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OBJECTIVES:Depression has been associated with numerous adverse health conditions. This study sought to determine the frequency of significant depressive symptoms and whether or not acculturative stress, discrimination, and reproductive health conditions were risk factors for significant depressive symptoms in migrant working women in China. STUDY DESIGN:The design of this study is cross-sectional. METHODS:Data were derived from a survey of female migrant workers at three employment sites in Changsha, China. The associations between acculturative stress, discrimination, reproductive health, and risk for significant depressive symptoms were obtained using F-tests for mean differences, correlations, ordinary least squares regression, and logistic regression analysis. RESULTS:Between March and June 2017, 232 eligible female participants completed the survey among whom the median age was 34.36 years (standard error 0.43) and 25.58% reported significant depressive symptoms. Significant depressive symptoms were associated with higher education (F-test, P=.006), all four acculturative stress factors (r=0.15 to r=0.29), both institutional and interpersonal discrimination (r=0.29, r=0.35), age (r=- 0.13), and self-rated health (r=- 0.19). In multivariate regression analysis of depression scale scores, interpersonal discrimination was the strongest predictor (beta=0.238, P=.002) among the nine factors identified in bivariate analysis. None of the other predictors (age, self-rated health, education, acculturative stress, and institutional discrimination) showed significant associations with the depression scale. Similar results were obtained for a multivariate logistic regression analysis of a clinically important threshold for depression (

1%的小肠机械性肠梗阻是由腹内疝引起的。若子宫阔韧带存在缺口，盆腔内脏器可经其疝出，称为经子宫阔韧带疝，占全部腹内疝的4%~5%。多为回肠疝入（约占90%），少见结肠、卵巢、输尿管疝入。经子宫阔韧带疝致肠梗阻是一种罕见的疾病。为提高临床对本疾病的认识，笔者结合自己对病例的诊治体验，并分析文献，现报告如下。.

OBJECTIVE: To determine the associations between the family history of rheumatic diseases and clinical features in patients with rheumatoid arthritis (RA). METHODS: In total, eight hundred and ninety patients with RA were enrolled. The demographic and clinical data were collected, including gender, age, height, body weight, age of disease onset, history of smoking and drinking, family history of rheumatic diseases, clinical and laboratory features, pain and global visual analogue scale (VAS), and multi-dimensional health assessment questionnaire (MDHAQ). Finally, 803 patients were completed the dataset and were included in the study. RESULTS: In this cohort, the male/female ratio was 1 ∶3.5, and the age of onset was (45.09±14.50) years. A total of 123 (15.32%) patients were accompanied with family history of rheumatic diseases, including RA, spondyloarthritis, Sjögren’s syndrome, systemic lupus erythematosus and systemic sclerosis. The percentages of first degree, second degree and both first and second degree relatives were 91 (73.98%), 22 (17.89%), and 10(8.13%) respectively. The most common disease was RA (70.73%), followed by other rheumatic diseases (21.95%), and RA combined with other rheumatic diseases (7.32%). The clinical and laboratory characteristics were compared between the patients with and without family history. The onset-age of the subjects was significantly different between those with and without family history of rheumatic diseases (39.97 ±13.68 vs. 46.01±14.46; P

To investigate the expression levels of T follicular helper (Tfh) with different subsets in patients with rheumatoid arthritis (RA) and their serum interleukin-6 (IL-6), interleukin-17 (IL-17), transforming growth factor-β (TGF-β) and matrix metalloproteinase 3 (MMP-3) contents.The medical records of 45 RA patients in the Department of Rheumatology and Immunology in the First Affiliated Hospital of Chengdu Medical College from January 2016 to April 2018 were retrospectively analyzed. They were divided into the RA high activity group (24 cases, group A) (DAS28 score ≥ 5.0) and RA low activity group (21 cases, group B) (3.2DAS28 score5.0). At the same time, 20 healthy subjects were selected as a control group. Flow cytometry was used to detect the expression levels of Tfh1, Tfh2 and Tfh17, enzyme-linked immunosorbent assay to detect serum IL-6, IL-17, IL-21 and MMP-3 concentrations. The correlation of Tfh cells with IL-6, IL-17, IL-21 and MMP-3 was analyzed.Those of peripheral blood mononuclear cell (PBMC) Tfh2 and Tfh17 cells were significantly higher in group A than those in group B (p0.05). Compared with the control group, the concentrations of serum IL-6, IL-17 and MMP-3 significantly increased (p0.001), but that of serum TGF-β markedly decreased in group A and group B (p0.01). The concentrations of serum IL-6, IL-17 and MMP-3 were remarkably higher in group A than those in group B (p0.001), but that of serum TGF-β was significantly lower in group A than that in group B (p0.001). The expression level of PBMC Tfh2 cells, PBMC Tfh17 cells was positively correlated with serum IL-6, IL-17 and MMP-3. The expression levels of Tfh2 and Tfh17 cells are positively correlated with serum IL-6, IL-17 and MMP-3 concentrations, negatively correlated with serum TGF-β concentration.Tfh2 and Tfh17 are expected to be new targets for immunotherapy in RA patients.

Telomeres are repetitive DNA sequences at linear chromosome termini, protecting chromosomes against end-to-end fusion and damage, providing chromosomal stability. Telomeres shorten with mitotic cellular division, but are maintained in cells with high proliferative capacity by telomerase. Loss-of-function mutations in telomere-maintenance genes are genetic risk factors for cirrhosis development in humans and murine models. Telomerase deficiency provokes accelerated telomere shortening and dysfunction, facilitating genomic instability and oncogenesis. Here we examined whether telomerase mutations and telomere shortening were associated with hepatocellular carcinoma (HCC) secondary to cirrhosis. Telomere length of peripheral blood leukocytes was measured by Southern blot and qPCR in 120 patients with HCC associated with cirrhosis and 261 healthy subjects. HCC patients were screened for telomerase gene variants (in TERT and TERC) by Sanger sequencing. Age-adjusted telomere length was comparable between HCC patients and healthy subjects by both Southern blot and qPCR. Four non-synonymous TERT heterozygous variants were identified in four unrelated patients, resulting in a significantly higher mutation carrier frequency (3.3%) in patients as compared to controls (p = 0.02). Three of the four variants (T726M, A1062T, and V1090M) were previously observed in patients with other telomere diseases (severe aplastic anemia, acute myeloid leukemia, and cirrhosis). A novel TERT variant, A243V, was identified in a 65-year-old male with advanced HCC and cirrhosis secondary to chronic hepatitis C virus (HCV) and alcohol ingestion, but direct assay measurements in vitro did not detect modulation of telomerase enzymatic activity or processivity. In summary, constitutional variants resulting in amino acid changes in the telomerase reverse transcriptase were found in a small proportion of patients with cirrhosis-associated HCC.

