Liver transplantation in Taiwan: the Chang Gung experience

Between March 1984 and February 1991, six orthotopic liver transplantations were performed at the Chang Gung Memorial Hospital in Taiwan. The indications for transplantation were Wilson's disease (5 patients) and biliary atresia (1 patient). Donors and recipients were matched only for size and ABO blood group compatibility, and the recipient operations were performed without the use of a venovenous bypass. Arterial reconstruction was carried out by end-to-end hepatic artery anastomosis (4), thoracic aortic conduit (1), or interposition of an iliac artery graft (1), whereas biliary reconstruction was accomplished by a choledochocholedochostomy using a T-tube stent (4) or a choledochocholedochostomy using an external cholecystostomy without stenting (2). Biliary complications occurred in three patients, and all required additional surgery. The average duration of donor-liver cold ischemia, operating time, and blood loss during surgery were 7 h and 50 min (range, 4.5–9 h), 13.5 h (range, 11.8–17h), and 4,385 ml (range, 750–12,000 ml) respectively. The immunosuppressive regimens included a cyclosporinsteroid combination (n=2) and a triple-drug combination (n=4). All except one of the surviving patients experienced at least one rejection episode that was reversed by a methyl-prednisolone bolus and/or recycle. One patient developed a primary cytomegalovirus (CMV) infection that responded well to Ganciclovir treatment. Two of the patients died, one of injuries sustained in a traffic accident 3 years after transplantation, and the other of massive upper gastrointestinal bleeding. The overall survival value at 3 months was 83%, and the follow-up period ranged from 3 months to 7 years. All of the survivors have achieved complete rehabilitation and currently enjoy an excellent quality of life with normal liver function. Althought the present study involved a small number of cases, our results indicate that liver transplantation can be successfully achieved in a high proportion of patients with acceptable morbidity, mortality, and cost in an Asian setting. The extreme shortage of donor organs is currently the most important obstacle limiting the application of liver transplantation in Taiwan.Presented at The Second International Symposium on Treatment of Liver Cancer. Taipei, 3–4 February 1991     

带血管蒂岛状筋膜瓣移植治疗晚期类风湿性髋关节炎

目的：阐明带血管蒂岛状筋膜瓣移植治疗晚期类风湿性髋关节炎的疗效。材料和方法：对４２例４８髋晚期类风湿性髋关节炎病人采用以旋股外侧血管降支为蒂的股前外侧筋膜瓣移植行患髋成形术。结果：术后随访４～１０．５年，平均４．５年，髋关节活动范围术前平均１６．５°，术后２２８．６°，按照Ｃｈａｒｎｌｅｙ和吴之康人工髋关节置换术后的疗效评定标准，优良２９髋、很好１３髋、好６髋，尚可、差、很差无。结论：患者年龄在１５～４０岁之间为合适的治疗年龄。与人工髋关节置换术相比，本方法对髋关节正常结构破坏小；一旦手术失败仍可选用其它治疗方法弥补；且并发症少、费用低、远期效果好。     

Characterization of prorenin activation using a synthetic peptide substrate.

Human renin is synthesized as an inactive zymogen (prorenin) which is processed to the active form. We synthesized an 11-amino acid peptide which spans the human prorenin processing site in order to develop a simple assay to study human prorenin activation. Six enzymes which are capable of activating recombinant prorenin in vitro were studied. Four of these enzymes digested the synthetic peptide in a specific fashion, as analyzed by reverse-phase high-performance liquid chromatography. Amino acid analysis of the purified digestion products revealed that trypsin cleaves between Arg-Leu, the authentic processing site, while kallikrein, plasmin and elastase all cleaved at alternate sites. On the other hand, pepsin and cathepsin D did not cleave this substrate, suggesting that the activation of prorenin by these proteases might occur at a site distinct from the authentic processing site. Our data suggest that this synthetic peptide may be used as a simple and specific assay for prorenin activation.     

