Search

Recent developments in the instrumentation and data analysis of synchrotron small-angle X-ray scattering (SAXS) on biomolecules in solution have made biological SAXS (BioSAXS) a mature and popular tool in structural biology. This article reports on an advanced endstation developed at beamline 13A of the 3.0 GeV Taiwan Photon Source for biological small- and wide-angle X-ray scattering (SAXS–WAXS or SWAXS). The endstation features an in-vacuum SWAXS detection system comprising two mobile area detectors (Eiger X 9M/1M) and an online size-exclusion chromatography system incorporating several optical probes including a UV–Vis absorption spectrometer and refractometer. The instrumentation and automation allow simultaneous SAXS–WAXS data collection and data reduction for high-throughput biomolecular conformation and composition determinations. The performance of the endstation is illustrated with the SWAXS data collected for several model proteins in solution, covering a scattering vector magnitude q across three orders of magnitude. The crystal-model fittings to the data in the q range ∼0.005–2.0 Å−1 indicate high similarity of the solution structures of the proteins to their crystalline forms, except for some subtle hydration-dependent local details. These results open up new horizons of SWAXS in studying correlated local and global structures of biomolecules in solution.

A new tender X-ray absorption spectroscopy beamline for operating over the photon energy range from 1.7 keV to 11 keV is under construction at port 32 of the Taiwan Photon Source (TPS). The TPS 32A beamline uses two back-to-back water-cooled double crystal monochromators (DCMs), InSb(111) and Si(111), for achieving the wide energy tunability. The beamline design takes advantage of the low emittance of the TPS accelerator and a bending magnet (BM) to obtain a high-brightness focussed beam. In order to overcome the issue of poor thermal conductivity of InSb(111) crystals while facing high thermal load, we have implemented the following features : (i) we have controlled the flux and heat load by optimizing the source collection angle of 2 × 0.15 mrad2 (h × v), and (ii) we have installed water cooled double-bounce high harmonic rejection mirrors (HHRMs) with a variable incidence angle upstream of the DCM to reduce the heat load on the first InSb crystal. The DCM is followed by a 2:1 toroidal focusing mirror (TFM) which focuses the beam parallel to the floor of the experimental endstation. The simulated focus beam size is 0.9 × 0.9 mm2 (h × v, FWHM) using the InSb(111) DCM at 1.7 keV, and 0.2 × 0.45 mm2 (h × v, FWHM) using the Si(111) DCM at 4 keV, respectively. The photon flux is 1010 -1012 photons s−1 in the energy range of 1.7 to 11 keV at the sample stage after passing through the Be windows. The design parameters of photon flux and beam spot size will facilitate a tender X-ray source for carrying out high-quality X-ray absorption spectroscopy experiments.

A considerable proportion of stroke survivors are prescribed with proton pump inhibitors (PPIs). Our study indicated that PPI use is associated with an increased risk of osteoporosis, hip fracture, and vertebral fracture in stroke patients. The risk tends to increase as the cumulative doses of PPIs increase.A considerable proportion of stroke survivors are prescribed with proton pump inhibitors (PPIs). Our study investigated the association between PPI use and the risk of osteoporosis and fracture among stroke survivors.A population-based propensity-matched retrospective cohort study was conducted using the National Health Insurance Research Database in Taiwan. Patients diagnosed with a new stroke between 2000 and 2012 were identified. After propensity score matching, 10,596 patients were enrolled, and 5298 patients were each assigned to the PPI user and non-user groups. Hazard ratios (HRs) were calculated for the risk of osteoporosis, hip fracture, and vertebral fractures according to PPI use or non-use. Sensitivity analyses were conducted to evaluate the dose effects of PPI.PPI use after stroke was associated with an increased risk of osteoporosis, hip fracture, or vertebral fracture, with an adjusted HR (aHR) of 1.28 (P 0.001). The aHRs were also significant for each outcome: osteoporosis, 1.26 (P 0.001); hip fracture, 1.18 (P = 0.048); vertebral fracture, 1.33 (P 0.001). A pattern of dose effect was identified. For any event (osteoporosis/hip fracture/vertebral fracture), the aHR for PPI use of 1-90, 91-365, and 365 cDDDs was 1.22 (P 0.001), 1.27 (P 0.001), and 1.66 (P 0.001), respectively. For each outcome, the highest dose was associated with the highest risk, with aHR of 1.79 (P 0.001), 1.41 (P = 0.039), and 1.82 (P 0.001) for osteoporosis, hip fracture, and vertebral fracture, respectively. Age- and sex-stratified analyses revealed similar patterns.PPI use is associated with an increased risk of osteoporosis, hip fracture, and vertebral fracture in stroke patients.