In this study, we investigated thermotolerance, several physiological responses and damage to reproductive cells in chlorpyrifos-resistant (Rc) and -susceptible (Sm) strains of the diamondback moth,Plutella xylostellasubjected to heat stress. The chlorpyrifos resistance of these strains was mediated by a modified acetylcholinesterase encoded by an allele,ace1R, of theace1gene. Adults of the Rc strain were less heat resistant than those of the Sm strain; they also had lower levels of enzymatic activity against oxidative damage, higher reactive oxygen species contents, weaker upregulation of two heat shock protein (hsp) genes (hsp69s andhsp20), and stronger upregulation of two apoptotic genes (caspase-7 and -9). The damage to sperm and ovary cells was greater in Rc adults than in Sm adults and was temperature sensitive. The lower fitness of the resistant strain, compared with the susceptible strain, is probably due to higher levels of oxidative stress and apoptosis, which also have deleterious effects on several life history traits. The greater injury observed in conditions of heat stress may be due to both the stronger upregulation of caspase genes and weaker upregulation ofhspgenes in resistant than in susceptible individuals.

The brain exhibits limited capacity for spontaneous restoration of lost motor functions after stroke. Rehabilitation is the prevailing clinical approach to augment functional recovery, but the scientific basis is poorly understood. Here, we show nearly full recovery of skilled forelimb functions in rats with large strokes when a growth-promoting immunotherapy against a neurite growth-inhibitory protein was applied to boost the sprouting of new fibers, before stabilizing the newly formed circuits by intensive training. In contrast, early high-intensity training during the growth phase destroyed the effect and led to aberrant fiber patterns. Pharmacogenetic experiments identified a subset of corticospinal fibers originating in the intact half of the forebrain, side-switching in the spinal cord to newly innervate the impaired limb and restore skilled motor function.

Summary This study aimed to evaluate the influence of supplemental dietary nicotinic acid (NA) on lipid metabolism and hepatic expression of related genes in female chickens of two distinct broiler strains [Arbor Acres (AA) and Beijing-You (BJY)]. The treatments were arranged in a 2 × 4 factorial in a completely randomized design. Day-old females (n = 384) were allocated to four treatments with six cages per treatment and fed diets (basal contained approximately 25 mg NA/kg) supplemented with 0, 30, 60 and 120 mg NA/kg. A sample of 72 birds from each breed was slaughtered and sampled at their different market times (8 week for AA and 16 week for BJY). Arbor Acres broilers had thickness of subcutaneous fat plus the skin (SFS), and plasma concentration of low-density lipoprotein cholesterol (LDLC) and lower percentage of abdominal fat (PAF), plasma concentrations of TG, NEFA and adiponectin than the BJY line. The hepatic transcription of apolipoprotein A-I (ApoA-I), apolipoproteinB (ApoB), and adiponectin was significantly higher in AA broilers than in BJY broilers. In both breeds, BW, PAF, SFS, NEFA and TG were increased with increasing supplementation from 0 to 60 mg NA/kg, but then decreased slightly with 120 mg added NA/kg. With increasing supplementation, hepatic expression and plasma concentrations of adiponectin decreased from 0 to 60 mg added NA/kg and then increased with 120 mg added NA/kg. The expression of ApoA-I and ApoB mRNA showed linear response to dietary supplementation with NA. These findings indicate that: (i) supplementation of NA influenced the lipid metabolism and related gene expression; (ii) when supplemented with 120 mg NA/kg, some pharmacologic actions on lipid metabolism appeared; and (iii) changes in BW and fat deposition appeared to be associated with hepatic expression of adiponectin.

Hoyeraal Hreidarsson syndrome (HHS) is a form of dyskeratosis congenita (DC) characterized by bone marrow failure, intrauterine growth retardation, developmental delay, microcephaly, cerebellar hypoplasia, immunodeficiency, and extremely short telomeres. As with DC, mutations in genes encoding factors required for telomere maintenance, such as telomerase reverse transcriptase (TERT), have been found in patients with HHS. We describe 2 sibling HHS cases caused by a homozygous mutation (p.T567M) within the TERT T motif. This mutation resulted in a marked reduction in the capacity of telomerase to processively synthesize telomeric repeats, indicating a role for the T motif in this unique aspect of telomerase function. We support this finding by demonstrating defective processivity in the previously reported p.K570N T-motif mutation. The consanguineous, heterozygous p.T567M parents exhibited telomere lengths around the first percentile and no evidence of a DC phenotype. Although heterozygous processivity defects have been associated with familial, adult-onset pulmonary fibrosis, these cases demonstrate the severe clinical and functional impact of biallelic processivity mutations. Thus, despite retaining the capacity to add short stretches of telomeric repeats onto the shortest telomeres, sole expression of telomerase processivity mutants can lead to a profound failure of telomere maintenance and early-onset multisystem disease.

Smith-Magenis syndrome (SMS) is a rare syndrome with multiple congenital malformations, including development and mental retardation, behavioral problems and a distinct facial appearance. SMS is caused by haploinsufficiency of RAI1 (deletion or mutation of RAI1). We describe an eight-year-old female Chinese patient with multiple malformations, congenital heart defect, mental retardation, and behavioral problems (self hugging, sleeping disturbance). High-resolution genome wide single nucleotide polymorphism array revealed a 3.7-Mb deletion in chromosome region 17p11.2. This chromosome region contains RAI1, a critical gene involved in SMS. To the best of our knowledge, this is the first report of an SMS patient in mainland China.

Mutations in the essential telomerase components hTERT and hTR cause dyskeratosis congenita, a bone marrow failure syndrome characterized by mucocutaneous features. Some (∼ 3%) sporadic aplastic anemia (AA) and idiopathic pulmonary fibrosis cases also carry mutations in hTERT and hTR. Even though it can affect clinical outcome, because the mutation frequency is rare, genetic testing is not standard. We examined whether the cooccurrence of bone marrow failure and pulmonary fibrosis in the same individual or family enriches for the presence of a telomerase mutation. Ten consecutive individuals with a total of 36 family members who fulfilled these criteria carried a germline mutant telomerase gene (100%). The mean age of onset for individuals with AA was significantly younger than that for those with pulmonary fibrosis (14 vs 51; P < .0001). Families displayed autosomal dominant inheritance and there was an evolving pattern of genetic anticipation, with the older generation primarily affected by pulmonary fibrosis and successive generations by bone marrow failure. The cooccurrence of AA and pulmonary fibrosis in a single patient or family is highly predictive for the presence of a germline telomerase defect. This diagnosis affects the choice of bone marrow transplantation preparative regimen and can prevent morbidity.

