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Multiportal video-assisted thoracic surgery (VATS) for major lung resection causes less immunochemokine production compared to thoracotomy. Whether uniportal VATS is similarly associated with lower early postoperative circulating levels of immunochemokines compared to multiportal VATS have not been studied. Selected patients who received uniportal or multiportal VATS major lung resection were recruited. Blood samples were collected preoperatively and on postoperative days 1 and 3 for enzyme linked immunosorbent assay of serum levels of Tissue Inhibitor of Metalloproteinase (TIMP)-1, Insulin Growth Factor Binding Protein (IGFBP)-3, and Matrix Metalloproteinase (MMP)-9. A linear mixed-effects models were used to analyze the effects of uniportal VATS on the postoperative circulating chemokine levels. From March 2014 to April 2017, 68 consecutive patients consented for the prospective study and received major lung resection by either uniportal VATS (N = 29) or multiportal VATS (N = 39) were identified. Uniportal VATS major lung resection was associated with lower post-operative levels of TIMP-1 and MMP-9 compared to multiportal VATS after controlling for the effects of the corresponding baseline level and the time of follow-up measurement. No difference was observed for the level of IGFBP-3. Less immunochemokine disturbances was observed after uniportal VATS major lung resection compared to multiportal VATS.

The aim of this study was to illustrate the role of long non-coding RNA (lncRNA) DLEU1 in regulating the malignant progression of clear cell renal cell carcinoma (ccRCC) by targeting microRNA-194-5p (miRNA-194-5p).DLEU1 expression level in ccRCC tissues and para-cancerous tissues was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between DLEU1 expression and pathological indexes of ccRCC patients was assessed. After the silence of DLUE1, the proliferative and migratory abilities of ACHN and 786-O cells were evaluated. Furthermore, Dual-Luciferase reporter gene assay and rescue experiments were conducted to identify the role of DLEU1/miRNA-194-5p in regulating the ccRCC progression in vitro.DLEU1 expression was markedly up-regulated in ccRCC tissues when compared with para-cancerous tissues. The rates of lymphatic metastasis and distant metastasis in ccRCC patients with a high level of DLEU1 were significantly higher, whereas the prognosis was significantly worse. Transfection of si-DLEU1 remarkably attenuated proliferative and migratory abilities of ACHN and 786-O cells. MiRNA-194-5p was identified as the target gene of DLEU1. In addition, the knockdown of miRNA-194-5p could reverse the regulatory effect of DLEU1 on the proliferative and metastatic abilities of ccRCC.DLEU1 is closely related to lymphatic metastasis, distant metastasis, and poor prognosis of ccRCC. It aggravates the progression of ccRCC by targeting miRNA-194-5p.

We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection.

The current study aimed to examine the role and mechanism of a conserved long noncoding RNA termed NORAD (noncoding RNA activated by DNA damage, also named LINC00657) in gastric cancer (GC) progression.Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to determine the expression level of relevant genes in GC cell lines. Cell proliferation was examined by cell counting kit-8 (CCK-8) assays. Cell migration and invasion were detected by transwell migration and invasion assays. Protein levels of the indicated genes were detected by Western blotting. Cell apoptosis was examined by flow cytometry.Results showed that NORAD knockdown decreased cell proliferation, migration and invasion but increased cell apoptosis. NORAD knockdown affected the expression of genes related to apoptosis and Epithelial-Mesenchymal Transition (EMT). In addition, NORAD's depletion resulted in reduced Ras Homolog Family Member A (RhoA) and Rho-associated coiled-coil containing protein kinase 1 (ROCK1) expression. Furthermore, NORAD's expression was positively correlated with RhoA and ROCK1 expressions in GC based on The Cancer Genome Atlas (TCGA) database.Our results demonstrate the oncogenic role of NORAD in gastric cancer progression.