Having contact and interacting with HIV/AIDS patients has long been recognized as a means for improving AIDS-related knowledge and attitudes among physicians and hence for increasing their intention to provide AIDS care. To investigate the impact of one-month residency training in an AIDS inpatient unit on internal medicine residents, this quasi-experimental, pre-post, two-group study, conducted from April 2000 to April 2001, used questionnaires. At follow-up, residents who received training in the AIDS unit (experimental group) were significantly more knowledgeable about HIV/AIDS, had more positive attitudes and greater intention to care for HIV-infected patients than residents who did not receive this training (control group). Results suggest that a one-month AIDS residency training intervention can effectively enhance residents' HIV-related knowledge, attitudes and intention to care for patients infected with HIV.

Foci of heterotopic gastric mucosa have been identified at different sites in the human body and the most common location is the proximal esophagus which is referred to as cervical inlet patch (CIP). The true prevalence of CIP varies and it is usually incidental findings during endoscopy. Because CIP is always asymptomatic, it was believed to be of little clinical relevance. However, emerging studies have described the acid-secreting characteristics of heterotopic gastric mucosa and associations of CIP with gastroesophageal reflux disease (GERD). In addition, complications such as stricture, fistula, infection, mucosal hyperplasia, and malignant transformation have been reported. In this study, we investigated the prevalence of CIP, its associations with clinical manifestations, and the effect of intentional screening upper esophagus by magnifying endoscopy-narrow-band imaging (ME-NBI) system. Consecutive healthy adults who underwent panendoscopy were separated into two groups. Patients in group I (n = 471) were examined by an endoscopist who intended to find CIPs by ME-NBI. Patients in group II (n = 428) were examined by two endoscopists who were unaware of the study and performed white-light imaging endoscopy. Participants provided questionnaires on GERD-related symptoms. Higher CIP prevalence (11.7% vs. 1.9%, P0.0001) and longer duration of esophageal examination (mean ± standard deviation, 17.50 ± 12.40 vs. 15.24 ± 10.78 seconds, P = 0.004) were noted in group I than in group II. Analyzing group I patients revealed the higher prevalences of reflux symptoms (32.7% vs. 18.3%, P = 0.013) and erosive esophagitis (43.6% vs. 25.5%, P = 0.005) in patients with CIP than in those without. CIP was not associated with globus or dysphagia symptoms. More small CIPs (5 mm) were detected by ME-NBI than by white-light imaging (85.3% vs. 41.4%, P = 0.001). In conclusion, CIP prevalence was not low under intentional ME-NBI examination of the upper esophagus. The clinical relevance of CIP and its association with GERD require further investigation.

MSN used to be the most popular application for communicating among social networks, but Facebook chat is now the most popular. Facebook and MSN have similar characteristics, including usefulness, ease-of-use, and a similar function, which is the exchanging of information with friends. Facebook outperforms MSN in both of these areas. However, the adoption of Facebook and abandonment of MSN have occurred for other reasons. Functions can be improved, but users’ willingness to use does not just depend on functionality. Flow status has been established to be crucial to users’ adoption of cyber applications and to affects users’ adoption of software applications. If users experience flow in using software application, they will enjoy using it frequently, and even change their preferred application from an old to this new one. However, no investigation has examined choice behavior related to switching from Facebook to MSN based on a consideration of flow experiences and functions. This investigation discusses the flow experiences and functions of social-networking applications. Flow experience is found to affect perceived ease of use and perceived usefulness; perceived ease of use influences information ex-change with friends, and perceived usefulness; information exchange influences perceived usefulness, but information exchange has no effect on flow experience.