Aims: This study was designed to evaluate the extent of vancomycin removal from the blood compartment during sustained low-efficiency dialysis (SLED) and the efficacy of our current vancomycin dosing practice. Material: 10 ICU patients were selected. They all had oliguric renal failure requiring SLED and were on vancomycin therapy. SLED was provided with the Fresenius 2000K machine and used an AV400 polysulfone dialyzer (sieving coefficient for vitamin B 12 = 1, and surface area = 0.7 m 2 ). Method: SLED prescriptions were individualized for each patient but the duration for all was at least 8 hours. The blood flow rate (Qb) and dialysate flow rate (Qd) did not vary between patients by greater than 100 cc per minute. Blood samples were drawn at 0, 2, 4, and 8 hours to determine the extent of reduction in vancomycin level. Results: The total reduction of vancomycin was about 36% with an 8-hour treatment, when following a typical SLED prescription. Serum vancomycin levels dropped below the therapeutic window (< 15 mcg/ml) at the end of an 8-hour SLED session in almost half of the patients. Drug removal was greatest during the first 4 hours (29.5 ± 6.5%) compared to the last 4 hours (9.1 ± 7.4%) of SLED. Conclusions: Vancomycin removal during a typical 8-hour SLED treatment approaches 36%. SLED patients are at risk for undertreatment of their infections. A redosing strategy should be considered if the estimated or measured predialysis level is 20 - 30 mcg/ml. Vancomycin should be redosed with at least 500 mg in most patients at the completion of the SLED. Therapeutic drug monitoring (TDM) is an essential part of any dosing scheme, until further studies are done.

The objective of this study was to investigate the contributions of mental health status and attitudes towards suicide on suicidal ideation in a sample of 6568 Chinese children and adolescents in China. Attitudes towards suicide were investigated as a possible moderator and mediator of the influence of mental health status on suicidal ideation.Descriptive statistical analyses, Pearson correlation analyses and hierarchical regression analyses were adopted as methods of data analyses.Approximately 35.38% of children and adolescents in our study reported having suicidal ideation. Mental health status and attitudes towards suicide both had an independent effect on the severity of suicidal ideation. Results indicated that mental health status was positively associated with suicidal ideation, while attitudes towards suicide were negatively associated with suicidal ideation. Moderation analysis showed that the impact of mental health status on suicidal ideation was significantly greater among children and adolescents who reported favourable attitudes towards suicide. Attitudes towards suicide partially mediated the link between mental health status and the severity of suicidal ideation. Specifically, students who experienced poorer mental health status might be more likely to report significantly more favourable attitudes towards suicide, which in turn promote greater suicidal ideation.These results have implications for the prevention of youth suicide, suggesting that mental health status and attitudes towards suicide could be important targets for prevention and intervention for children and adolescents at risk of suicidal ideation.

The study attempted to evaluate the value of ultrasonography in determining the therapeutic strategy for patients with osseous injuries caused by ankle sprains.A 10-MHz compact linear-array ultrasound transducer was used to assess patients with inversion ankle sprains. Eleven female and 12 male patients who had fractures detected by sonograms were included in the study. All 23 patients underwent radiographic examination for identification of fractures. Bone scintigraphy was performed for those who had negative x-ray findings.Eighteen patients had distal fibular tip fractures, three patients had the fifth metatarsal base fractures, one patient had a talar neck fracture, and one patient had a navicular fracture. These fractures were all detected by ultrasonography and then proved even by radiography or by bone scans. All the 23 patients had anterior talofibular ligament injuries. Among these patients, 11 had anterior ankle-joint recess effusion, and two had additional anterioinferior tibiofibular ligament injuries. Six weeks of immobilization with the ankle fracture brace was prescribed for all the patients after the identification of fractures. Their ankle pain symptoms soon improved.Ultrasonography is valuable in evaluating tiny foot and ankle fractures and coexistent soft tissue injuries. It can guide the treatment for patients with osseous injuries caused by ankle sprains.

To investigate the treatment effectiveness between ultrasound-guided and blind injection techniques in the treatment of subacromial bursitis.A total of 40 patients with sonographic confirmation of subacromial bursitis were recruited into this study. These patients were divided into blind and ultrasound-guided injection groups. The shoulder abduction range of motion was compared before injections and 1 wk after the completion of injections in both groups.The shoulder abduction range of motion before injection in the blind injection group was 71.03 +/- 12.38 degrees and improved to 100 +/- 18.18 degrees 1 wk after the injection treatments. However, the improvement did not reveal significant statistical differences (P0.05). The shoulder abduction range of motion before injection in the ultrasound-guided injection group was 69.05 +/- 14.72 degrees and improved to 139.29 +/- 20.14 degrees 1 wk after the injection treatments (P0.05).Ultrasound may be used as an adjuvant tool in guiding the needle accurately into the inflamed subacromial bursa. The ultrasound-guided injection technique can result in significant improvement in shoulder abduction range of motion as compared with the blind injection technique in treating patients with subacromial bursitis.

Mutations in the essential telomerase genes TERT and TR cause familial pulmonary fibrosis; however, in telomerase-null mice, short telomeres predispose to emphysema after chronic cigarette smoke exposure. Here, we tested whether telomerase mutations are a risk factor for human emphysema by examining their frequency in smokers with chronic obstructive pulmonary disease (COPD). Across two independent cohorts, we found 3 of 292 severe COPD cases carried deleterious mutations in TERT (1%). This prevalence is comparable to the frequency of alpha-1 antitrypsin deficiency documented in this population. The TERT mutations compromised telomerase catalytic activity, and mutation carriers had short telomeres. Telomerase mutation carriers with emphysema were predominantly female and had an increased incidence of pneumothorax. In families, emphysema showed an autosomal dominant inheritance pattern, along with pulmonary fibrosis and other telomere syndrome features, but manifested only in smokers. Our findings identify germline mutations in telomerase as a Mendelian risk factor for COPD susceptibility that clusters in autosomal dominant families with telomere-mediated disease including pulmonary fibrosis.