Background Commonly used complete mitral annuloplastic rings include saddle-shaped and semirigid rings, with no clear indication for either type. A semirigid ring may be preferred in patients whose native mitral saddle shape is well maintained. We present our experience of using semirigid rings for mitral valve repair. Methods We routinely measured the annular height-to-commissural width ratio by 3-dimensional transesophageal echocardiography prior to mitral repair. We generally chose a semirigid (Memo 3D) ring in patients whose annular height-to-commissural width ratio was normal (≥ 15%). The same semirigid ring with an additional chordal guiding system (Memo 3D ReChord) was selected for patients with anterior leaflet or bileaflet pathology. Over an 18-month period, 66 patients with severe degenerative ( n = 60) or functional ( n = 6) mitral regurgitation had Memo 3D ( n = 32) or Memo 3D ReChord ( n = 34) rings implanted. Results Postoperative 3-dimensional transesophageal echocardiography was completed in all patients (mean follow-up 7 ± 5 months). The majority of patients had no or mild residual mitral regurgitation; only two had moderate (2+) mitral regurgitation. There was no mortality at 30-days or on midterm follow-up. Conclusions Our series represents the first Asian clinical experience using the Memo 3D ReChord ring. Although the long-term durability of mitral repair with this type of semirigid annuloplastic ring warrants further validation, our current clinical data are encouraging.

Background Transcatheter aortic valve implantation has been established as a safe and effective treatment option for patients at high or prohibitive surgical risk. However, some patients may not be suitable for the transfemoral approach due to severe iliofemoral disease or aneurysmal disease of the thoracoabdominal aorta. The aim of this case series was to evaluate the feasibility and clinical outcomes of the transaortic approach. Methods From May 2015 to June 2016, 5 patients (mean age 78.4 ± 3.9 years) with severe symptomatic aortic stenosis underwent transaortic transcatheter aortic valve implantation after a heart team discussion. They were considered to be at high surgical risk and ineligible for the transfemoral approach due to iliofemoral or thoracoabdominal aortic disease. Results A CoreValve Evolut R was successfully deployed in all 5 patients. We performed 4 right mini-parasternal incisions and one J-incision partial sternotomy. None of the patients required permanent pacemaker implantation, one required reopening of the mini-parasternal incision for postoperative bleeding. Follow-up echocardiography one month after the procedure showed improvement in the mean aortic gradient (from 63.2 to 8.3 mm Hg) and aortic valve area (from 0.62 to 2.2 cm2). None of the patients had more than mild paravalvular leakage. There was no intraoperative or 30-day mortality. Conclusion Transaortic transcatheter aortic valve implantation is a safe and feasible option for patients with severe aortic stenosis who are considered unsuitable for transfemoral aortic valve implantation.

SUMMARYThe aim of this study was to characterize updated HIV subtypes in Yunnan to determine their origins and distribution within the population. RT–PCR of both thegagandenvgenes were sequenced from Yunnan province inhabitants newly diagnosed with HIV-1. Sequence data from 290 samples were used for statistical analysis of subtype distribution and phylogenetic tree construction. Distribution data were adjusted to account for different geographical distributions of HIV-1 subtypes in the population. Phylogenetic analysis revealed six HIV-1 subtypes in Yunnan, including eight types of unique recombination forms (URFs). The most prevalent subtypes in this province, CRF07_BC (18·9%), CRF08_BC (39·1%), CRF01_AE (22·4%), and URFs (subtype C, 5·9% and subtype B, 4·5%), were all recombinants. We found significant differences in the distribution of these HIV-1 subtypes not only geographically, but also between various ethnic groups and with respect to transmission routes. Our findings indicate a complex population of HIV-1 subtypes, URFs, and recombinant subtypes in Yunnan province. This diversity could make the prevention and control of HIV infection in Yunnan more difficult due to the possibility of virus recombination or infection by multiple subtypes.

SummaryBackground Functional dyspepsia (FD) is a common disease without an established optimal treatment. Aim To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints. Methods A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients’ response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index. Results All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups. Conclusions Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture relies on acupoint specificity.

Thoracic endovascular aortic repair (TEVAR) offers a less invasive treatment for aortic arch aneurysms. Clinical challenges arise when there is inadequate proximal landing for zone 1 TEVAR, such that a median sternotomy with total aortic debranching is required before stent deployment. The chimney technique was reported as an alternative approach to stent the arch branches and avoid sternotomy, but it was still associated with considerable chance of a type IA endoleak. We report a case of aortic arch aneurysm with an inadequate proximal landing for zone 1 TEVAR that was treated with debranching of head and neck vessels followed by TEVAR and preemptive and targeted coil embolization of the arch aneurysmal sac. Postoperative computed tomography showed no significant endoleak, and the patient had an unremarkable recovery.