There are two important pathological features associated with carotid-cavernous fistula (CCF): the retrograde cortical venous drainage that can cause intracranial haemorrhage and non haemorrhagic neurological deficit and the retrograde ophthalmic venous drainage that causes orbital venous congestion and visual impairment. We propose a sequential embolisation strategy by the selective occlusion of these two pathological features as the initial steps followed by occlusion of the rest of the cavernous sinus. Eight patients with spontaneous CCF were treated by transvenous embolisation using our embolisation strategy. The clinical features, angiographic findings, embolisation procedures, and clinical and angiographic outcomes were analyzed. The follow-up period ranged from one to 21 months. Clinical cure was achieved in six patients at one to two month follow-ups. One patient with bilateral CCFs had clinical cure of the right eye and clinical improvement of the left eye at three-month follow-up. Another patient had clinical cure at one-month follow-up except residual VI nerve palsy. Two patients had complete angiographic obliteration of the fistula immediately after the embolisation procedure. Another three patients underwent follow-up angiography at one to 16 months and all showed angiographic cure. There were no immediate or late complications. Our embolisation strategy offers a safe and effective option in the embolisation of spontaneous CCF as demonstrated by the clinical results of our eight patients.

The G gamma:A gamma ratios of Hb F were determined in 331 newborn babies of the Man ethnic group in Liaoning Province, P.R. China, using polyacrylamide gel electrophoresis; in 27 cases they were also determined by reversed phase high performance liquid chromatography. The results showed that a high G gamma value (> 80%) was present in four cases (1.21%) and low G gamma values (30-48%) in six cases (1.81%); not a single case with the A gamma T [A gamma 75(E19)Ile->Thr] chain was found. Gene mapping analysis demonstrated that two babies with high G gamma values had the -G gamma-G gamma-/-G gamma-A gamma- (0.60%), and two others the -G gamma-AG gamma-A gamma-/-G gamma-A gamma- (0.60%) arrangements. Two of the four babies with low G gamma values were identified as -A gamma-A gamma-/-G gamma-A gamma- (0.60%) and the other two as -GA gamma-/-G gamma-A gamma- (0.60%). The genotype -A gamma-A gamma- has not been reported before in Chinese.

Adopting the investment concepts of Rule#1 used by Phil Town and the formula for identifying and evaluating the stocks of tomorrow used by Michael Moe, this paper constructs a novel financial model of long term growing stocks for the Taiwan stock market. The investment themes are derived from the intersection of the emerging industry, megatrends, and hot areas for future growth. Then, the candidates of good companies are selected by using the three circle method. To evaluate the candidature of excellent companies, this paper uses both Town’s four Ms method (Meaning, Moat, Management, and Margin of safety) and the Big Five number (Return on Invest Capital (ROIC), Sale growth rate, Earning per share (EPS) growth rate, Equity or Book Value per share (BVPS) growth rate, and Free Cash Flow (FCF) growth rate) and Moe’s four Ps (People, Product, Potential, and Predictability). Also, the EPS growth rate is used to rank the companies. Furthermore, this paper finds the sticker price by estimating the future earnings growth and price/earnings ratio, checks the sticker price by the discounted cash flow method, the Price Earning to Growth Ratio (P/E/G) method and the Price to Sales Ratio (P/S) method, and then calculates the price of the Margin of Safety (MOS). Finally, the Taiwan long-term stock investment is studied by using this simple and step-by-step financial model. This paper aims to present a useful model that individual investors can apply easily.

An improved method for automatically reconstructing a three-dimensional object from serial cross sections is presented. The method improves the dynamic elastic contour interpolation technique. There are two major improvements: (1) in the case of branching that involves concave contours, instead of pairwise interpolation between the start contour and each goal contour, the goal image is considered globally and local constraints are imposed on the forces exerting upon the vertices; and (2) it takes the continuity of high-order derivatives into consideration and incorporates the schemes of spline theory, quadratic-variation-based surface interpolation, and finite-element-based multilevel surface interpolation to create smoother surfaces of the reconstructed object. Based on the output from the preliminary processing, two alternatives, a quadratic-variation-based surface interpolation algorithm and a finite-element-based multilevel surface interpolation algorithm, can be adopted to obtain the final surface representation. >

During the sterilization process of a typical food can, the geometric non-linear and elastic-plastic state is confronted. A derived procedure of updated lagrangian incremental formulation is proposed to simulate the deformation behaviour of the food can. The process is illustrated with a real example. Some interesting results can be noted wherein.