Purpose To compare the effectiveness of sonographically guided and palpation-guided steroid injection for the treatment of proximal plantar fasciitis. Patients and Methods Twenty-five consecutive patients with unilateral proximal plantar fasciitis were recruited and randomly divided into a sonographically guided group (n = 12) and palpation-guided group (n = 13). Proximal plantar fascia was assessed with a 5- to 12-MHz linear-array transducer. Pain intensity was quantified using a “tenderness threshold” (TT) and a visual analog scale (VAS). Injection of 7 mg (1 ml) of betamethasone and 0.5 ml of 1% lidocaine into the inflamed proximal plantar fascia was performed under the guidance of sonography or palpation. Patients were evaluated clinically and sonographically before injection and at 2 weeks, 2 months, and 1 year after injection. VAS- and TT-measured pain intensity, thickness, and echogenicity of the proximal plantar fascia, as well as the recurrence of heel pain, were assessed. Results Both VAS- and TT-measured levels of pain improved significantly after steroid injection in both groups (p < 0.001). Also, the thickness decreased significantly after injection (p < 0.01 in the palpation-guided group; p < 0.001 in the sonographically guided group). The number of patients with hypoechogenicity at the proximal plantar fascia decreased after steroid injection in both groups (p < 0.01 for both groups). The recurrence rate of plantar fasciitis in patients of the palpation-guided group (6/13) was significantly higher than that of the sonographically guided group (1/12) (p < 0.05). Conclusions Steroid injection can be an effective way to treat plantar fasciitis, and injection under sonographic guidance is associated with lower recurrence of heel pain. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound34:12–16, 2006

Background This study was conducted to investigate the feasibility of using ultrasound as an image tool to locate the sacral hiatus accurately for caudal epidural injections. Methods Between August 2002 and July 2003, 70 patients (39 male and 31 female patients) with low back pain and sciatica were studied. Soft tissue ultrasonography was performed to locate the sacral hiatus. A 21-gauge caudal epidural needle was inserted and guided by ultrasound to the sacral hiatus and into the caudal epidural space. Proper needle placement was confirmed by fluoroscopy. Results In all the recruited patients, the sacral hiatus was located accurately by ultrasound, and the caudal epidural needle was guided successfully to the sacral hiatus and into the caudal epidural space. There was 100% accuracy in caudal epidural needle placement into the caudal epidural space under ultrasound guidance as confirmed by contrast dye fluoroscopy. Conclusions Ultrasound is radiation free, is easy to use, and can provide real-time images in guiding the caudal epidural needle into the caudal epidural space. Ultrasound may therefore be used as an adjuvant tool in caudal needle placement.

To compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in managing lower limb spasticity and gait dysfunction in children with cerebral palsy.This is a case-controlled study that took place in a tertiary center's gait laboratory. A total of 27 ambulatory children with cerebral palsy spastic diplegia, aged from 3 to 7 yrs, and 20 normal children were recruited into this study. Sixteen children with cerebral palsy received BTX-A injections, and 11 received phenol motor point blocks. Gait analyses were assessed by a portable computer-assisted system (Computer DynoGraphy, Infotronic, The Netherlands). Both the BTX-A and phenol groups received gait analysis at 1 wk before and 2 mos after injection treatments.Significant improvements in gait variables of velocity and cadence were noted in children with cerebral palsy after BTX-A injections as compared with the phenol block group. Gaitline and cyclogram patterns also improved significantly in the BTX-A group. The adverse clinical effects of BTX-A injections were less severe as compared with phenol injections.BTX-A injections demonstrated superior treatment effects in improving gait variables and patterns in children with spastic diplegia as compared with phenol blocks. BTX-A injections also revealed fewer clinical side effects and were well tolerated by children with cerebral palsies.

This study was designed to study the individual or combined effects of estrogen and bipedal stance "exercise" on the lumbar vertebral body (LVB) and femoral neck (FN). At 6 months of age, six rats were sacrificed as baseline controls and all the others were either bilateral sham-ovariectomized or ovariectomized (OVX). Groups of OVX rats were housed in normal height cage (NC, 28 cm) or raised height cages (RC, 33 cm) and received biweekly s.c. injections of 10 microg/kg 17 beta estradiol (E2) or vehicle for 4 and 8 weeks. Histomorphometric measurements were performed on the undecalcified mid-transverse sections of the 4th LVB and FN. Ovariectomy alone induced cancellous bone loss by 21% and 39% in the LVB and FN, respectively; intracortical porosity area of the FN increased by 108% while total bone area did not change significantly because of the periosteal expansion following OVX. E2 alone partially prevented cancellous bone loss in the LVB and FN and prevented increased intracortical porosity area in the FN by reducing eroded surface and activation frequency. RC alone partially prevented the decrease of cancellous bone in the LVB and FN by reducing the bone-eroded surface but increased wall width. E2 plus RC completely preserved cancellous bone by having an additive effect on reducing eroded surface and activation frequency. RC helped to partially prevent decreased periosteal bone formation after estrogen administration. In conclusion, apart from inducing cancellous bone loss in the LVB and FN, OVX also increased intracortical remodeling in the FN. Estrogen prevented the overall activation of remodeling space induced by OVX. Apart from having similar effects as estrogen on remodeling space, RC induced positive bone balance within each remodeling unit. Combination treatment increased total bone mass beyond that of sham-control level by having an additive effect on lowering bone remodeling and increasing wall in both the LVB and FN.

Japanese encephalitis virus (JEV)-loaded poly(lactide) (PLA) lamellar and poly(DL-lactide-co-glycolide) (PLG) microparticles were successfully prepared with low molecular weight PLA by the precipitate method and with 6% w/v PLG in the organic phase, 10% w/v PVP and 5% w/v NaCl in the continuous phase, by using a water-in-oil-in-water emulsion/solvent extraction technique, respectively. JEV was entrapped in the PLG microparticles by a solvent extraction technique with trapping efficiencies up to 98%, loading level 5.5% w/w, and mean particle size 3.8 microm. The distribution (%) of JEV on the PLG microparticles surface, outer layer, and core were 11.2, 41.7 and 46.4%, respectively. The cumulative release of JEV had an upper limit of approximately 58% of the JEV load at 24 days. The steady release rate was 1.33 microg JEV/mg microparticles/day of JEV release maintained for 24 days. The corresponding virus loading of the PLA lamellae is approximately 0.78% w/w and the loading efficiency (77.8%), JEV content (7.84 microg/mg), and yield (96.3%), respectively. The distribution (%) of JEV on the microparticles surface, outer layer, and core were 82.1, 13.3 and 2.2%, respectively. The live JEV challenge in mice test, in which mice received one dose of 20 mg JEV-loaded PLG microparticles, 20 mg JEV-loaded PLA lamellar in comparison with JEV or PBS solution, was evaluated after IP immunization of BALB/c mice. The study results show that the greatest survival was observed in the group of mice immunized with 20 mg JEV-loaded PLG microparticles and 20 mg JEV-loaded PLA microparticles group (80%). The JEV incorporation, physicochemical characterization data, and the animal results obtained in this study may be relevant in optimizing the vaccine incorporation and delivery properties of these potential vaccine targeting carriers.