Studies on the relationship between transaldolase activity and testosterone synthesis in Leydig cells of pubertalmice

Objective: To study the relationship between transaldolase activity, protein expression and testosterone synthesis in Leydig cells of pubertal mice. Methods: Leydig cells were cultured for 2 hours and 8 hours, to the Stimulation Group, hCG was added and to the Controls, only the vehicle. The testosterone concentration was then determined by enzyme-linked immunoadsordent assay (ELISA) and the transaldolase activity and protein expression by Western blot. Results: (1) Both the testosterone concentration and the transaldolase activity in both Stimulation Groups were significantly higher than those in the corresponding Controls (2 h: p<0.05-0.01; 8 h: P<0.001); (2) The ratios of the A isoform, the B isoform and the total transaldolase protein to β-actin between the Stimulation and Control Groups did not differ signifi-cantly. Conclusion: hCG stimulates the transaldolase activity as well as the testosterone synthesis in the Leydig cells of pubertal mice, indicating a positive relationship between them.     

Tongqiao Huoxue Tang and Buyang Huanwu Tang for Treatment of Vascular Dementia -A report of 36 Cases

To study the effects of Tongqiao Huoxue Tang (通窍活血汤) and Buyang Huanwu Tang (补阳还五汤) onvascular dementia (VaD), 36 VaD patients in thetreatment group were treated with the two decoctions,which were compared with 28 cases in a controlgroup treated with Duxil.     

土地供给市场化是实现土地资源向土地资本转变的关键

由于传统计划经济形成的政府替代市场的土地审批定价模式存在，我国土地供给的市场机制并没有真正建立，市场在国家宏观调控下对土地资源配置起基础性作用的问题并没有解决，由此已经产生很大的诸如国有资产流失等经济外部性问题。目前改革的重点、难点应集中在审批定价和招标拍卖并存的双轨制方面。当前，为促进土地资源向土地资本转变，政府土地管理体制的改革首当其冲。要以土地供给市场化为核心来设计改革的突破口。     

Genome-wide scan identified QTLs underlying femoral neck cross-sectional geometry that are novel studied risk factors of osteoporosis.

A genome-wide screen was conducted using a large white sample to identify QTLs for FNCS geometry. We found significant linkage of FNCS parameters to 20q12 and Xq25, plus significant epistatic interactions and sex-specific QTLs influencing FNCS geometry variation. INTRODUCTION: Bone geometry, a highly heritable trait, is a critical component of bone strength that significantly determines osteoporotic fracture risk. Specifically, femoral neck cross-sectional (FNCS) geometry is significantly associated with hip fracture risk as well as genetic factors. However, genetic research in this respect is still in its infancy. MATERIALS AND METHODS: To identify the underlying genomic regions influencing FNCS variables, we performed a remarkably large-scale whole genome linkage scan involving 3998 individuals from 434 pedigrees for four FNCS geometry parameters, namely buckling ratio (BR), cross-sectional area (CSA), cortical thickness (CT), and section modulus (Z). The major statistical approach adopted is the variance component method implemented in SOLAR. RESULTS: Significant linkage evidence (threshold LOD = 3.72 after correction for tests of multiple phenotypes) was found in the regions of 20q12 and Xq25 for CT (LOD = 4.28 and 3.90, respectively). We also identified eight suggestive linkage signals (threshold LOD = 2.31 after correction for multiple tests) for the respective geometry traits. The above findings were supported by principal component linkage analysis. Of them, 20q12 was of particular interest because it was linked to multiple FNCS geometry traits and significantly interacted with five other genomic loci to influence CSA variation. The effects of 20q12 on FNCS geometry were present in both male and female subgroups. Subgroup analysis also revealed the presence of sex-specific quantitative trait loci (QTLs) for FNCS traits in the regions such as 2p14, 3q26, 7q21 and 15q21. CONCLUSIONS: Our findings laid a foundation for further replication and fine-mapping studies as well as for positional and functional candidate gene studies, aiming at eventually finding the causal genetic variants and hidden mechanisms concerning FNCS geometry variation and the associated hip fractures.     

Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese

Objectives  

To investigate clinical effects and manual operational point of Bryan cervical disc prosthesis in Chinese, to observe the stability and range of movement (ROM) post-operatively.