Background: Chronic hepatitis C virus (HCV) infection is prevalent in dialysis patients, and standard interferon monotherapy is the current standard of care for such patients. Aim: To investigate whether pegylated interferon has a better therapeutic efficacy and safety profile than standard interferon in dialysis patients with chronic hepatitis C. Methods: A total of 50 such patients were randomly assigned to receive either pegylated interferon alfa-2a 135 μg subcutaneously once per week or standard interferon alfa-2a 3 million units subcutaneously thrice per week for 24 weeks. The primary efficacy and safety end points were sustained virologic response (SVR) by intention-to-treat analysis and treatment-related withdrawal rate during the study. Results: In univariate analysis, patients with pegylated interferon alfa-2a tended to have a higher SVR than those with standard interferon alfa-2a (48% vs. 20%, p = 0.07). By using multivariate analysis, treatment with pegylated interferon alfa-2a (p = 0.02) and pre-treatment HCV RNA level < 800,000 IU/ml (p = 0.007) were independently predictive of SVR. All patients failing to achieve rapid virologic response (RVR) could not achieve SVR. In addition, patients receiving pegylated interferon alfa-2a had a significantly lower treatment-related withdrawal rate than those receiving standard interferon alfa-2a (0% vs. 20%, p = 0.04). Conclusions: Pegylated interferon alfa-2a once weekly provides more effective and safer therapy than standard interferon alfa-2a thrice weekly for treatment-naive dialysis patients with chronic hepatitis C. (ClinicalTrials.gov number, NCT00172809)

The construction of the competition go-kart must satisfy the philosophy of extreme simplicity: no redundant part is added and the go-kart frame is similar to the chassis of a sedan. Accordingly, the design of each part on the kart has to contribute to its performance. Due to the absence of a differential gear and suspension system, the frame must be responsible for offering proper rigidity and torsional stiffness to the kart and producing load transfers during cornering. Therefore, how to build a good kart frame is very important to go-kart design. In this paper, the torsional stiffness of the go-kart frame is analyzed in detail by using non-linear, explicit dynamic code LS-DYNA 3D. The kart frame presented by Solazzi is adopted to be the parent model, and two design concepts are investigated to improve the torsional stiffness of the kart frame. The first one is the arrangement of extra members at suitable positions on the frame, and nine different types of frame are studied. The second one is to increase the width between two kingpins, and four different types are studied. The torsional stiffness of each frame type is determined and compared with each other. The result shows that the torsional stiffness of the frames with larger kingpin width is better than those with extra members. Specifically, the one with width of 828 mm is the best type of frame, and the torsional stiffness is 31.03% higher than the original. In addition, among the frames with extra members, the one with a right-inclined member arranged in front of the centre member is the best design, and the torsional stiffness is 20.18% higher than the original. It is believed that the design concepts presented in this research will provide a useful reference for the design and manufacturing of an optimum go-kart frame.

Two time varying approaches are executed in analyzing dynamics for an involute planetary gear system, which respectively use a conventional discrete model of the equivalent mass-damping-spring elements and a continuous geometry model by the finite element method. In the discrete approach, the tooth number, position, and phasing difference of the meshing tooth pairs are described by time varying and nonlinear meshing stiffnesses. Natural frequencies, deformations, meshing forces, fillet stresses, and dynamic factors can be calculated by using the Jacobi transformation and the Runge-Kutta integration. In the continuum approach, dynamics of the planetary gear system is analyzed using the software, LS-DYNA. The approach of the continuous geometry model can incorporate the time varying properties intrinsically. In this continuum study, not CAD models, high quality mesh elements of the planetary gear system are automatically generated directly using the derived tooth profile equations. After assigning initial and boundary conditions, dynamic responses for the planetary gear system are solved. Natural frequencies and fillet stresses of the both approaches are verified by each other comparison. Potentially, the continuum approach can extensively and sophistically analyze dynamics problems of the planetary gear systems.