We earlier reported benefits for creativity in rehearsed music performance from alpha/theta (A/T) neurofeedback in conservatoire studies (Egner & Gruzelier, 2003) which were not found with SMR, Beta1, mental skills, aerobics or Alexander training, or in standby controls. Here the focus was the impact on novice music performance. A/T and SMR training were compared in 11-year old school children along with non-intervention controls with outcome measures not only of rehearsed music performance but also of creative improvisation, as well as sustained attention and phenomenology. Evidence of effective learning in the school setting was obtained for A/T and SMR/beta2 ratios. Preferential benefits from A/T for rehearsed music performance were replicated in children for technique and communication ratings. Benefits extended to creativity and communication ratings for creative improvisation which were shared with SMR training, disclosing an influence of SMR on unrehearsed music performance at a novice level with its greater cognitive demands. In a first application of A/T for improving sustained attention (TOVA), it was found to be more successful than SMR training, with a notable reduction in commission errors in the children, 15/33 of whom had attention indices in the ADHD range. Phenomenological reports were in favour of neurofeedback and well-being benefits. Implementing neurofeedback in the daily school setting proved feasible and holds pedagogic promise.

In this study we employed a raised cage model in combination with estrogen to observe their effects on the proximal tibial metaphysis (PTM) and tibial shaft (TX) in sham-operated or ovariectomized rats. A total of 105 6-month-old female Sprague-Dawley rats were used in the study. Bilateral sham ovariectomy or ovariectomy was performed at day 0 and the rats were housed in normal height or raised cages (RCs) and injected subcutaneously twice per week with 10 microg/kg of 17beta-estradiol (E2) or vehicle for 4 and 8 weeks. Because the time course of bone loss or bone gain distribution was not uniform in the metaphyses of the tibia, we subdivided the PTM into three zones (medial, central, and lateral) to observe the different bone loss or bone gain patterns after ovariectomy and/or raised cages. We found that: (1) E2 alone did not alter bone area or architecture in sham rats, whereas RC alone increased trabecular thickness and area of PTM, but had no effects on TX; (2) Ovx induced most bone loss from the central zone of the PTM and endocortical surface of TX, accompanied by decreased trabecular number and increased bone resorption; (3) E2 alone prevented ovx-induced bone loss by preserving trabecular number and depressing bone resorption; (4) RC alone partially compensated for bone loss following ovx by thickening the surviving trabeculae in lateral and medial zones, and tended to stimulate bone formation and decrease bone resorption; and (5) RC plus E2 increased trabecular bone area by having an additive effect on bone resorption and bone turnover. RCs helped to prevent the depressive effect of estrogen on periosteal bone formation. In conclusion, early and rapid bone loss occurred in the central zone of the metaphysis and endocortical surface after ovx. Estrogen replacement therapy prevented this loss. Raised cages partially compensated for bone loss following ovx by thickening the trabeculae in the lateral area of the metaphysis and decreased endocortical erosion. Combination treatment added bone to the PTM and prevented the decrease of periosteal bone formation after estrogen administration.

While previous research has indicated that the relative efficacy of attentional strategies on pain may be influenced by anxiety sensitivity (AS) and sex, no study appears to have examined this within the context of an emotion-focus versus distraction paradigm. The present study compared the effect of attentional emotion-focus and distraction instructions on pain response with noxious heat stimulation in 114 healthy adults (62 women and 52 men) varying in levels of AS. Results indicated that men reported a significantly higher mean tolerance time than women. Moderated regression analysis also revealed a significant strategy × anxiety sensitivity × sex interaction on pain tolerance. For those low in AS, relative efficacy was dependent upon sex, with distraction superior to emotion-focusing in women, but with strategies equivalent in men. For those high in AS, however, distraction resulted in uniformly greater pain tolerance than attentional emotion-focusing. These results indicate that AS and sex may be influential in determining the relative effectiveness of distraction and emotion-based attentional strategies for pain management.

The telomerase reverse transcriptase synthesizes new telomeres onto chromosome ends by copying from a short template within its integral RNA component. During telomere synthesis, telomerase adds multiple short DNA repeats successively, a property known as repeat addition processivity. However, the consequences of defects in processivity on telomere length maintenance are not fully known. Germline mutations in telomerase cause haploinsufficiency in syndromes of telomere shortening, which most commonly manifest in the age-related disease idiopathic pulmonary fibrosis. We identified two pulmonary fibrosis families that share two non-synonymous substitutions in the catalytic domain of the telomerase reverse transcriptase gene hTERT: V791I and V867M. The two variants fell on the same hTERT allele and were associated with telomere shortening. Genealogy suggested that the pedigrees shared a single ancestor from the nineteenth century, and genetic studies confirmed the two families had a common founder. Functional studies indicated that, although the double mutant did not dramatically affect first repeat addition, hTERT V791I-V867M showed severe defects in telomere repeat addition processivity in vitro. Our data identify an ancestral mutation in telomerase with a novel loss-of-function mechanism. They indicate that telomere repeat addition processivity is a critical determinant of telomere length and telomere-mediated disease., Author Summary Mutations in the essential telomerase components cause a spectrum of diseases mediated by short telomeres. Most frequently, these disorders manifest in the lung in an age-related disease: idiopathic pulmonary fibrosis. Telomerase synthesizes telomere repeats using a specialized reverse transcriptase, hTERT, that copies from a short template within its intrinsic RNA. In order to add long telomere tracts, telomerase adds a single repeat followed by additional repeats successively. This property, known as repeat addition processivity, is unique to the telomerase polymerase. We identified two families that shared two unique variants in the catalytic domain of hTERT: V791I and V867M. The variants co-segregated, indicating they are on the same allele, and were associated with short telomeres. Family history suggested the two families may have a single ancestor, and genetic studies confirmed they had a common founder. Telomerase reconstitution indicated that, although the double mutant did not significantly affect telomerase's ability to add a single telomere repeat, hTERT 791I-867M had severe defects in repeat addition processivity. Our data identify an ancestral mutation in telomerase; this mutation possesses a unique loss-of-function mechanism. Defects in telomere addition processivity are important determinants of telomere length maintenance and of telomere-associated disease.