A 57-year-old man was incidentally found to have a dissected diverticulum of Kommerell originating from aberrant origin of right subclavian artery during follow-up for treated colon cancer. A right carotid-axillary bypass was followed by embolization of aberrant artery and the diverticulum by deployment of multiple detachable coils using the Penumbra Ruby System (Penumbra, Alameda, CA). Angiography after embolization showed exclusion of flow to the aberrant artery and a patent right carotid-axillary bypass. The patient recovered uneventfully and remained well for 12 weeks after the operation, without any complications. We believe this targeted endovascular approach can avoid complications related to the coverage of thoracic aorta and reduce the risk of access vessel trauma.

To build a quantitative assessment system for normative cancer pain management.Two groups of 60 patients with malignant lower bowel obstruction were formed: the study group (n=30) patients receiving routine small intestinal decompression and enteral nutrition, and the control group (n=30) patients receiving nasogastric decompression and parenteral nutrition. The weight, protein indicators and occurrence of complications in the two groups were compared during the treatment.The weight gain, increase of albumin and prealbumin, and complication rate were (1.9667 ± 1.38298) kg, (2.9133 ± 1.38258) g/L, (18.5333 ± 10.92840) mg/L and 26.67% in the study group compared with (0.6667±0.87428) kg, (1.5500 ± 0.72099) g/L, (12.9333 ± 8.47688) mg/L and 86.67% in the control group. There were statistically significant differences (t = -4,352,-4.789, -2.218; χ2 = 21.9910; p0.05 or p0.01) between the two groups.The application of small bowel decompression tubes can improve the nutritional status, physical fitness, reduce complications in patients with malignant lower intestinal obstruction.

As a measure of both strength and muscle endurance of the plantar flexors, the unilateral heel rise (UHR) test has been suggested as a method to evaluate balance capabilities in older adults. Thus, the purpose of this study was to examine the association between UHR performance with biomechanical measures of balance in seniors. Twenty-two older adults completed two testing sessions. The first visit included UHR performance; the second visit included dynamic and static motion analysis. UHR performance was significantly associated with dynamic balance capability as measured by medial-lateral inclination angle during gait. As indicated by an analysis of center of pressure, there were significant associations between UHR performance and measures of static balance. Balance is influenced by plantar flexor performance as measured by the UHR test. We therefore suggest incorporating the UHR test in analyses of balance in seniors.

Conventional video-assisted thoracic surgery (VATS) is already well established as the approach of choice for definitive surgical management for primary pneumothorax. However, VATS itself is a constantly evolving technique. The needlescopic VATS (nVATS) approach uses the existing chest drain wound as a working port and adds only two 3-mm ports to provide equally effective pleurodesis as conventional VATS. Staple resection of bullae or blebs plus complete mechanical parietal pleural abrasion is achievable using nVATS. By potentially reducing morbidity for the individual patient, the nVATS approach may lower thresholds for surgical candidacy-even for first episodes of primary pneumothorax.

In this prospective, open-labeled study, 240 cancer patients were assigned to either a high-dose glucocorticoids (HDG) group that received chemotherapy containing HDG, or a control group that received chemotherapy without glucocorticoids. The Pittsburgh Sleep Quality Index (PSQI) was chosen to assess insomnia. The results of the study showed that dimensions of sleep latency, sleep duration, and sleep efficiency had the three largest differences in values and numbers of patients, with a score increase in the HDG group compared to the control group (p0.001). After chemotherapy in the HDG group, the PSQI score significantly increased in patients with stage II cancer (both p0.05), and patients diagnosed with lymphoma (p0.01), whereas the complete response and partial response rates (p0.05) had the smallest elevations. The average score of each dimension did not significantly decrease after hypnotics (p0.05). Our study suggests that the major clinical manifestations of insomnia in cancer patients receiving chemotherapy containing HDG include difficulty falling asleep, short sleep duration, and low sleep efficiency. however, we cannot definitively state that hypnotics can improve poor sleep quality.