A new concept of video-based virtual rail for vehicle navigation on pre- scheduled paths is proposed. The virtual rail uses skylines as landmarks for vehicle navigation in suburban residential areas. A video-based virtual rail is composed of skylines and the corresponding road locations. By matching the current skylines with the virtual rail, current vehicle location can be determined. Preliminary experimental results show that the longitudinal spatial resolution of one meter can be achieved.

A computational model for generating a graphic deformation process of the left ventricle of a heart from the diastolic state to the systolic state is presented. The deformation process is represented by several intermediate states which are interpolated from the two given states of the left ventricle. The model includes a topology preserved mapping, a generic correspondence scheme, and a process generator. The strength of the proposed technique is that it can handle the cases where two original shapes have different numbers of vertices. This makes the construction of the two original shapes independent. >

Modeling nonrigid moving 3-D objects entails recovery of global motion, global shape, and local shape. The already difficult problem of tracking nonrigid local shape is made worse by the need for a model-data correspondence scheme to make tracking possible. Both problems are addressed. Various methods for establishing 3-D model-data correspondence are discussed, and a correspondence scheme for tessellated data is presented. A force-based method for nonrigid motion tracking is presented. The authors' method does not use complex finite element techniques but follows a residual force-based dynamic model for local deformation. Another novel feature is that the net forces are obtained by an adaptive force distribution scheme which ensures smooth and stable deformation. Results are presented of tracking simulated as well as real 3-D data of the inner wall of the heart ventricle from segmented magnetic resonance images. >

The human globin gene cluster, which represents a prototypical eukaryotic multigene locus, has been investigated for more than two decades and is classic model for coordinate control of tissue-specific gene expression. It is well known that globin gene expression is restricted to specific tissues and that globin genes are sequentially switched on during development. What intricate regulatory mechanisms account for tissue-specific transcriptional control of globin gene expression? Previous studies have focused on the interactions of trans-acting factors and cis-acting elements including the locus control region (LCR), which is considered a potent enhancer in globin gene switching. More recent studies have not only focused on the local DNA regulatory elements but also on remodelling of chromatin and transcription at the globin gene cluster within the native genomic context. Moreover, several studies have presented extensive data that address whether the LCR is required to open the chromatin. Although there is increased insight into the regulation of the beta-globin gene switching, many aspects relating to the developmental activation of distinct globin genes remain elusive.

Using ligation-mediated polymerase chain reaction and in vivo footprinting methods to study the status of DNA-protein interactions at hypersensitive site 3.5 (HS3.5) of the locus control region in K562 and HEL cells, we found that there was protein occupancy in vivo at HS3.5 in both cell lines and the status of DNA-protein interaction was different between K562 and HEL. These data provide direct evidence that specific nuclear factor-DNA complexes form in vivo at functionally important sequence motifs of the HS3.5 in erythroid cells. This indicates that HS3.5 may play an important role in the regulation of the beta-globin gene cluster. K562 is a human erythroleukemia cell line in which the embryonic epsilon-globin gene is predominantly expressed, while the HEL cell line expresses predominantly the fetal beta-globin genes. Thus, HS3.5 might also be involved in the regulation of developmental stage-specific expression of beta-globin genes. Our results are also consistent with the model that each hypersensitive site acts as a functional unit and HS3.5 may facilitate the formation of the HS3 functional unit.

We give a preliminary report of the ophthalmologic outcome of four patients with transvenous embolization studied for their spontaneous carotid-cavernous fistulas. One of them is a direct type while three of them are indirect dural shunts. In indirect dural shunts, traditional transarterial embolization rarely achieves a complete clinical cure in a short period of time. All cases had an ophthalmologic disturbance justified for endovascular intervention. We performed catheterization, and subsequently embolization with Guglielmi Detachable coils, to the cavernous sinus via the femoral vein and inferior petrosal sinus/superior ophthalmic vein. All four patients achieved clinical and angiographic improvement with a follow-up period range from two to sixteen months except for one patient who had residual bilateral sixth nerve palsy. The transvenous approach offers an effective and safe alternative for the management of spontaneous carotid-cavernous fistula.