The effects of dietary supplemental nicotinic acid (NA) on growth performance, carcass characteristics and meat quality were investigated in three genotypes of chicken. Fast-growing AA (Arbor Acres) broilers were compared with two genotypes of a slow-growing local breed, Beijing-You, that had undergone selection for and against intramuscular fat content respectively (BJY+IMF and BJY-IMF). The treatments were arranged 3×4 factorial completely randomized design. Day-old females (n=624) were allocated to four treatments with six replicates per treatment and fed diets (basal contained ~25 mg NA/kg) supplemented with 0, 30, 60 and 120 mg NA/kg. A sample of 72 birds from each genotype was slaughtered at market time (8 weeks of age for AA and 16 weeks of age for BJY). The breast muscles of AA broilers were darker, had less redness and yellowness, lower drip loss and higher shear force as compared to the BJY genotypes (p0.01). The highest drip loss and the lowest shear force among the three genotypes were apparent in BJY+IMF (p0.01). Increasing supplementation from 0 to 60 mg NA/kg tended to increase average daily gain (ADG), average daily feed intake, width of intermuscular fat band, thickness of subcutaneous fat (including skin) and percentage of abdominal fat but, for most variables, values decreased slightly with 120 mg NA/kg. Increasing supplementation to 60 mg NA/kg decreased (quadratic, p0.001) drip loss, but it increased at 120 mg NA/kg. The present results indicate that (i) the AA broilers fed corn-soybean meal based-diets require approximately 60 mg NA/kg to maximize ADG and meat product yield and decrease the drip loss of breast muscle; (ii) the addition of 30 mg NA/kg meets the requirement of BJY genotypes; and (iii) there seems to be no beneficial effect of NA supplementation on chicken meat quality except for limiting the drip loss.

To determine the effect of increasing supplementary oxygen flow during ventilation with the Laerdal pocket mask 24 subjects ventilated a modified recording mannikin for four 90 s periods using the mask with oxygen flows of 5 l, 10 l, 15 l and 20 l.min-1. Oxygen concentration increased and carbon dioxide concentration decreased with increasing oxygen flow. Tidal volume also increased with oxygen flow. The delivered oxygen concentrations were lower than previously reported at all four rates; however, mask function improved with increasing flow up to 20 l.

The effects of varying the omega6 to omega3 fatty acid ratio (omega6/omega3) of diets on growth performance, carcass traits, meat quality and fatty acid composition of breast muscle were investigated in Beijing-you chickens grown to 92 days. A total of 360 one-day-old female BJY chickens were fed diets containing 0%, 0.12%, 0.42%, 1.00% or 1.97% linseed oil replacing equal weights of maize oil to make dietary omega6/omega3 to be approximately 30:1, 20:1, 10:1, 5:1 and 2.5:1. Subcutaneous fat thickness and intramuscular fat content increased significantly in birds fed up to 10:1 omega6/omega3. a* values (redness of meat, dimension of the CIELAB-system) progressively increased as the diets contained increasing omega3 content, up to the 10:1 omega6/omega3.The changes in b* (yellowness of meat, dimensions of the CIELAB-system) were also significant but the pattern was almost the reverse of changes in a*. Shear force increased significantly as dietary omega6/omega3 was reduced from 30:1 to 5:1. Decreasing the dietary omega6/omega3 clearly decreased the content in breast muscle of C20:1 and C22:1, but increased that of C24:1. C20:4, C20:5 and C22:5, increased significantly by decreasing the dietary omega6/omega3, and the birds fed the 10:1 diet had higher contents of C22:6 than other treatments. This study has clearly demonstrated that decreasing the dietary omega6/omega3, increases the deposition of desirable omega3 and omega6 long chain PUFA in the edible tissue, thereby achieving nutritionally enriched meat.

BACKGROUND Idiopathic pulmonary fibrosis is progressive and often fatal; causes of familial clustering of the disease are unknown. Germ-line mutations in the genes hTERT and hTR, encoding telomerase reverse transcriptase and telomerase RNA, respectively, cause autosomal dominant dyskeratosis congenita, a rare hereditary disorder associated with premature death from aplastic anemia and pulmonary fibrosis. METHODS To test the hypothesis that familial idiopathic pulmonary fibrosis may be caused by short telomeres, we screened 73 probands from the Vanderbilt Familial Pulmonary Fibrosis Registry for mutations in hTERT and hTR. RESULTS Six probands (8%) had heterozygous mutations in hTERT or hTR; mutant telomerase resulted in short telomeres. Asymptomatic subjects with mutant telomerase also had short telomeres, suggesting that they may be at risk for the disease. We did not identify any of the classic features of dyskeratosis congenita in five of the six families. CONCLUSIONS Mutations in the genes encoding telomerase components can appear as familial idiopathic pulmonary fibrosis. Our findings support the idea that pathways leading to telomere shortening are involved in the pathogenesis of this disease.

Objective: The objective of this study was to investigate whether the knee concentric and eccentric muscle strengths can be improved in patients with bilateral knee osteoarthritis after intraarticular hyaluronan injections. Design: A total of 25 patients with bilateral knee osteoarthritis and with a radiographic Ahlback grading scale of I or II participated in this study. One session of intraarticular knee injection of hyaluronan was given to both knees (weekly intraarticular knee hyaluronan injections for a total of 5 wks). Knee concentric and eccentric muscle strengths were recorded between 10 and 90 degrees of knee flexion. The recordings were done on two angular velocities, 80 and 240 degrees/sec. This study took place in a tertiary medical center with a gait laboratory and a KIN-COM isokinetic dynamometer. Results: An increase in concentric and eccentric muscle strength adjusted for body weight (P < 0.01) was observed in both knees, ranging between 5.1% and 27.7%. Conclusion: The decreased knee muscle contraction strength (concentric and eccentric) can be improved in knee osteoarthritis patients with an Ahlback grading scale of I or II after five weekly intraarticular knee injections of hyaluronan.

The plantar soft tissue properties under the metatarsal heads at different impact velocities in different age groups were measured. Each metatarsus of the left foot in healthy young adults (n = 9, 19 to 35 years old) and in healthy older persons (n = 10, 42 to 72 years old) was examined in vivo using a self-constructed loading-unloading device at low, medium and high impact status; the impact velocities of the device were about 2.5, 5 and 10 cm/s, respectively. The device comprised a 5- to 12-MHz linear-array ultrasound transducer, a miniature load cell and a fixation frame. From low to high impact status, the elastic modulus (E) in young adults significantly increased from about 300 kPa to about 500 kPa. However, the E in the older group did not show this trend. From low to high impact status, the energy dissipation ratio (EDR) of the metatarsus significantly increased from about 30% to about 60% in the young group and significantly increased from about 40% to about 70% in the older group. Most of the metatarsus in the older subjects had significantly greater E and EDR than those in the younger persons.