Purpose. Kattan and Stephenson nomograms are based on the outcomes of patients with prostate cancer recruited in the USA, but their applicability to Chinese patients is yet to be validated. We aim at studying the predictive accuracy of these nomograms in the Chinese population.Patients and Methods. A total of 408 patients who underwent laparoscopic or open radical resection of prostate from 1995 to 2009 were recruited. The preoperative clinical parameters of these patients were collected, and they were followed up regularly with PSA monitored. Biochemical recurrence was defined as two or more consecutive PSA levels >0.4 ng/mL after radical resection of prostate or secondary cancer treatment.Results. The overall observed 5-year and 10-year biochemical recurrence-free survival rates were 68.3% and 59.8%, which was similar to the predicted values by the Kattan and Stephenson nomograms, respectively. The results of our study achieved a good concordance with both nomograms (Kattan: 5-years, 0.64; Stephenson: 5-years, 0.62, 10-years, 0.71).Conclusions. The incidence of prostate cancer in Hong Kong is increasing together with the patients’ awareness of this disease. Despite the fact that Kattan nomograms were derived from the western population, it has been validated in our study to be useful in Chinese patients as well.

Background The number of older adults participating in yoga has increased dramatically in recent years; yet, the physical demands associated with yoga performance have not been reported. The primary aim of the Yoga Empowers Seniors Study (YESS) was to use biomechanical methods to quantify the physical demands associated with the performance of 7 commonly-practiced standing yoga poses in older adults. Methods 20 ambulatory older adults (70.7 + − 3.8 yrs) attended 2 weekly 60-minute Hatha yoga classes for 32 weeks. The lower-extremity net joint moments of force (JMOFs), were obtained during the performance of the following poses: Chair, Wall Plank, Tree, Warrior II, Side Stretch, Crescent, and One-Legged Balance. Repeated-measure ANOVA and Tukey’s post-hoc tests were used to identify differences in JMOFs among the poses. Electromyographic analysis was used to support the JMOF findings. Results There was a significant main effect for pose, at the ankle, knee and hip, in the frontal and sagittal planes (p = 0.00 – 0.03). The Crescent, Chair, Warrior II, and One-legged Balance poses generated the greatest average support moments. Side Stretch generated the greatest average hip extensor and knee flexor JMOFs. Crescent placed the highest demands on the hip flexors and knee extensors. All of the poses produced ankle plantar-flexor JMOFs. In the frontal plane, the Tree generated the greatest average hip and knee abductor JMOFs; whereas Warrior II generated the greatest average hip and knee adductor JMOFs. Warrior II and One-legged Balance induced the largest average ankle evertor and invertor JMOFs, respectively. The electromyographic findings were consistent with the JMOF results. Conclusions Musculoskeletal demand varied significantly across the different poses. These findings may be used to guide the design of evidence-based yoga interventions that address individual-specific training and rehabilitation goals in seniors. Clinical trial registration This study is registered with NIH Clinicaltrials.gov #NCT 01411059

Introduction This randomized, open-label study compared pemetrexed versus docetaxel as second-line therapy for Chinese patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). The primary endpoint tested non-inferiority of overall survival (OS) on the combined data from these patients and those in the global registration trial. Data from patients in the current study only (Chinese patients) were the basis for the study's secondary objectives. Methods Patients with stage IIIB/IV disease were randomized (1:1) to receive pemetrexed (500mg/m 2 ; 107 randomized; 106 treated) or docetaxel (75mg/m 2 ; 104 randomized; 102 treated) on Day 1 of each 21-day cycle. Treatment continued until progressive disease, unacceptable toxicity or patient/investigator decision. All efficacy and safety data were analyzed at the pre-specified study completion; supplementary OS analyses were performed later, after additional events had been recorded. Results The primary endpoint of OS noninferiority of pemetrexed to docetaxel was not met, the lower CL was P >0.025 (efficacy retained=97.9% [95% CLs: 47.1, 141.9]; P =0.0276), in the combined population (pemetrexed: n =390, docetaxel: n =392). Supplementary values were 101.3% (95% CLs: 57.9, 148.8), P =0.0186. For the secondary objectives, assessed in the population from the current study (pemetrexed: n =107, docetaxel: n =104), median OS was 11.7 and 12.2 months for the pemetrexed and docetaxel arms, respectively (HR [95% CLs]: 1.14 [0.78, 1.68], P =0.492). Supplementary values were 11.4 and 11.5 months, respectively (HR [95% CLs]: 1.02 [0.74, 1.40], P =0.926). Median PFS values were 2.8 and 3.1 months (HR [95% CLs]: 1.05 [0.75, 1.46], P =0.770) and ORR values were 9.6% and 4.1% (odds ratio [95% CLs]: 2.50 [0.76, 8.25], P =0.133) for pemetrexed and docetaxel, respectively. Pemetrexed-treated patients had significantly fewer drug-related grade 3–4 adverse events (pemetrexed: 20.8%, docetaxel: 40.2%; P =0.003). Few drug-related serious adverse events were reported (pemetrexed: 5 patients, docetaxel: 8 patients). Conclusion The comparable efficacy and superior tolerability of pemetrexed compared with docetaxel in this study supports the use of single-agent, second-line pemetrexed for advanced non-squamous NSCLC in Chinese patients. ClinicalTrials.gov: NCT00391274.

