Lack of Association Between Total Serum Homocysteine and Extracranial Cerebral Flow

Background/PurposeHigh homocysteine (Hcy) concentration is associated with slow coronary flow. This study examined the association between Hcy and hemodynamic status in the extracranial cerebral arteries in healthy individuals.MethodsA total of 535 healthy adults underwent physical examination and duplex ultrasonography of the extracranial carotid and vertebral arteries, and blood laboratory tests, including biochemistry and serum total Hcy. Flow hemodynamic parameters including velocity, resistance, and volume of the carotid and vertebral arteries were measured. Multiple regression analysis was performed to examine the association between Hcy and the flow parameters.ResultsParticipants with higher Hcy were more likely to have a lower systolic velocity of the internal carotid artery (p = 0.01) and vertebral artery (p < 0.001), and lower resistance of the vertebral artery (p = 0.004). However, the multiple-adjusted means of the flow velocity, resistance, and flow volume of the carotid or vertebral artery were not significantly different across quartiles of Hcy. When Hcy was treated as a continuous variable, there was still no significant relationship between Hcy levels and the aforementioned hemodynamic status.ConclusionOur results did not support the hypothesis that the levels of Hcy are associated with the flow velocity, resistance, and volume of the extracranial cerebral artery in healthy individuals

Investigation into the Detection and Antibiotic Treatments for Chlamydiosis in Koalas

The koala was listed as an endangered species due to a profound reduction of koalas in QLD and NSW, with chlamydial infections as the most observed bacterial disease across Australia. Clinical signs include conjunctivitis, urogenital/urinary tract inflammation causing infertility, and progresses to death if untreated. The thesis aimed to address the existing knowledge gaps and suggested future directions for managing chlamydial infections in this endangered marsupial. The doxycycline dosage administered to diseased koalas at 5 mg/kg was evaluated with the PK/PD study using a two-compartmental analysis. PTA modelling and the AUC/MIC target of ≥24 were also investigated. The retrospective study evaluated the treatment efficacy of antibiotics and the clinical outcome of hospitalised koalas. Female koalas exhibited lower odds of survival in comparison to males. Koalas given chloramphenicol treatment for ≥28d had increased odds of survival compared to those treated for <28d. Koalas administered doxycycline had higher odds of testing PCR negative compared to those treated with chloramphenicol. Female koalas had elevated odds of manifesting UGT signs and also increased odds of presenting both ocular and UGT signs compared to males. Notably, 28.5% of the koalas displayed no clinical signs but tested PCR positive. The suitability of TRP, KYN, and KYN:TRP as potential biomarkers for chlamydial infections in the koala was studied. Plasma concentrations of TRP, KYN, and KYN:TRP were quantified in 35 clinically normal koalas, 35 with chlamydial infection and 10 with co-morbidities other than chlamydiosis. Reference ranges and optimal cut-off points were also proposed. Potential biomarkers, especially TRP, may not be specific for detecting C. pecorum, but KYN and KYN:TRP may have a role in identifying unhealthy koalas, irrespective of the underlying cause. This opened future research direction into the potential prognostic markers of detecting C. pecorum in the koala

THE BIOMECHANICAL ANALYSIS OF THE TAEKWONDO FRONT-LEG AXE-KICK

The purpose of the study was to analyze the biomechanics of taekwondo front-leg axekick. One force plates, two synchronized high-speed cameras were used to measure biomechanical parameters in each phase of the front-leg axe-kick. The results included: 1. The average reaction time and movement time were 0.423 sand 0.327 s, which respectively occupied about 56% and 44% of attack time. 2. The maximum velocity of hip, knee and ankle were 1.74 m/s, 5.25 m/s and 7.43 m/s respectively. When the kicking leg touched the target, the velocity of knee and ankle were 0.78m/s, 1.72m1s, and 4.64m1s respectively. 3. The peak vertical GRF and impulse were 0.96 SW and 77.57N-s. For decreasing the movement time, it's suggested that an athlete should increase the power and flexibility of lower extremities during the training section

Increased Risk for Invasive Breast Cancer Associated with Hormonal Therapy: A Nation-Wide Random Sample of 65,723 Women Followed from 1997 to 2008

BACKGROUND: Hormonal therapy (HT) either estrogen alone (E-alone) or estrogen plus progesterone (E+P) appears to increase the risk for breast cancer in Western countries. However, limited information is available on the association between HT and breast cancer in Asian women characterized mainly by dietary phytoestrogens intake and low prevalence of contraceptive pills prescription. METHODOLOGY: A total of 65,723 women (20-79 years of age) without cancer or the use of Chinese herbal products were recruited from a nation-wide one-million representative sample of the National Health Insurance of Taiwan and followed from 1997 to 2008. Seven hundred and eighty incidents of invasive breast cancer were diagnosed. Using a reference group that comprised 40,052 women who had never received a hormone prescription, Cox proportional hazard models were constructed to determine the hazard ratios for receiving different types of HT and the occurrence of breast cancer. CONCLUSIONS: 5,156 (20%) women ever used E+P, 2,798 (10.8%) ever used E-alone, and 17,717 (69%) ever used other preparation types. The Cox model revealed adjusted hazard ratios (HRs) of 2.05 (95% CI 1.37-3.07) for current users of E-alone and 8.65 (95% CI 5.45-13.70) for current users of E+P. Using women who had ceased to take hormonal medication for 6 years or more as the reference group, the adjusted HRs were significantly elevated and greater than current users and women who had discontinued hormonal medication for less than 6 years. Current users of either E-alone or E+P have an increased risk for invasive breast cancer in Taiwan, and precautions should be taken when such agents are prescribed

One-stage reconstruction of large lower lip defect and oral competence with free composite anterolateral thigh-tensor fasciae latae flap

SummaryReconstruction for a large lower lip defect is a challenge to reconstructive surgeons. The most challenging problem is to maintain oral competence and prevent sialorrhea. We present three cases of such a defect reconstructed with composite anterolateral thigh-tensor fascia lata free flaps in one stage. The patients reported in this communication had advanced squamous cell carcinoma in the lower lip. A large lower lip defect (>90%) resulted in each case from wide excision of the tumor. A composite anterolateral thigh-tensor fasciae latae free flap was used to reconstruct the defect and to restore the dynamic oral competence in one stage. A tensor fasciae latae sling was attached by two strips sutured together to the upper orbicularis oris muscle in the first case. The four-strip method, a modification of the method described by Serkan,1 was adopted in the second case. The upper two strips bilaterally sutured to the orbicularis oris muscles in a mode somewhat different from Serkan’s method. The tensor fasciae latae sling was attached by two strips sutured to the periosteum of both zygomatic eminences in the third case. The tensor fasciae latae sling of Case 1 failed with persistent sialorrhea. The second case had good oral competence and comprehensible speech ability without sialorrhea. The third case had an acceptable result before he was lost to follow-up. A composite anterolateral thigh-tensor fasciae latae free flap is a good choice for a large lower lip defect to achieve oral competence reconstruction in one stage. Simultaneous dynamic and static suspensions are suggested to maintain oral competence and prevent sialorrhea