No abstract

A multicenter collaborative study was performed to investigate the prevalence of abnormal blood contents of 6 trace metals, copper (Cu), zinc (Zn), aluminum (Al), lead (Pb), cadmium (Cd), and mercury (Hg), in hemodialysis (HD) patients and to analyze their relationship with the medications, such as CaCO3, Ca acetate, Al containing phosphate-binding agents, 1,25-dihydroxy vitD3, 1-hydroxy vitD3, and erythropoietin (EPO), as well as hematocrit level, by chi-square statistics. From 6 medical centers in Taiwan, we included 456 patients in maintenance HD for more than 4 months for this study, and they had continued the previously mentioned medications for at least 3 months. Blood samples were collected before initiating HD, and atomic absorption spectrophotometry was used to measure plasma levels of Cu, Zn, and Al as well as whole blood levels of Pb, Cd, and Hg. Three hundred seventy-five (78%) of the HD patients had low plasma Zn levels, that is, <800 microg/L, and the mean (+/-SD) concentration was 705.8 (+/-128.23) microg/L in all subjects. One hundred forty-one (31%) of the HD patients had high plasma Al, that is, >50 microg/L, and the mean (+/-SD) was 44.30 (+/-28.28) microg/L in all subjects. Three hundred thirty-three (73%) of the dialysis patients had high Cd levels, that is, >2.5 microg/L, and the mean (+/-SD) was 3.32 (+/-1.49) microg/L in all subjects. The majority of HD patients had normal blood levels of Cu, PB, and Hg. Only 21 (4. 6%), 5 (1.1%), and 3 (0.06%) patients had elevated blood levels of Cu, Pb, and Hg, respectively. Their mean (+/-SD) blood concentration of Cu, Pb, and Hg were 1,049.78 (+/-233.25) microg/L, 7.45 (+/-3.95) microg/dL, and 3.17 (+/-25.56) microg/L, respectively. Three patients had elevated plasma Hg concentrations, that is, 546, 12.6, and 24.0 microg/L, respectively. In the 152 normal healthy age and sex matched control group, the blood levels of Al, Cd, and Pb were all significantly lower than the HD patients. However, the levels of Cu and Zn were higher in the control group. The Hg level was not significantly different in both groups. There was no statistical difference between patients with normal and abnormal blood levels of trace metals in various medications except Al containing phosphate binder. The Al containing phosphate binder users had significantly higher plasma Al levels (54.71 +/- 26.70 versus 41.15 +/- 28.03 microg/L, p < 0.001) and hematocrit levels (29.61 +/- 4.61 versus 27. 81 +/- 3.91, p < 0.0005). There was no statistical correlation between erythropoietin (EPO) dose and hematocrit level in these patients. In conclusion, the blood level of trace metals of these HD patients except Al was not related to their medications. However, caution must be exercised in interpreting this result as dose and duration of medication; efficiency of HD and water treatment may play an important role. Otherwise, environmental factors, diet, and the aging process may contribute to the trace metal burden in uremia. Thus, Zn and Cu are abundant in seafood, and Cd is abundant in contam...

Protoapigenone, isolated from the native fern plant Thelypteris torresiana, has anticancer activity against some cancer cells. However, the toxicological mechanism for protoapigenone is still unknown. Here, we investigated the anticancer effect of protoapigenone on human lung cancer cell lines. The comet assay showed that DNA damage induced by protoapigenone is dose-dependent. Trypan blue exclusion showed that the cell killing by protoapigenone is both time and dose dependent. The IC(50) of protoapigenone for 12, 24, and 48 h in H1299 cells is 6.11, 2.74, and 1.49 microM, respectively. Flow cytometry showed cell cycle perturbation such as sub-G(1) accumulation (at 1.57 microM for 48 h and at 3.57 microM for 12 and 24 h) and G(2)/M arrest (at 3.57 microM for 12 and 24 h) for protoapigenone. The sub-G(1) accumulation phenomena in the 3.57 microM for 24 h sample were shown to be apoptosis using Annexin V-immunofluorescence/propidium iodide staining. These results suggest protoapigenone is a potential chemotherapeutic agent for lung cancers.

The prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and their associations in 64 continuous ambulatory peritoneal dialysis (CAPD) patients (30 males and 34 females) were evaluated. A comparison was also made with 526 normal controls (266 males and 260 females). Forty-seven (75%) CAPD patients were anti-HBc positive, with no significant difference to the control group (81.9%). This probably reflects acquisition of HBV infection by CAPD patients before initiation of chronic dialysis therapy in a region hyperendemic for HBV. On the contrary, 11 (17.2%) CAPD patients were anti-HCV positive and 8 (15.2%) were seropositive for both anti-HBc and anti-HCV – much greater prevalence rates compared to those of the control group. The prevalence of anti-HCV correlated with the history and numbers of blood transfusion, and the length of time on previous hemodialysis. A similar correlation occurred in patients with both anti-HBc(+) and anti-HCV(+). In conclusion, in an HBV endemic area such as Taiwan, the prevalence of coexisting HBV and HCV infection in CAPD patients depends on the latter.

The study was designed to determine whether hemodialysis patients in Taiwan had a different antibody response to common virus infections compared to the normal population. Serum samples from 18 hemodialysis patients and 21 healthy volunteers were obtained every 3 months for 2 years. Geometric mean titers (GMTs) of immunoglobulin G (IgG) antibodies to cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), as well as Type A and Type B influenza viruses (Inf. A, Inf. B) were compared between the patient and the control groups. The prevalence rates and the rates of recurrent infection were similar in both groups. However, the patient group had a higher percentage of persons having persistent EBV and CMV infections (p < 0.05) and also higher GMTs of antibodies nearly the whole year round, especially significant in September and December (p < 0.05). In patients with hepatitis C, their GMTs of EBV, VZV, Inf. A, and Inf. B were higher than those without (p < 0.05).