PURPOSE: Pulsatile ocular blood flow (POBF) assessment aids the diagnosis of ocular diseases with defective ocular haemodynamics, such as glaucoma. Although each successful POBF measure given by the instrument represents five 'repeatable' pulses, there has been no study verifying how repeatable they are. There is also no report on the minimal number of measurements for an acceptable accuracy. METHODS: Forty-three healthy young subjects were recruited and each subject had five consecutive POBF measurements obtained from one randomly selected eye. The coefficient of variation was calculated from the raw data of the five 'repeatable' pulses. The average from five consecutive measurements was considered as the standard for comparison with the first, average of the first two, the first three and the first four measurements. The 95% limits of agreement were determined using the Bland and Altman approach. RESULTS: The coefficient of variation was greater than the manufacturer's claim of within 10%. The mean (+/-S.D.) POBF calculated from five consecutive measures was 732.5 +/- 243.2 microL min(-1). The mean (+/-S.D.) difference between the standard POBF and the first, average of the first two, the first three and the first four measurements was (in microL min(-1)): 12.5 +/- 59.8, 7.8 +/- 42.1, 9.6 +/- 32.5 and 3.7 +/- 19.6 respectively. The corresponding 95% limits of agreement were (in microL min(-1)): +/-117.2, +/-82.6, +/-63.8 and +/-38.4 respectively. CONCLUSIONS: As the five 'repeatable' pulses were not as repeatable as the manufacturer claims, practitioners should not rely on one single POBF measure. An average of three consecutive measurements will be adequate to detect the minimum reported difference in POBF between glaucoma and normal patients.

The cyclosporine (CsA) blood concentration at 2 hours postdose (C2) has been shown to be better than trough level (C0) to predict acute cellular rejection (ACR) in solid organ transplantations. We tried to assess the superiority of C2 monitoring to C0 in heart transplantation (HTx). Prospective data were collected from the HTx recipients from November 1991 to April 2003. The 100 patients surviving longer than 3 months after HTx, provided 237 sample sets, with ACR graded by endomyocardial biopsy (EMB) and concurrent C0 and C2 levels. ACR was defined as International Society of Heart and Lung Transplantation (ISHLT) grade lb or higher. Nonparametric methods, logistic regression model, and receiver operating characteristic (ROC) analysis were used. There was no significant demographic heterogeneity between ACR and non-ACR groups. C2 was significantly lower in ACR than non-ACR groups (P = .0192) whereas C0 showed no significant difference. In the logistic regression model, C2 was a significant predictor against ACR (P = .026, odds ratio = 0.76 per 100 ng/mL), but C0 was not. ROC analysis showed that C2 of 600 ng/mL might provide the optimal cut-off point, with a sensitivity of 51.23% and a specificity of 71.43%, but C0 did not show this association. In conclusion, C2 monitoring is superior to C0 for predicting ACR in HTx. ACR should be suspected when the C2 value is below 600 ng/mL.