Tc1/mariner transposons are widespread in the eukaryotes. In vitro transposition test indicated that the transposase is the only protein that is needed in transpositions. It was shown later that the reconstructed Tc1-like transposon, "sleeping beauty" in fish, and the Tc1 transposon in C. elegans jumps in human cells. This discovery indicates that the Tc1/mariner transposon may be engineered as a somatic gene therapy vector if coupled with an efficient gene delivery system. We introduced the Tc1 transposon from C. elegans into different mammalian cell lines and detected the transposition events, indicating that Tc1 transposon functions in different mammalian cells. Interestingly, a high inversion frequency of the transposon was also detected, suggesting that this type of transposon may add variations to host genome when it is horizontally transferred into a new species.

The emergence of infection with Coxiella burnetii, the causative organism of Q fever, has been only recently recognized in Taiwan. Several cases of acute Q fever infection have been described, but the prevalence of antibodies to C. burnetii in the general population in Taiwan has not been reported. Thus, we studied the seroprevalence of C. burnetii infection in southern Taiwan.We conducted a retrospective serosurvey to examine the prevalence of C. burnetii infection among subjects admitted to a rural hospital in Taiwan for various reasons, and among presumably healthy attendees of a routine physical examination clinic of an urban public hospital. The diagnosis of C. burnetii infection required the presence of antibodies to both phase I and II antigens (titeror = 1:16) or only to phase II antigens (titeror = 1:256), as detected by indirect immunofluorescence assay.The prevalence of C. burnetii infection was 4.2% in both the in-patient (15/357) and physical examination participant (11/259) populations. None of these subjects had signs compatible with acute Q fever (febrile illness within the past 3 months). The antibody prevalence rate was higher in males than in females, and peaked in persons aged 61 to 70 years.These data suggest that C. burnetii infection is not rare in southern Taiwan and does not cause clinical symptoms in all infected patients.

Using ligation-mediated PCR and in vivo footprinting methods to study the status of DNA-protein interaction at hypersensitive site 2 of locus control region and beta(maj) promoter of erythroid cells of fetal liver and adult bone marrow, we found that during different developmental periods, the status of DNA-protein interaction at both hypersensitive site 2 and beta(maj) promoter changed significantly, and indicated that locus control region might function through a looping mechanism to regulate the expression of downstream genes, and that distal regulatory elements (locus control region, hypersensitive sites) as well as proximal regulatory elements (promoter, enhancer) of beta-globin gene cluster participate in the regulation of developmental specificity.

Scar endometriosis may develop after pelvic operations, such as cesarean section, tubal ligation, hysterotomy and hysterectomy. This prompted us to demonstrate the proper diagnosis; management and prophylactic procedure of scar endometriosis.Twelve patients with scar endometriosis were diagnosed by clinical symptoms and signs, including a painful scar mass related to the menstrual cycle and cyclic bleeding from scars. Preoperative ultrasound needle aspiration cytology was arranged in three patients without painful mass. The management comprised complete surgical excision and selective medical treatment. Postoperative follow-up was scheduled at six-month intervals.Except for two patients who complained of scar pain but no palpable mass during menstruation, there was no evidence of recurrence in the other 10 patients.Diagnosis of scar endometriosis should involve detailed history taking and pelvic examination. Concerning the role of needle aspiration cytology, it still remains controversial. Several prophylactic procedures have been presented to prevent decidual contamination of the wound. Complete surgical excision including the adjacent fascia or skin is the proper treatment of scar endometriosis.

