the only group of crystallins possessing free amino groups amenable to sequence analysis by Edman degradation. Comparison of the amino acid contents of the purified subfractions of gamma-crystallins indicated their close relatedness in amino acid compositions and probably sequence homology as well. The amino-terminal sequence analysis of the purified gamma-crystallin subfractions showed extensive homology between these amphibian gamma-crystallin polypeptides themselves and also those from other vertebrate species, suggesting the existence of a multigene family and their close relatedness to gamma-crystallins of other vertebrates. The sequence comparison of the gamma-crystallin polypeptides from all major classes of vertebrates has provided strong support for the divergent evolution of gamma-crystallin family.

Lens crystallins were isolated from homogenates of reptilian eye lenses (Caiman crocodylus apaporiensis) by gel-permeation chromatography and characterized by gel electrophoresis, and amino acid and N-terminal sequence analyses. Four fractions corresponding to alpha-, delta/epsilon/beta-, beta- and gamma-crystallins were identified on the basis of their electrophoretic patterns as revealed by SDS gel electrophoresis. Comparison of the amino acid contents of reptilian crystallins with those of mammals suggests that each orthologous class of crystallins from the evolutionarily distant species still exhibits similarity in their amino acid compositions and probably sequence homology as well. All fractions except that of gamma-crystallin were found to be N-terminally blocked. N-terminal sequence analysis of the purified gamma-crystallin subfractions showed extensive homology between the reptilian gamma-crystallin polypeptides themselves and also those from other vertebrate species, suggesting the existence of a multigene family and their close relatedness to gamma-crystallins of other vertebrates.

The effects of metiamide, a histamine H2 blocker, on gastric secretion and ulcer formation in stressed pylorus-occluded rats were investigated. Metiamide, like atropine, significantly reduced the volume of gastric secretion and total acid output in unrestrained pylorus-occluded rats. Both drugs produced greater decreases in the volumes of gastric secretion in stressed rats than in their corresponding unrestrained groups. Stress itself reduced both parameters. Metiamide, like atropine, significantly reduced the incidence of gastric stress ulcers. When given together these two drugs did not provide greater protection. The results obtained with metiamide indicate that histamine plays a role in basal gastric secretion and in the pathogenesis of stress ulcers. As no correlation between gastric acid secretion and ulcer formation was demonstrated in this study, it is suggested that H2 receptors may also be involved in gastric motility. However, the possibility that metiamide could exert its ulcer-protecting effects through other mechanisms cannot yet be excluded.