Patients with an obscure and unrelievable abdominal condition may be forced to receive open laparotomy for diagnosis. Diagnostic laparoscopy has been suggested as an alternative to diagnostic laparotomy in selected cases. The aim of this article is to evaluate the circumstances suitable for laparoscopic diagnosis of certain abdominal conditions and the possible advantages of that approach.Among 256 patients undergoing elective laparoscopic operations using conventionally pneumoperitoneal techniques from January 1994 to June 1995, twenty patients received diagnostic laparoscopy. The correlation between preoperative diagnosis, laparoscopic diagnosis and pathologic diagnosis as well as the outcome of laparoscopic diagnosis and treatment have been assessed.Major indications for diagnostic laparoscopy included acute abdominal pain (n = 4), chronic abdominal pain (n = 6), differentiating intraabdominal tumor (n = 4), staging known malignancy (n = 3) and evaluating intraperitoneal implantation (n = 3). Two of the four patients with acute abdominal conditions, one of the six patients with chronic abdominal pain. Four of the seven patients with undifferentiated/unstaged abdominal tumors and all of the three patients with intraperitoneal-implanted drainage tubes had no reasons for a further exploratory procedure, thus preventing the morbidity or mortality which might occur after unnecessary laparotomy. The duration of operation and hospitalization was shorter than the group without laparotomy.Diagnostic laparoscopy benefits patients by avoiding unnecessary surgery, avoiding unnecessary delay in diagnosis and treatment and shortening the operative and hospitalized period. However, it provides only an alternative not a substitute for traditional diagnostic procedures and will never lessen the importance of conventional laparotomy.

Cerebrospinal fluid rhinorrhea is an uncommon but dangerous disease. Many lethal complications, such as bacterial meningitis and pneumoencephalus, may be the result of cerebrospinal fluid rhinorrhea. Otolaryngologist, neurosurgeons and radiologists must know how to diagnose, how to localize the site of leakage and how to choose the best method of treatment. A case of cerebrospinal fluid rhinorrhea and meningitis due to improper sinus surgery is presented. Satisfactory result, such as avoidance of unnecessary brain tissue damage, can be obtained by extracranial endonasal repairing of the fistula with a composite septal flap.

Chronic hypoxic pulmonary hypertension in the rat is associated with increased collagen and elastin in the pulmonary artery. We investigated whether excess vascular collagen contributes to chronic hypoxic pulmonary hypertension by administering the proline analogue cis-4-hydroxy-L-proline (cHyp), an agent relatively specific for inhibiting collagen production, to rats exposed to chronic hypoxia. Sprague-Dawley rats (weighting 200 g) were exposed to air or hypoxia (10% O2-90% N2) for 3 wk. Groups studied were: air-exposed injected with saline, air-exposed injected with cHyp, hypoxic injected with saline, and hypoxic injected with cHyp. At the end of 3 wk, we measured mean right ventricular pressure (RVP) of animals breathing room air and hydroxyproline and desmosine contents of the main pulmonary artery trunk. Hypoxia increased RVP from 13 +/- 1 to 27 +/- 1 mm Hg (p less than 0.05); cHyp partially prevented this increase since RVP was 17 +/- 1 mm Hg (p less than 0.05). There was no effect of cHyp on cardiac output. Hypoxia increased collagen from 0.9 +/- 0.1 to 2.0 +/- 0.3 mg/artery (p less than 0.05); cHyp completely prevented this increase since collagen was 1.0 +/- 0.2 mg/artery (p less than 0.05). Hypoxia increased elastin from 1.1 +/- 0.1 to 2.4 +/- 0.2 mg/artery (p less than 0.05); cHyp had no apparent effect since elastin was 2.1 +/- 0.1 mg/artery. Also, cHyp did not affect RVP or vascular collagen or elastin in air-breathing animals. The cHyp treatment prevented luminal narrowing and thickening of arteriolar walls by hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

NBT-PABA test was performed in 72 subjects with simultaneous determination of the plasma PABA time-concentration curve. The curve in 25 controls after oral administration of N-benzoyl-L-tyrosyl-P-aminobenzoic acid (NBT-PABA) peaked (3.88 +/- 0.78 micrograms/ml, M +/- SD) at the third hour. In patients with chronic pancreatitis (24) and pancreatic carcinoma (6), the curves were flattened, and peaked at the fifth hour (2.7 +/- 1.4 micrograms/ml, M +/- SD), and fourth hour (3.14 +/- 2.26 micrograms/ml, M +/- SD), respectively. The discrimination between the controls and patients with chronic pancreatitis was most significant in the third-hour plasma PABA concentration (P less than 0.0001). This study shows that determination of the third-hour plasma PABA concentration is better in sensitivity and specificity than the 6-hour urinary excretion of PABA, suggesting that the third-hour plasma PABA concentration after oral administration of NBT-PABA might be a sensitive index of exocrine pancreatic function test.