Background and purpose: Clinically, ankle dorsiflexion mobilization with movements (MWM) is a manual therapy technique widely used to increase joint range of motion, reduce pain, and improve functions. It has been reported in a single case study to have initial effects of improved functional outcomes and pain relief on acute ankle sprains. However, no study has examined the immediate effects of this technique on gait patterns in the ankle joint of healthy individuals. Methods: A total of 60 healthy collegiate students (40 females and 20 males, age 21±1.8 years; BMI 21.02±2.4) participated in three consecutive days. Spatial and temporal parameters of gait during level walking using a pressure sensor walkway and weight-bearing ankle dorsiflexion range using ankle lunge test were analyzed before and immediately after a single session of ankle dorsiflexion MWM intervention. Tests were repeated at day two and three after the intervention. Results: Significant improvements of ankle dorsiflexion range of motion on the dominant side were found between pre-and post-intervention (p＜0.0001), at day two (p＜0.0001) and at day three (p＜0.0001). Significant changes in spatial (step length, stride length, and base of support) during slow walking and in temporal (gait cycle time and step time) variables on both sides were also observed during self-paced walking at day two (p＜0.004) and day three (p＜0.004) compared with pre-intervention. Conclusion: The results suggest that immediate and sustained spatio-temporal effects occur following ankle MWM. Changes during level walking indicate possible effects of alterations in motor strategies during functional tasks following ankle MWM.

Successful treatment of end stage renal disease (ESRD) depends on the patient compliance with therapeutic regimens. This descriptive study was conducted to examine the relationship between the health locus of control (HLC) orientation and compliance with therapeutic regimens. The convenience sample of 86 hemodialysis patients was obtained at two hemodialysis centers of teaching hospitals in southern Taiwan. A Demographic Questionnaire, the Multidimensional Health Locus of Control (MHLC) Scale, and Multimethod Compliance Assessment (including: Laboratory Assessment, Nurse Assessment, and Patient Self-report) were used to collect the data. The average overall rate of compliance with therapeutic regimen was 76.4% by patient self-report and 69.2% by nurse assessment. Examining the three compliance measures, patients were most compliant in following instructions for taking phosphate-binding medication (PBM) and least compliant in limiting fluid intake according to patient self-report and by nurses' assessment. The level of compliance for diet restriction fell between the other two measures. No significant correlations between the three subscales of the multidimensional health locus of control (MHLC) and composite compliance measures were found in this study, except that those with a high score on the subscale of powerful others locus of control were positively correlated with patient self-report (r = 0.388, p0.001) and with the laboratory assessment (r = 0.21, p0.01). This suggests that the MHLC construct had only a slight influence on measures of compliance in hemodialysis patients of Taiwan. Implications of findings for nursing practice, theory, and research are also discussed.

Pregnancies complicated with placenta previa and a history of cesarean section are well known to be at increased risk for placenta accreta. Bladder injury is occasionally encountered in these patients during operation. From January 1992 to December 1995, 25 obstetrical hysterectomy were performed at Chang Gung Memorial Hospital, Linkou Medical Center. Of these 25 patients three had bladder injury. Ultrasonography is a unique way to screen and detect prenatally the abnormal placentation and intraplacental lacunae. Color Doppler ultrasonic scanning further discloses that the lacunae are mainly venous spaces. Elevated mid-trimester maternal serum x-fetoprotein (MSAFP) frequently leads to a suspicion of the abnormal placentation, and magnetic resonance imaging (MRI) can clearly identify the placenta accreta/increta. Uncontrollable bleeding frequently occurs in these patients during cesarean section, warranting emergency hysterectomy. Emergency obstetrical hysterectomy should be decided upon and performed by an experienced obstetrician. Massive hemorrhage and bladder injury are the major complications encountered in such operations. We review the literature and propose a protocol of management. As the incidence of cesarean section continues to rise world-wide, the problem of placenta previa/accreta is likely to become more common. Obstetricians should be ready to face the late sequelae of today's decision for cesarean section.

With the aim of determining an effective therapy for adolescent women with endometriosis, the authors analyzed the results of laparotomy performed on 16 cases of female teenagers over a seven-year period. All patients, whose average age of menarche is 12.8, were diagnosed with endometriosis between two months and nine years after the menarche, with an average interval of 5.2 years. The chief symptoms are dysmenorrhea, pelvic pain and abdominal fullness. Of the three patients of unicornuate uterus with rudimentary horn, endometriosis was found only involving the adnexa on the side of the rudimentary horn, two of the three patients had absence of affected side kidney. Conservative operation including six cases of salpingo-oophorectomy and 10 cases of ovarian cystectomy were chosen followed by danazol treatment. One year to seven years after surgical treatment, two patients required subsequent conservative operation for recurrence of endometriosis and two other patients resumed dysmenorrhea. Two married women became pregnant 5 and 10 months after surgical and medical therapy respectively. In conclusion, adolescent endometriosis may occur around five years after menarche and an obstructive uterine anomaly, enhancing retrograde menstruation, increases the occurrence rate. The symptoms and treatment of endometriosis in teenage group do not really differ from that in the older women. In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give three to six months of danazol after surgical treatment.