To compare the effects of carvedilol and metoprolol in preventing from left ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in rats.Twenty-four hours after ligating left coronary artery, 105 surviving female SD rats were randomly assigned to AMI control, carvedilol 1 mg/(kg.d) and metoprolol 2 mg/(kg.d) groups. Sham-operated rats (n = 16) were selected randomly as non-infarction control. After four weeks of drugs therapy, hemodynamic studies and pathologic analysis were performed. Exclusive of MI size35% or55%, complete experimental variables were obtained in 46 rats, which were comprised of AMI (n = 11), carvedilol (n = 12), metoprolol (n = 11), and Sham-operated (n = 12) groups.Compared with sham-operated group, left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV) and weight (LVW), were all significantly increased (P0.05-0.001), while maximal rate of rise and fall (+/- dp/dt) of LV pressure as well as their corrected values (+/- dp/dt/LVSP) were all significantly decreased (P0.01-0.001) in AMI group. In comparison with AMI group, the LVEDP and LVV were all significantly decreased (all P0.001), while +/- dp/dt and +/- dp/dt/LVSP were significantly increased (P0.05-0.001) in both carvedilol and metoprolol group, with LVW and RVW only decreased in carvedilol group (P0.05-0.01).1. Carvedilol can effectively attenuate LVRM, and improve hemodynamics and LV function after AMI in rats, 2. Metoprolol has equivalent beneficial effects as carvedilol on hemodynamics, LV dilatation and function, but not LV hypertrophy.

To study the changes and clinical significance of plasma von Willebrand factor (vWF) and nitric oxide (NO) levels in patients with pregnancy induced hypertension (PIH).Plasma vWF and NO were detected by ELISA and Griess assay respectively in 36 patients with PIH and 18 healthy pregnant women.The levels of plasma vWF in patients with moderate and severe PIH increased significantly. than those in healthy pregnancy. The levels of plasma NO in patients with PIH were significantly lower than those in healthy pregnancy. The higher the vWF levels or the lower the NO levels, the more severe in PIH. There was a negative correlation between the plasma vWF and NO levels.The results suggest that plasma vWF and NO concentration can be used as indicators in the judgement of the severity of PIH.

Endoscopic ligation has been extensively applied in the management of esophageal and gastric varices with or without bleeding. The varices are automatically eradicated through the use of ligation. However, whether avascular necrosis will occur in a gastrointestinal polyp when the base is ligated remains unclear. The aims of this pilot study were to investigate the sequential changes of gastric hyperplastic polyps following endoscopic detachable snare ligation and to determine the possibility of induction of avascular necrosis in these lesions following ligation.Eleven patients with eighteen gastric hyperplastic polyps were treated with endoscopic detachable-snare ligation. The polyps were observed for 5 minutes and biopsies were then conducted. At 14 days after endoscopic ligation, follow-up endoscopies were performed to assess the outcome of the strangulated polyps.After being strangulated by the detachable snares, a majority of the polyps immediately congested (94%), and then developed cyanotic change (89%) approximately 4 minutes later. Pathological examination revealed severe venous congestion in the lamina propria of the strangulated polyps. On follow-up endoscopy 2 weeks later, all the snares had dropped off, and avascular necrosis occurred in sixteen polyps (89%). All of the polyps with avascular necrosis were detected to have developed cyanotic changes in initial endoscopy. No complications occurred during or following the ligation procedure.Most gastric hyperplastic polyps develop avascular necrosis following ligation by detachable snare. Cyanotic change is an important predictor of the outcomes of the lesions following endoscopic ligation. The application of this ligation technique in treatment of bleeding or non-bleeding gastrointestinal polyps deserves further investigation.

HIV-positive men and women may have fertility desires and may intend to have children. The extent of these desires and intentions and how they may vary by individuals' social and demographic characteristics and health factors is not well understood.Interviews were conducted from September through December 1998 with 1,421 HIV-infected adults who were part of the HIV Cost and Services Utilization Study, a nationally representative probability sample of 2,864 HIV-infected adults who were receiving medical care within the contiguous United States in early 1996.Overall, 28-29% of HIV-infected men and women receiving medical care in the United States desire children in the future. Among those desiring children, 69% of women and 59% of men actually expect to have one or more children in the future. The proportion of HIV-infected women desiring a child in the future is somewhat lower than the overall proportion of U.S. women who desire a child. The fertility desires of HIV-infected individuals do not always agree with those of their partners: As many as 20% of HIV-positive men who desire children have a partner who does not Generally, HIV-positive individuals who desire children are younger, have fewer children and report higher ratings of their physical functioning or overall health than their counterparts who do not desire children, yet desire for future childbearing is not related to measures of HIV progression. HIV-positive individuals who expect children are generally younger and less likely to be married than those who do not. Multivariate analyses indicate that black HIlV-positive individuals are more likely to expect children in the future than are others. While HIV-positive women who already have children are significantly less likely than others both to desire and to expect more births, partner's HIV status has mixed effects: Women whose partner's HIVstatus is known are significantly less likely to desire children but are significantly more likely to expect children in the future than are women whose partner's HIV status is unknown. Moreover, personal health status significantly affects women's desire for children in the future but not men's, while health status more strongly influences men's expectations to have children.The fact that many HIV-infected adults desire and expect to have children has important implications for the prevention of vertical and heterosexual transmission of HIV, the need for counseling to facilitate informed decision-making about childbearing and childrearing, and the future demand for social services for children born to infected parents.

The purpose of this study was to evaluate the prevalence and characterize the patterns of hilar uptake (HU) on 67Ga-citrate imaging after cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy regimens for non-Hodgkin's lymphoma (NHL), to differentiate hilar lymphoma (HL) from HU of benign etiology.A total of 930 studies (698 planar, 232 thoracic SPECT) was reviewed retrospectively in 100 NHL patients (29 low-grade, 60 intermediate-grade, and 11 high-grade) treated with CHOP and followed up longitudinally with serial gallium studies (planar: median, 7; range, 3-16 studies in 100 patients; SPECT: median, 1; range, 0-11 studies in 72 patients) over a median duration of 36 mo (range, 6-112 mo) from diagnosis. Clinical outcome and size changes over time on correlative CT and/or radiographs were used to evaluate benign versus malignant changes within the hila.HU after CHOP was present in 79% of patients (90% confidence interval [CI], 71%-85%), with 33% showing HU on SPECT alone. Once present, HU persisted for a median of 27 mo (range, 2-84 mo) from onset. The prevalence of HU and HL at various time points was as follows: baseline HU, 52% with HL 60%; mid-CHOP HU, 59% with HL2%; post-CHOP HU, 52% with HL6%; follow-up HU, 76% with HL 9%. HU of benign etiology was not significantly correlated with CHOP dosage. HU was symmetric in 90% of patients (90% CI, 82%-95%) and less intense than the original disease in 89% of patients (90% CI, 80%-95%), and these features were highly predictive of benign etiology (negative predictive value [NPV], 98.6% if symmetric; NPV, 96.5% if less than original disease; NPV, 100% if both present). Asymmetric HU equal in intensity to the original disease, however, was highly predictive of HL (positive predictive value [PPV], 87.5% if asymmetric; PPV, 85.7% if equal to original disease; PPV, 100% if both present).HU after CHOP is common (overall incidence, 79%), often seen only on SPECT, and most likely of benign etiology when symmetric and less intense than the original disease. Asymmetric HU that equals the intensity of the original disease, however, is a possible indicator for HL.