The aerobic glycolysis rate and mitochondria-bound hexokinase activity of ascitic liver cancer cells are 8 and 50 times as high as those of the normal liver cells, and they can be inhibited by Na2SeO3 in concentration below 10 micrograms/ml. The inhibitory effect increases with selenium concentration. In contrast, Na2SeO3 at the same concentration does not significantly affect the glycolysis rate and mitochondria-bound hexokinase activity of the normal liver cells. The selective action of selenium on energy metabolism of the liver cancer cells may account for its inhibitory effect on cancer cells.

We studied damage and repair of lung connective tissue in rats exposed to toxic amounts of oxygen by measuring lung content of collagen and elastin and the number of collagen fragments in lung lavage fluid after exposure to 98% O2 for 60 h. Lung collagen was decreased 17%, and collagen fragments in lavage fluid were increased 4- to 5-fold in O2-exposed rats compared with those in control rats. No biochemical evidence of elastin degradation was found. Mild emphysematous changes and a leftward shift of fluid-filled, pressure-volume curves were induced within 2 wk after recovery from exposure to O2. Administration of the lathyrogen beta-aminopropionitrile worsened the emphysematous lesion produced by hyperoxia, suggesting that replacement of connective tissue during repair limits the extent of emphysema. We conclude that lung collagen is degraded and an emphysematous lesion is produced by relatively short exposure to toxic amounts of oxygen.

Serum ribonuclease (RNase) activity and its isoenzymes were determined by biochemical and PAGE electrophoretic separation technique in 20 patients with pancreatic cancer, in 27 with other gastroenterologic malignant tumors, 8 with acute pancreatitis, 7 with chronic pancreatitis, 5 with leukemia, 3 with chronic uremia of glomerulonephritis, and in 30 adult normal controls. Serum A1AT rocket immunoelectrophoresis and carcinoembryonic antigen (CEA) radioimmunoassay were also carried out simultaneously.

Sodium selenite in normal saline was administered intraperitoneally (1 mg/kg) into mice bearing ascitic hepatocarcinoma for 4 days. The cyclic AMP-dependent protein kinase isozymes (type I and type II) in normal liver and hepatocarcinoma cells were separated and assayed. The results show that the level of type I/II is markedly higher in hepatocarcinoma than in the normal liver cells. Sodium selenite is able to reduce it towards the normal level. Further analysis shows that the chief function of sodium selenite is to reduce the raised level of type I/II in hepatocarcinoma cells which, in fact, is due to the increase of total amount of type I cyclic AMP-dependent protein kinase. This paper presents the speculation that one of the mechanisms of the inhibitory effect of sodium selenite on carcinogenesis may be due to the selective action of this compound on the cyclic AMP-dependent protein kinase isozymes in tumor cells, thus inhibiting cancer cell division and facilitating differentiation and reversion.

Four hundred and seven cases of nasopharyngeal carcinoma were analyzed retrospectively; 403/407 were evaluable for recurrence and survival. Parapharyngeal boost significantly decreased local recurrences in parapharyngeal diseases without base of skull involvement (T2p), but not with base of skull involvement (T3p). Enhanced local control of T2p with boost was significant without neoadjuvant chemotherapy. Tumors localized within the nasopharynx (T1) and tumors with nasal involvement (T2n) suffering from local persistences after external radiation therapy were treated with an intracavitary afterloading method. They had survival and recurrence rates comparable to complete responders to external radiation therapy. Patients with bulky cervical nodes (maximal diameter greater than or equal to 4 cm, N1-N3), treated with neoadjuvant chemotherapy with cis-diamminedichloroplatinum II and 5-fluorouracil, had a regional failure rate, distant metastasis rate, actuarial survival rate, and disease-free survival rate comparable to those with smaller nodes treated with external radiation therapy alone. A simple modification of the Ho's classification by regrouping the T-stages into 'early T-stages' and 'advanced T-stages' and by combining the N1 and the N2 has greatly increased the power of the system in predicting local recurrence and distant metastasis, respectively. There was an overall improvement of the actuarial survival rate and disease-free survival rate over the historical control, and its significance is discussed.