We show that the Helfrich deformation can be used for fast response time, low driving voltage reflective displays by using cholesteric liquid crystals under short voltage pulses (∼10 ms). Rather than turning planar domains into focal conic domains through a nucleation process, as used in bistable modes, the fast voltage pulse only deforms the cholesteric planar layers to form wrinkled layers. Since the deformed state is formed through a homogeneous process, quick response times and low operating voltage can be achieved. We studied the effects of alignment layer and dispersed polymer on the stability of the Helfrich deformed cholesteric layers, and found that homogeneous alignment layer and polymer network can inhibit the nucleation process responsible for breaking the layers.

The G gamma:A gamma ratios of Hb F were determined in 331 newborn babies of the Man ethnic group in Liaoning Province, P.R. China, using polyacrylamide gel electrophoresis; in 27 cases they were also determined by reversed phase high performance liquid chromatography. The results showed that a high G gamma value (80%) was present in four cases (1.21%) and low G gamma values (30-48%) in six cases (1.81%); not a single case with the A gamma T [A gamma 75(E19)Ile-Thr] chain was found. Gene mapping analysis demonstrated that two babies with high G gamma values had the -G gamma-G gamma-/-G gamma-A gamma- (0.60%), and two others the -G gamma-AG gamma-A gamma-/-G gamma-A gamma- (0.60%) arrangements. Two of the four babies with low G gamma values were identified as -A gamma-A gamma-/-G gamma-A gamma- (0.60%) and the other two as -GA gamma-/-G gamma-A gamma- (0.60%). The genotype -A gamma-A gamma- has not been reported before in Chinese.

Spiral computed tomography (CT) allows for fast acquisition of a truly volumetric data set (Kalender et al. 1990). If contrast material is injected during scanning, the vasculature can be assessed in three dimensions. This procedure is named CT Angiography (CTA) and provides an excellent visualization of vessel lumina, stenoses and lesions (Napel et al. 1992). Contrast filled vessels share a common range of Hounsfield units with bone. Therefore, it is necessary to eliminate bone structures prior to 3D visualization. As interactive editing of bones, especially on a slice by slice basis, can be very time-consuming, we have developed a semi-automated technique (Slab-Editor) and various automatic methods for specific parts of the body, which minimize user interaction or even make it obsolete.

We report the results of a prospective trial using a loop electrosurgical excision procedure (LEEP) on 97 patients with cervical intraepithelial neoplasia. In the LEEP group the mean cutting time and whole procedure time were 6.2 +/- 1.9 seconds and 12.7 +/- 3.5 minutes, respectively. The average blood loss was 3.6 +/- 1.9 mL. In the control group (39 cases) using laser conization, the mean cutting time and whole procedure time were 11.7 +/- 3.5 minutes and 44.9 +/- 8.9 minutes, respectively. The average blood loss in the control group was 11.2 +/- 3.1 mL. The differences between the two groups were statistically significant. During LEEP surgery, four cases had accidental vaginal excision. There were three cases of late cervical bleeding after surgery; the surface of the cervix was smooth, and no adhesion or crypt formation was noted after re-epithelialization. Eight patients became pregnant after the loop excision and no cervical incompetence was noted during antenatal care. After a one-year follow-up period in the colposcopy clinic, there was no recurrence of cervical intraepithelial neoplasia in either group. We advise that among the modalities of treatment for cervical intraepithelial neoplasia, LEEP appears to offer patients several benefits such as less bleeding, precise specimens, local anesthesia, less cost and less discomfort. It is particularly suitable for treating younger women who have not yet completed their families.