The aim of this study was to evaluate the clinical effect of urokinase (UK) in unstable angina (UA). This study was a multicenter, single-blind, heparin-controlled, randomized clinical trial. Entry criteria was that effort angina was significantly aggravated within 96 hours and angina attack at rest within 24 hours. In addition to the control group, thrombolytic therapy was divided into two groups according to the dose of UK. The high-dose group was 18,000 IU/kg, and the total dose was no more than 1.5 million IU (no bolus of heparin in this dose). The low-dose group was 14,000 IU/kg, and the total dose was no more than 1 million IU. All patients were treated by aspirin 300 mg/day and heparin 3000 U IV bolus before thrombolytic therapy (except for the high-dose group), then subcutaneous heparin 7,500 U q12h. The primary endpoint for the comparison between the thrombolytic and control groups was death and AMI (cardiac event) within 30 days of enrollment. Five hundred and fifty-six patients with UA were selected, and 272 and 284 patients were enrolled in thrombolytic group and control groups, respectively. The 30-day incidence of cardiac events was a little higher, but not significantly, in the thrombolytic group than in the control group (7.0% vs. 5.3%, ns), but the rate for cardiac events was much lower in the low-dose UK group than in the high-dose UK group. The difference was significant (3.3% vs. 10.0%, P0.05). Even if the rate was also lower than in the control group, this difference was not significant (3.3% vs. 5.3%, P0.05). The time interval between enrollment and the AMIs was quite different in these two groups. The majority of AMIs (73.7%) occurred within 24 hours, including 37% of AMIs that occurred within 2 hours after the beginning of thrombolytic therapy in the UK group. However, only small number of AMIs (20%) occurred within 24 hours of enrollment in the control group. The increase in AMI risk on the first day of thrombolytic therapy in this study might be closely related to thrombolysis and to the lack of strong antithrombin therapy. The risk of AMI might be remarkably reduced by using low-dose UK in combination with antithrombin therapy before thrombolytic therapy.

The clinical characteristics and coronary angiographic findings in 50 patients with spontaneous angina (SA) were studied. Coronary angiography did not disclose any severe fixed narrowing in 7 patients with SA only; the episodes of SA in these patients is the result of subtotal occlusion of a major coronary artery induced by spasm. 43 patients with both SA and effort angina (EA) had more severe coronary obstructive lesions. In these patients, the localization of electrocardiographic ischemia during episodes of SA and EA were always identical, indicating that the episodes of SA are related to the coronary narrowing lesions. Our study showed that incidence of SA was highest with 90% stenosis of the ischemia related artery, suggesting that besides coronary spasm, physiological coronary vasoconstriction or increase of coronary vasomotor tone could play an important role in the production of SA. In addition, turbulent flow, stasis, platelet aggregation and transient thrombosis might be individually responsible for episodes of SA in patients with severe coronary stenosis.

In addition to method of ACTH RIA, a rat pituitary cell perfusion system was developed for the assessment of pituitary cells in stimulating and inhibiting ACTH secretion induced by some substances. Hypothalamic extract stimulated the ACTH secretion in a dose-dependent manner. AVP, cAMP, Ca2+, K+, noradrenaline, metoclopramide and haloperidol also had some stimulating effect. Dexamethasone and dopamine inhibited the basal ACTH secretion of pituitary cell and antagonized the effect of the various stimulating substances. Cyproheptadine could antagonize the effect of some of the stimulating substances while GABA had no marked inhibiting effect.

The authors retrospectively reviewed data regarding 14 patients with sarcomatoid carcinomas of the lung seen and treated at M.D. Anderson Cancer Center from 1955 to 1986. The following were the histologic criteria for inclusion in the study: (1) the concurrent presence of malignant epithelial and sarcomatoid spindle cell components, and (2) positive immunoreactivity for antikeratin antibody or ultrastructural demonstration of epithelial differentiation in sarcomatoid tumors in which the epithelial component was inconspicuous. For the sarcomatoid components, the most frequent pattern was malignant fibrous histiocytoma, which was present in ten tumors. An unclassified sarcomatoid pattern was found in two cases and a fibrosarcomatous pattern in two remaining cases. Clinically, the median patient age was 59 years; 12 patients were male and 2 were female; 13 were smokers and 1 used snuff. Three patients had Stage I, ten had Stage III, and one had Stage IV disease. One patient with Stage I, seven with Stage III, and one with Stage IV disease died of their carcinomas 2 to 26 months after diagnosis (median survival time 12 months). All patients who had lymph node metastases at presentation died of disease. The authors concluded the following: (1) patients with sarcomatoid carcinoma of the lung usually presented at an advanced stage; (2) lymph node metastasis, as with a usual carcinoma of the lung, is an important prognostic factor; and (3) for all lung tumors with a sarcomatoid pattern, especially a malignant fibrous histiocytoma pattern, extensive samples should be obtained and immunoperoxidase or ultrastructural studies done to identify epithelial differentiation.

Two hundred and five cases of pituitary lesion were treated in Tri-Service General Hospital up to March 1989. A case of pituitary abscess was diagnosed during operation. The primary clinical manifestations are consequent upon the pituitary dysfunction and the mass effect of the pituitary abscess. A pre-operative diagnosis of pituitary abscess is usually very difficult. Transsphenoidal drainage with an appropriate antibiotic coverage may provide an optimistic prognosis.

In this study we have used a computed tomographic (CT) method using profile analysis to measure the diameter of the basilar artery. In a search for a noninvasive and repeatable method to substitute for the traditional arteriography in the evaluation of the degree of cerebral vasospasm, we employed both CT and arteriography to measure the diameter of the basilar artery in eight adult mongrel dogs weighing between 7 and 12 kg. In three of these animals, assessments were made before and after subarachnoid hemorrhage (SAH) induced by injecting autologous arterial blood into the cistern magna. It was found that the basilar artery diameter as evaluated by CT was 47% larger than that measured by arteriography. However, there was a very good correlation (n = 63, r = 0.75, p less than 0.001) between the two methods. This paper presents a new model for the measurement of the basilar artery diameter, one which may also provide a safer method for the evaluation of vasospasm in humans.